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If you’re passionate about medicine and helping patients, you may be wrestling with a tough decision: Should you go to physician assistant (PA) school or med school? Both paths can lead to fulfilling careers in health care, but they come with significant differences in education, cost, responsibilities, and lifestyle. Understanding the differences can help you make an informed decision that aligns with your interests, abilities, lifestyle preferences, and long-term goals.

What Is PA School?

Physician assistant (PA) school is a graduate-level program designed to train students to practice medicine under the supervision of a licensed physician. PAs are highly skilled health care professionals who diagnose illnesses, develop treatment plans, prescribe medications, and often serve as primary care providers.

PA programs typically lead to a master’s degree and are known for their shorter time commitment compared to medical school. Programs typically last two to three years and combine classroom instruction with clinical rotations in specialties such as family medicine, emergency medicine, surgery, and pediatrics.

Another key advantage of the PA path is career flexibility. Because PAs are trained as generalists, they can often transition between specialties without completing a formal residency program. This adaptability is appealing to those who want to explore different areas of medicine.

The average cost of PA school ranges between $98,075 and $107,288 for a 27-month program.

💡 Quick Tip: You can fund your education with a competitive-rate, no-fees-required private student loan that covers up to 100% of school-certified costs.

PA School Admission Requirements and Curriculum

Admission to PA school is competitive and requires a strong academic background, particularly in science courses like biology, chemistry, and anatomy. Most programs require applicants to hold a bachelor’s degree, though the specific major is less important than completing prerequisite coursework.

In addition to academics, PA programs often require significant health care experience. This can include working as a medical assistant, EMT, nurse, or in another patient-facing role. Many programs expect applicants to have at least 2,000 hours of direct patient care experience, achievable through one year of full-time or two to three years of part-time work during college. Such experience is highly valued and can strengthen your application, even when not strictly required.

Standardized tests such as the Graduate Record Examination (GRE) or the Physician Assistant College Admission Test (PA-CAT) may also be required. Letters of recommendation, personal statements, and interviews also play an important role in the admissions process.

The PA curriculum is typically divided into two phases:

•   Didactic phase (about 4 semesters): Covers foundational medical sciences such as anatomy, pharmacology, pathology, and clinical medicine.

•   Clinical phase (about 3 semesters): Students rotate through specialties and gain hands-on experience in health care settings.

Overall, PA school is fast-paced and intensive, designed to prepare students to enter the workforce quickly.

After graduation, students must take the Physician Assistant National Certifying Exam (PANCE), administered by the National Commission on Certification of Physician Assistants (NCCPA). Passing this exam allows you to earn the PA-C credential.

Recommended: How Much Does a Physician Assistant Make?

What Is Medical School?

Medical school is a graduate program that trains students to become physicians — either a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). It’s a more extensive and in-depth education than PA school and is followed by residency training, which can last anywhere from three to seven years depending on the specialty.

Medical school itself typically takes four years to complete and is divided into preclinical and clinical years. The program is designed to give students a deep understanding of medical science, patient care, and clinical decision-making.

Physicians have the highest level of responsibility in patient care. They can diagnose complex conditions, perform surgeries, lead health care teams, and practice independently without supervision.

Medical school is significantly more expensive than PA school. The median total cost for the class of 2026 was $297,745 at public schools and $408,150 at private institutions.

Medical School Admission Requirements and Curriculum

Getting into medical school can be highly competitive and requires a strong academic record, particularly in science courses. Applicants must complete a bachelor’s degree (no specific major is required) along with prerequisite coursework in biology, chemistry, physics, and mathematics.

A key requirement is taking the Medical College Admission Test (MCAT), which assesses problem-solving, critical thinking, and scientific knowledge. In addition to academics, medical schools typically look for well-rounded applicants with extracurricular activities, clinical experience, research, leadership roles, and community service. Letters of recommendation, personal statements, and interviews are also an important part of the admissions process.

The medical school curriculum is typically divided into two main phases:

•   Preclinical years (Years 1–2): Students focus on foundational sciences such as anatomy, biochemistry, physiology, and pharmacology.

•   Clinical years (Years 3–4): Students complete rotations in various specialties, including internal medicine, surgery, pediatrics, psychiatry, and obstetrics/gynecology.

Throughout these four years, students must pass a series of national licensing exams. After graduating, they enter a residency program for specialized training, which lasts three to seven years and may be followed by a fellowship for further specialization.

