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Residency Loan Calculator

Most loan calculators assume you start repayment at full salary. This one models what actually happens — loans growing through 3-7 years of residency on a $65K stipend, then the transition to attending pay.

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Why residency changes everything

The average medical graduate leaves school with $212,000 in federal loans at approximately 7% interest. During a 3-year internal medicine residency earning $65,000 per year, a standard 10-year repayment plan would require roughly $2,400/month — impossible on a resident salary.

Most residents go on income-driven repayment (IDR), paying $300-$600/month. That is less than the interest accruing each month. The result: your $212,000 balance grows to $230,000-$250,000 by the time you finish residency. This is called negative amortization, and it's the norm for physician trainees.

The decision you make at the start of residency — PSLF, IDR with eventual forgiveness, or aggressive payoff — compounds over the next 10-25 years. The calculator below models all three paths from day one of residency through your attending years.

$212K

Average grad debt

AAMC class of 2024

$65K

Avg resident salary

ACGME 2025

3–7 yrs

Residency length

Depends on specialty

~$25K

Interest during 3-yr residency

At 7.05% federal rate

Your 3 options as a resident

PSLF — start your 120-payment clock now

If your residency hospital is a qualifying nonprofit (most are), every IDR payment you make as a resident counts toward your 120. After 10 years — including residency and fellowship — the remaining balance is forgiven tax-free. This is the most valuable strategy for residents at academic centers pursuing primary care, internal medicine, or psychiatry.

Best for: nonprofit/academic career path

IDR without PSLF — forgiveness after 20-25 years

If you plan to go into private practice or a non-qualifying setting, you can still use IDR to keep payments low during training. After 20 years on SAVE/PAYE or 25 years on IBR, the remaining balance is forgiven. Unlike PSLF, this forgiveness is taxable — the "IDR tax bomb" is a real consideration for balances of $200K+.

Best for: private practice with high debt

Aggressive payoff — attack the balance early

Pay more than the minimum during residency (even $100-200/month extra helps), then significantly overpay as an attending. This works best when your specialty salary is high enough to service the debt in 5-8 years. Eliminates long-term interest risk and gives you flexibility — no employer restrictions.

Best for: high-salary specialties, private practice

How residency length affects your loans

Assumes $212K starting balance, 7.05% interest, $400/month IDR payment during training.

Specialty exampleResidencyBalance at finishPSLF years leftAttending payment (10-yr)
Emergency Med3 years~$230K7 years~$2,650/mo
Internal Medicine3 years~$230K7 years~$2,650/mo
Pediatrics3 years~$230K7 years~$2,650/mo
Anesthesia4 years~$238K6 years~$2,740/mo
General Surgery5 years~$246K5 years~$2,830/mo
Ortho + Fellowship6 years~$255K4 years~$2,930/mo
Neurosurgery7 years~$264K3 years~$3,030/mo

* Estimates based on national averages. Use the calculator with your exact balance and program length for precise figures.

Residency loan FAQ

Should I start PSLF payments during residency?

Yes, if your program qualifies. Most nonprofit residency hospitals are PSLF-eligible. Even small IDR payments during residency count toward your 120. Waiting until attending salary to start PSLF means paying years of high attending-income IDR payments instead of low resident payments.

How much should I pay per month as a resident?

On SAVE or PAYE, your IDR payment is typically 5-10% of discretionary income. On a $65K resident salary, that works out to roughly $200-$500/month. If you're pursuing PSLF, pay this amount and not more — overpaying wastes money on a balance that will be forgiven anyway.

What is the SAVE plan and should I use it?

SAVE (Saving on a Valuable Education) is the most generous IDR plan for new borrowers — it caps payments at 5% of discretionary income for undergraduate loans and waives unpaid interest in certain situations. However, SAVE's status has been in legal limbo since 2024. Check studentaid.gov for current status.

Can I refinance during residency?

Technically yes, but be extremely careful. Refinancing means leaving federal loan protections: no IDR options, no PSLF, no forbearance flexibility. Most residents should stay federal until they know for certain whether they'll pursue PSLF.