53% of voting BMA resident doctors in England backed the government offer, ending three years of strikes that had disrupted NHS services.
The package includes a 3.5% pay rise this year, backdated to April 1, 2026, for an average 4.9% increase now and 6.6% by April 2027, according to the government and union.
Starting salaries will rise to just over £40,000 and the most senior resident doctors to £76,500 basic pay, with exam fees covered and 4,500 extra training places promised.
Hundreds of thousands of patient appointments were cancelled during the dispute, which involved doctors who make up nearly half of England's medical workforce.
The settlement narrows one of the UK's biggest NHS labor disputes even as Wales and Scotland pursue separate pay talks and Northern Ireland resident doctors stage a 24-hour strike.