How to Pay Off Medical School Debt in 5 Steps

Paying off medical school debt can take anywhere from 10 to 25 years, depending on your repayment strategy, loan type, and income. With careful planning, some doctors manage to pay off their loans faster, while others benefit from loan forgiveness programs.

In this guide, we’ll cover crucial steps to help you manage and accelerate repayment, including loan prioritization, repayment plans, and refinancing options.

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How to manage medical school debt
5 steps to pay off medical school debt
FAQ

How can you manage medical school debt efficiently?

Medical school debt repayment varies depending on your loan types, income, and career path. While loan forgiveness may be available to some, others may rely on income-driven repayment plans or refinancing to lower monthly payments.

How fast you pay off your debt depends on the strategy you choose and how aggressive you are in tackling your loans.

How the Doctors Darko paid off their loans

Take the example of Drs. Nii and Renée Darko, who started with a combined $662,900 in student loan debt. By making paying off their loans a priority, they developed a strict budget, significantly cut expenses, and avoided unnecessary spending. Three years later, they were debt-free. Their success story shows that while aggressive debt payoff is possible, it requires a clear plan and significant lifestyle changes.

How we did it

Drs. Nii and Renée Darko

We adjusted our budget to make paying off our student loans a priority. We significantly lowered our insurance and food spending and became more intentional by budgeting on a monthly basis. We told our money exactly where we wanted it to go in the beginning of every month rather than trying to figure out where it went at the end of every month.

5 steps to pay off medical school debt

Here are five steps to follow to manage medical school debt repayment.

1. Prioritize your loans

Medical graduates often have a combination of federal and private student loans. Start by listing all your loans and their interest rates. Focus on paying off high-interest loans first to reduce the total amount of interest paid over time. Federal loans may have lower rates, so it’s often wise to prioritize private loans with higher rates.

2. Choose the right repayment plan

Federal student loans offer various repayment plans; selecting the right one can make a significant difference.

Here are your main options:

SAVE Plan (formerly REPAYE): This new plan is more favorable for most borrowers compared to PAYE and IBR. It caps payments at 5% of discretionary income for undergraduate loans and 10% for graduate loans. It also offers an interest subsidy, meaning no interest accrues if your payments are lower than the interest charged. The forgiveness timeline is 20 years for undergraduate loans and 25 years for graduate loans.
Income-Based Repayment (IBR): Borrowers who took out loans before July 1, 2014, can still use this plan, which caps payments at 15% of discretionary income. For newer borrowers, the cap is 10%. Loan forgiveness comes after 20 or 25 years, depending on when the loans were taken out.
Income-Contingent Repayment (ICR)*: This plan caps payments at 20% of discretionary income or the amount you would pay on a fixed 12-year plan, whichever is lower. Loan forgiveness is available after 25 years, but ICR is less favorable compared to the other plans.
Pay As You Earn (PAYE)*: This plan offers fewer benefits than SAVE. It caps payments at 10% of discretionary income, and loan forgiveness is offered after 20 years. However, it does not have the same interest subsidy as SAVE.

*The PAYE and ICR plans are gradually being phased out or limited due to the transition to SAVE. As of July 2024, if you haven’t already enrolled in PAYE, it’s no longer available for new borrowers.

Use our income-based repayment calculator to determine whether this plan might be right for you:

Personal Information

State of Residence

Family Size

Income Information

Adjusted Gross Income

Annual Income Growth

Income Information

Were any of your federal student loans disbursed before July, 2014?

Yes

Current Federal Student Loan Balance

Average Weighted Interest Rate on Federal Loans

Calculator Results

	Current	IBR	Savings
First Month's Payment
Last Month's Payment
Total Forgiveness	$0
Total Cost

Switching to IBR would lower your current monthly student loan payment to , which is lower than your current payment. As your income increases, so will your monthly payments under IBR. Assuming annual income growth of , your last monthly payment would be , which is lower than your current payment. Overall, you would receive in student loan forgiveness by switching to IBR. However, switching to IBR would increase the total cost of your loan by .

Private loans don’t offer the same flexibility, so if you have private loans, consider refinancing to reduce your interest rate or extend your repayment term.

Tip

With some student loans, you may have the option to defer payments not just while you’re in school but also until after you finish your residency. While this can make finishing up your education easier in the short term, it can add thousands to your debt as interest continues to accrue.

Student Loan Deferment and Forbearance Calculator

3. See whether you qualify for loan forgiveness

Doctors working for qualifying employers, such as government or nonprofit organizations, can benefit from Public Service Loan Forgiveness (PSLF). This program forgives the remaining balance of federal loans after 120 qualifying monthly payments. Be sure you’re on an income-driven repayment plan and working for a qualifying employer to take advantage of PSLF.

Tip

Some states also offer loan forgiveness programs for doctors practicing in underserved areas. For example, California’s CalHealthCares offers up to $300,000 in debt relief, and New York’s Regents Physician Loan Forgiveness provides up to $10,000 per year.

4. Consider refinancing your medical school loans

Refinancing can help reduce your interest rate, which in turn lowers monthly payments or shortens your repayment period. If you have private loans with high interest rates, refinancing can be a smart option.

However, be aware that refinancing federal loans turns them into private loans, which means losing access to income-driven repayment plans and loan forgiveness programs.

5. Make extra payments whenever possible

Making extra payments on your loans—especially high-interest ones—can reduce the time it takes to pay off your debt. Look for ways to cut expenses or allocate windfalls (such as bonuses) toward your loans. For instance, physician signing bonuses are often substantial and can help you knock down a significant portion of your debt.

Avoid lifestyle inflation as your income rises. By maintaining a modest budget during the early years of your career, you can direct extra cash toward loan payments and become debt-free faster.

FAQ

How long does it usually take to pay off medical school loans?

The timeline for paying off medical school loans typically ranges from 10 to 25 years, depending on your repayment plan, loan type, and payment strategy.

Can medical school loans be forgiven?

Yes, federal medical school loans can be forgiven through PSLF or state-based loan forgiveness programs for doctors who work in underserved areas.

Should I defer my student loan payments during residency?

Deferring loans during residency may increase your debt due to interest accumulation. Making small payments or entering an income-driven repayment plan during this period is often a better financial strategy.

Is refinancing medical school loans a good idea?

Refinancing can lower your interest rate, but it’s not always the best option if you plan to pursue loan forgiveness or benefit from federal repayment protections.

How can I pay off my medical school loans faster?

You can pay off loans faster by making extra payments, refinancing high-interest loans, cutting unnecessary expenses, and avoiding lifestyle inflation as your income grows