One in two medical residents has student loan debt of more than $ 200,000. Four in five have at least $ 100,000 in debt. Asked about their biggest financial concerns, a survey of residents found that loan debt was at the top of the list.

As these numbers indicate, medical school is expensive and will likely require some sort of funding from the student. Yet, intimidating as these numbers may seem, if your passions lead you to consider a career in medicine, they shouldn’t deter you.

A four-part series of “Making the Rounds” Podcast-Listen and Subscribe on iTunes Where google play– currently airing focuses on student loans, student debt and financing. The podcast features expert advice from Alex Macielak of Laurel Road and Chirag Shah, MD, anesthesia specialist. Here’s a look at some of the takeaways that put the debt burden into context.

When it comes to debt related to training and graduate degrees, lawyers and doctors rank among the highest occupations. Yet these interns also have high income potential when they reach their professional heights. Considering this, medical school can be seen as a down payment on a potentially lucrative career.

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“I worked before going to medical school, so I had some money set aside to pay for the first part, but it’s obviously very expensive,” said Dr Shah, anesthesia researcher. at the University of Illinois. on “Take the Tour.” “I was actually able to refinance and it made me feel a little better about the investment I was making. Yes, that’s definitely a scary thought and it’s not a small number, which obviously adds to the anxiety. But as working professionals, we should be able to pay this back over the period that most of these loans are over. “

When your loan payments begin after you graduate from medical school, you won’t be maximizing your professional income. But, your loan repayments, with income-based programs, will reflect this.

“The first strategy a doctor should look at when you leave school and formulate your repayment strategy for residency, then look at federal repayment programs,” said Macielak, a student loan industry veteran who has helped thousands of physician borrowers determine their optimal repayment strategy.

“There is a refund based on income, a salary as you earn and a revised salary as you earn. All three require the borrower to make their monthly payments based solely on their income and family size, as opposed to what they owe. Instead of paying thinking you owe $ 200,000, you pay based on your residential salary of $ 50,000 or $ 60,000 and that gives a monthly payment that is much more in line with your monthly cash flow.

This includes the potential for debt cancellation; those who plan to work in nonprofit or government institutions for at least 10 years can use income-based repayment to continue the civil service loan forgiveness program. This option allows nonprofit employees to have their federal loans fully canceled – tax-free – after making 10 years of income-based payments.

“There are opportunities to use debt efficiently and economically,” Macielak said. “Whether it’s using federal repayment programs to get interest subsidies or getting your loans canceled, or refinancing and locking in a lower interest rate. There are opportunities for healthcare professionals [who] have very, very low unemployment rates and therefore very low debt default rates and that makes you one of the best loan candidates out there, and in many cases as you have seen in refinancing, eligible for very, very low interest rates. “