The substantial majority of the more than 2 million employees of the executive branch of the federal government are employed under a common set of personnel laws contained in title 5 of the United States Code. To a degree unprecedented in their history, these laws and the voluminous rules and regulations which flow from them are accused of being outdated or inadequate to the human resource challenges facing the government today. However, in a few federal agencies, some or all of their employees are employed under a completely different set of personnel laws, rules, and regulations. While the historical reasons for establishing these alternate personnel systems vary, each system offers an opportunity to examine how its alternate rules and methods meet the human resources needs of its agency and whether adoption of these rules and methods in the title 5 system would be desirable. Accordingly, this report examines the operation of a personnel system covering approximately 75,000 health care workers in the Veterans Health Services and Research Administration of the Department of Veterans Affairs. This latter system is referred to in this report as the "Title 38" system after the title in the United States Code where its legal basis is found. (Author)