Medicine is not an easy field to get into. Medical school is tough, and the student loan debt accrued through attending can be an even greater challenge to overcome. For young physicians, at the start of their careers, the going can be tough. The pay isn’t always great for fresh graduates and the looming specter of the loan repayments can be a frightening prospect.

Here are 7 tips to help young physicians struggling under the weight of all of their debt:

Income Reporting

Certain student loan payment programs are income-driven and allow you to choose whether to use your most recent pays slip or your most recent tax return. When such a choice is offered, it is always best to choose the one that is most advantageous. For example, those that have just started their residency would benefit from showing the previous year’s tax returns as opposed to their payslip, as they would have filed taxes with no income.

Retirement Contributions

Now that we’ve established that tax returns can be used to show income, let’s take a look at another way they can be helpful. Pre-tax retirement contributions are a great way to reduce your Adjusted Gross Income (AGI). Loan payments are based on AGI and pre-tax payments like retirement contributions or a 401k are not included in it. A lower AGI reduces your required loan payment.

Filing Separately

For those that are married and have loans that qualify for programs like PAYE or IBR, filing taxes separately might be an appropriate route. Doing so isolates your income for the sake of loan repayments.  While this might be a good option for some, there are benefits to joint filing that you will be losing out on so make sure to carefully weigh up the pros and cons before making a decision.

Community Property

Another advantage for married physicians is available to those living in community property states, of which there are 9. Community property treats all marital income as joint, allowing you to report only a half of this total as your income. Should your spouse earn significantly less than you the average of your earnings will be far lower than your own earnings.

Going Rural

Going rural might not have been your first choice upon graduating, but the reality is that there are many loan forgiveness programs for physicians working in rural hospitals. These programs can offer significant reductions in loan payments in exchange for a commitment to working in one of the approved rural hospitals.

Veterans Affairs

One of the very best loan repayment programs available is offered by the VA. It entails forgiveness of up to $200k spread across the first 5 years you work there. This is a reimbursement program, meaning you will first need to make the payments yourself and then the VA will reimburse you when they are shown evidence that you have done so. Salaries at the VA are nothing to write home about, but this is a benefit not offered by many other workplaces.

Refinancing

Refinancing is one of the most common methods of working around student loan debt. It involves changing the terms of your initial agreement, and many young physicians use this option during residency to fully rid themselves of their student loans. The best way to use this option is by refinancing for a very long period at a higher interest rate and paying it off quickly. While the interest rate might be higher, this route offers a great deal more flexibility. Besides, if you pay it all off quickly you won’t be hit by the interest anyway.