VA health system for J-1 waiver

[tyclin]

Hi everybody. I am new here and glad that I found this place. I have been trying to review all the messages as many as I could. I have not seen any comments about application for VA health system. Does anyone experienced in this application process provide some hints?

Does specialty affect the application process? (I am in gerenal surgery training)

Thank you

 

[MDGUTS1307]

Any specialty is okay

Any specialty with the VA is okay.
If you have questions you can send me a private email and I can try to answer them for you.

Overall, I would recommend against doing the waiver with the VA as there is a lot headaches (HR folks are not easy to work with ) and lower pay.

MDGUTS

 

[hadron]

The VA has re-vamped their payscale for specialists. I talked to a higher ranking administrator the other day who tried to recruit me away from private practice. The money is not quite PP, but it is definitely not the goverment pay they offered last year for exactly the same job.


As for doing a waiver with them:
- upside is that it is a 100% deal. They want the waiver, they get it, no numerical limitations, no neurotic state health departments to contend with.

- downside is that some VA administrators are ruthless slavedrivers. They know that they have you by the testicles and that they can squeeze at will to make you accept unfavorable employment conditions. The dirty secret of VA pay is that a lot of the bonusses are at the mercy of the administrator. If they know that you can't leave due to your waiver situation, at times they will demote people to the 'physician general practice' payscale using bogus interpretations of VA policies.

 

[MDGUTS1307]

VA salary will be low

I would recommend one to keep the options wide.


I have been with the VA for > 5 years.
Regarding paperwork: It may be less, but the HR folks can be difficult to work with as they can be very incompetent. Recently one VA refused to write a letter in support of NIW ! They finally did after a lot of pressure. I have seen scenarios where the paperwork took about 18 months with the VA ( 2 of my friends) to start the waiver.
It depends on the local VA. If you are applying, talk to folks who have done wiavers there and find out how helpful the HR folks were. If they were easy to work with then it is probably a okay VA.

With regards to salaries. The VA has promised an increase in salaries. For specialists and Surgeons, radiologists, etc, they will NEVER be able to match the Private practice set up. I have been hearing this for the last 2 years and I do not think there will be significant pay increase. Again, the private sector may not pay as much if one is doing a waiver . So one has to look at the offers and then decide.

I would suggest looking at all the offers you get and decide based on what is being offered.

With regards to the VA salary: make sure you ask for a sign on bonus- up to 25-30 K.
. Apart from the usual salaries, they can give you yearly bonuses: you have to ask for this . Make sure you have data on local pay for surgeons in the area you are looking at: this can help you a lot with negotiating the salary.

GOOD LUCK
MDGUTS

 

[hadron]

One more warning

Don't get suckered into the following deal:

- VA and university get you an O-1 to work at the VA telling you 'we can't to a J1 waiver H1b at this time due to XYZ policy (any number of reasons: haven't advertised long enough, had a citizen candidate we didn't want to hire after the last ad......).
- Get strung along for YEARS with varying excuses why your J1 waiver can't be processed in this quarter/year/century. All the while sitting on an O-1 which has to be renewed annually while you are blocked from pursuing permanent residency due to your pending HRR.
- After 2-3 years get blackmailed into 'we can get your waiver started until you sign this 5 year contract which incidentally doesn't have an exit clause for you'.

So if VA, then J1-waiver H1b from DAY ONE. If they want you, they can make things happen. It is the goverment. Any policy can be overridden by the signature of a higher up.

Yes, the VA can be a good opportunity to get a J1 waiver and eventually a GC. But just like in the private sector: 'Caveat Emptor' before you sign up for anything. Ideally, you want to know someone who did a waiver at the same VA (or in the same VISN as some of these administrative things are done at the VISN level) before you sign your contract. Not all VAs are created equal.

 

[angio]

Great info on the VA waivers.
I have heared that the advantages are also that VAs usually have an academic affiliation with University medical centers, and that you participate as Faculty in these centers as well, working there one day per week or so (I'm sure this depends on which VA, etc). I have also heared that the hours are usually pretty good, and that it offers a good starting point for someone that just graduated and has no experience working as an attending (particularly in surgical specialties).
I have also seen the scenario Hadron just presented, where they trick you into taking an O-1 and then never committing to an actual waiver, so beware!
How long does a VA waiver take? Three years like the underserved areas or 5 years, like the research/academic waivers?
Thanks!

 

[hadron]

> and that you participate as Faculty in these centers as well, working
> there one day per week or so

The standard deal is that the VA has you 5/8th, and the university 3/8th of your time (which works out to about 1 day/week). Your already measly VA salary gets downcorrected by that amount. But usually, the higher income you get at the university for that extra day more than makes up for the loss.

> I have also heared that the hours are usually pretty good,

And because most VAs have residents, your calls are fairly cush.

> and that it offers a good starting point for someone that just graduated
> and has no experience working as an attending (particularly in
> surgical specialties).

The good thing in the VA is that you are protected by the federal tort reform act. So, your liability is capped at 250k, and even for that the federal goverment indemnifies you. So during the first couple of years as a surgical or procedural specialist, you don't have to start in the ladder scheme of 'claims made' malpractice insurance. Also, this is the time where you still learn, being somewhat protected against frivolous lawsuits is very helpful. Young neurosurgeons actually will choose VA positions at times for that very exact reason (also, veterans as a whole have a low proclivity to sue).
And while it is not everyones thing, I loved working with veterans. They are such a unique population and most of them are grateful for what you do for them. Well, you have a good share of nutcases (ahem, clients with psychiatric needs), most of them are pretty easy to work with.