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". 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). Grade Determinations: GS-4 Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the position to be filled. Six months of this experience may have been in medically related fields such as nursing assistant, practical nursing, or similar fields. The remaining six months must have been in operating diagnostic and therapeutic equipment covered by this occupation. Experience gained in the operation of equipment for animal diagnosis or treatment may be credited at this level. In addition, the candidate must demonstrate the following KSAs: OR Education. 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. Demonstrated Knowledge, Skills, and Abilities (a) Knowledge of basic medical terminology (b) Ability to learn the components, operating characteristics, and settings of the equipment to be used. (c) Ability to learn typical patient reactions to the basic procedures involved and ability to recognize signs of distress. (d) Ability to learn the standard positions for the procedure being conducted. (e) Ability to communicate orally and in writing. GS-5: Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the position to be filled. In addition, the candidate must demonstrate the following KSAs: OR Education. Successful completion of 4 academic years above high school leading to a bachelor's degree with courses related to the occupation, or a bachelor's degree in a major field of study appropriate to medical instrument technician functions. Demonstrated Knowledge, Skills, and Abilities (a) Knowledge of standard medical terminology to interpret physician orders or instructions. (b) Knowledge of common physical disabilities and ability to position patients for the examination or treatment. (c) Ability to learn the normal and abnormal results for routine procedures to recognize and report obvious. abnormalities.(d) Ability to operate the equipment to administer routine/standard diagnostic treatment or 8 procedures. (e) Ability to perform standard operator maintenance on the equipment including the ability to disassemble, clean, reassemble, and calibrate the machine. GS-6: Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. In addition, the candidate must demonstrate the following KSAs: Demonstrated Knowledge, Skills and Abilities (a) Knowledge of the anatomy and physiology of the heart and great vessels. (b) Knowledge of cardiac arrhythmias and their relationship to hemodynamic conditions of the cardiac cycle. (c) Knowledge of basic cardiac ultrasound physics and the acoustic mechanisms by which high quality cardiac images are obtained. (d) Ability to set up and adjust the ultrasound equipment to meet the conditions of the examination and the patient and to operate the equipment for standardized, routine procedures. (e) Ability to interact with patients explaining procedures and positioning the patient for the procedure. GS-7: Experience. At least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics related to the duties of the positions to be filled. In addition, the candidate must demonstrate the following KSAs: Demonstrated Knowledge, Skills and Abilities (a) Ability to assist with insertion of temporary transvenous pacemaker catheters. (b) Ability to conduct cardiac testing to determine the severity and variety of cardiac problems, i.e., valvular dysfunction, myocardial wall kinesia, effusions, endocardial lesions, etc. (c) Knowledge of the set-up for transesophageal echocardiograms. (d) Ability to set up and adjust the ultrasound equipment to meet the conditions of the examination and the patient and to operate the equipment for more complex, but standardized procedures. GS-8: Experience. Applicants must have at least 1 year of experience comparable to the next lower grade level which demonstrates the knowledge, skills, abilities, and other characteristics of the positions to be filled. This would be experience which provided the overall knowledge, skills, and abilities to conduct diagnostic echocardiography examinations in complex and unusual cases. In addition, the candidate must demonstrate the following KSAs: Demonstrated Knowledge, Skills, and Abilities (a) Ability to produce diagnostic quality images and Doppler frequency shift recordings using M-mode, two-dimensional, pulsed and continuous wave Doppler spectral display, and colorflow Doppler imaging. (b) Knowledge of normal echocardiographic findings and deviations produced by a wide variety of cardiovascular diseases. (c) 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. (d) Ability to perform complementary ultrasonic examinations (including noninvasive) transthoracic, Bubble studies and contrast echocardiography, (invasive) stress echocardiography, and transesophageal echocardiography. (e) 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. Preferred Experience: 1 year of completing adult echocardiograms. Registry preferred but not required. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-8. Physical Requirements: Physical aspects associated with work required of this assignment are typical for the occupation and would generally not require a pre-placement examination.