Office of Academic Affiliations
Advanced Fellowships and Professional Development Frequently Asked Questions
ADVANCED FELLOWSHIPS FAQs
STATUS OF THE FELLOW DURING THE FELLOWSHIP?
The concern is whether the fellow would accrue VA time in grade, have a full federal benefits package, incur salary increases due to longevity, etc. while completing the fellowship.
Fellows are considered VA trainees. The benefits they are eligible for include health insurance, life insurance, annual leave and sick leave. They are not entitled to contributions to retirement nor TSP. They get paid a stipend and depending on the fellow level at which they are appointed they may or may not go up in salary for the 2nd year of the fellowship.
CAN TRAINEES HAVE DUAL APPOINTMENTS?
Trainee appointments are under authority of Title 38 USC 7406 (physicians/dentists) or Title 38 7405(a)(1)(D). There are important implications, as the trainee effort is subject to different, usually lower, pay, and the effort is not creditable for purposes of Federal retirement benefits (see http://vaww.va.gov/OHRM/Benefits/FERS/2012/Flyer-StudentsTrainees-20120410.pdf).
FLEXIBILITIES IN HIRING VA TRAINEES
OAA has been working closely with the VHA Office of Workforce Management and Consulting to disseminate knowledge of hiring flexibilities for recruiting and appointing Title 38 and Hybrid Title 38 health professions trainees into VA employment positions.
Below, please find an updated flyer and FAQs that were recently released. Many HR Officers are not aware that expedited hiring procedures for trainees in our training programs can be used. We have also created a "Myth Busters" document, in collaboration with VHA Workforce Management and Consulting’s Healthcare Recruitment and Marketing Office, to address common misconceptions we hear from the field.
This information is to remind you that jobs do NOT have to be announced on USAjobs and only must comply with local bargaining agreements. In addition, offers may be made to trainees PRIOR to completion of training contingent on successful completion of the training program and meeting VA’s profession-specific qualification standards.
The biggest stumbling block for trainee hiring appears to be misunderstandings by field HR staff -- which we are attempting to rectify through these educational materials.
Please share this document broadly with your HR staff (both VISN and facility), service chiefs, and profession-specific training directors.
LESS THAN FULL-TIME ADVANCED FELLOW PARTICIPATION
VA Advanced Fellows can participate in the VA Advanced Fellowship program less than 100%, but no less than 50%. If you have a fellow wishing to do this we would need you to do the following:
- Upload to the Advanced Fellowships Nomination Portal a letter signed by the program director describing the situation, the percentage of time 50% or above) the fellow wishes to work, and how the fellow will be successful given the reduced time in the fellowship.
- Once the letter is uploaded please send Kimberly Uhl an email indicating that the request is in the database.
- The VA Advanced Fellowships National Office will then review and let you know our thoughts (approved/not approved).
OAA only has the ability to send the full 100% time stipend to the site. If approved for less than 100% participation please notify your facility Designated Education Official to return excess funding through the OAA Quarterly Needs and Excess process.
MANDATORY TRAINING FOR TRAINEES
Advanced Fellows are subject to the same TMS requirements as other trainees as listed on this link.
VA policy does not reference Authorized Absence (AA) for this purpose. AA is approved if the activity involves the functions or activities of VA, or will contribute to improved conduct, supervision, or management of those functions or activities. VA Handbook 5011 provides guidance for AA for employees during duty hours. The following information is provided.
An employee may be given authorized absence without charge to leave when:
- The activity is considered to be of substantial benefit to VA in accomplishing its general mission or one of its specific functions
- The activity will clearly enhance an employee's ability to perform the duties of the position presently occupied or may be expected to prospectively occupy
- The basis for excusing the employee is fairly consistent with prevailing practices of other Federal establishments in the area concerning the same or similar activities.
VA Handbook 5011 Part III, Chapter 3, paragraph 14c provides the only guidance for military leave for residents.
