Choosing whether to refinance your medical student loans is a high-stakes decision. For only 20–30% of physicians does refinancing beat federal forgiveness paths like PSLF. We compare the top lenders for residents (SoFi) and attendings (Earnest) with fixed vs. variable rates, resident-specific payment plans, and clear guidance on when to refinance vs. when to stay federal.
If you're a doctor carrying medical school debt, you've heard the advice: refinance to get a lower rate. But the real answer is more nuanced. Refinancing is the right choice for only about 20% to 30% of physicians — everyone else is better off pursuing Public Service Loan Forgiveness (PSLF) or an income-driven repayment (IDR) plan.1
So how do you know which camp you're in? It comes down to your employment path. If you work at a non-profit hospital, a VA, or an academic medical center, PSLF can forgive your remaining balance tax-free after 120 qualifying payments. Refinancing would forfeit that. But if you're in private practice, have a high-earning spouse, or simply want the lowest possible rate, refinancing makes sense.
Here are the two best lenders for doctors, depending on where you are in your career.
SoFi is the largest student loan refinancing platform in the U.S., and they offer specific benefits for doctors in training. Their resident program includes $100-per-month payment options during residency, which can be a lifeline when your salary is still low.1
They've refinanced billions in medical school debt and offer both fixed and variable rates. Fixed rates give you predictable payments; variable rates start lower but can rise with the market. For residents who plan to refinance again as an attending, a variable rate can save money in the short term.
| Spec | Detail |
|---|---|
| Resident plan | $100/mo payments during residency |
| Rate types | Fixed and variable available |
| Best for | Residents and early-career physicians |
Once you've finished residency and are earning an attending salary, Earnest stands out for its extreme repayment flexibility. They offer loan terms up to 180 months (15 years), which is longer than most lenders allow, keeping monthly payments manageable even on large balances.1
Earnest also uses a more holistic underwriting model that considers your savings and earning trajectory — not just your credit score. For attendings with high debt-to-income ratios, this can mean access to better rates.
| Spec | Detail |
|---|---|
| Max term | Up to 180 months (15 years) |
| Underwriting | Holistic — considers savings and career trajectory |
| Best for | Attending physicians with large balances |
When you refinance, you choose between fixed and variable interest rates.
This is the most important decision you'll make about your medical school debt.
Refinance if:
Stay federal (PSLF or IDR) if:
The rule of thumb from Student Loan Planner: only about 20–30% of physicians should refinance. The rest should max out PSLF.1
Disclosure: We may earn a commission if you click through and apply for a loan via the links above. This doesn't affect our recommendations — we only feature lenders we believe offer genuine value to doctors.
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