The Cardiothoracic Surgery Physician Assistant (PA) works directly under a supervising physician (SP) within the Surgery Section. They PA acts as an agent of his SP and will exercise no independent authority. The PA and a SP will be in daily communication regarding care of patients on the service.
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. Physician Assistant-I (PA-I) Experience and Education. None beyond the basic requirements. This is the entry level for PAs. Demonstrated Knowledge, Skills, and Abilities(KSAs). 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)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. Demonstrated Knowledge, Skills, and Abilities (KSAs). 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) 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. Demonstrated Knowledge, Skills, and Abilities(KSAs). 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. Grade Determinations: In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates: Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is 3. The actual grade at which an applicant may be selected for this vacancy is in the range of 1 to 3. Physical Requirements: Applicants must meet physical standards for the position. A physical examination prior to placement is required. This is a designated drug testing position. After appointment, you will be subject to random testing for illegal drug use. Requires lifting 15-44 pounds; pushing (approx. 2 hours); reaching above shoulder; use of fingers and both hands; walking and standing from 3-5 hours and kneeling. Ability for rapid mental and muscular coordination simultaneously. Must have depth perception and ability to distinguish basic colors and shades of colors. Hearing aid is permitted.
VA offers a comprehensive total rewards package. Work Schedule: 8:00am to 4:30pm, Monday through Friday Relocation/Recruitment Incentives: Not Authorized The Cardiothoracic Surgery PA acts as an agent of his Supervising Physician (SP) and will exercise no independent authority. Each Cardiothoracic surgery attending will supervise the PA which on call for the service. The PA and a SP will be in daily communication regarding care of patients on the service. The major duties and responsibilities include, but are not limited to: Perform initial and interim histories and physicals (H&Ps) on all inpatients and outpatients assigned to the Cardiothoracic Surgery Section. Perform initial CT surgery consultations as requested by the Emergency Department, other inpatient services, and/or outside referrals in clinic. Screen patients to determine the need for hospital admission and may so admit patients when indicated after informing SP or his designee of the decision to admit. Order and initially interpret tests including but not limited to blood lab work, such as chemistry, CBC, liver function tests, lactate, BNP, HgbA1c, PT/PTT, INR, TSH and thyroid tests, type and cross, hepatitis screens, MRSA screens, hematologic panels, urinary analysis, micro, all cultures, pathology, ECG, medical imaging studies, such as x-rays, echocardiograms results, ziopatch results, catheterization results, as well as other procedures needed for ensuring adequate diagnosis, differentials, and continued health maintenance. Initiate or expedite requests for consultation, special test and studies on assigned patients and will keep the SP or his designee apprised of results and progress. Make rounds on assigned inpatients and write interim progress notes and may write or dictate the discharge summary. Initiate social work consultation, work with social work on patient needs, initiate physical therapy and occupational therapy consultation, and work with therapists on patient care needs. Initiate specialty consultation to include but not be limited to endocrine consultation for diabetes, vascular surgery consultation, general surgery consultation, infection disease consultation, hematology/anticoagulation consultation, neurology consultation, pulmonary consultation, and cardiology/CHF/EP consultation. Provide necessary patient education and apply currently accepted preventive health care measures to our patients and/or their families. Monitor and evaluate the need for reordering medications which are routinely required for maintenance of various chronic medical conditions including, but not limited to, HTN, DM, COPD and arthropathies. Order or transmit an order for x-ray, other studies, therapeutic diets, physical therapy, occupational therapy, respiratory therapy, and nursing services and will be required to co-sign (certify) treatment plans developed by rehabilitation therapists. Document in the medical record consultations required for initiating or continuing medications. The PA will document controlled substances he/she administers or transcribes secondary to an order by a supervising physician for a particular patient. The entry will include the name of the SP. Evaluation of daily ECGs, adjustment of medications for heart rate and blood pressure with appropriate consultation, consultation with cardiology regarding pacemaker, treatment of atrial fibrillation with po and IV medication. Evaluation of daily CXRs with adjustment of diuretics. Adjustment of medications for glucose control under supervision of physician or endocrine consult. Initiation of anticoagulation, po or IV and adjustment as needed to therapeutic dosing. Reversal of anticoagulation as needed for over anticoagulation, therapeutic procedure, or preoperative planning.