Before getting into this story, I want to acknowledge something many physicians quietly think about at the start of a new year: Is there a better version of this job out there for me? Less call. Better support. A different city. Or just a setup that fits the life you’re trying to build.

For years, I relied almost entirely on word of mouth when it came to job opportunities. Recently, though, I spent some time on Marit, and I was surprised by how quickly I found roles that actually aligned with my priorities.

Marit is a clinician-run job platform that pulls 100,000+ physician and APP jobs into one place. You can browse privately and see real details up front—salary ranges, call expectations, benefits, practice model, and location—without recruiter spam.

It's free for clinicians, find your next opportunity. (Sponsored by Marit)

On Halloween 2025, I received a letter from Mohela, my federal loan servicer, confirming that I reached student loan forgiveness after I completed 120 qualifying payments through the Public Service Loan Forgiveness (PSLF) program.

It was a letter I had started to believe would never come.

When I opened it, I felt an enormous sense of relief, gratitude, and accomplishment. For years, I worried my past financial mistakes would keep me from ever reaching this milestone. Early in my career, I couldn’t imagine a way out from under my massive student debt.

But another feeling crept in as I reread that letter: guilt. I found myself wrestling with a question I hadn’t expected. Can someone like me really deserve student loan forgiveness?

This post is about that journey, both the practical steps that led to forgiveness and the deeper questions it raised about fairness, privilege, and policy.

My Student Loan Journey

When I graduated high school, my parents were honest with me: they didn’t have money saved for college. I’d be responsible for everything, mainly through loans.

I decided to bet on myself. I wanted to attend the best school possible, and I chose Emory University. It was excellent, but also expensive. I received a small scholarship and a work-study job, but still graduated with about $200,000 in mostly private loans.

Medical school presented the same choice: attend a lower-cost state school or a higher-ranked private one. I chose the University of Rochester. That decision ultimately set me on the path to plastic surgery, a rewarding but long road. Still, it added another $250,000 in federal and private debt. I lovingly call it the best financial mistake I ever made.

After that came six years of plastic surgery residency and a one-year microsurgery fellowship. My debt terrified me, so I ignored it. Each year, I deferred payments because I earned little, lived in an expensive city, and didn’t understand how to create a savings rate. I also wasn’t properly informed about income-driven repayment programs that could have helped.

By the end of training, with interest, my student debt had ballooned to about $500,000. I had no plan and little hope.

So how did I end up reaching forgiveness?

The Mechanics of Student Loan Forgiveness

Here’s a quick overview of the Public Service Loan Forgiveness program:

• It applies only to federal Direct Loans. Other loans must be consolidated into a Direct Loan to qualify.
• It requires 120 qualifying monthly payments (roughly ten years) made under a qualifying repayment plan such as IBR, ICR, PAYE, or REPAYE.
• You must make payments while working full time for a qualifying employer, which includes U.S. federal, state, local, or tribal government organizations, or tax-exempt 501(c)(3) nonprofits.
• Private practices or for-profit hospitals do not qualify.

In practical terms, here’s what borrowers must do to achieve forgiveness:

1. Consolidate any non-Direct federal loans into a Direct Loan.
2. Enroll in a qualifying repayment plan (ideally one that minimizes your monthly payment).
3. Make monthly payments while working for a qualifying employer.
4. Submit your employer certification form each year to verify qualifying employment.
5. Track your progress at StudentAid.gov. Once you hit 120 payments, your servicer will issue a letter confirming forgiveness.

A few lessons and pitfalls to avoid:

• Stay in close contact with your servicer and StudentAid.gov to ensure payments and certifications are properly logged. Rules and systems change often.
• Remember: only Direct Loans qualify. If you have private loans, refinance them for the lowest rate possible and pay them down aggressively like I did.
• Don’t forget to consolidate any stray federal loans, or they won’t count toward forgiveness.
• And finally, celebrate the milestones. The first payment, the halfway mark, the final year, each is a small victory worth recognizing.

How I Reached Forgiveness

During my seven years of training, I deferred my federal loans because I couldn’t afford payments under the standard plan. I was told I didn’t qualify for income-based repayment, which I later learned was incorrect.

Normally, months of deferment don’t count toward PSLF.

But in 2018, the government launched the Temporary Expanded Public Service Loan Forgiveness (TEPSLF) program, allowing certain non-qualifying payments to retroactively count toward PSLF for Direct Loans. Later, the Income-Driven Repayment Account Adjustment also allowed some periods of deferment to qualify.

