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Paying Off Medical School Debt: 5 Strategies for Doctors
The best strategy to pay off medical school loans will depend on your career, salary and financial priorities.
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Teddy is a former student loans writer with NerdWallet, where she covered topics around managing money before, during and after college. Her work has been featured by The Associated Press, USA Today, the Chicago Tribune and Reuters.
Des Toups Lead Assigning Editor | Student loans, repaying college debt, paying for college
Des Toups was a lead assigning editor who supported the student loans and auto loans teams. He had decades of experience in personal finance journalism, exploring everything from car insurance to bankruptcy to couponing to side hustles.
Ryan Lane Assigning Editor | Small business, student loans
Ryan Lane is an editor on NerdWallet’s small-business team. He joined NerdWallet in 2019 as a student loans writer, serving as an authority on that topic after spending more than a decade at student loan guarantor American Student Assistance. In that role, Ryan co-authored the Student Loan Ranger blog in partnership with U.S. News & World Report, as well as wrote and edited content about education financing and financial literacy for multiple online properties, e-courses and more. Ryan also previously oversaw the production of life science journals as a managing editor for publisher Cell Press. Ryan is located in Rochester, New York.
Paying off medical school debt can be a bitter pill. As a resident, you’re probably not earning enough to make full monthly student loan payments. As an attending physician, you’re likely facing a balance that’s thousands of dollars more than it was when you graduated.
These five strategies can help make paying off medical school loans a bit easier.
1. Make payments during residency
Medical school loans accrue interest while you're in school and typically enter repayment six months after you graduate.
It’s possible to postpone student loan payments during your residency or fellowship, but it will cost you. Interest accrues during periods of deferment and forbearance, increasing your total balance.
For example, pausing payments for three years on $201,490 — the average medical school debt among the class of 2019 — would add about $37,779 to your balance, assuming that you had a 6.25% average interest rate, didn’t make any interest payments during that time and had no subsidized loans.
To save on interest, make at least partial payments during residency and use deferment and forbearance only as a last resort. If you can’t afford full payments during residency, sign up for an income-driven repayment plan.
An income-driven repayment plan is the best option for residents who can’t afford to make full payments.
There are four federal income-driven plans that cap monthly payments at a percentage of your income, extend the repayment period to 20 or 25 years and forgive any balance that’s remaining after the repayment period. Many doctors choose Pay As You Earn (PAYE) or Revised Pay As You Earn (REPAYE) when paying off medical school debt.
Monthly payments can be substantially lower on an income-driven plan: With a $$57,191 annual income — the average stipend for first-year residents in 2019, according to the Association of American Medical Colleges — you’d owe $320 a month if you had no dependents.
The downside of income-driven repayment is that your monthly payment may not cover all of the interest as it accrues, meaning your total loan balance may increase. REPAYE offsets this with its unique, partial interest subsidy that waives half of the unpaid interest.
Payments will increase as your income increases, meaning you may outgrow income-driven repayment as your career advances. On REPAYE, for instance, your monthly payment could end up being higher than it would be on the standard, federal 10-year repayment plan.
3. Seek loan forgiveness
There are several medical school loan forgiveness programs, including Public Service Loan Forgiveness, available to doctors who are willing to work in the public sector or in underserved areas for a certain period of time. Loan forgiveness may be a good option if your career goals align with one of these program’s requirements.
Depending on whether you have federal or private student loans, you may be able to combine loan forgiveness for doctors with another repayment strategy to maximize the amount you get forgiven.
4. Refinance to save on interest
Student loan refinancing is likely the best option for doctors paying off medical school debt aggressively. If you can get a lower rate, you could save thousands of dollars in interest over the life of your loan.
Physicians are typically ideal candidates in the eyes of student loan refinance lenders. Qualifying for the lowest rates requires excellent credit and a high income relative to your debt. You may want to refinance medical school loans during or after your residency, or both.
If you refinance during your residency, you may be able to pay as little as $100 a month. However, those low monthly payments won’t be enough to cover the interest as it accrues, meaning your balance will increase.
Before refinancing — either as a resident or as an attending — make sure you’re comfortable giving up access to Public Service Loan Forgiveness and income-driven repayment. Refinanced loans aren’t eligible for those federal programs.
How much could refinancing save you?
Note: This calculator assumes that after you refinance, you’ll make minimum monthly payments.
