Loan Repayment Programs

Med school is no doubt very expensive, and for international medical graduates like me, living in the Caribbean where cost of living is high and traveling around to different clinical rotation sites does not help the amounting debt that we build up during our training. After four strenuous years, I now have an MD degree, a Dr. in front of my name, an intern position at a hospital, and over $317,000 of increasing med school debt. The only thing I know that is not increasing is the number of strands of hair on my head.

With my repayment grace period up, and not enough income to pay back with the standard repayment schedule, I immediately chose an income-based repayment schedule, which decreased the amount per month I have to pay to a fraction. Although I’m thankful that repayment is now doable, it’s still not enough to cover the interest, which would capitalize onto my principal over time and continue to increase my debt. My goal during residency is to pay at least the cost of the interest per month to prevent my debt from automatically increasing.

There are also several career paths and programs that family practitioners and other medical specialists can do that can help repay their debts. Here, I’ve compiled a list of some programs that are worth looking into. There are nation-wide programs as well as state-specific programs. I’ve included a Georgia program, because I’ll be practicing in Georgia, but many states have some sort of initiative for new physicians.

1. National Health Service Corps (NHSC)

• Who: Eligible applicants include Family Medicine, General Internal Medicine, General Pediatrics, Ob/Gyn, Geriatrics, Psychiatry physicians who have finished residency who are board-certified and/or state-licensed. PAs, NPs, Dentists, and several other health professionals are also eligible. You apply to the NHSC when you start working at an NHSC-approved medical facility.

• Where: The NHSC will help repay some of your loans if you work at an NHSC-approved medical facility in a Health Professionals Shortage Area (HPSA). If your medical facility is not NHSC-approved but is in an HPSA, you can apply for NHSC approval.

• What: If working 2 years full-time in an HPSA with score 14 or more, NHSC will help repay $50,000 of your loans. If working 2 years full-time in an HPSA with score less than 14, NHSC will help repay $30,000. If working 2 years half-time in an HPSA with score 14 or more, NHSC will help repay $25,000. If working 2 years half-time in an HPSA with score less than 14, NHSC will help repay $15,000. Loans that the NHSC are willing to help you repay include any federal or private loans that you have taken out and have not repaid yet. They will not help repay Parent PLUS loans or loans that you have already paid back. If you don’t follow through on the commitment, there will be monetary penalties, often more than the repayment amount.

2. Public Service Loan Forgiveness

• Who: Anyone working full-time for a public service organization. This isn’t just limited to health care professionals but also teachers, public safety officers, military workers, librarians, and law enforcers.

• Where: The loan forgiveness applies if you work for a public service organization, including those on a federal, state, local, or tribal level. It could also apply if you work for a non-profit, tax-exempt organization under section 501(c)(3) of the Internal Revenue Code. Labor Unions and Partisan political organizations do not count.

• What: Technically this is a loan forgiveness program rather than a loan repayment program, meaning that instead of the government helping you pay your loans, they’ll just forget about it after you fulfill your committment. If you work at least 30 hours per week for 10 years, the government will forgive your loans after 10 years, and whatever you still owe will not be counted as taxable income.

3. Georgia Physicians for Rural Areas Assistance Program

• Who: Eligible applicants include Family Medicine, General Internal Medicine, General Pediatrics, Ob/Gyn, Geriatrics, Psychiatry physicians who have finished residency and licensed to practice in the state of Georgia. The physician must accept and treat Medicaid patients.

• Where: The assistance program applies if you work in a medical facility, hospital or private practice, in a Georgia county with a population of less than 35,000.

• What: The Georgia Board of Physician Workforce (GBPW) will repay $25,000 of your student loans each year, for up to 4 years max (or $100,000). You must work at least 40 hours per week, and must work completely in a county of less than 35,000 in population.

4. National Institutes of Health (NIH) Loan Repayment Program

• Who: Scientists, Researchers, Physicians, and any other health professionals who have doctoral degrees. You don’t need an NIH grant to be eligible for the NIH Loan Repayment Program. For applicants with MD and DO degrees, I didn’t see anything about needing to have gone through residency to be eligible. Correct me if it is otherwise.

• Where: The repayment program applies if you do research with either the NIH or at a domestic non-profit research institute.

• What: The NIH will repay you up to $35,000 per year on your loans if you commit to do research for at least 2-3 years (depending on the type of research), with minimum 20 hours per week. The types of research that apply include: AIDS research, clinical research, pediatrics research, health disparities research, contraception and infertility research, and research on individuals from disadvantaged backgrounds. Loans that the NIH are willing to help you repay include any federal or private loans that you have taken out and have not repaid yet (Parent PLUS loans do not count).

5. U.S. Navy Health Professions Loan Repayment Program

• Who: You can apply for the repayment program if you are in your final year of residency as an MD, DO, or dentist. For physicians, you must be a graduate of an LCME or AOA accredited medical school (so unfortunately IMGs cannot apply).

• Where: You must serve at least 2 years in active duty (not reserve duty) to have repayment for one year.

• What: The maximum amount the navy will help you repay your loans is $40,000 minus 25% federal income tax. Not that great of a deal in my opinion.