At NerdWallet, we strive to help you make financial decisions with confidence. To do this, many or all of the products featured here are from our partners. However, this doesn’t influence our evaluations. Our opinions are our own.

Earning a Doctor of Veterinary Medicine degree is hard. But figuring out how to pay off vet school loans after getting that D.V.M. can seem impossible.

On average, newly graduated veterinarians have student debt that more than doubles their salaries. To overcome this disparity, here are four options vets should consider as they map out their repayment plans.

» MORE: How much is vet school?

1. Qualify for forgiveness or a repayment program

Best for: Vets working in public service or shortage areas.

Forgiveness and veterinary student loan repayment programs are the best ways to pay off vet school loans, but only those with certain specialties or living in specific regions are typically eligible. Look for these programs if your job falls under one of the following categories:

Public Service Loan Forgiveness eliminates the federal student loans of borrowers who work at an eligible nonprofit or government agency and make 120 eligible payments over 10 years. Because animal hospitals are typically for-profit businesses, many practicing vets won’t qualify for PSLF.

But veterinarians may choose jobs in other sectors that do qualify. For example, a vet who opts to teach at a university or practices at a nonprofit animal shelter would likely qualify for PSLF. Someone who works for a government agency, such as the USDA, could as well.

Many states have their own vet student loan repayment program, typically for those who practice in areas of need — like in rural parts of a state or with large animals.

For example, North Dakota provides up to $80,000 over four years to eligible vets in selected communities who practice food animal veterinary medicine. The American Veterinary Medical Association has a list of state-based programs.

The USDA also offers the Veterinary Medicine Loan Repayment Program. This program requires vets to make a three-year commitment to practice in a veterinarian shortage area, as determined by the National Institute of Food and Agriculture. Participants receive $25,000 a year to repay vet school loans in exchange for their service.

Student loan repayment assistance is becoming a popular benefit among health care employers, and veterinarians should see if their company has a program. For example, Banfield Pet Hospital, which employs more than 3,500 veterinarians at more than 1,000 hospitals across the United States, pays $150 each month toward eligible employees’ qualifying student loans.

Vets should understand the tax implications of any forgiveness or repayment program they use. For example, amounts forgiven under Public Service Loan Forgiveness aren’t considered taxable income, but you are taxed on payments from the Veterinary Medicine Loan Repayment Program or a repayment assistance benefit.

2. Stick to a 10-year repayment plan

Best for: Vets who can afford their current payments.

The standard repayment plan splits student loans into 120 equal payments over 10 years. A veterinarian who owes the average vet school debt of $183,014 would pay $2,132 each month on this plan and $255,900 altogether, assuming current federal interest rates.

Standard payments are typically more than you’d owe under other student loan repayment plans. But if you can afford those amounts, you’ll pay the least overall under this plan.

Vets who can’t quite afford standard payments right now should consider graduated repayment. This plan starts with lower payments that increase every two years over 10 years — ideally, allowing you to afford more as you start earning more.

» MORE: How much you’ll really pay for that student loan

If the standard payment is manageable, look for ways to pay off your loans faster so you can save more money. These strategies could include taking on extra procedures and putting that money toward your loans; paying more than your monthly minimum payment, if you can afford to do so; or refinancing your loans at a lower interest rate (more on that below).

3. Plan for income-driven repayment forgiveness

Best for: Vets who can’t afford payments long-term.

Income-driven repayment plans typically set payments at 10% of your discretionary income. For a veterinarian with the average starting salary of $76,633, payments would start at less than $500 — or roughly one-quarter of the standard amount. Those amounts change annually with your income.

While income-driven plans cost less now, you pay more in the long run. These plans stretch repayment to 20 or 25 years. At that point, any remaining balance is forgiven, but you pay taxes on that amount.

That bill could be substantial, depending on your tax rate and how much you owe. Here’s how much a vet with the average debt and starting salary could pay overall under two income-driven options:

  • Under Pay As You Earn: A veterinarian who owes $183,014 and earns $76,633 would pay $206,098 over 20 years on PAYE and have $236,795 forgiven and taxed, according to the Department of Education’s Repayment Calculator. At a tax rate of 30%, the total cost for this borrower would be $277,136.
  • Under Revised Pay As You Earn: REPAYE extends repayment to 25 years if you have graduate school debt, like vet school loans. As a result, the average vet would pay $302,689 on this plan, have $173,411 forgiven and face a tax bill of $52,023 — for a total cost of $354,712.

To prepare for that potential tax bill, vets aiming for income-driven forgiveness should put aside money in addition to making their regular loan payments.

» MORE: PAYE vs. REPAYE: Which is right for you?

4. Refinance your loans

Best for: Vets with a manageable debt-to-income ratio who don’t need federal benefits.

Refinancing replaces existing student loans with a new private loan with new terms. Refinancing vet school loans could lower your payments or decrease the amount you repay overall — if you can meet a lender’s qualifications.

Refi lenders may not approve applicants who have a lot of debt compared to their income, as a veterinarian might. Enlisting a co-signer is a potential way around your debt-to-income ratio, if refinancing is right for you.

You shouldn’t refinance if you’ll qualify for a federal loan forgiveness or repayment program. Refinancing also doesn’t make sense if you need an income-driven payment; even with a lower interest rate, your refinanced loan will likely have a larger payment than income-driven plans.

If you won’t need those federal benefits, or took private loans to pay for vet school, compare refi offers to see how much you might save. Refinancing the average vet school debt from 7.08% to 5% would decrease your monthly payment by $191 and save you $22,962 overall.

How much student loan refinancing could save you

Financial News Go