Doctor salaries in SA: medical officer, registrar & specialist pay

Government doctor salary scales (DPSA OSD, 2026/27)

Public-sector doctors are paid on the occupation-specific dispensation (OSD) — national scales set by the DPSA, adjusted every 1 April. These are the packages effective 1 April 2026, straight from the OSD annexures. The two junior stages have dedicated deep-dives with worked take-home examples: intern pay and community-service pay. This page owns the rest of the ladder.

From MO to registrar to specialist: what happens to your pay

The question behind most “registrar salary” searches is really: do I take a pay cut to specialise? The answer is no — registrar posts are advertised on the MO Grade 1 scale (R1,041,402 for 2026/27), plus commuted overtime, which registrars almost always work. What you give up is the progression you’d have made as a career MO: Grade 2 (R1,188,255+) and Grade 3 (R1,375,245+) arrive with experience, while a registrar stays on the training scale for the 4+ years of the programme — and then moves to the specialist scales. Doctors between posts, or supplementing an MO salary, often locum — a different pay mechanic entirely (hourly rates, provisional tax, no benefits).

What every package is made of

The structure is the same at every grade:

• A basic salary, set by your grade and notch on the DPSA scale.
• Commuted overtime, a fixed monthly amount for your after-hours work (more below).
• A rural allowance, if your post qualifies (18% of basic at designated facilities, 22% at ISRDS nodes).
• Benefits, meaning medical aid (GEMS) and pension (GEPF), with an employer contribution on the government package.

Government vs non-government package

You’ll choose between two ways of taking your package. On the government package, your medical aid and pension are arranged for you with an employer contribution, and you can take an optional 13th cheque in your birth month. On the non-government package, you take fuller cash pay and arrange your own benefits, with the 13th cheque spread across your monthly salary. Neither is automatically better. It depends on your circumstances and how much you value the employer’s contribution to your benefits.

Commuted overtime

After-hours work at every grade is paid as commuted (fixed) overtime: you contract into a weekly-hours band paid at about 1.3 times your hourly rate as a fixed monthly amount. The rand value scales with your notch — which is why overtime matters more, not less, as you climb — and the policy is being renegotiated (a new national policy was published in December 2025), so read the current terms before signing. Worked junior-grade figures are in the intern and community-service guides.

Tax and deductions

Give HR your SARS tax number and bank details before you sign, so your salary isn’t delayed. PAYE comes off automatically, and if you start mid-tax-year the monthly tables can over-withhold — the difference comes back when you file a return. The one non-negotiable deduction is tax; optional ones include GEPF, GEMS and a union subscription. SAMA is a professional association, not a trade union, so its fees are voluntary and aren’t on Persal, and interns don’t pay the bargaining-council agency fee. As reference rates, GEPF is generally 7.5% from you and 13% from the employer, while the SARS PAYE brackets and GEMS contributions are set each year.