Medical Student Loan Repayment

A medical education is one of the most expensive career paths there is, with arguably one of the most rewarding payoffs — becoming a medical professional.

Despite the rising costs, many hopeful physicians continue to seek out top medical programs, and should feel confident in doing so. However, the substantial stress of medical school debt means that these future care-givers need more help in managing the heavy financial burden that follows these rigorous years of training.

If you’re an aspiring medical professional, you’ve likely seen the numbers. According to the Education Data Initiative, 74% of the graduating class of 2025 reported leaving medical school with student loan debt. Across the country, the average medical school debt balance for each member of the class of 2025 was $216,659.

With graduation in May, a move in June, and residencies beginning in June and July, there will be less free time available for dealing with finances than you might think.

What should you do to prepare for residency?

1. Get organized.

Gather the records of all your debt, e.g., student loans, car payments, mortgage, personal loans, credit cards, etc., and keep them in one safe place. Be sure your records include balances, terms, payments, interest rates, and any other key information.

2. Know what you owe.

Familiarize yourself with the full picture of your debt so you can make informed financial decisions. This should encompass how much you owe, monthly payment due dates, and your current payoff dates, even if they are 10, 15, or 20 years away.

3. Map your personal and professional goals.

House, kids, private practice, lifestyle—include it all. Even if plans and circumstances change, thinking about where you want to go now will help you be better prepared for the future.

4. Determine when and how you will be paid.

Weekly, bi-weekly, or monthly – and if direct deposit is available, take advantage of it.

5. Create—and stick to—a monthly budget.

• Live like a resident on a resident’s salary – the average yearly salary for a resident is $68,000 according to a Medscape survey.
• Remember that location affects total cost of living.
• Don’t forget about retirement – it’s never too early to start saving for retirement. If your workplace provides retirement account plans—and almost all do—take advantage of them and any matching-funds options offered.

6. Protect yourself with insurance.

Disability, life (if you’re married and/or have children), and umbrella liability insurance coverage preserves your investment in yourself, your assets, and your capacity to earn future income.

7. Establish an emergency savings fund.

Since insurance can’t cover every eventuality, having a financial cushion could help get you through an unexpected challenge. An online savings account, such as a high-yield savings or money market savings account, could be one way to build your rainy day fund.

8. Maximize your tax deductions.

For example, you may be eligible to deduct up to $2,500 of student loan interest paid in a given year. There are some restrictions, though, so check the income requirements each tax year and consult a tax professional for more information.

9. Set a loan repayment strategy.

• Do the math to ensure your repayment plan makes financial sense.
• If you are in a period of deferment or forbearance, or still in school, consider making some sort of payment on the interest that is accruing on the costliest loans, particularly private in-school loans, federal unsubsidized loans, or GRAD Plus loans.
• Pay off higher interest rate loans first to potentially save on interest.
• Eliminate the smallest balance which may free up more money to tackle the next-largest balance.
• Make every effort to make on-time payments. A late payment may result in late fees and/or a negative impact to your credit score.

Medical student loan forgiveness programs

Public Service Loan Forgiveness (PSLF)

Borrowers who work for the government or eligible nonprofit organizations could have their loans forgiven after making 120 qualifying monthly payments under a qualifying repayment plan. Learn more about the PSLF Program at studentaid.gov to see whether you might qualify.

Key considerations:

• The amount forgiven is not taxed. Consult your tax advisor for more details.
• Money saved needs to be balanced against income lost if taking a job that pays significantly less than private or for-profit sectors.
• US Department of Education policy for PSLF may change, so borrowers should monitor developments.

Medical student loan repayment assistance programs by state

In certain states, the government offers funding to help physicians and doctors repay their medical school loans. For a comprehensive list of medical student loan repayment assistance programs by state, please visit the Association of American Medical Colleges (AAMC) website.

Compare medical school repayment options

Direct Consolidation Loan

If you have federal student loans, a Direct Consolidation Loan can help simplify loan repayment. Consolidation combines two or more loans into a single loan with one fixed interest rate, which is based on the weighted average of the original loans’ rates. Repayment terms can vary.

Learn more about Direct Consolidation Loans.

Key considerations:

Income-Driven Repayment plans

Income-Driven Repayment (IDR) plans allow you to reduce monthly payment amounts for federal loans according to your income. The payment amount is typically calculated as a percentage of your discretionary income and is updated annually to account for changes. Learn more about Income-Driven Repayment.

Key considerations:

• The monthly payment amount for IDR plans is recalculated each year and can increase as your income rises.
• These plans offer some relief should your financial situation change for the worse during repayment.
• Savings can be achieved if your student loans are forgiven; however, any amount forgiven is considered taxable income.

Medical student loan refinancing

Refinancing provides the opportunity to pay off your original student loans by obtaining a new, consolidated loan with different repayment terms and a potentially lower interest rate. Each lender has its own criteria for determining eligibility and rates, such as your credit history, total monthly debt payments, and income. Those who are in good financial standing, demonstrate a strong career trajectory, have good credit scores, and have shown they are responsible with debts and monthly budgeting are more likely to be approved with a potentially lower interest rate.

Student loan refinancing could provide an opportunity for those who are looking to:

• Save with a lower interest rate or shorter term¹
• Save money over the life of their loans
• Pay off their loans more quickly
• Lower their monthly payments
• Change from a fixed rate to a variable rate, or vice versa
• Reduce the number of loans in repayment
• Gain terms and rates based on their current financial situation and creditworthiness

Student Loan Refinancing: Questions to Ask Your Lender

Student Loan Refinancing: Doing the Math

For residents, it is important to consider how you will pay back your student loans and create a plan during training. To make your monthly payments more manageable, you might consider an IDR plan or refinancing. Some lenders may offer refinancing options designed for residents.

The benefit of an IDR plan during residency is that monthly payments are based on your income, not the total outstanding loan balance. However, after residency, that payment may likely jump significantly based on your salary as an attending.

Alternatively, student loan refinancing for residents offers an opportunity for residents to pay lower monthly payments during training without having to enter into a longer loan term, potentially saving money on interest. After training, they begin paying full monthly payments for a similar term as their original loans, which are more manageable given the higher earning potential.

So, what are some of the other factors that could impact this decision toward refinancing?

• If you earn more income during training (or have a high-earning spouse)
• If you are able to make extra payments while in residency
• If you have a short residency period
• If you might need to take advantage of federal benefits in the future

Evaluate your medical student loan repayment options

Medical school graduates face unique challenges when it comes to student loan debt. Speaking with an expert who understands medical school debt may make the process easier. Fortunately, you may be able to use a variety of tools to manage your loans. To explore your options, schedule a free consultation with a student loan specialist at KeyBank.

Sources:

1. The DO – What residents are getting paid in 2025
2. AMA Medical Student Financial FAQ: https://www.ama-assn.org/medical-students/medical-school-life/medical-student-financial-faq-insight-loan-forgiveness