Summary VA Northern California Healthcare System is seeking Staff Physicians - Gastroenterology to serve as Fee Basis providers. What is Fee Basis? Fee Basis are temporary appointments for professional and technical occupations under Title 38 USC, Section 7405(a)(2). Fee Basis appointments are on a fee-for-service basis compensated per specific task or procedure provided, not based on time or annual salary. Individuals under this authority are subject to standard pre-employment hiring processes. Responsibilities Fee Basis position of Staff Physician is with the Gastroenterology section at the VA Northern California Health Care System in Sacramento, California. The Gastroenterology Service is in need of a clinician who has experience with diagnostic and therapeutic endoscopic ultrasound including fine needle aspiration and biopsy of pancreatic lesion and lymph nodes for diagnosis and staging, cyst and pseudocyst drainage, who can assist with ERCP and antegrade drainage, assist with mucosal resection of esophageal, gastric or colonic tumors, provide pain relief with celiac axis block and selective drainage of biliary system through EUS guided left hepaticogastrostomy. Experience with esophageal therapy including treatment of refractory strictures and esophageal ablation techniques, including radiofrequency ablation and cryoablation/cryotherapy. Someone with experience with diagnostic and therapeutic ERCP including papillotomy, stone removal, stent placement for benign and malignant bile duct obstruction and drainage of gallbladder using stents and pancreatic pseudocyst drainage. The major duties include, but are not limited to: Provide independent care delivery for patients with general gastroenterology problems and subspecialty care depending on the provider's special expertise. The @type of care includes acute management and long term follow up of patients with chronic GI conditions such as upper and lower GI pathologies. The portion of clinical assignment depends on individual labor mapping and tour of duty. A part of the responsibility is to write orders for diagnostic testing, prescribe medications (also include medication reconciliation), consult with subspecialty services, and utilize computerized electronic medical records. Major function of the position includes Health risk Assessment, goal setting for prevention, and chronic diseases management. A major focus is in preventive medicine with emphasis on the achievement of positive outcomes for patients, improve coordination of care, decrease clinic waits or delays, and appropriate use of resources. Provide direct patient care to include, but are not limited to: history and physicals, medication management, evaluation of diagnostic tests and treatment planning, clinical reminder completion as applicable. Provide routine diagnostic and therapeutic upper and lower endoscopy procedures in addition to complex advanced procedures relevant to individual expertise. As part of the TEAM in the delivery of GI care, which emphasizes a team-based approach to healthcare. Oversee GI service with compliance to Message Manager, MyHealtheVet, and encounter completion. Proficient in Tele-Health to home visits (VA Video Connect). Pay: Fee Basis rate between $34.75 to $1,130.54 (Fee-for-service basis compensated per task or procedure.) Licensure: 1 full and unrestricted license from any US State or territory Malpractice: Free liability protection with tail coverage provided Work Schedule: Fee Basis; this system of VA compensation pays based on the specific task or service provided; Providers are paid in accordance with the fee schedule listed above; Providers are scheduled based on the needs of the service. Requirements Conditions of Employment U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. 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. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. 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). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement. Qualifications 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. Preferred Experience: Experience with diagnostic and therapeutic endoscopic ultrasound including fine needle aspiration and biopsy of pancreatic lesion and lymph nodes for diagnosis and staging, cyst and pseudocyst drainage, can assist with ERCP and antegrade drainage, assist with mucosal resection of esophageal, gastric or colonic tumors, provide pain relief with celiac axis block and selective drainage of biliary system through EUS guided left hepaticogastrostomy. Experience with esophageal therapy including treatment of refractory strictures and esophageal ablation techniques, including radiofrequency ablation and cryoablation/cryotherapy. Someone with experience with diagnostic and therapeutic ERCP including papillotomy, stone removal, stent placement for benign and malignant bile duct obstruction and drainage of gallbladder using stents and pancreatic pseudocyst drainage. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. The incumbent may be exposed to infected patients and contaminated materials and may be required to wear protective clothing in isolation situations or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs. Must be able to perform CPR per ACLS/BLS protocols. Education Degree of Doctor of Medicine or an equivalent degree resulting from a course of education in allopathic medicine or osteopathic medicine. The degree must have been obtained from an institution whose accreditation was in place for the year in which the course of study was completed. Approved schools are: Schools of medicine accredited by the Liaison Committee on Medical Education (LCME) for the year in which the degree was granted, or Schools of osteopathic medicine approved by the Commission on Osteopathic College Accreditation of the American Osteopathic Association for the year in which the degree was granted. For foreign medical graduates not covered in (1) or (2) above, facility officials must verify with the Educational Commission for Foreign Medical Graduates (ECFMG) that the applicant has met requirements for certification, and must obtain a copy of the ECFMG certificate, if claimed by the applicant. [If the applicant does not claim an ECFMG certificate, facility officials must still confirm that the medical school meets (or met) ECFMG eligibility requirements for the year the candidate graduated.] NOTE: The Under Secretary of Health or designee in the VHA Central Office may approve the appointment under authority of 38 U.S.C. 7405 of a physician graduate of a school of medicine not covered above if the candidate is to be assigned to a research, academic, or administrative position with no patient care responsibilities. The appointment will be made only in exceptional circumstances where the candidate's credentials clearly demonstrate high professional attainment or expertise in the specialty area. Additional Information This job opportunity announcement may be used to fill additional vacancies. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. 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. 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. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