Here’s what I did:

• Consolidated my non-Direct loans into a Direct Loan.
• Applied for TEPSLF.
• Certified my qualifying employers (residency, fellowship, and attending roles).
• Enrolled in a qualifying repayment plan and kept making payments.

Because of these policy changes, many of my prior payments and deferment months were credited toward PSLF. By 2022, I was only about ten payments away from forgiveness.

The next three years were complicated. A court injunction paused my repayment plan, and it took months of bureaucratic effort to switch plans and resume progress. It's all laid out here. But finally, in October 2025, my remaining $268,000 in federal loans were forgiven.

The relief was indescribable. After years of anxiety and paperwork, it finally happened.

Do I Deserve Forgiveness?

That question still lingers.

I’m aware of my privilege as a physician, and specifically as one in a high-earning specialty. I understand the criticism that forgiveness for people like me seems unfair. Should taxpayers really “pay” for a doctor’s education?

Let’s look at this from a few perspectives.

Policy:
The purpose of forgiveness isn’t to reward individuals with certain net worth, it’s to shape behavior through incentives. PSLF exists to encourage professionals to serve the public in roles that might otherwise pay less. In both training and practice, I’ve provided reconstructive surgery to patients who would never have had access to it otherwise. That matters. Like the tax code, I followed the incentives as designed.

Moral reflection:
As physicians, we must balance gratitude with social responsibility. Our work is demanding and often underappreciated, but we also benefit from opportunities and programs not available to most people. Pretending otherwise risks sounding tone-deaf.

The counterargument:
Critics argue it’s unfair for others to fund a doctor’s education. I understand that view, but it’s worth noting that forgiveness doesn’t involve directly taking taxpayer dollars. It’s essentially accounting relief on government-issued debt. More importantly, our country faces a severe physician shortage. Programs like PSLF help attract and retain doctors in public and nonprofit roles, which benefits everyone.

As for physicians who already paid off their loans, I empathize with their frustration, but progress shouldn’t be halted because others didn’t have the same opportunity.

My take:
I met the requirements. I served the public. I followed the rules. By design, I qualified for the benefit. Ethically, I can accept that. On a broader level, the program aligns with my values: incentivizing public service and creating space for physicians to do meaningful work without lifelong debt.

Lessons Learned

My path to forgiveness followed five clear stages:

1. Fear: Avoiding my loans and letting interest grow.
2. Education: Learning about repayment options and forgiveness programs.
3. Opportunity: Applying for TEPSLF and benefiting from policy changes.
4. Execution: Staying organized, submitting forms, and making consistent payments.
5. Relief: Achieving forgiveness and reclaiming financial peace.

Here’s what I hope others, especially doctors, can take away.

For residents:
Educate yourself early. Get onto a qualifying repayment plan during training so those years count toward PSLF. When you become an attending, you’ll be well positioned to continue. If your employer doesn’t qualify, refinance and pay down your loans aggressively. See debt as a solvable problem, not a personal failure.

For attendings:
Revisit your student loans. You may still qualify for forgiveness under current programs. If you do, consolidate into Direct Loans, enroll in a qualifying plan, and certify your employment. If forgiveness isn’t an option, explore refinancing or adjusting your plan to minimize interest and accelerate repayment.

Above all, stay engaged. The rules evolve, and so do opportunities.

Final Thoughts

Achieving student loan forgiveness has been one of the most profound financial experiences of my life. It required persistence, education, and yes, a little luck.

But beyond the paperwork and policy, it raised bigger questions about fairness, opportunity, and gratitude.

I believe programs like PSLF can coexist with fiscal responsibility and moral awareness. They can both encourage service and acknowledge privilege.

But remember, debt management is only part of the path to financial freedom. These posts will help you get the rest of the way there:

• How Doctors Can Calculate Their Expected Net Worth
• The 7 Step Basic Formula for Wealth as a Physician
• The 1/3 Rule That Helped Me Build Wealth Fast
• How Much Do You Need to Save for a $5 Million Nest Egg?
• When Will I Truly Reach FIRE?

What do you think? Is student loan forgiveness fair for high-income earners? Have you achieved forgiveness or are you still working toward it? And will programs like PSLF continue to exist? Let me know in the comments below!