Pharmacy Residency Curriculum
Internal Medicine I
Internal Medicine involves the provision of pharmaceutical care on internal medicine/telemetry units within the hospital. The resident will review medication profiles daily to ensure appropriate indications for use, appropriate dosing, monitor for adverse effects, prevent drug interactions, and ensure proper laboratory monitoring. Daily responsibilities will also include providing pharmacokinetic dosing and management, parenteral nutrition management, ensuring medication safety, properly documenting patient care activities, and effectively communicating with healthcare providers and patients. The resident will provide drug information and education for healthcare providers, patients, and students. In addition, the resident will observe medical procedures as available to gain a better understanding and knowledge base.
Internal Medicine II
On Internal Medicine II, the resident will participate in rounds with the Medicine Team for the Family Medicine Residency Program. The resident will be responsible for identifying and resolving pharmacotherapy issues for the patients admitted to the hospital under the care of Family Medicine. This includes an appropriate review of outpatient and admission medications for indication, interactions, dose, and duration and providing therapeutic drug monitoring. The resident will serve as the drug information specialist to the team and will provide at least one in-service presentation. The resident will also assist the medical residents with the medication reconciliation process upon discharge of a patient from the service and will provide discharge counseling to the patients. The resident will follow-up with the patient two days after discharge to see if the patient is having any adverse effects or has any questions or concerns.
The critical care learning experience is intended to provide an opportunity for the resident to apply didactic learning with clinical experience, to further knowledge of critical care medicine, and to develop skills in providing pharmaceutical care to the critically ill. The resident will participate in pharmacokinetic dosing, parenteral nutrition consults, and respond to medical emergencies. The resident is expected to monitor patient labs and culture and sensitivity reports, review patient medical records, and participate in interdisciplinary morning rounds. The resident will participate in teaching sessions pertaining to disease states or medications, education of medical and hospital personnel, and attend multidisciplinary team conferences.
Drug Information is a two-month longitudinal rotation with a concentrated one-month rotation involving gathering and organizing information in order to assist or directly identify ongoing drug related problems, root cause analyses, and formulary issues important to SVMC. This rotation entails evaluating and analyzing the medication-use system against current best practices to ensure optimal outcomes. The Drug Information learning experience is devised in a format to establish a working foundation for providing pharmaceutical care to patients and pharmaceutical information to healthcare professionals and the general public. The resident will participate in a drug class review, medication use evaluation, journal clubs, and will formulate a drug monograph. The resident will also be required to participate and interact with select medical professionals and hospital committees including the Pharmacy and Therapeutic Committee.
Pharmacy Management is a longitudinal rotation with a concentrated one-month rotation involving the management of the pharmacy department services in the hospital environment. The longitudinal experience is for five two-month longitudinal rotations focusing on pharmacy administration, pharmacy education, quality management, and drug-information/ clinical services. The resident participates with the pharmacy managers in all aspects of the department management. The resident will be introduced to basic principles of pharmacy financial management, human resource management, clinical performance measures, regulatory requirements, and professional strategic planning.
Pharmacy Practice is a longitudinal rotation intended to provide the resident the opportunity to develop necessary skills to function as an independent, confident practitioner while providing pharmaceutical care to patients. The resident will complete pharmacy practice shift assignments one evening a week and every third weekend. In addition, the resident will staff one major holiday (Thanksgiving, Christmas, or New Year’s Day) and two minor holidays (the day after Thanksgiving, Christmas Eve, or New Year’s Eve and Labor Day, Good Friday or Memorial Day). Staffing assignments will be sufficient to provide the practice experience necessary to function as a competent practitioner. Responsibilities will include both distributive functions utilizing established systems and procedures and clinical pharmacy services for the physicians, nursing staff, and patients. The depth of the resident’s level of responsibility will increase during the residency year as the resident develops further knowledge and competency with distributive and clinical services. Shifts requiring increasing professional independence will be assigned progressively to the resident during the course of the residency year.
