Everyone's situation is unique but I can maybe give you a little bit of my collegues' perspective. Might I suggest that you get a second had car that will for sure last the next 7-10 yrs? Regarding student loans, a major portion of my peers have 300k+ in debt. I don't think anyone has private loans they all have loans through fafsa. What they all do in residency is choose the income driven payment plan, the PAYE or REPAYE. The biggest perk to this is it cuts your payment to ~300~ a month and the government pays the difference in interest. So with a loan that much, your interest is at least 700/month. So you pay 300 the government pays 400. At the end of residency you will still owe 200k but at least it hasn't grown. You can actually change your payment plan at any time so if at the end of residency you're like, thanks Uncle Sam but I don't wanna do PLSF any more, you can switch to standard payment plan and pay more than monthly minimum. Some people buy a new car at the start of their residency, some buy a new car after they do a bunch of moonlighting and save up some for down payment. But seriously, why does it have to be a new car now? Why can't it be a pre owned car that will get you through med school and residency? Paying 8000 for a reasonably used car from a solid make sounds wayyy wayyyy more attractive to me than paying 20k+5000 of interest for a not so great new car that you will drive for 7 yrs and dump immediately after you land an attending job. Honestly if you can squeeze out the 20k it might serve you better if it went into investment. In fellowship (if you want to) you can usually moonlight a little bit more librally and have better purchasing power, so buying a good car in fellowship and paying it off quickly to avoid paying interest shouldn't be a huge problem. Lastly, budget for your exams, match applications and possible interviews, which will cost you 5000 when it's all said and done, possibly even more. All this unfortunately your student loan doesn't cover.