An assistant doctor’s salary in Germany depends mainly on the collective agreement that applies, not on the job title. In municipal hospitals the TV-Ärzte/VKA pay scale starts at about 5,720 euros gross per month, and on-call duties and night shifts come on top.
Short answer: Under the TV-Ärzte/VKA collective agreement for municipal employers, the monthly pay of an assistant doctor in step 1 is 5,722.05 euros gross (as of June 2026, valid until 31 December 2026). On-call duty and night work are paid extra. University hospitals run by the federal states usually follow a different collective agreement.
The most important points at a glance
- Assistant doctors are placed in pay group I of the TV-Ärzte/VKA. Step 1 is 5,722.05 euros gross per month.
- Steps rise after one, two, three, four and five years of medical work.
- On-call duty is paid per hour, with rates by step between about 37 and 40 euros.
- Night work carries a 20 percent supplement, Sunday work a 25 percent supplement.
- With extra duties, total pay can exceed the insurance threshold for compulsory statutory health insurance. Check this when you choose your insurer.
How high is the basic pay under the TV-Ärzte/VKA?
The table shows full-time monthly gross pay. The step depends on the length of medical work, not on age.
| Step | Gross monthly pay, pay group I (assistant doctor) | Time to next step |
|---|---|---|
| 1 | 5,722.05 euros | Entry |
| 2 | 6,046.42 euros | after 1 year |
| 3 | 6,278.07 euros | after 2 years |
| 4 | 6,679.58 euros | after 3 years |
| 5 | 7,158.37 euros | after 4 years |
| 6 | 7,355.29 euros | after 5 years of medical work |
Source: TV-Ärzte/VKA pay table, valid from 1 June 2026 to 31 December 2026. These figures come from a secondary website and should be checked against the original text of the collective agreement before any negotiation. A new table may apply from 2027.
Your grade depends on the activity you actually perform, not on the job title alone. The collective agreement sets out which earlier periods count towards the step, so have this confirmed in writing before you sign.
What do on-call and night duties add?
In hospital life, duties often make up a large share of total pay. On-call time is paid per hour, and night work receives a supplement. The table shows the hourly on-call rates that apply from 1 June to 31 December 2026, according to the same source.
| Step | Hourly rate for on-call duty |
|---|---|
| 1 and 2 | 36.86 euros |
| 3 and 4 | 38.26 euros |
| 5 and 6 | 39.66 euros |
According to the source, you also receive 15 percent of the hourly rate for the duration of a duty that cannot be converted into time off. From more than four duties per month, the valuation increases by 10 percentage points.
Assumption: 48 hours of on-call duty per month in step 1 add about 1,769 euros gross (48 × 36.86 euros). The actual payment depends on how each duty is credited and valued.
- Night work: 20 percent supplement on the hourly rate.
- Overtime: 15 percent supplement.
- Sunday work: 25 percent supplement.
- Saturday work between 13:00 and 20:00, without shift rota: 20 percent of the hourly rate.
- Public holiday work: 135 percent without time off in lieu, 35 percent with time off in lieu.
What remains as net pay?
Assumption: tax class 1, no children, no supplements, no church tax and an additional health insurance contribution of 2.9 percent. At 5,722.05 euros gross, the estimate is about 3,500 euros net per month. With 9 percent church tax on income tax it is about 3,410 euros.
Supplements raise net pay only partly, because they also trigger taxes and social insurance. The estimate does not replace a payslip, but it shows the order of magnitude for planning.
Health insurance during the assistant years
Without duties, the basic pay is below the insurance threshold of 6,450 euros per month (77,400 euros per year, 2026). On-call duty, however, can push total pay above this threshold. Then the question of compulsory statutory insurance changes. Check this early, before choosing a fund. Our guide PKV beim Berufseinstieg (in German) explains the options.
Worked example: annual pay including duties
Assumption: basic pay in step 1 for twelve months and 48 hours of on-call duty every month at 36.86 euros per hour. This gives 68,664.60 euros basic pay and about 21,231 euros from duties, or roughly 89,900 euros gross per year. Annual bonuses and other allowances are not included, because the collective agreement may regulate them separately.
The example shows why duties weigh so heavily in hospital pay. At the same time, a higher number of duties increases the strain, which should play a part in your decision.
Which documents should you check?
- The employment contract, with an explicit reference to the applicable collective agreement and pay group.
- The crediting of earlier periods for your steps, recorded in writing.
- An overview of on-call duties and of supplements for night, Sunday and public holiday work.
- Rules on annual bonuses, leave and further training.
Frequently asked questions
Do assistant doctors earn the same at university hospitals?
No. University hospitals run by the federal states usually follow the TV-Ärzte TdL, which has its own tables. Values from the TV-Ärzte/VKA must not be transferred to them. Ask the hospital which collective agreement applies.
How does pay rise over the years?
Basic pay rises in steps according to the table. The difference between step 1 and step 2 is about 324 euros gross per month (calculated from the table). Step timing follows the length of medical work.
Is night duty worth it financially?
Night duty brings supplements, but it costs recovery time and can increase the strain considerably. Do not decide on money alone. Ask for the duty roster and the number of duties per month in advance.
What changes after the specialist exam?
With the specialist title you move into a different pay group. The table for specialists is separate and is not shown in this guide. Plan the transition with your HR department, because training periods can be credited differently for the steps.
Where do I find the current table?
The pay table is tied to the collective agreement and is updated regularly. Ask your HR department for the version in force and check that it matches the original text.
What to do now
- Confirm in writing whether the TV-Ärzte/VKA or the TV-Ärzte TdL applies.
- Calculate on-call and night duties for a typical month before you accept.
- Check your health insurance as soon as total pay could reach the insurance threshold.
- Have the crediting of earlier periods for your steps written into the contract.
Related reading
- Health Insurance Income Limit 2026: What It Means
- Health Insurance After the Trainee Period: What Comes Next
- Starting salary with a master or bachelor degree
- Disability insurance in medical studies (in German)
Sources: TV-Ärzte/VKA pay table valid from 1 June 2026 (secondary copy, as of June 2026); TV-Ärzte/VKA overview with step periods and supplements (as of July 2026; the original collective agreement is decisive).
Last updated: October 2026. This guide is general information, not individual advice.
