7 Best Strategies for Paying Off Medical School Debt

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medical school debt

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You don’t make it through medical school and residency without a passion for researching and practicing medicine. But the promises of a lucrative salary and financial freedom are also an undeniable draw to the profession.

However, in order to achieve these high incomes, most doctors take on medical school debt.

Medical school debt doesn’t have to be a fact of life. In fact, getting past your medical school debt is key to finding fulfillment and financial success as a physician. Here’s why.

What $164,800 in average medical school debt actually costs

Four out of five medical school graduates borrow to finance their studies, according to the 2016 AAMC Medical School Graduation Questionnaire. What’s more, the average medical school debt is $164,800, according to a recent Student Loan Hero survey of medical schools.

This huge medical school debt is more than many Americans’ mortgages. And if you want to repay your debt within 10 years instead of the usual 30, that means high monthly payments — $1,830 for the average medical school debt of $164,800 (assuming 6.00% interest).

Medical school debt is also usually held in the form of graduate student loans. These types of loans typically carry higher interest rates of 5.00-6.00% or more. So $164,800 in student debt actually costs a whopping $220,000 to repay.

7 strategies for paying off medical school debt faster

The burden of medical school debt just adds stress on top of an already demanding career.

“[That’s why] aggressively paying down debt and accumulating wealth to become financially independent is important,” said Jon Sycamore, a certified financial planner and founder of Physician Wealth Planning.

“Many physicians burn out but are stuck because they can’t afford to stop and are miserable,” Sycamore said. “[However,] having the option to continue practicing medicine, or not, brings a powerful paradigm shift that can make practicing more enjoyable and avoid burnout in the first place.”

Here are seven ways a doctor can make student loan repayment a priority while taking advantage of repayment help and tools.

1. Don’t defer medical school debt in residency

Many medical school graduates choose deferment for federal student loans during their medical residency, pausing their repayment. Yet their medical school debt will still accrue student loan interest, which will capitalize once the deferment ends.

So deferring medical school debt in residency might lower your student loan stress now — but at a significant cost.

On a $164,800 balance with a 6.00% rate, for instance, deferring student loans for a three-year residency would add $29,664 in accrued interest. The new balance would be just under $194,500, with monthly payments of $2,159. Not to mention the total cost, with interest, would be $259,000 to repay over 10 years.

Clearly, deferring student loans while in residency can have huge costs. On the other hand, a typical resident earns around $54,000 — making the payment on average medical school debt equal to about half of their take-home pay.

You might not be able to afford $1,800 a month — but it will help if you pay what you can. Try to cover at least some of your interest costs, which would be $824 on a $164,800 balance with a 6.00% rate. This will keep your balance from ballooning once you’re done with the deferment.

2. Choose an income-driven repayment plan

As mentioned above, it’s unlikely you’ll be able to afford monthly payments on your medical school debt while you’re in residency. However, an income-driven repayment (IDR) plan can help.

When it comes to federal student loans, there are a few payment plans that set payments to match your income.

Most income-driven repayment plans will result in lower monthly payments for residents with high medical school debt. Revised Pay As You Earn (REPAYE) might be the best deal.

That’s because REPAYE offers a subsidy on your student loan interest. Essentially, the federal government will cover 50 percent of all interest above the monthly payment amount throughout repayment.

For a single resident earning around $55,000, monthly payments would be set at around $300. REPAYE will cover half of the remaining $524 in monthly interest.

So, instead of adding $824 in interest on a $164,800 balance each month, you would only pay $262 — saving you $9,432 in subsidized interest.

What’s more, your post-residency balance would be just $174,232 and your total loan costs on this balance over 10-year repayment would be $232,000. That saves you about $27,000 compared to the $259,000 you’d pay if you deferred for three years.

3. Look into forgiveness programs

If you have a low income compared to your medical school debt, pursuing student loan forgiveness for doctors could make the most sense for you, according to Sycamore.

“Someone with two to three times the debt as their annual income would benefit most from Public Service Loan Forgiveness,” Sycamore explained.

Public Service Loan Forgiveness (PSLF) offers student loan forgiveness after 10 years for physicians working for public service employers. Many physicians might qualify for PSLF if they work in:

  • A public or nonprofit hospital
  • Academia
  • The public health sector
  • The military

While working in public service can be rewarding on the personal level, it does often require you to serve in low-paying positions and/or undesirable locations. The trade off is that you not only earn loan forgiveness, but have the chance to help the people who really need it.

