[Editor's Note: The following guest post was submitted by Dan Mendelson, author of BYE Loan and Debt. This is a subject we cover frequently, but it's always nice to get a new voice and perspective on it. I hope it brings hope to those struggling under the burden of medical school debt and mired in the often complex process of managing those loans. It's also fun to see a post from/about non-physician high-income professionals. We have no financial relationship. ]

In the winter of 2011, I learned that the love of my life had over six figures of student loan debt. She was starting her MBA holding a bachelor’s and a master’s degree in engineering and entering the professional workforce. Both degrees came at a price. In the process of earning them, she had racked up nearly $120,000 in student loan debt by the age of twenty-three.  Fortunately for us, I graduated with identical credentials and had only accumulated a mere $10,000 of student loan debt.  While we both earned our MBAs, our interest continued to accrue and our total burden of debt peaked in May 2013 to almost $150,000 – essentially the average American mortgage loan, without the house!

Not so shockingly, my now wife joined the growing echelons of students saddled with enormous debts after earning their degrees. Our story of student loan debt is not unique.  In 2016, 70% of college graduates exited school with student debt – totaling 43 million student loan borrowers in the United States. All of this debt in the U.S. totals $1.4 trillion dollars in loans, and it is growing at a rate of about $3,000 per second! The average 2017 graduate will leave school with over $37,000 in debt and an average payment of almost $400 per month! [That sounds pretty nice to a lot of readers I bet -ed]

For graduates that leave with white coats, it is even more expensive. More than half of all advanced education students have over $100,000 in student loan debt and more than 30% have over $200,000 in debt. Year-after-year, these statistics continue to rise, making a frightening situation for most young professionals trying to start their careers, but especially for doctors. While my wife and I are not doctors, we both work with surgeons every day in our day job and have numerous friends and family that are doctors, dentists, or other health care professionals. While these professions lead to dramatically better earning potential then most, the debt burden that comes with them can cause loads of stress and difficult decisions in their prime for millions of young adults.

1) Figure Out Your State of Affairs

Fast forward 5 years and as of May of 2018, we are now debt free. However, when I first found out about my wife’s debt issues, I went into full on panic mode and started drilling her with questions. After about fifteen minutes, it was obvious she had her head in the sand about her loan situation. This is by far the most important step to getting your situation under control – figure out your state of affairs.

We spent an entire weekend combing through her eight different loans to figure out loan sources, principle and unpaid interest, interest rates, fixed vs. variable loans, and general repayment terms. Only with this knowledge were we able to assess the situation and create a plan. For doctors, this step is even more important, as it could dramatically change your repayment strategy. For those that do not employ a loan forgiveness option, what follows is your best course of action. However, I will address some alternatives for those that will work for a hospital or non-for-profit.

2) Create a Budget

The second thing that we did was to create an old-fashioned budget. Except in this version of a budget, there was one ginormous line item under expenses labeled ‘minimum student loan payment'. This served two purposes: it forced us to look hard at our spending habits and it showed how much money we had at the end of each month after all expenses including student loan minimums. This magic number was the amount of money we could pay extra each month to aggressively crush our student loan problem.

student loan plan Dan Mendelson

Dan Mendelson, Author of “BYE Student Loan Debt”

3) Set a Goal

The third part of our strategy was to set a goal. One that was tough, but realistic. For us, that meant eliminating nearly $150,000 in less than 5 years while getting married, buying a house, and living our lives the way we wanted. A helpful tool we used was an amortization calculator to determine the monthly payments required to meet our goals.

4) Loan Consolidation/Forgiveness

Before executing on this plan, you have to tilt the odds in your favor by any means possible. The main way to do this is through a beautiful tool called loan consolidation. Once you have a job, especially as a new attending physician, showing an income and having credit will do amazing things towards your loan terms.

