Physicians, dentists and veterinarians take on hundreds of thousands of dollars of debt to pay their way through school. Once in residency or practice, it’s time to start repaying these loans.

Different people have different student loan repayment strategies based on their financial goals, like paying the lowest monthly payment, paying it off as quickly as possible, paying it off by a certain date, or paying the least amount over time. If your goal is to pay the least over time, here are tips to help you accomplish just that.

Tips for reducing total student loan cost

Understand your loans

Before diving into repayment strategies, be sure you know the loan types and interest rates of your loans. Knowing these factors and how they impact your total student loan cost with no changes can give you a baseline to compare other options to.

Consider loan forgiveness programs

If you have federal student loans, loan forgiveness programs could reduce your total student loan cost. Public Service Loan Forgiveness is one of the most well known options for this.

PSLF allows eligible borrowers who work full-time for a qualified public service employer to have their remaining federal student loan balance forgiven after making 120 qualifying monthly payments. This can be a great option for doctors who work at 501(c)(3) organizations like university and community hospitals or military or public health corps.

If you have federal student loans but don’t work for a qualifying employer, there are still options for loan forgiveness through Income-Driven Repayment programs. Depending on the IDR plan, your loan balance can be forgiven after 20-25 years of qualifying payments. The Saving on A Valuable Education plan (SAVE) has an additional benefit of waiving any interest not covered by your monthly payment.

For more information about loan forgiveness programs, check out our Student Loans 101 webinar recording.

Make extra payments

If you aren’t aiming for forgiveness, making extra payments toward your loans can reduce the total interest paid over time. Finding extra money to put towards loans can be challenging but not impossible.

Even making just one extra payment per year can have an impact on the total interest paid over the life of the loan, but if you plan to use PSLF or IDR to achieve forgiveness, making extra payments is not recommended. Doing so will only increase your total payment amount in the long term (and lowering the amount that would be forgiven). This strategy would be most beneficial to borrowers with private or refinanced student loans.

Choose a shorter repayment term

Another strategy for lowering your total student loan cost is choosing a shorter repayment term. A shorter term will result in a higher monthly payment but will reduce the total interest paid in the long run. This is another strategy that would be beneficial to those with private or refinanced student loans but most likely will not be an option for those still in training.

Enroll in automatic payments

Most federal student loan servicers offer a 0.25% reduction in your interest rate if you set up automatic monthly payments. This discount can make a difference in total interest paid over the life of your loan.

Refinance or consolidate your loans

Refinancing and consolidating student loans can be viable options for borrowers seeking to lower their interest rates or simplify their repayment process. Additionally, consolidating multiple loans can streamline repayment and potentially lower monthly payments.

However, it’s essential to weigh the pros and cons carefully, especially when considering refinancing federal loans with a private lender. Refinancing your federal loans means you lose access to federal forgiveness or income-driven repayment options.

Comparing the impact of these options

Let’s take a look at how some of these options would impact total student loan cost.

Note: Unless otherwise stated, we used the StudentAid.Gov Loan Simulator with a starting total loan amount of $215,100 (the average medical school student debt according to EducationData.Org) at a 7.05% interest rate (the current average for graduate loans). We used the “lowest total paid over time” goal and set annual income at $63,395 (the average income for a medical resident according to the 2024 Residents & Fellows Survey Report).

These are just simplified calculations that don’t take into account different loan types, increased income post-training, and other factors. These calculations are meant to illustrate the way various forgiveness programs and repayment strategies can benefit your total loan payment.

How PSLF can lower your total student loan cost

Using the table below, it’s obvious just how beneficial PSLF can be to your student loan repayment strategy. The SAVE plan is often the best IDR plan for most borrowers, but regardless of which IDR plan you choose, you will pay only a fraction of the monthly payment and total loan payment when compared to standard repayment.

Reminder: We used the StudentAid.Gov Loan Simulator with a starting total loan amount of $215,100 at a 7.05% interest rate. We used the “lowest total paid over time” goal and set annual income at $63,395.