PA School vs Medical School: Key Differences

While both PA and medical school prepare students for careers in health care, there are several key differences between the two paths:

•   Length of training: PA school typically takes two to three years, while medical school requires four years plus an additional three to seven years of residency training.

•   Cost: Medical school is more expensive due to its longer duration and additional training requirements. Shorter PA programs typically result in lower overall tuition costs and less student debt.

•   Scope of education: Medical school provides a more in-depth and comprehensive education, preparing students to handle complex and specialized medical cases. PA programs focus on general medical training.

•   Career flexibility: PAs can switch specialties more easily without additional formal training. Physicians must complete a residency in a specific specialty and typically remain in that field.

•   Work-life balance: PAs often have more predictable schedules, while physicians — especially in certain specialties — may work longer or less consistent hours.

While both medical and PA students often take out loans to pay for school — including federal student loans and private health profession loans — med students typically accumulate significantly more debt.

Physician Assistant vs MD: Scope of Practice and Autonomy

One of the most significant differences between PAs and physicians is their level of autonomy.

Physician assistants work under the supervision of a physician, although the degree of supervision varies by state and workplace. In many settings, experienced PAs have substantial independence and perform many of the same duties as physicians, including diagnosing illnesses and prescribing medications.

Physicians, however, have full autonomy in their practice. They are ultimately responsible for patient care decisions and can practice independently. They may also specialize in complex fields such as surgery, cardiology, or neurology.

Both roles are collaborative, but physicians typically take on leadership positions, while PAs play a critical supporting role in patient care.

Recommended: Nurse Practitioner vs Physician Assistant

Salary and Career Outlook

Both PAs and physicians enjoy strong job prospects and competitive salaries, but there are notable differences.

•   Salary: According to the most recent data from the U.S. Bureau of Labor Statistics (2024), the median annual salary for physician assistants is $133,260. Physicians typically earn between approximately $222,300 and $450,800 or more, depending on the specialty.

•   Career outlook: The job outlook is strong for either profession, but particularly promising for PAs. Employment for physicians is projected to grow about 3% within the next decade, while PA jobs are expected to grow around 20%, much faster than average.

While physicians generally earn more, they also invest significantly more time and money into their training.

💡 Quick Tip: Master’s degree or graduate certificate? Private or federal student loans can smooth the path to either goal.

Which Path Is Right for You?

Choosing between PA school and medical school ultimately depends on your personal goals, preferences, and priorities.

You might consider PA school if you:

•   Want to enter the workforce more quickly

•   Prefer a flexible career with easy specialty changes

•   Place a high value on work-life balance

•   Value patient care but don’t require full practice autonomy

You might consider medical school if you:

•   Want full responsibility and practice autonomy

•   Are interested in specializing in a specific field

•   Are willing to commit to a longer, more demanding training process

•   Are motivated by higher earning potential and leadership roles

When debating PA vs med school, it’s also important to consider your tolerance for academic rigor, financial investment, and the lifestyle associated with each career path.

The Takeaway

Both PA school and medical school offer rewarding paths into health care, but they differ significantly in terms of training, cost, scope of practice, and career outcomes. PA programs provide a faster, more flexible route, while medical school offers deeper training, greater independence, and a higher earning potential.

There is no one-size-fits-all answer — the best choice is the one that aligns with your goals, values, and vision for your future.

If you’ve exhausted all federal student aid options, no-fee private student loans from SoFi can help you pay for school. The online application process is easy, and you can see rates and terms in just minutes. Repayment plans are flexible, so you can find an option that works for your financial plan and budget.

Cover up to 100% of school-certified costs including tuition, books, supplies, room and board, and transportation with a private student loan from SoFi.

FAQ

Is PA school harder to get into than medical school?

Admission to both PA and medical school is highly selective, with average acceptance rates of around 7%. However, the average GPA for accepted medical students is a little bit higher than that of accepted PA students (3.79 vs. 3.6), which might make PA programs slightly easier to get into.

Can a physician assistant become a medical doctor?

A physician assistant (PA) can choose to become a medical doctor (MD) or Doctor of Osteopathic Medicine (DO), but it is not a direct transition. A PA must apply to and complete medical school and then a residency program, just like any other aspiring physician. None of the PA training, clinical experience, or credentials substitute for the requirements of medical school. However, some PAs do choose this path, leveraging their clinical experience to strengthen their medical school application.