Of course, not every doctor is going to work in public service or qualify for PSLF. In this case, if you still want to pursue student loan forgiveness, consider enrolling in an income-driven repayment plan. They not only cap payments as a percentage of your income, as mentioned above, but also award forgiveness of your remaining loan balance after 20 to 25 years of payments — if there’s anything left over.

Sycamore recommends doing the math and comparing options to see if student loan forgiveness would be worth it for you.

“When going for forgiveness, you have to make some assumptions regarding your projected income over the next 20 years, your spouse’s income, and the size of your family,” Sycamore pointed out.

“Then you have to estimate how much your balance will be at the end of 20 years because that amount will be taxable as income in the year the debt is forgiven,” added Sycamore.

4. Refinance your medical school loans

For many doctors, interest rates on their medical school debt is a major pain point.

In fact, federal student loans for graduate programs, including medical school, usually carry interest rates that are 1.50-2.50% higher than rates on undergraduate student loans.

Since medical school debt typically has both high balances and high interest rates, the opportunity to save can be big. In fact, the best student loan refinancing lenders today offer rates as low as 1.95%.

“If your debt-to-income ratio is lower, you are probably best off refinancing your federal loans to a private lender to take advantage of lower interest rates,” Sycamore said.

Let’s look at an example of a borrower who wants to refinance their student loans. This borrower wants to go from an interest rate of 6.00% to 4.00%. They also have an average medical school debt of $164,800.

By refinancing student loans, this borrower will lower his monthly payments from $1,830 to $1,669 and save $161 a month. Overall, he will save $19,332 over 10 years.

If you’re curious to see how much you could potentially save each month, check out our student loan refinancing calculator and plug in your info to find out.

Keep in mind — refinancing student loans will have its tradeoffs.

“Remember that you are giving up many consumer protections that are only available with federal loans and you can’t go back,” Sycamore said. This includes access to many student loan forgiveness options, strong deferment protections, and access to federal IDR plans.

5. Make extra student loan payments

Paying extra (or even the standard monthly payment) may be tough for you to do right out of medical school or while in residency.

But once you can afford to, making extra payments on student loans can help you pay off your medical school debt more quickly. Not only does it shorten your repayment term, it also lowers the amount of student loan interest you’ll pay. Ultimately, your debt costs you less.

For instance, maybe you can pay $1,000 extra each month on $164,800 worth of medical school debt. By paying this extra amount, you would repay this debt in 5.8 years instead of 10, and save $24,279 on interest charges.

Take some time to project your own savings of prepaying student debt with this calculator and see if this is the most beneficial strategy for you.

6. Keep living like a resident

To keep up with extra payments on medical school debt, you need to make them a top financial priority. That means keeping your living expenses and discretionary spending low.

“The most practical advice I can really give is to mentally prepare yourself to continue to live like a resident for a few years after you’ve completed your training and are earning like an attending,” Sycamore said.

In other words, make the most of your doctor’s salary as an attending by keeping your lifestyle in check. You’ve probably already been doing that as a resident, so try to keep it up for the next few years.

Ultimately, if you can spend like a resident while making three times more (or higher) as an attending physician, your expenses will be a smaller portion of your take-home pay. This will help you devote a larger portion of your income toward paying extra on your student loans.

7. Apply your physician signing bonus to medical school debt

Physician signing bonuses are common benefits offered to attract doctors.

However, they can also be great opportunities for you to pay down a substantial chunk of medical school debt. Nine in 10 physicians received signing bonuses in 2016, according to the 2017 Physician Placement Report from The Medicus Firm, with the average amount just under $25,000.

If you apply an extra lump-sum payment of $25,000 at the beginning of a 10-year repayment schedule to an average medical school debt of $164,800, that can make a big difference. It shortens your repayment period by two whole years, and saves you $17,987 in interest over the life of the loan.

Before you spend your signing bonus, use this extra payment calculator to see the impact of making your own extra lump-sum payments.

Even after receiving a signing bonus, you can continue employing this strategy by applying “extra” income such as raises, tax refunds, or bonuses to take a big chunk out of your student debt.

Take the time to tackle your medical school debt

As a recent medical school graduate, you might be anxious to get rid of your student debt. You might feel overwhelmed and unsure of the best path forward. Plus, finding the time and mental energy to tackle your student loans on top of practicing medicine can be challenging.

However, keeping your medical school debt repayment a top priority can take years off your loans. Plus, you’ll save thousands of dollars in interest. It can seem time-consuming to manage your student loan payments, but your wallet will thank you in the long run.

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1 Important Disclosures for Earnest.

