Question 1

When does refinancing medical school loans actually make sense?

Accepted Answer

Refinancing makes sense when two conditions are true: you do not qualify for (or are not pursuing) Public Service Loan Forgiveness, and you can secure a rate meaningfully lower than your current federal rate. For most attending physicians in private practice with a strong credit score, refinancing into a 5-7 year term at a lower fixed rate can save tens of thousands of dollars over the life of the loan.

Question 2

Does refinancing disqualify me from PSLF?

Accepted Answer

Yes. The moment you refinance federal loans into a private loan, those loans are permanently ineligible for PSLF. There is no way to reverse this. If you work for a 501(c)(3) hospital, academic medical center, or government employer, run a full PSLF analysis before refinancing. Our calculator models both paths side by side so you can see which strategy wins for your situation.

Question 3

Can residents refinance their student loans?

Accepted Answer

Some lenders allow it. Juno, SoFi, Earnest, Laurel Road, and Splash Financial all offer resident-friendly programs with reduced monthly payments (typically $100/month) during training. ELFI requires full payments during residency, which is typically unaffordable on a resident salary — sign in to compare all lenders. That said, refinancing during residency also locks you out of income-driven repayment plans and PSLF permanently, so most residents are better served staying on IBR during training (SAVE was vacated in 2026; IBR is now the primary IDR option for new enrollees).

Question 4

Does RAP change the refinancing decision in 2026?

Accepted Answer

RAP (Repayment Assistance Plan), created by the One Big Beautiful Bill Act (OBBBA), is now the required income-driven plan for anyone who first borrowed on or after July 1, 2026 — it is not optional for that group the way IBR is. If your loans predate July 1, 2026, you can generally still choose IBR instead. This matters for refinancing because RAP, like IBR, only applies to federal loans: refinancing converts your loans to private and removes both RAP and PSLF eligibility permanently. Run the numbers on your actual RAP or IBR payment in the calculator before refinancing so you are comparing your real monthly cost, not an outdated one.

Question 5

What is physician-specific underwriting and why does it matter?

Accepted Answer

Physician-specific underwriting means the lender evaluates your application based on your signed employment contract or residency match letter rather than your current income. For residents earning $65,000-$85,000 per year with $300,000+ in debt, standard underwriting would disqualify them entirely. Lenders with physician underwriting like Juno, SoFi, Earnest, and Laurel Road approve residents based on their future attending income, enabling access to competitive rates that standard programs would not offer.

Question 6

Fixed rate or variable rate for medical school refinancing?

Accepted Answer

For most physicians, a fixed rate is the right call. Medical school debt is large (average $200,000+) and takes 5-15 years to pay off. Variable rates are tied to benchmarks like SOFR, which can rise significantly over that timeframe. Unless you plan to pay off your entire balance within 2-3 years, the interest rate risk on a variable rate outweighs the initial lower rate. If you are an attending with aggressive payoff plans, a variable rate on a 5-year term can save money, but run the numbers first.

Question 7

What credit score do I need to refinance medical school loans?

Accepted Answer

Most physician refinancing lenders look for a 680+ credit score for approval and 720+ for the best rates. Residents approved via physician underwriting often get approved with shorter credit histories than standard applicants. If your score is below 680, spending 6-12 months building credit before applying will result in meaningfully better rates. Common factors that hurt physician credit scores: high utilization during medical school, thin credit files from years of being a student, and no mortgage history yet.

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Refinancing questions, answered

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Refinancing questions, answered