How much less do PAs earn compared to physicians?

The median annual salary for a physician assistant (PA) is $133,260, according to 2024 data from the U.S. Bureau of Labor Statistics (BLS). Physicians, however, typically earn significantly more, with salaries generally ranging from $222,300 to over $450,800, depending heavily on their specialty. Therefore, PAs earn substantially less than medical doctors, though the exact difference varies widely based on the physician’s field of practice.

Do PAs need to complete a residency after PA school?

No. Unlike medical doctors, physician assistants (PAs) are not required to complete a formal residency program after graduation. PA training is designed to be generalist, allowing graduates to enter practice immediately after passing the PANCE certification exam.

However, some PAs choose to complete an optional postgraduate residency or fellowship program to gain specialized training in a particular field, such as emergency medicine, surgery, or cardiology.

What student loan options exist for PA and medical students?

Graduate students primarily choose between federal and private student loans. Federal Direct Unsubsidized Loans are often the best starting point, offering fixed interest rates and protections like income-driven repayment and potential forgiveness. Private graduate loans from banks can cover any remaining costs and may offer competitive rates for those with excellent credit (or a strong cosigner), though they lack federal benefits. It’s wise to maximize scholarships and federal aid before turning to private lenders to ensure you have the most flexible repayment options after graduation.

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Please borrow responsibly. SoFi Private Student loans are not a substitute for federal loans, grants, and work-study programs. We encourage you to evaluate all your federal student aid options before you consider any private loans, including ours. Read our FAQs.

Terms and conditions apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. SoFi Private Student loans are subject to program terms and restrictions, such as completion of a loan application and self-certification form, verification of application information, the student's at least half-time enrollment in a degree program at a SoFi-participating school, and, if applicable, a co-signer. In addition, borrowers must be U.S. citizens or other eligible status, be residing in the U.S., Puerto Rico, U.S. Virgin Islands, or American Samoa, and must meet SoFi’s underwriting requirements, including verification of sufficient income to support your ability to repay. Minimum loan amount is $1,000. See SoFi.com/eligibility for more information. Lowest rates reserved for the most creditworthy borrowers. SoFi reserves the right to modify eligibility criteria at any time. This information is subject to change. This information is current as of 4/22/2025 and is subject to change. SoFi Private Student loans are originated by SoFi Bank, N.A. Member FDIC. NMLS #696891 (www.nmlsconsumeraccess.org).

SoFi Bank, N.A. and its lending products are not endorsed by or directly affiliated with any college or university unless otherwise disclosed.

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If you’re considering a career in health care, you may be debating whether to pursue nursing or attend medical school. While both doctors and nurses care for patients and often work as a team, they follow different care models. Physicians generally focus on diagnosing and treating disease through medical intervention, whereas nurses prioritize holistic, patient-centered care. There are also significant differences in the amount of schooling required, cost of education, and future earning potential.

Below, we walk you through nursing school vs. medical school — from admissions and curriculum to salary and career outlook — to help you find the path that best aligns with your skills, interests, and goals.

What Is Nursing School?

Nursing school trains students to become licensed nurses who provide patient care, support physicians, and play a critical role in the health care system. These programs combine classroom lectures, science courses, and hands-on clinical rotations in health care settings to prepare students for national licensure exams and real-world patient care.

If you want to become a registered nurse (RN), there are two main degree paths:

•   Associate Degree in Nursing (ADN): Typically takes 2 years

•   Bachelor of Science in Nursing (BSN): Usually takes 4 years

An ADN is a faster, more affordable route to becoming an RN, while a BSN offers broader, more comprehensive training and is preferred by some employers. Regardless of the path, graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam to practice.

Nursing offers a wide range of specialties, including pediatrics, oncology, and emergency care. Nurses can also pursue advanced roles — such as nurse practitioners or nurse anesthetists — with additional education.

💡 Quick Tip: You can fund your education with a competitive-rate, no-fees-required private student loan that covers up to 100% of school-certified costs.