One of the outcomes of the residency program is the completion of a research project. It requires the resident to identify a pharmacy practice-related issue that needs to be investigated and design, execute, and report the results of the investigation. The resident will present the research results at the Florida Residency Conference. The completed project should include a written paper suitable for publication. The objective of this activity is for the resident to gain skills in study design, the IRB approval process, data collection, presentation of research data, and publication. The resident may choose the research project from a list of ideas from the pharmacy department or from an idea of their own. The Research Council will give final approval of the research project idea, oversee the progress of the research project, and will serve as a resource for the resident. The resident will work closely with a primary co-investigator and reviewer that will be assigned based on the research project.
Anticoagulation is designed to enable the resident to acquire the necessary knowledge and skills regarding anticoagulation drug monitoring and therapy. The purpose of this learning experience is to familiarize the resident with the knowledge base and skills to ensure the safe and effective provision of anticoagulation in an in-patient setting. The resident will gain experience with warfarin therapy management, education, novel anticoagulation agents, anticoagulation bridge therapy, and optimizing patient outcomes. The experience will include learning to gather and extrapolate information from a patient’s medical record, to clinically monitor patients and drug therapy, to make patient-specific therapeutic recommendations, to provide useful and precise drug information, protocol development, and to build effective communication skills. The resident will be able to develop and strengthen his/her clinical skills and knowledge base in order to provide quality pharmaceutical care. The resident will actively participate as a co-preceptor of any pharmacy students on the rotation, lead topic discussions, serve as a mentor, facilitate learning opportunities, participate in evaluations, and other activities as determined by the preceptor.
Cardiology is designed to enable the resident to acquire the necessary knowledge and skills regarding basic pharmacotherapy of cardiovascular disorders. The resident will have the option to take the full 4 weeks (Telemetry and cardiac intensive care) or divide 4 weeks of the rotation between anticoagulation and cardiology based on resident’s need, preference, and interest. Resident will also observe cardiac interventions, discuss cardiology topics, and may participate in heart failure rounds and education. At the end of the rotation, the resident should be able to identify, manage, and counsel patients and other healthcare providers regarding medication therapy, with an emphasis on cardiovascular conditions.
The resident will review admission and non-admission patient medication orders to ensure appropriate indications for use, appropriate dosing, and the avoidance of potential drug interactions in order to provide pharmaceutical care for patients in the Emergency Medicine Department. The resident will be responsible for identifying patients presenting with adverse drug events, including overdoses, sub- or supra-therapeutic laboratory parameters and allergic or other drug-related events. Daily responsibilities will include initiation of pharmacokinetic dosing consultations, response to medical emergencies, ensuring medication safety, properly documenting patient care activities, and effectively communicating with healthcare providers and patients. The resident will also provide drug information and education for healthcare providers, patients, and students.
The Family Medicine rotation involves the provision of pharmaceutical care for patients in the Family Medicine outpatient clinic. The pharmacy resident will be responsible for identifying and resolving pharmacotherapy issues for patients including reviewing outpatient medications for appropriate indication, interactions, dose, duration, and appropriate monitoring accordingly to evidence based medicine. The resident will obtain medication histories, assess patient compliance, and provide counseling for inhalers, insulin administration, and all new medications. One patient home visit with an attending physician and medical resident will be required. The resident will also provide patient education classes for cardiac medications, pulmonary medications, and warfarin. Finally, the resident will serve as a drug information resource for Family Medicine and will provide one formal presentation.
The Infectious Disease rotation involves the evaluation of empiric as well as definitive antibiotic therapy. The resident will gain experience and proficiency in a diverse patient population. The resident will develop problem solving skills through a variety of patient care experiences including antibiotic dose optimization and antibiotic surveillance. The resident will also participate in a variety of interdisciplinary activities in the inpatient setting such as lab rounds and Antibiotic Stewardship Program. The ultimate goal is to facilitate and increase the therapeutic knowledge and development of practice skills in the infectious disease setting.
