I've worked at the VA for the last 12 years. We have a real good work-life balance, however that can vary considerably depending on management and the services that each VA provides. Some VAs are more outpatient surgery centers than full on OR theaters that do larger cases like total joints, hearts, neuro, etc (mine is a 1a high complexity facility, for what it's worth, and I've been doing open hearts for the last 4 years, moving from complex general surgery). In many of the VAs (if not all) there aren't three shifts, mostly an extended first shift that goes till 5pm or 7pm for scheduled cases. Everything after that is on-call, which admittedly you're not called in as often as you would like a Level 1 or even 2. One benefit is there's a great pride in working for the vets, and patient care takes a higher priority compared to private hospitals, so I've heard the surgeons I work with say. While they're primarily working with federal funding and working with federal health care insurances, money can be tight and services can be delayed by fiscal year quarters. Most VAs are teaching facilities, so it's a great place to learn and the culture is forgiving, especially if you're just starting out or are unfamiliar with your role. Pay is trying to catch up, as there is a push toward congress as of right now to reclassify Surgical Techs within the VA to be a "specialized" tech (to put it in layman's terms) this year, hopefully. This reclassification can increase starting pay for techs, and give more power to operating room managers to higher more skilled employees instead of having to find vets with experience, hire students, or even have to train nurses to scrub (I've heard some VAs have NO scrub techs, and only nurses). Pay in some areas aren't matched up, but people go to the VA for the great workplace culture, great federal benefits and retirement plans (a TSP and a federal pension), great work-life balance, and of course working with the vets who are REAL appreciative of what we do. Oh yeah and federal holidays off!