Top medical specialties with highest student loan debt

By Victoria Holliday | Published on October 21, 2025

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As aspiring doctors embark on their medical careers, they often face a daunting challenge beyond their rigorous training: substantial student debt. While the rewards of practicing medicine can be significant, the financial burden and financial investment varies widely across specialties. In the US, healthcare workers are more likely than other professions to carry educational debt, collectively owing more than $150 billion.

In this post, we'll dive into the landscape of medical school debt, exploring which specialties tend to carry the heaviest financial burdens. Whether you're a pre-med student weighing your options or trying to understand your options for medical school student loans, understanding medical school can provide valuable insights into the education investment.

The big picture: Medical school student loan debt statistics

Before we break down the typical student loan debt held by medical specialty, let's look at some statistics that paint a broad picture of medical school debt in the United States:

• The average medical school debt is $234,597, and that's excluding premedical undergraduate and other educational debt

• 73% of medical school graduates have educational debt when they graduate

To put this in perspective, the average medical school graduate owes 2.25 times as much as the average postgraduate college student, including their undergraduate debt. And 70% of medical school students use loans specifically to help pay for medical school.

Debt by medical field and specialty

The proportion of physicians carrying student loan debt varies by specialty and area of focus. As of 2023 these are the top 10 medical specialties by the percentage of physicians with the most student loan debt:

Medical specialty

Percent still paying loans

Average salary

• Emergency Medicine | 31% | $437,000
• Critical care | 29% | $340,000+
• Family medicine | 28% | $283,000
• Physical Medicine & Rehabilitation | 27% | $306,000
• OB-GYN | 25% | $274,680
• Pediatrics | 24% | $190,350
• Urology | 24% | $424,300
• Plastic surgery | 23% | $441,008
• General surgery | 23% | $441,100
• Otolaryngology | 22% | $419,874

Source

What these numbers mean for aspiring doctors

For those considering a career in medicine, these figures shouldn't be discouraging but rather informative. Here are some key takeaways:

• Debt is common: If you're worried about taking on debt for medical school, know that you're not alone. The vast majority of medical students use loans to finance their education.
• Specialty matters: Your choice of specialty can impact your debt burden and your ability to repay it. Consider both your passion and the financial implications when choosing your path.
• Plan ahead: Understanding the potential debt you might incur can help you make informed decisions about your education and career. Consider factors like scholarship opportunities, loan repayment programs, and the cost of living in different areas when planning your medical journey.
• Education is an investment: While the debt numbers may seem daunting, remember that a medical degree is an investment in your future. Many physicians find that their earnings over time justify the initial financial burden.

Managing medical school debt

While the debt figures can seem overwhelming, there are several strategies that new doctors can employ to manage their student loans effectively:

Income-Driven Repayment (IDR) Plans

IDR plans can be a lifeline for many new doctors, especially during residency when salaries are lower. These federal programs adjust your monthly payment based on your income and family size.

The Department of Education explains all IDR Plan options on its studentaid.gov page. These are the three different plan types. Additionally there is the SAVE Plan but as of now, a federal court has issued a stay preventing the U.S. Department of Education (ED) from operating the Saving on a Valuable Education (SAVE) Plan. Please refer to studentaid.gov for the current status of SAVE.

• PAYE Plan: This plan uses your income and family size to determine how much you’ll pay, but your payments can’t exceed the standard repayment plan.
• IBR Plans: The only option that allows you to make income-driven payments while your loans are in default.
• ICR Plan: This plan uses 20% of your discretionary income. However, you cannot enroll in this IDR after July 1, 2024, unless you are the exception.

Loan Forgiveness Programs

There are also several loan forgiveness programs available to doctors, including:

• Public Service Loan Forgiveness (PSLF): For those working in qualifying public service jobs, this program forgives the remaining balance on Direct Loans after 120 qualifying monthly payments.
• National Health Service Corps (NHSC) Loan Repayment Program: Offers loan repayment assistance to healthcare professionals who work in high-need areas.
• State-specific programs: Many states offer loan repayment programs for doctors who agree to work in underserved areas.

Refinancing: A timely opportunity with low 2024 interest rates

Refinancing your medical school loans can be an excellent option for some doctors, especially in the current economic climate. Here's why:

• For the first time in 4 years, interest rates are low: The Federal Reserve recently lowered interest rates for the first time since 2020, which means that private lenders like Earnest are now offering some of the lowest refinancing rates we've seen in four years.
• Refinancing can provide potential for significant savings. By refinancing to a lower interest rate, you could save money over the life of your loan. Refinancing also allows you to consolidate multiple loans into a single loan with one monthly payment and simplify your repayments.

However, it's crucial to consider the trade-offs associated with refinancing. First, refinancing federal loans to private loans means losing access to all current and future federal benefits like IDR plans and loan forgiveness programs. Your eligibility and interest rate will depend on factors like your credit score, income, and debt-to-income ratio. You can easily check your rate with our rate-calculator to see how much you could save. It’s fast, free, and won’t affect your credit score.

Ultimately the best debt management strategy depends on your individual circumstances. If you're planning to work in the public sector or a non-profit hospital, keeping your federal loans and pursuing PSLF might be your best option. If you're heading into a high-paying private practice and have a strong credit score, refinancing could potentially save you a significant amount of money. Moreover, your debt management strategy can evolve as your career and earning potential changes. What works best during residency might not be the optimal choice once you're an attending physician.

By understanding your options and making informed decisions, you can find a path to financial freedom that aligns with your career goals and personal circumstances.

About the Author

Victoria Holliday

Victoria is the Head of Content at Earnest. She brings extensive ed-tech expertise from six years at Chegg, where she developed educational resources reaching over 20 million students nationwide.

With a Master’s in Political Science and experience in public policy from several California campaigns, she’s passionate about creating accessible content that enhances student outcomes in the dynamic world of higher education.