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Lowest Paying Medical Specialties (UK Salaries)

Lowest Paying Medical Specialties (UK Salaries)

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

Some medical specialties have lower earning potential than others in the UK, despite the fact that on the whole doctors are well-paid.

This is a result of a number of factors, from patient demand to capacity for private work to the type of medicine each specialist practices.

In this article, I’m going to delve into the lowest-paying medical specialties and explore some of the reasons behind their lower salaries.

The Lowest Paid Types Of Doctor

The problem with comparing the salaries of different types of doctors in the UK is there really isn’t a lot of research out there to go off.

What’s more, every consultant doctor working in the NHS is essentially paid according to the same pay scale- which is exactly the same no matter what specialty you work in.

Therefore, to a certain extent, considering the lowest-paying medical specialties is a bit of a moot point here in the UK, as the vast majority of doctors work in the NHS.

Where the differences really start to creep in are for a specialty’s capacity for private work- essentially it’s much harder to set up a bustling private practice as an immunologist compared to if you were an orthopaedic surgeon, for example.

The most substantial paper I could find on the topic was an article from 2008 looking at consultants’ NHS and private incomes in England from 2003/4.

Below are the 10 lowest-paying medical specialties from that paper, with a discussion of why they may not have as large earning potentials as some of the other areas of medicine:

Rank (Lowest to Highest)Lowest Earning Specialties
1Clinical genetics
2Occupational medicine
3Palliative care
4Public health
5Audiological medicine
6Genito-urinary medicine
7Paediatrics
8Child and adolescent psychiatry
9Rehabilitation medicine
10Microbiology and virology

One point to note, however, is that I’ve only included broader specialties in this list, rather than some smaller subspecialties that were considered in the original research.

If you’re interested, you might also want to check out this list of the highest paying medical specialties.

Clinical Genetics

Clinical genetics involves the study of how genetic variations contribute to health and disease.

A doctor specialising in clinical genetics plays a crucial role in diagnosing and managing hereditary and genetic disorders that affect individuals and families.

These specialists work closely with patients and families to assess their risk of inherited conditions, provide genetic counselling, and offer guidance on potential treatments and preventive measures.

Despite the significance of their work, clinical geneticists often find themselves in one of the lowest-paying medical specialties due to a combination of factors.

The intricate nature of genetic disorders demands substantial time and resources for analysis, consultations, and follow-up care.

Moreover, the limited patient pool with specific genetic concerns reduces the potential patient load for a specialist compared to more common areas of medicine such as general surgery.

The complexity of the field also requires ongoing education and training to stay abreast of rapid advancements in genetics which can limit a doctor’s ability to stay at the forefront of their specialty.

Occupational Medicine

A doctor specialising in occupational medicine is dedicated to safeguarding the health and well-being of workers within various industries.

Their role encompasses a comprehensive approach to health, where they focus on preventing and managing work-related illnesses and injuries.

By collaborating with employers and employees, they develop strategies to create safer and healthier work environments, while also addressing concerns related to workplace stress, ergonomic issues, and occupational hazards.

This emphasis on preventive care and education, however, means that patient interactions may be less frequent than in other specialties, impacting potential revenue.

Additionally, the administrative complexities of working with multiple stakeholders, including employers and insurance companies, can be time-consuming and potentially limit income.

The broader scope of their work, extending beyond individual patient care to the realm of policy and workplace interventions, may not always align with traditional compensation models.

Palliative Care

Doctors working in palliative care focus on enhancing the quality of life for patients facing serious illnesses, particularly those with life-limiting conditions.

Their role encompasses a holistic approach, addressing physical, emotional, and spiritual needs to alleviate pain and discomfort while providing emotional support to patients and their families.

Despite the immense value they bring to patients and families during a vulnerable time, palliative care specialists often find themselves within one of the lowest-paying medical specialties.

The nature of palliative care involves spending considerable time with patients, engaging in in-depth discussions, and providing ongoing emotional support.

This level of involvement may limit the number of patients they can attend to, impacting potential revenue.

Additionally, the focus on improving quality of life over curative interventions can lead to lower billable services in traditional fee-for-service models.

The field’s intrinsic altruism also tends to attract professionals who prioritise patient well-being over financial rewards.

Public Health

Public health is all about safeguarding and improving the health of entire communities and populations.

Rather than focusing solely on individual patients, these specialists work to identify and address health disparities, promote disease prevention, and design strategies for health promotion at a broader level.

In the face of the profound impact they have on society’s health, public health specialists aren’t always that well-paid compared to some other types of doctors.

A doctor giving a patient a flu shot
Flu vaccination campaigns are all a part of public health

Part of the reason for this is that public health initiatives often yield long-term results that may not immediately translate into financial gains, contrasting with the fee-for-service models predominant in private medical practice.

Additionally, public health efforts involve collaboration with various stakeholders, including government agencies and non-profit organisations, which can lead to complexities in funding and resource allocation.

Furthermore, the emphasis on preventive measures and community-based interventions can result in fewer billable services compared to specialties focused on direct patient care as opposed to policies.

