Pharmacy Residency Program

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*time is the minimum requirement and may be increased if objectives are not met

Key for footnotes for table below:

​1 Time is the minimum requirement and may be increased if objectives are not met.  

​^ If PGY1 completed at LVAHCS, orientation will be reduced to 3 days  

​* Preceptors may opt to cover all minor holidays to recuse the resident from the minor holiday requirement. This will be clearly communicated to the resident at the beginning of the residency year. 

For entry into any Lexington VA Health Care System pharmacy residency program, the resident must have an unrestricted pharmacy license OR be eligible for pharmacy licensure in any state or US territory. It is strongly encouraged for residents to obtain pharmacist licensure prior to the beginning of the residency program as their orientation period may be hindered otherwise. If pharmacist licensure is not available, pharmacy intern license is sufficient in the interim for PGY1 residents but must be currently valid from the state in which it was issued for the duration of time in which the resident is not licensed. 

During this time, all pharmacist activities will require direct supervision until proof of pharmacist licensure is provided. Pharmacy residents are required to be licensed for a minimum of two-thirds of their residency program. If the resident has not obtained his/her pharmacist license prior to the beginning of residency, they should have all applicable examinations scheduled within the first 30 days of residency start date. Per ASHP requirements, residents must be fully licensed within 120 days of the residency start date. Failure to meet the 120-day requirement will result in dismissal from the program. The resident is responsible for presenting a copy of their pharmacy license to their RPD within the specified timeframe.

Failure to maintain professional pharmacist licensure during the residency program can result in a pharmacy resident being placed on probation, dismissed, or voluntarily withdrawn from the residency program (see Pharmacy Resident Dismissal Procedure/Termination of Residency). 

If completing any clinical learning experience outside of VAHCS (i.e. PGY1 electives, PGY2 required), the resident will be required to obtain pharmacist license from the state of Kentucky and provide proof prior to participation in the learning experience. 

Verification of PGY1 Residency Completion (PGY2 only)

For all PGY2 residency programs, the resident must provide proof of completing a PGY1 ASHP accredited or accreditation pending residency within 14 days of starting the PGY2 program. The resident will be required to submit a copy of their PGY1 certificate which will be added to resident’s file. The PGY2 residency program director may also contact the resident’s PGY1 program director or review their graduate tracking in PharmAcademic™ for confirmation and this will be added to resident’s file. If it is determined that a PGY2 resident did not complete their PGY1 program or if documentation is not available, the resident will be dismissed from the program.

Reference:

VHA Directive 1108.07

The purpose of this policy is to ensure that pharmacy residents of Lexington VA Health Care System are provided with a sound training program that is balanced with concerns for patients’ safety and residents’ well-being. This policy reflects the American Society for Health-System Pharmacists (ASHP) requirements for resident duty hours to support the physical and emotional well-being of all residents while promoting an educational environment that promotes patient care (Duty- Hour Policy (ashp.org)

Definitions

Duty hours: All hours spent on scheduled clinical and academic activities, regardless of setting, related to the pharmacy residency program that are required to meet the educational goals and objectives of the program.

Duty hours include: inpatient and outpatient patient care (resident providing care within a facility, a patient’s home, or from the resident’s home when activities are assigned to be completed virtually); staffing/service commitment; in-house call; administrative duties; work from home activities (i.e. taking calls from home and utilizing electronic health record related to at home call program); and scheduled and assigned activities such as conferences, committee meetings, classroom time associated with required teaching activities and health and wellness events that are required to meet the goals and objectives of the residency program.

Duty hours do not include reading, studying, and academic preparation time (e.g., presentations, journal clubs, closing knowledge gaps); travel time to and from conferences and hours that are not scheduled by the residency program director or a preceptor.

