10 Best Small Cities for Nurses With Big Student Loan Debt

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Although nurses shell out less money than doctors to pay for their medical schooling, they’re often just as stressed out about how to pay for it.

About 7 in 10 nurses take out student loans to pay for their graduate program, according to a 2017 report from the American Association of Colleges of Nursing. What’s more, 50% stated their biggest concern after graduation was figuring out how to repay their loans.

But relocating can often help struggling borrowers get a handle on student loan payments, especially if they can combine low costs of living with a healthy salary and job demand.

So if you’re a nurse looking to jump-start your debt payoff journey, check out the following best small cities to live in and work in when paying off student loans.

10 best small cities for nurses paying off student loans


To help nurses figure out whether relocating to a smaller city might be worth it, we first wanted to be able to answer the following questions:

  • What annual salary can a nurse expect to earn?
  • How much demand is there for nurses?
  • How far will a nurse’s salary go when paying for goods and services?

We relied on three data points from the Bureau of Labor Statistics (BLS) to help formulate our answers to the three questions.

  • Average annual wage: The median pay for registered nurses nationally in 2017 was $70,000, according to the BLS.
  • Location quotient: The location quotient compares the employment of nurses in a city to the average for the nation. If a city reports a location quotient greater than 1.0, which is the national average, nurses are more likely to be in demand in that city. Cities with marks below 1.0 are less likely to offer as many employment options.
  • Regional price parity: Price parity refers to varying costs of goods and services in cities, which in turn affects the purchasing power of your wages (or how much you can actually buy with your paycheck). If a city’s regional price parity is less than 100, which is the average, goods and services are less expensive in that city (so a large paycheck will go further). If a city reports a mark greater than 100, goods and services are more expensive there.

Here are the top 10 small cities that received the highest marks in these areas:

1. Bay City, Michigan

The first of two Michigan cities atop our rankings, Bay City comes with the benefit of a lower cost of living. In fact, thanks to the city’s regional price parity, the purchasing power of the average annual wage for a nurse jumps to $78,020, according to the BLS.

  • Average annual wage: $69,360
  • Location quotient: 1.42
  • Regional price parity: 88.9

2. Saginaw, Michigan

Like their neighbors in Bay City, Saginaw nurses can take advantage of the Michigan State Loan Repayment Program. It provides a maximum of $200,000 over eight years to help nurse practitioners repay their loans.

  • Average annual wage: $66,030
  • Location quotient: 1.58
  • Regional price parity: 89.4

3. Greenville, North Carolina

Despite being the most populous small city on our list, Greenville reported a relatively high demand for registered nurses. In fact, it recorded the highest location quotient of any city in our top 10.

  • Average annual wage: $63,130
  • Location quotient: 2.02
  • Regional price parity: 88.4

4. Johnstown, Pennsylvania

Johnstown nurses can look into receiving help repaying their debt via the Pennsylvania Primary Care Loan Repayment Program. It awards up to $60,000 to full-time nurse practitioners in exchange for two years working in an underserved area. Contact the program to stay abreast of application periods.

  • Average annual wage: $62,120
  • Location quotient: 1.69
  • Regional price parity: 87.2

5. Cumberland, Maryland

Aside from being paid well, nurses in Cumberland can take advantage of the Janet L. Hoffman Loan Assistance Repayment Program. In exchange for treating low-income and underserved residents, nurses can receive up to $30,000 in aid over three years if they have debt totaling $75,001 or more.

  • Average annual wage: $65,010
  • Location quotient: 1.36
  • Regional price parity: 88.2

6. Florence, South Carolina

Combine a relatively high demand for nurses with a low cost of living and, boom, you have a city that’s conducive to paying off your student loans.

The cost of goods and services in Florence is so low, in fact, that the average salary of $60,470 has a purchasing power of $70,725, according to the BLS.

  • Average annual wage: $60,470
  • Location quotient: 1.85
  • Regional price parity: 85.5

7. Duluth, Minnesota

Duluth cracked our top 10 because it reported strong marks in each of the three data categories under consideration.

Here’s a fourth reason for its rise up the rankings: the Minnesota Health Care Loan Forgiveness program. It offers repayment assistance of up to $20,000 over four years to nurses who work at least two years in a nursing home.

  • Average annual wage: $66,780
  • Location quotient: 1.38
  • Regional price parity: 91.7

8. Hanford, California

The lone West Coast city among our top 10, Hanford made up for its relatively higher cost of living with an equally impressive salary. In fact, of the 334 small, midsized, and large cities we reviewed, Hanford reported the 13th-highest annual average wage.

Plus, Hanford (and other California) residents can look for assistance via the state’s Bachelor of Science Nursing Loan Repayment Program. Recipients may receive up to $10,000 after agreeing to a one-year obligation practicing direct patient care at a qualifying facility in California.

