1. MANAGING STUDENT DEBT Considerations for 2016 Utah Interns

2. AGENDA  Repayment Marketplace: Payment & Savings Case Studies  Loan Forgiveness and Legislation Update  The Refinancing Marketplace  Training “Exit Interview”  Available Resources: I’ll be available to answer questions

3. CHANGES IN STUDENT DEBT LEVELS  Debt levels have quadrupled in the last 20 years 1993 2000 2015 ~$220k $300k ~$89k ~$50k

4. PHYSICIAN STARTING SALARIES BY SPECIALTY  Anesthesia: $276k  Emergency Medicine: $231k  Family Medicine: $161k  IM, General: $180k  OBGYN:$220k  Pediatrics:$160k  Psychiatry:$179k  Surgery, General:$275k  Surgery, Neuro:$520k Higher Salaries Reduce Forgiveness Benefit

5. REPAYMENT TIMELINE AFTER GRADUATION Spring 2016: Graduation, File 2015 Taxes July 2016: Begin Residency, Consolidate? Fall 2016: End of Grace Period on Stafford/Grad PLUS IDR Renewal every 12 Months / Review Profile and Legislative Changes Training Exit Analysis: PSLF / Standard / Refinance

6. REPAYMENT OPTIONS UPON GRADUATION MOST COSTLY! MPH/other students CAN waive deferment if in residency Forbearance / Deferment 15% of discretionary income, 25 year taxable forgiveness Available if loans outstanding on Oct 1, 2007 IBR 10% of discretionary income, 20 year taxable forgiveness Available if no loans outstanding on Oct 1, 2007 PAYE 10% of discretionary income, 25 year taxable forgiveness for grads 50% of accruing interest not charged, no borrowing restriction REPAYE Available with attractive underwriting profile, may be appropriate for some graduates Refinancing Most Housestaff need payment relief during training Standard or Extended Term

7. Almost $7,000 in interest paid PAYE: Interest accrues, REPAYE = $20k interest savings! PSLF Eligible PAY/REPAYE AS YOU EARN FOR 2016 GRADUATE Extended Term Payment: 10-Year Standard Payment: Salary: $1,961 $1,961 $1.961 $1,961 $1,154 $1,154 $1,154 $1,154 $ 50,000 $51,500 $53,045 $54,636 $175k @ 6.21% PAYE Payment: $ 0 $ 57 $261 $262

8. PUBLIC SERVICE LOAN FORGIVENESS  Eligible Loans: Direct Stafford & Grad PLUS  (FFEL, Perkins, HPSL and LDS can be consolidated for eligibility)  Specific requirements:  Borrower must make 120 qualifying payments on a Federal Direct Loan  Borrower must work for a public service entity as defined by the program, such as a Federal, State, Local, or non-profit organization Approximately 80% of hospitals are non-profit

9. 10 YEAR CASE STUDY: 2016 GRADUATE

10. A PHYSICIAN’S FORK IN THE ROAD FORGIVENESS REFINANCING

11. RECOMMENDED REFINANCING PROCESS 1. Identify if refinancing is suitable! Debt-to-income ratio considered No negative credit history, min 680 score Adding co-signer can improve results 2. Review existing financial and credit profile to determine if refinancing is available 3. Approach marketplace Work with an Advisor Deferment/Low payments in residency available Better rates available for shorter terms, but can you afford higher payment right after training? 4. Once terms and rates are quoted, select option in the context of your liquidity needs

12. TRAINING EXIT STRATEGY

13. EXIT INTERVIEW  After 4 years of training, a graduating resident contemplates the next step in her career. How does loan forgiveness impact the economics of working for a non-profit? Original Debt: $250,000 Debt after training:$308,000 Non-profit salary offer:$155,000 For-profit salary offer:$205,000

14. EXIT INTERVIEW

15. SALARY EQUIVALENT PUBLIC VS. PRIVATE Additional from Public Service derived from forgiveness Actual Public Service Salary Actual For-Profit Practice Salary

16. WISHING YOU THE BEST OF LUCK WITH YOUR CAREER IN MEDICINE DWOQ.COM Jason DiLorenzo Help@DWOQ.com 314-787-7399