PGY2 Psychiatric Pharmacy Residency

Inpatient Psychiatric Unit (IPU)

Preceptors: Joel Grussendorf, BCPP; Rachel Bauer, BCPS, BCPP; Cathy Yao.

There are four teams within this 30-bed unit and various trainees of all disciplines with whom the resident will be working (psychology interns, physician assistants (PA), nurse

practitioners (NP), psychiatry residents, etc.). The resident teaches patient education groups, is involved in daily patient rounds, completes admission and discharge medication reconciliations, provides medication management and treatment recommendations, and leads topic discussions. There are usually opportunities to precept students and residents during this rotation.

Substance Abuse Residential Rehabilitation Treatment Program (SARRTP)

Preceptors: Sadie Roestenburg, PharmD, BCPP; Audrey Wadhwani, PharmD, BCPP

SARRTP is a 15-bed residential treatment program for Veterans with substance use disorders and often-times concomitant mental health disorders, including PTSD. The Veterans reside on the unit for 5-9 weeks depending on their treatment plan (SUD vs. SUD + PTSD treatment). The pharmacy resident will interact with a dynamic interdisciplinary clinical staff (psychiatrist, physician assistant, social workers, psychologists, recreational therapist, etc.), along with various trainees in these areas. The resident completes admission and discharge medication reconciliations, documents encounters and interventions, provides medication management and treatment recommendations for the team, and leads patient education groups and topic discussions. Other experiences include attending the Veteran groups related to SUD treatment to obtain different perspectives about residential treatment, in addition to attending recreational therapy outings.

Services for Outpatient Addiction and Recovery (SOAR) clinic

Preceptor: Zac Hill, BCPP

The SOAR team, embedded within Addiction Treatment Services (ATS), is an interdisciplinary team focused on caring for those with addiction and co-occurring mental health, medical, and psychosocial issues. Throughout a Veteran’s course of treatment, the SOAR team provides care coordination through a stepped care model. The resident will see patients for mental health medication management appointments, provide medication management recommendations to psychiatric staff, and coordinate medication-assisted treatment (MAT) for patients. They will have the opportunity to lead patient education groups in the intensive outpatient program and develop topic discussions related to SUDs. The resident will interact with various disciplines and trainees (psychology, social work, psychiatry, and nursing, etc.) as well as participate in didactic lectures with psychiatric residents at University Neuropsychiatric Institute. Other experiences may include assisting with lectures for University of Utah pharmacy students and participating in recovery-oriented substance abuse groups to experience multiple facets of outpatient substance abuse treatment.

Vulnerable Veteran Innovated Patient Aligned Care Team (VIP-PACT)

Preceptors: Natalie Valentino, BCPP; Jake Matano, MBA

The VIP team offers a unique primary care service delivery model with a goal to improve the health of Veterans who are particularly vulnerable due to medical disease and/or their social determinants. This includes Veterans with substance use disorders, co-occurring addiction and pain disorders, social determinants of health (ex. homelessness), and high utilizers of healthcare services. The VIP team consists of two MH/SUD PharmDs, three addiction medicine MDs, a mental health APRN, and a social worker who work collaboratively to determine appropriate treatment plans. On this unique rotation, the resident will have the opportunity to manage patients longitudinally for MOUD/MAUD, including management of buprenorphine/naloxone, mental health medications, and fully integrate into the team through shared medical appointments with primary care providers

Outpatient Mental Health (OMH) and Primary Care Mental Health Integration

Preceptor: Jeff Gower, BCPP, BCPS

This rotation provides exposure to a broad range of outpatient mental health care experiences. The resident will build relationships with other practitioners and improve medication management abilities through participation in several services, including: clozapine clinic, Mental Health Intensive Case Management (MHICM) team which serves Veterans with serious mental illnesses in the community, and Primary Care Mental Health Integration (PCMHI). Additional rotation activities include completing mental health pharmacist consults, non-formulary review, coordination of long-acting injectable antipsychotics, and supporting the lithium monitoring clinic.

Mental Health Consult Liaison

Preceptor: Ana Kasabyan, APRN;

The resident will work in an interdisciplinary team consisting of psychology, social work, neurology, and psychiatry to assess and evaluate patients on inpatient medical floors of the hospital with acute mental health needs. The resident will be expected to respond to consults/pages placed by acute medicine teams, assess disease state endorsed for evaluation, goals of care, and obtain pertinent social history from patients through clinical interviewing. Expectation of pharmacy resident will be to function in the same capacity as psychiatric medical residents to develop clinical interviewing skills, communication with acute care medical team for recommendations, and documentation of recommended interventions for medications, non-pharmacologic, and follow-up for all parties involved.

Toxicology - Utah Poison Control Center

Director of Utah Poison Control Center: Amberly Johnson PharmD, DABAT.

Preceptors: there are approximately 12 preceptors that rotate the precepting responsibilities depending on days/times of year of the rotation.