Public Loans

You can automatically consolidate all loans into a monthly automatic payment. [You end up with the weighted average of your loans rounded UP to the nearest 1/8th of a percentage point. Also be sure to look into the income drive repayment programs like IBR and RePAYE if appropriate.-ed]

Private Loans

Showing your income and credit could dramatically reduce your interest rates by negotiating with your current or different lenders. My wife had some private loans that were over 10% and she was paying $10,000 a year in interest alone. After graduating and consolidating her loans through Wells Fargo, we reduced this interest rate to 5%, a huge savings.

med school scholarship sponsor
[Editor's Note: I recommend against using Wells Fargo for anything, but there are plenty of great companies that may refinance your private student loans, even as an intern.]

Refinancing Public Loans to Private Loans

Lastly, you can even refinance some public loans into private loans at a lower interest rate. We used SOFI to take my wife’s 6.5% public loans down to 5.1%. These changes might not sound huge, but it means paying thousands less in interest every year. It could be the difference between meeting your goal and not.

[Editor's Note: Before refinancing public loans, you need to be very sure you no longer need the benefits of the income drive repayment programs and that you won't qualify for PSLF. There is no going back. Here's a list of WCI student loan refinancing partners.]

Company **
Cash and Bonus
Variable 1.88%-6.15% APR
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Variable 1.90%-5.25% APR
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Variable 1.87%-4.79% APR
Fixed 2.85%-3.97% APR
** White Coat Investor accepts advertising compensation from these companies.
† Bonus includes cash rebates and value of free course. Borrowers who refinance more than $100,000 in student loans using the WCI links will be enrolled in The White Coat Investor’s flagship course, Fire Your Financial Advisor for free ($799 value). Borrowers will still receive the amazing cash rebates that WCI has negotiated with each lender. Offer valid for loan applications submitted from May 1, 2021 through October 31, 2021. Free course must be claimed within 90 days of loan disbursement. To claim free course enrollment, visit https://www.whitecoatinvestor.com/RefiBonus.
Student Loan Refinancing Disclosures

Loan Forgiveness

For many doctors that are directly employed by a non-profit (501(c)3) or government agency, loan forgiveness is often your best choice. My sister, for example, is a pathologist who is employing the Public Service Loan Forgiveness (PSLF) program. This program will forgive all public student loans for those doctors that work for a qualified employer (most non-private practice facilities). Since she will be spending 6 years in residency and fellowship, she just has to be sure to commit to being employed by a hospital, rather than private practice, for her first four years of practice.

In addition, when paired with IBR or PAYE but not REPAYE, PSLF allows lower-income workers to cap their loan payments at just 10% of their discretionary income and never more than the minimum 10-year repayment plan. This can be a fraction of the overall payment for high debt borrowers, even those with a high-income thanks to the cap. Most residents will qualify for a lower payment in an IDR program than in a standard 10-year repayment plan. After 10 years of very low payments relative to the borrowers overall debt burden, the remaining loan balance will be completely forgiven! This is one of many forbearance, flexible repayment plans, or forgiveness options that can be employed to lessen or eliminate your loan burden.

[See upcoming “Student Loans 101” post publishing in late October for more details on all of these programs–ed.]

4) Take Action

pro assurance wci sholarshipThe last part of our plan was to take action. Once you have determined your loan and budget situation, reduced your interest rates as low as possible, created a budget, and determined how much extra you can pay a month, you finally are able to execute on a plan. If the monthly payment goal you established creates a mismatch from the net income your budget allows, you have three choices: 1) You can increase your income (overtime or side hustle) 2) cut expenses, or 3) reset your goals to be in line with your situation.

While student loans can be a significant burden for most doctors, if you understand your goals and your entire loan situation you have numerous options at your disposal. Eliminating this burden will allow you to live your life that you sacrificed years to have!

Do you have a plan in place for paying off your student loan debt? What elements of your plan keep you from derailing? Why do you think some physicians take 10+ years to pay off their loans? What advice would you give to them? Sound off below!