Pharmacy Residency Program
The postgraduate year one (PGY1) and postgraduate year two (PGY2) pharmacy residencies at Tennessee Valley Healthcare System, located in Murfreesboro and Nashville, provide residents with the skills and knowledge required to enter a contemporary practice environment where they can effectively provide clinical services.
Tennessee Valley Healthcare System pharmacy residency programs will be represented at the VA Virtual Recruitment Showcase Event on December 8-9, 2021. Registration is free.
Postgraduate Year 1
Accredited by the American Society of Health-System Pharmacists since 1991.
We, at TVHS, understand the changing face of pharmacy health care and strive to prepare our residents for entrance into a competitive job market. Be it clinical skills, research, publication, teaching, or leadership, we care about our residents’ future and will prepare each of them for a meaningful career as a pharmacy practitioner. For this reason, our PGY1 resident training schedules are customized on a quarterly basis with the resident, considering the resident’s goals, interests, and previous experiences. We understand that completing a PGY1 residency is a sacrifice of money and time, and we want our residents to gain the experience needed to prepare them for the next step in their pharmacy career.
To get an exclusive look at our award-winning residency program, watch our video.
The objectives of the residency program are to prepare pharmacy residents for any of the following:
- direct patient care positions
- faculty positions
- PGY2 training in area of choice
- A competitive stipend of $41,533
- 12 federal holidays per year
- Vacation days and sick leave are both accrued at a rate of 4 hours every two weeks totaling 13 days of paid vacation time and 13 days of paid sick leave
- Health insurance
- Dental/Vision insurance
- Residents attend ASHP’s Midyear Clinical Meeting and a spring residency conference to present research.
- Travel funds are available to offset some of the expenses for these educational meetings
- No night/holiday staffing
- Dual appointment opportunity: Dual appointment allows for the pharmacy resident to work 4-hour shifts as a clinical pharmacist in the central pharmacy. Typical duty hours are 4 p.m. – 8 p.m. during the week and 9 a.m. – 1 p.m. on Saturday and Sunday but are subject to change based on the needs of the service. During this time, the resident works as a clinical pharmacist and income earned is outside of the salaried residency stipend. As this work is compensated outside of the residency stipend, the resident is expected to complete the duties of a clinical pharmacist working in the central pharmacy and not utilize this time for work related to other residency responsibilities. Residents are typically approved for dual appointment and begin having the ability to acquire shifts in September, but actual date may vary. As a reminder, residents must remain within the requirements of ASHP duty hours.
Postgraduate Year 1 Rotations
The specific program for each resident is developed initially based upon the resident’s goals, interests, and previous experience. The program is continually developed throughout the training year at regular intervals based on evolving resident goals and interests, resident training needs determined by review of summative preceptor evaluations, resident self-evaluations, quarterly evaluations by the residency leadership board, and the pharmacy service infrastructure.
All residents are required to complete rotations in core subject areas considered to be essential to the general pharmacy practitioner. These include drug distribution and operations, practice management & pharmacoeconomics, critical care, acute psychiatry, primary care, and acute medicine. Extended 4-month block longitudinal learning experiences aimed at producing a well-rounded pharmacy practitioner include: drug information (DI) with newsletter (The Valley Times), medication safety, and antimicrobial stewardship. Yearlong longitudinal learning experiences aimed at producing a well-rounded pharmacy practitioner include: (1) resident-initiated research project related to pharmacy practice, (2) Community Living Center (CLC) chart review (3) prior authorization drug review, and (4) drug distribution and operations. A broad range of elective rotations are available to permit the resident flexibility in attaining individual goals. Upon satisfactory completion of the program, trainees are awarded a residency certificate.
