Summary The Surgical Service Section of the San Francisco VA Health Care System provides surgical care in outpatient and inpatient settings throughout the facility. Assess, stabilize, and determine the disposition of patients with emergent and elective conditions consistent with medical staff policy regarding emergency and consultative call services under the supervision of the attending surgeon. Responsibilities VA offers a comprehensive total rewards package. Work Schedule: 7:30am to 4:00pm, Monday through Friday Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required The Surgical Service Section of the San Francisco VA Health Care System provides surgical care in outpatient and inpatient settings throughout the facility. Assess, stabilize, and determine the disposition of patients with emergent and elective conditions consistent with medical staff policy regarding emergency and consultative call services under the supervision of the attending surgeon. The Cardiothoracic Surgery Physician Assistant (PA) acts as an agent of their supervising physician (SP) and will exercise no independent authority. The PA and a SP will be in daily communication regarding care of patients on the service. The PA is authorized to write medical orders on patients assigned or being evaluated by the Cardiothoracic Surgery Section. All orders written by the PA will be within the parameters of his/her scope of practice. The PA is authorized to write prescriptions, new and refilling previously prescribed medications and supplies for inpatients and outpatients, and inpatients going on pass or upon discharge. The PA will perform initial and interim H&Ps on all inpatients and outpatients assigned to the Cardiothoracic Surgery Section. The initial H&Ps will be reviewed by the primary or alternate SP (cardiothoracic surgery attending on call) and countersigned within a 24-hour period. Regular review of the care rendered to stable outpatients and inpatients will also be accomplished. The major duties and responsibilities include, but are not limited to: The PA will perform initial CT surgery consultations as requested by the Emergency Department, other inpatient services, and/or outside referrals in clinic. The PA will be able to 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. The PA will be able to 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. The PA will make rounds on assigned inpatients and write interim progress notes and may write or dictate the discharge summary. The PA may 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. Assist in the intraoperative care of the patient including but not limited to 1st and 2nd assisting and conduit vessel harvest. Requirements Conditions of Employment 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. You may be required to serve a probationary period. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details. 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. Preferred Experience: Current BLS provider card issued by American Heart Association (AHA) or Military Training Network (MTN). Current Advanced Cardiovascular Life Support (ACLS) provider card. 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: 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. References: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-8 Physician Assistant Qualification Standard. This can be found in the local Human Resources Office. 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. 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/. Additional 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. Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process. 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.