Audiological Medicine

A doctor specialising in audiological medicine plays a crucial role in diagnosing and treating disorders related to hearing and balance.

Their expertise lies in identifying the causes of hearing loss, tinnitus, vertigo, and other auditory issues, and they work to provide tailored solutions that enhance their patients’ auditory experiences and overall quality of life.

However, the extended time spent with each patient, conducting thorough assessments and providing detailed counselling, can limit the number of patients audiologists can see in a day, potentially affecting revenue.

Additionally, the ongoing advancements in hearing aid technology and treatment methods require continuous education and investment in equipment, which may impact financial returns.

The challenges in medical reimbursement for audiological services, along with the misconception that hearing care is not as integral as other medical specialties, all contribute to lower compensation rates for audiologists.

Genitourinary Medicine

Genitourinary medicine (GUM), also known as sexual health medicine, is dedicated to diagnosing, treating, and preventing a range of sexually transmitted infections (STIs) and genitourinary conditions.

GUM doctors’ expertise encompasses a wide spectrum of diseases and conditions affecting the reproductive and urinary systems.

Unfortunately, the stigma associated with STIs can lead to reduced patient volume and reluctance to seek care, impacting the revenue generated by these specialists.

The majority of their work involves outpatient care, often focused on counselling and education, which may lead to fewer billable procedures compared to other specialities.

Additionally, the prevalence of public health clinics and government-funded services in this field can lead to compensation challenges, as these settings may not offer the same financial incentives as private practices.

Paediatrics

Paediatricians provide comprehensive medical care, from routine check-ups and vaccinations to diagnosing and treating a wide range of illnesses and developmental issues in children.

Their expertise involves understanding the unique physiological and psychological needs of young patients, often working closely with families to ensure the best possible outcomes. 

In spite of the immense significance of their work in shaping the future health of society, paediatricians often find themselves among the lowest-paid medical specialties.

Paediatric care often requires a considerable investment of time for consultations, patient education, and communication with parents, potentially limiting the number of patients seen within a given day.

Additionally, a significant portion of paediatric care involves preventive measures and health promotion, which may not yield immediate billable services as frequently as more interventional specialties.

The reliance on government healthcare programs for a substantial portion of their patient base can also contribute to lower compensation rates.

Child And Adolescent Psychiatry

A doctor specialising in child and adolescent psychiatry plays a pivotal role in addressing the mental health and well-being of young individuals.

These specialists possess a deep understanding of the complex psychological and emotional needs of children and teenagers, working to diagnose, treat, and provide support for a wide range of mental health disorders and behavioural challenges.

Several factors contribute to the fact that this isn’t a particularly highly paid specialty.

Just like in some of the other specialties on this list, the intricacies of working with young patients demand extended time for assessments, building rapport, and adapting therapeutic techniques, potentially limiting the number of patients seen within a day.

Lowest Paying Medical Specialties Pixel Image

In a similar vein to genitourinary medicine, the stigma surrounding mental health care can deter families from seeking help, thus reducing the patient volume for these specialists.

The reimbursement models for mental health services also may not fully reflect the depth of care provided, as therapeutic interventions might not be as procedurally oriented as many other medical specialties.

Rehabilitation Medicine

Rehabilitation medicine focuses on enhancing the functional abilities and quality of life for individuals with physical disabilities, injuries, or chronic conditions.

Rehab specialists employ a holistic approach, integrating medical, physical, and psychological interventions to help patients regain independence, manage pain, and improve their overall well-being.

Unfortunately for doctors working in this specialty, the multidisciplinary nature of rehabilitation care involves coordination with various therapists and specialists, which can complicate reimbursement processes.

Additionally, the emphasis on long-term outcomes and gradual progress in rehabilitation contrasts with the procedural focus of some higher-paying specialties.

The fact that there often aren’t any quick fixes in rehabilitation medicine doesn’t lend itself to lucrative private practices with quickly satisfied patients.

Microbiology And Virology

Microbiology and virology delves into the intricate world of microorganisms, including bacteria, viruses, fungi, and parasites.

Microbiologists and virologists’ expertise lies in studying these organisms’ behaviour, interactions, and effects on human health.

These specialists play a crucial role in diagnosing infectious diseases, identifying pathogens, and developing strategies for their prevention and treatment.

The majority of their work takes place in laboratories and involves laboratory-based analyses, which may not always align with traditional clinical care models that generate higher revenue.

Additionally, the emphasis on research and diagnostics over direct patient care may lead to fewer billable services compared to specialties focused on patient interactions.

The reliance on government-funded research institutions and public health settings, where compensation models might differ, can also have a negative impact on earning potential.

Final Thoughts

If your interests lie with one of the specialties on this list, I’d by no means be put off from pursuing it.

You’re going to have a far more rewarding career as a doctor if you genuinely enjoy your work compared to just doing it for the money.

However, if you happened to be exactly on the fence between one specialty and another, there’d likely be no harm in not pursuing one of the lowest-paid medical specialties in favour of an alternative.

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.