Attendance

The residency is a full-time temporary appointment of 52-weeks in duration. The resident will have a scheduled tour of duty which consists of a minimum of 5 working days to represent at least 40 hours per week to perform activities related to the residency as necessary to meet the goals and objectives of the program. In order to receive a residency certificate, time away from the program may not exceed 37 scheduled workdays per 52-week appointment. This includes annual leave, sick leave, holidays, interview days, and extended leave. A resident cannot have more than 37 days off the normal tour of duty over the 52-week appointment without requiring a program extension.

Prompt arrival and attendance is required at all clinics, conferences, meetings, rounds and other scheduled activities during each learning experience throughout the term of the residency. In the event of an absence, the program director and current learning experience preceptor must be notified and grant approval, and procedures for leave must be followed. At times, the resident will be expected to attend other residency-related conferences or experiences off site during regular working hours. The resident will be scheduled for learning experiences and staffing assignments and is expected in the locations as scheduled.

Unexcused absences and/or tardiness will not be tolerated and can be a basis for failure of the learning experience involved. Repeated events could be the basis for termination from the program (Refer to Dismissal Policy). It is the responsibility of the resident to contact the immediate preceptor and/or the residency program director as soon as is practical to report unavoidable absences or tardiness.

Holidays

There are 11 Federal holidays. PGY1 residents will be required to work 2 holidays (1 major (ex. Thanksgiving, Christmas, New Year's Day) and one minor (all other holidays) and will be granted the remaining holidays. PGY2 residents are not required to work holidays.

Annual Leave (AL)

AL is earned at the rate of 4 hours per pay period (higher accrual rates may apply for prior federal employment subject to HR guidance). Annual leave can be used for rest, relaxation, recreation, as well as time off for personal business. It may be used only after it has been earned; advanced leave is not permitted. Leave must be requested in advance, preferably 2 weeks, and approved before being taken. Per VHA Directive 1231, residents with scheduled patient panels MUST request annual leave at least 45 days in advance for appropriate clinic cancellations. Residents may not be on annual leave on the last day of the residency. Timing of requests and impact on learning experiences and completion of goals/objectives will be considered when approving/denying requests. If a resident is expected to miss more than 20% of a required learning experience due to an approved leave, the learning experience will be extended. Request for annual leave is carried out by completing a leave request in Government Time and Attendance (GovTA) after approval by the immediate preceptor of the learning experience you are assigned, as well as the residency program director. Residents are encouraged to use their annual leave prior to the end of the residency. 

Residents are expected to be at their workstation ready to begin work at the beginning of their scheduled tour. Annual leave may be requested in intervals of 15 minutes and must be used to account for tardiness if more than 7 minutes late for duty.

Sick Leave (SL)

SL is earned at the rate of 4 hours per pay period. Sick leave can be used for illness and injury as well as medical, dental, optical, and other medically related appointments or procedures. Per VHA Directive 1231, residents with scheduled patient panels MUST request scheduled sick leave at least 45 days in advance for appropriate clinic cancellations. Unscheduled sick leave must be reported as soon as you determine you will not be able to come to work and preferably at or prior to the beginning of your scheduled tour of duty, but in any event, not later than 2 hours thereafter. It is the resident's responsibility to directly notify the immediate preceptor of their learning experience and the residency program director of the absence. Sick leave must be entered in GovTA prior to use (ex. scheduled medical or dental appointment) OR immediately upon returning to work following an unscheduled leave. The resident must call in sick for each consecutive day of illness unless otherwise instructed by pharmacy administration.

If more than 3 consecutive workdays of sick leave are used, a medical certification attesting to the need for sick leave may be requested. Residents cannot miss more than 20% of any one required learning experience (due to annual, sick or authorized leave) and need to plan accordingly). Excessive use of SL could negatively affect performance and the achievement of the goals of the residency. If extended sick or family leave is necessary, refer below to Extended Leave section.

Care and Bereavement/Family Leave

May be used for family care (i.e., medical care for immediate family member), adoption-related purposes, or bereavement for an immediate family member or individual with relationship equivalent to an immediate family member. Care and bereavement/Family leave should be requested in advance, if possible, and the hours used are subtracted from the resident’s accrued sick leave hours.

