VA appeal

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greensky

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It seems like many students in PhD programs want to eventually work at a VA. I am just curious to see what you think the appeal is? Aren't you paid the same at general hospitals?
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Off the top of my head: good benefits, reasonable workload/hours, no need (yet) to worry about billing, fairly easy access to referral resources for your patients (e.g., primary care, neurology, PM&R, etc. are often all in the hospital with you), security of government employment, and ample training opportunities. There are perks to non-VA hospitals as well, of course, such as likely being more able to negotiate salary and things like a sign-on bonus, travel funds, and (if interested) some type of research/clinical split. And PP pay tends to outstrip both of those settings after perhaps 5 or so years if you're playing your cards correctly, although that of course comes with its share of risks as well.

Edit: and what psycscientist mentioned above.
 
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I get to work at 8 (ok sometimes 10 after) and I leave at 430! I do not take any work home. Where else does this happen?!
 
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I pracced at a VA in primary care. It was wonderful. I'd have gone for a VA internship if I were an American, and I'd have seriously considered a career there (the only time I've ever thought about a non-academic career).
 
From what I understand, there is some variability from VA to VA in terms of structure/internal politics, training infrastructure/opportunities, caseload, and prestige level. Even though it is a federal system and there are some things that remain the same (e.g., paygrades, benefits, etc), my understanding is that there are some regional and local differences in the level of respect for psychologists within the system (internally and externally), how much power psychologists actually have within the system, etc.

I think a VA setting that is closely affiliated with a University might be one of the more ideal ones, at least if you care about prestige. But I have also seen VA physicians and psychologists looked down upon by the AMC folks in that scenario (although perhaps that was specific to the specialties I was working closely with rather than a blanket bias).

Generally speaking though, for reasons mentioned by others above, it is viewed as one of the more well-compensated positions for early-career psychologists with a higher degree of stability and better benefits, work-life balance, etc, than most other options out there. That said, I think any government position carries some degree of long term risk, and there are other professions politicking their way into the system (e.g., masters level providers) looking to take away some of the opportunities out there for psychologists. I'd still consider it one of the better options out there for psychologists, but it isn't perfect.
 
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I work at a VA on the West Coast. All things considered, best possible gig I could have gotten as an ECP. I get to take advantage of generous time to work on professional development (typically research) projects, I get to supervise students, and generally speaking, our profession is respected. Agreed with Pragma on the variability in different psychologist work environments.... I am aware of psychologists who are worked like dogs at the VA and they aren't treated as respectfully. If you're applying for a VA job, here's what I would generally avoid:

1) Comp & Pen positions. I don't know anyone who's worked in those jobs but I hear of them referred to as "the ninth circle of hell."
2) Jobs in the mental health care line. That's harder to avoid because so many psychologist jobs work in mental health, but if you get those, you'll have all sorts of requirements potentially associated with your work, e.g., performance measures (e.g., clearing consults within a particular amount of time), event capture, clearing clinical reminders, et cetera. I work for Extended Care, myself (still answering to Psychology). Documentation requirements and performance measure issues are much, much easier and more straightforward.
3) Working at a VA without a separate Psychology Service. Not all VA's are created equal. I have a Service Chief I answer to who is a Psychologist. Some VAs don't have a Psychology Service and you might end up working for a Psychiatrist or a Social Work Supervisor. Might make for a different environment.
4) A job that's entirely about delivering psychotherapy. Encroachment is happening at the VA as well. Although if you're hired, you certainly won't get fired just so they can replace you with a cheaper MFT, I wouldn't want my job having a chance of being viewed as a glorified MFT position.

Just some thoughts.
 
I definitely like the VA, but it has its positives and negatives. I have applied for a few VA postions, but being outside the VA currently has shown me a few negatives as well. Broadly, the VA runs on very different rules than the rest of healthcare. This can be a great thing in some ways. However, it also can limit opportunities outside of the VA if you ever have to leave. For example, try getting into an administrative position outside the VA without knowing the ins and outs of billing insurance.
 
