Associate Chief of Staff - Behavioral Health Service


Vacancy ID: 852370   Announcement Number: MPA-2013-852370   USAJOBS Control Number: 339010300

Social Security Number

Vacancy Identification Number

852370
1. Title of Job

Associate Chief of Staff - Behavioral Health Service
2. Biographic Data

3. E-Mail Address

4. Work Information

5. Employment Availability

6. Citizenship

Are you a citizen of the United States?
7. Background Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

8. Other Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

9. Languages

If you are applying by the OPM Form 1203-FX, leave this section blank.

10. Lowest Grade

03
13
15

11. Miscellaneous Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

12. Special Knowledge

If you are applying by the OPM Form 1203-FX, leave this section blank.

13. Test Location

If you are applying by the OPM Form 1203-FX, leave this section blank.

14. Veteran Preference Claim

15. Dates of Active Duty - Military Service

16. Availability Date


17. Service Computation Date


18. Other Date Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

19. Job Preference

If you are applying by the OPM Form 1203-FX, leave this section blank.

20. Occupational Specialties

001 Supervisory Psychologist
002 Supervisory Social Worker
003 Supervisory Nurse
004 Supervisory Psychiatrist

21. Geographic Availability

205880173 Wichita, KS

22. Transition Assistance Plan

23. Job Related Experience

24. Personal Background Information

If you are applying by the OPM Form 1203-FX, leave this section blank.

25. Occupational/Assessment Questions:

Please choose A (Yes) or B (No) for each of the following items to identify which of the following descriptions applies to you.

1. Are you are a current permanent VA employee?

A. Yes
B. No

2. Veterans who served on active duty in the U.S. Armed Forces and were separated under honorable conditions may be eligible for Veterans' preference. For service after October 15, 1976, the Veteran must have received a Campaign Badge, Expeditionary Medal, a service connected disability, or have served during the Gulf War between August 2, 1990 and January 2, 1992 or for more than 180 consecutive days, other than training, any part of which occurred during the period beginning September 11, 2001, and ending on the date prescribed by Presidential proclamation or by law as the last day of Operation Iraqi Freedom. To claim Veterans' preference, Veterans should be ready to provide a copy of their DD-214, Certificate of Release or Discharge from Active Duty, or other proof. Veterans with service connected disability and others claiming "10 point preference" will need to submit Form SF-15, Application for 10-point Veterans' Preference. Please choose the ONE statement below that applies to you.

A. I am eligible for tentative ("5-point") preference.
B. I am eligible for "10-point" preference as a 30% or more compensably disabled Veteran.
C. I am eligible for "10-point" preference as a compensably disabled Veteran (less than 30%).
D. I am eligible for widow or spouse preference.
E. I am not eligible for Veterans preference.

3. Your rating is subject to verification based on the resume, narratives and other relevant documents you submit, and through verification of references as appropriate. Deliberate attempts to falsify information are grounds for non-selection and for termination. In addition, falsifying information on your application can result in you being barred from federal employment. Please choose A to certify that your answers are accurate and complete.

A. I certify that my answers are accurate and complete.
B. I do not wish to certify. I understand that I will not be considered for this position.

This position can be filled as a Supervisory Psychologist, Social Worker, Nurse, or Physician. You
must apply under the correct set of assessment questions in order to be considered for this position.

1. Which of the following best describes your doctoral education?

A. I possess a doctoral degree in psychology from a graduate program in
psychology accredited by the American Psychological Association (APA). The
program was accredited at the time I completed the requirements for my degree.
The specialty area of the degree is consistent with the assignment for which I
am applying.
B. I do not possess a doctoral degree in psychology from a graduate program in
psychology accredited by the American Psychological Association (APA). The
specialty area of the degree is consistent with the assignment for which I am
applying.

2. Which of the following best describes your internship?

A. I have completed a professional psychology internship that was accredited by
the APA at the time I completed the internship.
B. I have not completed a professional psychology internship that was accredited
by the APA at the time I completed the internship.

