The Vascular Physician position is assigned to the Operative Care Line (OCL) at the Michael E. DeBakey VA Medical Center (MEDVAMC) in Houston, Texas, one of the most complex facilities in the VA healthcare system. MEDVAMC is interested in acquiring the employment of an experienced vascular subspecialist, researcher, and educator. To qualify for this position, you must meet the basic requirements as well as any additional requirements (if applicable) listed in the job announcement. Applicants pending the completion of training or license requirements may be referred and tentatively selected but may not be hired until all requirements are met. Currently employed physician(s) in VA who met the requirements for appointment under the previous qualification standard at the time of their initial appointment are deemed to have met the basic requirements of the occupation. 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. Degree of doctor of medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine. The degree must have been obtained from one of the schools approved by the Department of Veterans Affairs for the year in which the course of study was completed. Current, full and unrestricted license to practice medicine or surgery in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. Residency Training: Physicians must have completed residency training, approved by the Secretary of Veterans Affairs in an accredited core specialty training program leading to eligibility for board certification. (NOTE: VA physicians involved in academic training programs may be required to be board certified for faculty status.) Approved residencies are: (1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR [(2) Those approved by the American Osteopathic Association (AOA),OR (3) Other residencies (non-US residency training programs followed by a minimum of five years of verified practice in the United States), which the local Medical Staff Executive Committee deems to have provided the applicant with appropriate professional training and believes has exposed the physician to an appropriate range of patient care experiences. Residents currently enrolled in ACGME/AOA accredited residency training programs and who would otherwise meet the basic requirements for appointment are eligible to be appointed as "Physician Resident Providers" (PRPs). PRPs must be fully licensed physicians (i.e., not a training license) and may only be appointed on an intermittent or fee-basis. PRPs are not considered independent practitioners and will not be privileged; rather, they are to have a "scope of practice" that allows them to perform certain restricted duties under supervision. Additionally, surgery residents in gap years may also be appointed as PRPs. Proficiency in spoken and written English. Additional Requirements: Provide resident supervision and clinical instruction in the operating room, outpatient clinic and inpatient settings. Attend, participate and supervise residents/students in outpatient clinics and take an active role in the evaluation of the patient, decision for treatment/care, and documentation in the patient electronic records. Supervise Residents/students in clinical instruction and the performance of any bedside procedures appropriate to their level of graduate responsibility. Participate in call coverage to advise and supervise residents. Call response time of 15 minutes by phone and 60 minutes in person is expected at MEDVAMC. This includes nights, weekends, and holiday hours. Maintains professional competency, courtesy, and flexibility to provide the necessary services of this specialty. Provide regional level specialty support to VA facilities located in in VISN 16 through such means as tele-medicine and referral-based consultations and treatment. Meet annual and mandatory training requirements that are specific to the Veterans Healthcare Administration. The surgeon must be able to function as an independent clinical provider. Initiative, diplomacy, and confidentiality are employed when dealing with patients, staff, and trainees. At least 400 cases (independent or with supervision) of diagnostic angiography. At least 200 cases (independent or with supervision) of endovascular intervention, including angioplasty, stent placement, intravascular lithotripsy, and other interventions, at all levels from the abdominal aorta to the level of the distal foot. Infrainguinal bypasses of all types, including: femoropopliteal, femorotibial, and femoropedal; and re-operative bypasses. Because of our hospital's high volume and high complexity, we are looking for applicants with experience of at least 150 peripheral cases (independent or with supervision). Harvesting of autogenous vein, including arm veins. Experience with cryopreserved human allograft vein and/or arterial segments for use in infrainguinal bypass. Construction of distal vein patches for use in infrainguinal bypass with prosthetic conduits. Femoral artery reconstructions, including endarterectomies and patch angioplasties. Aortobifemoral bypass for occlusive disease. Extraanatomic bypasses, including femorofemoral and axillofemoral. Able to safely and effectively perform procedures for the management of infected prosthetic vascular grafts, including graft explantation and replacement with extra-anatomic bypasses or with biologic conduits. Able to safely and effectively perform procedures for the management of acute limb ischemia, including (but not limited to): open surgical thromboembolectomy; catheter-directed pharmacochemical and mechanical thromboembolectomy; and performance of four-compartment fasciotomies of the calf. Able to safely and effectively perform other common peripheral vascular procedures, including the establishment of permanent hemodialysis access, carotid endarterectomy, amputations of the lower extremity (including transfemoral, transtibial, and partial foot levels) and ablation and/or stripping for varicose saphenous veins. Preferred Experience: Board Certified Experience effectively using the Anigojet, Penumbra, and Inari devices for percutaneous endovascular management of