Psychiatry vs Internal Medicine

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.

Internal Medicine

Most internal medicine physicians work at academic medical centers, VA hospitals, or nonprofit health systems — all PSLF-qualifying employers. With a 3-year residency counting toward the 120-payment requirement, IM physicians can reach forgiveness just 7 years into attending practice.

Refinancing makes more sense if you're heading into private practice or a for-profit setting where PSLF doesn't apply. With an attending salary around $310K, aggressive payoff over 7–9 years is very achievable.