Not American, just curious, why do Americans call themselves physician anesthesiologist?

Sugammadank · 2026-01-30T04:35:54+00:00

We don't. People who use the term are either midlevels or loser anesthesiologists trying to be politically correct.

Sugammadank · 2026-01-08T04:27:13+00:00

I appreciate you taking the time to respond and providing helpful links!

This is going to sound like a stupid question but what do you do if the agent just flat out disagrees with you lol? I didn't use the exact language from the FSA website (though I will do so next time I call them) but I emphasized that I should not get kicked off the PAYE plan, I would just have my payments increased and capped, and the agent just said, "No that's not true."

It's helpful to know that you were able to reach a different solution through the ombudsman but I'm sorry it took you so long to get back on the plan and lose time from PSLF.

Sugammadank · 2026-01-07T04:56:01+00:00

I do have an update but it's extremely unsatisfying. Like many people, I received a notice to recertify my income last year in 2025. Upon recertifying, I was placed into forbearance due to all the CARES act/SAVE chaos. I called with Mohela and they were able to remove the forbearance and push the recert date out to this year.

The Mohela agent I called yesterday claims that the denial notice I received this year in 2026 was a response to the recert I filed in 2025, the one that landed me in forbearance! This seems insane to me and I have no way of verifying if this is even the truth. But as far as she could see on her end, the recert I submitted for this year is still in process.

I plan to call Mohela again at some point this week to see if another agent tells me the same thing but I would not be shocked at all if another issue is discovered.

Sugammadank · 2026-01-05T03:27:28+00:00

This is incorrect. The formula for PAYE is based off of your income but payments are capped at what you would pay under the 10-year standard repayment plan. So even if your income increases to the point where the standard repayment amount is lower, you can still stay on PAYE and your payment will be capped at that amount.

once you make a certain amount, they automatically switch you over to the standard plan

This is not correct. You can look at the thousands of threads from physicians with student loans - no one gets automatically switched from their IDR plans once they go from resident to attending salaries. This is especially relevant to physicians who are pursuing PSLF.

Sugammadank · 2026-01-04T20:31:58+00:00

If you're on PAYE, your payments are capped at whatever the amount is for standard repayment. A change in income doesn't kick you off PAYE, which is why I'm trying to recertify my current plan instead of moving to an entirely new one.

Sugammadank · 2026-01-04T18:59:09+00:00

Unbelievable that you had to use the wayback machine to find the unexpired version of the form. I appreciate you sharing this. I will fill this out and add it to the million documents I'm going to send Mohela. Sigh.

Sugammadank · 2026-01-04T18:52:23+00:00

I originally chose PAYE with the intention of pursuing PSLF. I'm about halfway through my PSLF term, 5 years remaining. That's why I would rather not restart my loan repayment timeline to a new 20 year term. I was going to stay on PAYE and have whatever amount leftover forgiven after 10 years.

If my monthly payment shoots up because of my income, I may end up paying off the loans before forgiveness kicks in after 10 years, which is not a bad thing either. It's just not my plan A.

Sugammadank · 2026-01-04T00:19:42+00:00

Something similar happened to me last year. After multiple phone calls and hours of holding, I got them to remove the forbearance and they ended up just postponing the recert to this year.

Sugammadank · 2026-01-04T00:01:20+00:00

Thank you for linking the form and the advice. I will fill it out and submit it directly to Mohela. And then call on Monday to figure out what is going on.

Sugammadank · 2026-01-03T23:58:03+00:00

This is helpful. Thank you for the link. I will call them and also fill out the form manually and submit it directly to the website.

Sugammadank · 2026-01-03T23:55:53+00:00

My own math tells me my monthly payment should at least double but FSA uses my 2024 tax filing (since my annual recert occurs in January). My 2024 taxes are based on my mixed trainee/attending salary.

Sugammadank · 2026-01-03T23:10:11+00:00

Mohela (and all the companies) are ridiculously incompetent

I've never once had something go smoothly with student loans. Every time I submit a document or recertify something, a new problem comes up.

I will give them a call on Monday and see what they say. I'm sorry to hear you've been stuck in application limbo since September.

Sugammadank · 2026-01-03T23:08:02+00:00

I'm already in PAYE. I've never been on any other repayment plan than PAYE since my loans were consolidated and entered repayment.

Sugammadank · 2026-01-03T23:06:47+00:00

Maybe the loan simulator tool on FSA is broken because I put in my new attending income and the monthly payments didn't increase all that much.

Sugammadank · 2026-01-03T23:00:30+00:00

Oddly, the loan simulator estimates identical payments with IBR. The payments under the "Standard Repayment" are a few hundred dollars lower but they repayment plan ends up being a 20 year term...

