Physician - Interventional Pain Medicine

This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.

VA offers a comprehensive total rewards package. VHA Physician Total Rewards.

Recruitment/Relocation Incentives (Sign-on Bonus): Authorized
Education Debt Reduction Program (Student Loan Repayment): Learn more.
EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact V21CCOEEDRP@va.gov, the EDRP Coordinator for questions/assistance

Work Schedule: Monday - Friday and some Saturdays, 7:30am - 4:00pm
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

This physician serves as a licensed independent practitioner (LIP) and physiatrist (PM&R) with subspecialty training and/or demonstrated competency in interventional pain medicine, practicing at VA Pacific Islands Healthcare System (VAPIHCS). The physician provides expert evaluation and management of acute and chronic pain conditions, performs interventional pain procedures within approved privileges, supports interdisciplinary rehabilitation and pain management services, and ensures high-quality, patient-centered care for Veterans across VAPIHCS facilities.

The physician works under the chain of command of the Associate Chief of Staff (ACOS) PM&R or their designee, with clinical oversight by the Chief of Staff. New privileges are subject to Focused Professional Practice Evaluation (FPPE) with direct observation/proctoring for a defined number of cases (per facility bylaws, e.g., first 5-10 of each new procedure type) before conversion to unsupervised (OPPE) status. Advanced/neuromodulation procedures may require an additional proctoring period and/or co-management with Neurosurgery/Anesthesia Pain Medicine per local policy. Trainees (residents/fellows) performing procedures must be supervised in accordance with VHA Directive 1400.01, Supervision of Physician, Dental, Optometry, Chiropractic, and Podiatry Residents. Work is evaluated for clinical effectiveness, compliance with policy, quality of care, and contribution to service-level goals.

Major duties include but are not limited to:

• Perform comprehensive musculoskeletal, neurologic, and pain-focused history and physical examinations, including functional assessments and rehabilitation planning.
• Diagnose and provide non-operative management of acute and chronic pain conditions (spine, joint, musculoskeletal, neuropathic, myofascial, cancer-related, and post-amputation/phantom limb pain).
• Develop and oversee multidisciplinary, biopsychosocial pain treatment plans consistent with the VA/DoD Clinical Practice Guideline for Opioid Therapy for Chronic Pain and the Stepped Care Model for Pain Management.
• Provide chronic pain assessment and management with emphasis on multimodal, non-opioid- focused approaches and appropriate tapering or cross-titration to partial agonist opioid therapy when indicated.
• Order and interpret diagnostic studies relevant to PM&R and pain medicine (e.g., X-ray, MRI, EMG/NCS, ultrasound as privileged).
• Refer and coordinate with Whole Health, behavioral health, physical/occupational therapy, addiction medicine, surgical specialties, social work, nurse educator, pharmacy, and primary care.
• Needle electromyography (EMG) and nerve conduction studies (NCS) for evaluation of radiculopathy, plexopathy, peripheral neuropathy, and myopathy.
• Cervical, thoracic, and lumbar epidural steroid injections (interlaminar and transforaminal approaches). Cervical, thoracic, and lumbar facet joint (zygapophyseal) injections. Medial branch blocks (diagnostic). Sacroiliac joint injections.
• Radiofrequency ablation (RFA)/neurotomy - cervical, thoracic, lumbar medial branches.
• Cooled or pulsed radiofrequency procedures (if separately trained).
• Sacroiliac joint RFA (lateral branch).
• Peripheral joint injections/aspirations (shoulder, hip, knee, and other appendicular joints).
• Peripheral nerve blocks (e.g., genicular, suprascapular, occipital).
• Trigger point injections.
• Ultrasound-guided musculoskeletal and nerve injections.
• Regenerative/orthobiologic injections (e.g., platelet-rich plasma) - if approved under local policy.
• Other duties as assigned by the supervisor or department leadership.

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 allopathic 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 accrediting bodies for graduate medical education, the Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA), in the list published for the year the residency, or fellowship if applicable, was completed; OR
  • (2) One year of post medical school training (internship, first year of residency, or transitional year residency) approved by ACGME or AOA followed by two years of post-training independent practice (performing under a full and unrestricted license) in the United States; OR
  • (3) Non-US residency training programs followed by a minimum of three years of verified independent practice in the United States (performing under a full and unrestricted license) performing duties related to the position they are applying for (United States fellowships would be creditable towards this requirement), 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.
  • Exceptions:
    • 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 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.
    • In rare and unusual circumstances, the Facility Director can submit a memo to the VISN Director through the VISN Chief Medical Officer, who may approve requests for reasonable exceptions to the residency training requirement for Physicians whose composite record of experience, accomplishments, performance, and qualifications warrant such action.
• Proficiency in spoken and written English.

Preferred Experience:

• Interventional Pain
• Physical Medicine and Rehabilitation and Pain Medicine Board Certification

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

Physical Requirements: Requires lifting 15-44 pounds; pushing (approx. 2 hours); reaching above shoulder; use of fingers and both hands; walking and standing from 3-5 hours and kneeling. Ability for rapid mental and muscular coordination simultaneously. Must have depth perception and ability to distinguish basic colors and shades of colors. Hearing aid is permitted.

Pre-placement Examination: Complete TB Testing and Immunization evaluations. See VA Directive/Handbook 5019

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:

1. Schools of medicine accredited by the Liaison Committee on Medical Education (LCME) for the year in which the degree was granted.
2. Schools of osteopathic medicine approved by the Commission on Osteopathic College Accreditation (COCA) for the year in which the degree was granted.
3. For foreign medical graduates not covered in (1) or (2) above, confirmation must be made that the medical school meets (or met) Educational Commission for Foreign Medical Graduates (ECFMG) eligibility requirement for year 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.