The program is a twelve-month, post-graduate training experience composed of month-long discrete core components:
- Drug Distribution and Operations (with longitudinal weekend assignments)
- Critical Care
- Primary Care
- Acute Medicine
- Acute Psychiatry
- Practice Management & Pharmacoeconomics
Yearlong extended longitudinal experiences are comprised of:
- Research Project
- Community Living Center Chart Review
- Prior Authorization Drug Review
- Drug Distribution and Operations (weekend assignments – see below on details)
Extended 4-month block longitudinal experiences are comprised of:
- Drug Information with newsletter (shared months of service)
- Medication Safety (shared months of service)
- Antimicrobial Stewardship (shared months of service)
Residents will gain experience managing all aspects of pharmacotherapy for acutely ill patients through active participation on a medicine team, ensuring medications are properly reconciled on admission to and discharge from the ward, and attending morning reports/grand rounds. The resident will document in computerized progress notes pertinent clinical activities.
Residents will see scheduled patients in a clinic setting and have the opportunity to develop, implement, and redesign pharmacotherapeutic plans. The resident will document in computerized progress notes all clinical activities. Residents will also develop the physical examination skills that are necessary to be an effective clinician in the primary care setting.
Residents will monitor patients in the Medical Intensive Care Unit (MICU) or Surgical Intensive Care Unit (SICU), which includes cardiology and pulmonary critical care patients, on a daily basis for pharmacotherapeutic needs through rounding and medication reconciliation/discharge planning. Residents will have active participation on a critical care team. The resident will document in computerized progress notes pertinent clinical activities.
Practice Management and Pharmacoeconomics
Residents will participate in pharmacy leadership, work on relevant assignments/projects, attend committee meetings with pharmacy representatives, lead pharmacy events (pharmacy week, medication reconciliation week, and residency recruitment), and have discussions with the pharmacoeconomic clinical pharmacy specialist two to three times a week. Additionally, the resident will complete P&T minutes.
Drug Distribution and Operations
Residents will gain experience reviewing and processing patient-specific orders, correctly preparing medications and successfully communicating medication-related issues with providers.
Residents will review patient specific data, prepare and update pharmaceutical care plans, meet with the inpatient psychiatric treatment care team along with the patient, and serve as a drug information resource. The resident will document in computerized progress notes pertinent clinical activities.
Antimicrobial Stewardship (ASP)
Each resident will engage in both clinical and administrative aspects of the TVHS Antimicrobial Stewardship Program (ASP). Clinical aspects will include evaluating antimicrobial regimens, reviewing culture and sensitivity data, monitoring drug levels, consulting with physicians, patients, and other clinical pharmacists, and providing education to the healthcare staff as necessary. Administrative aspects consist of program management duties that include but are not limited to preparing for and attending ASP and P&T meetings, evaluating antimicrobial usage data, developing/updating policies and protocols, tracking ASP activities, and developing the annual repo.
Drug Information Service
Residents will each have experience carrying the Drug Information pager, replying to inquiries in a timely fashion, and documenting each response.
Residents will each have experience preparing an adverse drug reaction (ADR) monthly report, documenting and submitting relevant ADRs to the Food and Drug Administration’s MedWatch program and communicating findings.
Antimicrobial Stewardship (ASP)
Each resident will engage in both clinical and administrative aspects of the TVHS Antimicrobial Stewardship Program (ASP). Clinical aspects will include evaluating antimicrobial regimens, reviewing culture and sensitivity data, monitoring drug levels, consulting with physicians, patients, and other clinical pharmacists, and providing education to the healthcare staff as necessary. Administrative aspects consist of program management duties that include but are not limited to preparing for and attending ASP and P&T meetings, evaluating antimicrobial usage data, developing/updating policies and protocols, tracking ASP activities, and developing the annual report.
Residents will gain experience in completing a practice-related project of publishable quality. Residents will be involved in literature review, project design, data gathering, statistical evaluation, writing, and reporting of their project. Residents will work closely with the Residency Research Advisory Board and a team of co-investigators that will assist them at every step of the process.
Prior Authorization Drug Review
Residents will gain hands-on experience reviewing and then either approving or denying requests for non-formulary/restricted medications entered by healthcare providers.
Community Living Center (previously known as Long Term Care)
Residents will gain experience completing monthly CLC chart reviews for 5 patients throughout the year and communicate their recommendations to the patient’s primary provider.
