Dermatology vs Psychiatry

Dermatology

Dermatology is predominantly practiced in private offices, dermatology groups, and private equity-backed practices — very few of which qualify for PSLF. Even for the minority of dermatologists at academic or nonprofit medical centers, the $512K salary means IDR payments are high and the forgiven amount is small. PSLF rarely produces a meaningful advantage in this specialty.

Refinancing is the dominant strategy for dermatologists. At $512K, directing $8–12K/month toward loans eliminates $235K in 2–3 years. The combination of high income and predominantly private employment makes dermatology one of the clearest cases in medicine for refinancing over PSLF.

Psychiatry

Psychiatrists have unusually strong PSLF access: community mental health centers, VA hospitals, and state psychiatric facilities all qualify, and these represent a large share of psychiatric employment. Psychiatry's National Health Service Corps (NHSC) loan repayment eligibility adds another layer of loan-reduction options.

Refinancing is most relevant for psychiatrists in private practice or group settings without PSLF access. At $340K attending, aggressive repayment is feasible — debt-free in 5–7 years with focused effort.