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Physician Assistants in the Spine Center specialize in the diagnosis and treatment of spinal diseases and conditions. With additional training, the physician assistant will specialize in the areas of sports medicine, spine surgery, and trauma surgery. This position is located in the Surgical Service and reports directly to the Section Chief of Orthopedics. 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: Knowledge of operating room technique, spine surgical technique, normal and pathological physiology of the axial skeletal system. Grade Determinations: 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 multidisciplinary 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. 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 Grade 3. The actual grade at which an applicant may be selected for this vacancy is in the range of Grade 1 to Grade 3. Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Service. ["Duties include, but are not limited to: Performs as the first or second assistant to the primary surgeon, i.e., assists in the preparation of the patient for surgery; assists with opening and closing of exposures to the spine. Serves as a clinical preceptor to healthcare students or organizes and participates in facility medical educational programs. Makes significant contributions which serve to enhance the distinctive role of PAs within the local institution and the healthcare system. Health care management of assigned veteran patients with acute and chronic illnesses. Health promotion and disease prevention Patient, family, and staff education and counseling. Clinical research; and participate in basic science research studies under the direction of principal investigator on the Surgical Service. Support IRB approved clinical research/trials through a variety of activities including but not limited to obtaining consent, ordering diagnostic tests, recording laboratory and diagnostic results, administering therapeutic interventions and documenting and reporting patient outcomes; Administrative activities, including performance improvement activities, committee and task force assignments, peer review and administrative, research, and non-clinical tasks as assigned; and Admits patients to spine surgery section after consultation with the supervising physician. Participates with surgeons in daily rounds of all patients to observe and record patient's medical progress. Notifies the physician of significant changes in patient's condition. Performs medical assessments to include history physical and mental status examination. These will be reviewed by the supervising physician, who will note concurrence or addendum and countersign the assessment. Orders appropriate laboratory, radiological and diagnostic tests after consultation of supervisory physician. Orders consults, referrals and patient care supplies after consultation of supervising physician. Initiates, renews and adjusts therapeutic regimens after consultation of the supervising physician. Performs diagnostic procedures which may include EKG, venipuncture, ABG and arthrocentesis. Performs therapeutic procedures after consultation of supervising physician which may include starts intravenous solution, administers intravenous medication and blood transfusions, places nasogastric tubes, performs gastric lavage, inserts foley catheters, and joint injections. Performs technical procedures only after direct consultation and explicit approval of supervising physician to include suture removal, sterile strip applications, routine wound incision and drainage, wound aspiration, wound care and debridement, wound lavage via existing drains; sutures minor wounds and incisions, wound drain removal. Writes orders and prescribe medications and supplies in accordance with the authorized medication list (Prescriptive Authority) Attends spine center outpatient clinic to perform patient assessment in consultation with the supervising physician. Assists in chart review of preoperative patients to ensure appropriate data in charts. Provides post-discharge evaluation of patient status by telephone contact with patients and families. Patient follow-up, as appropriate Collects data on all surgical patients and inputs into computer as part of spine cneter data base. Documents verbal telephone orders from supervising physician on Doctor's Order Form (VAF10-1158) for inpatients and progress notes (VAF509) for outpatients. Other duties as assigned. VA offers a comprehensive total rewards package. Work Schedule: Monday - Friday, 8:00am - 4:30pm with rotational call Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Financial Disclosure Report: Not required"]

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