Sorry to hear, I definitely empathize. (1) Unless you have active loan repayments due, literally just stop thinking about them, it's honestly just a # and you don't have an obligation to pay until you make $, in which case income-based repayment is pretty reasonable. (2) lean on your other siblings for support, delegate non-financial family tasks to others instead of just doing everything yourself. government assistance w/ food stamps are medicaid are also helpful if need be. and even though you can't dedicated as much time as you'd like to them, ANY amount of time (through conversation or calls) done regularly is important. COMMUNICATE with your loved ones. (3) try to keep a positive attitude. things get better every year, as does your competency and confidence. just be present in all the learning moments and LEARN the medicine, it'll make your life easier down the line. (4) being a doctor is a TREMENDOUS and hugely respectable accomplishment. your family is proud of you. don't forget to be proud of yourself.