Authorized Absence (leave with pay)

Professional leave may be requested through the Residency Program Director (RPD) who will direct the resident of the procedure for the specific request. Following approval, the resident can enter a request for “LN” in GovTA.

Extended Leave

The residency year is 52-weeks in duration. The program is incomplete unless the time and all requirements for completion are met. Per the ASHP Standards, an extension of the program would be required to complete the program if a resident exceeds 37 days away from the program for any reason. (See ASHP-Accreditation-Standard-for-Postgraduate-Residency-Programs.pdf pages 5-6). A program extension will be equivalent in competencies and number of days missed.

Opportunity to extend the program with pay will depend on the decision of the National Director of Residency Programs and Education. The RPD will also inform the Chief of Pharmacy of the potential extension. If extended leave is granted, a resident must use all earned leave prior to going on leave without pay (LWOP). LWOP would be in effect until the resident returned to the program. Health insurance benefits will be continued during LWOP, however, upon return to the program, resident will be expected to repay all employee-share premiums. 

With an approved extension of the residency program, completion of all requirements of the residency and the number of days that exceeded the allotted leave must be accomplished within 1 year of the initially scheduled completion date (the date planned for completion if there had not been a need for extended leave). Therefore, the maximum time for LWOP would be 1 year. 

For military leave, Veterans who are called to active duty may request an exemption from the National Director of Residency Programs and Education for the requirement to complete the 52 weeks within 1 year of the initially scheduled date of completion.

Such exemption will be considered on an individual basis in collaboration with the local Residency Program Director if the Veteran has been on active duty/military leave for the time of absence from the residency program. 

If a resident is called for jury duty, he/she is requested to ask for a waiver, however, if waiver is not granted or if the resident chooses to serve on jury duty, this time must be accounted in their maximum of 37 days away from the program and subject to a program extension as described above.

Absent without Leave (AWOL)

Status will be assigned to residents for failure to request appropriate leave for absences during their scheduled tour, at the discretion of the Chief of Pharmacy. Repeated instances of AWOL will result in disciplinary action up to dismissal from residency program.

References

VA Handbook 5011 

VHA Dir 1231, Outpatient Clinic Practice Management (navao.org)

eCFR :: 5 CFR Part 890 -- Federal Employees Health Benefits Program

“My residency experience at the Lexington VA has been nothing short of excellent. The program focuses on creating well rounded clinical pharmacists through a variety of learning experiences, projects, and staffing opportunities. I appreciated how every preceptor, technician, and even other non-pharmacy healthcare professionals were dedicated to my learning and supportive of my personal and professional development. Throughout my time here I have experienced tons of growth in both my professional knowledge and confidence. For all these reasons I chose to continue my professional training with a PGY2 in ambulatory care. I look forward to the experiences and development I will undoubtedly experience in the coming year!” --Brianna Rahman

“During my time as a PGY1 pharmacy resident at the Lexington VA, I have continued to grow as a well-rounded health care professional because of the supportive environment provided by my preceptors. I appreciate the focus on interdisciplinary collaboration and its commitment to serving the veteran population. I look forward to continuing my training here as a PGY2.”-– Grace Martini

My PGY1 pharmacy residency program at the VA was an invaluable experience that provided me with a solid foundation in clinical pharmacy practice. I had the opportunity to work alongside dedicated healthcare professionals, gaining hands-on experience in various areas such as medication therapy management, medication reconciliation, antimicrobial stewardship, and engaging in comprehensive medication reviews and developing personalized care plans. The program's emphasis on evidence-based medicine and veteran-centered care has greatly enhanced my clinical skills and prepared me to deliver high-quality care to our nation's veterans. Additionally, the mentorship I received from experienced pharmacists during the program was instrumental in shaping my career and instilling a passion for lifelong learning and professional growth. Witnessing the strong role of pharmacists within the VA healthcare system, where they practice at the top of their licenses, further inspired me to pursue excellence in the field. It is an honor to extend my training through the PGY2 program at the Lexington VA. --ALI KHALAF