  • Average annual wage: $91,340
  • Location quotient: 1.56
  • Regional price parity: 95.5

9. Alexandria, Louisiana

You might scoff at Alexandria’s relatively low salary, but the BLS gave this small city in Louisiana a purchasing power of $67,355, thanks to its lower cost of living.

Residents can access the Louisiana State Loan Repayment Program if they work in rural or inner-city communities or for a nonprofit. It awards a maximum of $45,000 over three years.

  • Average annual wage: $59,070
  • Location quotient: 1.89
  • Regional price parity: 87.7

10. Eau Claire, Wisconsin

Although not as mighty as Milwaukee or Madison, Eau Claire represented Wisconsin well by rounding out our top 10. The smaller city reported high marks across the board and also boasts the state’s Health Professions Loan Assistance Program, which offers up to $100,000 in repayment aid.

  • Average annual wage: $66,500
  • Location quotient: 1.42
  • Regional price parity: 92.3

Should you move to a smaller city?


Chances are you don’t already live or work in one of the top 10 best small cities for nurses paying off student loans, but it’s worth considering the benefits of such a move. After all, your location affects the amount of disposable income you can put toward student loan repayment.

Sure, your salary, job prospects, and cost of living vary from city to city. But you’ll also want to compare differences between states. There are many state-based loan forgiveness programs for nurses, for example.

Similarly, you might target smaller cities within states that have no income tax. That way, you can take home more of your paycheck.

Say you moved to Sherman, Texas, which ranked 15th among our top small cities for nurses. You might see a pay increase, more job demand, and a lower cost of living — but you’d also appreciate Texas being one of nine states without an income tax.

Like refinancing or consolidating your loans, moving to a smaller city is a potential repayment tool. It could be the right choice if it helps you pay down debt faster. And, hey, you could always return to the big city once you’re debt-free.

Top 25 small cities for nurses


In case your city fell outside the top 10 but still ranked highly, consider our top 25:

Rank City Annual mean wage Location quotient Regional price parity
1 Bay City, Mich. $69,360 1.42 88.9
2 Saginaw, Mich. $66,030 1.58 89.4
3 Greenville, N.C. $63,130 2.02 88.4
4 Johnstown, Pa. $62,120 1.69 87.2
5 Cumberland, Md. $65,010 1.36 88.2
6 Florence, S.C. $60,470 1.85 85.5
7 Duluth, Minn. $66,780 1.38 91.7
8 Hanford, Calif. $91,340 1.56 95.5
9 Alexandria, La. $59,070 1.89 87.7
10 Eau Claire, Wis. $66,500 1.42 92.3
11 Rome, Ga. $56,250 2.35 82.2
12 St. Cloud, Minn. $79,700 1.17 93
13 Asheville, N.C. $62,030 1.62 92
14 Battle Creek, Mich. $63,460 1.24 90.5
15 Sherman, Texas $60,130 1.74 91.5
16 Redding, Calif. $89,960 1.55 98.6
17 Flint, Mich. $64,920 1.57 93.8
18 Kalamazoo, Mich. $64,200 1.36 92.7
19 Huntington, W.Va. $55,140 2.01 86.7
20 Wenatchee, Wash. $74,290 1.36 96.3
21 Lewiston, Idaho $60,960 1.38 91.7
22 Dothan, Ala. $54,410 1.8 85
23 Cape Girardeau, Mo. $51,990 2.32 82.8
24 Albany, Ga. $60,910 1.09 85.1
25 Danville, Ill. $62,050 1.03 79.4

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Interested in refinancing student loans?

Here are the top 8 lenders of 2019!
LenderVariable APREligible Degrees 
Check out the testimonials and our in-depth reviews!
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 3.20% APR (with Auto Pay) to 6.99% APR (with Auto Pay). Variable rate loan rates range from 1.99% APR (with Auto Pay) to 6.89% 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 December 13, 2019, 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 12/13/2019. 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 our student 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 SoFi.

SoFi Disclosures

  1. Student loan Refinance: Fixed rates from 3.46% APR (with AutoPay) to 7.61% APR (without AutoPay). Variable rates currently from 2.31% APR (with AutoPay) to 7.61% (without 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 2.31% APR assumes current 1 month LIBOR rate of 2.31% plus 0.75% margin minus 0.25% for AutoPay. If approved for a loan, the fixed or variable interest rate offered will depend on your credit history and the term of the loan 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.

3 Important Disclosures for Figure.

Figure Disclosures

Figure’s Student Refinance Loan is a private loan. If you refinance federal loans, you forfeit certain flexible repayment options associated with those loans. If you expect to incur financial hardship that would impact your ability to repay, you should consider federal consolidation alternatives.


