be in the ‘high earner’ group, but we must pay our bills now, when we either have no income as medical students or a small income (compared to loan burden) as a resident.”


Over 90% of survey respondents said their plan is to slowly pay back their debt as they work—a task that can be long and difficult.


“The resident pay is not sufficient to cover student loan interest in its current state,” said Samuel Ianuario, MD, a resident at LewisGale Medical Center. “For example, I will accrue about $2,400 a month in interest, but my monthly pay is about $3,000 after taxes and benefits are withdrawn.”


According to Dr. Ianuario, his residency period is expected to last 6 years. “No matter which plan I choose or how much I pay towards my student loan, the interest will accrue to the point where my original $450,000 loan capitalizes to over $650,000 by the time I finally make a salary sufficient enough to meet the demands of a loan this steep,” he said.


While some survey respondents, like Dr. Weber, were able to take electives offered by their medical schools that provided debt education, many aspiring physicians feel there is a significant knowledge gap on the topic.


“Whenever I express apprehension about my loan debt, I’m typically greeted with ‘it’s an investment in your future. You’ll pay it off in no time.’ Only through open discussions with my attendings have I learned some of the challenges and nuances of paying back loan debt,” said Stacy Ruther, a medical student in Arizona. “For example, one attending explained that he had refinanced his loans early on and didn’t realize this made him ineligible for loan forgiveness programs.”


Ruther said she believes that more education on the pros and cons of different loan repayment options would be incredibly valuable to medical students, especially those in a specialized field like IR.


“If we have a better understanding of our options, we can make more informed decisions,” Ruther said. “Typically, loan forgiveness options are thought to apply


If you have student loan debt, approximately how much will you owe when you complete your degree or residency?


ANSWERED: 195 SKIPPED: 19


$5,000– $50,000


$60,000– $100,000


$110,000– $200,000


$210,000– $350,000


Other (please specify)


0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Would you consider working in a rural or underserved area in the United States in order to pay back your student loan debt?


ANSWERED: 191 SKIPPED: 23 Yes


No 0 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


only to primary care specialties. I think it’s a shortcoming of our medical system because many rural areas lack specialty providers more than anything.”


Existing rural relief programs Of the survey respondents, 80% indicated they would be willing to work in a rural or underserved community to pay back their loans, if given the option.


There are federal loan forgiveness programs that, in part, target rural workforce shortages, but IRs are eligible for only a few.


1. The NHSC Students to Service Loan Repayment Program: Provided by the Health Resources and Services Administration, this program will award up to $120,000 in relief over 4 years to those working in


health professional shortage areas. Recipients must provide 3 years of service at an approved site in a Health Professional Shortage Area (HPSA).


2. Indian Health Service (HIS) Loan Repayment Program: Eligible physicians can receive up to $25,000 a year in loan repayment in return for 2 years of working full time at a qualifying site administered by the Indian Health System, a Tribal organization or an Urban Indian program. Participants can extend their service commitment.


In addition, some state governments offer loan repayment programs that target underserved areas, such as New York. The Regents Physician Loan Forgiveness Program will provide up to $20,000 in repayment for physicians


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