Orthopedic Surgery vs General Surgery

Orthopedic Surgery

PSLF is almost never the right choice for orthopedic surgeons. At $730K, IDR payments approach or exceed standard repayment amounts, leaving little to forgive. The specialty also skews heavily toward private practice, ambulatory surgery centers, and orthopedic groups that don't qualify as PSLF employers.

Refinancing is frequently the right move for orthopedic surgeons once they have an attending contract. At $730K, an aggressive $15K/month toward loans eliminates $245K in under 2 years. The interest savings from refinancing are real but secondary — the main advantage is faster payoff and simplified loan management.

General Surgery

With a $477K attending salary, general surgeons have the income to pay off debt aggressively in 4–6 years after training — often beating PSLF in total cost. PSLF only makes sense if your practice setting is nonprofit and your income-driven payments are significantly lower than a standard 10-year plan.

Refinancing is often the best move for general surgeons heading into private practice. At $477K, you can direct $4–6K/month toward loans and be debt-free within 5 years. Rates from physician-focused lenders like Laurel Road and Earnest can drop your rate below 5%.