PGY-1 Pharmacy Residency Program Structure and Rotations

The postgraduate year 1 (PGY1) pharmacy residency year is divided into four quarters, each with three blocks. All blocks are either four or five weeks in length. Each resident is expected to staff every third weekend, with one day off after each weekend worked. Additionally, in order to facilitate rapid advancement of distributive skills — the resident will staff for a four-hour commitment (5 to 9 p.m.) at the end of the day on the Friday of each staffing weekend, starting in orientation through the next three blocks. This Friday staffing requirement may be extended beyond the three blocks, based on determination of need by the longitudinal staffing preceptor regarding the resident’s ability to achieve specific milestones in the learning experience. Residents also will work two of seven holidays.

Required rotations listed below, plus four direct patient care (DPC) elective rotations selected by the resident, in consultation with the residency program director (RPD), comprise the majority of the year. The two remaining blocks may be used for any rotation (direct patient care electives or practice management electives). The five longitudinal learning experiences add a broader array of objectives that are practiced over the entire residency year.

Each resident will be assigned to a home-base practice site within the Norton Healthcare system. This is where the orientation, internal medicine and critical care rotations, as well as weekend staffing requirements will be completed. More information on the structure can be found here.

Required Rotations – Direct Patient Care (DPC)

This five-week rotation orients residents to their home-base practice site as well as Norton Healthcare facilities where learning experiences occur. This rotation serves as an introduction to pharmacy practice as it relates to both health-system and hospital-specific operations and delivery of patient care. During the orientation period, residents become familiar with the hospital facility and departmental policies and procedures, and begin the process of integration within the pharmacy staff.

The internal medicine (IM) five-week rotation provides residents with a broad training experience in managing acutely ill internal medicine patients who are admitted to an adult medical/surgical unit for diverse and complex medical management. The goal of this rotation is for the resident to develop knowledge, skills and competencies to provide evidence-based, patient-centered medication therapy management.

The critical care medicine I rotation is a five-week rotation designed to provide the resident with an introduction to critical care medicine. The goal of this rotation is for the resident to develop knowledge, skills and competencies to provide evidence-based, patient-centered medication therapy management for disease states commonly encountered in critically ill patients. At the conclusion of this learning experience, the resident should be able to recommend appropriate treatment options, perform therapeutic drug monitoring for selected medications and communicate with other health care professionals to ensure optimal drug therapy.

The infectious diseases rotation provides PGY1 residents with a broad training experience in the infectious diseases pharmacotherapy needs of acutely ill inpatients and in the principles of antimicrobial stewardship. Across a four-week rotation, residents will complete prospective audit and feedback; blood culture reporting and recommendation; patient counseling; anti-infective allergy clarification and management; and drug information service. Using Norton Healthcare’s pharmacist-driven rapid response bacteremia protocol will allow residents to be first responders to initiate and adjust antibiotic therapy.

The four-week transitions of care rotation provides residents with practical experiences related to a clinical pharmacy service in transitions of care. Through this experience, residents will explore unique opportunities and document challenges/barriers that exist for providing medication management during transitions of care. The role of the pharmacist in these areas is to facilitate transitions of care for patients admitted to medical/surgical units and deemed to be at high risk for readmission. This will be accomplished through the collection of accurate admission medication histories, the delivery of comprehensive medication education at admission and discharge, and coordination with the outpatient pharmacy.

Required Longitudinal Experiences

All longitudinal experiences are 52 weeks long, spanning the entire residency year.

This longitudinal experience enhances teaching skills by allowing residents to earn a teaching and learning certificate through Sullivan University College of Pharmacy. The didactic teaching and learning curriculum is complemented by activities facilitated by Norton Healthcare, such as educating patients, other pharmacists and health care providers, and serving as a preceptor.

Each resident will complete a major project during their residency year, designed to improve pharmacy practice as well as align to Norton Healthcare and pharmacy department strategic goals. A list of potential projects is generated and vetted by pharmacy leadership prior to the beginning of each new resident class. Residents are assigned projects from the list based on interests and alignment with future goals. All projects are facilitated by a project team, with the resident and project preceptor serving as the primary investigators/facilitators. All projects must be presented at the Great Lakes Pharmacy Resident Conference. Finally, the project is presented to the residency program director in final manuscript format as a criterion for successful completion of the residency program. Publication prior to successful completion of the residency program is encouraged but not required.

This learning experience is conducted across a wide variety of professional situations, including but not limited to local, state, regional and national professional meetings, Norton Healthcare pharmacy departments and multidisciplinary committee work (such as pharmacy clinical leadership and pharmacy and therapeutics committee meetings), colleges of pharmacy and the community. Opportunities to participate in legal and regulatory situations vary from year to year (for example, DNV accreditation, and residency accreditation survey). This learning experience emphasizes patient and professional advocacy as leadership skills and a professional obligation.

As part of this learning experience, residents each will have a leadership role for the duration of the year. Available leadership positions include:

  • Residency advisory committee/continuous quality improvement representative (1)
  • Longitudinal learning experience coordinator (1)
  • Recruitment and technology chair (2)
  • Resident engagement coordinator (2)

This learning experience provides the resident with longitudinal exposure to experiences and practice with information systems. This learning experience may occur at any location/facility. It will focus on the role of the pharmacist in the integration of technology throughout the pharmacy enterprise and will emphasize how pharmacists and technology interface to support delivery of pharmacy services. The resident can expect to participate in specific learning experiences that are coordinated through the core rotations.

This longitudinal learning experience occurs in the home-base practice site for each resident. It serves to develop the skills necessary to practice pharmacy in a hospital setting, with emphasis on operational pharmacy practice. In general, this rotation takes place in the central pharmacy, with a good amount of interaction with health care team colleagues including pharmacy, nursing and physician staffs. The roles of the pharmacist in the central pharmacy include coordination and oversight for all manufacturing and dispensing of medications, verification of medication orders, managing the work flow with an emphasis on prioritization according to efficiency and safety, and provision of medication-related direct patient care when applicable. Specific areas of emphasis include using department and facility policy and procedure; functioning as a member and leader of the pharmacy team; using various hospital information systems and technology; and participating in the management of medical emergencies.

Electives

All elective rotations are four weeks long.

List is not inclusive:

  • Advanced Infectious Diseases
  • Ambulatory Care Neurology Multiple Sclerosis
  • Ambulatory Heart Failure
  • Ambulatory Oncology
  • Cardiology
  • Critical Care II
    • Cardiac
    • Medical
    • Neurocritical Care
  • Hematologic Malignancies
  • Kentucky Poison Control Center of Norton Children’s Hospital
  • Medical/Surgical Pediatrics
  • Medical/Surgical Adult
  • Neonatal Intensive Care
  • Pediatric Hematology/Oncology
  • Pediatric Infectious Diseases
  • Primary Care
  • Specialty Pharmacy Services
  • Transition From Training to Practice

All elective rotations are four weeks long.

  • Clinical Pharmacy Practice Management
  • Information Technology
  • Practice Management and Administration

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