The Mohs Surgeon at the Iowa City VA Health Care System provides direct, hands-on treatment and reconstruction of patient skin cancer, in both outpatient and inpatient settings, as needed. The Mohs surgeon ensures that all skin cancer has been removed and determines how the wound will be repaired. In addition to removing skin cancer, fellowship-trained Mohs College surgeons have specialized reconstructive surgery training for repairing the wound. 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), 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: The incumbent will be able to perform the following closures: Linear closures (Complex linear closures); Grafts (Full-thickness skin graft and Cartilage composite graft (cartilage taken from ear to replace structure of nasal ala)), and Flaps (Rhombic flap, Bilobed flap, Trilobed flap, Rotation flap, Helical advancement flap, East-to-west advancement flap (nose), Lip wedge resection flap, Ear wedge resection flap, Mercedes flap, and keystone flaps, along with Two stage interpolation flaps (Paramedian forehead flap (forehead to nose), Nasolabial cheek flap (cheek to nose), and Postauricular scalp flap (scalp to ear). Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Placement in this position is subject to meeting the physical requirements of the position. This includes Walking (up to 2 hours); standing (up to 2 hours); Light and moderate lifting (up to 44 lbs.) light to moderate carrying (up to 44 lbs.); straight pulling and pushing, reaching above shoulder; use of fingers; both hands required; ability for rapid mental and muscular coordination simultaneously. Near vision correctable at 13" to 16"; Depth perception; Ability to distinguish basic colors; Ability to distinguish shades of colors; Hearing (aid permitted). ["The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being. Mohs surgeons are dermatologists who have performed additional fellowship training to become experts in Mohs micrographic surgery. Fellowship-trained Mohs surgeons are highly skilled in all aspects of this technique, including surgical removal of the tumor, pathologic examination of the tissue, and advanced reconstruction techniques of the skin. Duties and Responsibilities include but are not limited to: Responsible for wound care, to include: 1) Small, simple wounds which may be allowed to heal by themselves (a process known as secondary-intention healing), 2) Slightly larger wounds closed with stitches in a side-to-side fashion, and 3) Larger or more complicated wounds requiring a skin graft from another area of the body, or a flap, which closes the defect with skin adjacent to the wound. On rare occasions, the patient may be referred to another reconstructive surgical specialist, otherwise all closures are completed by the Mohs surgeon, on the same day of surgery. Responsible for the full spectrum of dermatology care and surgery, ranging from full body skin exams for high risk patients, excisions, biopsies, intralesional; injections, curettage & fulgaration, methotrexate, bleomycin, palliative care, and other procedures, as scheduled per Mohs case manager. Mohs Surgeons will administer their own local anesthesia and complete their own specimen mapping/inking. Provides clinical guidance over the phone. Ensures accurate documentation of medical assessments and observations. Responsible for supervising and teaching dermatology residents in the outpatient setting and completing periodic assessment of staff and resident proficiencies. The applicant must be eligible for an academic appointment at the affiliated University of Iowa to supervise academic activities (teaching, research, publications in medical journals) of dermatology residents from the affiliated medical school, as this supervision and evaluation is a critical element of the job. Establishes inter-personal and intra-departmental relationships to enhance optimal patient care. Demonstrates competent and effective oral and written communication. Provides appropriate patient/family member teaching and education; evaluates effectiveness and level of patient/family member understanding of teaching provider. Responsible for the entry of appropriate order sets, including pathology, consults, orders (lab, imaging, pharmacy, etc.), utilizing the CPRS computer software/program for entering and signing of medical orders. Maintains familiarity and compliance with hospital infection prevention policies and procedures, ensuring the use of antiseptic methods of all in-clinic procedures. Ensures a safe work environment and employee safe work habits. VA offers a comprehensive total rewards package. VHA Physician Total Rewards. 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 Work Schedule: Monday - Friday, 8:30am - 5:00pm, additional information may be provided during interview process."]
The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,321 health care facilities, including 172 VA Medical Centers and 1,138 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of our medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision care. Some medical centers also offer advanced services such as organ transplants and plastic surgery.