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PSLF Calculator for Doctors

Model Public Service Loan Forgiveness against aggressive payoff and refinancing — with your actual specialty salary, residency length, and IDR plan. Know which strategy saves you more before you commit.

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What is PSLF — and does it make sense for physicians?

Public Service Loan Forgiveness (PSLF) cancels your remaining federal student loan balance after 120 qualifying monthly payments while working full-time for a nonprofit or government employer. For physicians, that typically means academic medicine, VA hospitals, safety-net hospitals, and most residency programs.

The math works in your favor when your debt is high relative to your income during the repayment window. Residents earning $60,000-$80,000 per year make very small IDR payments — sometimes $0-$400/month — which means the loan balance grows through residency and fellowship. Under PSLF, that growing balance gets forgiven tax-free at the 10-year mark.

The 2026 federal loan cap ($200,000 total borrowing limit) changes the calculus for some specialties. Physicians whose debt is capped at $200K may find aggressive payoff more competitive than before, while those at high-debt schools who need private loans above $200K lose PSLF eligibility for the private portion entirely.

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Qualifying employer

Nonprofit 501(c)(3) hospitals, government, VA, academic medical centers. Private practice does not qualify.

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IDR plan required

Must be on SAVE, PAYE, IBR, or ICR — not standard 10-year repayment. Payments are income-based.

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120 payments

Exactly 10 years. Residency and fellowship payments count — start your clock early.

PSLF vs aggressive payoff vs refinancing: which wins?

There is no universal answer — it depends entirely on your debt amount, specialty salary, years in training, and whether your future employer qualifies. A primary care physician with $280K in debt planning to work at a federally qualified health center will almost always win with PSLF. A dermatologist with $150K in debt joining private practice will often come out ahead by refinancing and aggressively paying down the balance.

Our calculator runs all three scenarios simultaneously with your exact inputs — specialty salary preset, residency length, loan balance, and IDR plan — and shows you the net-worth crossover: the date when each strategy leaves you better off than the others.

PSLF by specialty

General guidance — run the calculator with your exact numbers for a precise comparison.

Primary Care / Family Medicine

Lower attending salary + longer training = more forgiven. Academic and FQHC positions qualify easily.

Strong PSLF candidate

Internal Medicine / Hospitalist

Hospital-employed hospitalists typically work for qualifying nonprofits. Salary makes IDR payments manageable.

Strong PSLF candidate

Psychiatry

Community mental health and VA positions qualify. High unmet need = easy qualifying employer access.

Strong PSLF candidate

Surgery

5-7 year residency + fellowship builds PSLF clock, but high attending salary makes IDR payments larger in attending years.

Case by case

Radiology / Anesthesia

High salary and frequent private practice employment. If employer won't qualify, aggressive payoff or refinancing often wins.

Often better to refinance

Dermatology / Plastics

Very high salary, mostly private practice employment. Aggressive payoff feasible. Model both — dermatology attending salary makes PSLF payments large.

Usually better to refinance

PSLF FAQ for physicians

Does residency count toward PSLF?

Yes — if your residency program is at a qualifying nonprofit hospital (most are), and you are on an IDR plan, those payments count. Starting your PSLF clock during residency is one of the highest-leverage moves you can make.

What happens to PSLF with the 2026 federal loan cap?

PSLF only applies to federal loans. The $200K cap limits how much you can borrow federally. Any amount above $200K you borrow privately cannot be forgiven through PSLF. If your school's average debt exceeds $200K, model the private loan portion separately.

Is PSLF forgiveness taxable?

Federal PSLF forgiveness is tax-free under current law. This is different from IDR forgiveness (after 20-25 years), which is taxable. The tax bomb concern applies to long-term IDR forgiveness, not PSLF.

Can I switch employers and keep my PSLF progress?

Yes. PSLF does not require continuous employment at one employer — just that each payment is made while employed at a qualifying organization. Gaps in qualifying employment don't erase prior payments; they just pause the clock.

Should I refinance if I'm pursuing PSLF?

No. Refinancing converts federal loans to private loans, which permanently disqualifies them from PSLF. Never refinance loans you intend to forgive through PSLF.