My time as a resident at the Lexington VA-HCS has fostered so much growth, both professional and personal. I am confident that my experiences here have prepared me to be an independent and effective practitioner moving forward. The PGY2 Ambulatory Care Program is extremely comprehensive, allowing residents to develop and implement their own approach to patient care in an independent setting, while also offering support from preceptors in all different areas of practice. I am so thankful for my time here as a PGY1 and for the opportunity to continue on as a PGY2, as well as for all of the relationships that have been built along the way! --KENDALL STRATTON

My experience as a PGY1 pharmacy resident at the Lexington VA Health Care System has made a significant impact on my journey toward becoming a more proficient and empathetic pharmacist. The invaluable training I received at the Lexington VAHCS has instilled in me the confidence to step into a clinical position and function independently as a pharmacist. Additionally, I am thankful for the connections I’ve formed while collaborating with my co-residents, mentors, and preceptors. These relationships have been vital to my growth and development, and I am truly grateful for their guidance and support. --GARRETT FANNIN

The experiences I was able to obtain at the Lexington VA during my PGY1 and PGY2 psychiatric pharmacy residency allowed me to grow exponentially as an independent clinical practitioner. My growth was fostered through an ability to work independently at the top of my license in managing complex medical conditions paired with support, guidance, and formal/informal mentorship from preceptors amongst all residency programs offered at the Lexington VAHCS. Additionally, preceptors and mentors went above and beyond to ensure my learning experiences were tailored to my interests and career aspirations. I am confident that the knowledge and growth I obtained from my experiences at the Lexington VAHCS will allow me to easily transition into my first role as a clinical practitioner in mental health following completion of the residency year. --KAITYLN (KATIE) LAHNA 

The Lexington VA has helped me evolve as a pharmacist by providing many diverse experiences in both the outpatient and inpatient setting. Throughout my PGY1 and PGY2 years, I had wonderful preceptors coaching me to become the confident clinician that I am today. I will always cherish my time at the Lexington VA and the opportunities it has afforded me! --MARY KATE KERBLER

During my time in residency at the Lexington VAHCS, I have experienced great professional and personal growth. One of the most rewarding aspects has been the autonomy granted, allowing me to make critical decisions and take ownership of out patients’ care. Our program’s comprehensive and challenging natures has pushed me to expand my knowledge and skills beyond my comfort zone, ultimately shaping me into a well-rounded professional ready to excel. I will be forever grateful for the experiences gained and relationships built as a PGY1 and PGY2 pharmacy resident at the Lexington VAHCS. --ALYSON MATHIS

The Lexington VA Pharmacy Residency Program is highly regarded for its commitment to excellence in training future pharmacists. It offers a supportive learning environment, ample opportunities for professional growth, and a focus on providing exceptional patient care. --NEA’ JACKSON

Davis K, Kaucher A, Scheerenberger, Bowden J, DeJarnett, Fannin G, Mitchell, A, Johnson M, Bennett J. Outcomes in patients with untreated versus treated asymptomatic bacteriuria within five Veterans Affairs facilities. Infect Control Hosp Epidemiol. 2025 Sep 15:1-3. doi: 10.1017/ice.2025.10255. Online ahead of print.

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Mathis A, Lane M, Reid JM. Risk of Urinary Tract Infections in Male Veterans With Diabetes Prescribed Sodium-Glucose Cotransporter-2 Inhibitors Versus Sulfonylureas Across the Veterans Health Administration. J Pharm Pract. Published online October 21, 2024. doi:10.1177/089-719-00241292692

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Kerbler MK, Isaacs C, Eatmon C, Reid J, Davis KW. Impact of an HIV pre-exposure prophylaxis dashboard on veteran PrEP enrollment. J Am Pharm Assoc (2003). 2024 Mar-Apr;64(2):471-475. doi: 10.1016/j.japh.2024.01.002. Epub 2024 Jan 10. PMID: 38215824.

