She blows up accusing me of forcing her to live in squalor
How dare she. You have paid off her debt and likely already provide for her a style of living significantly above what she could achieve herself.
You are not being frugal by making your debt a priority over lavish luxurious vacations. Miserable without 5 star accommodations? I'm betting most redditors here do not understand what that really means. 5 stars is luxury. Like pool on par with a resort, full spa, gym equipped as well as a professional gym, room service comparable in quality to a nice restaurant, actual restaurant that is on par with the hottest spots in town... etc.
I am not trying to paint my wife as a “gold digger” or something
Did she know you were going to be a doctor when you met her and started dating her? It's clear that she is incredibly entitled and materialistic.