Depending on your situation, you should be able to consolidate while still in school. You can go with Direct (the federal government), which is the only lender that I know of that you can consolidate with while in school. I did it, and it has worked out well. I just had to make sure that I took out some "regular loans" during my last year of med school so that I would be able to reconsolidate after I graduate (If I hadn't taken out any additional loans after I consolidated the bulk of my student loans with Direct, then I would be stuck with Direct & unable to shop around after I graduate). Since I still had loans to take out this year with my current lender as a 4th year med student, I now have two lenders (Direct & my original lender which I took out loans with again this year). With two lenders, I will be able to shop around after I graduate to find the best possible deal on a consolidation loan that will include my Direct consolidation loan & my 4th year loans. If the government chooses to make future consolidation loans have variable interest rates, one could choose to keep the consolidation loan that they made now with Direct and not reconsolidate their latest loans with the Direct consolidation loan that they would already have. That way after graduation, there could be two consolidation loans--One consolidation loan with the bulk of one's med school loans locked into a fixed interest rate Direct consolidation loan made under present interest rate rules and a second variable interest rate consolidation loan (if one wants to consolidate under variable rates) that only contains the last little bit of loans used for med school. Remember, I'm not a financial expert, so be sure to talk with Direct or another professional about your particular situation. You can also check out your financial aid office, but keep in mind that they normally follow the "regular" path of most med students and may not consider the approach that I took since most med students don't utilize it.