I had no interest in doing PSLF and I wanted to pay at least the interest on my loans while in residency. I refinanced and was able to pay more than interest accumulating every month and paid down some of my loan while in residency.
If you're having trouble making ends meet you have several options.
1. IBR
2. Choose to refinance and not be eligible for IBR plans
3. Forbearance as a last resort
4. Increase income by moonlighting or cut expenses by getting a roommate
As a side note, I was freaking out about paying 400-500 a month as an intern, figuring out how much this would effect my eventual debt wishing I could pay more. As an attending, I'm now throwing between 3-4k a month at the loans and could easily do more if I wasn't saving to buy a house. Don't freak out, the loans are manageable over time. Find a payment plan that helps you sleep at night while in residency while still trying to pay something towards the loans. Good luck!