Pharmacy Residency Program

The postgraduate year one (PGY1) and postgraduate year two (PGY2) pharmacy residencies at Tennessee Valley Healthcare System (TVHS), 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.

TVHS pharmacy residency programs will be represented at the 2023 ASHP Midyear Clinical Meeting in Anaheim, CA on Monday, Dec. 4 from 1 - 4 p.m. We will also be participating in the VA Virtual Recruitment Showcase Event on Oct. 18, 2023 from 11 to 1 p.m. CT. 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.

Diversity, Equity, and Inclusion Statement

Culturally and socially responsive practice is integral to the mission of our residency program at TVHS. We recognize the importance of acknowledging and supporting individual differences in our residents, and within relationships between our residents, staff, and patients. We work to identify, respect, and nurture the unique personal attributes that an individual brings to each relationship, and believe that fostering a culturally rich and diverse training environment is foundational to a strong residency program, and to nurturing pharmacists capable of providing culturally sensitive, socially responsive, and patient-centered care. To that end, we promote an awareness of, and sensitivity to, individual cultural diversity identities across multiple settings during the residency through discussions during supervision, practice, seminars, and workshops.

Objectives

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

Benefits

A competitive stipend of $47,397
11 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 holiday staffing
Dual appointment opportunity: Residents are offered, but not required, to participate in dual appointment which allows for the pharmacy resident to work 4-hour shifts as a clinical pharmacist in the central pharmacy for GS-12 pharmacist pay. Typical duty hours include evening shifts during the week and weekends 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

Structure

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, acute medicine, critical care, acute psychiatry, primary care, and pharmacoeconomics. 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 practice management. 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
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)
Practice Management

Required Core Rotations

Acute Medicine

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.

Primary Care

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.

Critical Care

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.

Pharmacoeconomics

Residents will participate in formulary management decision making and provides an overview of the relationships between pharmacy service and other services in our healthcare system. Residents will participate in the development of a criteria for use (CFU) and drug monograph.

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.

Acute Psychiatry

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.

Extended Block Core Experiences

Drug Information Service

Residents will each have experience carrying the Drug Information pager, replying to inquiries in a timely fashion, and documenting each response.

Medication Safety

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.

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 complete a Medication Use Evaluation (MUE). Additionally, the resident will complete P&T minutes.

Longitudinal Rotations

Research Project

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.

Cased-Based Presentation

Each PGY1 pharmacy resident will present a one-hour case-based CE presentation to pharmacists and pharmacy technicians at TVHS.

Journal Club

Each PGY1 pharmacy resident will present a one-hour journal club to pharmacists at TVHS.

Elective Rotations

Residents may repeat core rotations for one of their elective months, or they may choose one of the rotations listed below:

Academic Detailing
Anticoagulation
Antimicrobial Stewardship/Infectious Disease
Advanced Medicine
Cardiology
Chronic Pain Management
Community Living Center
Geri-PACT
Home Based Primary Care
Hospice/Palliative Care
Integrated Pharmacy Operations
Oncology
Outpatient Mental Health
Outpatient Substance Use Disorder
Pain Management, Opioid Safety and PDMP (PMOP)
Stem Cell Transplant
Mental Health Residential Rehabilitation Treatment Program (RRTP)
Substance Use Disorder Clinic
Women’s Health

Postgraduate Year 2 Residency Programs

Accredited by the American Society of Health-System Pharmacists

Ambulatory Care PGY2

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 development, implementation, and management of a new outpatient clinic based on the interests of the resident and needs of the 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.

Pain PGY2

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.

Psychiatry PGY2

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.