Full-time residents whose periods of training in VA are not limited to 1 year or less are entitled to the same military leave benefits provided full-time physicians and dentists.
If residents are not covered by this authority, then they are handled by Office of the Chief Academic Affiliations Officer for leave of absence.
OPM’s regulation at 5 CFR 353.106 Personnel actions during employee's absence states:
An employee absent because of service in the uniformed services is to be carried on leave without pay unless the employee elects to use other leave or freely and knowingly provides written notice of intent not to return to a position of employment with the agency, in which case the employee can be separated.
MOONLIGHTING AND ADDITIONAL COMPENSATION
Questions arise as to whether it is acceptable for advanced fellows to receive supplemental pay (e.g. from grants or the academic affiliate) or if they can moonlight. There are a few issues here, few of which are specific for somebody being a trainee or fellow as they apply to all of us as VA employees. General guidance is...
1. Be aware that violation of many Government ethics regulations can result in criminal and/or administrative sanctions. Unlike ignoring ethics positions of professional groups, violation of these regulations can result in being fired as well as criminal prosecution. Obviously, criminal penalties can result in loss of license, fines, and even prison. And that doesn’t even take into account legal fees in defending oneself, even if the charges sputter out along the way.
2. With limited exceptions, VA cannot pay us for more than 40 hrs/week through either a single or multiple appointments. The regulations don’t consider this an ethics issue but a matter of HR regulation, and is addressed by VA Handbook 5005. We can split the appointment so that they are a fellow not less than half time, and then the facility can appoint them to any other position up to the 40 hour limit. However, be mindful of clinical privilege issues, so that we don't end up with a fellow being a dependent practitioner for certain privileges during one shift when paid as trainee, but an independent practitioner for the same privileges during another shift when paid as staff. The principal exception to the 40 hour limit is authority for a VA trainee to be appointed as an ‘admitting physician.’ This is a very limited circumstance, addressed by VA Handbook 5005, Part II, Chapter 3, Paragraph 3.b.
3. No VA employee can legally receive any non-Federal compensation for the performance of official duties for which VA is already paying us. Thus it is criminal for a fellow or staff to receive 'supplemental' pay from another source for time for which VA is already paying.
VA employees can legally receive outside income so long as there are no technical or ethical conflicts. The following checklist is provided as general guidance:
- Not on time VA is already paying for (including sick leave).
- The opportunity isn't offered to the person because of their VA responsibilities (e.g. not ok for an understanding that the VA Chief of whatever always gets to be a consultant to company X).
- The employee is selected because of their own knowledge and expertise rather than their VA position (maybe the same as b, but from a different angle).
- The employee's outside work is not related to their official duties. For example, a VA SCI physician could conceivably receive honorarium to give a lecture about SCI medicine off-hours to a non-VA audience. But it would not be legal for that same employee to receive honorarium to give a lecture about VA's approach to SCI care. This can be a slippery slope and VA staff getting compensated for outside lectures or academic work should be cautious about this.
The regulation addressing this, 5 C.F.R. § 2635.807, states that the conduct of teaching, speaking or writing is related to official duties, and thus compensation is barred, where:
- the invitation was extended to the employee primarily because of the employee’s position.
- the invitation was extended by someone whose interests may be affected substantially by the employee’s government duties.
- if the information conveyed draws substantially on non-public information.
- the subject matter deals significantly with:
- 1) any matter to which the employee is assigned or was assigned within the past year of his or
- 2) any ongoing or announced VA policy, program, or operation.
- Note that it is ok to have fellows in alternate tours of duty, say compressed schedules for their trainee effort, so that they have more personal time available during weekdays in order to seek other legal employment. Timekeeping policy and strategy is a local responsibility, and no clearance from OAA is needed. Of course, the local facility is required to follow the trainee time regulations. Consultation from local DEO is appropriate if there are questions, and OAA stands ready as an information resource if needed.
