The Pay Off Debt vs Invest Debate (For Doctors)

If you hang around personal finance circles long enough, you will hear the term “investment arbitrage.” It sounds technical and intimidating, but the core idea is very simple. And for doctors, interest arbitrage usually shows up in one very real question:

Should I pay off debt or should I invest?

In this post, I will walk through what investment arbitrage really is, how people use the term in real life, and how I think about it in my own financial plan and for other doctors.


Upcoming Webinar | After the Correction: Why 2026 Is a Turning Point For Real Estate (March 5th)

This session with Lightstone Direct will cover:

  • Why new apartment and industrial construction is slowing down and why that matters for future rent growth
  • How rental demand has quietly reached record highs
  • Why steady cash flow and good management may matter more in this cycle than betting on rapid appreciation
  • Where larger institutional investors are putting money right now including workforce housing and smaller industrial properties

📅 Date: Thursday, March 5th

🕗 Time: 8:00 PM EST

Reserve Your Spot!


What Investment Arbitrage Technically Means

In its classic definition, investment arbitrage is the practice of buying an asset in one market and then quickly selling it in a different market at a higher listed price to lock in a profit.

interest arbitrage doctors

You are taking advantage of a price difference between two markets. You are not necessarily trying to predict the future (unless the investment you place it in is an active one). Most often, you are simply seeing a mismatch and capturing the spread.

That textbook definition is accurate. But it is not what most people are talking about when they use the phrase “investment arbitrage” in day to day financial conversations.

How Most People Use The Term

In real life, when someone talks about investment arbitrage, they are usually talking about this idea:

  • Borrow money at one interest rate
  • Invest that money at a higher expected rate of return
  • Use the higher return to pay back the debt and keep the difference as profit

You are still taking advantage of a spread. Instead of buying and selling the same asset in two markets, you are borrowing in one “market” and investing in another.

On paper, this can seem almost too rational. Just listen to Robinhood. Actually, please do not.

However, I do use this concept to some extent in my own financial plan. But you need to be very clear about what is guaranteed and what is not.

The Classic Question: Pay Off Debt Or Invest?

Here is where interest arbitrage shows up for most doctors.

You might have:

  • Student loan debt
  • A mortgage on your home
  • Other relatively low to moderate interest loans

Let us say your debt is at 4 to 4.5 percent. At the same time, you are investing in the stock market in a thoughtful way using low cost, broadly diversified index funds. Historically, you might expect about a 6-7% average return from that kind of passive index fund investing.

The rational math question becomes:

If my expected investment return is 6 to 7 percent and my debt costs 4 to 4.5 percent, why would I pay extra on my loans instead of investing more?

And make no mistake. This everyday example still fits into the above definition of interest arbitrage, and it is very unique to doctors. While we don't directly borrow money to then invest for a margin, that is essentially what we do when we neglect paying off our student debt (or other debt) to invest instead.

On a spreadsheet, that argument makes sense. You keep your low interest debt, invest aggressively, and “win” by capturing the spread. That is investment arbitrage in action.

But the spreadsheet is not the full story.

The Problem With “Rational” Arbitrage

The key issue is this: you can never guarantee your investment return.

Even with a simple, diversified, passive index fund strategy, you are not getting 7 percent every single year like clockwork. That 7 percent number is an average over time. Some years are far above. Some years are far below. That is how averages work.

Debt, on the other hand, is very simple and very guaranteed.

If you have a loan at 10 percent interest and you pay it off, you know with 100 percent certainty that you just locked in a 10 percent return on that money. You no longer pay that 10 percent interest. That is real, guaranteed, and immediate.

Compare that with someone offering you an investment that “should” return 10 percent. It might be a real estate deal or some other opportunity. No matter what they say, they cannot guarantee that return. No one predicts the future.

So while investment arbitrage can look clean on paper, in real life you are trading a guaranteed return for a hoped for return. That is a very important distinction.

Why I Do Not Love Extreme Interest Arbitrage for Doctors

There are people who push this concept to the extreme. They make only the minimum payments on their debt, invest everything else, and claim they are maximizing investment arbitrage.

To me, that is risky for two reasons.

First, you are relying heavily on uncertain returns. Markets have bad years. Real estate deals fail. That is just reality.

