Patient centered care at the South Texas Veterans Health Care System (STVHCS), a great tertiary training and research Veteran's hospital. This gastroenterology (GI) position supports this mission through administrative dependability, direct patient care, and support of their section's educational and research activities. 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. BASIC REQUIREMENTS Citizenship: Citizen of the United States [in accordance with section 7402(c) to title 38, United States Code (U.S.C.). Non-citizens may be appointed when it is not possible to recruit qualified candidates in accordance with 38 U.S.C. § 7407(a).] Education: Graduate of a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations. Additionally, candidates must meet one of the following: (1) Master's degree in any discipline OR (2) Bachelor's degree in any discipline with one year of experience as a PA. Certification: Must have successfully passed the PA National Certifying Exam (PANCE). NOTE: Current and continuous certification by the National Commission on Certification of Physician Assistants (NCCPA) is no longer required for employment in VHA. Licensure: PAs must possess an active, current, full, and unrestricted license to practice in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. PAs must maintain current registration in the State of licensure if this is a requirement for continuing active and current licensure in that State. English Language Proficiency: Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f). Exceptions for Graduate PAs. (a) PAs who otherwise meet the basic requirements, but do not possess the required licensure, may be appointed, pending licensure, as a graduate PA on a temporary full-time appointment not-to-exceed two years under the authority of 38 U.S.C. § 7405(c)(2)(B). (b) Graduate PAs may only be appointed at the entry grade level and may not be promoted/converted until certification is obtained. (c) Temporary graduate PA appointments may not be extended beyond two years or converted to a new temporary appointment. NOTE: Individuals who have or have had multiple licenses and had any such license revoked for professional misconduct, professional incompetence or substandard care, or who surrendered such license after receiving written notice of potential termination of such license by the State for professional misconduct, professional incompetence, or substandard care, are not eligible for appointment to the position unless such revoked or surrendered license is fully restored (38 U.S.C. § 7402(f)). This requirement does not apply to licensed PAs currently employed by VA as of November 30, 1999, provided they maintain continuous appointment and are not disqualified for employment by any subsequent revocations or voluntary surrenders of State license, registration or certification 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) a) Experience and Education. None beyond the basic requirements 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. References: VA HANDBOOK 5005/78 SEPTEMBER 27, 2020 PART II APPENDIX G8 II-G8. Physical Requirement: Please see Education Section below. ["The Physician Assistant (PA) is a dependent practitioner and therefore, must have a clearly designated supervising physician with one assigned back-up when first not available. The supervising physician does not have to be on site; however, he or she must be available telephonically for assistance or an alternative physician may be identified verbally to supervise or advise on an as needed basis. The PA will be licensed in a state, territory, or the District of Columbia (D.C.) and should be certified or qualified. a. Administrative Duties, Physician Assistant i. Will abide by all Veterans Affairs (VA) rules and regulations pertinent to the scope of practice within any VA facility. ii. Be responsible for maintaining current clinical privileges and keeping licensure, cardiopulmonary resuscitation (CPR)/advanced cardiovascular life support (ACLS),and all other appropriate documents and training requirements up to date. iii. Be actively engaged in evaluating and addressing patient and clinic needs. In addition, be expected to evaluate clinical performance, and formulate and implement plans to improve the care delivered to our patient population. iv. The supervising physician will abide by all VA facility By Laws regarding the supervision of physician assistants and review of medical charting. v. The provider will perform administrative duties as directed by the supervising physician or agent of the supervising physician. vi. Complete all required encounter information in computerized patient record system (CPRS) in a timely manner. b. Clinical Duties: i. Inform patients of biopsy results obtained during endoscopy when the GI staff endoscopist is not available in accordance with established timelines. ii. Assist in reviewing and in the disposition of routine GI consults for triage as needed. iii. Maintain a face-to-face designated clinic or VVS clinic for clinical evaluation and develop treatment plans under direct staff supervision as needed. This will depend on the immediate needs of the GI Service as directed. Work in conjunction with the Nursing staff to address Secure Messaging issues as needed. iv. Transcribe into CPRS routine prescriptions for colonoscopy preparation and refill GI medications as needed and notify by phone or secure messaging. v. Be available to GI nursing services and technical staff as a consultant for any problems that arise during their routine work. vi. Assist the gastroenterologists in the endoscopy unit by discussing and educating patients about their endoscopic procedure, complete a pre-anesthesia assessment, place pre-procedure orders and obtain an informed consent. vii. Post-procedurally, discuss with patients the procedure results and provide post-procedural education. viii. Assist with the coordination of care that may result from procedural findings included but not limited to new diagnoses of malignancy. ix. Review upcoming procedures for indications, contraindications and appropriateness. In cases where procedure orders are found to be contraindicated or not appropriate, the PA will discuss the case with available gastroenterologists x. Perform elastography of the liver by using FibroScan® and entering the interpretive result into CPRS xi. Be proficient with patient contact with telecons and Video communications. May have an independent established clinic for this method of contact. xii. Place community care consults into CPRS if services not available at ALMVAH. xiii. Perform other duties as assigned by the GI section chief. c. Education i. Duties may include teaching and trainee supervision as needed. ii. Maintain continued professional medical training and GI/Hepatology specific training needed to complete the clinical duties as outlined above. d. Research Duties (if applicable) i. Clinical research conducted by established protocols with prior VA IRB approval may be an option dependent on needed clinical support. VA offers a comprehensive total rewards package. Work Schedule: 7:30 am to 4:00 pm Telework: Ad-Hoc Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized"]

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