Sanman said:
I definitely like the VA, but it has its positives and negatives. I have applied for a few VA postions, but being outside the VA currently has shown me a few negatives as well. Broadly, the VA runs on very different rules than the rest of healthcare. This can be a great thing in some ways. However, it also can limit opportunities outside of the VA if you ever have to leave. For example, try getting into an administrative position outside the VA without knowing the ins and outs of billing insurance.
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I do actually worry about being ruined for other jobs, so point taken. Working at the VA is sometimes like working in a bizarro world where the rules of the "real world" don't really apply.
 
JeyRo said:
... a bizarro world where the rules of the "real world" don't really apply.
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Heeeeyyy...we're talking about the Federal Government here. What are you trying to say? (JK, of course.)

If you work in the VA system (say paid, full-time position), could you possibly "moonlight" and learn billing this way to make yourselves quickly up-to-speed (on the very least) Medicaid/Medicare billing? Would you really even need to do this to compensate for any training shortcomings?

For instance, working in a community mental health clinic, possibly PRN weekend shifts per month (you'd definitely need to carve your niche in a 15-hour/week MH postition, but just saying...) or pro bono type-work were the ROI (not RO1) would yield experience in what you're lacking to get your 'cake job' down the road?

WisNeuro said:
I don't know, I've seen many people seamlessly transition out to AMC's and the like. I don't see this as that big of a barrier.
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WisNeuro just answered my question, but I'm posting it anyway.
 
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CheetahGirl said:
Heeeeyyy...we're talking about the Federal Government here. What you trying to say? (JK, of course.)

If you work in the VA system (say paid, full-time position), could you possibly "moonlight"
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You can moonlight. I know some people who do some IME and forensic chart review on the side. I know of no "exclusivity" clause in the VA. As long as you are not guilty of dereliction of duty, what you do during your off-duty hours is your business. Just don't violate the Hatch Act.
 
yep. I do utilization review on the side. I learn billing that way.
 
erg923 said:
yep. I do utilization review on the side. I learn billing that way.
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Well, I can see that. But "utilization review".... it sounds so, well, boring. To be honest.
 
When I was training at a VA, there were numerous psychologists and psychiatrists who had part-time private practices on the side.
 
eowyne said:
When I was training at a VA, there were numerous psychologists and psychiatrists who had part-time private practices on the side.
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This has been my experience as well. It doesn't afford quite the same opportunity/flexibility for outside work as a tenure-track position (once you're tenured), but having a set 40-hour work week (for the most part) does allow you to plan for these sorts of things either after-hours or on weekends.
 
WisNeuro said:
I don't know, I've seen many people seamlessly transition out to AMC's and the like. I don't see this as that big of a barrier.
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I don't think it would hinder you from a n academic or fully clinical service position, but I can't imagine it would bode well for administrave or mixed clinical and admin positions where billing, utilization reviews, and the business aspects of psychology come into play. At least I have not seen it in the later career psychologists that have made or up the ladder. There is always going to be a premium for certain business skills, IMO.
 
Sanman said:
I don't think it would hinder you from a n academic or fully clinical service position, but I can't imagine it would bode well for administrave or mixed clinical and admin positions where billing, utilization reviews, and the business aspects of psychology come into play. At least I have not seen it in the later career psychologists that have made or up the ladder. There is always going to be a premium for certain business skills, IMO.
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I would disagree, with the caveat that the VA, within the past 2-3 years, has become extremely concerned with service utilization, "productivity", outcome/performance measurments, and general penetration of services. Its a slow process that has reached my VA, but I am sure not all VAs. My chief seems well versed in organizational development, clincial oversight and supervision, as well as general administration. This is my experience anyway.
 
