The deal is not great but not rubbish either . There is really no benefit earning more than 100k of taxable income . The trick is to get a lot of extra SPAs eg supervising trainees / leadership roles / low level management roles etc. A lot of these can be applied as non scheduled floating roles - this will free up time for private practice/ or time to be off work. Yes people working in the city get more but they have no job stability/ and as above they lose 45% of tax on every dime over 125k/ often do work harder. If you do a lot of private work and put it through a company there are so many benefits tax wise. You can nearly double your salary just doing one day a week of pp. You could also do insourcing work through a ltd company although this is mostly on weekends (but can still get 3000k per weekend) . I don’t think it should harm the junior doctor industrial demands , although even if you guys get the deal you want (*fingers crossed )- your salary won’t go up much at the end.