PGY2 Ambulatory Care Pharmacy Residency

Program Purpose Statement

Our PGY2 Ambulatory Care Pharmacy Residency program builds on Doctor of Pharmacy (PharmD.) education and PGY1 pharmacy residency program to contribute to the development of clinical pharmacists in Ambulatory Care. This PGY2 residency provides residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporate both into the provision of patient care that improves medication therapy. Residents who successfully complete the PGY2 Ambulatory Care pharmacy residency should possess competencies that qualify them for clinical pharmacist and/or faculty positions and position them to be eligible for attainment of board certification in Ambulatory Care.

Program Description

The impetus for the PGY2 Ambulatory Care Pharmacy Residency Program is our program’s opportunity to thoroughly train and expose residents to comprehensive Ambulatory Pharmacy experiences in various areas such as Transitions of Care, Transplantation, Emergency Medicine, Infectious Diseases, Hepatology, Gastroenterology, Dermatology, Neurology, Rheumatology, Administration, Anticoagulation, Internal Medicine, Hematology/Oncology, and Cardiology. This residency provides a comprehensive experience in a variety of ambulatory care settings with an emphasis on multidisciplinary teamwork and teaching. The program enables residents to confidently assume a clinical role and to become efficient healthcare team members and educators for patients, caregivers, healthcare professionals, and students. The program is a twelve-month, postgraduate training experience composed of 9 required outcome competencies and 1 elective competency.

Residency Goals

Required Goals

• Provide comprehensive medication management to ambulatory care patients following a consistent patient care process.
• Design and/or deliver programs that contribute to public health efforts or population management.
• Manage the development or revision, and implementation, of proposals related to the ambulatory care setting.
• Demonstrate ability to conduct a research project.
• Demonstrate leadership skills.
• Demonstrate management skills in the provision of care for ambulatory care patients.
• Manage the operation of an ambulatory care pharmacy service.
• Demonstrate excellence in providing effective medication and practice-related education.
• Effectively employ appropriate preceptor roles when engaged in teaching students, pharmacy technicians, or fellow health care professionals in ambulatory care.

Elective Goals

Effectively fulfill the major functions of a specialty pharmacist, including intake, clinical management, fulfillment, and facilitating optimal outcomes.

Training Site

The predominate location for the residency is in the Perelman Center for Advanced Medicine (PCAM). PCAM is designed to create an ideal environment for patient-focused care and collaboration among health professionals. The Perelman Center is a state-of-the-art, 500,000 square foot outpatient facility located on the corner of 34th Street and Civic Center Boulevard, adjacent to the Hospital of the University of Pennsylvania. Our pharmacy services extend into a multitude of areas including: Oncology, Cardiology, Anticoagulation, Internal Medicine, Infectious Diseases, Gastroenterology, Hepatology, Neurology, Dermatology, Transplantation, and Rheumatology.

Learning Experiences

Required Core Rotations (26 weeks*)

• Orientation/Operations (six weeks*)
• Infectious Diseases/HIV (six weeks)
• Internal Medicine (10 weeks)
• Research (four weeks)

*Orientation rotation length may be adjusted to match resident’s entering experience.

Required Longitudinal Learning Experiences (approximately 11 weeks)

• Specialty Pharmacy Operations – Longitudinal – four hours weekly on Mondays for approximately 46 weeks (starts after completion of Orientation).
• Internal Medicine Ambulatory –  Longitudinal – 12-hours weekly for approximately 36 weeks (starts after completion of IM 10 week core LE). Eight hours on Tuesday and four hours on Thursday.
• Anticoagulation Ambulatory I – Longitudinal - resident assigned anticoagulation patients for assessment, monitoring, and patient communication telephonically over the course of 12 weeks. Plan to spend four hours on this activity every Wednesday.

