Hi everyone. Looking for guidance from people who understand student loan strategy.
Background (brief):
- 32 y/o
- GED → college at ~24 (independent FAFSA status)
- Started with an associate’s, later transitioned into EMS (EMT to paramedic)
- Entered a 3+2 PA program in 2022 at age 28
- No student loan debt prior to PA track
Current situation:
- ~$150k total debt so far (undergrad + first two semesters of PA school, started May 2025)
- Loan mix includes:
- Federal subsidized & unsubsidized loans
- Some private student loans (used for living expenses earlier on)
- Beginning Grad PLUS loans now for tuition + living expenses
- Final didactic semester ends May 2026
- Clinical year: May 2026–May 2027
- Graduation: May 2027
Projected outcome:
- Estimated total debt at graduation: $250k+
- No family financial support, no savings, must maintain independent housing
- Average PA salary in my region: ~$110k/year
I always knew PA school would be expensive, and I worked as much as possible during undergrad as a medic, but full-time work wasn’t feasible due to GPA requirements for matriculation into the graduate portion of the program.
What I’m looking for:
- Realistic repayment strategies at this debt-to-income level
- Thoughts on aggressive payoff vs IDR vs PSLF (if applicable)
- How to prioritize federal vs private loans post-graduation
- Anything you’d do differently if you were starting over in my position
Not looking for judgment or hindsight critiques, just practical advice from those who’ve navigated similar numbers.
Thanks in advance.
PA student projecting ~$250k total debt looking for realistic repayment strategy advice
byu/bearyhappytobhere inStudentLoans
Posted by bearyhappytobhere
4 Comments
How much is your PA school? I’m an incoming student and I’m wondering how similar our situation is
Gonna be very hard / impossible to pay off $250k on $110k income
Best bet imo is to get on IDR for federal loans and find a job at a PSLF-qualifying hospital (lots of options). Then just pay the minimum on your federal loans and try to pay ahead on the private ones if possible
Maybe consider getting a VA job, specifically one that qualifies for the Education Debt Reduction Program. It’s easier said than done because they don’t hire new grads often, but it could be worth a shot
Congrats on your educational Journey. So if you still have federal loan capacity that you don’t need for school, I’d take out more federal loans to pay off your private loans, if you can. This gives you much more flexibility for repayment.
PSFL is def the way to go. Depending on where you live, it’s pretty easy to find a PA job for a major Health system that is a nonprofit (most of the health systems tied to big universities are non profits). Ride out your 10 years. Income driven payments can qualify you for PSFL.