Already have a ton of student loan debt.....suggestions please!!! Ah!

I feel like I’ve been a frequent poster lately. Anyhow, I already have a TON of student loan debt, both from undergrad and my doctoral work. My fiance (we will be married in October) is about to be a PGY2 in internal medicine, so he also has a TON of student loan debt. Between the two of us, whew! It’s overwhelming. I’m working towards my pre-reqs now and am trying to do it as cost conscious as possible(CC or state U). I’m (we’re) going into this with over 300k in student loans. Any suggestions for me as far as financing all of this goes (prereqs and school, if I can get in).

We had huge student loans after grad school, though nowhere near yours. Probably around $100k, and with only one income (around $50k per year). We worked hard, lived frugally, and…took out value in our house to consolidate.


If you’re going to have two professional incomes including a doctor’s salary, then honestly, you will be fine. Just live like students for the first five years and pump all your income into debt repayment. At the rate you will be earning money, you might actually completely pay off your debt in that time.


Seriously, this could happen. Assume you’re bringing in, let’s say, a combined total of $350k per year. After taxes, you will have around $200k to live on, and just the two of you, or maybe even a baby by then. You can very easily (and comfortably) live on $50k per year, unless you insist on twice-yearly flights to Paris and caviar every Friday. That means you’re repaying $150k per year into your loans. At that rate, $300,000 in loans will still be paid off in just over TWO YEARS, and you’re golden. Even a lower repayment rate, say $100k per year, will repay even more extensive loans in short order, within several years.


Just don’t buy a 5000-sq-ft house or a Beemer until your loans are paid off. Live frugally, enjoy the non-materialist lifestyle, and get your finances in order when you’re pulling down the big bucks.

You are not alone! Part of the real reason I am aiming for med school and not FNP, besides the fact that FNP is not a high enough level of practice for me and I don’t really want to either, is that I straight up can’t afford to be an FNP. I need to bump my income up to the next level in order to meet the demand of the existing and expected debt for my new professional aspirations.


In ten years time, even though I will need to borrow probably another $150k for med school, I will be a good 500 grand ahead of myself if I was a Family Nurse Practitioner/Psych specialty instead. And I may not be able to afford to be an internal medicine or family medicine practitioner either. Might have to look at other options… like gas or a psych specialty or CC/Trauma surgery. I also like the idea of putting people to sleep for a living, or working with sleeping, sedated, people. lol.

Especially since your fiance is already in residency, you need to at least look into Income Based Repayment and Loan Forgiveness available through the US Dept. of Education. Check with the AAMC for details. www.aamc.org/FIRST Questions to first@aamc.org or contact the financial aid office where he graduated.


This is a new and generous program which may lower your payments and significantly reduce the amount you have to repay without all of the stipulations attached to some other repayment offers.

What about the costs of malpractice insurance?

  • blueshift Said:
What about the costs of malpractice insurance?



If insurance costs you 20% of your income, just figure your income at 20% less. It will still be significant money. The point is the same: If you live a frugal, non-materialistic lifestyle, you will pay off the student loans in short order.

Malpractice insurance is going to vary widely depending on what type of practice you are in and where you are. Many physicians join groups or choose hospital employment where malpractice insurance is part of the benefits package.


In any case, who knows what will happen to malpractice insurance over the next several years. A few state have already addressed the issue (Texas, for example), and I expect more states will eventually.

Hey there! This is such a frequent problem! My advice would be that if you have a lot of debts from different lenders, combines all the student loan debts into one debt through a debt consolidation process so that you will get money in low and fixed interest rates.