Earnest Disclosures

To qualify, you must be a U.S. citizen or possess a 10-year (non-conditional) Permanent Resident Card, reside in a state Earnest lends in, and satisfy our minimum eligibility criteria. You may find more information on loan eligibility here: https://www.earnest.com/eligibility. Not all applicants will be approved for a loan, and not all applicants will qualify for the lowest rate. Approval and interest rate depend on the review of a complete application.

Earnest fixed rate loan rates range from 3.89% APR (with Auto Pay) to 7.89% APR (with Auto Pay). Variable rate loan rates range from 2.47% APR (with Auto Pay) to 6.97% APR (with Auto Pay). For variable rate loans, although the interest rate will vary after you are approved, the interest rate will never exceed 8.95% for loan terms 10 years or less. For loan terms of 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% (the maximum rates for these loans). Earnest variable interest rate loans are based on a publicly available index, the one month London Interbank Offered Rate (LIBOR). Your rate will be calculated each month by adding a margin between 1.82% and 5.50% to the one month LIBOR. The rate will not increase more than once per month. Earnest rate ranges are current as of Month/Day/Year, and are subject to change based on market conditions and borrower eligibility.

Auto Pay discount: If you make monthly principal and interest payments by an automatic, monthly deduction from a savings or checking account, your rate will be reduced by one quarter of one percent (0.25%) for so long as you continue to make automatic, electronic monthly payments. This benefit is suspended during periods of deferment and forbearance.

The information provided on this page is updated as of 08/21/18. Earnest reserves the right to change, pause, or terminate product offerings at any time without notice. Earnest loans are originated by Earnest Operations LLC. California Finance Lender License 6054788. NMLS # 1204917. Earnest Operations LLC is located at 302 2nd Street, Suite 401N, San Francisco, CA 94107. Terms and Conditions apply. Visit https://www.earnest.com/terms-of-service, email us at hello@earnest.com, or call 888-601-2801 for more information on ourstudent loan refinance product.

© 2018 Earnest LLC. All rights reserved. Earnest LLC and its subsidiaries, including Earnest Operations LLC, are not sponsored by or agencies of the United States of America.

2 Important Disclosures for Laurel Road.

Laurel Road Disclosures

APR stands for “Annual Percentage Rate.” Rates listed include a 0.25% EFT discount, for automatic payments made from a checking or savings account. Interest rates as of 11/8/2018. Rates subject to change.

Variable rate options consist of a range from 3.27% per year to 6.09% per year for a 5-year term, 4.64% per year to 6.14% per year for a 7-year term, 4.69% per year to 6.19% per year for a 10-year term, 4.94% per year to 6.44% per year for a 15-year term, or 5.19% per year to 6.69% per year for a 20-year term, with no origination fees. APR is subject to increase after consummation. The variable interest rate will change on the first day of every month (“Change Date”) if the Current Index changes. The variable interest rates are based on a Current Index, which is the 1-month London Interbank Offered Rate (LIBOR) (currency in US dollars), as published on The Wall Street Journal’s website. The variable interest rates and Annual Percentage Rate (APR) will increase or decrease when the 1-month LIBOR index changes. The variable interest rates are calculated by adding a margin ranging from 0.98% to 3.80% for the 5-year term loan, 2.35% to 3.85% for the 7-year term loan, 2.40% to 3.90% for the 10-year term loan, 2.65% to 4.15% for the 15-year term loan, and 2.90% to 4.40% for the 20-year term loan, respectively, to the 1-month LIBOR index published on the 25th day of each month immediately preceding each “Change Date,” as defined above, rounded to two decimal places, with no origination fees. If the 25th day of the month is not a business day or is a US federal holiday, the reference date will be the most recent date preceding the 25th day of the month that is a business day. The monthly payment for a sample $10,000 loan at a range of 3.27% per year to 6.09% per year for a 5-year term would be from $180.89 to $193.75. The monthly payment for a sample $10,000 loan at a range of 4.64% per year to 6.14% per year for a 7-year term would be from $139.65 to $146.76. The monthly payment for a sample $10,000 loan at a range of 4.69% per year to 6.19% per year for a 10-year term would be from $104.56 to $111.98. The monthly payment for a sample $10,000 loan at a range of 4.94% per year to 6.44% per year for a 15-year term would be from $78.77 to $86.78. The monthly payment for a sample $10,000 loan at a range of 5.19% per year to 6.69% per year for a 20-year term would be from $67.05 to $75.68.

However, if the borrower chooses to make monthly payments automatically by electronic funds transfer (EFT) from a bank account, the variable rate will decrease by 0.25%, and will increase back up to the regular variable interest rate described in the preceding paragraph if the borrower stops making (or we stop accepting) monthly payments automatically by EFT from the designated borrower’s bank account.