Elective Rotation Opportunities** (31-33 weeks): Rotations lengths are 8-10 weeks

• Administration
• Cardiology (HF) Ambulatory I
• Dermatology Ambulatory I
• Emergency Medicine
• Gastroenterology Ambulatory I
• Infectious Diseases Ambulatory II/III
• Neurology Ambulatory I
• Introduction to Ambulatory Oncology
• Pulmonary Ambulatory I
• Rheumatology Ambulatory I
• Transplantation Clinic with Transitions of Care Focus Rotation

Longitudinal Experiences**

Specialty Pharmacy Operations

The specialty pharmacy operations rotation is a required, longitudinal learning experience at the PCAM outpatient specialty pharmacy that will recur approximately four hours once weekly. The retail/specialty pharmacy setting fills approximately 400 prescriptions daily for complex patients seen by primary care and specialty care providers. The role of the resident is to anticipate, review, or resolve medication-related problems for all patients in addition to ensuring safe and effective medication use for patients on both specialty and maintenance mediations.

Internal Medicine

To build upon the required Internal Medicine ten-week rotation, the resident will participate in a weekly 12-hour longitudinal experience (divided into three 4-hour clinic sessions) in an Internal Medicine clinic. This experience will enhance the resident’s understanding of the continuity of care that Ambulatory Care Pharmacists provide to patients and will additionally present the resident with opportunities to foster relationships with patients and healthcare teams. The pharmacy resident will be involved in obtaining patient medical and medication histories, evaluating drug therapies, developing pharmaceutical care plans, monitoring patients’ therapeutic outcomes, consulting with other health care providers, providing education to patients and health care providers, and answering drug information questions. In addition, the resident will be an integral part of the transitions of care clinic, which focuses on post-hospitalization outpatient visits where the pharmacy resident will provide medication-related services that include medication education, medication reconciliation, medication access, and medication therapy/disease state management.

**Based on resident’s progression, preference and rotation availability, elective rotation lengths are chosen between an 8-10 week duration. Additionally, rotations may be repeated based on resident’s preference and rotation availability. For repeated learning experiences (LE), preceptors will develop a new LE description that differentiates the repeated LE from the initial LE.
**Elective and Longitudinal experiences offered and/or rotation durations or frequencies are subject to change based on preceptor availability, resident's experience, schedule and resident's preference.

Research/Scholarly Activities

• Identify a research question and develop methods to complete an ambulatory care-related research project.
• Complete a quality improvement project and present to the Specialty Pharmacy Quality and Safety Meeting.
• Coordinate and develop, a poster outlining the methodology of the research project for presentation at the ASHP Midyear Clinical Meeting.
• Submit a research project manuscript to an appropriate journal (optional).
• Submit an abstract for poster presentation (research or case report) to a national meeting (optional).
• Participate in writing a review article (optional).

Teaching/Education

• Assist in the mentoring of pharmacy residents, students and staff.
• Provide in-service education to nursing, pharmacy and/or physician and advanced provider staff.
• Develop presentations for Therapeutics Conference.
• Attend ambulatory care conferences and specialty conferences as assigned by the preceptor.
• Attend all and present one topic monthly at the biweekly Ambulatory Care Topic Discussion.
• Provide an ACPE-accredited presentation at Pharmacy Grand Rounds.
• Instruct pharmacy students in didactic coursework at Jefferson College of Pharmacy (optional).
• Present a lecture at Jefferson College of Pharmacy to pharmacy students (optional).
• Serve as primary preceptor for an IPPE or APPE student rotation (optional).

Leadership

• Develop drug or therapeutic guidelines and drug utilization reviews as needed.
• Participate in the clinical intervention program, adverse drug reaction reporting program and medication error program.
• Participate in and serve as secretary of the Specialty Pharmacy Quality and Safety Meeting.
• Certify in Basic Life Support.
• Attend monthly Ambulatory Care Pharmacy Residency meetings.
• Attend the ASHP Mid-year clinical meeting, Eastern States Residency Conference (optional) or an Ambulatory Care focused meeting (optional), as funding allows.

Program Director

Danielle Burkhart, PharmD, MBA, BCACP
Ambulatory Pharmacy Coordinator
Hospital of the University of Pennsylvania
Danielle.Burkhart@pennmedicine.upenn.edu

Application Requirements

Candidates interested in the program should submit the following via PhORCAS by Jan 3rd:

• Academic transcripts from your pharmacy school (including pre-pharmacy college training)
• Letter of intent which addresses the following: why you have chosen the Hospital of the University of Pennsylvania, why you have chosen to pursue specialized training in ambulatory care and your residency and career goals.
• Curriculum vitae
• Three letters of recommendation (at least one from a clinical rotation preceptor, preferably from an Ambulatory Care rotation)