- A fellow can be paid via a non-VA grant if all of the above conditions are present-- and the work that they do for the grant is different then what they are paid to do for their official duties. For example, if somebody is on a compressed schedule for their VA work, and has outside compensation for another 10 hours/week, that work shouldn't take place at their VA office and it shouldn't be on the same project as their VA trainee work. It should be a separate activity so that payment via a non-VA grant does not result in an illegal supplementation of salary discussed above.
- Be aware that violation of many Government ethics regulations can result in criminal and/or administrative sanctions. Unlike ignoring ethics positions of professional groups, violation of these regulations can result in being fired as well as criminal prosecution. Obviously, criminal penalties can result in loss of license, fines, and even prison. And that doesn’t even take into account legal fees in defending oneself, even if the charges sputter out along the way.
4. For completeness in discussing ethical obligations, don't forget that even non-paid outside relationships may have official implications for us. There are certain things we're allowed to do on official duty for outside entities for which we can use official time, for instance teaching courses at our affiliate (so long as it doesn't interfere with our VA duties). Be wary of getting involved in slippery slopes of intermingled relationships. For example, I know of a VA physician who had a relationship as a consultant to a medical education publishing company, which was perfectly legal. However, the physician crossed the line when she thought it would be boon to VA for that company to publicize some of VA’s educational achievements at no cost to VA. She hadn’t gone very far before it dawned on her that her interests were getting intermingled. The VA physician consulted with VA Regional Counsel who confirmed the likelihood of a problem, and she quickly resolved the conflicts by withdrawing from the outside role and deciding that if a mutually beneficial relationship for VA and the publishing company were to occur, that it should have absolutely nothing to do with her.
As mentioned above, those are some of the things we’ve picked up along the way. But the only definitive opinion about legality of specific relationships comes from Ethics Counsel at either VA Regional or General Counsel. Each office has people trained in making ethics assessments for situations that employees bring to them, and in my experience in both VISN 22 and OGC in DC, they are very responsive. I encourage VA employees considering outside compensation arrangements or even volunteer activities (e.g. to serve on the board of a professional group) to seek Ethics Counsel opinion prior to entering into such relationships because if they receive that opinion (get it in writing and hang on to it) the employee has a ‘good faith reliance’ resulting in a virtual guarantee protected from later administrative action or criminal prosecution should it later be determined that the relationship was not appropriate (say, if the OIG investigates and is critical). If Counsel recommends against the relationship, the thoughtful employee would be best served knowing that sooner than later.
We have received several inquiries for an OAA offer letter for Advanced Fellowship nominations. While we can't issue this type of letter, program directors can make a written offer to a candidate, offering the appointment but stating that it is conditional on satisfactory verification of application information and determination of suitability for VA appointment.
- You can submit the materials to the database at any time; we recommend not later than about 6 weeks prior to desired start date.
- The following programs require OAA review (the database will convert to OAA review once the Program Director certifies):
- Poly Trauma Brain Injury Rehabilitation
- Psychiatric Research/Neurosciences
- The approval/certification chain starts with the Program Director and ends with the DEO or OAA.
- Once the DEO certifies the official OAA approval memo will be generated and housed in the document section for you to pull down and send to your HR and Fiscal staff.
- We will accept partial nominations at any time.
- If you are looking for a position commitment or a qualification review, send a separate e-mail so we know to look for the submission and can do the requested review.
- Once the review is done we will mark it either incomplete or conditional depending on the findings of the review.
- You must finalize the nomination in the usual timeframes and cannot start a fellow without the official OAA approval memo.
PROCEDURE FOR DETERMINING PGY CREDIT
VHA Handbook 1400.7 (Education of Advanced Fellows) dated February 26, 2016 states the following:
VA Appointment and Pay.
