Medical Instrument Technician (Echocardiography)

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Basic Requirements

United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. There are no specific educational requirements for this occupation. Education may be substituted for experience only at the GS-4 and GS-5 levels. See the grade requirements part of this standard for information regarding educational substitutions. Licensure or Certification.

Licensure or Certification is not required for this occupation; however, it is strongly desirable at GS-6 or above as evidence of possession of the essential knowledge, skills, and abilities. For certain functional areas at the higher levels or supervisory assignments, specific certifications appropriate to the specialty are indicated in this standard under "Titles and Certification/Registrations". For all specialties identified in this standard, Basic and Advanced Cardiac Life Support certifications are desirable.

Training which does not result in official certification does not meet this definition. English Language Proficiency. Medical Instrument Technicians must be proficient in spoken and written English in accordance with chapter 2, section D, paragraph 5a, this part. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grandfathering Provision.

The following is the standard grandfathering policy for all Title 38 Hybrid qualification standards. Some of these provisions may not apply to this occupation. Please carefully review the qualification standard to determine the specific education and/or licensure/certification/ registration requirements that apply to this occupation.

All persons employed in VHA in this occupation on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series and grade held, including positive education and licensure/certification/registration that are part of the basic requirements of the occupation.

For employees who do not meet all the basic requirements required in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following provisions apply: Such employees in an occupation that does not require a licensure/certification/registration, may be reassigned, promoted, or demoted within the occupation.

Such employees in an occupation that requires a licensure/certification/registration, may be reassigned, promoted up to and including the full performance (journey) level, or demoted within the occupation, but may not be promoted beyond the journey level or placed in supervisory or managerial positions.

Such employees in an occupation that requires a licensure/certification/registration only at higher grade levels must meet the licensure/certification/registration requirement before they can be promoted to those higher grade levels.

Grade Determinations

GS-9. In addition to the core competencies defined at the GS-8 full performance level, positions at this grade may be lead, supervisory, or non-supervisory with specialized advanced knowledge and assignments. GS-8 core competencies / KSAs include: .1) Ability to produce diagnostic quality images and Doppler frequency shift recordings using M-mode, two-dimensional, pulsed and continuous wave Doppler spectral display, and color flow Doppler imaging.

1. Knowledge of normal echocardiographic findings and deviations produced by a wide variety of cardiovascular diseases. 3) Ability to perform complex procedures such as cardiac studies of the four chambers of the heart and valves using sector scanning techniques to detect stenotic and incompetent valves, chamber enlargement, and pericardial effusion and cardiovascular studies deriving pressure gradients across obstructed valves, etc.
2. Ability to perform complementary ultrasonic examinations (including noninvasive) transthoracic, Bubble studies and contrast echocardiography, (invasive) stress echocardiography, and transesophageal echocardiography. 5) Ability to adapt transducer positioning, instrument controls, and examination techniques to the individual patient being studied and the problem being evaluated including recognizing pertinent abnormalities and documenting abnormal findings. (a) Experience.

At least 1 year experience comparable to the next lower grade level, which is directly related to the duties of the position to be filled, and must fully meet the KSAs at that level. This would be experience which demonstrates possession of the knowledge required in order to provide all aspects of echocardiography services.

In addition, the candidate must demonstrate the following technical KSAs and the potential to acquire the assignment specific KSAs designated by an asterisk (): (b) Demonstrated Knowledge, Skills, and Abilities. 1. Knowledge of the more complex examination and treatment procedures and techniques in order to provide training and supervision in these procedures, to evaluate and initiate performance improvement projects, and to write policies, procedures, and protocols, that pertain to Echocardiography. 2.

Knowledge of JCAHO and other regulatory requirements. 3. Ability to communicate effectively and professionally with employees at varying grade levels. (c) Certification. Registration by Cardiovascular Credentialing International (CCI) as a Registered Cardiac Sonographer (RCS) or by the American Registry of Diagnostic Medical Sonographers (ARDMS) as a Registered Diagnostic Cardiac Sonographer (RDCS) is highly desirable.

Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certifications are also desirable. (d) Assignments. For all assignments above the full performance level, the higher-level duties must consist of significant scope, complexity (difficulty), and range of variety, and be performed by the incumbent at least 25% of the time.

Preferred Experience

Certification by Cardiovascular Credentialing International (CCI) as a Registered Cardiac Sonographer (RCS) or by the American Registry of Diagnostic Medical Sonographers (ARDMS) as a Registered Diagnostic Cardiac Sonographer (RDCS) is preferred.

Minimum five years of experience performing cardiac ultrasound is preferred; OR Minimum of four years of experience performing cardiac ultrasound and successful completion of two years of education above high school or an associate's degree with a major field of study directly related to the medical instrument technician occupation is preferred; OR Minimum of three years of experience performing cardiac ultrasound with a a bachelor's degree in a major field of study appropriate to medical instrument technician functions, or 4 years of post-high school education leading to a bachelor's degree with courses related to the occupation is preferred.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this occupation series is GS-8. This vacancy is being filled above the full performance level at the GS-9.

Physical Requirements

The work requires long periods of careful arm and hand positioning, standing, bending over, and pushing the echo machine from the Echo Lab to the Intensive Care Units or other areas to perform echocardiograms on patients who cannot move. Lifting of incapacitated patients is done only with help of other employees and the use of safe patient handling equipment.

The GS-9 Medical Instrument Technician (Echocardiography) position at John Cochran Medical Center at VA Saint Louis Health Care System is primarily responsible for performing the full spectrum of echocardiogram procedures to include transthoracic 2D/3D imaging, 2D/3D transesophageal echocardiography, and stress echocardiograms (doppler and ischemic). The Cardiac Sonographer GS-9 should demonstrate a high degree of knowledge of cardiac anatomy and physiology related to cardiovascular function.

The position also entails the need to perform studies which include various protocols. This position requires the technologist to use independent judgment and problem-solving skills to optimize the evaluation and tailor the examination to ensure comprehensive and accurate diagnosis. This position also includes the requirement to teach and mentor others in complex echocardiographic imaging and in the development of standardized polices and protocols pertaining to the Echo Lab department.

The sonographer interprets the results of the examination and presents recommendations or possible diagnosis to the interpreting physician. Duties include but are not limited to: Performs, records, and archives echocardiograms using digital technology. Performs 2D/3D, M-Mode, continuous and pulse wave Doppler and color flow imaging 85% of the time. Independently perform 2D transthoracic (TTE) examinations and makes decisions for saline injection studies and the use of a LV cavity opacification agent.

Performs stress echocardiograms using digital acquisition and pharmaceuticals agent with and without the use of an LV cavity opacification agent. Assists staff cardiologist with 2D/3D-Transesophageal (TEE) echocardiography and acquires images utilizing digital acquisition 85% of the time.

Demonstrates the ability to don required lead personal protective equipment and safely obtain high quality echocardiographic images during fluoroscopy guided structural heart and interventional procedures, including transcatheter aortic valve replacement (TAVR) and endomyocardial biopsy, while adhering to radiation-safety standards and maintaining proper positioning within the procedural field . Inform Cardiologist of preliminary results of exam as needed.

Receives patients, explains procedure, assists patient in undressing, and getting off and on exam bed, performs exam, changes bed linen and disinfects equipment after each patient. Responsible for capturing workload by entering CPT codes into encounters. Independently performs 3D transthoracic (TTE) examinations for complex valvular heart disease 85% of the time. Ability to perform strain imaging in echocardiography. Assist with QI review per IAC accreditation guidelines.

Knowledge of JCAHO and other regulatory requirements Performs 12-Lead EKGs as needed. Work Schedule: Full Time, Permanent, Mon-Fri 7:30 a.m. - 4:00 p.m. Schedule is subject to change based on the needs of the health care system. Telework: Not available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not authorized. Permanent Change of Station (PCS): Not authorized.