Debt Strategy
Turn student debt into a strategic variable
A physician's finances start unlike anyone else's, and that curve is exactly what we plan the repayment decision around.
Why it's different
The income jump changes everything
A decade of borrowing
Physicians finish training owing more than almost any other profession, often $200K or more before the first attending paycheck.
Years earning a fraction
Residency pays roughly $60–80K for three to seven years, while that balance keeps compounding in the background.
Then it all changes at once
Attending income climbs past $220K and keeps rising by specialty. No other career has this jump, and it's what turns a routine repayment choice into a six-figure decision.
- Median medical-school debt: AAMC, Medical Student Education: Debt, Costs & Loan Repayment; U.S. Department of Education, Federal Student Aid.
- Resident & fellow pay: AAMC Survey of Resident/Fellow Stipends & Benefits (training-level pay, not attending compensation).
- Attending compensation: U.S. Bureau of Labor Statistics, OEWS (May 2024), national mean annual wage by physician occupation.
alooola modeling, the $50K–$200K range reflects PSLF-versus-refinance outcomes that vary with loan balance, interest rate, income trajectory, filing status, and employer eligibility; it is not a single published figure.
The options
What tips the balance
PSLF, refinancing, and standard repayment each win under different conditions. We model all three against your actual numbers.
| PSLF | Refinance | Standard | |
|---|---|---|---|
| Tends to win when | Employer qualifies, larger balance | High income, smaller balance | Short payoff horizon |
| Monthly payment | Lowest (income-driven) | Higher, fixed | Highest |
| What drives total cost | Forgiveness amount | Interest rate | Principal + interest |
| Tax-free forgiveness | ✓ | ✗ | ✗ |
| Locks your rate | ✗ | ✓ | ✗ |
How we work
Your actual numbers, modeled both ways
We map every loan, balance, rate, and qualifying payment, then model PSLF, refinancing, and standard repayment side by side at real rates, using your specialty income and filing status.
The repayment plan we land on fits the rest of your plan, what you invest, the bracket you optimize around, the household you file with, never decided in a silo. And when your income jumps, we recheck, because the right answer changes.
Common questions
Debt strategy, answered
Should I refinance or pursue PSLF?
I've already started PSLF. Is it too late to switch?
My spouse also has loans. Does that change the strategy?
Are you a fiduciary?
Related
Keep reading
For residents & fellows
The decisions that matter most in training: PSLF, disability timing, Roth strategy.
For new attendings
The training-to-attending income jump, and what to do with it.
Retirement planning
One projection across your 401(k), IRA, Roth, taxable accounts and Social Security.
Fees & pricing
Exactly how we're paid and what's included. No commissions, no product sales.