Welcome to the latest episode of the Physician Cents Podcast, where we explore complex financial topics tailored specifically for physicians. Whether you're a medical student, resident, fellow, or attending physician, you're going to find valuable insights that can help you increase your financial IQ, further your financial journey, and improve your overall well-being. Hosted by Chad Chubb and Tyler Olson, let’s dive in!

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Student Loans, PSLF Updates, Home Buying, and Insurance: Real-World Answers for Physicians

Trying to make sense of doctor loans, PSLF, home buying, or the wild world of disability insurance? You’re in the right place, my friend. The Physician Sense podcast mailbag episode just dropped a mountain of wisdom, and we’re breaking it all down for you—like you’re sitting across the coffee table, muffin in hand, sweating over your future finances. Whether you’re just starting med school, getting roasted somewhere humid, or gritting your teeth under the weight of your third-year fellowship, we’ll break it down with answers and a lived-in, honest vibe. Ready? Let’s run through what you actually need to know.

The Current State of Public Service Loan Forgiveness (PSLF) for Physicians

All right, first big question on everyone’s mind: What’s happening with PSLF? Is it going away? Is it about to change? Is Uncle Sam playing a cosmic prank on interns?

Let’s hit the basics first.

What Is PSLF and Who Actually Gets It?

The PSLF program (Public Service Loan Forgiveness) is like that elusive unicorn everyone in medical training keeps hearing about. You work ten years in qualifying public service jobs, make 120 qualifying payments on your federal loans (think nonprofit hospitals, government gigs, academic centers—all the usual suspects), and—whoosh—your remaining federal student loan balance vanishes, tax-free.

Here’s the kicker: PSLF is still available to incoming interns as of July 2025. Yes, you read that right. If you’re starting your intern year, you’re not excluded from PSLF. This is a hot topic because so many incoming doctors (and future incoming doctors) are worried the door is about to slam shut.

Now, there’s a wrinkle—the rules can change for future medical students entering after the latest proposed legislation goes through. Let’s not lose sleep tonight, though. If you’re already out of med school and in training, you’re in.

Interns, Residents, Fellows, Attendings: Does the Label Matter?

Absolutely. The big distinction the hosts make is this: If you’re an intern, senior resident, fellow, or even an attending (provided you finished med school), PSLF remains on the table. Only current medical school students and future applicants may be looking at new rules when the legislative winds shift.

Legislative Status Update: House/Senate Bills and What’s Next

Now, let’s get into this moving target. As of the beginning of July 2025:

No current law is canceling PSLF for current trainees.
House and Senate bills are on the table, juggling lots of new ideas. Nothing’s final.
Medical people freaking out about change: Your PSLF is safe—for now.
Big talk in Congress? Adjustments to income-driven repayment (IDR) plans like IBR (Income-Based Repayment) and RAP (Revised Pay As You Earn Alternative Plan), which could shape monthly payments and what counts for forgiveness.

You want the too-long-didn’t-read? Here it is:

No PSLF changes for folks already out of med school.
Legislative sausage gets made slow—probably nothing concrete until 2026.
Some scary headlines (capping forgiveness at $150,000 for professional study, changing plan options), but no law yet.

Knowns:

PSLF is alive for current trainees.
Bills floating around, but nothing signed or enforced.
Government loves changing student loan rules mid-game—expect new info every few months.

Unknowns:

What plans qualify for PSLF in the future? IBR and RAP seem likely, but not in stone.
Will they cap forgiveness for grad/professionals?
What will repayment amounts look like under the new plans?

Want updates on the daily drama? Tap in to Tyler Olson’s Twitter feed—he’s living in the student loan news cycle so you don’t have to.

Real-Life Advice for Medical Trainees on PSLF and Repayment

Let’s cut through it. Here’s how you play this round:

If you’re in medical training and PSLF is your goal:

Stay on a low-cost IDR plan. Lower payments = more breathing room.
Don’t go superhero and pay everything extra unless you’re married to someone earning serious cash.
The only time to smash extra debt is if you and your partner both have fat incomes or unique situations.

