Radiology vs Internal Medicine

Radiology

A $660K attending salary makes income-driven repayment payments so high that PSLF provides minimal benefit — you would pay off most of the balance before forgiveness kicks in. Radiology is also predominantly practiced in private or independent group settings that rarely qualify as PSLF employers.

Refinancing is strongly advantageous for radiologists. At $660K, even a modest $10K/month toward loans eliminates $240K in just over 2 years. The interest savings from refinancing to 4.5–5% vs. a 6.5%+ federal rate on that payoff timeline are modest but real — and the simplicity of private loan servicing is a genuine benefit.

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.