Doctors’ wages: How do countries in Europe compare?

Health personnel and doctors in particular worked ceaselessly to save lives during the COVID-19 pandemic. Many did not go home for days or weeks at a time, and many lost their lives helping others. They became heroes, and the public showed its appreciation for their work and devotion.

However, health personnel remain largely unhappy about their salaries and working conditions. This includes doctors; both specialists and general practitioners (GPs).

In 2022, doctors marched in protest, warned of the possibility of strikes, or went on strike in European countries such as France, Germany, Spain, Portugal, Greece, and Turkey. They asked for increased pay but also complained about the lack of staff in their hospitals.

In England, junior doctors have launched a fifth round of industrial action over pay and working conditions, with thousands joining the picket lines just days after becoming the National Health Service in their first jobs. 

This follows a series of historic strikes by nurses in December and again earlier this year.

The British Medical Association (BMA) said that newly-qualified doctors earn just £14.09 an hour (€15.95), less than a barista at coffee shop chain Pret-a-manger (which pays £14.10, or €15.96), adding that junior doctors have had a 26 per cent real terms pay cut since 2008.

In most European countries, the annual gross salaries of doctors increased in real terms between 2010 and 2020, according to figures released by the OECD. Salaries in real terms are values that take inflation into account. However, salaries fell in some countries in real terms in the last decade.

How much are doctors paid in Europe? Which countries pay doctors the most and the least? How much have doctors’ salaries changed in the last decade, and how much do doctors earn considering the concept of purchasing power parity?

The OECD dataset includes information for 25 European countries, and doctors’ salaries vary greatly among them.

In 2020 or the closest year with available data, the annual gross salaries of specialists ranged from €20,200 in Poland to €258,552 in Luxembourg (2015 data). In other words, the difference between doctors paid the most and doctors paid the least is more than tenfold.

In addition to Luxembourg, there are four other countries where specialists were paid more than €150,000 in 2020. They are Ireland (€172,882), the Netherlands (€160,869), Denmark (€156,061), and Iceland (€155,276). Germany (€146,200) and the UK (€136,375) followed closely.

Specialists earn less than €50,000 in many EU countries

Salaries were markedly lower than €100,000 in France, Italy, and Spain. There are several other countries in the EU, including Portugal and Greece, where specialists earn less than €50,000. These figures all reflect annual gross remuneration for salaried specialists.

GPs are paid less than specialists. For example, specialists earn 85 per cent more in the UK, where the average annual gross salary for GPs was €73,408 while specialists received €136,375 on average.

In 2020, the difference was 45 per cent in the Netherlands. In Germany, the difference between specialists and GPs was much smaller, at about 20 per cent.

Doctors’ salaries fell in real terms in the UK in the last decade

Did the salaries of doctors rise between 2010 and 2020? We can look at this question in two ways: in nominal terms and real terms.

Nominal change refers to values obtained when inflation is not taken into account. On the other hand, real change takes inflation into account, providing more meaningful insights. Salaries increased in real terms in many countries but fell in some others.

Increases among both specialists (6.4 per cent) and GPs (4.8 per cent) were particularly strong in Hungary. It saw the highest rise for specialists, followed by Slovakia, Czechia, and Estonia. Germany and France also had slight increases in both categories.

In some countries, such as Portugal, Slovenia, and the UK, the salaries of both specialists and GPs decreased in real terms between 2010 and 2020. In the UK, the decline was 1.2 per cent for specialists and 0.8 per cent for GPs.

Between 2010 and 2020, the salaries of specialists increased faster than those of GPs in several countries, resulting in increasing salary gaps according to the OECD.

However, the gaps narrowed slightly in some countries such as Austria, Belgium, and the Netherlands where the incomes of GPs grew more than those of specialists.

Ratio to average wage: Ireland, Germany, and the UK are at the top

The ratio of doctors’ salaries to average wages in each county is another useful indicator. The average wage is based on the total wages paid and the average number of employees in the country’s overall economy.

The salaries of doctors – both specialists and GPs – are substantially higher than the average national wage in all countries considered here. In most countries, GPs earned two to four times more than the average wage in 2020, while specialists received two to three and a half times more.

The ratio of specialists’ salaries to the average wage was three or higher in five countries. These are Ireland (3.5), Germany (3.4), the UK (3.3), the Netherlands (3.2), and Spain (3). That means that specialists in these countries earned at least three times more than the average wage.

Poland (1.4) had the lowest ratio, followed by Latvia and Norway (1.7 for both).

Salaries in purchasing power parity

Salaries are also compared in terms of purchasing power parity (PPP). This eliminates the effect of price level differences across countries.

PPP basically tells us how many currency units a particular quantity of goods or services costs in different countries. It is used as a currency conversion rate of sorts to convert expenditures expressed in national currencies into an artificial common currency.

Salaries of specialists in PPP vary largely, and the ranking differs from that for nominal wages. In 2020 or the closest year with available data, specialists’ salaries in PPP terms ranged from €33,835 in Latvia to €136,010 in Germany. 

The gaps in PPP across countries are narrower compared to the differences in nominal salaries, but they still vary considerably.

The PPP-based salary in Germany was four times higher than that in Latvia. In Turkey, remarkably, the PPP-based salary of specialists was higher than that of Sweden, Norway, and France in 2020.