Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Moving Past Debt 


With my student loans forgiven, financial pressures were substantially allayed. With this stress removed, I feel more focused on serving my patients.  

I recently had my medical student loan debt forgiven. I still don’t believe it, so I’ll write it again: today I had my medical student loan debt forgiven. I previously hadn’t been eligible for Public Service Loan Forgiveness, but because of the temporary rule changes, I was in fact eligible for the Temporary Expansion of Public Service Loan Forgiveness (TEPSLF). I filled out the forms, sent them in with a sticky note message attached thanking the person for helping me, and waited.  


This afternoon, my friend and colleague texted me a photo of her zero-loan balance. We were both waiting to hear about our TEPSLF applications, and sure enough hers went through! I logged into my account and mine said $0 too. My jaw dropped. I couldn’t believe over $90,000 suddenly went away. But it had.  


You may wonder, why does a well-paid physician care about this so much? I wondered that too. Since I finished residency, paying my monthly loan payment was a feasible expense. It was hard to fathom I would be doing this for 30 years (the extended repayment available if your balance was as high as mine), but I was almost to the 15-year mark. That being said, you make tradeoffs. As a primary care physician, I make a very good salary compared to the rest of the country but make less than half of some of my specialist colleagues. That means that I must decide between paying extra on my loans or saving for a first home down payment. Or saving for my wedding. Or paying for my kids’ daycare. So, it looked like it would be 30 years.  


But then, suddenly, it was over. I hadn’t realized how much of weight these loans were until they were gone. But upon reflection, I realized how my loans impacted my choices. In residency, there were more than a few times when the reason I got out of bed and went to work was my debt. I had no other marketable skill, so if I quit, I would have no way to repay my loans. After residency, I considered fellowships in geriatrics or medical education. However, I was single at the time, with one income, and two extra years of a lower salary was not worth it. As my now-husband and I were dating and discussing our future, we both disclosed our student loan balances to make sure we wanted to marry our loans.  


Tomorrow will be the first day that I will be practicing medicine without debt. It’s amazing to know that I’ll be going to work not because I have loans hanging over my head, but because I want to continue to care for my patients and do the work I do in medical education. When my patients ask me if I will be staying in our practice long-term, I can no longer dryly reply with the half-truth, “I’m not going anywhere, I still have my student loans.” I can instead tell them the full truth, that I’m sticking with them because this is exactly where I want to be. 







This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.