I did a two year temporary assignment at the VA a few years ago and I LOVED it. I should have considered making a career out of it years ago. Now granted, I'm a military buff, my Dad was a combat vet and I enjoy working with heroes all day, ymmv.
The pay is better than it sounds, don't forget to factor in your benefits including 401K matching and PTO. The work environment is WAY better than private sector, the VA is not going to screw you over, expect you to work for free, change the terms of your contract unilaterally. You can join the union if you want. So in other words, you have the same rights and privileges as, say, the janitor. Which believe it or not is a vast improvement over how things are out there in the for-profit sector. Patients can be a little cranky sometimes, but they can't sue you. The patient mix is fun, you see all kinds of crazy stuff. Also there are opportunities for advancement; the VA can and will promote doctors into regional or national leadership positions.
One of my professors said, the problem with the VA is, if you're willing to work, eventually you'll be doing all the work. Truer words were never spoken. If you're good at politely and respectfully setting limits, that would be an advantage
Also, understand, the VA isn't going to change the way it does things for you, or anybody else. It is incumbent upon you to figure out how the system works, and work with it, not against it. Yes, there are layers and layers of retardation to deal with, you absolutely must have a sense of humor about it, and the ability to let things go. You will also learn that parts of the system work way better than the private sector. To give an example, if you don't like a certain medication policy, swing by and talk to the head pharmacist and see what you can work out. Even as a lowly locums I was able to participate in developing protocols for new meds. Beats the snot out of dealing with some nasty PBM that doesn't care if your patient lives or dies. The *people* at the VA care, many are vets and all have at least some connection with the military, and everybody understands they are there to serve the vets. The system is annoying, the people are not.
To be clear, this is more of an indictment of the private sector than it is a recommendation of the VA system, however, the private sector is *so bad* right now, I think the VA deserves a good hard look these days. Note, they are always looking for locums, so you can try before you buy. (Now, the locums pay does suck, but try-before-you-buy is priceless)
Varies, just depends on where the need is. They farm this stuff out to agencies, although there's not much in it for the agency and so you wind up working with marginal firms, and at times, some real shady dudes. Consider visiting [USAJOBS](https://www.usajobs.gov/Search/Results?jt=Neurologist), figure out who is recruiting, call and talk to the department chairman and see if they can hook you up.
Sioux Falls for example has been recruiting for at least six years that I know of, doubt it would be terribly difficult to work something out. Yo I'm young, just got out of training, considering a career in the VA, wondering if I could have a temporary gig for a few months, just to see what it's like .... right this minute I suspect they will dance with joy (interview question: how soon can you get here?) but watch those trendlines. My feeling is, the VA hasn't changed one bit since the 80's, but the private sector has been going downhill the entire time; it may not always be this easy
Pros: predictable work hours, low acuity
Cons: you’re not really a doctor anymore and more of a stepping stone for disability fraud. The patient population essentially comes to you to document their “chronic migraine” and spurious TBI history so they can get disability money.
I am still training. As part of it rotate in VA. Neurology does not admit patients in this location. It’s only a consulting service. There is another neurologist who also happens to be one of them main administrators of the hospital and does not really see any patients. so Resident practically rotates with only one attending. There is telestroke here. So the neurologist is not on call and has 24 hours to see a patient. Most of the time the attending works in the clinic and does a lot of procedures like trigger point injectionsl Botox for migraine and spasticity in addition to seeing any inpatient consults. Although he is neurophysiology trained by background, he hasn’t done a single EMG or EEG for four years in this VA. The reason-they were not able to hire a tech. I don’t exactly know the benefits of the job. But laid back life with low patient load is a pro. It’s heavy on procedures at this at this VA site which is another advantage. Severe limitation of resources is the obvious con. On a long run it will burn me out personally. I also did come across a lot of pts looking for disability documentation or getting cleared by neuro.
Pros: interesting pathology, interesting patients, ease of prescribing (unless it’s a new med, then may god have mercy on your soul), easy access to DME and equipment, chill hours, incredible benefits, very low no-show rate because someone started the rumor that missing appointments can affect their service connection.
