Mr.Happy

Membership Revoked
Removed
Account on Hold
Jun 2, 2014
169
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Pre-Medical
http://www.burlingtonfreepress.com/story/news/local/2014/10/13/veterans-affairs-wooing-medical-students/17213877/

Could someone comment on the pros and cons of joining the VA after completing residency? Will they offer a salary package that is competitive as compared to the marketplace?

The article mentions that the VA can forgive up to $120,000 of the medical school loans. Pretty tempting. Any hidden cons not mentioned here?

I think a lot of pre-meds are worried about taking huge loans to pay off medical school so this may be a viable option. Is it fairly easy to find an employer willing to offer loan forgiveness to physicians (not including Army or Navy or US Airforce)?
 

minor.groove

5+ Year Member
Jun 27, 2014
140
124
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Pre-Medical
my understanding is gross pay in generally noticeably lower. that being said, there are several offsetting benefits. namely, VA doctors don't have to carry malpractice insurance and likely work a more forgiving schedule (more days off, and shorter days). also in addition to the program you mention there, any employee of the US gov (among others) are eligible for loan forgiveness programs. you also are licensed to work at any VA in the country (once hired) so it is potentially easier to move (in practice i have no idea how this pans out).

there are a number of drawbacks though, first i would refer you to the controversy that just broke a few months ago. in addition, there are some procedures in any given field you as a VA physician would likely never do (either the gov wont pay for them or refers them out to a private hospital). the bureaucracy is likely pain to work with (can't speak to this personally). the computerized records they like to tout are on a system so old it has to be just horrible to work with...

all of which is to say, i think it is an interesting option that is probably often under appreciated. it is definitely something i'm thinking about. many med schools are affiliated with VA hospitals so you best bet is probably just to gain some experience during your years in med school and/or residency.
 

SAHawks_37

2+ Year Member
Oct 1, 2014
9
21
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Pre-Medical
I am currently a VA employee working in systems improvement. To address a few of the points from above using my observations:

1) From what I have seen VA doctors do not currently work a more forgiving schedule. Because there is a high no-show rate for many of the veterans, many times patients are double booked into the schedule. This means that on certain days there is the possibility that more patients will arrive than there is capacity for resulting in longer hours. On the other hand, there are also the issues of working within the bureaucracy, which can hinder a doctor's ability to be effective. There is also currently a shortage of doctors (but that is what McDonald is trying to fix with this).

2) The patients can also be extremely difficult to work with because of disabilities. There are also those who are distrusting of authority (especially older veterans). However it can also be a very satisfying patient population to work with. There are some doctors who are especially good at developing relationships with their patients and are efficient and effective at caring for veterans.

3) In reference to the current contreversy, I think that because of all the negative media coverage there will only be positive effects on the entire system. There is definitely a change in the culture and work in my department has only been increased, which means more people are buying into McDonald's idea of systems improvement. However, we have to see if these long term changes are sustainable. A lot of the current solutions involve throwing money at it and a long term solution has to be developed.

4) As minor.groove mentioned the computerized systems are outdated. I see this as one of the biggest problems.

5) On the research side of things, the VA has a large amount of data that can be analyzed for all sorts of retrospective studies. It is organized each month and can be used for example to see how changes in policies produce positive or negative trends. Getting access to this data is a long process though.

6) Finally the VA has opportunities for many doctors to become involved outside of the clinic. My office is not the only one to do project based work, and I know that many of these teams require a multidisciplinary team including doctors. Some of these projects are pretty cutting edge believe it or not.