February 01, 2026

Taxes and Student Loans with Adam Markowitz, Ep #046

32 minutes

Physicians, medical trainees, and other healthcare professionals walk a uniquely challenging financial path. High educational debt, income variations throughout career stages, and complicated tax policies are just the start.

We're joined by tax expert and Certified Student Loan Planner (CSLP) Adam Markowitz to tackle a complicated topic all physicians have to deal with: how taxes and student loans are intertwined. Adam brings a wealth of firsthand experience, and you'll want to listen to his strategies to help keep your payments low and avoid IRS headaches.

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...

04:09 Managing student loans post-COVID.
10:24 Community property tax impact explained.
16:59 Tax strategies for maximizing your benefits.
19:19 Tax challenges amid the rising costs of living.
23:57 IRS complexity and processes.
28:03 The importance of taking expert tax advice.

Why Taxes Matter in Student Loan Planning

If you think your tax return is a standalone document, think again. Student loan repayment plans, especially income-driven plans like SAVE or IBR, use your latest tax filings to calculate monthly payments. As our guest, Adam Markowitz says, for medical residents and fellows earning lower salaries, it could be strategically advantageous to delay filing your next return if your income will soon increase.

For instance, a trainee finishing residency in 2025 could benefit from an extension, resulting in their student loan payments for the coming year being calculated from their lower 2024 income. This maneuver buys them another 12 months of cheaper student loan payments, cushioning the financial leap into attending status.

The Impact of Public Service Loan Forgiveness (PSLF)

While PSLF aims to forgive student loan debt for those working at qualifying institutions, it can be tricky to get to grips with. Many residents, especially post-COVID, haven't made qualifying payments due to forbearances, so ensuring they're on the right repayment plan (rather than SAVE during a non-qualifying period) is so important.

Even if you're not on PSLF, income-driven payments during lower income years can provide a fantastic financial runway with manageable bills, reduced stress, and preparation for larger payments as your income grows.

Community Property States

Marriage introduces another layer of complexity, especially in community property states. As Adam explains, that in the majority of situations, half of what you earn is technically money your spouse has earned, and half of the money that your spouse has earned is what you have earned. This can help or hinder student loan payment calculations, depending on who earns more within the couple. For example, a resident married to a high-earning spouse could see their payments jump since their incomes are pooled. We also touch on states with opt-in community property laws. While technically possible, opting in comes with wider legal ramifications, including asset division, so it's not a simple student loan hack.

DIY Tax Filing Risks Missing Out on Big Benefits

Many trainees opt for DIY tax apps, but this approach can be risky. Adam estimates that while about 60% of returns will come out fine, the other 40% can contain costly errors or missed opportunities, especially regarding student loan recertification, credits for retirement contributions, and unique deductions. There's also the peace of mind factor, receiving an IRS notice is universally stressful and having a professional to interpret these letters or catch tricky policy changes can be invaluable.

The IRS is overstretched, and communication delays persist. From delayed EIN number confirmations to confusing notices, a simple mistake or missed 1099 can easily snowball. Now more than ever, having proactive, accessible financial and tax advice is essential for physicians and trainees.

Seek Guidance, Save Stress

Student loan repayment and tax filing go hand in hand, especially for physicians and medical trainees. From optimizing payments based on timing, navigating marriage and state laws, or simply surviving IRS quirks, consulting experienced professionals can mean the difference between financial ease and future headaches.

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