The affordability of medical education continues to be a critical topic. The median debt for graduates of colleges of osteopathic medicine (COMs) is $247,218. In 2017, public COM graduates reported mean indebtedness of $217,525, with private COM graduates’ mean indebtedness at $253,168.¹ As the proportion of private over public COM graduates continues to rise, median indebtedness will continue to climb.^2-3 As the burden of debt has evolved over time, so have the tools used by early-career physicians to repay loans. 

Created under the College Cost Reduction and Access Act of 2007,⁴ the Public Service Loan Forgiveness (PSLF) program is one of several federal student loan forgiveness programs available to recipients of federal student loans. Through this program, indebted graduates are able to discharge the balance of their federal student loans after making 120 qualified payments while maintaining full-time employment for an eligible public service employer. This program is distinct from but runs in parallel to the federally mandated student loan repayment programs as outlined in the Higher Education Act.⁵ Since PSLF's adoption, the growth and popularity of the program among osteopathic medical graduates has been well documented; anticipated participation rates have risen from 50% in 2011 to 65% in 2017.^2,6