
Many doctors face the challenge of paying off large student loans, with some carrying debt amounting to $300,000 or more. While this can be a daunting task, there are several strategies that can help physicians effectively manage and repay their student loans. These include loan forgiveness programs, refinancing options, income-driven repayment plans, and adopting a frugal lifestyle to accelerate debt repayment. Additionally, working locum tenens or per diem shifts can boost income and expedite loan repayment. This guide will explore various approaches to tackle substantial student loan debt for doctors and provide insights into making informed financial decisions.
| Characteristics | Values |
|---|---|
| Average student loan debt for doctors | $200,000 |
| Average signing bonus for doctors | $24,802 |
| Average loan repayment offered by larger health systems | $100,000 |
| Average loan repayment offered by medium-sized health systems | $98,665 |
| Average hourly rate for physicians working locum tenens | $32.45 more than permanent-only doctors |
| Public Service Loan Forgiveness (PSLF) loan forgiveness period | 10 years |
| Number of income-driven repayment plans | 4 |
| Number of states with medical student loan forgiveness programs | 10 |
| Maximum loan repayment amount offered by VA's SELRP program | $160,000 |
| Maximum annual loan repayment benefit offered by VA's SELRP program | $40,000 |
| Number of income-driven repayment plans accepting applications | 3 |
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What You'll Learn

Live below your means
Living below your means is a common strategy for doctors to pay down large student loans. This involves making sacrifices and living frugally to stretch your dollar further. For example, one doctor shared that they worked labour jobs during any break to earn extra cash and were comfortable with their friends knowing them as "cheap".
The idea is to live like a resident for 2-5 years after residency, with the duration depending on the size of your debt. During this period, you should aim to keep your expenses low, even if your income increases. For instance, if your income grows from $60,000 to $350,000 per year, you should still aim to spend only around $50,000 on living expenses. This leaves a substantial amount of money to pay off your student loans and build wealth.
In addition to living below your means, you can also take on extra locum tenens shifts, which can provide higher earnings than permanent positions and give you more control over your workload. Locum tenens work can be a great way to boost your income and accelerate your debt repayment.
Another strategy to consider is employer-sponsored loan repayment. Some hospitals and healthcare facilities offer loan repayment incentives to attract physicians. This typically involves committing to stay in a position for a certain period, after which the employer will make a lump-sum payment towards your student loans.
Finally, student loan forgiveness programs can provide significant financial relief. Public Service Loan Forgiveness (PSLF) is an option for doctors working in nonprofit or public medical institutions for 10 or more years. Additionally, many states offer student loan forgiveness or repayment assistance for healthcare professionals.
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Work locum tenens
Working locum tenens is a popular option for doctors looking to pay down large student loans. Locum tenens is a form of temporary work where physicians fill in for employees at a facility when there are gaps in care. This type of work offers several benefits that can help doctors address their student loan debt:
Higher Pay and Flexible Work
Locum tenens physicians typically earn a higher hourly wage than those in permanent positions. This higher pay can be crucial in accelerating debt repayment. Additionally, locum tenens work offers flexibility, allowing doctors to choose their work schedule and location. This flexibility enables doctors to take on additional shifts or work in rural areas, further increasing their income.
Cost Savings
Taking temporary positions through locum tenens can result in cost savings. For example, eliminating housing expenses during temporary assignments can significantly reduce overall expenses, leaving more income available for loan repayment.
Work-Life Balance
Locum tenens work can provide a better work-life balance than traditional employment. Doctors can work with recruiters to find assignments that fit their lifestyle preferences, such as those within driving distance or with specific workdays and hours. This flexibility can help reduce burnout while still allowing for focused debt repayment.
Strategies for Success
To maximize the benefits of locum tenens work for debt repayment, doctors can consider the following strategies:
- Full-time locum tenens work: Some doctors choose to work locum tenens exclusively to accelerate debt repayment. This approach requires a strict schedule and careful budgeting to ensure earnings are directed towards loans.
- Combining with a Full-Time Job: Others may opt to work locum tenens on the side, using the extra income to make larger loan payments.
- Rural Assignments: Facilities in rural areas often pay locum tenens physicians more due to the challenge of attracting candidates. Accepting jobs in these areas can increase income and expedite debt repayment.
- Negotiate Pay Rates: Doctors can negotiate the highest possible locum pay rates and work with multiple agencies to ensure a consistent stream of assignments.
- Live Below Your Means: Maintaining a resident-level budget, even with a higher income, can help maximize the portion of earnings allocated to loan repayment.
By leveraging the advantages of locum tenens work and implementing strategic financial management, doctors can effectively address their student loan debt while building their medical careers.
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Student loan forgiveness programs
Public Service Loan Forgiveness (PSLF)
The PSLF program is a federal program that offers tax-free loan forgiveness for borrowers who meet the eligibility requirements. To qualify, borrowers must make 120 qualifying monthly payments while working full-time for a qualified employer, such as a nonprofit or government organization. It is important to carefully review the requirements and eligibility criteria before enrolling in this program.
National Health Service Corps (NHSC)
The NHSC offers loan forgiveness programs with short service requirements of 2-3 years. Doctors can receive up to six figures in loan repayment assistance by serving in designated Health Professional Shortage Areas (HPSAs). The NHSC Students to Service Loan Repayment Program provides up to $120,000 in loan repayment for a three-year service commitment at an approved NHSC site in an HPSA of greatest need.
