A PA is a credentialed health care professional who provides medical care to assigned patients as a member of a health care team. 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: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. 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. Physical Requirements. See VA Directive and Handbook 5019, Employee Occupational Health Service. English Language Proficiency. Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f). Experience and Education. 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. 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. ii. Skill to incorporate training and experience into the successful practice of patientcare 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. Physical Requirements: Physical demands include repetitive body movements including the following: frequent reaching, standing, walking, and lifting of equipment and/or patients to provide patient care. This position requires extension of the hand(s) and arm(s) in any direction including above or below shoulder level, during the provision of patient care, including retrieval of needed equipment, supplies and to make contact with the patient. This position requires the maintenance of an upright position to perform duties associated with patient care. This position is typically non-sedentary, and frequently involves being in the standing position. This position requires moving about accomplish tasks, such as assisting with patient ambulation and moving one patient area to the next. This position requires the raising of objects from a lower position to a higher position or the movement of objects horizontally position to position. Lifting may be done to move a patient from one location to the next, i.e.- from the exam table to the chair, and in the movement of equipment or supplies. ["VA offers a comprehensive total rewards package. Core Elements: (1) Obtaining medical histories and performing physical examinations. (2) Providing and coordinating medical care for assigned patients, including establishing diagnoses, formulating and implementing care plans, and providing follow-up care. (3) Evaluating patients to determine the need for further health care. (4) Ordering diagnostic studies and other special tests, such as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) scans, etc. (5) Carrying out health promotion, disease prevention, and patient education activities. (6) Ordering or obtaining laboratory specimens. (7) Ordering ancillary services, such as, pharmacy, social services, physical medicine and rehabilitation therapies, prosthetic services, etc. (8) Ordering VA specialty service consults and initiating requests for non-VA medical care and consults in accordance with VHA and local facility policy and procedures. (9) Ordering patient care supplies. (10) Writing orders for or prescribing medications. (11) Admitting patients to the hospital. Discharging patients after consultation with the collaborating physician. Obtaining admission history and performing physical examinations, conducting patient rounds, documenting progress notes and summaries in the patient record, and writing patient orders. The PA may also be delegated the task of documenting the discharge summary, but the collaborating physician must write a discharge note, and co-sign discharge s summaries written by the PA. (12) Patient record entries by PAs, including medical histories, physical examinations, progress notes, service consults and patient orders do not require physician co-signature unless specifically required by Federal law, VA policy, or the standards of applicable external accrediting bodies. (14) Providing education and counseling to patients and families in preventive care, medical conditions, and the use of prescribed treatments and drugs. (15) Obtain informed consent, when participating in the provision of procedures or therapies requiring documentation of consent. (16) Obtaining prescription database reports, such as eKASPER, etc. (17) Communicate with families and participate in family meetings. (18) Perform suicide risk screening (19) Complete discharge instructions notes. (20) Completion of forms including insurance, FMLA, etc. (21) Act as liaison with outside facilities in coordinating care. (22) Identify areas for performance improvement and promote programs and projects that could improve the delivery of patient care. (23) Providing comprehensive primary care for Women veterans including, but not limited to, pelvic/breast exams; contraception counseling and management; management of osteoporosis, menopause, pelvic pain, abnormal uterine bleeding, and sexually transmitted diseases; in additional to screening for breast and cervical cancer or a history of sexual trauma. b. Expanded Elements: (1) Perform cardiopulmonary resuscitation in accordance with policy. (2) Perform Advanced Cardiac Life Support (ACLS) per established ACLS protocols and policy, with current ACLS certification. (3) Treat life threatening injuries. c. Additional duties as assigned (1) Administrative assignments (2) Clinical research projects (3) Chart reviews (4) Teach and provide direction for health care students (5) Serve on committees, workgroups and projects Page 3 of 5 d. Non-routine and Non-emergency Duties The PA is authorized to perform the following tasks as granted. A staff physician must be available for consultation, at least by telephone, and be physically present within a reasonable period of time as necessary. Work Schedule: Monday - Friday 8 a.m. - 4:30 p.m."]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.