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erg923 said:
I would disagree, with the caveat that the VA, within the past 2-3 years, has become extremely concerned with service utilization, "productivity", outcome/performance measurments, and general penetration of services. Its a slow process that has reached my VA, but I am sure not all VAs. My chief seems well versed in organizational development, clincial oversight and supervision, as well as general administration. This is my experience anyway.
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It is good to hear that and I guess it varies by VA, but I expect a service chief to be week versed in that. However, at least in some/most of the VA hospitals I have worked at there are only a select few people that get that chance. I guess my fear is that if you are in the VA and have to leave after several years, your focus is likely more clinical service while it seems like there are more opportunities in the private arena to gain admin, billing, etc skills as there seems to be more movement/opportunity to advance. Then again, it may also have to do with my little geropsych world and the business of nursing homes.
 
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I agree with erg, I think the VA deals with a lot more of that stuff than you think. Also, in many VA's (at least the ones I've worked in), psychologists are department heads and hold many high level admin posts.
 
WisNeuro said:
I agree with erg, I think the VA deals with a lot more of that stuff than you think. Also, in many VA's (at least the ones I've worked in), psychologists are department heads and hold many high level admin posts.
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You may be right, I am far from an expert on these matters. All I know is that for my niche area I see some differences. My work in certain areas was more highly valued on the private market than at the VA (vent pts) and most of the clinical directors I see at my job have more to do on the side of facility issues, medicare regs, billing, etc. I am just worried that taking a VA position in the future may hinder my ability to obtain an administrative position on the private market without a lot familiarity in these areas.
 
Sanman said:
You may be right, I am far from an expert on these matters. All I know is that for my niche area I see some differences. My work in certain areas was more highly valued on the private market than at the VA (vent pts) and most of the clinical directors I see at my job have more to do on the side of facility issues, medicare regs, billing, etc. I am just worried that taking a VA position in the future may hinder my ability to obtain an administrative position on the private market without a lot familiarity in these areas.
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It may be for some, but I personally haven't seen it. In general, several mentors that I've known have left to become division heads or directors of npsych services at AMC's. Others leave for the forensic world.
 
I am interested in observations on how the VA handles pregnancy, maternity/paternity leave, and other issues related to parenting. Do they offer part-time positions once a career is established?
 
They do have part-time positions, yes. Not all that many though. There are about 8 different types of paid leave. I took care and bereavement leave for my paternity leave, which actually drew from my sick leave bank. A female will need to answer with regards to maternity leave.
 
Also, you can actually petition to get additional leave time. People can donate unused leave (essentially leave that they can't carry over once they reach their rollover cap). I see those e-mails pop up about once a month.
 
Jon Snow said:
I am at a va/r1 academic medical center. I like this environment. My work week is diverse. I do research, program development, work with students on research and clinical training, and clinical work. The va system isn't really setup for my type of position. So, there a bit more administrative hurdles that have to be traversed than in a typical say, clinical position. I have responsibilities across both institutions and they have slightly different goals and metrics and I am independently evaluated by both sides. I think I am currently an active member of 5 departments spanning both institutions. Which, of course means I am not a fully functioning member of any department. This situation sort of grew organically. There are some advantages. I have a wide network. I am involved in a large number of projects and the research is quite interesting. Disadvantages include too many meetings, a lot of time demands, and have to shift thinking sets frequently. It will be interesting to see how long I can maintain this.
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Yep, that would be one of the advantages of an AMC--the flexibility to have the type of position like Jon does. I actually know of someone in a similar setup (works clinically a day or so a week at a VA, then in research for about the same amount at the same VA, and then in research at a nearby AMC), so it's possible, you just need to find a VA that's affiliated with a local medical center. I also know of a couple more career research folks who split time 50/50 between the VA and AMC. I'm not sure whether it's typically the VA or the AMC that handles the actual recruiting and hiring in these sorts of situations, but I'd imagine it probably just depends.
 
docma said:
I am interested in observations on how the VA handles pregnancy, maternity/paternity leave, and other issues related to parenting. Do they offer part-time positions once a career is established?
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I'm not sure about leave, but staff at the VA where I was an extern were very supportive of work-life balance in general and family commitments in particular. And the staff of the VA where I will intern seem even moreso. While it varies from VA to VA, I can't think of many other employers these days where an 8 - 4:30 workday is normative. There may be notes or research on top of that, but on the whole it's very reasonable.


