The ever-changing world of student loans is a subject at the top of every doctor's mind right now. With new regulations rolling out, interest resuming, and federal repayment plan changes looming, there's a lot of confusion about the best steps to take next.

On this episode, you'll hear the latest updates on student loan forgiveness programs, shifts in income-driven repayment plans, and the tricky decisions surrounding refinancing versus sticking with federal loans. We're also sharing real-world examples, client scenarios, and fresh insights from the front lines of financial planning for physicians.

Whether you're nearing Public Service Loan Forgiveness, exploring your repayment options, or debating a move to private lending, this episode is packed with the clarity and practical advice you need to make informed, confident decisions.

Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients.

You will want to hear this episode if you are interested in...

• Evaluating PSLF strategy options [05:15]
• IBR payment caps removed [08:34]
• Physician loan forgiveness challenges [13:33]
• Navigating uncertainty in physician careers [16:37]
• Refinance strategy - do you want flexibility or a cushion? [20:04]
• Evaluating PSLF viability for careers [25:20]
• Loan interest comparison example [26:12]

Two Paths: PSLF Seekers and Beyond

• The current financial environment leaves most borrowers in one of two camps:
• Those pursuing PSLF, looking to maximize forgiveness via public service employment
• Those planning a private payoff, who may consider refinancing to lower their interest rates

The ideal strategy depends on your career path, household income, family size, and how many qualifying payments remain if you're hitting the PSLF 120-payment threshold.

For PSLF-Bound Physicians: Strategy Amidst Change

If you're aiming for PSLF, several changes directly affect your repayment game plan, especially with the phasing out of certain plans like PAYE and changes to the Income-Based Repayment (IBR) plans.

Interest Is Not Your Enemy: For those close to 120 payments for PSLF, accrued interest will be forgiven if you stick with the forgiveness programs. Therefore, for many, remaining on SAVE until you're forced to switch (anticipated between December and June) might be optimal, even as interest grows.

Shifting Eligibility: New IBR rules will eventually remove the "partial financial hardship" requirement, broadening eligibility—but also eliminates the "payment cap" that protected high earners from excessively high payments. This can significantly impact high-income households, so careful cash flow planning and timely re-application are crucial.

Application Backlogs and Buyback Realities: The PSLF Buyback process has proven slower and sometimes more expensive than anticipated, with actual "buyback" costs coming in higher than expected. Advisors now recommend proactively starting or restarting your PSLF payment clock, rather than waiting for an uncertain buyback windfall.

Complexity in Tax and Filing Considerations: Married filing separately, AGI adjustments, and state-specific community property rules can all impact monthly payment calculations. As Tyler noted, coordination with tax professionals is increasingly essential.

For Those Not Going for PSLF: Refinancing and Payoff Considerations

If PSLF isn't on your horizon, perhaps due to private practice plans or employer type, the private refinancing market may seem appealing. But it's not a step to be taken lightly:

Don't Jump for Minimal Savings: Unless you can achieve a meaningful rate reduction (at least 1% or more), it's usually not worth giving up federal protections, flexibility, and the slim-but-real possibility that your future career path could shift back into PSLF-eligible territory.

Opt for Flexibility: Even when refinancing, it may be better to lock into a longer (e.g., 10-year) term for lower required monthly payments, but pre-pay aggressively at the 5-year rate if possible. This provides cash flow safety in case of income disruption without locking you into a punishing payment schedule.

Don't Ignore Lump Sums: If transitioning to private loans, paying down accrued interest at the time of refinance can save on total costs and prevent additional negative amortization.

Knowledge, Intentionality, and Professional Support

There is no universal "best" solution. The student loan landscape is changing fast, and even professionals need to re-educate themselves regularly as new details and government guidance emerge. Physicians should work closely with knowledgeable advisors, invest time in understanding options, and remember—sometimes peace of mind is worth a higher payment to put debt stress behind you.

Whether you are actively pursuing PSLF or considering refinancing, do your homework, seek personalized advice, and stay adaptable. As the rules shift, knowledge and strategic flexibility are your best assets for financial well-being in your medical career.

The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers.

Resources & People Mentioned

• The College Investor
• Laurel Road
• Credible Loan Refinance

Connect With Physician Cents

• WealthKeel LLC
• Olson Consulting LLC
• Tyler Olson on Twitter
• Chad Chubb, CFP®, CSLP® on Twitter

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