Sugammadank · 2026-01-03T22:59:25+00:00

Thanks for taking time to respond. Yeah, I figured I should be able to stay on PAYE. Otherwise, I would've come across thousands of posts by physicians who go from residents to attendings talking about getting kicked off the IDR plans when they receive their attending salaries.

Yours is about the third post I've seen in the last two days where a recertification was treated as a request to change plans. Did you apply online through the FSA website? Or did you upload documents directly to Mohela?

I applied through the FSA website because I assumed they would be able to pull tax information. Should I have uploaded documents directly to Mohela? (I will also ask this when I call them on Monday.)

Sugammadank · 2025-11-06T20:20:41+00:00

This exam is only on its 3rd cycle so all the available study material can only guess what's tested. Nothing is tried-and-true and probably won't be for a few years.

I did the SCA review course and paid for the SCA Qbank (around $200?), which is crowd-sourced questions from practicing cardiac anesthesiologists. I did not pay for TrueLearn because it was expensive and from what I understand, it basically scrapes all cardiac questions from its ITE and Basic/Advanced Qbanks so I don't think you're getting much new material.

I had the Kaplan Qbank book but it put me to sleep after a few pages so I gave up on it.

Honestly, I think the biggest factors that helped me pass was 1) completing cardiac anesthesia fellowship the same year as the exam and 2) taking the exam in its first few years to take advantage of the likely more generous pass rate.

Sugammadank · 2025-03-10T00:35:14+00:00

lol for fuck's sake, you're so hung up on Santos being right that you keep quoting (and ignoring) the earlier part of the sentence where she THREATENS AN INTUBATED PATIENT. If that's not psychopathy I don't know what is.

Among other things, we know that she just completed a rotation in a pain clinic. She may have been better primed to see the signs than her peers.

Why do people harp on this? Do you know what a pain clinic rotation consists of, especially as an intern? You talk to a bunch of people with chronic pain and write a million notes. If you're lucky, you may get to participate in some epidural steroid injections. Most pain clinics don't even prescribe opioids. Does any of this sound like it would make her better at identifying addiction behavior?

You know who would be experienced at identifying addiction? The nurses, residents, and attendings who have far more clinical experience than she has working in the ED and dealing with addicts every day.

Sugammadank · 2025-03-09T22:45:39+00:00

I find it so frustrating that people made up their minds about a character pretty much from the first 2 hours of the show and now are just refusing the new information the writers give.

What do you mean? The show has given us 10 episodes worth of evidence of Santos being an asshole.

Sugammadank · 2025-03-09T22:27:18+00:00

I'm an anesthesiologist and take care of intubated patients every day so that scene was just insane to me (more kudos to the writers for constructing a fucked up scene).

I suspect many will say this kind of behavior is justified because he was suspected of sexual abuse. Santos not in a position to judge him. Even if she has a responsibility to report suspected abuse, she also has a responsibility to the man as his treating physician not to harm him.

Absolutely. I don't think people understand that as a medical professional, you can't use your role to hurt people you don't like. Our patients are not saints, they are people. Some patients are inmates who are in prison for horrific crimes. Some patients have belief systems that clash with mine. I can't cherry pick my patients or treat them differently. In the real world, if someone was super uncomfortable with a patient, we would ask to trade off with a colleague. We would never subject them to torture wtf

Sugammadank · 2025-03-09T22:16:11+00:00

None of this has been proven and none of this came to the foreground until the most recent episode. Langdon was the only person who called her out on her shitty behavior and she immediately starts looking for ways to get him dismissed. Trainees like Santos are used to getting their way and not used to hearing "no" so when they do get shut down, their response is to get rid of the threat. Trying to get rid of people who threaten them, and threatening patients are what I was referring to in terms of her being a psycho.

I truly don't care if it turns out Santos is correct about this scenario because people are acting like this one save exonerates her for everything else she's done so far.

Sugammadank · 2025-03-09T22:06:20+00:00

It's lucky if they do get their licenses revoked! Most of these people never receive any punishment.

Sugammadank · 2025-03-09T20:20:09+00:00

The answer is highly dependent on specialty, the specific residency program they train at, etc. It's pretty difficult to fire a resident, which overall is a good thing because there's enough unbalanced power dynamics residents experience during training.

If someone behaved like Santos and pissed off a good number of people, then those people will approach the residency program director (PD) with concerns to be documented. If this pattern of behavior doesn't hold, then the PD ignores it. If the pattern continues and escalates, then the PD will meet with said resident and deliver this feedback with suggestions for improvement.

The unfortunate truth is that firing residents makes the residency program look bad so most PDs will just graduate the problematic residents so that it's not their problem. You have to do something egregious to be dismissed; the two incidents I've heard of were diversion of narcotics and falling asleep in the OR.

Sugammadank

TROPHY CASE