“This is not time for debt payoff for most interns.” Think cash flow, not crushing debt, until you’re actually earning that attending income and can see your career map more clearly.

So what do you do once you finish training and start raking in the big checks? That’s when you can revisit your loans, your goals, and what the next move is.

Chopping Up Federal Loans: The “Chunked Refinancing” Strategy—Genius or Just Extra Work?

Bet you’ve heard about refinancing all your federal loans into private loans to grab a lower rate. But what if, instead, you just refinanced in small chunks—as in, move $30,000 at a time from federal to private, then pay that chunk (supposedly at a better rate), and repeat?

Hang on—let’s break down what this hospitalist came up with and if it’s worth your time.

What Is Incremental Refinancing?

Here’s the play-by-play from the mailbag:

Start with your (let’s say) $300,000 in federal student loan debt.
Decide you’re not aiming for PSLF (maybe you’re in private practice).
Instead of refinancing the entire amount, you move over $30,000 chunks at a time to private loans.
Tackle that small private loan fast, keep the rest federal (so you hang on to those sweet federal protections and flexibility).
Repeat until you’re debt-free or bored stiff.

Pros and Cons of This Approach

Let’s call it like it is. Here’s how the “chunk at a time” refinancing looks on paper:

Pros:

Maybe you get lower rates on the $30K private chunk (if today’s market isn’t wild).
You keep the bulk of your debt in federal loans—so, if disaster strikes, you still have those government perks (forgiveness, income-based plans).

Cons:

Bunch of extra admin work: multiple private loan applications, tracking payments, dealing with fine print.
Possible refinance fees every chunk (ouch).
Private loan interest rates change all the time—last year’s sweet deals might be gone today.
If private rates drop low enough that you save real money, why not just refinance the whole loan instead of playing Jenga with your debt?
Federal loan protections matter, but if you’re set on paying everything off fast, you’re already moving out of the government safety net.

The truth: This sounds like a lot of paperwork for not a lot of actual savings. Unless the math clearly checks out (and you love loan applications like cats love bathtubs), it’s tough to see the big win here.

When Could This Ever Make Sense?

In the rare world where:

You’re an attending making good money and ready to kill your debt quickly,
Private rates on small chunks are way better than your federal rates,
You’re a little risk-averse but want to hedge your bets,

...well, maybe. But for most physicians, just picking a lane and running with it makes more sense. You want protection from bad breaks? Get top-notch disability insurance. You want to save money on interest? Refinance once, and move on.

Want a pro’s opinion? The hosts admit even they haven’t seen this one in action—and they see dozens of debt strategies a week.

Bottom line: Not a strategy for most. If you hear about it in the wild, give that hospitalist street cred for creativity, but don’t expect to see everyone doing it.

Med School Debt and Buying a Home: What Really Happens to Your Mortgage Dreams?

Let’s shine a light on one of the scariest parts of being a newly minted doc: “Is my mountain of med school debt going to kill my shot at buying a house with my partner?” Good news—there are options.

Demystifying Debt-to-Income Ratios (DTI) for Physicians

DTI is mortgage speak for: how much do you owe each month (on loans, cars, credit cards) compared to how much you make. Banks love this ratio—too high, and they run. So what happens when two people want to buy a home and one has med school debt stacked higher than their car?

Let’s break it down, mailbag style.

FAQ: Common Home-Buying Scenarios for Physicians with Debt

Married, but only one borrower on the mortgage?
- The bank looks at only that person’s income and debt. Spouse’s debt isn’t counted.
Both partners on the mortgage?
- Income and debt from both get factored in. Sometimes that helps (more income), sometimes it hurts (more debt).
Not on the mortgage but on the deed?
- You can own the home (on the deed) even if the mortgage is only in one partner’s name.
How do student loans count?
- Depends on the lender and the repayment plan.
- Income-driven repayment plans show lower monthly payments, which can help your DTI.

Big note: “Debts won’t necessarily block your real estate goals!” Most buyers only list one spouse for the mortgage anyway. It’s more common than you think.