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Jon Snow said:
I was recruited by the AMC by people that were dual appointed. Initially funding was mostly through a VA grant and things have evolved from there. I started as a research assistant prof and transitioned to tenure track w bigger grants.
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Yeah, I would figure if nothing else, HR at an AMC is infinitely easier to deal with than HR at a VA, even if the VA's the one paying most of the salary.
 
I think that one of my mentors in UG had a similar appointment; he was a director at the local VA, PI on a large PTSD study, and a faculty member at the medical school that housed the study he was PI for.
 
AcronymAllergy said:
Yeah, I would figure if nothing else, HR at an AMC is infinitely easier to deal with than HR at a VA, even if the VA's the one paying most of the salary.
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The VA where I will intern is affiliated with an AMC. When I worked at this VA prior to graduate school, I was hired by the AMC but remained at the VA until the grant ended and the clinical research was transferred to the AMC.

In the future, as a clinical psychologist looking for employment, would I seek out positions at the VA or pursue clinical appointments at the AMC affiliated with the same VA? I suppose it depends, but both are doing clinical PTSD research, and both have post-docs.
 
As an aside, I hadn't been posting here for awhile (about a year) and I found this thread: http://forums.studentdoctor.net/threads/just-wanted-to-brag.928458/#post-12744103Update on that (relates to VA positions) - I tried to get funded for Hawaii, but I was told that there would be no more funding for psychologists to attend national conferences... and this has come from the top (so I didn't go - I really only had a couple of posters to present anyways, which some co-authors did for me). This year I'm up for a symposium again (and a first-authored poster), so I'm off to DC, but it's basically going to be out of my own pocket.

Germaine to the topic of "VA Appeal" - apparently the funded-conference gravy-train I've been enjoying at the VA for the past several years is now over. As another aside, I had spoken with a GS-15 who has supervisory responsibilities over my work area, and he said that ironically, the VA has "plenty of money" to cover funded travel to conferences, but politically, it's just something they can't do, at least currently. Austerity - or at least the appearance of it - is where it's at right now.
 
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docma said:
I am interested in observations on how the VA handles pregnancy, maternity/paternity leave, and other issues related to parenting. Do they offer part-time positions once a career is established?
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I agree that the VA can be flexible, but there is no paid maternity/paternity leave specifically. You can accumulate sick time to cover it, so once you are at the VA for awhile (and if you can plan ahead for it, and if you don't need sick leave for anything else), you are fine. You can also ask for donated leave from others. But if you are recently hired (or if your position switches from the affiliated AMC due to funding, which is what I saw happen with coworkers when I was at a VA), good luck...
 
nessa34 said:
I agree that the VA can be flexible, but there is no paid maternity/paternity leave specifically. You can accumulate sick time to cover it, so once you are at the VA for awhile (and if you can plan ahead for it, and if you don't need sick leave for anything else), you are fine. You can also ask for donated leave from others. But if you are recently hired (or if your position switches from the affiliated AMC due to funding, which is what I saw happen with coworkers when I was at a VA), good luck...
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Do you really work in Appalachia?
 
Is it pretty doable to transfer to an AMC from a VA? I'm asking because my internship will be at a VA and I've been finding the idea of working at an AMC very appealing.
 
JeyRo said:
As an aside, I hadn't been posting here for awhile (about a year) and I found this thread: http://forums.studentdoctor.net/threads/just-wante

Germaine to the topic of "VA Appeal" - apparently the funded-conference gravy-train I've been enjoying at the VA for the past several years is now over. As another aside, I had spoken with a GS-15 who has supervisory responsibilities over my work area, and he said that ironically, the VA has "plenty of money" to cover funded travel to conferences, but politically, it's just something they can't do, at least currently. Austerity - or at least the appearance of it - is where it's at right now.
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This issue isn't so cut and dry. It depends on how many people are going to the conference. If it's over a certain number, they won't fund it. I'm not sure what the number is, but I was told there was a list of big conferences somewhere that they won't fund. There may also be a loophole if you are going somewhere for recruitment (i.e., INS for postdoc interviews.)
 