4 Important Disclosures for Laurel Road.

Laurel Road Disclosures

Laurel Road is a brand of KeyBank National Association offering online lending products in all 50 U.S. states, Washington, D.C., and Puerto Rico. Mortgage lending is not offered in Puerto Rico. All loans are provided by KeyBank National Association.
As used throughout these Terms & Conditions, the term “Lender” refers to KeyBank National Association and its affiliates, agents, guaranty insurers, investors, assigns, and successors in interest.

ANNUAL PERCENTAGE RATE (“APR”)
This term represents the actual cost of financing to the borrower over the life of the loan expressed as a yearly rate.

FEE INFORMATION

There are no origination fees or prepayment penalties associated with the loan. Lender may assess a late fee if any part of a payment is not received within 15 days of the payment due date. Any late fee assessed shall not exceed 5% of the late payment or $28, whichever is less. A borrower may be charged $20 for any payment (including a check or an electronic payment) that is returned unpaid due to non-sufficient funds (NSF) or a closed account.

LOAN AMOUNT

For bachelor’s degrees and higher, up to 100% of outstanding private and federal student loans (minimum $5,000) are eligible for refinancing. If you are refinancing greater than $300,000 in student loan debt, Lender may refinance the loans into 2 or more new loans.
For eligible Associates degrees in the healthcare field (see Eligibility & Eligible Loans section below), Lender will refinance up to $50,000 in loans for non-ParentPlus refinance loans. Note, parents who are refinancing loans taken out on behalf of a child who has obtained an associates degrees in an eligible healthcare field are not subject to the $50,000 loan maximum, refer to https://www.laurelroad.com/refinance-student-loans/refinance-parent-plus-loans/ for more information about refinancing ParentPlus loans.

ELIGIBILITY & ELIGIBLE LOANS

Borrower, and Co-signer if applicable, must be a U.S. Citizen or Permanent Resident with a valid I-551 card (which must show a minimum of 10 years between “Resident Since” date and “Card Expires” date or has no expiration date); state that they are of at least borrowing age in the state of residence at the time of application; and meet Lender underwriting criteria (including, for example, employment, debt-to-income, disposable income, and credit history requirements).

Graduates may refinance any unsubsidized or subsidized Federal or private student loan that was used exclusively for qualified higher education expenses (as defined in 26 USC Section 221) at an accredited U.S. undergraduate or graduate school. Any federal loans refinanced with Lender are private loans and do not have the same repayment options that federal loan program offers such as Income Based Repayment or Income Contingent Repayment.

All loans must be in grace or repayment status and cannot be in default. Borrower must have graduated or be enrolled in good standing in the final term preceding graduation from an accredited Title IV U.S. school and must be employed, or have an eligible offer of employment. Parents looking to refinance loans taken out on behalf of a child should refer to https://www.laurelroad.com/refinance-student-loans/refinance-parent-plus-loans/ for applicable terms and conditions.

For Associates Degrees: Only associates degrees earned in one of the following are eligible for refinancing: Cardiovascular Technologist (CVT); Dental Hygiene; Diagnostic Medical Sonography; EMT/Paramedics; Nuclear Technician; Nursing; Occupational Therapy Assistant; Pharmacy Technician; Physical Therapy Assistant; Radiation Therapy; Radiologic/MRI Technologist; Respiratory Therapy; or Surgical Technologist. To refinance an Associates degree, a borrower must also either be currently enrolled and in the final term of an associate degree program at a Title IV eligible school with an offer of employment in the same field in which they will receive an eligible associate degree OR have graduated from a school that is Title IV eligible with an eligible associate and have been employed, for a minimum of 12 months, in the same field of study of the associate degree earned.

INTEREST RATES

The interest rate you are offered will depend on your credit profile, income, and total debt payments as well as your choice of fixed or variable and choice of term. For applicants who are currently medical or dental residents, your rate offer may also vary depending on whether you have secured employment for after residency.

DISBURSEMENT OPTIONS

The repayment of any refinanced student loan will commence (1) immediately after disbursement by us, or (2) after any grace or in-school deferment period, existing prior to refinancing and/or consolidation with us, has expired.

POSTPONING OR REDUCING PAYMENTS

After loan disbursement, if a borrower documents a qualifying economic hardship, we may agree in our discretion to allow for full or partial forbearance of payments for one or more 3-month time periods (not to exceed 12 months in the aggregate during the term of your loan), provided that we receive acceptable documentation (including updating documentation) of the nature and expected duration of the borrower’s economic hardship.

We may agree under certain circumstances to allow a borrower to make $100/month payments for a period of time immediately after loan disbursement if the borrower is employed full-time as an intern, resident, or similar postgraduate trainee at the time of loan disbursement. These payments may not be enough to cover all of the interest that accrues on the loan. Unpaid accrued interest will be added to your loan and monthly payments of principal and interest will begin when the post-graduate training program ends.

