Should I refinance my medical school loans?
Refinancing replaces your federal (or existing private) loans with a new private loan, ideally at a lower interest rate. Done at the right moment, it can save a physician tens of thousands of dollars. Done at the wrong moment, it can permanently destroy a benefit worth far more. The trick is knowing which situation you're in. Work through these questions in order.
Question 1: Are you pursuing PSLF — or might you?
If you work (or expect to work) for a nonprofit hospital, academic center, or government employer, do not refinance. Refinancing converts your loans to private debt and permanently forfeits Public Service Loan Forgiveness — potentially six figures of tax-free forgiveness. Even if you're unsure, the option to pursue PSLF has real value; don't give it away cheaply. This single question disqualifies refinancing for a large share of physicians.
Rule of thumb: if there's a reasonable chance you'll spend your career at a qualifying employer, stay federal until you're certain. You can always refinance later; you can't un-refinance.
Question 2: Do you still want federal protections?
Federal loans come with safety nets private loans don't: income-driven payments if your income drops, generous deferment and forbearance, and the income-driven forgiveness backstop. If your balance is very large relative to your income, those protections — and the possibility of forgiveness — may be worth more than a slightly lower rate. Refinancing trades all of that for a fixed contract.
Question 3: Is your balance manageable for your income?
For an attending with a balance that's modest relative to a strong, stable income — say, you'll comfortably pay it off in 5–10 years — refinancing to a lower rate is often the cheapest path. You won't reach income-driven forgiveness anyway (you'd pay it off first), so the federal benefits aren't doing much for you, and a lower rate simply saves interest.
Question 4: Will the new rate actually beat your current one?
Refinancing only helps if the new rate is meaningfully lower than what you're paying now. Physicians with strong credit and stable income tend to qualify for the best available rates — in 2026, competitive fixed physician rates have run roughly 4.0–5.5%, with shorter terms priced lowest. If your federal rate is already below that, refinancing may not save enough to justify losing federal flexibility.
Choosing a term once you've decided to refinance
Shorter terms carry lower rates and far less total interest, but higher monthly payments. Longer terms lower the monthly bill but cost more overall. The right term is the shortest one whose monthly payment fits comfortably in your budget — that minimizes total interest without straining your cash flow. Seeing all the terms side by side (monthly vs. total cost) makes the tradeoff obvious.
Timing: now or wait?
If you're a resident a year or more from finishing, there's a strong case to wait. Your best refinance rates arrive once you're an attending with a high, stable income — and staying federal during your low-income training years keeps your payments tiny and your PSLF option open. Refinancing in residency locks in a worse rate and closes federal doors. Most physicians who ultimately refinance do it after starting as an attending.
If you're already an attending with no PSLF plans and a manageable balance, you're in the strongest position to refinance — and locking a fixed rate sooner protects you if rates rise.
Don't guess your rate. Our engine models refinancing at today's actual physician rates across every term, compares it against doing nothing, PSLF, and income-driven plans, and tells you whether refinancing is truly your cheapest path — before you ever talk to a lender.
Educational only, not financial advice. Refinancing federal loans permanently forfeits federal benefits. Get personalized quotes (soft credit check) before deciding.