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Wilhite K, Reid JM, Isaacs C, Lane M. Analysis of drug-induced pancreatitis reports within the United States Food and Drug Administration and Veterans Health Administration Drug Event Reporting Systems. jpadr [Internet]. 2023Dec.1 [cited 2024May7];4(4):9-15. Available from: https://www.jpadr.com/index.php/jpadr/article/view/150

Nelson MW, Downs TN, Puglisi GM, Simpkins BA, Collier AS. Use of a Deprescribing Tool in an Interdisciplinary Primary-Care Patient-Aligned Care Team. Sr Care Pharm. 2022 Jan 1;37(1):34-43. doi: 10.4140/TCP.n.2022.34. PMID: 34953511.

Whitehead WJ, Reid JM. Underreported Risk of Lisinopril-Induced Angioedema in a Veteran Population. Ann Pharmacother. 2022 Apr;56(4):430-435. doi: 10.1177/106-002-80211032404. Epub 2021 Jul 20. PMID: 34282637.

Hellman MD, Davis KW, Hackworth B, Evans ME. Implementing a postdischarge methicillin-resistant Staphylococcus aureus decolonization protocol within a Veterans Affairs Health Care System facility. Infect Control Hosp Epidemiol. 2022 Sep;43(9):1276-1277. doi: 10.1017/ice.2021.225. Epub 2021 May 24. PMID: 34027838.

Moody BL, Eatmon CV. Perceived Barriers and Facilitators of Clozapine Use: A National Survey of Veterans Affairs Prescribers. Fed Pract. 2019 Oct;36(Suppl 6):S22-S27. PMID: 31772495; PMCID: PMC6876424.

Banaszynski M, Truong T, Embree H, Cullen G, Zhu M, Houranieh J, Dahl BJ, New JL, Harris BA, Crawford BS. A Multi - Center Retrospective Study Evaluating Palliative Antineoplastic Therapy Administered and Medication De-escalation in Veteran Cancer Patients Toward the End - of - Life. Federal Practitioner. 2020.

Ammerman CA, Simpkins BA, Warman N, Downs TN. Potentially Inappropriate Medications in Older Adults: Deprescribing with a Clinical Pharmacist. J Am Geriatr Soc. 2019 Jan;67(1):115-118. 

Albers R, Downs T, Lane M. Effect of high-dose ergocalciferol on rate of falls in a community-dwelling, home-based primary care, Veteran population: a case-crossover study. Fed Pract. 2018 Jun;35(6):32-36.

Wahking RA, Steele RL, Hanners RE, Lockwood SM, Davis KW. Outcomes From a Pharmacist - led Proton Pump Inhibitor Stewardship Program at a Single Institution. Hosp Pharm. 2018 Feb;53(1):59-67. doi: 10.1177/001-857-8717747192. Epub 2017 Dec 13. PMID: 29434389; PMCID: PMC5805020.

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Simpkins RC, Downs TN, Lane MT. FRAX Prediction With and Without Bone Mineral Density Testing. Fed Pract. 2017 May;34(5):40-43. PMID: 30766280; PMCID: PMC6370431.

Palladino CE, Eberly ME, Emmons JT, Tannock LR. Management of U-500 insulin users during inpatient admissions within a Veterans Affairs Medical Center. Diabetes Res Clin Pract. 2016 Apr;114:32-6. doi: 10.1016/j.diabres.2016.02.004. Epub 2016 Feb 16. PMID: 27103366.

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Eberly ME, Lockwood AG, Lockwood S, Davis KW. Outcomes After Implementation of an Alcohol Withdrawal Protocol at a Single Institution. Hosp Pharm. 2016 Oct;51(9):752-758. doi: 10.1310/hpj5109-752. PMID: 27803505; PMCID: PMC5080994.