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  • Medical Student Loan Repayment

Medical Student Loan Repayment

When it's time to manage your medical school debt, there are several options to explore, including repayment, forgiveness, and refinancing. Learn how to create an effective strategy to tackle medical student loan repayment.

Published August 27, 2024 10 min read
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Table of Contents

  • Steps to prepare for residency
  • Medical student loan forgiveness programs
  • Compare medical school repayment options
  • Medical student loan refinancing

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 Association of American Medical Colleges (AAMC), 70% of the graduating class of 2023 reported leaving medical school with student loan debt. Across the country, the median level of medical school debt for each member of the class of 2023 was $200,000.

With graduation in May, a move in June, and residencies beginning in June/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 $67,400 according to a Medscape survey.
    • Remember that location matters to 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 the Laurel Road High Yield 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. Qualifying public service employment includes work in 501(c)(3) nonprofits, government agencies, and/or some other not-for-profit organizations, such as qualifying medical schools and teaching hospitals, employment with AmeriCorps or Peace Corps, military service, public health, and public safety. Learn more about the PSLF Program 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.

Student Loan Forgiveness Counseling

Need help navigating your Income-Driven Repayment or federal repayment options? Schedule a free consultation from a student loan expert who can help you evaluate your repayment, forgiveness and refinancing options.

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 that allows you to search by location and profession.

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:

Pros Cons
Simplified repayment – consolidation facilitates the consolidation of multiple loans into a singular more manageable monthly payment No lower interest rate – Unlike refinancing, consolidation does not result in a reduction of your interest rate. Its primary advantage lies in simplifying your payment structure.
Access to federal student loan benefits – federal student loan consolidation could potentially make you eligible for Income-Driven Repayment (IDR) plans which offer repayment flexibility based on your income and eventual forgiveness. Loss of benefits – be mindful of potential loss of any borrower benefits from the original loan such as interest rate discounts or principal rebates.

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 in your income. Learn more about Income-Driven Repayment.

IDR Comparison Chart

Applications for IDR plans and loan consolidation are available on http://studentaid.gov. You can also submit a PDF application to your loan servicer by uploading it to your servicer’s website or mailing it to them. Expect a delay in processing times.
Plan Monthly Payments Repayment Period Status
Income-Based Repayment (IBR)
  • 10-15% of your discretionary income (and your spouse’s if filing jointly)
  • Never more than federal 10-year Standard Repayment Plan amount
20-25 years, depending on when you become a new borrower Accepting new enrollments.
Income-Contingent Repayment (ICR)

The lesser of the following:

  • 20% of your discretionary income or
  • What you would pay on a repayment plan with a fixed payment over the course of 12 years, adjusted according to your income
25 years Accepting new enrollments.
Pay as You Earn (PAYE)
  • 10% of your discretionary income (and your spouse’s if filing jointly)
  • Never more than federal 10-year Standard Repayment Plan amount
20 years Accepting new enrollments.

IDR Plans: Challenges to SAVE

Multiple legal challenges made by states to the Saving on A Valuable Education (SAVE) plan could impact implementation of key aspects of the plan. For the most up-to-date developments, visit studentaid.gov.

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 rate1 or shorter term
  • 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

Interest Rates, Fees & Terms

Loan Application Process

Refinancing Options & Offers

  • How is the interest rate calculated?
  • Is it a fixed or variable rate loan?
  • What are the terms of the loan?
  • What is the monthly payment?
  • Is there an online application?
  • Can rate options be checked instantly?
  • Is a co-signer required?
  • If a co-signer is needed, can the co-signer eventually be removed from the loan and what is the process?
  • When does repayment start?
  • Are deferment and forbearance options offered after graduation and during residency?
  • Are incentives offered for on-time or electronic payments?
  • Are there any pre-payment penalties?

To learn more about what Laurel Road offers, check out our FAQs

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 with a company like Laurel Road, which offers special repayment options specifically tailored to residents.

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

Alternatively, Student Loan Refinancing offers an opportunity for residents to pay lower monthly payments during training without having to enter into a longer term, potentially saving money on interest. During training, residents only pay $100 a month,2 and accrued interest does not compound while in training. Afterwards, they begin paying full monthly payments for a similar term as their original loans, which are manageable given the higher earning potential and may allow you to pay off your student loans in a shorter time period than an IDR plan.

