PGY1 pharmacy residency program

This is a 6-week rotation where the resident will be responsible for managing patient health care needs in the Patient Aligned Care Team (PACT) and Anticoagulation clinics.

The resident will gain proficiency in comprehensive medication management and chronic disease state management through direct patient care experiences. Activities include evaluating drug regimens for efficacy, adherence, and adverse effects, making appropriate adjustments in the medication regimen, and ordering necessary laboratory tests.

This is a 4-week rotation where the resident will participate in adjudicating prior authorization drug requests (PADR), completing a formulary tool-related project, and completing a medication use evaluation. The goal of these projects is to facilitate improvements to the health care system medication use process.

This is a 6-week rotation where the resident will be assigned to one of the three Community Living Centers (CLC). There is also an outpatient clinic component with the Palo Alto Geriatric Research, Education, and Clinical Center (GRECC).

Each CLC and GRECC utilizes an interdisciplinary team approach to the care of its Veterans. Depending on the location, the CLC accommodates long-term care, short stay/rehabilitation, palliative care, hospice care, or respite patients.

Residents will learn to conduct monthly medication reviews and attend weekly geriatric seminars.

The resident will create one Grand Rounds presentation during residency on a topic related to pharmacotherapy or pharmacy practice.

The resident will have an opportunity to sharpen their ability to critically analyze the literature and reach conclusions based on the available literature, presenting their findings, analysis, and conclusions in an audio-visual presentation.

This is a 6-week rotation, and the resident will play an active role in managing patients admitted to the medicine service.

The resident will provide the medicine team with drug information and patient-specific medication recommendations with the goal of improving patient outcomes.

Other activities include participating in daily medical team rounds, monitoring, and performing patient admission interviews and medication reconciliation, re-designing patient medication therapy, reporting adverse drug reactions, pharmacokinetic and anticoagulation monitoring, and discharge medication reconciliation and counseling.

This is a longitudinal rotation throughout the year.

The residents will participate in bimonthly (every two month) leadership discussions regarding pharmacy management. Leadership topics may include leadership philosophy, LEAN, staff management, effective communication, pharmacy budget, accreditations, and more.

Residents may also participate in committee meetings as applicable to their current rotations. Residents will independently complete project/tasks as assigned which may include preparing records and reports, presenting oral and written reports, and developing and completing pharmacy administration projects.

This is a 4-week rotation where the resident will learn the medication-use system and the administrative roles of a medication safety officer. Residents will review external literature to identify improvement opportunities for the medication-use system and present recommendations. Residents may also facilitate improvements and assist with medication safety performance measurement.

This is a longitudinal rotation where residents work under the direct supervision of preceptor(s) on a Pharmacy Service year-long quality improvement project. The resident is responsible for the development, execution, and timely completion of the quality improvement project as well as the completion of deliverables including a presentation, poster, and manuscript.

Residents will present their projects at Western States Conference and GRECC Allied Health Scholars Symposium.

This is a longitudinal rotation consisting of concurrent ambulatory care and inpatient operations service commitments. Assigned hours will vary to meet the needs of the service.

Ambulatory care is a longitudinal experience with a concentration on population management. The resident will be provided with an introduction to performance metrics and a reinforcement of comprehensive medication management skills. Potential population management areas include--but are not limited to--diabetes, hypertension, congestive heart failure, anticoagulation, women's health, COPD, nicotine cessation and medication safety. Residents are precepted by Clinical Pharmacy Practitioners and will gain experience working under their preceptor's scope of practice to improve facility performance metrics using population health tools.

Inpatient operation is a longitudinal rotation. Inpatient pharmacy staffing responsibilities include verifying inpatient orders, checking unit dose packages and sterile compounded medications, and answering drug information or pharmacy-related questions from other health care providers.

• Academic detailing
• Ambulatory care II
• Critical care
• Emergency medicine
• Hematology/oncology
• Infectious diseases: inpatient and outpatient
• Mental health: inpatient and outpatient
• Oncology operations
• Outpatient mental health
• Pain management
• Pharmacoeconomics
• Physical Medicine Rehabilitation

*Other elective learning experiences may be developed based on resident interest and preceptor availability.

Core block rotations will vary between 4 to 6 weeks in length depending on the experience, while elective block rotations are 4 weeks long.

There are 5 core block rotations. Ambulatory care, geriatrics and internal medicine are 6 week experiences. Medication safety and formulary management are 4 week experiences. Residents get a total of 16 weeks of electives, approximately, 4 elective block rotations during the year.

Each longitudinal rotation is approximately 11 months long.

Longitudinal rotations include: Service commitments in ambulatory care and inpatient operations, research/QI, and leadership.

Our projects are quality improvement in nature. Project ideas are reviewed and discussed with preceptors and pharmacy leadership to ensure feasibility, innovation, and quality. The ideas are then presented to the residents during orientation, allowing residents to select a project-based on their interests.

Residents and preceptors meet regularly to discuss the project throughout the year. Residents have many opportunities to present their projects and receive feedback before presenting at the Western States Conference.

The longitudinal leadership rotation consists of 2 learning activities:

1. Monthly leadership conference, and
2. Committee participation

Residents meet with the residency program director and a guest speaker from pharmacy leadership on a regular cadence to discuss a leadership topic (e.g., leadership philosophy, embracing change, staff management, communication).

Residents may also participate in committees as applicable to their rotation(s). Committees may include: Anticoagulation Oversight Team (AOT), Antimicrobial Stewardship Program (ASP), Medication Management Committee (MMC), Mental Health Oversight Team, Oncology Oversight Team (OOT), Pain Management Committee, and Residency Advisory.

During orientation, residents will be asked to rank electives based on interest and plans for applying to PGY2 programs.

On a quarterly basis and at any time during the program year, residents have the opportunity to discuss their schedule with the residency program director if interests change.

Yes, VA Palo Alto residency program offers a teaching certificate program through the University of the Pacific School of Pharmacy, and it's optional.

VA Palo Alto is the regional APPE site of UOP for the Palo Alto/South Bay region. There are many opportunities to teach and precept APPE students throughout the year.

Staffing requirements include ambulatory and inpatient service commitments. Both are longitudinal experiences and will be scheduled and adjusted to meet the needs of the pharmacy department.

Ambulatory care responsibilities include using population health tools to improve health outcomes for patients with chronic conditions.

Inpatient pharmacy responsibilities include unit dose and IV order verification, checking unit doses and IVs, and answering drug information or pharmacy-related questions from other health care providers.