Physicians and Dentists. Physician and Dentist Advanced Fellows in this category are paid at the rate for their approved Post Graduate Year (PGY)-level, as defined by the Resident Training Stipend Schedule. PGY level for this purpose is determined using the following decision rules:
a. All years for completed specialty training in a single pipeline program in an ACGME/AOA- or ADA-approved residency or clinical fellowship shall count year for a year as calculated by ACGME/AOA standards and as creditable towards ABMS or ADA board certification. A physician who has completed two pipeline programs may get credit for only one, whichever is longest. No training conducted outside the United States or Canada shall be countable unless accepted in writing by the specialty board in question granting credit for all or part of said foreign training.
b. Chief Resident positions will count for 1 year, provided the appointment had the following attributes:
- (1) The responsibility was fulfilled after the candidate became Board Eligible in the specialty in which the Chief Residency took place,
- (2) The responsibility was fulfilled in relation to an ACGME-approved residency program which counts chief resident time as a PGY, and
- (3) The candidate must have participated for 1 year.
c. Participation in a prior VA Advanced Fellowship may credit for up to two completed full years.
NOTE: The total credit for post-graduate years shall not exceed PGY-8, no matter how many creditable years are determined through the above steps.
PSYCHOLOGY TRAINING ELIGIBILITY
Eligibility Requirements for All Programs
- U.S. citizenship. VA is unable to consider applications from anyone who is not currently a U.S. citizen. Verification of citizenship is required following selection. All interns and fellows must complete a Certification of Citizenship in the United States prior to beginning VA training.
- A male applicant born after 12/31/1959 must have registered for the draft by age 26 to be eligible for any US government employment, including selection as a paid VA trainee. Male applicants must sign a pre-appointment Certification Statement for Selective Service Registration before they can be processed into a training program. Exceptions can be granted only by the US Office of Personnel Management; exceptions are very rarely granted.
- Interns and Fellows are subject to fingerprinting and background checks. Match result and selection decisions are contingent on passing these screens.
Additional Eligibility Criteria for Internship
Internship applicants also must meet these criteria to be considered for any VA Psychology Internship Program:
- Doctoral student in good standing at an American Psychological Association (APA) or Canadian Psychological Association (CPA) accredited graduate program in Clinical, Counseling, or Combined psychology or Psychological Clinical Science Accreditation System (PCSAS) accredited program in Clinical Science. Persons with a doctorate in another area of psychology who meet the APA or CPA criteria for respecialization training in Clinical, Counseling, or Combined Psychology are also eligible.
- Approved for internship status by graduate program training director.
Additional Eligibility Criteria for Postdoctoral Fellowship
Postdoctoral fellowship applicants also must meet the following criteria to be considered for any VA Psychology Postdoctoral Program:
- Have received a doctorate from an APA or CPA accredited graduate program in Clinical, Counseling, or Combined Psychology or PCSAS accredited Clinical Science program. Persons with a doctorate in another area of psychology who meet the APA or CPA criteria for respecialization training in Clinical, Counseling, or Combined Psychology are also eligible.
- Have completed an internship program accredited by APA or CPA or have completed a VA-sponsored internship.
Eligibility for Employment
Internship applicants also must meet these criteria to be considered for any VA Psychology Internship Program:
- To be eligible for employment as a VA Psychologist, a person must be a U.S. citizen and must have completed an APA, or CPA accredited graduate program in Clinical, Counseling, or Combined psychology or PCSAS accredited Clinical Science program AND must have completed an APA or CPA accredited internship in Psychology, with the emphasis area of the degree consistent with the assignment for which the applicant is to be employed. The only exception is for those who complete a new VA internship that is not yet accredited.
STUDENT LOAN DEFFERALS
Potential fellows/fellows with student loans are encouraged to find out if their loans can be deferred by participating in the VA Advanced Fellowship program. Not all loans would allow this so the fellow would need to inquire with the lender directly. If eligible, OAA’s Advanced Fellowship leadership can provide a letter to the fellow (upon request by the fellow) attesting participation in the program. The fellow would then need to provide the letter to the lender and follow up from there.