This section includes an item related to the experience
requirement for this vacancy. Please select the response that best describes
your level of experience. You may only select one response. If you feel that
your experience exceeds all of the descriptions, choose the description that is
the closest to the level of experience that you possess. If you are unsure as to
whether or not you participated in an internship that was accredited by the APA,
please reference http://www.apa.org/ed/accreditation/programs/index.aspx for a
list of internships that have been accredited by the APA.

3. Select the response that best describes your level of experience.

A. I possess the equivalent of at least one year of postdoctoral experience
equivalent in level and difficulty to a GS-12 in the Federal Service. Practice
at the GS-12 level includes diagnosing mental disorders, conducting
psychological and/or neuropsychological assessments, treating mental disorders
through a variety of modalities, and providing adjunctive interventions for
treatment of medical disorders.
B. I do not possess the experience described in A above.

Psychologists are required to hold a full, current, and
unrestricted license to practice psychology at the doctoral level in a State,
Territory, Commonwealth of the United States (e.g., Puerto Rico), or the
District of Columbia. This requirement may be waived for a period not to exceed
2 years from the date of employment, on the condition that such a psychologist
provide care only under the supervision of a psychologist who is so licensed.
Non-licensed psychologists who otherwise meet the eligibility requirements may
be given a temporary appointment as a graduate psychologist. Failure to obtain
licensure during that period is justification for termination of the
appointment. The following item is for informational purposes only - you will
not be screened in or out of the selection process on the basis of your response
to this item.

4. Do you hold a full, current, and unrestricted license to practice psychology
at the doctoral level in a State, Territory, Commonwealth of the United States
(e.g., Puerto Rico), or the District of Columbia?

A. Yes
B. No

For each task in the following group, choose the statement from
the list below that best describes your experience and/or training. Darken the
oval corresponding to that statement in Section 25 of the Qualifications and
Availability Form C. Please select only one letter for each item.

A- I have not had education, training or experience in performing this task.
B- I have had education or training in performing the task, but have not yet
performed it on the job.
C- I have performed this task on the job. My work on this task was monitored
closely by a supervisor or senior employee to ensure compliance with proper
procedures.
D- I have performed this task as a regular part of a job. I have performed it
independently and normally without review by a supervisor or senior employee.
E- I am considered an expert in performing this task. I have supervised
performance of this task or am normally the person who is consulted by other
workers to assist them in doing this task because of my expertise.

5. Knowledge of, and ability to apply, a wide range of professional
psychological theories and assessment methods to a variety of patient
populations.

6. Ability to develop coherent treatment strategies.

7. Ability to incorporate new clinical procedures.

8. Identify psychological diagnostic tests and other procedures to assess the
behavioral, emotional, functional, or psychological condition of patients.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

9. Administer psychological diagnostic tests and other procedures to assess the
emotional, functional, or psychological condition of patients.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

10. Interpret the results of psychological diagnostic tests and assessments to
develop patient treatment plans.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

11. Diagnose mental disorders using information collected from the
administration of psychological assessments.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

Responses to the items in the following sections will be used to
clarify your training, experience and demonstrated capability in performing
duties related to the Psychologist position. The questions in the following
sections are for informational purposes only - you will not be screened in or
out of the selection process on the basis of your responses in these sections.
For each of the items below, select the ONE statement that BEST describes your
training and experience using the scale provided. In determining which option
best reflects your own experience and demonstrated capability, consider your
past experiences such as paid work, educational pursuits, volunteer service,
professional organization membership, task forces, or committees. When answering
each question, remember that your experience and education are subject to
verification.

12. Propose an action plan with recommendations to address clinical, research,
or organizational problems.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

13. Evaluate input and feedback from team members to facilitate collaborative
decision making.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

14. Identify and evaluate the potential impact and consequences of alternatives
in making clinical, administrative, or organizational decisions.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

The next three questions refer to "customers." Customers are
defined as clients, colleagues, or any individuals to whom services are
provided.

