Summary The Urology Physician Assistant provides clinical and surgical care for patients on the Urology service. As an agent of the supervising physician, the PA functions within defined levels of autonomy as outlined in his/her scope of practice. Responsibilities The Urology Physician Assistant will provide patient care consistent with the scope of practice and with clinical oversight, consultation, and input by the designated collaborating physician while working in the clinic, cystoscopy suite, and operating room. Some core responsibilities include: Obtaining medical histories and performing physical examinations. Providing and coordinating medical care for assigned patients in any care setting, including establishing diagnoses, formulating and implementing care plans, and providing follow-up care. Evaluating outpatients to determine the need for further health care. Ordering diagnostic studies and other special tests, such as Magnetic Resonance Imaging {MRI}, Computerized Tomography (CT) scans, etc. Carrying out health promotion, disease prevention, and patient education activities. Ordering or obtaining laboratory specimens. Ordering ancillary services, such as, pharmacy, social services, physical medicine and rehabilitation therapies, prosthetic services, etc. 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. Ordering patient care supplies. Writing orders for or prescribing medications for care of veterans on the Urology service. Obtaining and documenting informed consent for treatments and procedures for which the PA is responsible either as the provider providing treatment under Full Autonomy or Limited Autonomy, or participating as an integral member of the treatment team performing the procedure such as assisting the primary surgeon. The PA need not participate in the particular procedure the patient is scheduled to undergo as long as he is authorized to perform, participate in, or assist during the procedure and have sufficient knowledge and training in the treatment or procedure, its indications, risk and benefits, complications, and alternative treatments, to effectively counsel the patient. Providing education and counseling of patients and families in preventive care, medical conditions, and the use of prescribed treatments and drugs. Preliminary EKG interpretation. Preliminary imaging interpretation. Ordering appropriate pre-procedure & pre-operative antibiotics (IM, IV, or PO) and/or other medications. Change dressings on surgical wounds. Obtain specimens in surgery or on wards or ICU for patient care diagnostic or treatment purposes. Perform other diagnostic or treatment procedures as qualified. Ordering administration of blood products. GU SURGERY EXPANDED RESPONSIBILITIES Responsibilities performed with full autonomy in the clinic and cystoscopy suite include: Obtains informed consents for common GU surgeries and procedures about which the PA is familiar with including the indications and associated risks and benefits. Triages symptoms and manages outpatients on the Urology service. Assists other health care professionals assigned to the Urology section with the coordination of medical care. Acts as a care coordinator for patients in the Urology section. Monitors appointment management software to ensure accuracy in scheduling practices. Reviews all outpatient Urology clinic profiles for accuracy. Provides peri- and post-operative teaching. Performs pre-operative history/physical examinations. Triages, assigns, and evaluates new patients referred to the Urology service. Insertion of urethral catheters. Urethral catheter placement over a wire. Removal or exchange of suprapubic tubes/catheters. lntracavernosal injections and teaching. Percutaneous tibial nerve stimulation. Cryoablation of genital lesions with liquid nitrogen. Removal of drains, ureteral stents, and nephrostomy tubes. Administer oral medications. Injection IV medications, start intravenous infusions of any variety, as long as hospital protocols regarding preparation of skin sites, checking of blood products, and attention to sterile techniques are followed. Performing procedures: Cystoscopy Cystoscopy with ureteral stent removal Cystoscopy with basketing of stones/ foreign body Transrectal ultrasound Urodynamic studies Work Schedule: Monday - Friday, 8:00am - 4:30pm VA offers a comprehensive total rewards package. Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not authorized. Requirements Conditions of Employment All qualified candidates encouraged to apply. Open to U.S. Citizens but non-citizens may be appointed when it is not possible to recruit qualified citizens. 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 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 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: 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. Grade Determinations: The full performance level of this vacancy is PA-III. The actual grade at which an applicant may be selected for this vacancy is in the range of PA-1 to PA-III. 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 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. Preferred Experience: Experience performing Urologic procedures - to minimally include cystoscopies. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Walking, bending, stooping, and some lifting in the direct care of patients. There may also be extended periods of sitting. 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: 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). Additional Information DUTIES CONTINUED: Responsibilities performed with limited autonomy include: Assists in the operating room as a surgical assistant to help open and close all incisions pertinent to genitourinary surgery. Acts as a first or second assistant to the resident or the staff physician in the operating and procedure room. Assist in the day-to-day management of patients on the surgical wards and in the Intensive Care Unit. This entails writing admission and discharge orders, transfer orders from the ICU to other wards, medication orders, IV orders, and all other orders that are potentially required for the management of patients. Dictate discharge summaries which must be countersigned by the attending physician. Write discharge orders for inpatients and outpatients (day surgeries/observation patients). Removes intravenous and central lines. Insert intravenous lines. Performing procedures: Cystoscopy with biopsy and fulguration. Responsibilities performed with supervised autonomy include: Prostate needle biopsy under transrectal ultrasound guidance. Placement of prostate fiducial markers under transrectal ultrasound guidance for planned radiation therapy. This job opportunity announcement may be used to fill additional vacancies. 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.
