All moves, med school to late career · Students · Residents · reviewed October 27, 2026 · oldest source check October 21, 2026
The decision. Submitting a rank order list, matching, and signing the residency (GME) agreement.
What changes
- A match is a binding commitment under the NRMP Match Participation Agreement. Neither the applicant nor the program can release the other from it; only the NRMP can grant a waiver.NRMP, 2027 Match Participation Agreement; NRMP help: declining a matched position · checked October 27, 2026
- Residents are employees of their program as well as trainees. The residency agreement sets salary, benefits, leave, moonlighting rules, due process and the grounds for dismissal; where residents have a union, a collective bargaining agreement sets many of those terms.Andwise: resident union contract benchmarks · checked October 21, 2026
- Direct Loans have a six-month grace period after a borrower drops below half-time enrollment. Interest on unsubsidized loans accrues during grace.34 CFR 685.207, grace periods; Federal Student Aid: interest rates and fees · checked October 21, 2026
- Residency forbearance is mandatory on request, granted up to 12 months at a time for the length of training. Interest accrues, and forbearance months earn no credit toward PSLF or toward RAP or income-driven forgiveness.34 CFR 685.205, forbearance; Federal Student Aid: forbearance · checked October 21, 2026
- On-time RAP payments, or required IBR payments, made while employed full-time by a nonprofit or government hospital count toward the 120 payments PSLF requires.34 CFR 685.219, Public Service Loan Forgiveness; Public Law 119-21 (2025), Title VIII, §§81001 and 82001–82004 · checked October 21, 2026
- Consolidating federal loans on or after July 1, 2026, for example to end grace early, produces a loan that only RAP or Tiered Standard can repay.Public Law 119-21 (2025), Title VIII, §§81001 and 82001–82004 · checked October 21, 2026
Who is paid for what
How each party at this decision is paid, and what its role does not include. The page states payment structures only, not intentions.
The residency program and its sponsoring institution
Medicare pays teaching hospitals for graduate medical education: a direct payment from a per-resident amount, the weighted count of residents and Medicare's share of inpatient days, plus an add-on to each Medicare inpatient payment. Resident counts are generally capped at each hospital's 1996 level.CMS, direct graduate medical education (DGME) payments; CMS, indirect medical education (IME) adjustment; 42 CFR 413.79, resident counts and the 1996 cap
Not part of its role Advising on loans, taxes or the first attending contract.
Federal loan servicer
The Department of Education pays contracted servicers a monthly amount for each borrower account. Under the contracts in effect since April 2024, it can withhold up to 5% of a bill for each missed performance metric, up to 20% in total.GAO-16-523, federal student loan servicing (May 2016); GAO-26-108534, student loan servicing contracts (March 2026)
Not part of its role Choosing a repayment plan for the borrower.
Costs that come later
What is agreed at this decision, and when its cost arrives.
- Forbearance instead of payments during residencyLands at PSLF and RAP forgiveness, where those months never countCompare repayment plans
- Moonlighting and outside-activity termsLands at PGY-2 onward, if outside income mattersOutside-activities clause
- Moving to the matched program before the first paycheckLands at July of PGY-1Match Day money plan
- Consolidating to end grace earlyLands at The repayment plans open to the loan for the rest of its lifeLoan repayment comparison
Dates for a calendar
Contract dates come from the terms the contract checker read, saved in this browser only; a start date places them. Rule changes come from the site's feed of dated changes. The calendar file is built on this device.
What is fixed and what moves
Ratings are Andwise's reading of the evidence beside each one. No national data measures what negotiating changes.
- Resident salary and benefits
- Programs set resident pay and benefits for each training year; collective bargaining agreements set them where residents have a union.Andwise: resident union contract benchmarks
Deadlines, and who sets them
- Set by the program or a licensing body2027 Match: rank order lists certified by 9:00 p.m. ET on March 3, 2027; Match Day is March 19, 2027NRMP, 2027 Main Residency Match applicant calendar
- Set by lawEnd of grace: six months after dropping below half-time enrollment34 CFR 685.207, grace periods
- Set by lawBorrowers moved off the SAVE plan: at least 90 days from their servicer's notice to choose a plan; those who do not choose are placed in Standard or Tiered StandardU.S. Department of Education: next steps for borrowers enrolled in the SAVE plan
Tools, in the order this decision uses them
Match Day money plan
Take-home pay in the matched state, cash before the first paycheck, loan dates.
Resident pay per hour
Hourly pay on 60–80 hour weeks.
Union contract benchmarks
Provisions from ratified resident contracts.
Compare repayment plans
Which plan applies, what it costs in training, whether PSLF counts.
Starting residency
Training licenses by state, credentialing and the move.
Questions for a professional or the other party
The program
- Is moonlighting permitted, and how is it counted toward duty hours?
- Which leave is paid, and how does leave change the training end date?
- What is the process for appealing a dismissal or non-renewal?
The loan servicer
- Which repayment plan applies when grace ends?
- Do payments made during residency at this employer count toward PSLF?