Nursing School Admission Requirements and Curriculum

Admission requirements for nursing school vary by program, but typically include:

•   High school diploma

•   Completion of prerequisites classes such as Algebra I and II, Geometry, Biology, and Chemistry

•   Minimum GPA (often between 2.5 and 3.5)

•   Standardized tests (SAT/ACT and/or nursing-specific exams like the TEAS or HESI)

•   Volunteer or health care-related experience (recommended)

•   Letters of recommendation

The nursing curriculum combines classroom learning with clinical experience. Common subjects include:

•   Anatomy and physiology

•   Psychology

•   Microbiology

•   Nutrition

•   Patient care techniques

•   Health assessment

•   General nursing care

•   Care of special populations (e.g., older adults, children, patients with complex conditions)

Clinical rotations are a key component of nursing school, allowing students to gain hands-on experience in hospitals, clinics, and other health care settings. This training helps students develop the skills needed to provide direct patient care from day one.

Recommended: How to Pay for Nursing School

What Is Medical School?

Medical school trains students to become physicians who diagnose illnesses, develop treatment plans, perform procedures, and often take leadership roles in patient care. Students pursue either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree.

Becoming a doctor requires a longer and more intensive educational path compared to nursing. Medical school typically lasts four years and is followed by residency training, which can range from three to seven years depending on the specialty.

Most students begin with a bachelor’s degree (often in a science-related field), though any major is acceptable as long as prerequisite courses are completed.

Medical School Admission Requirements and Curriculum

Admission to medical school is often highly competitive and typically requires:

•   A four-year degree (B.A. or B.S.)

•   Completion of pre-med courses (biology, chemistry, physics, math)

•   A strong GPA

•   A competitive score on the Medical College Admission Test (MCAT).

•   Letters of recommendation

•   Extracurricular activities (e.g., volunteering, research)

The medical curriculum is typically divided into two main phases:

Pre-Clinical Years (Years 1–2)

Students study foundational sciences, including:

•   Anatomy

•   Biochemistry

•   Microbiology

•   Pathology

•   Pharmacology

•   Medical history-taking

Clinical Years (Years 3–4)

Students do rotations at hospitals and clinics affiliated with their school and assist residents in a particular specialty, such as:

•   Internal medicine

•   Surgery

•   Pediatrics

•   Family medicine

•   Obstetrics and gynecology

•   Psychiatry

After graduation, students must complete residency training in their chosen specialty and pass licensing exams before practicing independently.

Recommended: How to Pay for Medical School

Nursing School vs Medical School: Key Differences

While both paths lead to careers in health care, nursing and medical school differ in several important ways:

•   Time to degree: Nursing programs can take as little as two to four years, whereas becoming a physician requires at least eight years of education plus three to seven years of residency.

•   Curriculum focus: While some courses are the same, nursing school emphasizes holistic, patient-centered care, while medical school focuses on diagnosing and treating disease.

•   Cost: Medical school typically involves significantly higher tuition and a much longer training timeline, leading to higher overall costs and student debt compared to nursing school.

•   Licensure exam: To obtain a nursing license, nursing students must pass the NCLEX-RN, which is a one-time test taken after graduation. Doctors must pass the U.S. Medical Licensing Examination (USMLE), which is taken in three steps at different phases of their medical education.

•   Career flexibility: Nurses can change specialties more easily. Physicians are generally committed to the specialty chosen during residency.

Salary and Career Outlook

Salary is often a key factor when choosing a career path, and there are notable differences between nursing vs. medicine.

According to the Bureau of Labor Statistics (BLS), registered nurses earned a median annual salary of $93,600 in 2024. Nurses who pursue graduate-level education can earn more. For example, an advanced practice RN (APRN), such as a nurse practitioner, can earn over $130,000 per year.

Doctors generally earn significantly higher salaries. The median salary for a family medicine physician is 256,830, according to BLS data, while specialists (such as pediatric surgeons) can earn $450,000 or more.

Both professions have strong job outlooks due to growing health care demand. The BLS projects overall nursing employment to grow about 5% within the next decade, with approximately 190,000 openings annually. Overall employment of physicians and surgeons is expected to grow at a slower rate (around 3%), with about 23,600 openings per year.

Cost of Nursing School vs Medical School

The financial investment differs significantly for each path:

Cost of Nursing School

The average cost of nursing school depends on which degree you pursue and whether you attend a public or private college.

The total cost of a two-year ADN degree can range anywhere from $20,000 (at a public school) to $86,000 (at a private college), while total expenses for a four-year BSN can run anywhere from $108,000 (at a public school) to $304,000 (at a private institution).

While it’s common to take out loans for nursing school, many students graduate with relatively low debt, especially if they attend public schools or receive financial aid.