thromboembolic problems. Experience performing transcarotid arterial revascularization (TCAR) for the treatment of extracranial carotid artery stenosis. Experience performing thoracic outlet decompression for the treatment of venous, arterial +/- neurogenic thoracic outlet syndrome. Able to perform fasciotomies of the thigh, calf, foot, forearm and upper arm compartments. Willing to do community outreach to prevent limb loss within the veteran population. Interest in occasional travel to VA community-based outpatient clinics (CBOCs) in the regional that refer to MEDVAMC for outpatient clinics. Experience with root cause analysis and focus group meetings to improve quality, safety and outcomes. Advanced (Master's or Doctoral) degree in patient safety, quality improvement, outcomes or public health to provide the capability of co-leading MEDVAMC efforts to reduce amputation incidence among its patient population. Experience with statistical analysis of clinical outcomes data using Stata or R statistical programing language. Certified or eligible for Registered Physician in Vascular Interpretation (RVPI) certification by the Alliance for Physician Certification and Advancement (APCA). Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-2 Physician Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: Light lifting & carrying (under 15 lbs.), reaching over shoulders, , walking (2 hrs.), standing (4 hrs.), Use of both legs, ability for rapid mental and muscular coordination simultaneously, use of both eyes, ability to distinguish basic colors, ability to distinguish shades of colors. Include being outdoor and Inside, working closely with others & around moving parts to include electrical energy and vehicles. ["VA offers a comprehensive total rewards package. VHA Physician Total Rewards. Recruitment Incentive (Sign-on Bonus): Authorized Education Debt Reduction Program (Student Loan Repayment): Learn more. EDRP Authorized: This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. The EDRP coordinator can be reached at Ms. Demetrius Roberts at Demetrius.Roberts@va.gov. Pay: Competitive salary, annual performance bonus, regular salary increases Paid Time Off: 50-55 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year and possible 5 day paid absence for CME) Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Licensure: 1 full and unrestricted license from any US State or territory CME: Possible $1,000 per year reimbursement (must be full-time with board certification) Malpractice: Free liability protection with tail coverage provided Contract: No Physician Employment Contract and no significant restriction on moonlighting Duties: MEDVAMC is the largest hospital in the VHA network and home to the highest-volume vascular surgery service. Its Operative Care Line is ranked #1 in operating room efficiency and #1 in case complexity. We typically perform about 1,200 cases per year. The majority is limb salvage, the remainder a balance of carotid disease, dialysis access, aneurysms and amputations. You would become a vascular surgeon in a group that is - when at full capacity - comprised of five 8/8ths vascular surgeons. We have three nurse practitioners, two of which have been members of the team 5+ years and three ultrasound technicians, all with 10+ years of experience. We work with fellows, residents and students from the Baylor College of Medicine: two senior vascular trainees (fellow or PGY-4+ resident), one general surgery PGY-4, one general surgery PGY-2, and three interns. Baylor medical students common as well. We have two hybrid ORs with floor-mounted Philips systems that are dedicated to our vascular team. We have a total of seven block time-days Monday through Friday (i.e. one room Monday-Friday, second OR block time Wednesday and Friday). A non-salaried faculty appointment in the Baylor College of Medicine's Michael E. DeBakey Department of Surgery would be expected. A wide array of open and minimally invasive vascular and endovascular procedures. The vascular surgeon is responsible to perform surgery and assist surgical residents with vascular surgery. The vascular surgeon is responsible for seeing patients in consultation in both inpatient and outpatient settings. Provides care of the Veterans' medical needs by performing examination, surgical consultation, and developing treatment and follow-up plans. Physician will provide ongoing patient and family education throughout the course of treatment. Spends most of his/her time on the following: Vascular Surgery; Attending on Surgical Service and; Caring for patients in the outpatient Surgical clinic. Physician should have expertise in invasive and non-invasive endovascular surgical techniques as established in current delineation of privileges. Responsible for completing patient encounters, notes, and correctly coding visits in accordance with coding guidelines, VA Handbook 1907. Provider will participate in discharge planning and interdisciplinary patient care plan activities. Maintain skills, proficiencies, and professional knowledge required for licensing and clinical scope of practice. Patient care may be delivered via face-to-face, Telehealth, or phone consultation, as well as consultation via face-to-face encounters, MyHealtheVet, and e-consults. Required to attend staff meetings, serve on committees, teams, workgroups, and peer reviews as requested. PRIVILEGES include history and physical, admit, evaluate, diagnose, consult, and provide pre-, intra and post-operative care, and perform surgical procedures, to patients of all ages, except where specifically excluded from practice, to correct or treat various conditions, diseases, disorders, and injuries of the arterial, venous, and lymphatic circulatory systems, exclusive of those circulatory vessels intrinsic to the heart and intracranial vessels. Management of critically ill patients with underlying surgical conditions in the emergency department and intensive care unit. Work Schedule: Monday - Friday (Multiple Schedules)"]
About Veterans Affairs, Veterans Health Administration
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.