You are absolutely correct. There are ways to have income driven repayment or loan forgiveness.This all sounds like you have a well-thought-out plan to shoot yourself in the foot as soon as you get out of school. Refinance? Are your loans federal or private? The only situation in which your plan makes financial sense is if every bit of your loan debt (or the vast majority of it) is from private loans. With your stated planned income, a person who had that much in federal loans would simply enroll in an income-driven repayment program and have a huge portion of that money forgiven. You have also taken 40% off the top in taxes, and that is very unlikely--even in the states with the highest income taxes you wouldn't approach $96,000 in taxes. Your payment on an income-driven repayment plan would be more in the range of $1200-1800 per month, or less...followed by outright forgiveness of hundreds of thousands of dollars. If you DO have that much in private loans, then...ouch. That sucks. But I don't want people who might stumble across this to think that your scenario is the only option. Read Ben White's Medical Student Loans for plenty of info about repayment options and planning: Student Loans | Ben White
All my loans are private loans (not eligible for any federal loans, I'm not US citizen). So my situation is worst outcome that can ever be in this country for a medical student. I just wanted to show that even in this very bad situation - it's absolutely doable and you can live comfortably.