Money Foundations · 10 min read
The Med School Money Map
How the loans you sign at 23 shape the next fifteen years — rates, fees, caps, and an accrual clock that never pauses
Reviewed by Jonathan Shafer, DO, July 2026. Disclosure: the reviewer is the founder and owner of Attending Financial LLC. This is education, not individualized financial advice.
A four-minute signature with a fifteen-year tail
In the week before orientation, you will sign a Master Promissory Note. The signature takes about four minutes. The terms follow you for ten to twenty-five years. For loans first disbursed in the 2026–27 year, a graduate Direct Unsubsidized loan carries a fixed 8.07% rate, and the meter starts the day the money moves: about $11 per day on your first $50,000, before you have attended a single lecture. By graduation, a student who borrows the federal maximum owes roughly $240,350 against $197,886 that actually arrived — $42,464 of interest and origination fees accumulated while studying. The map was also redrawn on July 1, 2026: the Grad PLUS program closed to new borrowers, and students entering professional school now face a $200,000 aggregate federal cap. Which side of that date you signed on determines which rules govern you. Most attendings still making payments at 38 are not paying for choices they made at 30. They are paying for signatures they gave at 23 without reading the map. This module is the map: the two loan types, the real accrual math, and the grace-period mechanics your servicer will assume you already know.
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- Two loans, one point apart — and one just closed
- Four years of quiet accrual: $42,464 before your first paycheck
- Grace defers payments, not interest
- Check the map before intern year
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