Physician Student Loan Calculator: 2026 Edition
The IDR landscape changed significantly. SAVE was vacated by courts in 2025 and is no longer available. The plans currently on the table are PAYE, IBR (for borrowers with pre-July 2026 federal loans), and the brand-new Repayment Assistance Plan (RAP) introduced by OBBBA, available July 1, 2026. Compare all five options — including PSLF and private refinance — for your specific situation below.
What the plans actually do in 2026
| Plan | Payment basis | Term | Forgiveness | Taxable? |
|---|---|---|---|---|
| PAYE | 10% of discretionary (AGI − 150% FPL), capped at 10-yr standard payment | 20 yrs | Remaining balance | Yes |
| IBR (new borrowers) | 10% of discretionary (AGI − 150% FPL), no cap | 20 yrs | Remaining balance | Yes |
| RAP (new Jul 2026) | 1–10% of full AGI by $10K income brackets, minus $50/dependent; minimum $10/mo | 30 yrs | Remaining balance | Yes |
| PSLF | Lowest qualifying IDR payment (PAYE or IBR) | 10 yrs (120 qualifying payments) | Remaining balance | No — tax-free |
| Private refinance | Fixed amortization at private rate | 5–20 yrs | None | N/A |
RAP payment formula = (AGI × rate) ÷ 12 − ($50 × dependents).2 Rate steps up 1% per $10K of AGI, capped at 10%. Example: $65K AGI → 7% rate → $379/mo before the dependent reduction.
Why the right answer is rarely obvious
For a physician with $300K of debt at 6.8%, the typical decision tree looks like this:
- PSLF wins by a large margin if you'll work 10 years at a qualifying non-profit hospital or government employer. Your payments during residency are tiny (typically $200–300/month at $65K income), and forgiveness is completely tax-free. The catch is committing to a non-profit employer for the full decade.
- Refinancing wins if you're going into private practice or high-income employed work, can handle a $3–4K/month payment, and want to be debt-free in 5–7 years. You permanently give up federal IDR protections and PSLF eligibility the moment you refinance.
- PAYE and IBR produce nearly identical payments for most physicians — both use 10% of discretionary income with 20-year forgiveness. PAYE caps payments at the 10-year standard amount (matters mainly for physicians earning $500K+). IBR has no cap and slightly broader eligibility (no partial financial hardship requirement since 2025).
- RAP is the only IDR option for new federal borrowers after July 1, 2026 and is also available to existing borrowers as an alternative. Because RAP applies its percentage to full AGI (not discretionary income), it typically produces higher monthly payments than PAYE or IBR for resident-income physicians — but it does qualify for PSLF. Most physicians should prefer PAYE or IBR over RAP for PSLF.
- PAYE/IBR without PSLF is often the most expensive path — low payments during residency let interest accrue for years, leading to a large taxable "tax bomb" at 20-year forgiveness. It only beats refinancing when income stays unusually low throughout the repayment period.
This calculator projects simplified scenarios: income transitions from your current AGI to the attending AGI at the end of your training, then stays static for the remainder of the repayment term. It does not model salary growth, filing-status optimization (married-filing-separately often lowers PSLF-qualifying payments significantly), state income tax on forgiveness, or future IDR rule changes.
Related reading
Get a real loan analysis
This calculator is a rough compass. With SAVE gone, RAP launching July 1, and Grad PLUS being eliminated for new loans, the stakes of choosing the wrong plan have never been higher. A fee-only advisor who specializes in physicians can model your exact loan servicer balance, current IDR eligibility, projected income path, and PSLF counting status — and coordinate with your tax strategy and retirement plan.
Sources
- HHS ASPE — 2026 Poverty Guidelines (published January 17, 2026). 1-person FPL $15,960; +$5,680 per additional person, 48 contiguous states. Values verified June 2026.
- NerdWallet — What Is the New Repayment Assistance Plan (RAP)? RAP formula: rate = min(10%, (floor(AGI/$10K)+1)%) applied to full AGI, minus $50/dependent, minimum $10/month; 30-year forgiveness term; available July 1, 2026.
- Kitces — OBBBA Student Loan Changes (2025). RAP qualifies for PSLF; SAVE vacated; IBR available to existing borrowers through July 1, 2026 cut-off for new enrollment.
- Tate Esq — IBR 2026 Overview. New IBR (borrowers since July 1, 2014): 10% discretionary income, 20-year forgiveness. Old IBR (pre-July 2014): 15%, 25-year forgiveness.
Tax values and IDR plan terms verified against HHS, NerdWallet, Kitces, and StudentLoanPlanner as of June 2026. IDR regulations have changed frequently — verify your plan status with your loan servicer and a qualified advisor before making repayment decisions.