My wife has $400,000 of medical student loan debt. We are on PSLF but are nervous about the program and question if her student loans will really be forgiven. If they are not forgiven at the end of our 10 years of qualifying payments we plan to leave the country. If you can find a job outside the U.S. and don’t mind learning a new system I think leaving the U.S. is a great option. Will people do this over medical debt in the future? As the world becomes more integrated this option becomes easier. Especially since speaking only English is not as limiting as it used to be.