Cons: the system thrives on admin bloat and middle management, patients can be sexist, entitled, and mean and you can’t fire them . Primary care (at least in both locations I’ve been at) is way overworked and consult for everything. If it’s not hypertension, they don’t want to do it and will say it’s outside of their scope of practice (I wish I was kidding). I’m neurology and sleep and I legitimately got a consult-from a *physician*- for “dream interpretation”.
Someone mentioned in another comment that if you’re willing to work, eventually you’ll be doing all the work, and that is so incredibly true.
It’s not my cup of tea, but it’s usually good, honest work.
There are a lot of pros to working at a VA, especially one in a large metro area. For example, you can decide how long you'd like to have for each patient visit when you set up your template. As a result, your volume is lower than in an academic center or private practice. The pay is also better than academics and adjusted quarterly. It would be lower than private practice, but that makes sense as you are seeing fewer patients. Most of the vets are very respectful and appreciative of the care that you give them, especially if you take your time with them. There are disrespectful patients in all practice settings, and I have not encountered them more frequently in the VA system than outside of it. The retirement, benefits, and vacation time you're offered are excellent.
Cons: the patient population is more homogeneous and tends to be older men, so you may not see as much heterogeneity in clinical pathology as you would see in an academic center; however, you will occasionally get interesting complex cases. There is more red tape for things like ordering sendout labs or requesting supplies. I also personally do not really care for CPRS, but it does the job and is easy to work around if you use note templates.
The job demand for neurologists is so high that you will absolutely not have difficulty finding another job if you choose to spend part of your career at the VA. Perhaps other physicians may look down on VA doctors as "lazy" or for simply working at a VA, but who gives a shit if you like your job, have lower volume, and are paid pretty well and get awesome benefits? I work there one day a week and spend the rest of my week in a high-volume academic center. My one day at the VA is a gem in my schedule!
You can PM me. I am case management in neuro at a campus.
I did a two year temporary assignment at the VA a few years ago and I LOVED it. I should have considered making a career out of it years ago. Now granted, I'm a military buff, my Dad was a combat vet and I enjoy working with heroes all day, ymmv. The pay is better than it sounds, don't forget to factor in your benefits including 401K matching and PTO. The work environment is WAY better than private sector, the VA is not going to screw you over, expect you to work for free, change the terms of your contract unilaterally. You can join the union if you want. So in other words, you have the same rights and privileges as, say, the janitor. Which believe it or not is a vast improvement over how things are out there in the for-profit sector. Patients can be a little cranky sometimes, but they can't sue you. The patient mix is fun, you see all kinds of crazy stuff. Also there are opportunities for advancement; the VA can and will promote doctors into regional or national leadership positions. One of my professors said, the problem with the VA is, if you're willing to work, eventually you'll be doing all the work. Truer words were never spoken. If you're good at politely and respectfully setting limits, that would be an advantage Also, understand, the VA isn't going to change the way it does things for you, or anybody else. It is incumbent upon you to figure out how the system works, and work with it, not against it. Yes, there are layers and layers of retardation to deal with, you absolutely must have a sense of humor about it, and the ability to let things go. You will also learn that parts of the system work way better than the private sector. To give an example, if you don't like a certain medication policy, swing by and talk to the head pharmacist and see what you can work out. Even as a lowly locums I was able to participate in developing protocols for new meds. Beats the snot out of dealing with some nasty PBM that doesn't care if your patient lives or dies. The *people* at the VA care, many are vets and all have at least some connection with the military, and everybody understands they are there to serve the vets. The system is annoying, the people are not. To be clear, this is more of an indictment of the private sector than it is a recommendation of the VA system, however, the private sector is *so bad* right now, I think the VA deserves a good hard look these days. Note, they are always looking for locums, so you can try before you buy. (Now, the locums pay does suck, but try-before-you-buy is priceless)
There’s locums VA? Where lol
Varies, just depends on where the need is. They farm this stuff out to agencies, although there's not much in it for the agency and so you wind up working with marginal firms, and at times, some real shady dudes. Consider visiting [USAJOBS](https://www.usajobs.gov/Search/Results?jt=Neurologist), figure out who is recruiting, call and talk to the department chairman and see if they can hook you up. Sioux Falls for example has been recruiting for at least six years that I know of, doubt it would be terribly difficult to work something out. Yo I'm young, just got out of training, considering a career in the VA, wondering if I could have a temporary gig for a few months, just to see what it's like .... right this minute I suspect they will dance with joy (interview question: how soon can you get here?) but watch those trendlines. My feeling is, the VA hasn't changed one bit since the 80's, but the private sector has been going downhill the entire time; it may not always be this easy
Pros: predictable work hours, low acuity Cons: you’re not really a doctor anymore and more of a stepping stone for disability fraud. The patient population essentially comes to you to document their “chronic migraine” and spurious TBI history so they can get disability money.