WisNeuro said:
This issue isn't so cut and dry. It depends on how many people are going to the conference. If it's over a certain number, they won't fund it. I'm not sure what the number is, but I was told there was a list of big conferences somewhere that they won't fund. There may also be a loophole if you are going somewhere for recruitment (i.e., INS for postdoc interviews.)
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I could be wrong, but my understanding was that this was an issue specific to conferences in appealing vacation destinations - that it would look bad to congress for the government to be sending a bunch of employees to hang out in Hawaii...


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cara susanna said:
Is it pretty doable to transfer to an AMC from a VA? I'm asking because my internship will be at a VA and I've been finding the idea of working at an AMC very appealing.
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A professor at my undergrad did his internship at a VA and then worked at an AMC for many years.
 
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eowyne said:
I could be wrong, but my understanding was that this was an issue specific to conferences in appealing vacation destinations - that it would look bad to congress for the government to be sending a bunch of employees to hang out in Hawaii...


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That's the way it was explained to me. I'll certainly make yet another formal push for full funding to attend APA in DC this year, but I'm less optimistic than ever.
 
JeyRo said:
That's the way it was explained to me. I'll certainly make yet another formal push for full funding to attend APA in DC this year, but I'm less optimistic than ever.
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I think APA may be one on the "Do Not Fund" list. I heard there are just too many people system-wide who apply for funding for it. Doesn't bother me much because APA isn't a great place to network or do business, but it makes sense financially.
 
WisNeuro said:
I think APA may be one on the "Do Not Fund" list. I heard there are just too many people system-wide who apply for funding for it. Doesn't bother me much because APA isn't a great place to network or do business, but it makes sense financially.
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My brother lives about an hour from DC.
 
There is no paid maternity leave for VA employees. I don't have immiment plans to get pregnant, but I've actually been saving as much sick leave as possible for that very purpose ever since I started my first VA job. It's not specific to the VA, though. I don't think federal employees get paid parental leave, regardless of agency, although you can use FMLA to protect your job while you're out.

The conference funding issues aren't specific to the VA, either, but I second the notion that the gravy train has ended. It's definitely way harder to get any travel money, especially in the last couple of years. There are concerns that "looks bad" for government dollars to fund employee travel to conferences, so they've been clamping down on conference funding for DoD and NIH employees as well. Less than 10 years ago, the VA where I worked paid for all of us to attend the same yearly conference, even if we weren't presenting. Now they're balking at even approving authorized absence to attend a conference that you fund yourself.

ETA: I've done most stages of my training at a VA, and I hope to stay in the system for my whole career.
 
Didnt realize that the VA doesnt pay for conferences. I would think it more an annoyance than anything if I were a GS-13, given all the other perks, but as a fellow I'm certainly glad that my hospital is paying for the AACN conference in New York this year...holy crap is that hotel expensive even with the conference rate.
 
IT514 said:
Didnt realize that the VA doesnt pay for conferences. I would think it more an annoyance than anything if I were a GS-13, given all the other perks, but as a fellow I'm certainly glad that my hospital is paying for the AACN conference in New York this year...holy crap is that hotel expensive even with the conference rate.
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Yeah, not a huge deal for me personally. In the end, you have to find what works for you. Plus, all of the other perks make up for the downfalls for me. Although, if someone out there finds a job that has generous paid annual and sick leave, paid paternity/maternity leave, paid conference travel, a pension, excellent insurance benefits, matching retirement benefits, paid federal holidays, and protected research time, you let me know :) I'm happy with just most of those benefits if I can't get all of them.
 
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