As long as your program is at a not-for-profit hospital system, the years you are in residency can count towards loan forgiveness through the Public Service Loan Forgiveness program through the government. With that program, you sign up for either Income Based Repayment or the Pay As You Earn repayment plans (which tend to have payments between $0-$100 per month while in residency) - for the former, your monthly payment is just 10% of your discretionary income (which is all of your income above and beyond some fraction of the poverty line - either 100% or 150% I can't remember right now) - the idea is that that should always be relatively affordable for you. With Income Based Repayment, it's 15% of your discretionary income. With either payment plan, if you make 120 payments while working at a not-for-profit hospital or clinic including any local,state, or federal program, then everything else you owe is forgiven. For most people, this is a really amazing deal. The cool thing is that those 120 payment (10 years) don't have to be consecutive, so if you wanted to you could work 5 years at a non profit, take a year off, work 2 years doing concierge medicine if you want, then come back to work for a non-profit and still wind up with 120 payments and loans forgiven. It's a pretty great plan for people interested in primary care, particularly in underserved areas. The other cool thing is that 70-80% of residencies are at not-for-profit hospital systems (sorry Kaiser residents!) so the years you are in residency, earning (and thus paying) very little, count towards the final loan forgiveness goal. Learning about it certainly lowered my blood pressure a bit!