Your friend doesn't have federal student loans. That's the problem.
Some of my loans are/were state loans or whatever they call them, which is totally different than federal loans. The federal loans are like 1% interest or something, non federal varies with the interest rate of everything else.
Other than medical school how in the fukc do you end up with 200k in student loans? Or better yet end up with such a shitty job that you are spending 3/4 of your paycheck to pay them back?