Pharmacy residency PGY1 rotation descriptions

The Acute Care I and II rotations are required learning experiences for the pharmacy practice resident. During each month-long experience, the resident will participate in the provision of pharmaceutical care to acute care patients who have been admitted to one of the internal medicine wards at the Little Rock campus. For Acute Care I, the resident will be assigned to a teaching team, consisting of medical students, medical residents, an attending physician as well as other interdisciplinary team members.  For Acute Care II, the resident is assigned to a Hospitalist team, where more independence is the expectation.  The rotation is designed to allow the resident the opportunity to apply basic pharmacy-related concepts to patient care as a member of a multi-disciplinary health care team. The resident is responsible for identifying, preventing, and resolving medication therapy issues for patients and serving as a drug information resource for the team. This will include, but is not limited to, developing pharmaceutical care plans for patients with complicated medical histories and patients on high-risk medications, performing pharmacokinetic and pharmacodynamic assessments, screening medications for appropriate dosing, and proactively identifying drug interactions. The resident will create therapeutic regimens for individual patients, utilizing the system’s formulary when possible. The resident should be proactively involved in the medication use process. This includes assisting nursing service with medication-related issues and working to promptly solve problems that impede the appropriate delivery of medications to optimize outcomes. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident will be expected to communicate their findings and recommendations to the appropriate clinician(s). The resident may also be responsible for day-to-day supervision of pharmacy students in conjunction with the preceptor.

Acute Care III is a specialized area of acute care.  The resident may be assigned to the Medical Intensive Care Unit, Surgical Intensive Care Unit, Acute Care Cardiology, or the Emergency Department. PGY1 Residents must complete a minimum of Acute Care 1 and Preferably Acute Care II prior to completing an Acute Care III experiences.  Acute Care III experience will preferably be scheduled in the second half of the residency year.  Some exceptions may be considered. Clinical Pharmacy Specialists in these areas are highly trained and are responsible for ensuring safe and effective medication use for all patients admitted to the team or area. 

The PGY1 Resident will be required complete a geriatrics-focused rotation. The month-long experience involves the provision of direct patient care for patients admitted to the Geriatric Evaluation and Management Unit, Home-Based Primary Care Service, or the Community Living Center. The pharmacy practice resident will work in a clinical setting and interact with all team members including physicians, APNs, nurses, social workers, dieticians, patients and caregivers. This rotation is designed to allow the resident to gain independence as the pharmacist member of a multidisciplinary healthcare team, as well as improve literature retrieval skills and communication with other healthcare professionals. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team.

Residents will actively participate in discovering drug-induced problems, adjusting dosages when necessary, counseling patients on medications when appropriate, and making sure the patient is on the optimal drug regimen for each condition or disease state. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for supervision of a senior pharmacy student in conjunction with the preceptor.

The CAVHS Primary Care rotation is an ambulatory care concentrated learning experience that provides the PGY1 resident with direct patient care experience in the Patient Aligned Care Team (PACT) Clinic.

The PACT Clinic is an outpatient clinic that is comprised of a multidisciplinary healthcare team including physicians, APNs, pharmacists, nurses, dietitians, and social workers. The PACT Clinic is designed to provide patient-centered care while reducing health risks and improving clinical outcomes in chronic disease states. During this learning experience, the resident’s responsibilities include, but are not limited to: providing counseling, interpreting and evaluating laboratory values and procedural results, developing therapeutic regimens and monitoring plans for patients, identifying medication-related problems/errors and devising a plan to assure proper follow up is made, performing medication reconciliation, processing and editing prescriptions, documenting clinic encounters using SOAP notes, serving as a drug information resource for the team, and reviewing and completing restricted/non- formulary medication consults.  While this rotation is team-based, it is designed to encourage the resident to work independently. The resident may also be responsible for supervision of a senior pharmacy student in conjunction with the preceptor.

The CAVHS Medication Management rotation is an ambulatory care concentrated learning experience that provides the PGY1 resident with direct patient care experience in the Medication Management Clinic. The Medication Management Clinic is a pharmacist-run clinic created to closely monitor the therapy of anticoagulated patients. Residents are required to attend a specialty anticoagulation didactic training program and successfully pass an anticoagulation exam. During this learning experience, the resident’s responsibilities include, but are not limited to: providing patient counseling face to face or via telephone, interpreting and evaluating laboratory values and managing anticoagulant dosing, medication-related problems/errors and devising a plan to assure proper follow up is made, processing and editing prescriptions, documenting clinic encounters using SOAP notes, and reviewing and completing restricted/non-formulary medication consults. While this rotation is team-based, it is designed to encourage the resident to work independently. Lastly, the resident may also be responsible for supervision of a senior pharmacy student in conjunction with the preceptor.

The Administration rotation provides the PGY1 resident an introduction to the general administrative skills necessary to lead a complex tertiary care center with extensive inpatient, outpatient, and clinical pharmacy services.  The pharmacy resident will become familiar with policy development and review, organization and department structure, management techniques, human resources, economic rationale and problem solving, strategic planning, departmental performance improvement efforts, quality and safety practices, information systems and budgeting. The rotation will also provide the resident with insight into key issues confronting pharmacy practice, specifically from the VISN Executive's or Pharmacy Chief/Associate Pharmacy Chief's perspective.

During the residency year, the resident and will be responsible for staffing in pharmacy operations areas on a rotating basis on weekends. The resident will gain experience in all aspects of medication dispensing. He/She will be directly responsible for all aspects of professional involvement and oversight of dispensing medications, security of medications, extemporaneous compounding, parenteral product preparation, quality control, and procurement activities. The resident will be involved in patient counseling, providing drug information to providers, and supervising support staff. The resident will be expected to display professionalism and ethical behavior in their practice and manage time effectively to fulfill all practice responsibilities.

The various committee longitudinal rotations are designed to provide administrative experiences to the resident that may not otherwise be gained during monthly rotations. Residents will gain experience in the Pharmacy and Therapeutics committee, Pharmacy and Nursing subcommittee, and Formulary Action and Compliance Team.  The resident is expected to function fully as a contributing member of the committee, although voting privileges may not be granted. Involvement in these interdisciplinary committees provides the opportunity for residents to establish relationships with other members of the healthcare team.  In addition, the resident should better understand the medication use system and the role that each healthcare provider plays in its successful and safe utilization. Through involvement in the committee, the resident will be responsible for preparation of meeting agendas and minutes, and assist in any ongoing committee projects.

The Drug Information rotation is a longitudinal experience that will expose the resident to the role of the pharmacist as a drug information resource for all health care providers. The rotation is designed to allow the resident the opportunity to improve drug information retrieval skills using state of the art databases, to develop critical thinking skills, and appropriate interpretation of evidence based literature. Additionally, the resident will gain experience in formulation of responses and effective communication to health care professionals. The experience is designed to apply drug information retrieval skills to lifelong learning. The purpose is to assist all professionals at CAVHS in pursuing safe, appropriate and cost-effective drug therapy, while resolving medication related issues, thus improving patient outcomes. As part of the drug information experience, residents will participate in monthly pharmacy journal club presentations and lead bi-weekly topic discussions for fourth year pharmacy students.

Therapeutics recitation is a longitudinal teaching experience in which the resident is responsible for leading a group of approximately 15 to 20 second or third year pharmacy students from University of Arkansas for Medical Sciences College of Pharmacy. The resident facilitates the learning experience of these students through direct teaching as well as student-led patient case presentations. The resident is responsible for evaluating student performance. The resident performance is evaluated through observation by experienced faculty as well as student evaluations.