NerdWallet's ratings are determined by our editorial team. The scoring formula for student loan products takes into account more than 50 data points across multiple categories, including repayment options, customer service, lender transparency, loan eligibility and underwriting criteria.
Actual rate and available repayment terms will vary based on your income. Fixed rates range from 4.20% APR to 9.24% APR (excludes 0.25% Auto Pay discount). Variable rates range from 6.14% APR to 9.99% APR (excludes 0.25% Auto Pay discount). Earnest variable interest rate student loan refinance loans are based on a publicly available index, the 30-day Average Secured Overnight Financing Rate (SOFR) published by the Federal Reserve Bank of New York. The variable rate is based on the rate published on the 25th day, or the next business day, of the preceding calendar month, rounded to the nearest hundredth of a percent. The rate will not increase more than once per month. The maximum rate for your loan is 8.95% if your loan term is 10 years or less. For loan terms of more than 10 years to 15 years, the interest rate will never exceed 9.95%. For loan terms over 15 years, the interest rate will never exceed 11.95%. Please note, we are not able to offer variable rate loans in AK, IL, MN, NH, OH, TN, and TX. Our lowest rates are only available for our most credit qualified borrowers and contain our .25% auto pay discount from a checking or savings account.
650
5.89-
9.74%
Actual rate and available repayment terms will vary based on your income. Fixed rates range from 4.20% APR to 9.24% APR (excludes 0.25% Auto Pay discount). Variable rates range from 6.14% APR to 9.99% APR (excludes 0.25% Auto Pay discount). Earnest variable interest rate student loan refinance loans are based on a publicly available index, the 30-day Average Secured Overnight Financing Rate (SOFR) published by the Federal Reserve Bank of New York. The variable rate is based on the rate published on the 25th day, or the next business day, of the preceding calendar month, rounded to the nearest hundredth of a percent. The rate will not increase more than once per month. The maximum rate for your loan is 8.95% if your loan term is 10 years or less. For loan terms of more than 10 years to 15 years, the interest rate will never exceed 9.95%. For loan terms over 15 years, the interest rate will never exceed 11.95%. Please note, we are not able to offer variable rate loans in AK, IL, MN, NH, OH, TN, and TX. Our lowest rates are only available for our most credit qualified borrowers and contain our .25% auto pay discount from a checking or savings account.
NerdWallet's ratings are determined by our editorial team. The scoring formula for student loan products takes into account more than 50 data points across multiple categories, including repayment options, customer service, lender transparency, loan eligibility and underwriting criteria.
With all discounts. Fixed rates range from 3.99% APR to 9.99% APR with 0.25% autopay discount and 0.25% direct deposit discount. Variable rates range from 5.99% APR to 9.99% APR with 0.25% autopay discount and 0.25% direct deposit discount. Unless required to be lower to comply with applicable law, Variable Interest rates will never exceed 13.95% (the maximum rate for these loans). SoFi rate ranges are current as of 10/4/24 and are subject to change at any time. Your actual rate will be within the range of rates listed above and will depend on the term you select, evaluation of your creditworthiness, income, presence of a co-signer and a variety of other factors. Lowest rates reserved for the most creditworthy borrowers. For the SoFi variable-rate product, the variable interest rate for a given month is derived by adding a margin to the 30-day average SOFR index, published two business days preceding such calendar month, rounded up to the nearest one hundredth of one percent (0.01% or 0.0001). APRs for variable-rate loans may increase after origination if the SOFR index increases. The SoFi 0.25% autopay interest rate reduction requires you to agree to make monthly principal and interest payments by an automatic monthly deduction from a savings or checking account. This benefit will discontinue and be lost for periods in which you do not pay by automatic deduction from a savings or checking account. The benefit lowers your interest rate but does not change the amount of your monthly payment. This benefit is suspended during periods of deferment and forbearance. Autopay and Direct Deposit are not required to receive a loan from SoFi. You may pay more interest over the life of the loan if you refinance with an extended term. 0.25% Direct Deposit Discount: Terms and conditions apply. Offer good for Student Loan Refinance (SLR) borrowers that apply for a new SLR on or after 9/17/2024. To be eligible to receive the 0.25% interest rate reduction offer: You must (1) Complete a Student Loan refinance application with SoFi beginning September 17, 2024; (2) Be approved by SoFi for the loan meeting all SoFi’s underwriting criteria; (3) Have either an existing SoFi Checking and Savings account, a SoFi Money cash management account or open a new SoFi Checking and Savings account within 30 days of funding the new loan, AND receive a direct deposit of at least $1,000 to the account within the first 30 days of funding the new loan ("Direct Deposit Account"); (4) Be the primary SLR account holder. If eligible at SoFi’s sole discretion, you will receive this discount during periods in which you have received direct deposits of at least $1,000 every 30 days to a Direct Deposit Account. This discount will be removed during periods in which SoFi determines you have not received at least $1,000 every 30 days in direct deposits to your Direct Deposit Account. You are not required to enroll in direct deposits to obtain a Loan. This discount lowers your interest rate but does not change the amount of your monthly payment. SoFi reserves the right to change or terminate this Rate Discount Program to unenrolled participants at any time without notice.