Second, there is a behavioral component. Debt weighs on you. For many people, carrying large balances while aggressively investing creates stress and bad decision making. Paying off debt, on the other hand, gives a sense of progress and control.

On the flip side, there is another extreme: the person who puts every spare dollar into paying off a 2 percent loan and does not invest at all. That also does not make sense to me. You are passing up the opportunity to build wealth in productive assets in order to get rid of very cheap debt.

As with most things in personal finance, the extremes are where you get into trouble.

Finding A Hybrid Approach

My own approach is a hybrid.

I very aggressively pay off my debt. Because I like the guaranteed return. I like the psychological benefit of seeing balances fall. And I like the freedom that comes with less obligation. I did that with my student debt until it was forgiven. And I do that with my home mortgage by paying extra to principal each month.

At the same time, I do not ignore investing. I still invest in the stock market using index funds. I also invest in real estate. That means I am not paying off my debt as aggressively as I possibly could, but I am balancing two important goals:

  • Reducing guaranteed costs and risk by paying down debt
  • Building long term wealth and financial freedom by consistently investing

I do not take on new debt just to invest. For example, I do not borrow on margin or take out extra loans simply to put more into the stock market. That kind of leveraged investing is dangerous in my view.

Instead, I accept that some level of arbitrage exists in my plan. I may have a mortgage at a lower interest rate while investing in assets that, over time, should return more. But I keep that risk in check and make sure my overall strategy still lets me sleep at night.

Where Do You Stand On Investment Arbitrage?

The important thing is not to memorize a textbook definition of arbitrage. It is to understand how this concept shows up in the real decisions you make as a physician:

  • How quickly do you want to pay off your student loans and mortgage?
  • Are you in line to achieve federal student loan forgiveness or not?
  • How much risk are you willing to take in pursuit of higher returns?
  • How much does debt bother you psychologically?
  • Are you tempted by extreme strategies, like borrowing specifically to invest?

There is no one “right” answer that fits every person. But there are clearly dangerous edges. Ignoring investing to focus only on very low interest debt is one. Taking on more and more debt so you can invest every possible dollar is another. As doctors, we generally don't need to take extra risk thanks to our status as high income earners.

A balanced approach that respects both the math and the behavioral side tends to work best. Pay down your debt at a healthy pace. Invest consistently in simple, low cost index funds. If you decide to add things like real estate, do it thoughtfully, not as a way to justify more leverage in the name of arbitrage.

In other words, doctors need to understand investment arbitrage, but do not let the idea push you into extremes. Use it as one lens to look at your financial choices, not as a rule that overrides common sense.

Final Thoughts

Investment arbitrage sounds complex, but at its core it is about spreads. In theory, you borrow at one rate, invest at a higher rate, and keep the difference.

In practice, for most doctors, the real question of interest arbitrage is how to balance paying off debt with investing for the future. My take? The guaranteed return from paying down high interest debt is powerful. The potential long term growth from investing is also powerful. The sweet spot usually lies in a thoughtful middle ground that honors both.

Take some time to think about where you sit on this spectrum. Be honest about your risk tolerance and your feelings about debt. Then design a plan that fits you, not a theoretical spreadsheet.

These resources can help:

What do you think? How do you view interest arbitrage for doctors? Is it a strategy to be used or a pitfall to be avoided? What does your plan call for? Let me know in the comments below!

Love the blog? We have a bunch of ways for you to customize how you follow us!

Join 20,000+ physicians on a journey to financial freedom.

Join The Prudent Plastic Surgeon Facebook group to interact with like-minded professionals seeking financial well-being

The Prudent Plastic Surgeon

Jordan Frey MD, a plastic surgeon in Buffalo, NY, is one of the fastest-growing physician finance bloggers in the world. See how he went from financially clueless to increasing his net worth by $1M in 1 year  and how you can do the same! Feel free to send Jordan a message at [email protected].

Leave a Reply

Your email address will not be published. Required fields are marked *

Related Posts

March 11, 2026

Cash your dividends…or compound them?

Reinvesting vs taking cash can change your long-term returns.

March 11, 2026

How Many Rental Properties Do You Need to Retire?

It seems like a straight forward question. How many rental properties do you need to retire? However, it is very much a subjective question. And

March 9, 2026

Doctors vs Financial Advisors: Who Actually Wins?

Most physicians get pitched an advisor before they even finish training. But do you actually need one?