On the Oncology rotation, the resident will become part of the Oncology team which includes the Oncologist, Patient Care Coordinator (PCC), Oncology Pharmacist, and Oncology nurse in order to provide direct patient care to patients on St. Vincent’s two Oncology units. The resident will assume the responsibility for all aspects of patient drug therapy including advising physicians, nurses, and patients on appropriate drug use, participating in formal morning Oncology rounds, monitoring patient labs, monitoring culture and sensitivity reports, pharmacokinetic and parenteral nutrition consulting, and medication-use assessment. Other responsibilities include patient education, drug information consults, contributing to the pharmacy Oncology monthly newsletter, reviewing chemotherapy medications and cancer disease states, attending oncology educational meetings and providing lectures on drug therapy to medical and nursing staff.
The Parenteral Nutrition (PN) elective specializes in adult parenteral nutrition support. The resident will be responsible for the designing, implementing, and monitoring PN’s throughout the hospital. The resident will meet the learning objectives through readings, case studies, practical experience monitoring patients throughout the institution, and through documentation functions involved with parenteral nutrition care. The resident will develop the knowledge and skills required to prepare PN solutions and provide pharmaceutical care for patients at SVMC who require parenteral nutrition support.
Pharmacy Informatics involves the management and development of pharmacy technology and informatics in the hospital environment. The resident will work on technology projects at St. Vincent’s Medical Center Riverside, Southside and Clay County campuses. The resident will contribute to meetings with the health system’s Information Technology Department. In addition, the resident will participate in topic discussions including principles of process analysis and automation, clinical decision support, clinical documentation in the electronic medical record, evidence based protocols for CPOE, automated dispensing, workload statistics and clinical reporting, and medication integration in the electronic medical record.
Quality Management entails quality and patient safety issues that involve the pharmacy department services in the hospital environment. The resident will participate with the department manager in all aspects of quality management and patient safety issues such as adverse drug reaction investigating, medication error reporting, Joint Commission readiness, and root cause analyses. The resident will be given an opportunity to participate in projects that address quality improvement and patient safety.
Sterile Products is focused on the compounding of intravenous admixtures in a hospital setting. The rotation will cover aseptic technique, USP 797 guidelines and compliance, stability and compatibility of compounded products, and specialty products such as intrathecal pain pumps, chemotherapy, and TPNs. The pharmacy resident is responsible for developing proficiency in aseptic technique. Once this is achieved, the resident will progress to IV room pharmacist responsibilities: managing workflow, performing the final check of sterile products, chemotherapy review and verification, TPN review and verification, and high risk compounding processes.
On the Surgery rotation, the resident will be responsible for identifying and resolving pharmacotherapy issues for patients in the Operating Suites, Holding, Recovery, Endoscopy and Labor and Delivery units. The resident will work with anesthesiologists, surgeons, perfusionists, CRNA’s, operating room nurses and staff, and students to ensure appropriate drug therapy, administration, and drug utilization. Daily responsibilities will include dispensing and reconciling controlled substances, providing drug information quickly to care providers, and monitoring drug utilization in the OR and associated areas. The resident will provide and document therapeutic drug monitoring of all pre-operative, peri-operative, and post-operative medications in selected cases according to evidence based medicine. The resident may also be responsible for discharge teaching including warfarin therapy in the orthopedic units and Lap-Band consults. In addition, the resident will provide drug information and education for healthcare providers, patients, and students.
Transitions of Care
The goal of the Transitions of Care Residency Learning Experience is to provide opportunities for residents to build on knowledge and skills acquired through didactic education and practical pharmacy practice experiences and apply them in direct patient care activities. Resident responsibilities will include; actively participate in direct patient care, including obtaining patient medical and medication histories, evaluating and optimizing drug therapies, developing pharmacy care plans, monitoring patients' therapeutic outcomes, consulting with physicians and non-physician providers, and providing education to patients. Residents will learn about federal guidelines for MTM reimbursement and pharmacist roles in achieving core measures and outcomes. Residents will work directly with an interdisciplinary team and develop skills to achieve patient care outcomes and increase patient awareness of health conditions.
Pediatrics, Psychiatry and Toxicology are potential electives at other local healthcare facilities based on availability.
St. Vincent’s Medical Center Riverside Department of Pharmacy Services is committed to developing and maintaining high quality learning experiences and opportunities. Changes may be made to the curriculum and other learning activities in order to ensure excellence in the training program.