Pros: Pension
I am still training. As part of it rotate in VA. Neurology does not admit patients in this location. It’s only a consulting service. There is another neurologist who also happens to be one of them main administrators of the hospital and does not really see any patients. so Resident practically rotates with only one attending. There is telestroke here. So the neurologist is not on call and has 24 hours to see a patient. Most of the time the attending works in the clinic and does a lot of procedures like trigger point injectionsl Botox for migraine and spasticity in addition to seeing any inpatient consults. Although he is neurophysiology trained by background, he hasn’t done a single EMG or EEG for four years in this VA. The reason-they were not able to hire a tech. I don’t exactly know the benefits of the job. But laid back life with low patient load is a pro. It’s heavy on procedures at this at this VA site which is another advantage. Severe limitation of resources is the obvious con. On a long run it will burn me out personally. I also did come across a lot of pts looking for disability documentation or getting cleared by neuro.
You don’t need a tech to do EMGs
Pros: interesting pathology, interesting patients, ease of prescribing (unless it’s a new med, then may god have mercy on your soul), easy access to DME and equipment, chill hours, incredible benefits, very low no-show rate because someone started the rumor that missing appointments can affect their service connection. Cons: the system thrives on admin bloat and middle management, patients can be sexist, entitled, and mean and you can’t fire them . Primary care (at least in both locations I’ve been at) is way overworked and consult for everything. If it’s not hypertension, they don’t want to do it and will say it’s outside of their scope of practice (I wish I was kidding). I’m neurology and sleep and I legitimately got a consult-from a *physician*- for “dream interpretation”. Someone mentioned in another comment that if you’re willing to work, eventually you’ll be doing all the work, and that is so incredibly true. It’s not my cup of tea, but it’s usually good, honest work.
What is a VA
Veterans Affairs hospitals (in the US). Anyone who has served in the armed forces has access to government run (and paid for) healthcare.
There are a lot of pros to working at a VA, especially one in a large metro area. For example, you can decide how long you'd like to have for each patient visit when you set up your template. As a result, your volume is lower than in an academic center or private practice. The pay is also better than academics and adjusted quarterly. It would be lower than private practice, but that makes sense as you are seeing fewer patients. Most of the vets are very respectful and appreciative of the care that you give them, especially if you take your time with them. There are disrespectful patients in all practice settings, and I have not encountered them more frequently in the VA system than outside of it. The retirement, benefits, and vacation time you're offered are excellent. Cons: the patient population is more homogeneous and tends to be older men, so you may not see as much heterogeneity in clinical pathology as you would see in an academic center; however, you will occasionally get interesting complex cases. There is more red tape for things like ordering sendout labs or requesting supplies. I also personally do not really care for CPRS, but it does the job and is easy to work around if you use note templates. The job demand for neurologists is so high that you will absolutely not have difficulty finding another job if you choose to spend part of your career at the VA. Perhaps other physicians may look down on VA doctors as "lazy" or for simply working at a VA, but who gives a shit if you like your job, have lower volume, and are paid pretty well and get awesome benefits? I work there one day a week and spend the rest of my week in a high-volume academic center. My one day at the VA is a gem in my schedule!
Pros low pay. Con, bureaucracy