PGY1 pharmacy residency program
The PGY1 pharmacy residency is a 1-year postgraduate program that provides training and experience in pharmacy practice and education.
Points of contact
Cynthia Spann PharmD
Ambulatory Care Pharmacy Supervisor
VA Palo Alto health care
Email: cynthia.spann@va.gov
Pharmacy service
VA Palo Alto health care consists of 3 inpatient facilities located at Palo Alto, Menlo Park, and Livermore, in addition to 4 Community Based Outpatient Clinics (CBOCs) in San Jose, Capitola, Monterey, and Fremont, as well as 2 residential homes for Veterans in the Compensated Work Therapy program. VA Palo Alto operates close to 800 beds, including 3 nursing homes and a 100-bed homeless domiciliary.
The health care system is affiliated with Stanford School of Medicine, and the pharmacy service is affiliated with University of the Pacific (UOP), University of Southern California (USC) and Touro University.
The VA Palo Alto pharmacy service provides 24-hour coverage, 7 days a week. Patient care is provided by a staff of more than 180 pharmacists, residents, students, and technicians. The pharmacy also provides a pharmacoeconomics center and staff to participate in local, regional, and national committees.
About our program
The pharmacy residency is a 1-year postgraduate program that provides training and experience in pharmacy practice and education. Patient care responsibilities are foremost; residents also receive instruction and experience in management, managed care, and quality improvement process. Residents are provided with ample opportunities to teach in clinical clerkship and didactic settings. A residency project is required and a focus on economics, outcomes analysis, or health care policy is encouraged.
The residency offers an optional teaching certificate program through the University of the Pacific.
Learning experiences
Below is a list of required and elective learning experiences. Most elective rotations are 6 weeks long, and at least one elective rotation must be in the inpatient setting.
Ambulatory care (block) - required
This is a 6-week rotation, and the resident will be responsible for managing patient health care needs in the following clinics:
- Patient Aligned Care Team (PACT)
- Anticoagulation
- Geriatrics
- ESA/renal
- Immune HIV clinic
The resident will evaluate drug regimens for efficacy, adherence and adverse effects, make appropriate adjustments in the medication regimen, and order necessary laboratory tests.
Ambulatory care (longitudinal) - required
This is a weekly, one half day longitudinal clinic rotation, and the resident will be provided with training in comprehensive medication management for patients with diabetes, hypertension, hyperlipidemia, congestive heart failure, and anticoagulation within a Patient Aligned Care Team (PACT) clinic.
Conference presentation - required
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 ability to critically analyze the literature and reach conclusions based on the available literature.
Formulary management - required
This is a 6-week rotation running concurrently with the medication safety rotation.
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.
Geriatrics - required
This is a 6-week rotation, and the resident will be assigned to one of the three Community Living Centers (CLC).
Each CLC 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.
Internal medicine - required
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 rounds, monitoring patient medication therapy, reporting adverse drug reactions, pharmacokinetic monitoring, performing admission and discharge medication reconciliation, discharge counseling. and performing patient admission interviews.
Medication safety - required
This is a 6-week rotation running concurrently with the formulary management rotation.
The resident will learn the medication-use system and the administrative roles pharmacists serve. 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.
Pharmacy leadership - required
This is a longitudinal rotation throughout the year with monthly meetings and committee participation.
The residents will participate in monthly leadership discussions regarding pharmacy management. Leadership topics include leadership philosophy, LEAN, staff management, effective communication, pharmacy budget, accreditations, and more.
Additionally, each resident will participate in a committee throughout the year.
Quality improvement/research - required
This is a longitudinal rotation, and the resident will be responsible for the development, execution, and timely completion of the project.
Residents will present their projects at Western States Conference.
Service (staffing) - required
This is a longitudinal weekend rotation, and the resident will spend the full year staffing in the inpatient pharmacy.
Inpatient pharmacy staffing responsibilities include verifying inpatient orders, checking unit dose packages and IVs, and answering drug information or pharmacy-related questions from other health care providers.
Elective learning experiences
- Academic detailing
- Ambulatory care
- Critical care
- Emergency medicine
- Infectious diseases
- IV room
- Oncology
- Pain management
- Pharmacoeconomics
- Polytrauma/rehabilitation
- Population health management
- Psychiatry
Benefits
- Health & dental insurance
- Vacation - 13 days/year
- Sick leave - 13 days/year
- Paid educational leave*
- All weekday federal holidays off
- Free parking
*Residents are paid for their time to attend meetings. Funding to support travel and meeting registration is limited.
How to apply
Our program participates in the ASHP PhORCAS system and National Matching Service. This residency site agrees that no person at this site will solicit, accept, or use any ranking-related information from any residency applicant.
NMS Number: 191213
Eligibility requirements
Prior to match:
1. Applicants must be a U.S. citizen.
After the match:
2. Return signed resident appointment letter by the stated deadline.
3. Successfully pass a pre-employment physical exam.
4. Pharmacist licensure in at least one state secured within 120 days of starting residency.
Candidates wishing to apply are required to submit the following via PhORCAS:
- A “letter of intent” stating why you are pursuing a residency position in our program (max. 1 page)
- A current curriculum vitae
- VA form 10-2850D - Application for health professions trainees
- A current official School of Pharmacy transcript
- 3 letters of recommendation. One of the reference writers must be a clinical rotation preceptor. All 3 reference writers should use the standard PhORCAS template to submit their recommendation.
Frequently asked questions and answers
Below is a list of frequently asked questions and answers regarding the pharmacy residency program at VA Palo Alto.
How long are your learning experiences for each rotation?
Each core block rotation is 6 weeks long (e.g., ambulatory care, internal medicine, geriatrics, formulary and medication safety management). Each longitudinal rotation is about 11 months long (e.g., staffing, research/QI, leadership, ambulatory care clinic).
Elective rotations are either 3 weeks or 6 weeks long, depending on the rotation. Residents get a total of 18 weeks of electives.
Can you describe the longitudinal QI/research rotation?
Our research projects are quality improvement in nature. Project ideas are reviewed and discussed with project preceptors and pharmacy leadership to ensure feasibility, innovation, and quality. The project ideas are then presented to the residents during orientation, allowing residents to select a project based on their interests.
Residents and the project 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.
Can you describe the longitudinal leadership rotation?
The longitudinal leadership rotation consists of 2 learning activities:
- Monthly leadership conference, and
- Committee participation
Residents meet with the residency program director and a guest speaker from pharmacy leadership on a monthly basis to discuss a leadership topic (e.g., leadership philosophy, embracing change, staff management, communication).
Residents also participate in a committee of their interest as an active member throughout the year. Committees include Medication Management Committee (P&T), Anticoagulation Oversight Team, Antibiotic Stewardship Program Committee, Pain Management Committee, VISN 21 Clinical Pharmacy Practice Council, and Residency Advisory Committee.
How flexible is the program with electives?
During orientation, residents will be asked to rank electives based on interest and plans for applying to PGY2 programs.
On a quarterly basis, residents have the opportunity to discuss their schedule with the residency program director if interests change.
Does your program offer a teaching certificate program?
Yes, VA Palo Alto residency program offers a teaching certificate program through the University of the Pacific School of Pharmacy, and it is 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.
What are the staffing requirements?
Residents staff approximately 20 weekend days throughout the year in the inpatient pharmacy.
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.