Utah Poison Control Center (UPCC) is a certified regional poison control center, established in 1954 that serves the entire state of Utah and is located on the University of Utah campus. The UPCC responds to approximately 120 requests for assistance daily and over 40,000 cases annually. The service is staffed around-the-clock by pharmacists and nurses who have additional training in clinical toxicology. Students on rotation will interact with various members of the UPCC team. Students will meet almost daily with medical toxicologists who will participate in rounds, inpatient bedside consults, and topic discussions, weekly with SPIs that include a nurse and pharmacists, and several times with the health education staff in discussions about and participation in outreach education. Students and residents on rotation will be involved in the management of cases that are admitted to the hospital for treatment, which is approximately 5% of all cases managed by the poison center and represents the most seriously ill. Trainees will conduct telephone follow-up calls, work up patients, provide recommendations to healthcare providers, present patient cases, present topic discussions, and more.

These are routine electives available. Additional electives can be pursued within the VA or other non-VA facilities pending resident interest and preceptor availability.

Child and Adolescent Psychiatry

Preceptor: Katherine King, PharmD, BCPS, BCPP

This is a four-week elective experience, and requires the resident to have a Utah pharmacist license. This rotation provides exposure to a variety of inpatient and outpatient pediatric psychiatry experiences. This experience is hosted by Intermountain Healthcare and is located at Primary Children’s Wasatch Canyons Campus. The rotation includes inpatient rounding with the multidisciplinary inpatient psychiatric team for new evaluations, crisis stabilization, medication initiation and adjustments, and post-discharge planning. In addition, the resident will manage patients via an ADHD collaborative practice agreement in the outpatient setting, complete medication histories and recommendations to the Day Treatment Program, teach medication education classes, and be available for case consultations as needed.

Geriatric outpatient clinics - (Geri-assessment, Geri-PACT clinic, Geri-med psych)

Preceptor: Jenni Ladutko, PharmD, BCGP

This rotation is an elective learning experience designed to strengthen the resident’s knowledge and skill set in outpatient psychiatry, geriatric primary care and geriatric mental health concerns. The resident will be involved with many different outpatient geriatric services throughout the rotation. The goals for the resident are to work as a mid-level provider to develop pharmaceutical care plans targeted to optimize mental health conditions, reduce polypharmacy, and manage chronic disease states in geriatric populations. He/she will have extensive experience working with interdisciplinary teams, and independently in clinical pharmacist clinic. Experiences include, working in geri-med psych clinic in primary care, geri-psych with mental health providers, geri-assessment clinic with an interdisciplinary team, and geriatric PACT clinics. This rotation and experiences within the rotation can be customizable to meet the resident’s rotation and career goals.

Huntsman Mental Health Institute (HMHI)

This is an inpatient psychiatry rotation affiliated with the University of Utah. This elective depends on preceptor availability and requires the resident to have a Utah pharmacist license. 

Precepting and teaching

Residents can elect to precept a student or PGY1 resident on rotation, depending on availability and rotation schedule. Residents also have various opportunities to assist with pharmacy student trainings and teaching at the University of Utah throughout the year depending on availability.

Longitudinal Rotations

Residents will have three longitudinal rotations throughout the year, lasting 2-5 months. The residents will spend a 1/2 day each week in the following experiences:

Outpatient mental health pharmacist - The resident will work with our OPMH pharmacist on Tuesday mornings with clozapine clinic team. The resident will also assist with lithium monitoring, drug information questions from providers, and MH PharmD consults.

Outpatient MH provider - The resident will complete shared medical visits with a psychiatrist or mental health nurse practitioner. The purpose of this experience is to gain exposure to different practice styles of various interdisciplinary colleagues. The resident will have the opportunity to observe and practice patient interviews, including new patient intakes

Patient education group facilitation - The resident will have the opportunity to observe group education facilitation for a couple weeks, then will work towards independently facilitating one-hour per week group education with patients. This rotation generally occurs on the SARRTP unit, but may occur with SOAR clinic depending on preceptor/rotation availability

Patient Panel

After their initial SUD pharmacist rotation, residents will continue following 5-10 patients from this experience throughout the rest of the year. The residents will be responsible for coordinating follow up with both the patient and the preceptor at appropriate intervals. Follow up is conducted during downtime on their scheduled rotations. While the pharmacist preceptor will provide oversight, the resident is considered the patients' pharmacist provider and responsible for all aspects of medication management. The purpose of this rotation is to gain experience with continuity of care and independent outpatient practice.

Weekend staffing

Residents are required to staff every third weekend on the IPU and SARRTP. Responsibilities include completing admission medication reconciliation and providing medication management recommendations to the weekend psychiatry team, teaching patient medication education groups, and addressing medication needs. While residents will be the sole pharmacist on the unit after initial training, clinical pharmacist preceptors are on site for patient staffing and resident support.

Other opportunities and experiences

• Interdisciplinary topic discussions (NP residents, psychology interns, pharmacy residents, etc.)
• Topic discussions starting second half of the year with PGY2 residents and mental health clinical pharmacy preceptors
• Year-long research or process improvement project with support and trainings with the SLC VA Systems Redesign and Improvement team
• Medication use evaluation (MUE
• Funding for registration and travel is provided for either ASHP Midyear or the American Association of Psychiatric Pharmacists (AAPP) Annual Meeting. Authorized absence will be approved should the resident choose to attend both.
• Oral platform presentation at Mountain States Conference located at the University of Utah in the spring