3 Important Disclosures for SoFi.

SoFi Disclosures

  1. Student loan Refinance:
    Fixed rates from 3.899% APR to 7.979% APR (with AutoPay). Variable rates from 2.470% APR to 6.990% APR (with AutoPay). Interest rates on variable rate loans are capped at either 8.95% or 9.95% depending on term of loan. See APR examples and terms. Lowest variable rate of 2.470% APR assumes current 1 month LIBOR rate of 2.30% plus 0.91% margin minus 0.25% ACH discount. Not all borrowers receive the lowest rate. If approved for a loan, the fixed or variable interest rate offered will depend on your creditworthiness, and the term of the loan and other factors, and will be within the ranges of rates listed above. For the SoFi variable rate loan, the 1-month LIBOR index will adjust monthly and the loan payment will be re-amortized and may change monthly. APRs for variable rate loans may increase after origination if the LIBOR 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. The benefit will discontinue and be lost for periods in which you do not pay by automatic deduction from a savings or checking account. *To check the rates and terms you qualify for, SoFi conducts a soft credit inquiry. Unlike hard credit inquiries, soft credit inquiries (or soft credit pulls) do not impact your credit score. Soft credit inquiries allow SoFi to show you what rates and terms SoFi can offer you up front. After seeing your rates, if you choose a product and continue your application, we will request your full credit report from one or more consumer reporting agencies, which is considered a hard credit inquiry. Hard credit inquiries (or hard credit pulls) are required for SoFi to be able to issue you a loan. In addition to requiring your explicit permission, these credit pulls may impact your credit score.
  2. Terms and Conditions Apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. To qualify, a borrower must be a U.S. citizen or permanent resident in an eligible state and meet SoFi’s underwriting requirements. Not all borrowers receive the lowest rate. To qualify for the lowest rate, you must have a responsible financial history and meet other conditions. If approved, your actual rate will be within the range of rates listed above and will depend on a variety of factors, including term of loan, a responsible financial history, years of experience, income and other factors. Rates and Terms are subject to change at anytime without notice and are subject to state restrictions. SoFi refinance loans are private loans and do not have the same repayment options that the federal loan program offers such as Income Based Repayment or Income Contingent Repayment or PAYE. Licensed by the Department of Business Oversight under the California Financing Law License No. 6054612. SoFi loans are originated by SoFi Lending Corp., NMLS # 1121636. (www.nmlsconsumeraccess.org)

4 Important Disclosures for LendKey.

LendKey Disclosures

Refinancing via LendKey.com is only available for applicants with qualified private education loans from an eligible institution. Loans that were used for exam preparation classes, including, but not limited to, loans for LSAT, MCAT, GMAT, and GRE preparation, are not eligible for refinancing with a lender via LendKey.com. If you currently have any of these exam preparation loans, you should not include them in an application to refinance your student loans on this website. Applicants must be either U.S. citizens or Permanent Residents in an eligible state to qualify for a loan. Certain membership requirements (including the opening of a share account and any applicable association fees in connection with membership) may apply in the event that an applicant wishes to accept a loan offer from a credit union lender. Lenders participating on LendKey.com reserve the right to modify or discontinue the products, terms, and benefits offered on this website at any time without notice. LendKey Technologies, Inc. is not affiliated with, nor does it endorse, any educational institution.

5 Important Disclosures for CommonBond.

CommonBond Disclosures

Offered terms are subject to change. Loans are offered by CommonBond Lending, LLC (NMLS # 1175900). If you are approved for a loan, the interest rate offered will depend on your credit profile, your application, the loan term selected and will be within the ranges of rates shown.

All Annual Percentage Rates (APRs) displayed assume borrowers enroll in auto pay and account for the 0.25% reduction in interest rate. All variable rates are based on a 1-month LIBOR assumption of 2.28% effective October 10, 2018.

