The strategies, refinancing, and simple math that gets you debt-free fast.
One of the best things about being a rehab professional is that you are not stuck. You can work in any setting, take travel contracts, go PRN, and live anywhere in the country. Your license is in demand everywhere. For many people, that flexibility is worth getting out of debt ASAP and forgoing loan forgiveness.
While Public Service Loan Forgiveness (PSLF) is cheaper on paper, often by $50,000–$90,000, it requires 10 years of full-time work at a nonprofit or government employer. That means no travel PT, no home health, no going part-time if you have kids. A lot of people look at that trade-off and decide keeping their options open is worth the extra cost.
I was one of those people. My wife and I knew we wanted to have children and wanted the flexibility of reducing to part time if needed. So, I started aggressively paying off my loans, and managed to eliminate $170k in student loans in 5 years.
Run your numbers
Is this the right path for you?
Before we get into our numbers, go ahead and run your numbers at the calculator.
Let's use the same scenario as our previous post, The Physical Therapist Repayment Guide: $150,000 balance, 6.5% interest rate, $90,000 average adjusted gross income (AGI). Your situation will be different. Use the calculator to model it.
If your loans originated before July 1, 2026, Income Based Repayment (IBR) is still an option. In this scenario, IBR costs $178,050 total vs. $180,227 to pay it off. Close enough that your life plans should be the primary driver behind the decision to pay the loans off early.
For me? The relief of not being indebted to the federal government for 20 years was enough to be ok losing $2000 in savings over 20 years by repaying early.
If your loans were disbursed post-July 1, 2026, they no longer qualify for IBR. Instead, the new Repayment Assistance Plan (RAP) runs 30 years and costs ~$315,000 on a $150k balance, resulting in a difference of $135,000 compared to paying it off. The case for aggressive repayment of these loans is obvious.
Should you refinance?
If you're paying the loans off early, refinancing almost always makes sense. Same scenario, $2,000/month:
| Rate | Payoff time | Total paid | |
|---|---|---|---|
| Federal, unrefinanced | 6.5% | ~8 years | ~$193,000 |
| Refinanced | 5.0% | ~7.5 years | ~$180,227 |
About $13,000 in savings. I personally refinanced any loan where I could get more than a 1.5% rate reduction. Below that, it didn't feel worth giving up federal protections, as noted below.
What you lose when you refinance:
- No income-driven repayment if your income drops
- No federal hardship deferment (some private lenders have their own, but it's not guaranteed)
- No path back to PSLF. Ever.
If there's any real chance you'll end up at a qualifying employer and are considering the 10 year PSLF, don't refinance.
→ Learn more about the pros/cons of refinancing: refi guide
Cut your expenses
The mechanics are simple: minimize the three big line items.
Housing. This is the single biggest decision you will make. A huge recurring expense. The difference between a $1000 and $1900/month rental is $10,800/year. This single decision drops your 150k payoff timeline by 2.5 years.
Transportation. The second most significant decision you can make. A new car payment with insurance and depreciation runs $600–$800/month. That's $8,000–$10,000 a year, before fuel and repairs. 8k per year into your loans equates to roughly 2 years lopped off your repayment timeline.
Food. When I was in repayment mode, my wife and I tracked our spending and were shocked at how much was spent on quick bites out of the house or going out for drinks with friends. We quickly switched to cooking more of our meals and exclusively shopped sales at our local grocery store. We both learned to cook and got pretty good at it! This was a few hundred dollars per month. Little choices added up and we honestly did not feel like we were depriving ourselves.
None of this is forever. Two to three years of low expenses plus high income is enough to make a serious dent in most balances.
Max out your income
This is where rehab has a real edge over most professions.
Travel PT/OT/SLP pays $70–$90/hour equivalent when you factor in the housing stipend and per diem (largely tax-advantaged, since they're reimbursements, not wages). That's $30,000–$50,000 more per year than a staff position in the same setting. The work is the same.
If your local market is slow, go somewhere that needs PTs. Rural areas and underserved markets consistently pay better. Your license is portable. Use it.
PRN is also a unique feature of healthcare professions. We have virtually unlimited opportunities to work weekend PRN at local hospitals and rehab centers. These facilities are always looking for help and pay 15-25% higher than the typical staff rate. It's not unusual to see $60/hr PRN rates. Two shifts per month, in addition to your staff or travel job, can clear an extra $900 take-home pay going straight to your loan balance. There's another 2.5 years lopped off the initial balance!
I balanced a travel contract with PRN work and cleared $120k in a year. That income, combined with low expenses, is what made $130k in 4 years possible.
The tax situation
Not much to take advantage of when paying off aggressively. W2 employees have limited options for tax optimization.
You can deduct up to $2,500/year in student loan interest. At a 22% bracket that's $550 in actual savings. It also phases out between $80k–$95k modified AGI (MAGI) for single filers. If you're income-stacking, you may not get it at all.
Everything else is post-tax dollars, unless you get a travel per diem/stipend.
One thing worth asking your employer: some hospital systems offer student loan repayment as a benefit. Employers can contribute up to $5,250/year tax-free toward your balance. Not common, but worth asking during negotiations.
Before you start
- Run your scenario at the calculator and compare payoff vs. IBR
- Get refinancing quotes if you can save more than 1–2%; see the refi guide
- Don't refinance if PSLF is still on the table for you
- Find your three biggest expenses and cut them
- Find out how others maximized their incomes in our subreddit!
I'm a PT, not a financial advisor. This is not financial advice. Please consult a qualified professional before making major decisions about your loans.