15. Assess customer satisfaction to identify methods to improve services.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

16. Implement recommendations to improve the quality of services delivered to
customers.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

17. Explain psychological assessment results, interventions, or outcomes to
customers to ensure understanding.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

18. Plan clinical treatment for individual patients based on psychological
assessment data.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

19. Plan psychological intervention strategies as part of a multidisciplinary
team.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

20. Provide comprehensive, evidence-based psychotherapeutic interventions,
including individual, family, and group psychotherapy to meet the needs of
patients.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

21. Develop comprehensive, customized psychological or behavioral health
treatment plans for patients with complicating factors (e.g., physical
disabilities, lack of support or resources).

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

22. Develop new and unique treatment plans to meet the needs of patients that
have made minimal progress in prior treatment programs.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

23. Recommend newly proven or experimental psychological or behavioral health
treatment when a clinically sound and professional argument can be made.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

24. Evaluate effectiveness of psychological or behavioral health treatment
strategies to adjust practices as necessary.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.

25. Supervise and manage an interdisciplinary team.

A. I do not have experience, demonstrated capability, or training in performing
this activity, but I am willing to learn.
B. I have limited experience and limited demonstrated capability in performing
this activity. I have had exposure to this activity but would require additional
guidance, instruction, or experience to perform it at a satisfactory level.
C. I have a fair amount of experience and a fair amount of demonstrated
capability in performing this activity. I have performed this activity
satisfactorily but could benefit from additional guidance, instruction, or
experience to perform this activity more effectively.
D. I have considerable experience and considerable demonstrated capability in
performing this activity. I have performed this activity independently and
normally without review by a supervisor or senior employee.
E. I have extensive experience and extensive demonstrated capability in
performing this activity. I am considered an expert; I am able to train or
assist others; and I have reviewed and/or evaluated the work of others
performing this activity.




For each task in the following group, choose response below that
best describes your experience and/or training. Darken the oval corresponding to
that statement in Section 25 of the Qualifications and Availability Form C.
Please select only one letter for each item.

A- Yes.
B- No.

26. Do you have a master's degree in social work (MSW),from a school of social work fully accredited by the Council on Social Work Education (CSWE)? TRANSCRIPTS ARE REQUIRED. Graduates of schools of social work that are in candidacy status do not meet
this requirement until the school of social work is fully accredited. A doctoral degree in social work may not be substituted for the master's degree in social work.

27. Are you licensed or certified at the Master's level to independently
practice social work in a state?

28. Do you have at least 1 year of experience equivalent to a GS-12 level in a clinical setting?

A. Yes.
B. No.

For each task in the following group, choose the statement from
the list below that best describes your experience and/or training. Darken the
oval corresponding to that statement in Section 25 of the Qualifications and
Availability Form C. Please select only one letter for each item.

A- I have not had education, training or experience in performing this task.
B- I have had education or training in performing the task, but have not yet
performed it on the job.
C- I have performed this task on the job. My work on this task was monitored
closely by a supervisor or senior employee to ensure compliance with proper
procedures.
D- I have performed this task as a regular part of a job. I have performed it
independently and normally without review by a supervisor or senior employee.
E- I am considered an expert in performing this task. I have supervised
performance of this task or am normally the person who is consulted by other
workers to assist them in doing this task because of my expertise.

29. Ability to independently organize work, set priorities, and meet multiple
deadlines.

30. Knowledge and skill in management/administration, which includes
supervision, consultation, negotiation, and monitoring.

31. Ability to ensure provision of clinical social work services by supervised
social workers.

32. Ability to provide administrative supervision and clinical supervision,
including supervision for social work licensure.