State-Specific Programs
Many states offer student loan forgiveness programs for doctors and healthcare professionals. For example, Minnesota has the Urban Physician Loan Forgiveness Program, offering up to $33,000 in annual forgiveness, and the Rural Physician Loan Forgiveness Program, with a cap of $29,000 per year. Kansas offers the Kansas Bridging Plan, which provides loan forgiveness for those serving in eligible rural counties for a three-year commitment.
Indian Health Service (IHS) Loan Repayment Program
The IHS Loan Repayment Program offers up to $40,000 in loan repayment for a two-year commitment to practice in health facilities serving American Indian and Alaska Native communities.
Health Resources & Services Administration (HRSA) Faculty Loan Repayment Program (FLRP)
The HRSA FLRP is open to faculty members and provides up to $40,000 in loan repayment assistance over two years.
Employer-Sponsored Loan Repayment
Some employers may offer loan repayment incentives to attract physicians. For example, Dr. Samantha Benz received $100,000 towards her student loans from Aurora Health Care in exchange for a two-year commitment. Larger health systems often have the capacity to offer more substantial loan repayment incentives.
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$85

Refinance your student loans
Refinancing your student loans can be a great way to save money and manage your debt. Doctors often find themselves burdened by significant student loan debt, and refinancing can help make it more manageable.
When to Refinance
You can refinance medical school loans during residency, or wait until you become an attending physician. Refinancing early can be beneficial, but it's important to note that refinancing federal loans means you will lose access to federal benefits like Public Service Loan Forgiveness (PSLF) and income-driven repayment plans. Therefore, it is best to refinance federal loans early if you decide not to pursue PSLF and can find a lower interest rate than your current effective rate.
Benefits of Refinancing
Refinancing student loans can lead to significant savings. By consolidating multiple loans into one loan with a lower interest rate, you will accrue less interest over the life of the loan, reducing your monthly payments and overall debt. This can be especially beneficial for doctors with high-interest private student loans.
Companies Offering Refinancing
There are several companies that offer refinancing specifically for doctors and other healthcare professionals, including SoFi, Laurel Road, FNB, and Panacea Financial. These companies often provide tools to help you understand your options, such as calculators and free consultations with loan specialists.
Things to Consider
When considering refinancing, it is important to compare lenders and interest rates to ensure you are getting the best deal. Additionally, keep in mind that your credit score and debt-to-income ratio can improve as you pay down your loans, potentially lowering your interest rate further.
Example Interest Rates
Fixed annual percentage rates (APR) for refinancing can range from 4.70% to 10.24% APR, with potential discounts for autopay. Variable APRs can range from 6.13% to 10.24% APR, also with potential discounts. These rates may vary based on your financial profile and the company you choose to refinance with.
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Employer-sponsored hiring incentives
Healthcare employers can partner with financial institutions to offer unique benefits to their employees. For example, Laurel Road works directly with healthcare employers to provide exclusive student loan options, including student loan forgiveness counselling, refinancing rate discounts, and financial education tools.
Employers can design an optional paid-contribution plan to help employees pay down their loans faster. They can also connect employees to state-sponsored programs or offer repayment matching. For instance, a new regulation allows companies to match employee student loan payments with contributions to their retirement accounts (e.g., 401(k) funds). This approach provides an immediate financial benefit to employees, which can be a powerful incentive for recruitment and retention.
Loan repayment incentives offered by employers can range from $10,000 to $400,000, with larger health systems typically offering $100,000 or more. In exchange, employers usually require a commitment to stay in the position for a given period, often three years or more. For instance, Dr. Samantha Benz received $100,000 towards her loans in exchange for a two-year commitment to Aurora Health Care in Milwaukee.
In addition to these employer-sponsored incentives, new physicians can also explore Public Service Loan Forgiveness (PSLF) and state-level loan forgiveness programs. PSLF forgives the remaining loan balance tax-free after ten years of full-time service for a qualified employer, such as a hospital or university. However, it is not an option for those planning to work in private practice or for-profit groups. State-level loan forgiveness programs can also provide substantial benefits, with some states offering up to $20,000 or more in annual loan repayment assistance.
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Frequently asked questions
Public Service Loan Forgiveness (PSLF) is the quickest way to pay off student loans as a doctor. PSLF is a federal student loan repayment plan available to professionals who work full-time for qualifying nonprofit organizations or government agencies.
PSLF forgives the remaining loan balance tax-free after 10 years of service of working full-time for a qualified employer. The total savings can be significant, especially if you have a higher student loan balance.
Many states offer student loan aid to doctors and other healthcare professionals through health departments, agencies, and local private funders. You can also refinance your student loans if you have good credit or a co-signer who does.
Many doctors work locum tenens or per diem shifts and apply the extra earnings towards paying off student loans more quickly. It is also important to live below your means for a few years after residency and save 20% of your income for retirement and paying off loans.
The VA's SELRP program can relieve up to a maximum of $160,000 in student loans for resident doctors who commit to at least 24 months of service.








