Drug Distribution and Operations
Residents will gain experience reviewing and processing inpatient and outpatient prescriptions for patients or working on the acute medicine floor participating in pharmacokinetic dosing, anticoagulation management, and discharge medication reconciliation/counseling. Weekend Staffing: Weekend coverage will be provided by 2 residents every Saturday from 7 AM – 5:30 PM at the Nashville campus. Resident 1 will be assigned to work on the floor with a decentralized clinical pharmacist where responsibilities will include, but are not limited to: assistance with pharmacokinetics (vancomycin, aminoglycosides, warfarin, etc.), providing discharge medication reconciliation and discharge counseling to patients being discharged by the medical teams, and being an available clinical resource to the medical teams. Resident 2 will be assigned to work in the central pharmacy where responsibilities will include, but are not limited to: processing of orders, dispensing of discharge medications, compounding of IVs, and preparation of inpatient medication orders. Please note that these responsibilities and duties may vary based on the needs of the service.
Each PGY1 pharmacy resident will present a one-hour case-based CE presentation to pharmacists and pharmacy technicians at TVHS.
Each PGY1 pharmacy resident will present a one-hour journal club to pharmacists at TVHS.
Residents may repeat core rotations for one of their elective months, or they may choose one of the rotations listed below:
Residents will gain experience serving as the drug therapy specialist actively participating in team meetings and bedside rounds with the cardiology attending and fellow on service. Interventions and patient education will be recorded in the medical record. Residents can expect to have exposure to a variety of acute cardiovascular conditions including acute coronary syndromes, heart failure exacerbation, and arrhythmias during this elective rotation.
Outpatient Cardiology Pharmacotherapy Clinic
This ambulatory clinic service within the cardiology specialty clinics at Nashville and Murfreesboro campuses gives PGY1 residents exposure to evaluating and optimizing pharmacotherapy for ambulatory patients with cardiovascular diseases including heart failure, coronary artery disease with and without angina, hypertension, hyperlipidemia, and arrhythmias.
Residents will work with interdisciplinary teams for patients admitted in our Long-Term Care facility, known as Community Living Centers (CLC) in the VA. Residents gain experience in reviewing CLC charts each month (Medication Therapy Management) and entering Minimum Data Set information. Additionally, residents will attend interdisciplinary treatment team meetings and submit reports as required by accreditation bodies.
Home-Based Primary Care
Residents will gain experience performing initial and quarterly chart reviews, participating in interdisciplinary treatment team meetings, visiting veterans in veterans’ homes if desired, completing telephone follow-up calls, acting as the drug expert for HBPC team, and assisting with performance improvement projects as requested.
Residents will serve as a functioning member of an interdisciplinary treatment team. Throughout the rotation, residents will come to understand and apply palliative care principles including pain management, nausea, constipation, depression, and insomnia. Residents will also receive Minimum Data Set training.
Residents will see scheduled patients in a clinic setting and have the opportunity to develop, implement, and redesign pharmacotherapeutic (pain) plans. The resident will document in computerized progress notes all clinical activities.
Outpatient Mental Health
This elective will allow the resident to participate in a team-based outpatient mental health clinic, referred to as BHIP (Behavioral Health Interprofessional Program). With the Clinical Pharmacy Specialist, residents will participate in individual clinic appointments, attend interprofessional treatment team meetings, and assist in mental health medication-related consultant services.
Residents will have the opportunity to develop, implement, and redesign a pharmacotherapeutic plan in patients requiring anticoagulation through a telephone-based warfarin clinic and population-based management of direct oral anticoagulants. Residents will also gain experience with difficult and unique anticoagulation cases as the centralized clinics manage all anticoagulation patients and questions for TVHS. The resident will document computerized progress notes of all clinical activities.
Residents will gain experience providing drug information to the interprofessional team at the point of care, medication order processing, medication refill services, and chronic disease management following triage by a physician.
Residents will gain experience in the clinical and administrative aspects associated with an antimicrobial stewardship program as well as gain knowledge in infectious diseases. Residents will evaluate and manage the antimicrobial therapies of patients, consult with physicians and other clinical pharmacists, as well as be involved with administrative aspects such as preparing guidelines/pathways to be implemented into the computer decision support system, providing education to the pharmacy staff and other healthcare providers, performing medical usage evaluations, and providing antimicrobial drug information as necessary.
