So if you're in 6 yrs of residency under IBR
and then as an attg your ibr payments are larger
than standard would be, you switch to standard but lose the
forgiveness thing and have to pay in 4 yrs is what you mean? (ie leaving
ibr for another 25 yr repayment plan will or won't
get you forgiveness?).
Forgiveness after all that interest is paid that is.
You don't lose the forgiveness thing. As long as you pay the minimum of (IBR/PAYE or the original standard 10-year payment) they are qualifying payments and the count towards the 10-year public service loan forgiveness and the 25/20-year standard loan forgiveness.
Let's say you were a resident for 6 years, and your IBR/PAYE payments only paid off some of the interest. Dang, you are finished with residency in 6 years and your loans are even larger. What to do???
Well, now that you are an attending, if you really started paying 15%/10% of your disposable income towards your loans, your loan payments would be absolutely enormous. So instead you switch to the monthly payments that would have existed if you had in fact been paying off the original loan at the 10-year standard rate. Of course, your loans are slightly larger now because they grew in residency, so in reality it might take you 11 or 12 years to pay off the loan.
Scenario 1: You make these original 10-year sized payments, and you work for a non-profit (and your residency was at a non-profit too, because most of them are). Four years later, you turn in all your receipts for 120 monthly qualifying payments (six years in residency, four more years as an attending), and the government forgives all of your student loans via PSLF. The end.
Scenario 2: You make these original 10-year sized payments, and you don't work for a non-profit. After maybe 11 or 12 years or however many years it takes, your loan is paid off in full. Congratulations, you just paid off your loan.
Scenario 3: For some reason you are having serious loan trouble. Maybe you had high interest rates? Maybe you went to a really expensive undergrad and medical school? Maybe you spent a very long time in residency? Maybe you got a very low paying private sector job? Anyway, even as an attending, you aren't making much progress on those student loans, but you continue to make the appropriate payments, which as always is the minimum of the IBR payment or what the original 10-year standard payment would have been. Finally, 19 years (IBR) or 14 years (PAYE) later, the government says enough is enough and forgives your student loans because you've been making qualifying loan payments for 25 (IBR) or 20 (PAYE) years. Unfortunately this kind of loan forgiveness is considered taxable income, so depending on your tax bracket approximately 2/3 of the remaining loan is really forgiven and the other 1/3 shows up as taxes the following year.
Conclusion: There is a constant undercurrent of fear in this forum that one small mistake somewhere along the way will doom people into losing all of the benefits of their student loan payment plans or forgiveness plans, when that is just not the case. What if I switch from being a resident to being an attending? What if I switch in year 9 to a private practice for a year? Will all of my loan payments and loan forgiveness options completely vanish? No, and no. The only legitimate fear is that PSLF will cease to exist before we can use it, so scenario 1 would cease to exist. But scenarios 2 and 3 aren't really catastrophic. You get loans, you get job, you pay loans. No problem!