LOAN FORGIVENESS and REPAYMENT A Physician’s Guide to LOAN FORGIVENESS and REPAYMENT Conflict of Interest Statement: Speaker is president of Navigate, a company that consults with health systems regarding student loan education and advice for employees. UPMC secured the services of Navigate. The purpose of the seminar is educational and includes no solicitation of any type.

ROAD MAP Public Service Loan Forgiveness Options for Private Refinance Flip the script on student debt Joy, please add any additional information you’d like included.

84% of new have student loan debt Medical Graduates Source: 2014 https://www.aamc.org/download/152968/data/debtfactcard.pdf Source: 2014 https://www.aamc.org/download/152968/data/debtfactcard.pdf

$300,000 $150,000 $693,000

Financial pressure Interest $344,739 $300,000 education debt Monthly payments of $3,506 Extended plan payments $2,149 Interest $344,739 Joy, please add any additional information you’d like included.

Impact on physicians Symptoms of depression Delay marriage, major purchases Regret choosing family medicine Joy, please add any additional information you’d like included.

Impact on Health system “… negative impact on physician performance…” –Dr. Julie Phillips Joy, please add any additional information you’d like included.

Signing bonuses up Loan repayment offers Higher salaries Financial support Trends Signing bonuses up Loan repayment offers Higher salaries Joy, please add any additional information you’d like included.

PUBLIC SERVICE LOAN FORGIVENESS Created by Congress in 2007 10 years of qualifying payments Qualifying employment Tax-free forgiveness Source: U.S. Department of Education. See www.studentloans.gov for details. Source: U.S. Department of Education. See www.studentloans.gov for details.

Public Service Loan Forgiveness common Public Service Loan Forgiveness mistakes

Type of loans FFEL or Direct loans? National Student Loan Data System Direct Consolidation Loan When NOT to consolidate?

REPAYMENT PLANS STANDARD GRADUATED or EXTENDED INCOME-DRIVEN PLANS INCOME-BASED REPAYMENT (IBR) PAY AS YOU EARN (PAYE) REVISED PAY AS YOU EARN (REPAYE)

employment Government or Nonprofit Full time—30 hrs/week Employment Certification Form

Dr. Susan’s Solution Original loan amount $275,000 $275,000 Standard PAYE Original loan amount $275,000 $275,000 Monthly payment $3,130 $325 to $1,624 Principal - interest paid $375,548 $162,121 Total debt forgiven $0 $310,266 Years until debt relief 10 10 Walk through the example

Details … Married borrowers’ benefit Missing the annual deadline The “paid ahead” trap Source: “The Hidden Costs of Declining Physician Engagement”, Dr. Dan Smith

Refinance Lender pays off existing loan You get a new loan You get a lower interest rate As of 09/01/2017: fixed rates from 3.350% APR; variable rates from 2.815% 

WHY refinance? Rates Terms Other factors Source: “The Hidden Costs of Declining Physician Engagement”, Dr. Dan Smith

Refinance example Lower payments by $540 Save $65,000 overall ($300k at 7.15% vs 3.5% for 10 years) Source: “The Hidden Costs of Declining Physician Engagement”, Dr. Dan Smith

lenders www.credible.com Local Bank Sofi, DRB, Commonbond Source: “The Hidden Costs of Declining Physician Engagement”, Dr. Dan Smith

Getting Advice White Coat Investor forum Loan servicing company Attorneys, financial advisors Independent advisors Fee expectations

FLIP THE SCRIPT--RESULTS Residents saved $40k-$400k (family medicine, radiology and emergency medicine) Cumulatively: $3.2 million

THE SYSTEM RESULTS 17 of 20 offers accepted Filled 75% more positions this year Reduced turn-over Supports physician resiliency

FREE Resource Discovery Session Confirm YOUR student loan plans with an individual, 15-minute phone call. Text DISCOVERY to 612-470-3040. -Offer expires 10/18/2017

Final Thoughts “Our great struggle in medicine these days is not just with ignorance and uncertainty. It’s also with complexity: how much you have to keep in your head to think about.” --Atul Gawande

SOURCES: Research on Family Medicine and Student Debt: Julie Phillips, MD, MPH, Michigan State University, Julie.Phillips@hc.msu.edu Federal student loan repayment: www.studentloans.gov Employment Certification Form for Public Service Loan Forgiveness: https://studentaid.ed.gov/sa/sites/default/files/public-service-employment-certification-form.pdf National Health Service Corps: http://www.nhsc.hrsa.gov/ Private loan refinance: http://whitecoatinvestor.com/refinance-your-medical-school-loans-at-a-lower-rate/

DEAR RESIDENTS • Do you have questions on your student loans? • Do you wonder if you qualify for Public Service Loan Forgiveness? • Are you wondering if you should start payments now or defer until after residency? We’ve partnered with Navigate, national experts on physicians’ student loans, to answer your questions. If you answered “yes” to any of the above questions, then schedule a free 15-minute appointment with Navigate (link here) to get your questions answered. If you wish to continue with a full analysis and action plan, we’ve negotiated a discounted fee of $395 (regularly $1000). No pressure--and satisfaction is guaranteed.