650
5.99-
9.99%
With all discounts. Fixed rates range from 3.99% APR to 9.99% APR with 0.25% autopay discount and 0.25% direct deposit discount. Variable rates range from 5.99% APR to 9.99% APR with 0.25% autopay discount and 0.25% direct deposit discount. Unless required to be lower to comply with applicable law, Variable Interest rates will never exceed 13.95% (the maximum rate for these loans). SoFi rate ranges are current as of 10/4/24 and are subject to change at any time. Your actual rate will be within the range of rates listed above and will depend on the term you select, evaluation of your creditworthiness, income, presence of a co-signer and a variety of other factors. Lowest rates reserved for the most creditworthy borrowers. For the SoFi variable-rate product, the variable interest rate for a given month is derived by adding a margin to the 30-day average SOFR index, published two business days preceding such calendar month, rounded up to the nearest one hundredth of one percent (0.01% or 0.0001). APRs for variable-rate loans may increase after origination if the SOFR index increases. The SoFi 0.25% autopay interest rate reduction requires you to agree to make monthly principal and interest payments by an automatic monthly deduction from a savings or checking account. This benefit will discontinue and be lost for periods in which you do not pay by automatic deduction from a savings or checking account. The benefit lowers your interest rate but does not change the amount of your monthly payment. This benefit is suspended during periods of deferment and forbearance. Autopay and Direct Deposit are not required to receive a loan from SoFi. You may pay more interest over the life of the loan if you refinance with an extended term. 0.25% Direct Deposit Discount: Terms and conditions apply. Offer good for Student Loan Refinance (SLR) borrowers that apply for a new SLR on or after 9/17/2024. To be eligible to receive the 0.25% interest rate reduction offer: You must (1) Complete a Student Loan refinance application with SoFi beginning September 17, 2024; (2) Be approved by SoFi for the loan meeting all SoFi’s underwriting criteria; (3) Have either an existing SoFi Checking and Savings account, a SoFi Money cash management account or open a new SoFi Checking and Savings account within 30 days of funding the new loan, AND receive a direct deposit of at least $1,000 to the account within the first 30 days of funding the new loan ("Direct Deposit Account"); (4) Be the primary SLR account holder. If eligible at SoFi’s sole discretion, you will receive this discount during periods in which you have received direct deposits of at least $1,000 every 30 days to a Direct Deposit Account. This discount will be removed during periods in which SoFi determines you have not received at least $1,000 every 30 days in direct deposits to your Direct Deposit Account. You are not required to enroll in direct deposits to obtain a Loan. This discount lowers your interest rate but does not change the amount of your monthly payment. SoFi reserves the right to change or terminate this Rate Discount Program to unenrolled participants at any time without notice.
NerdWallet's ratings are determined by our editorial team. The scoring formula for student loan products takes into account more than 50 data points across multiple categories, including repayment options, customer service, lender transparency, loan eligibility and underwriting criteria.
Credible lets you check with multiple student loan lenders to get rates with no impact to your credit score. Visit their website to take the next steps.
4.89-
9.04%
See LendKey's full terms and conditions at https://www.lendkey.com/disclaimers
680
5.54-
9.12%
See LendKey's full terms and conditions at https://www.lendkey.com/disclaimers
Credible lets you check with multiple student loan lenders to get rates with no impact to your credit score. Visit their website to take the next steps.
NerdWallet's ratings are determined by our editorial team. The scoring formula for student loan products takes into account more than 50 data points across multiple categories, including repayment options, customer service, lender transparency, loan eligibility and underwriting criteria.
