I think Mr. Youngblood said that this was actually "fresh off the press" (his own words). I don't think they are trying to hide things; I think because it's such a new program and no one has actually went thru the whole thing, they don't want to make verbal promises they can't keep.
That being said, I don't particularly understand the added fellowship years time because like... they need so many specialists who literally HAVE to do fellowships (especially IM specialties). So why create this discouragement for fellowships? They're treating fellowships as like "niche" stuff when it is most definitely not.
For the PSLF part, I am getting conflicting information. On one hand, I hear it's a pretty common pathway physicians take but on the other hand (in the non-physician sphere) I have heard sooo many people apply for forgiveness and never get it because of some technicalities, changes in loan servicers, a payment misstep, etc. 10 years is a long time to have to get it right all the time. For example, "Among processed applications of PSLF,
2.16% have been accepted since Nov 2020 (
source). Couple that with the fact that I don't really trust that, in the next 14 years, the government won't make some crazy changes to the program or scrap it completely. Too many variables like that that make me worried about PSLFāwouldn't want to pay minimum payments for so long, wrack up an insane about of interest only to find out I am denied when I could have been aggressively paying off my loans for a few years at that point.
The specialty thing you bring up is very poignant; definitely do not want to be in my 3rd year having to factor that into my decision of specialty. I would realllllly like to know how much your preference in location factors into their decision. I mean I would not at all mind being 6.5 years in Seattle of DC or NYC or...! But how much is my choice factored in? And how is the list of positions generated? All available VA hosp positions in your specialty in the country or only the ones that need more personnel?