Since all of those years are working for a nonprofit, yes. And, again, you could do something like do a year or two working for a private group right after you finish that general surgery residency. Save up $100-200k during that time period that you would use to supplement your lifestyle during the years you are in fellowships and doing research.
I just used this calculator to get a rough estimate in your hypothetical situation :
http://www.finaid.org/calculators/scripts/ibr.cgi
I assumed you'd have an average adjusted gross income of 45k during residency/fellowship, 3 family members (wife + 1 kid) and an average income of 200k during your 2 years as an academic surgeon.
I calculate that you would pay $50,000 in net present value towards your student loans whether your personal loans were $200,000 or $500,000. It does
not matter at all how much you borrowed total, only how much you made over your 10 years of public service. Net present value, btw, is how much money it would cost if you had the money in today's dollars in the bank right now.
In the long run, this is a
gigantic problem for the Federal government. We can't have people able to borrow any amount for school and then to only pay back a small fraction of it. That will encourage schools to raise their tuitions to unheard of levels since it will no longer matter at all how much they charge.
I have a strong hunch it won't last, just like they took away the student loans at 2% interest you could get a few years ago. This is why I said that you need something in writing stating that the government will forgive your loans after 120 payments, and that working job X qualifies as public service. That way if Congress were to change the laws before you got your loans forgiven, you would have evidence to be used in a lawsuit for compensation. As far as I know, while the federal government has enormous power it has historically nearly always had to obey it's own laws and written contracts. Those folks with the 2% student loans still have them, btw, just no one can get any new loans like that.