Mental Health Residential Rehabilitation Treatment Program (RRTP)
Residents will gain experience working in the Resident Rehabilitation Treatment Program (RRTP), a voluntary inpatient admission for patients to receive intensive treatment for substance abuse, PTSD, depression, etc.
Bone Marrow Transplant
Residents will work with the interdisciplinary team on the Bone Marrow Transplant Unit where duties will include both inpatient and outpatient patient care. They will gain experience with medication dosing in special patient populations and supportive care management.
Academic Detailing will allow residents a unique opportunity to learn how to utilize motiviational interviewing skills to work one on one with providers in regard to evidence-based education. This rotation will also allow the residents to develop evidence-based resources for providers. They will also glean an understanding of utilization of metrics including dashboards and other forms of clinical data
Outpatient Pain and Mental Health Telemedicine
Residents will learn how to properly use televideo equipment for the management of psychiatry and pain management in the Veteran population. Residents will be responsible for reviewing patients, executing appropriate assessment measures, analyzing current therapies, making changes to treatment plans, and monitoring pertinent lab information.
Geri-PACT (Outpatient Geriatrics)
The geriatric patient-aligned care team (GeriPACT) at TVHS is an outpatient interdisciplinary team of providers, including physicians/geriatricians, nurse practitioners, nurses, social workers, dieticians and administrative assistants. Routine clinic visits are shared appointments between the primary provider and clinical pharmacy specialist (CPS). Medication management is provided by the GeriPACT CPS in several different ways: medication reconciliation, assessment and management of fall risk and neurocognitive impairment, deprescribing, chronic disease state management, preventative care, and caregiver support.
Outpatient Substance Use Disorder
Residents will provide comprehensive medication management services for substance use disorder (SUD) within an outpatient addiction specialty clinic. This includes participation in individual clinic appointments, interprofessional treatment team meetings, and overdose prevention services. There will also be opportunities to extend SUD medication services to veterans receiving care within primary care and general mental health clinics.
During this elective rotation, residents are able to expand on the knowledge and skills obtained during the core primary care rotation. The Women’s Clinic provides both primary care and gynecologic services to women veterans at TVHS. Daily activities during this rotation include provision of PACT services to patients assigned to four designated women’s clinic providers. Additionally, residents have the opportunity to serve as a women’s health resource to all primary care teams across the facility via e-consultation and to perform teratogenic medication reviews for veterans who are currently pregnant and breastfeeding.
Postgraduate Year 2 Residency Programs
Accredited by the American Society of Health-System Pharmacists
The Ambulatory Care PGY2 residency schedule provides ample opportunities in ambulatory care to work with more than 30 clinical pharmacy specialists who run clinics specializing in management of diabetes, hypertension, hyperlipidemia, COPD, cardiology / heart failure, women's health, mental health, anticoagulation, emergency medicine, substance use disorder, pain management, etc. The specific program schedules for each resident are customized initially based on the resident’s goals, interests, and previous experience. We then continually customize the plan throughout the training year at regular intervals based on evolving resident goals and interests as well as training needs determined by preceptor evaluations, resident self-evaluations, and quarterly evaluations by the Residency Leadership Board. Longitudinally, residents will be expected to manage their own primary care pharmacotherapy clinic throughout the PGY2 year. Residents will also be charged with to development, implementation, and management of a new outpatient clinic based on the interests of the resident and needs of pharmacy service. Previous residents have chosen to implement and develop outpatient clinics in women’s health, HIV, substance use disorder, COPD, pain management, emergency medicine, etc. Other longitudinal opportunities include completion of the teaching certificate program, precepting numerous PGY1 residents and APPE students, leadership opportunities, and completion of a formal research project. Our goal is for residents to be able to excel in a variety of clinical practice settings, to be a leader in their future practice site and in the profession, and to be well prepared to achieve board certification in ambulatory care pharmacy. Upon satisfactory completion of the program, trainees are awarded a residency certificate.