Cost of Medical School

The full cost of attending medical school can range from approximately $160,000 for in-state students at a public school to around $465,000 at a top private university.

Medical students often accumulate substantial debt, which may include a mix of federal loans and private medical school loans, due to high education costs and limited ability to work during school. While physician salaries are higher, it can take many years to pay off medical school debt.

💡 Quick Tip: Even if you don’t think you qualify for financial aid, you should fill out the FAFSA form. Many schools require it for merit-based scholarships, too.

Which Path Is Right for You?

Choosing between pre-med vs. nursing depends on your personal goals, interests, and circumstances.

Nursing school may be a better fit if you:

•   Want to start working and earning soon (within 2-4 years)

•   Prefer spending more time with patients and getting to know them

•   Value flexibility to switch between specialties without years of retraining.

•   Prefer a lower-cost education

Pursuing a medical school may be the right fit if you:

•   Are driven by the “why” behind diseases and want to understand medicine at a cellular or molecular level

•   Want to perform specialized procedures or major surgeries

•   Are willing to commit to a long, rigorous educational journey

•   Are motivated by higher earning potential

It’s also important to think about your lifestyle preferences. Physicians often work long hours, especially during residency, while nursing schedules can offer more flexibility.

To make an informed decision about nursing vs. medicine, consider speaking with professionals, volunteering in health care settings, or shadowing a nurse or physician.

The Takeaway

Both nursing school and medical school can lead to rewarding careers in health care, but they differ significantly in time commitment, cost, responsibilities, and long-term outcomes.

Nursing offers a faster, more flexible path into patient care, while medical school provides deeper specialization and higher earning potential — at the cost of longer training and greater financial investment.

Ultimately, whether to choose pre-med vs. nursing comes down to your goals, strengths, and willingness to invest in your education. Carefully weighing these factors can help you find a path that leads to a fulfilling and impactful career in health care.

If you’ve exhausted all federal student aid options, no-fee private student loans from SoFi can help you pay for school. The online application process is easy, and you can see rates and terms in just minutes. Repayment plans are flexible, so you can find an option that works for your financial plan and budget.

Cover up to 100% of school-certified costs including tuition, books, supplies, room and board, and transportation with a private student loan from SoFi.

FAQ

Is nursing school harder than medical school?

“Harder” depends on the challenge you prefer. Medical school is a longer, more academically intense journey focused on deep scientific theory, complex diagnosis, and high-pressure clinical residency. Nursing school is more compressed, requiring immediate hands-on clinical mastery, high emotional labor, and a focus on holistic patient care.

While medical school has a heavier academic volume, nursing school often has a steeper practical learning curve early on. Both paths require dedication and resilience.

Can a registered nurse go to medical school?

Yes, a registered nurse (RN) can go to medical school. Many RNs decide to pursue a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree after gaining clinical experience.

RNs must first complete any missing pre-medical course prerequisites (like organic chemistry and physics) and earn a competitive score on the Medical College Admission Test (MCAT). Their clinical experience as a nurse is often viewed favorably by admissions committees, as it demonstrates deep health care knowledge and patient-interaction skills.

How long does it take to become a nurse vs. a doctor?

Becoming a nurse typically takes two to four years. You can earn an Associate Degree in Nursing (ADN) in about two years or a Bachelor of Science in Nursing (BSN) in four. Both paths require passing the NCLEX-RN exam for licensure.

Becoming a doctor takes 11 to 15 years after high school. This path includes four years of undergraduate study, four years of medical school, and three to seven years of residency training, depending on the specialty.

What is the difference between the nursing model and the medical model of care?

The nursing model emphasizes holistic, patient-centered care, focusing on the patient’s response to illness, well-being, and ability to cope with health challenges. It includes addressing physical, emotional, social, and spiritual needs. The medical model, by contrast, focuses on diagnosing and treating the specific disease or illness. Physicians aim to identify the pathology and administer interventions (like medication or surgery) to cure or manage the condition. In practice, the two models often overlap, with nurses and doctors collaborating to provide comprehensive patient care.

What student loan options are available for nursing and medical students?

Nursing and medical students can access both federal and private funding. For federal loans, start by completing the FAFSA®. Undergraduate nursing and pre-med students may qualify for Direct Subsidized and Unsubsidized Loans, while graduate nursing and medical students can utilize Direct Unsubsidized Loans.