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

Laurel Road understands the unique stresses of medical student, residents and professionals, especially when it comes to managing medical school debt. That’s why we offer student loan forgiveness counseling and refinancing for residents with special terms tailored to the unique needs of medical residents and professionals. To explore you options, schedule a free consultation with a student loan specialist.

Sources:

  1. Medscape 2023 Residents Salary Debt Report
  2. AMA Medical Student Financial FAQ: https://www.ama-assn.org/medical-students/medical-school-life/medical-student-financial-faq-insight-loan-forgiveness

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    IMPORTANT INFORMATION: Please note that if you refinance qualifying federal student loans with Laurel Road, you may no longer be eligible for certain federal benefits or programs and waive your right to future benefits or programs offered on those loans. Examples of benefits or programs you may not receive include, but are not limited to, Public Service Loan Forgiveness, Income-Driven Repayment plans, forbearance, or loan forgiveness. Please carefully consider your options when refinancing federal student loans and consult Federal Student Aid for the most current information.

    1. Savings vary based on rate and term of your existing and refinanced loan(s). Refinancing to a longer term may lower your monthly payments, but may also increase the total interest paid over the life of the loan. Refinancing to a shorter term may increase your monthly payments, but may lower the total interest paid over the life of the loan. Review your loan documentation for total cost of your refinanced loan.

    2. Estimated Student Loan Refinance Post-residency Payment Examples
      Borrowers employed full time as an intern, resident, fellow, or similar postgraduate trainee at the time of loan disbursement are eligible to make $100 monthly payments throughout their training (“Residency Period”). These payments may not be enough to cover all of the interest that accrues on the loan. Unpaid accrued interest will be added to the loan principal and monthly payments of principal and interest will begin when the Residency Period ends. Assumptions: Repayment examples shown below are based on an original loan amount of $100,000 and assume that you make $100 monthly payments during the Residency Period of 36 months before the full repayment term begins. Repayment examples do not include any discounts.
      Fixed Rate Loans
      Term Interest Rate APR Monthly Payment Total Payments
      5 years 3.93% - 5.53% 36 months of $100 60 months of $1,998 - $2,181 $123,506 - $134,441
      7 years 4.35% - 5.85% 4.26% - 5.68% 36 months of $100 84 months of $1,514 - $1,656 $130,755 - $142,743
      10 years 4.59% - 6.03% 4.51% - 5.88% 36 months of $100 120 months of $1,147 - $1,273 $141,188 - $156,336
      15 years 4.81% - 6.33% 4.74% - 6.19% 36 months of $100 180 months of $866 - $994 $159,391 - $182,595
      20 years 4.91% - 6.63% 4.84% - 6.50% 36 months of $100 240 months of $728 - $876 $178,294 - $213,828
      Variable Rate Loans
      Term Interest Rate APR Monthly Payment Total Payments
      5 Year 3.98% - 5.62% 3.90% - 5.44% 36 months of $100 60 months of $1,994 - $2,170 $123,256 - $133,780
      7 Year 4.25% - 5.75% 4.17% - 5.58% 36 months of $100 84 months of $1,505 - $1,647 $129,982 - $141,921
      10 Year 4.40% - 5.93% 4.32% - 5.78% 36 months of $100 120 months of $1,131 - $1,264 $139,272 - $155,248
      15 Year 4.65% - 6.23% 4.58% - 6.10% 36 months of $100 180 months of $853 - $986 $157,078 - $181,001
      20 Year 4.90% - 6.53% 4.83% - 6.40% 36 months of $100 240 months of $727 - $867 $178,100 - $211,642

      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.

      Interest Rate: A simple annual rate that is applied to an unpaid balance.

      Variable Rates: The current index for variable rate loans is derived from the 30-day Average Secured Overnight Financing Rate (“SOFR”) and changes in the SOFR index may cause your monthly payment to increase. Although the rate will vary after you are approved, it will never exceed 15.00%. There is no limit on the amount your interest rate can increase at one time. The Index is currently published by the Federal Reserve Bank of New York (“New York Fed”). If the Index is no longer available, it will be replaced by a replacement Index according to the terms of the promissory note.

    In providing this information, neither Laurel Road or KeyBank nor its affiliates are acting as your agent or is offering any tax, financial, accounting, or legal advice. Any third-party linked content is provided for informational purposes and should not be viewed as an endorsement by Laurel Road or KeyBank of any third-party product or service mentioned. Laurel Road’s Online Privacy Statement does not apply to third-party linked websites and you should consult the privacy disclosures of each site you visit for further information.