For each task in the following group, choose response below that
best describes your experience and/or training. Darken the oval corresponding to
that statement in Section 25 of the Qualifications and Availability Form C.
Please select only one letter for each item.

A- Yes.
B- No.

33. I possess a bachelor's degree (RN applicants) or a master's degree (ARNP applicants) from a program accredited by the NLNAC or CCNE.
TRANSCRIPTS ARE REQUIRED

34. I possess a current, full, active and unrestricted registration as a nurse or nurse practitioner
in a State, Territory, or Commonwealth (i.e., Puerto Rico) of the
United States or in the District of Columbia.

In accordance with 38 U.S.C. 7402(d), no person shall serve in
direct patient care positions unless they are proficient in basic written and
spoken English. You must be proficient in basic written English in order to
perform the duties of this position.

35. Are you proficient in basic written and spoken English?

A. Yes
B. No

36. Are you a U.S. Citizen or U.S. Naturalized Citizen?

A. Yes
B. No

The following question pertains to your degree of doctor or
medicine or its equivalent degree resulting from a course of education in
medicine or osteopathic medicine.

37. Have you been awarded a degree of Doctor of Medicine or Osteopathic Medicine
obtained from one of the schools approved by the Secretary of Veterans Affairs
for the year in which the course of study was completed?

A. Yes
B. No

The following question pertains to your licensure and/or
registration.

38. Do you hold a current full and unrestricted license to practice medicine or
surgery in a State, Territory, or Commonwealth of the United States, or in the
District of Columbia.

A. Yes
B. No

39. Are you board certified in Psychiatry?

A. Yes
B. No

This position is Supervisory, candidates must have demonstrated in
their work experience or training that they possess, or have the potential to
develop, the qualities of successful super-vision, as listed under the
appropriate category below.

For each task in the following group, choose the statement from
the list below that best describes your experience and/or training. Darken the
oval corresponding to that statement in Section 25 of the Qualifications and
Availability Form C. Please select only one letter for each item.

A- I have not had education, training or experience in performing this task.
B- I have had education or training in performing the task, but have not yet
performed it on the job.
C- I have performed this task on the job. My work on this task was monitored
closely by a supervisor or senior employee to ensure compliance with proper
procedures.
D- I have performed this task as a regular part of a job. I have performed it
independently and normally without review by a supervisor or senior employee.
E- I am considered an expert in performing this task. I have supervised
performance of this task or am normally the person who is consulted by other
workers to assist them in doing this task because of my expertise.

40. Experience in assigning and reviewing work of subordinates, train and work
effectively with subordinates from a variety of backgrounds and with different
levels/areas of training.

41. Accomplish the quality and quantity of work expected within set limits of cost
and time.

42. Knowedge and ability to plan own work and carry out assignments effectively.

43. Knowledge and experience in communicating with others effectively in writing in
working out solutions to problems or questions relating to the work.

44. Knowledge and experience communicating with others effectively orally in working
out solutions to problems or questions relating to the work.

45. Knowledge to understand and further management goals as these affect day-to-day
work operations.

46. Experience in developing improvements in or designing new work methods and
procedures.

Certification of Understanding- Select the appropriate answer to
the statement below. Failure to provide an answer will result in your not being
considered for this position.

47. I certify that, to the best of my knowledge and belief, all of the
information included in this questionnaire is true, correct, and provided in
good faith. I understand if I make an intentional false statement, or commit
deception or fraud in this application and its supporting materials, or in any
document or interview associated with the examination process, I may be fined or
imprisoned (18 U.S.C. 1001); my eligibilities may be cancelled; I may be denied
an appointment; or I may be removed and debarred from Federal Service (5 C.F.R.
part 731). I understand any information I give may be investigated and
responding "No" or providing no response to this item will result in my not
being considered for this position.

A. Yes, I understand the information provided above and certify the information
provided in this questionnaire is true, correct, and provided in good faith.
B. No, I do not certify this information and do not wish to be considered for
this position.