Public Service Loan Forgiveness cancels the remaining balance on your federal Direct Loans after 120 qualifying monthly payments made while employed full-time by a qualifying employer — a government organization or an eligible nonprofit. The 120 payments do not need to be consecutive, and the forgiven balance is not taxed as federal income.

A qualifying payment is a month where three things line up at once: you were on a qualifying repayment plan (an income-driven plan for almost all physicians), you were employed full-time by an eligible employer, and the payment was made on time for the full billed amount. A $0 income-driven payment during residency counts exactly the same as an attending-sized payment — which is why PSLF is most valuable when you certify employment starting in training.

Generally no. Months spent in forbearance or deferment make no PSLF progress even though interest may accrue, which is why a $0 income-driven payment is almost always better than forbearance during training. Reviewing your payment history for non-counting months is one of the most common ways physicians find errors in their count.

No — balances forgiven through PSLF are not treated as taxable income at the federal level, unlike forgiveness at the end of a 20- or 25-year income-driven repayment term. That difference is why the tax-free amount this calculator estimates can be worth six figures for physicians with large balances and long training.

Government employers and 501(c)(3) nonprofit organizations qualify — which includes most academic medical centers and many community hospital systems, but not most private practices. What matters is who employs you, not where you work: a physician staffed at a nonprofit hospital by a for-profit group generally does not qualify. Certify your employer with the official PSLF form rather than assuming.