The VA Palo Alto Healthcare System (VAPAHCS) is part of VA Sierra Pacific Network (VISN 21), which includes facilities in California, Nevada and Hawaii. VAPAHCS is a teaching hospital, providing a full range of patient care services, with state-of-the-art technology as well as education and research, Comprehensive health care is provided through primary, tertiary and long-term care in areas of medicine, surgery, psychiatry, physical medicine and rehabilitation, neurology, oncology, dentistry, geriatrics and extended care. The Research and Development Service excels as a leader in the Department of Veterans Affairs. The non-profit corporation, the Palo Alto Veterans Institute for Research (PAVIR), has contributed to making VAPAHCS a leader in research.

Major duties and responsibilities:

1. Cross coverage of surgical subspecialty and direct patient care (Typical census ~20) as well as direct supervision of a three resident internal medicine night team. All new admissions are carried out by house staff; our nocturnist does not admit new patients. The nocturnist does staff high acuity medicine admissions (intermediate ICU/step-down unit) with the medicine house staff, as well as supervise procedures (lumbar puncture, paracentesis, arterial lines) and supervise all codes and rapid response emergencies. The Palo Alto VA has a closed ICU and is not part of the nocturnist responsibilities; Anesthesia and ICU are in-house overnight and attend all codes and e-teams to manage airway issues and help with central access.
2. Environment of Care: Follows Life Safety Management (fire protection) procedures. Reports safety hazards, accidents and injuries. Familiar with hazardous materials, Material Safety Data Sheets (MSDS), and waste management procedures. Follows Emergency Preparedness plan. Follows building security policies/procedures. Complies with federal, state and local environmental and other requirements preventing pollution, minimizing waste, and conserving cultural and natural resources.
3. Infection Control: Demonstrates infection control practices for disease prevention, i.e., hand washing, standard precautions, and isolation procedures, including TB requirement/precautions. No eating or drinking or the storage of such containers, applying cosmetics, or inserting contact lenses in patient care areas, including nurses' stations.
4. Health and Safety: Fosters a high profile of the VA Occupational Safety and Health Program by assuring employee awareness of potential safety hazards, promptly reporting all injuries and ensures supervisors are effective in corrective actions necessary to eliminate safety and health hazards in the work area.

Requirements include:

• Completion of a U.S. based residency program and subsequent Board Eligibility and/or Board Certification in Internal Medicine.
• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy

Compensation details:

1. Salary of $280-$300K annually
2. Performance Pay up to $15,000 (These are based on measurable goals
3. This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application.

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