The excitement over completing medical school and beginning your career as a doctor may be tempered by the idea of repaying your student loans. Over the years you may have watched those numbers add up, or you may have made up your mind not to pay attention. You needed the money to pay for school, so there wasn’t anything you could do about it. Now as you set off on your career, it is time to take action. Once you are working, those payments come due. For many early-career physicians, the student loan payment will be more than rent, mortgage, or any other expense. While repayment is necessary, there are ways to make it more manageable.

Consider Consolidation

You can take all of your existing student loans and consolidate them into a single payment. This not only simplifies the repayment process, but it can also lower your monthly expenses. For example, your existing loans are probably on a 10-year repayment term. When consolidating, you can also extend the repayment terms over a longer span which lowers your overall monthly payment significantly. Another plus of consolidating is a lower interest rate. Any savings on the interest rate will lead to not only a lower monthly payment, but could save thousands in interest over the life of the loan.

Paying More Interest

One consideration that may stop you from refinancing and extending the term of your loan is the additional interest you pay. Even at a lower interest rate, extending the repayment terms from 10 to 30 years means you will pay more in interest overall. When consolidating, check that there is not a penalty for early repayment. Early in your career, the long hours and lower pay can make repayment a painful process. Once you complete residency and any fellowships or additional training, your salary will take a jump, and you can afford a more aggressive repayment plan. Consolidating takes the pressure off during those early, lower-earning years, and then allows you to control how aggressively you attack the debt later on.

Explore Your Options

Depending on your specialty, you may consider forgiveness. The terms of this program require that you work in a non-profit or under-served setting. Not all loans or positions qualify for loan forgiveness, so if it is something you wish to explore, make sure that the choices you make with your finances and job selection align with this goal. Another consideration is your plan for your personal life. If you are considering having a family once you establish a career, you may choose to pay aggressively early on, even if it makes finances tight while doing so. Working as a resident requires long hours and not much time for a social life, so living in a small apartment that you choose based on cost rather than amenities allows you to dedicate more of your smaller salary to debt repayment. Later, when your income goes up and your schedule is more reasonable, you may decide to consolidate to lower your payments to purchase a home or work a reduced schedule. Working as a doctor allows flexibility. To take advantage of it, you need to have your educational expenses under control.