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Physician Student Loan Calculator
The only calculator that models the full physician journey — from medical school debt through residency, fellowship, and your attending salary. Compare PSLF vs aggressive payoff vs refinancing with your actual specialty and loan balance.
Why physicians need a different calculator
Generic student loan calculators assume a standard 22-year-old borrower with $35,000 in debt and a job that starts immediately after graduation. That model is useless for physicians.
The average physician graduates with $200,000–$300,000 in medical school debt (AAMC, 2024), then spends 3–7 years in residency earning $60,000–$90,000 before reaching attending income. During that entire training window, interest compounds daily. The decisions you make in residency — whether to defer, enroll in IBR, pursue PSLF, or start paying aggressively — determine outcomes that span decades.
The MedDebt Calculator is built specifically for this trajectory. It models resident income during training years, switches to attending salary on the year you specify, applies specialty-specific income data from Marit Health and Medscape, and shows you the net worth crossover point for every repayment strategy side by side.
21 specialty presets
with 2026 salary data
PSLF modeling
120-payment tracker
Resident income
year-by-year modeling
Net worth crossover
see when each strategy wins
The physician loan journey — phase by phase
Every phase has a different income, a different optimal strategy, and a different set of decisions. Missing any of them is expensive.
Medical School
Loans in deferment. Interest accrues — ~$16K/year on $230K balance. Consider starting IBR to avoid capitalization and start PSLF clock if your school is 501(c)(3).
Residency
IBR payments of $200–$500/month. If your program qualifies as PSLF employer, these count toward your 120 payments. Never defer if you can avoid it.
Fellowship
Still on resident salary. IBR payments continue accumulating PSLF credit. A physician who completes 7 years of training may have 84 of 120 PSLF payments banked before their first attending paycheck.
Attending — Year 1
Decision point. Do you: (A) continue IBR for PSLF if you're at a nonprofit, (B) refinance to private loan and aggressively pay down, or (C) stay on IBR toward 20/25-year forgiveness? This decision is worth modeling carefully.
Repayment strategy by specialty
Your specialty determines your income ceiling, which determines whether PSLF or aggressive payoff wins. Salary data: Marit Health / Medscape 2026.
| SPECIALTY | AVG SALARY | TYPICAL DEBT | BEST STRATEGY |
|---|---|---|---|
| Neurosurgery | $788K | $280K | Aggressive payoff |
| Orthopedic Surgery | $573K | $275K | Aggressive payoff |
| Radiology | $495K | $265K | Aggressive payoff or refinance |
| Internal Medicine | $264K | $250K | PSLF if academic |
| Pediatrics | $244K | $245K | PSLF almost always wins |
| Family Medicine | $255K | $240K | PSLF if nonprofit employer |
High-income specialties (neurosurgery, ortho, radiology) almost always benefit more from aggressive payoff than PSLF — their attending salary makes IBR payments high enough to clear the debt without waiting 10 years. Lower-income specialties pursuing academic or nonprofit careers get the most from PSLF.
Physician student loan FAQ
How much student loan debt does the average physician have?
According to AAMC's 2024 data, the median medical school debt at graduation is $200,000. About 25% of graduates carry more than $300,000. When you add 4+ years of interest during residency, the balance at the start of attending practice is often $230,000–$350,000.
Should physicians use PSLF or pay off loans aggressively?
It depends on your specialty and employer. Physicians at nonprofit hospitals, VA facilities, or academic medical centers often save $100,000–$300,000 with PSLF compared to aggressive payoff. High-income specialties (neurosurgery, orthopedics, radiology) in private practice usually benefit from refinancing and aggressive payoff. Use the calculator to see your specific numbers.
What happens to physician loans during residency?
Loans continue accruing interest during residency at 6.5%–8% annually. On a $250,000 balance, that's ~$18,000/year. The best approach is to enroll in IBR immediately after graduation to make small income-based payments ($200–$500/month), prevent interest capitalization, and start accumulating PSLF-qualifying payments if your training program qualifies.
Can physicians refinance medical school loans?
Yes, and for the right physician it saves significant money. Refinancing makes sense if you're in private practice (no PSLF), your debt-to-income ratio is under 1.0x, and you have stable high income. It permanently ends access to federal IDR plans, PSLF, and federal forbearance — so the decision is irreversible. See the MedDebt refinancing comparison at /refinance.
What IDR plan should physicians use in 2026?
IBR (Income-Based Repayment) is the default for most physicians in 2026. SAVE was vacated by the 8th Circuit in March 2026. PAYE closed to new enrollees on July 1, 2026. The new RAP plan only covers loans first disbursed after July 1, 2026. For existing medical school debt, IBR is the primary IDR option.