6 Important Disclosures for Citizens Bank.

Citizens Bank Disclosures

  1. Education Refinance Loan Rate Disclosure: Variable rate, based on the one-month London Interbank Offered Rate (“LIBOR”) published in The Wall Street Journal on the twenty-fifth day, or the next business day, of the preceding calendar month. As of November 1, 2018, the one-month LIBOR rate is 2.29%. Variable interest rates range from 2.79%-8.39% (2.79%-8.39% APR) and will fluctuate over the term of the borrower’s loan with changes in the LIBOR rate, and will vary based on applicable terms, level of degree earned and presence of a cosigner. Fixed interest rates range from 3.75%-8.69% (3.75%-8.69% APR) based on applicable terms, level of degree earned and presence of a cosigner. Lowest rates shown require application with a cosigner, are for eligible, creditworthy applicants with a graduate level degree, require a 5-year repayment term and include our Loyalty discount and Automatic Payment discounts of 0.25 percentage points each, as outlined in the Loyalty and Automatic Payment Discount disclosures. The maximum variable rate on the Education Refinance Loan is the greater of 21.00% or Prime Rate plus 9.00%. Subject to additional terms and conditions, and rates are subject to change at any time without notice. Such changes will only apply to applications taken after the effective date of change. Please note: Due to federal regulations, Citizens Bank is required to provide every potential borrower with disclosure information before they apply for a private student loan. The borrower will be presented with an Application Disclosure and an Approval Disclosure within the application process before they accept the terms and conditions of their loan.
  2. Federal Loan vs. Private Loan Benefits: Some federal student loans include unique benefits that the borrower may not receive with a private student loan, some of which we do not offer with the Education Refinance Loan. Borrowers should carefully review their current benefits, especially if they work in public service, are in the military, are currently on or considering income based repayment options or are concerned about a steady source of future income and would want to lower their payments at some time in the future. When the borrower refinances, they waive any current and potential future benefits of their federal loans and replace those with the benefits of the Education Refinance Loan. For more information about federal student loan benefits and federal loan consolidation, visit http://studentaid.ed.gov/. We also have several resources available to help the borrower make a decision at http://www.citizensbank.com/EdRefinance, including Should I Refinance My Student Loans? and our FAQs. Should I Refinance My Student Loans? includes a comparison of federal and private student loan benefits that we encourage the borrower to review.
  3. Citizens Bank Education Refinance Loan Eligibility: Eligible applicants may not be currently enrolled. Applicants with an Associate’s degree or with no degree must have made at least 12 qualifying payments after leaving school. Qualifying payments are the most recent on time and consecutive payments of principal and interest on the loans being refinanced. Primary borrowers must be a U.S. citizen, permanent resident or resident alien with a valid U.S. Social Security Number residing in the United States. Resident aliens must apply with a cosigner who is a U.S. citizen or permanent resident. The cosigner (if applicable) must be a U.S. citizen or permanent resident with a valid U.S. Social Security Number residing in the United States. For applicants who have not attained the age of majority in their state of residence, a cosigner will be required. Citizens Bank reserves the right to modify eligibility criteria at anytime. Interest rate ranges subject to change. Education Refinance Loans are subject to credit qualification, completion of a loan application/consumer credit agreement, verification of application information, certification of borrower’s student loan amount(s) and highest degree earned.
  4. Loyalty Discount Disclosure: The borrower will be eligible for a 0.25 percentage point interest rate reduction on their loan if the borrower or their co-signer (if applicable) has a qualifying account in existence with us at the time the borrower and their co-signer (if applicable) have submitted a completed application authorizing us to review their credit request for the loan. The following are qualifying accounts: any checking account, savings account, money market account, certificate of deposit, automobile loan, home equity loan, home equity line of credit, mortgage, credit card account, or other student loans owned by Citizens Bank, N.A. Please note, our checking and savings account options are only available in the following states: CT, DE, MA, MI, NH, NJ, NY, OH, PA, RI, and VT and some products may have an associated cost. This discount will be reflected in the interest rate disclosed in the Loan Approval Disclosure that will be provided to the borrower once the loan is approved. Limit of one Loyalty Discount per loan and discount will not be applied to prior loans. The Loyalty Discount will remain in effect for the life of the loan.
  5. Automatic Payment Discount Disclosure: Borrowers will be eligible to receive a 0.25 percentage point interest rate reduction on their student loans owned by Citizens Bank, N.A. during such time as payments are required to be made and our loan servicer is authorized to automatically deduct payments each month from any bank account the borrower designates. Discount is not available when payments are not due, such as during forbearance. If our loan servicer is unable to successfully withdraw the automatic deductions from the designated account three or more times within any 12-month period, the borrower will no longer be eligible for this discount.
  6. Co-signer Release: Borrowers may apply for co-signer release after making 36 consecutive on-time payments of principal and interest. For the purpose of the application for co-signer release, on-time payments are defined as payments received within 15 days of the due date. Interest only payments do not qualify. The borrower must meet certain credit and eligibility guidelines when applying for the co-signer release. Borrowers must complete an application for release and provide income verification documents as part of the review. Borrowers who use deferment or forbearance will need to make 36 consecutive on-time payments after reentering repayment to qualify for release. The borrower applying for co-signer release must be a U.S. citizen or permanent resident. If an application for co-signer release is denied, the borrower may not reapply for co-signer release until at least one year from the date the application for co-signer release was received. Terms and conditions apply.

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