7 Best Strategies for Paying Off Medical School Debt

medical school debt

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 2.60-3.00%.

“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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