Students who still have gaps in funding can apply for private student loans through banks, credit unions, and online lenders. These can cover up to 100% of school-certified costs. Some lenders also offer specialized health professions loans.

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SoFi Private Student Loans
Please borrow responsibly. SoFi Private Student loans are not a substitute for federal loans, grants, and work-study programs. We encourage you to evaluate all your federal student aid options before you consider any private loans, including ours. Read our FAQs.

Terms and conditions apply. SOFI RESERVES THE RIGHT TO MODIFY OR DISCONTINUE PRODUCTS AND BENEFITS AT ANY TIME WITHOUT NOTICE. SoFi Private Student loans are subject to program terms and restrictions, such as completion of a loan application and self-certification form, verification of application information, the student's at least half-time enrollment in a degree program at a SoFi-participating school, and, if applicable, a co-signer. In addition, borrowers must be U.S. citizens or other eligible status, be residing in the U.S., Puerto Rico, U.S. Virgin Islands, or American Samoa, and must meet SoFi’s underwriting requirements, including verification of sufficient income to support your ability to repay. Minimum loan amount is $1,000. See SoFi.com/eligibility for more information. Lowest rates reserved for the most creditworthy borrowers. SoFi reserves the right to modify eligibility criteria at any time. This information is subject to change. This information is current as of 4/22/2025 and is subject to change. SoFi Private Student loans are originated by SoFi Bank, N.A. Member FDIC. NMLS #696891 (www.nmlsconsumeraccess.org).

SoFi Bank, N.A. and its lending products are not endorsed by or directly affiliated with any college or university unless otherwise disclosed.

SoFi Loan Products
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The Public Service Loan Forgiveness (PSLF) program is not ending. However, the program will be undergoing changes starting in July 2026, when the Education Department (ED), acting on an executive order signed by President Trump, institutes new limitations on who can qualify for PSLF.

If you are pursuing forgiveness through PSLF or planning to do so, you’ll need to be aware of the latest on Trump and PSLF and the upcoming changes to the program.

What Is the PSLF Program?

The Public Service Loan Forgiveness program was created by the Education Department (ED) in 2007 as a way to help federal student loan borrowers who work in public service to pay off their student loans.

Under the PSLF program, borrowers with eligible federal loans who work full-time in public service for a qualifying nonprofit or government agency and repay their loan under a qualifying repayment plan, such as an income-driven plan, may be eligible to have the remaining balance on their student loans forgiven after making 120 qualifying payments.

If you’ve been hearing about a student loan executive order impacting PSLF and wondering if that means the PSLF program is going away, the good news is that PSLF is still operating. But some student loan borrowers and employers may no longer be eligible for the program starting on July 1, 2026.

Who Qualifies for PSLF?

Borrowers are required to have specific types of jobs and work for certain types of employers to qualify for PSLF. Here’s what a borrower needs to be eligible for the program:

•   A qualifying job: Borrowers who work full-time (a minimum of 30 hours per week) in public service for an eligible nonprofit or government organization may qualify for PSLF. This typically includes such professionals as teachers, doctors, nurses, first responders, and members of the military, as well as full-time volunteers with AmeriCorps and the Peace Corps.

•   A qualifying employer. Organizations that qualify for the PSLF program currently include federal, state, municipal, military, and tribal government agencies, and 501(c)(3) nonprofit organizations. Certain other nonprofits may qualify if they do most of their work in certain areas, such as civilian service to the military, law enforcement, public health, and public safety. (Under the upcoming changes on July 1, the organizations that qualify for PSLF may change.)

•   Eligible loans. Only borrowers with federal Direct loans are eligible for PSLF. This includes Direct Subsidized and Unsubsidized Loans, Grad PLUS Loans (but not Parent PLUS loans), Direct Consolidation Loans, and Stafford Loans. Federal Family Education Loans (FFEL) and Perkins Loans must be consolidated into a Direct Consolidation Loan to qualify for PSLF.

•   An income-driven repayment (IDR) plan. To qualify for PSLF, eligible borrowers must make 120 qualifying payments under a qualifying repayment plan like an IDR plan.

Private student loans are not eligible for PSLF. Borrowers who are looking to lower their private student loan payments may instead want to explore student loan refinancing. When you refinance student loans, you replace your current loans with a new private loan that ideally has a lower interest rate that could reduce your monthly payments. (Be aware that refinancing federal loans makes them ineligible for federal protections and programs like forgiveness and income-driven repayment.)