Tips for Medical Students, Residents, and Their Partners Eyeing That First Home

Here’s what actually works:

Talk to a mortgage broker early—let them run numbers for both of you, together and apart.
Make sure your lender “gets” doctor loans and knows how to treat income-driven student loans.
If your partner has a W2 job and good credit, use that to your advantage.
Don’t panic about being “left off”—if you’re on the deed, you co-own the house.
If your student debt payments are low (hello, IBR or REPAYE), lots of lenders give you more breathing room on DTI.

Always, always, always check with your own lender—these rules can shift faster than Florida weather.

Disability Insurance: The Single Most Important Backup Plan for Physicians

Here’s something not enough people talk about—your career, your income, your ability to do those fancy doctor things, can all stop in an instant. That’s why disability insurance matters so much.

Why Disability Insurance Is a Must-Have for Doctors

Let’s face it. If you get sick or injured and can’t practice, all of those years of hard work and debt can go up in smoke. That’s not drama, that’s just numbers.

Here’s a gut-punch stat: More than half of fully underwritten disability insurance applications get denied or modified for new physicians. (See the 2025 Milliman Survey if you want the receipts.)

What does “modified” even mean? It means you thought you’d get a juicy policy and instead, the company slaps restrictions on it. Not ideal. Denied? Even worse.

Guaranteed Standard Issue (GSI): Disability Insurance for Mayo Residents (and Beyond)

Now, the good news. If you’re at Mayo Clinic (shout out, Jacksonville!)—or another big-name program—you probably have access to a Guaranteed Standard Issue policy. This is the ultimate “no underwriting, no awkward questions, just sign here” disability coverage for folks in training.

GSI at Mayo gets you:

$5,000 a month while in training (enough to breathe easy)
Ability to bump that up to $15,000/month once you’re an attending
No medical underwriting—so no random note from your primary care from four years ago is going to torpedo your application

If you can get GSI, especially at the start of your training, don’t hesitate. It’s like a VIP pass for insurance. Once you develop any health problems, getting normal coverage can get...messy.

Want the right experts in your corner? Trusted names include Physician Financial Services and MR Insurance Consultants. Or just connect with Larry Keller or Michael Relvas—these folks know the ropes, and if they can’t help you for your particular spot, they’ll point you to someone who can.

A big thank you to everyone sending in real-life questions. That’s what keeps the podcast and blog rolling with actual advice, not just boring theory. Love mailbag episodes? More are coming, stacked with breaking news on tax changes (watch for the “SALT tax” deep dives) and student loan updates.

Wrapping It All Up: What to Do Next

If you remember nothing else from this blog, take these tips with you:

PSLF is safe for interns and current trainees as of July 2025.
Stay on income-driven repayment plans until you know your long-term path.
Don’t get clever with loan payoff strategies unless the numbers seriously work out.
Your debt won’t block you from home ownership—just plan smart and talk to lenders.
Disability insurance isn’t optional. Get it early, especially if GSI is available.

Getting your financial life together as a physician isn’t a straight line, and it definitely isn’t boring. Expect more twists than a Jacksonville hurricane path or a Rochester hockey trip. But with the right info (and a solid sense of humor), you can make it through in one piece.

Mailbag’s open. More episodes are on the way. Go grab that pumpkin latte—you’ve earned it.

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_{The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don’t expect!) about a sponsor, please let us know. We call it the “best of the best” for a reason, and we will maintain that standard for our listeners & viewers.}

_{This information is for general purposes only. This information is not intended to be a substitute for specific professional financial, tax, or legal advice, as individual circumstances vary. Please see a financial professional, CPA, and/or an attorney in regards to your own individual situation.}

_{Wealthkeel’s Advisory Services and Financial Planning offered through Vicus Capital, Inc., a Federally Registered Investment Advisor. WealthKeel LLC, 615 Channelside Drive, Suite 207, Tampa, FL 33602 -- 267.590.9533.}

_{Olson Consulting LLC, Offering Advisory Services and Financial Planning, is a State-Registered Investment Advisor.}

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Student Loan Mailbag Episode: Your Questions, Our Answers