The Cardiology PGY2 residency offers clinical experiences across the spectrum of acuity for cardiovascular care ranging from ambulatory care to critical care, with core experiences including cardiology pharmacotherapy clinic, acute medicine with cardiovascular emphasis, acute cardiology consult service, medical intensive care unit, which includes our cardiac care unit. Elective opportunities allow the resident to focus in on specific areas of interest including advanced heart failure and transplant, geriatrics, and emergency medicine. The focus of the residency is advanced understanding of cardiology pharmacotherapy, development of complex decision-making skills in a variety of practice environments, literature evaluation abilities, and a knowledge base that is transferable across practice areas. The specific program schedules and activities are customized continuously based on the resident’s goals, interests and experience. Upon satisfactory completion of the program, trainees are awarded a residency certificate.
The Pain PGY2 residency program is a twelve-month, post-graduate training experience with a focus on longitudinal experiences including Comprehensive Pain Clinic, PACT Pain, Substance Abuse Treatment Program (SATP), and Palliative Care. There are a host of elective opportunities from which to choose including, Pain Psychology, Pain Procedures, Dialysis, Rheumatology, Neurology, Infectious Disease/HIV, Nephrology, and Hepatology/GI. Upon satisfactory completion of the program, trainees are awarded a residency certificate.
The Psychiatry PGY2 residency schedule provides ample opportunities in mental health including a 60-bed acute psychiatry unit, inter-professional mental health outpatient clinics, long-term care and pain management. The specific program schedules are customized initially based on the resident’s goals, interests and previous experience. We then continually customize the plan throughout the training year at regular intervals based on evolving resident goals, interest and feedback as well as training needs determined by preceptor evaluations, resident self-evaluations and quarterly evaluations. Upon satisfactory completion of the program, trainees are awarded a residency certificate.
Why Choose TVHS
Tennessee Valley Healthcare System is an integrated Veterans Affairs health care system consisting of two medical centers, 350 acute care and geriatric beds, various specialty clinics, and 19 community-based outpatient clinics located throughout middle Tennessee and southern Kentucky. TVHS provides ambulatory care, secondary care in acute medicine and surgery, specialized tertiary care, and a full range of extended care and mental health services.
The VA TVHS pharmacy service provides progressive clinical and distributive services with approximately 180 pharmacy staff members including over 50 clinical pharmacy specialists in a variety of practice settings and a number of clinical pharmacists dedicated to providing decentralized inpatient pharmacy services and medication reconciliation. Clinical pharmacy specialists are assigned to areas such as primary care, emergency medicine, acute medicine, cardiology, critical care, transplant, psychiatry, oncology, geriatrics, nutritional support, anticoagulation management, long-term care, chronic pain management, home-based primary care, palliative care, hepatitis C management, pharmacoeconomics, and clinical practice management. Within these areas, all clinical pharmacy specialists have scopes of practice which include prescribing authority. A large majority of the residency preceptors are board certified by the Board of Pharmaceutical Specialties actively involved in national pharmacy organizations, and/or are working to contribute to medical literature through publications/research, giving residents an extraordinary ability to work with clinical pharmacy specialists practicing at the top of their respective fields and an in-depth view of how our pharmacy services positively influence the health of Veterans.
The health care system has strong affiliations to the Vanderbilt University School of Medicine and Meharry Medical College as well as several colleges of pharmacy including the University of Tennessee, Samford University, Belmont University, Lipscomb University, and Union University.
Pharmacist Training at TVHS
Eight (8) PGY1 pharmacy residents, two (2) Ambulatory Care PGY2 residents, one (1) Cardiology PGY2 resident, two (2) Pain PGY2 residents, two (2) Psychiatry PGY2 residents, and over 200 students from several colleges of pharmacy are trained at TVHS each year. Residents will have clinical opportunities at both medical centers: the Nashville Campus and the Alvin C. York Campus in Murfreesboro. There are additional rotation opportunities at area community-based outpatient clinics (CBOCs), including Chattanooga and Clarksville, if desired. Throughout TVHS, the extensive range of medical and clinical pharmacy services allows for an optimal training and teaching environment.