Some private lenders may even offer flexible refinancing options. For example, borrowers can combine refinancing and saving money through a program like SmartStart refinancing from SoFi. Under this program, borrowers pay only the interest on their student loans for the first nine months, and they can put their extra money into savings. Just be aware that the total repayment amount over the life of the loan may be slightly higher with this kind of program than it would be by making standard payments of loan principal plus interest.

What Did Trump’s Executive Order on PSLF Do?

Regarding Trump and PSLF, in March 2025, Trump signed an executive order (EO) to exclude certain organizations from being qualified employers under PSLF. The EO directed the Education Secretary to revise the program, and in October 2025, the Education Department released the final rule to exclude organizations that have a “substantial illegal purpose” from PSLF eligibility. The final rule will go into effect as of July 1, 2026.

It is not yet clear how the ED will determine whether an organization has an illegal purpose. Examples cited in the final rule include organizations that support terrorism and those that aid and abet illegal immigration. But by changing the definition of what a qualifying employer is, the Education Department may restrict PSLF eligibility for some borrowers.

Multiple lawsuits have been filed regarding Trump’s changes to PSLF and challenging the final rule.

Which Borrowers Does the Order Target?

By excluding organizations deemed to have a “substantial illegal purpose” from the PSLF program, President Trump’s executive order could restrict PSLF eligibility for public service employees of those organizations. This could affect both existing and aspiring borrowers of the PSLF program.

According to the final rule issued by the Education Department, “On or after July 1, 2026, no payment made by a borrower will be credited as a qualifying PSLF payment for any month that their employer was found to have engaged in illegal activity that rose to the level of substantial illegal purpose.”

Can the President Legally Change PSLF?

Because the PSLF program was established by law, technically, the president cannot fundamentally change the program on his own. Congress must vote on any significant changes to PSLF.

Plaintiffs in the lawsuits challenging the final rule issued by the ED say the Education Secretary does not have the authority to change who is eligible for PSLF. The ED says that under the Higher Education Act of 1965, it does have the authority to regulate the program.

Is PSLF Going Away?

The PSLF program is not ending. To eliminate the program would require an act of Congress. However, as discussed above, the program is undergoing regulatory changes as a result of President Trump’s executive order. Eligibility for the program may be restricted for borrowers whose employers are determined to have engaged in illegal activity on or after July 1, 2026.

How the End of the SAVE Plan Affects PSLF Borrowers

The SAVE (Saving on a Valuable Education) IDR plan has ended due to court rulings. Borrowers currently on SAVE will be notified on or after July 1, 2026 that they must switch to a new IDR plan within 90 days to continue qualifying for forgiveness. Options they can choose from include the Income-Based Repayment (IBR) plan or the soon-to-be-launched Repayment Assistance Plan.

Because the SAVE plan was essentially in limbo due to court actions, the Education Department placed all SAVE borrowers in administrative forbearance in July 2024. While time spent in forbearance does not count toward the 120 payments required for PSLF forgiveness, the PSLF Buyback program, which was created under the Biden administration, allows certain PSLF borrowers to “buy back” the months they spent forbearance to complete the 120 qualifying payments needed to achieve forgiveness.

The amount of a borrower’s buyback payment is based on what their loan payment amount would have been during the forbearance months that they’re buying back.

If you believe you are eligible for PSLF Buyback, you will need to submit a request through PSLF Reconsideration from the Office of Federal Student Aid.

What Other Student Loan Changes Are Coming in 2026?

In addition to the changes to the PSLF program, other student loan changes are scheduled to be implemented by the Education Department as of July 1, 2026 as a result of Trump’s One Big Beautiful Bill. Here’s what to know.

New Repayment Plans: Standard Plan and RAP

For borrowers who take out new student loans on or after July 1, 2026, there will be only two repayment plans: a revised Standard Plan and the new Repayment Assistance Plan.

On the new Standard Plan, borrowers pay fixed monthly payments over a repayment term of 10 to 25 years, depending on their total loan amount. The higher a borrower’s loan balance, the longer their repayment term.

On RAP, borrowers will pay 1% to 10% of their annual adjusted gross income (AGI) every month, with the percentage based on their earning level. Forgiveness can occur after 30 years of payments under RAP — or 10 years for those in PSLF. On RAP, any unpaid accrued interest is waived by the government if a borrower’s monthly payment doesn’t cover it, and at least $50 per monthly payment goes directly toward the loan principal.

