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'There is no perfect job': Benefits of working across VA system outlined by current practitioners

BY PEGGE HALANDRAS, MD

Many believe the adage, “There is no perfect job.” If your list of “musts” for a career in vascular surgery includes working with a completely unique patient population with unparalleled opportunities for career development, the VA (Department of Veteran Affairs) healthcare system may offer the perfect job for you. These opportunities are best illustrated by the reflections below of early-, mid- and late-career VA vascular surgeons.

William J. Yoon, MD, assistant professor, VA Northern California Health Care System and University of California, Davis Medical Center

I am a junior faculty member in an academic medical center with a flexible work schedule arrangement at the VA. One of the real joys of vascular surgery is learning new technologies and using the latest devices to benefit patients. The VA has a good track record of offering new endovascular devices soon after they are introduced. With access to state-of-the-art technologies, VA vascular surgeons have more options to offer patients. Additional advantages of working for the VA include the ability to have protected time for research and educational support, which gives young vascular surgeons room to grow in their careers. Best of all and importantly, vascular surgeons at the VA have the privilege of caring for veterans. The VA can offer you endless opportunities for growth and satisfaction.

Carlos Bechara, MD, associate professor, Edward Hines, Jr. VA Hospital and Loyola University Chicago Health System

Working at the Veterans Hospital will always be dear to my heart; taking care of our veterans is what makes it special. Veterans are the most grateful patients you will ever meet.

I started my clinical and academic career at the largest VA hospital in the country, the Michael E. DeBakey VA in Houston, and I’d do it all over again! I always told people it is the only place where I can practice patient-centered and evidence-based medicine. It was truly multidisciplinary since we were not fighting over the same patient with other services; it allowed us to do what is right and best for the patient.

The complexity of the patients and the surgeries allowed me to gain confidence in a very short period but, at the same time, kept me humble. And I am proud to say that we performed many procedures before or around the same time as with the other major academic hospitals.

We were involved there in multiple research projects, including the OVER [Open versus endovascular repair] trial and the learning-curve percutaneous endovascular aneurysm exclusion. Finally, in terms of work environment, some of the best clinicians and researchers I met work at the VA. I get to work with some of the best nurses in the country who I am proud to call “my sisters” for making my patients and me feel at home.

Vivian Gahtan, MD, professor, Edward Hines, Jr. VA Hospital, chair of the department of surgery, Loyola University Chicago Health System

While the VA is not always the easiest place to work, significant opportunities exist for someone who truly wants to develop an academic surgical career. I have been affiliated with a VA hospital since I was a medical student and have spent time at seven different VA hospitals.

It has been rewarding to take care of the veteran population, many of whom lack choices in where they obtain care. The early exposure to clinically complex cases was stimulating and valuable to my development. In contrast, a volume of complex cases came along later on the university side. My first clinical administrative leadership roles occurred at the VA, including chief of vascular surgery and director of the vascular lab. They were meaningful roles in-and-of themselves, but I also gained a foundation and credibility as I applied for and obtained other leadership roles.

Until summer 2019, my lab was based at the VA. My first career development award was through VA Merit Funding and it has been the major source of funding for my research. I have also received some institutional and regional funding through the VA as well, plus the VA system has recommendations for designated time in research related to the amount of grant funding, so I have had a portion of my time mapped to research.

I have been part of the VA for more than 25 years as an attending physician. As a new department chair, I decided to maintain a role at the Hines VA, for five hours per week, with predominantly a clinical support role. This allows me to continue a clinical role for this population of patients, as well as having a closer affiliation with the VA related to resident education and faculty recruitment and development.

Mohammed M. Moursi, MD, professor, division chief, Little Rock VA and University of Arkansas Medical Sciences

I came to the VA because, as a young surgeon, it gave me the ideal opportunity to become an academic “triple threat.” I was able to practice clinical vascular surgery, conduct both basic science and clinical research, as well as mentor students, residents and fellows.

The VA is a unique environment in which to practice vascular surgery. As is well recognized, the veteran population carries a substantial burden of vascular surgical disease. As such, the opportunities to help these patients and their families are abundant.

I have worked as a vascular surgeon at the VA for more than 25 years. I have seen the progression of our field advance from solely open operations to the complicated endovascular techniques that we employ today. The VA has been incredibly supportive of these advancements in terms of their dedication to maintaining state-of-the-art technology. For example, our VA had one of the first hybrid rooms in our state. This has enabled us to provide veterans with world-class care. It is incredibly gratifying to help those who have served our country.

The environment at the VA has enabled me to climb the academic ranks and establish myself as a senior vascular surgeon. While this could have been accomplished at a non-VA medical center, the support of the administration and the patient population itself made it much more of a rewarding and satisfying journey.

While some complain about a bureaucratic and inefficient system, I have rarely found that to be true. The VA’s commitment to young surgeons is very evident in my view. I would recommend any young vascular surgeon starting their career to seriously consider a VA position. They will find it—I assure you—rewarding.

Pegge Halandras is a member of the SVS VA Vascular Surgeons Committee.