TVHS consists of two medical centers, one in Murfreesboro and one in Nashville.
Murfreesboro is a suburb of Nashville, located approximately 40 minutes south on I-24. The city boasts a unique blend of Civil War history and a thriving 21st century community, having beautiful French Colonial downtown homes dating back to the early 1800s blended with new developments, modern shopping, restaurants, medical facilities, and other amenities to bring a touch of southern nostalgia to middle Tennessee.
Murfreesboro is also home to the beautiful 550-acre campus of Middle Tennessee State University (MTSU), which, at an enrollment of 20,000 students, is the second largest undergraduate university in the state behind University of Tennessee.
Located within the largest metropolitan area in the state, Nashville is a big city that offers southern hospitality with a small town feel right in the heart of Tennessee. From great restaurants, comedy clubs, live music venues, Grand Ole Opry, and professional sports, you never run out of fun things to do in "Music City". The city is called home by numerous celebrities so there is always the possibility of celebrity sightings. Nashville also excels in providing a robust cultural arts scene with the Frist Art Museum, Schermerhorn Symphony Hall, National Museum of African-American Music, Tennessee Performing Arts Center, and the Ryman Auditorium. For laid back atmospheres, Nashville is surrounded by beautiful scenery. You can always visit the local Cheekwood Botanical Gardens, spend a day on a nearby lake or river, or enjoy hiking at one of the many nearby parks. There is something for everyone!
How to Apply
Applicant must be a U.S. Citizen who has completed a Doctor of Pharmacy curriculum from an accredited school of pharmacy with a GPA of 3.2 or above. Only applicants from ACPE-accredited or pending accreditation schools of pharmacy will be reviewed and considered for an interview
All applicants must participate in the ASHP Residency Matching Process.
APPLICATION MATERIALS REQUIRED
- Letter of intent
- Curriculum Vitae
- Official college of pharmacy transcript
- Three (3) letters of recommendation using standard template in PhORCAS (no longer requiring formal letters of recommendation)
All application materials are due no later than December 31st.
PGY2 Program Residencies
For application requirements and deadlines, please visit each PGY2 residency program page for more details.
PGY1 and PGY2 Contacts
For the PGY1, please contact:
PGY1 Residency Program Director: David Eplin, Pharm. D., BCOP at Dwight.Eplin@va.gov
PGY1 Residency Recruitment Coordinator: Rebecca J. Cripps, Pharm.D., BCPS at Rebecca.Cripps@va.gov
Current Residents: Courtney Baldridge at Courtney.Baldridge@va.gov; Kyrsten (Kacy) Chaplin at Kyrsten.Chaplin@va.gov; Laura Cherry at Laura.Cherry@va.gov; Courtney Clarke at Courtney.Clarke4@va.gov; Megan Jackson at Megan.Jackson@va.gov; Justin Petway at Justin.Petway@va.gov; Dillon Thompson at Dillon.Thompson@va.gov; Elizabeth (Betsy) Trainham at Elizabeth.Trainham@va.gov
For the Ambulatory Care PGY2, please contact:
PGY2 Residency Program Director: Bishoy Ragheb, Pharm.D., BCACP, CACP at Bishoy.Ragheb@va.gov
PGY2 Residency Recruitment Coordinator: Rebecca J. Cripps, Pharm.D., BCPS at Rebecca.Cripps@va.gov
For the Cardiology PGY2, please contact:
PGY2 Residency Program Director: Emily Young, Pharm.D., BCPS, BCCP at Emily.Young@va.gov
Current PGY2 Resident: Amanda Searls at Amanda.Searls@va.gov
For the Pain PGY2, please contact:
For the Psychiatry PGY2, please contact:
PGY2 Residency Program Director: Jennifer Bean, Pharm.D., BCPS, BCPP at Jennifer.Bean@va.gov
Find out more about us at these locations:
VA Pharmacy Residency Program
American Society of Health System Pharmacists