TUITION FOR UNIVERSITY COURSEWORK
The VA can pay for or provide training necessary for a fellow to accomplish his/her official duties (and in this case, pertaining to research duties), but transcript or CME credit cannot legally be provided by the government. If the registration fee includes credit to participants, there’s no problem. But if they provide a menu pricing scheme, then VA can pay for the option least costly to the agency that provides the training to the employee. Should there be menu options that allow personal benefit to the employee (e.g. cme credit or transcript recognition) the employee can pay the difference. With that logic, VA can (at agency’s option and determination) pay tuition for employees at universities, but would be at the lowest possible amount, such as audit. The employee is at liberty to pay the difference between that lowest cost to participate and the charges for transcript credit and/or degree recognition.
J1 & J2 VISA GUIDANCE
OAA has recently been informed by ECFMG that they will no longer authorize J-1 visas for physicians who are appointed as licensed independent practitioners (LIP’s). We haven’t been able to confirm whether this also applies to J-2 visa, so to be cautious we suggest that we proceed with the assumption that it does. Therefore, please note the following:
- Physicians who are not US Citizens (J-1, J-2, H-1B, permanent resident, or other valid status) remain eligible to apply for VA Advanced Fellowships when permitted by the applicable Program Announcement. Any qualified US citizen (as defined by eligibility criteria in the applicable Program Announcement) who applies must be selected prior to a somebody who is not a US citizen. However there are now changes in the mechanics of the appointment for Advanced Fellow physician trainees holding J-1 or J-2 visa, described below.
- This change is not due to change in VA or Federal Government policy, but to ECFMG requirements. OAA requires no action for current advanced fellows on a valid J-1 visa. Please note however that academic affiliates are the sponsors of J-1 visas, so it is possible that limitations on current fellows could be imposed by the academic affiliates or by ECFMG.
- All advanced fellows must have a TQCVL completed prior to appointment. When a non-citizen on a J-1 or J-2 visa is selected for an advanced fellowship position, the TQCVL is the sole documentation necessary to qualify them to engage in supervised clinical practice- they shall not go through the Credentialing and Privileging process to be appointed as LIP.
- Non-citizens on other visa types or with other immigration status being appointed to advanced fellowships shall continue to be required to have a completed TQCVL and be credentialed and privileged as LIP in their primary specialty, unless Advanced Fellowships has approved a waiver of this requirement.
- We don’t have more information about this, but we are happy to try to clarify anything that might be confusing on this issue.
WHAT ARE THE APPROPRIATE LEAVE CATEGORIES FOR STIPEND PAID TRAINEES?
Most HPTs are in Leave Group 1, and earn 4 hours annual leave (AL) and 4 hours sick leave (SL) for every 80 hours in pay status. Full Time Physician and Dentist trainees are either in Leave Group 4 and accrue 26 days of AL and 13 days of SL per year, or in Leave Group 5 and accrue the number of days annual leave at the index hospital. HR must check with the facility DEO to determine the leave rate at the affiliate. This leave rate is put into HR·Smart in the “Accrual Rate:” box.
WHAT IS THE STATUS OF THE FELLOW AFTER COMPLETION OF THE FELLOWSHIP?
Is there any predetermined grade at which they are required to return to regular VA employment?
It is up to fellows to find jobs on their own following the fellowship. They would need to apply for openings. If you’re talking about a staff person who leaves staff employment and becomes a full time fellow, I would advise him/her to talk to Program Director or Designated Education Officer (DEO) about what happens to him/her after the fellowship.
REQUESTING AN ADDITIONAL YEAR OF SUPPORT
- Submit extension requests at least 45 days prior to end of initial appointment
- Please upload the three required documents
- Updated fellow CV
- Letter from fellow
- Letter from Director
- Make sure to select the correct document type – they should all start with “Extension Request –“
- Remember to highlight
- accomplishments during fellowship
- the impact of fellow’s work
- the need for an additional year to pursue opportunities that will continue the fellow’s development
Once you have uploaded the documents the Request Extension button will turn blue and you can select it. That will push the file for OAA review.