Physician Assistant - Surgical Care

Summary

The Physician Assistant provides clinic-based care exclusively within the Pre-Operative & Pre-Procedure Clinic (COTC). The PA will function with Full Autonomy as defined by VHA Directive 1063, appropriate to a non-procedural, non-operative assignment. As such, the PA will be in periodic contact with a collaborating physician, who is available in person, by telephone, or through other suitable means (e.g., telehealth) for consultation regarding patient care activities.

Duties

The PA's responsibilities in this assignment are limited to pre-operative/pre-procedure evaluation, coordination, recommendations, and documentation. The PA is not assigned procedural duties and does not participate in operating room activities or bedside procedures as part of the Pre-Operative & Pre-Procedure Clinic (COTC) role. The PA is authorized to write medical orders within this Scope of Practice and approved privileging, including verbal orders in emergencies. a. Utilize CPRS for documentation of all clinic activities and communications. b. Maintain a working schedule of COTC appointments; track surgical/procedural candidates and clearance status; ensure timely completion of pre-op requirements. c. Perform pre-operative/pre-procedural history and physical, document in CPRS, and communicate pertinent findings to the collaborating physician and surgical/procedural team. d. Coordinate pre-operative/pre-procedure testing and consults (e.g., anesthesia, cardiology) and ensure results are reviewed and acted upon. e. Assist in day-to-day management of patients preparing for procedures, including order entry for diagnostics, medications, and pre-procedure preparations as indicated. f. Make follow-up calls or encounters to review readiness, update the record, and notify the physician responsible for significant changes in patient condition. g. Order appropriate pre-operative antibiotics according to written protocol. h. Provide patient and family education regarding the planned procedure, preparation requirements, and post-procedure expectations. i. Obtain and document informed consent for procedures for which the PA has sufficient knowledge of the procedure, its indications, risk and benefit profiles, complications, and alternative treatments, and when authorized by the PA's Scope of Practice. NOTE: The PA need not participate in the particular procedure the patient is scheduled to undergo but must be authorized to perform, participate in, or assist the procedure by the Scope of Practice and must have sufficient knowledge and training to effectively counsel the patient. j. Identify deviations from established protocols, care standards, and clinic pathways and actively intervene to avoid/correct variances. k. Participate in teaching of residents and health professions trainees regarding pre-operative/pre-procedural protocols specific to COTC. l. Collaborate with COTC RN staff, anesthesia providers, clearing physicians, and specialty services to ensure comprehensive clearance and readiness. The PA may also be assigned additional duties which include but are not limited to: (a) administrative duties such as quality assurance, peer review, research, and serving on various committees as directed by the section chief or administration; (b) education of health profession trainees and students; (c) preventive medicine programs and related duties; (d) emergency preparedness; and (e) other non-clinical tasks as necessary. Work Schedule: Monday - Friday 8:00am - 4:30pm VA offers a comprehensive total rewards package. Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Requirements

All qualified candidates encouraged to apply. Open to U.S. Citizens but non-citizens may be appointed when it is not possible to recruit qualified citizens. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Must be proficient in written and spoken English. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical evaluation. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement. Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Physician Assistant Basic Requirements Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant AND Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) AND Currently hold, or will hold, a full and unrestricted license to practice in a State, Territory, or Commonwealth of the United States or in the District of Columbia. Grade Determinations: The full performance level of this vacancy is PA-III. The actual grade at which an applicant may be selected for this vacancy is in the range of PA-1 to PA-III. Physician Assistant-I (PA-I) (a) Experience and Education. None beyond the basic requirements. This is the entry level for PAs. (b) Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include, but is not limited to: i. Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care. ii. Ability to perform patient history and physical. iii. Ability to formulate a plan and provide treatment to the patient. iv. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. Physician Assistant-II (PA-II) (a) Experience and Education. The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below. Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Individuals demonstrate the KSAs of PA-II intermediate level by: i. Two years of successful practice as a PA. OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency. OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education. (b) Demonstrated Knowledge, Skills, and Abilities (KSAs). PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II: i. Skills to analyze and solve complex medical problems. ii. Ability to function autonomously and make independent medical decisions. iii. Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care. iv. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. v. Ability to practice with colleagues and peers collaboratively. Physician Assistant-III (PA-III) (a) Experience and Education. PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system. They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes. They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Individuals can demonstrate the KSAs for the full performance level by: i. Three years of successful practice as a PA.OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency and one year of professional practice as a PA.OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA. (b) Demonstrated Knowledge, Skills, and Abilities. PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III: i. Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care. ii. Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE). iii. Ability to present clinical findings and recommendations to appropriate management officials. iv. Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel. v. Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes. vi. Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records. Preferred Experience: Experience with evaluating veterans who will be undergoing a surgical procedure. Experience with assessing co-morbidities and risks related to the surgical procedure. Experience with the performance of history & Physical exams in an efficient and timely manner. Experience working collaboratively and communicating with surgeons, anesthesiologists, RNs, other physician extenders, trainees, and staff from multiple services. Experience or exposure to EKG readings. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Walking, bending, stooping, and some lifting in the direct care of patients. There may also be extended periods of sitting.

Education

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. How You Will Be Evaluated

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment. NOTE: A formal pay-setting process will be used to determine your salary. The salary may be at any point in the range listed for this vacancy. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members. Other Information

This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.