New Borrowing Limits for Graduate Students

There are also big changes coming to federal student loans for graduate students. As of July 1, 2026, the Grad PLUS program that allowed graduate students to borrow up to the full cost of attendance each year will be eliminated. The amount that students in graduate degree programs will be able to borrow starting on July 1, 2026 will be capped at $20,500 per year, with a $100,000 lifetime borrowing limit.

Students in professional degree programs such as medicine and law can borrow up to $50,000 per year with a $200,000 lifetime limit.

What PSLF Borrowers Should Do Now

In light of all the changes, it’s important to manage your PSLF progress. Make sure to file all PSLF paperwork accurately and on time and certify your employment regularly. Keep hard copy documentation of all activity related to your student loans, including your payment dates, amounts and confirmation of receipt, as well as details about your loan and any correspondence with your loan servicer.

Log in to your account on StudentAid.gov regularly to make sure the balances and statuses of your loans are accurate and up to date. Also, make sure your contact information is accurate, check which repayment plan you are enrolled in, and switch to a new plan if necessary to make sure your payments count toward PSLF forgiveness.

Finally, watch out for any communication from the Education Department and/or your loan servicer and read it immediately. You can also set up news alerts for student loan forgiveness updates to stay in the know about changes to the program.

The Takeaway

The PSLF program is not ending, but there will be some changes coming to it starting on July 1, 2026. An executive order signed by President Trump directs certain restrictions to be put in place regarding the employers that qualify.

Federal student borrowers on the program can check for developments regarding PSLF at StudentAid.gov and sign up for news alerts about the program. It’s also wise to monitor your PSLF progress to make sure you are complying with all the eligibility rules.

For those borrowers with private student loans who are struggling with monthly payments, PSLF is not an option, but refinancing might be one path to consider, especially if you believe you might qualify for a lower interest rate that could save you money.

Looking to lower your monthly student loan payment? Refinancing may be one way to do it — by extending your loan term, getting a lower interest rate than what you currently have, or both. (Please note that refinancing federal loans makes them ineligible for federal forgiveness and protections. Also, lengthening your loan term may mean paying more in interest over the life of the loan.) SoFi student loan refinancing offers flexible terms that fit your budget.

With SoFi, refinancing is fast, easy, and all online. We offer competitive fixed and variable rates.

FAQ

Is PSLF still a thing in 2026?

Yes, PSLF is still a thing in 2026 — meaning the program is still up and running. PSLF is available to existing and new federal student loan borrowers who qualify. However, under an executive order signed by President Trump, regulatory rules for the program are changing as of July 1, 2026. PSLF eligibility for borrowers whose employers are determined by the Education Department to have engaged in “illegal activity” may be restricted.

What happens to PSLF borrowers who were on the SAVE plan?

PSLF borrowers who were on the SAVE plan will be notified by the Education Department on or after July 1, 2026 that they must switch from SAVE to a new income-driven repayment plan to continue qualifying for forgiveness. SAVE borrowers have been in administrative forbearance since July 2024 due to court actions. Although time in forbearance does not count toward PSLF forgiveness, through the PSLF Buyback program, certain borrowers can “buy back” the months they spent in forbearance to complete the 120 qualifying payments needed for PSLF forgiveness.

Can Trump end the PSLF program without Congress?

Technically, no, Trump cannot end the program without an act of Congress. However, the program is undergoing regulatory changes as a result of an executive order the President signed in 2025. Eligibility for the program may be restricted for certain borrowers starting on July 1, 2026.

Which employers could lose PSLF eligibility under the executive order?

Under Trump’s executive order, employers that are determined to have a “substantial illegal purpose” can be excluded from PSLF eligibility. This will go into effect as of July 1, 2026. It is not yet known how the Education Department will determine whether an organization has an illegal purpose, but examples cited by the department include those that support terrorism and organizations that aid and abet illegal immigration.

What is the PSLF Buyback program?

If a federal borrower has a period of deferment or forbearance on their student loan payments, they may be able to “buy back” those months to complete the 120 payments needed for PSLF forgiveness. The amount of a borrower’s buyback payment is based on what their loan payment amount would have been during the deferment or forbearance months that they are buying back.

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Photo credit: iStock/zeljkosantrac

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