Credible lets you check with multiple student loan lenders to get rates with no impact to your credit score. Visit their website to take the next steps.
4.84-
8.44%
Subject to credit approval. Terms and conditions apply. https://www.elfi.com/terms/
680
4.86-
8.49%
Subject to credit approval. Terms and conditions apply. https://www.elfi.com/terms/
Credible lets you check with multiple student loan lenders to get rates with no impact to your credit score. Visit their website to take the next steps.
NerdWallet's ratings are determined by our editorial team. The scoring formula for student loan products takes into account more than 50 data points across multiple categories, including repayment options, customer service, lender transparency, loan eligibility and underwriting criteria.
Splash Financial, Inc. (NMLS # 1630038) reserves the right to modify or discontinue products and benefits at any time without notice. The information you provide is an inquiry to determine whether Splash’s lending partners can make you a loan offer, but does not guarantee you will receive any loan offers. Terms and conditions apply. Products may not be available in all states. These rates are subject to change at any time. If you do not use the specific link included on this website, offers on the Splash website may include other offers from lending partners that may have a higher rate. Fixed Rate options range from 5.94% APR - 8.95% APR (without autopay). Variable rate options range from 7.60% APR (with autopay) to 7.85% APR (without autopay). Variable APRs and amounts subject to increase or decrease. Lowest rates are reserved for the highest qualified borrowers and may require an autopay discount of 0.25%. Some of the rates are based on the one-month London Interbank Offered Rate (“LIBOR”) index and some are derived by adding a margin to the 30-day average SOFR index, published two business days preceding such calendar month, rounded up to the nearest one hundredth of one percent (0.01% or 0.0001). Fixed loans feature repayment terms of 5 to 20 years. For example, the monthly payment for a sample $10,000 with an APR of 7.50% for a 10-year term would be $118.70. Variable loans feature repayment terms of 5 to 20 years. For example, the monthly payment for a sample $10,000 with an APR of 7.85% for a 5-year term would be $202.05.
650
7.60-
7.85%
Splash Financial, Inc. (NMLS # 1630038) reserves the right to modify or discontinue products and benefits at any time without notice. The information you provide is an inquiry to determine whether Splash’s lending partners can make you a loan offer, but does not guarantee you will receive any loan offers. Terms and conditions apply. Products may not be available in all states. These rates are subject to change at any time. If you do not use the specific link included on this website, offers on the Splash website may include other offers from lending partners that may have a higher rate. Fixed Rate options range from 5.94% APR - 8.95% APR (without autopay). Variable rate options range from 7.60% APR (with autopay) to 7.85% APR (without autopay). Variable APRs and amounts subject to increase or decrease. Lowest rates are reserved for the highest qualified borrowers and may require an autopay discount of 0.25%. Some of the rates are based on the one-month London Interbank Offered Rate (“LIBOR”) index and some are derived by adding a margin to the 30-day average SOFR index, published two business days preceding such calendar month, rounded up to the nearest one hundredth of one percent (0.01% or 0.0001). Fixed loans feature repayment terms of 5 to 20 years. For example, the monthly payment for a sample $10,000 with an APR of 7.50% for a 10-year term would be $118.70. Variable loans feature repayment terms of 5 to 20 years. For example, the monthly payment for a sample $10,000 with an APR of 7.85% for a 5-year term would be $202.05.
After years of education and training, you’ll finally reap the income benefits of your career once you become an attending physician. But if you can live like a resident for a few more years, you’ll have more money to devote to saving, investing and paying off medical school debt.
You may want to make extra payments to get rid of medical school loans faster. But before you do, focus on other financial priorities including:
Establishing an emergency fund of at least $500, but ideally enough to cover three to six months of living expenses.
Investing in a retirement fund, at least enough to get your employer’s 401(k) match.
Paying down high-interest debt like credit cards.
How long does it take to pay off medical school debt?
Your repayment strategy will determine how long it takes to pay off medical school debt. For example, pursuing Public Service Loan Forgiveness will mean 10 years in repayment, while income-driven plans can last as long as 25 years.
There's never any penalty for paying off student loans early, and many doctors choose to aggressively repay their medical school debt.
According to a 2019 survey from staffing agency Weatherby Healthcare, 35% of doctors paid off their loans in fewer than five years. They did this via strategies like making extra payments and refinancing student loans. Of the doctors who still had loans, the majority expected it to take at least 10 years to finish repayment.
