The tool
PSLF vs refinance vs aggressive payoff, side-by-side. 16 specialty presets. Charts redraw the moment a number changes.
Med School Debt Simulator
PSLF vs refinance vs aggressive payoff · 21 specialty presets
StrategyCustom
All settings below are manually controlled. Adjust any input to build a custom scenario.
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Pursue PSLF.
Saves $333,855 vs aggressive payoff
PSLF saves you an estimated six figures vs standard repayment given your $250K debt and lower-paying specialty.
via Marit Health 2026 + AAMCvia studentaid.gov
Estimated timeframe
Debt resolved in ~10 yrs
Monthly payment range
$220 – $298
Key assumption
Assumes continued employment at a 501(c)(3) non-profit or government employer for 10 qualifying years.
Strategy comparison
All three paths, side by side.
Same inputs — three different repayment philosophies. The recommended row is the one our engine picked for your scenario.
via studentaid.govvia IRS guidance
Moderate
A few optimizations could make a big difference.
Focus area: Interest cost (Moderate)
Based on your debt-to-income ratio, payment affordability, payoff timeline, and interest efficiency.
Debt-to-incomeExcellent
Your debt ($250K) is less than your annual income — well below the typical physician ratio.
Payment affordabilityStretched
Payments are 13% of gross income. Consider refinancing or IDR to lower the monthly obligation.
Time to payoffExtended
13.0-year payoff horizon. Each extra year of debt is a year of compounding you can't access.
Interest costModerate
Interest will add 61% to your total repayment — consider refinancing if rate > 5%.
The right strategy depends on your employer and career path
Enable PSLF or refinancing above to model both sides. Or see the full framework.
Join the MedDebt refinancing cohort + get the free PDF
We pool physicians by specialty and submit groups to lenders quarterly — they compete for your loans. Plus the PSLF vs. Refinancing Decision Framework PDF, free.
Your future income is your biggest asset.
You've modeled your debt — now see what it costs to protect your paycheck if you can't work.
Yr 6
First year back in the black
Income Protection
Your plan assumes your income continues.
See your disability coverage gap — free calculator at MedDisabilityCalc.
Calculate gap →
Loan balance
What you owe, year by year
Standard repayment plotted against the PSLF projection when enabled.
Net worth
When you turn the corner
After 32% tax · minus living expenses · minus loan payments.
Opportunity cost
$69K
If the $42K you paid above IDR minimums had been invested instead, it would grow to roughly this over the payoff horizon.
Assumes monthly contribution of the “extra” and compound growth at your assumed market return.
Audit trail
Year-by-year snapshot
First 12 years
Audit trail
Year-by-year snapshot
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