How Much Do Specialist Doctors Earn in Spain? 2026 FEA Salary Data by Region
Specialist doctors working in Spain’s public health system can see a substantial difference in their gross monthly pay depending on the autonomous community in which they work.
The latest 2026 remuneration data for Facultativos Especialistas de Área (FEA) — hospital specialist physicians — shows ordinary gross monthly compensation ranging from approximately €3,066 to €4,813, before seniority payments and on-call duties are added.
That creates a difference of more than €1,700 per month between regional health services.
For hospital specialists in Spain, this is an important point: while parts of the public-sector salary structure are nationally standardised, regional supplements mean that the amount appearing on a specialist physician's payslip can vary considerably depending on where they work.
What does a specialist doctor earn in Spain in 2026?
According to the 2026 regional salary analysis, the ordinary gross monthly remuneration for an FEA without seniority payments or on-call duties is:
Autonomous community | Health service | Gross monthly FEA pay |
Basque Country | Osakidetza | €4,813 |
Valencian Community | Sanitat | €4,206 |
Balearic Islands | IB-Salut | €4,202 |
La Rioja | SERIS | €4,135 |
Aragón | SALUD | €4,083 |
Madrid | SERMAS | €4,027 |
Ceuta & Melilla | INGESA | €4,008 |
Andalucía | SAS | €4,000 |
Canary Islands | SCS | €3,973 |
Cantabria | SCS | €3,789 |
Catalonia | ICS | €3,648 |
Asturias | SESPA | €3,624 |
Navarra | SNS-O | €3,501 |
Galicia | SERGAS | €3,345 |
Castilla y León | SACYL | €3,172 |
Castilla-La Mancha | SESCAM | €3,128 |
Murcia | SMS | €3,066 |
These figures refer to an ordinary month's gross remuneration, without trienios for seniority and without guardias.
They should therefore be treated as a benchmark for fixed monthly public-sector compensation rather than a measure of a specialist's complete annual earnings.
Why does specialist doctor pay vary so much across Spain?
Spain's public-sector physician salary is made up of several components.
For an FEA, the common elements include:
Base A1 salary: €1,387.24 per month
Destination supplement: €729.14 per month for level 24
Seniority payment: €53.39 per month for each three-year period of service
Specific and productivity supplements: approximately €950 to €3,400 per month depending on the regional health service
On-call payments: paid separately and set regionally
The nationally determined base components therefore tell only part of the compensation story.
The major differences arise from the complemento específico, productivity payments and other remuneration determined by each autonomous community.
For a specialist doctor considering compensation in Spain, location can consequently make a meaningful difference even when the underlying clinical grade is similar.
What does an FEA mean in Spain?
FEA stands for Facultativo Especialista de Área.
In practical terms, it refers to a specialist physician working within the hospital-based public health system.
The category can include doctors working across specialties such as:
cardiology;
oncology;
neurology;
radiology;
gastroenterology;
pulmonology;
dermatology; and
other hospital specialties.
However, the 2026 remuneration data does not provide separate salary scales for these individual specialties.
It should therefore not be interpreted as showing a specific salary for a cardiologist, oncologist or neurologist.
The figures provide a compensation benchmark for the FEA employment category.
For an individual specialist, clinical specialty may influence workload, working patterns and opportunities for additional remuneration, but the regional salary figures themselves are not specialty-specific.
How much does a specialist doctor earn in the Basque Country?
The 2026 data shows an ordinary gross monthly FEA remuneration figure of approximately:
€4,813 per month for the Basque Country.
Official 2026 Osakidetza remuneration documentation separately confirms that the annual remuneration framework for a standard Facultativo position is €45,875.43, before considering every possible additional payment or individual circumstance.
This illustrates an important methodological point: monthly salary comparisons and annual public-sector remuneration tables do not always describe exactly the same components.
Physicians should therefore examine the individual elements included in any figure before making direct comparisons.
How much does an FEA earn in Madrid?
For Madrid, the ordinary gross monthly FEA figure in the regional comparison is approximately:
€4,027 per month before seniority and guardias.
But that figure does not tell the whole compensation story.
On-call work can add substantially to a hospital specialist's earnings.
From August 2026, the Community of Madrid increased physician guardia payments to:
€484.31 for a standard working-day guardia
€748.57 for a guardia performed on a public holiday
with further increases scheduled for 2027.
