nurses against doctors; The wage gap that has led nurses to leave the profession

The feeling of occupational injustice in nurses manifests itself in three ways: migration, job change, and remaining in the profession with reduced motivation. This trend is dangerous for the health system; Because training a nurse takes years of time and money, but losing her can happen in a short time.

For years, the nursing community has been talking about problems that are no longer unknown to health officials; Lack of manpower, heavy shifts, overtime, job burnout, delay in payment of claims, incomplete implementation of tariffs and most importantly, a significant gap between the salaries of nurses and some medical groups.

In the past years, nurses have been mentioned many times as the pillar of the treatment system and one of the main frontline groups of health. The Corona era also made this picture bolder. However, from the point of view of union activists, the gap between this literature and the economic reality of nurses' lives is increasing day by day.

Now the problem is not only that the nurse receives a low salary; The more important question is why there is such a gap between the income of nurses and doctors in a single healthcare system and what is the status of this gap in other countries?

An important part of the income gap between doctors and nurses is related to the distribution of efficiency and performance-based payments

Mohammad Sharifi-Moghadam, the secretary general of the Nursing Home, has warned many times about the income gap between doctors and nurses in recent years. Based on his statements and analysis, the difference received by these two groups in Iran is not only limited to basic rights; An important part of the gap is related to the way of efficient distribution, performance-based payments, service tariffs and the share of each group of financial resources of the health system.

This difference becomes more sensitive especially when we know that the nurse is present continuously and around the clock in many hospital departments. The nurse must be with the patient during night shifts, holidays, high-traffic days and critical situations; While the payment model does not necessarily reflect this amount of attendance and work pressure in the same proportion in his income.

The dispute is not only about "rights"; The problem is the payment model / the implementation of the tariff law did not eliminate this huge difference

Mehdi Zare, a nurse and union activist, told Ambassador Arjan about this: One of the most important criticisms of the nursing community is that the payment system in the treatment sector does not calculate the economic value of different services in a balanced way. The problem is not only low salaries; The difference in the payment system has made the nurse feel that the value of her work is not seen in the health structure

He adds: The nursing services tariff law has also been implemented after years of follow-up, but its implementation has not been able to significantly reduce the existing gap. On the other hand, the reports on the income of nurses in 1405 also show that the amount received is highly dependent on the history, type of employment, place of service, overtime and benefits.

This trade union activist emphasizes: But in the case of doctors, especially specialist doctors and faculty members, the income is not just based on the basic salary, and fees and payments from medical services can significantly increase the final figure.

Such a gap does not end only in the lack of income, but also creates a feeling of job injustice

Mehdi Zare, stating that the main problem of Iran's nursing society cannot be solved by increasing salaries by a few percent, says: Nursing is a profession that has high physical and mental exhaustion. Night shifts, lack of manpower, increase in the number of patients, heavy responsibility for the patient's life and overtime are hidden costs that cannot be seen in the pay slip.

He adds: For this reason, when a nurse sees that despite years of experience and university education, her income is far from some other groups in the health system, the problem is not just "lack of income"; A sense of occupational injustice is formed.

This trade union activist emphasizes: This feeling of injustice finally manifests itself in three forms: migration, changing jobs and staying in the profession with a decrease in motivation. This trend is dangerous for the health system; Because training a nurse takes years of time and money, but losing her can happen in a short time.

Increasing the capacity of nurse education alone will not solve the problem

Although the migration of nurses continues, it is not the only form of leaving the profession. Some of the nurses go to other jobs due to work pressure and disproportionate income, and even some nurses who have years of experience do not consider it economically and psychologically justified to continue working in the hospital.

In such a situation, increasing the capacity of nurse training alone will not solve the problem. If the new force also faces the same conditions after a few years, the cycle of shortage of force will repeat again.

The nursing community now needs a change in the payment mechanism more than it needs new promises; A change in which the pricing of nursing services, overtime, efficiency, work difficulty and service history can really be seen in the final income.

A look at the situation of nurses in other countries

The important issue for nurses in Iran is that the distance between them and doctors has never been clear. In fact, this gap is sometimes so large that officials prefer not to provide any specific statistics on this matter, while in most countries of the world, the percentage that doctors receive more than nurses is known and is clearly mentioned in the statistics.

Türkiye; The distance is there, but it's more measurable

Based on the estimates of 2025, the average annual gross income of a nurse in Türkiye is about 649 thousand liras, equivalent to about 54 thousand liras per month. In the same estimate, the average annual income of doctors is about 1,497,000 liras, which means nearly 125,000 liras per month. Therefore, the average income of a doctor in this estimate is about 2.3 times that of a nurse.

Emirates; Higher income, gap still significant

In the UAE, there is also a difference in income between doctors and nurses. Estimates for 2025 state that the average annual gross income of nurses is about 193,500 dirhams, which means about 16,000 dirhams per month. For doctors, this figure is about 446,600 dirhams per year or nearly 37,000 dirhams per month. In this way, in this estimate, the average income of a doctor is about 2.3 times that of a nurse.

In Germany, doctors earn more than nurses, but the income gap is regulated by specific tariff systems and work contracts. According to the official data of the German Federal Labor Agency, the average gross monthly salary of nurses in the field of health and hospital care is about 4,329 euros. On the other hand, the average gross monthly income of doctors in the data of the same organization is reported as 7,450 euros. Therefore, the average income ratio of doctor to nurse in this comparison is about 1.7 times.

England; Doctors earn more, but nursing also has a specific payment system

In England, there is also an income gap between doctors and nurses. Based on the data for the year ending June 2025, the average annual basic salary of full-time medical staff was about 87,701 pounds and the average basic salary of nurses was about 41,431 pounds; That is, the basic salary of doctors was on average 2.1 times that of nurses.

In the NHS, nurses' salaries are determined by job "band". In 2025/26, the basic salary of a nurse in Band 5 starts at around £31,000 and can reach around £37,800 with increasing experience; The number increases at higher levels.

For doctors, the payment system is defined based on the job level, expertise and experience, and expert doctors and consultants have a much higher income. For example, the basic annual salary of consultant doctors in England from April 2025 is announced to be around £109,000 to £145,000.