We may agree under certain circumstances to allow postponement (deferral) of monthly payments of principal and interest for a period of time immediately following loan disbursement (not to exceed 6 months after the borrower’s graduation with an eligible degree), if the borrower is an eligible student in the borrower’s final term at the time of loan disbursement or graduated less than 6 months before loan disbursement, and has accepted an offer of (or has already begun) full-time employment.

If Lender agrees (in its sole discretion) to postpone or reduce any monthly payment(s) for a period of time, interest on the loan will continue to accrue for each day principal is owed. Although the borrower might not be required to make payments during such a period, the borrower may continue to make payments during such a period. Making payments, or paying some of the interest, will reduce the total amount that will be required to be paid over the life of the loan. Interest not paid during any period when Lender has agreed to postpone or reduce any monthly payment will be added to the principal balance through capitalization (compounding) at the end of such a period, one month before the borrower is required to resume making regular monthly payments.

KEYBANK NATIONAL ASSOCIATION RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE.

This information is current as of November 8, 2019 and is subject to change.


5 Important Disclosures for Splash Financial.

Splash Financial Disclosures

Terms and Conditions apply. Splash reserves the right to modify or discontinue products and benefits at any time without notice. Rates and terms are also subject to change at any time without notice. Offers are subject to credit approval. To qualify, a borrower must be a U.S. citizen or permanent resident in an eligible state and meet applicable underwriting requirements. Not all borrowers receive the lowest rate. Lowest rates are reserved for the highest qualified borrowers.


6 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 1.76% effective November 10, 2019.


7 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.

Subject to floor rate and may require the automatic payments be made from a checking or savings account with the lender. The rate reduction will be removed and the rate will be increased by 0.25% upon any cancellation or failed collection attempt of the automatic payment and will be suspended during any period of deferment or forbearance. As a result, during the forbearance or suspension period, and/or if the automatic payment is canceled, any increase will take the form of higher payments. The lowest advertised variable APR is only available for loan terms of  5 years and is reserved for applicants with FICO scores of at least 810.

As of 12/07/2019 student loan refinancing rates range from 1.90% to 8.59% Variable APR with AutoPay and 3.49% to 7.75% Fixed APR with AutoPay.


8 Important Disclosures for College Ave.

College Ave Disclosures

College Ave Student Loans products are made available through either Firstrust Bank, member FDIC or M.Y. Safra Bank, FSB, member FDIC. All loans are subject to individual approval and adherence to underwriting guidelines. Program restrictions, other terms, and conditions apply.

1College Ave Refi Education loans are not currently available to residents of Maine.

2All rates shown include autopay discount. The 0.25% auto-pay interest rate reduction applies as long as a valid bank account is designated for required monthly payments. Variable rates may increase after consummation.

3$5,000 is the minimum requirement to refinance. The maximum loan amount is $300,000 for those with medical, dental, pharmacy or veterinary doctorate degrees, and $150,000 for all other undergraduate or graduate degrees.

4This informational repayment example uses typical loan terms for a refi borrower with a Full Principal & Interest Repayment and a 10-year repayment term, has a $40,000 loan and a 5.5% Annual Percentage Rate (“APR”): 120 monthly payments of $434.11 while in the repayment period, for a total amount of payments of $52,092.61. Loans will never have a full principal and interest monthly payment of less than $50. Your actual rates and repayment terms may vary.

Information advertised valid as of 12/1/2019. Variable interest rates may increase after consummation.

1.99% – 6.89%1Undergrad
& Graduate

Visit Earnest

2.31% – 7.36%2Undergrad
& Graduate

Visit SoFi

1.99% – 6.75%3Undergrad
& Graduate

Visit Figure

1.99% – 6.65%4Undergrad
& Graduate

Visit Laurel Road

2.43% – 7.60%5Undergrad
& Graduate

Visit Splash

1.85% – 6.13%6Undergrad
& Graduate

Visit CommonBond

1.90% – 8.59%7Undergrad
& Graduate

Visit Lendkey

2.74% – 6.25%8Undergrad
& Graduate

Visit College Ave

Our team at Student Loan Hero works hard to find and recommend products and services that we believe are of high quality. We sometimes earn a sales commission or advertising fee when recommending various products and services to you. Similar to when you are being sold any product or service, be sure to read the fine print to help you understand what you are buying. Be sure to consult with a licensed professional if you have any concerns. Student Loan Hero is not a lender or investment advisor. We are not involved in the loan approval or investment process, nor do we make credit or investment related decisions. The rates and terms listed on our website are estimates and are subject to change at any time.