Residency is PSLF gold. Don’t waste a payment.
Every on-time IBR payment during residency counts toward your 120 PSLF payments — at the lowest payment amount you’ll ever have. A 3-year IM residency gets you 36 payments done before your attending salary even starts.
$350–500
Typical IBR payment on PGY-1 salary
~10% of discretionary income
36
PSLF payments earned in 3yr IM residency
Of 120 required
$65K
Median PGY-1 gross salary
ACGME 2025
$0
Federal tax on PSLF forgiveness
vs ~$80K+ on IDR forgiveness
The decision that matters most
PSLF vs. refinancing — a real example
Same debt, same residency. The difference is which employer you join as an attending. Run the calculator with your actual numbers to see the gap for your specialty.
IM resident → Academic center attending (PSLF)
Tax-free forgiveness after 10yr
IM resident → Private practice attending (Refi)
Paid in full in ~7–8yr at 6% refi rate
Illustrative example — actual savings depend on specialty, salary, debt amount, and years in training. Run your exact numbers →
Free tools
Everything a resident needs to model their debt
Debt Calculator
Model your exact situation: PGY year, specialty, expected attending salary. Side-by-side PSLF vs. refinancing vs. aggressive payoff — showing true cost over 10–20 years.
Run my residency numbersPSLF Employer Checker
Verify whether your hospital or health system qualifies as a PSLF employer. Covers nonprofit hospital systems, academic medical centers, and VA facilities.
Check my employerPSLF Payment Tracker
Track your 120 qualifying payments. Know exactly how many you've made, how many remain, and what your projected forgiveness date is given your repayment timeline.
Track my paymentsCommon questions
Resident loan questions
Should I be on IBR or PAYE during residency?
As of 2026, IBR is the recommended plan for most residents. PAYE and ICR are no longer accepting new enrollees (they were phased out July 1, 2026). SAVE was eliminated by court order in March 2026. For residents with loans disbursed before July 1, 2026, IBR is the best available IDR plan. New residents with post-July 2026 loans should look at RAP, which is the new government plan but has less favorable long-term terms than IBR.
How do I start PSLF payments during residency?
Three steps: (1) Enroll in IBR on studentaid.gov. (2) Submit an Employment Certification Form (ECF) to MOHELA — do this annually, not just at the end. (3) Make on-time monthly payments. PSLF payments count from the date your employer is certified, not retroactively. Many residents lose 1–2 years of PSLF credit by not certifying their first hospital. Submit the ECF within the first 3 months of PGY-1.
What if I do fellowship after residency — does it still count?
Yes — as long as your fellowship program is at a 501(c)(3) nonprofit institution (almost all academic fellowship programs are). Each fellowship payment counts toward your 120, and fellowship extends your total training time, which means more payments at the lower IBR level before your attending salary kicks in. More payments at low-income rates = more forgiveness.
When does it make sense to refinance instead of pursuing PSLF?
Refinancing makes sense when: (1) You're certain your attending employer will not be nonprofit — private practice, for-profit hospital, employed by a private group. (2) Your projected PSLF savings are small — typically if you have below $150K in federal loans and high earning potential. (3) You can get a refinance rate at least 2–3% below your current federal rate and can aggressively pay down the loan in 5–7 years. Use the MedDebt Calculator to run both scenarios with your actual numbers before deciding.
Can I moonlight as a resident and still stay on IBR?
Yes, moonlighting income is counted in your AGI, which can raise your IBR payment slightly (since IBR = 10% of discretionary income). For most residents, moderate moonlighting of $10K–$30K/year raises monthly IBR payments by $80–$250/month — usually still far below what you'd pay on a standard 10-year plan. Moonlighting also doesn't affect PSLF eligibility as long as your primary employer is a qualified nonprofit. Put any moonlighting income directly toward student loans or a Roth IRA.
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PSLF or refi? Run the math.
Enter your PGY year, debt balance, and specialty to see PSLF savings vs. refinancing — with residency and fellowship phases modeled in.
Model my residency debt — free