This demonstrates why two specialists with the same underlying FEA salary can ultimately receive very different total annual compensation depending on their working patterns.
How important are guardias to specialist physician earnings?
Very important.
On-call work — guardias — is generally paid in addition to the ordinary monthly remuneration.
The 2026 analysis estimates that guardias can contribute approximately:
€12,000 to €24,000 in additional gross income per year
depending on the number performed and the rates applied by the relevant autonomous community.
This means that an FEA's headline monthly salary should not automatically be interpreted as their total earning potential.
A specialist undertaking frequent nights, weekends and public-holiday guardias may have substantially higher gross annual earnings than another specialist on the same fixed remuneration but with fewer additional duties.
What other payments can increase a specialist doctor's income?
Beyond ordinary salary and guardias, several other components can affect remuneration.
Seniority — trienios
Doctors receive an additional payment for completed periods of service.
The 2026 national A1 figure cited for a three-year period is approximately:
€53.39 per month for each trienio.
A physician with a longer public-sector career may therefore receive more than a newly appointed specialist.
Professional career progression
Many regional health systems also operate carrera profesional systems recognising experience, training and professional development.
The amounts differ by autonomous community and career level.
According to the 2026 analysis, these supplements can range from roughly €130 per month at lower stages to considerably higher amounts at advanced career levels in some regions.
Exclusivity or dedication supplements
Some health services also offer remuneration connected with exclusive dedication to the public system or incompatibility with private practice.
Again, these arrangements differ significantly between regions.
Is €3,066–€4,813 the total monthly income of a specialist doctor?
Not necessarily.
The clearest interpretation of these figures is:
They represent ordinary gross monthly FEA remuneration before seniority and guardia payments.
A specialist's actual compensation may include:
base salary;
destination supplement;
specific supplement;
productivity payments;
seniority;
professional career payments;
guardias;
nights and public-holiday payments; and
other regional supplements.
This distinction is essential when comparing physician salaries.
A €4,000 ordinary monthly figure should not be compared directly with another dataset reporting total annual earnings including extensive on-call work.
Why is the region so important for specialist doctors in Spain?
Spain operates a decentralised health system.
Although some salary components are nationally defined, autonomous communities administer their own health services and determine important additional remuneration.
The result is that two hospital specialists employed within the Spanish public health system can have materially different fixed compensation depending on where they work.
According to the 2026 figures, the difference between the highest and lowest ordinary FEA monthly remuneration is approximately:
€1,747 per month.
For specialists evaluating a role, salary comparisons should therefore consider the regional health service rather than relying on a single "Spanish doctor salary".
Does this tell us what cardiologists or oncologists earn?
Not specifically.
This dataset is useful because it provides a current benchmark for hospital specialist physicians as an employment group.
It does not provide separate compensation figures for cardiology, oncology, radiology, neurology or other individual specialties.
A cardiologist working as an FEA should therefore use the relevant regional FEA figure as a public-sector employment benchmark — not as evidence of a cardiology-specific national salary.
The same applies to other hospital specialties.
Specialty-specific compensation analysis requires specialty-specific evidence.
What should specialist doctors in Spain take from the 2026 data?
For hospital specialists working in Spain's public health system, the most important finding is that there is no single FEA salary that accurately describes compensation throughout the country.
Ordinary gross monthly FEA remuneration in the latest 2026 data ranges from approximately:
€3,066 to €4,813 per month
before seniority and guardias are included.
Additional duties can then have a major effect on total remuneration, particularly guardias.
For an individual specialist physician, the more useful question is therefore not simply:
“How much does a specialist doctor earn in Spain?”
It is:
“What is the fixed FEA remuneration in my autonomous community, and how much do seniority, career progression and guardias add to my total compensation?”
That provides a much more meaningful benchmark for understanding specialist physician pay in Spain.
Sources: 2026 regional physician remuneration tables compiled by CalculadorNomina.es from national and autonomous-community salary documentation, including SERMAS, ICS, SAS, Osakidetza, SERGAS and other regional health services. The comparison was published on 23 July 2026. Official 2026 remuneration documentation from Osakidetza and the Community of Madrid was also reviewed as supporting evidence.
Discover how nuaxia can support your next medical education initiative:
Find out more about our specialist services - Moore's Outcome Assessments, Educational Needs Assessments and Patient Impact Studies for the Medical Education sector
Contact us on: support@nuaxia.com
Comments