PGY-2 Internal Medicine Residency | Department of Pharmacy Services | UC Davis Health

Preceptor Team

Rachelle Barry, PharmD, BCPS
Clinical Pharmacist, UC Davis Health, Internal Medicine
Assistant Clinical Professor, University of California, San Francisco School of Pharmacy

TJ Gintjee, PharmD
Clinical Pharmacist, UC Davis Health, Internal Medicine

Rebecca Hluhanich, PharmD
Senior Clinical Pharmacist, Internal Medicine
Assistant Clinical Professor, University of California, San Francisco School of Pharmacy

Matthew Horton, PharmD, BCPS
Clinical Pharmacist, UC Davis Health, Internal Medicine

Mattie Huffman, PharmD, BCPS
Clinical Pharmacist, UC Davis Health, Internal Medicine

Kathie Le, PharmD, BCPS
Senior Clinical Pharmacist, UC Davis Health, Internal Medicine
Associate Clinical Professor- University of California, San Francisco School of Pharmacy

Bo (Anne) Liu, PharmD, BCPS
Clinical Pharmacist, UC Davis Health, Internal Medicine
Assistant Clinical Professor, University of California, San Francisco School of Pharmacy

Tiffany Pon, PharmD, BCPS
Clinical Pharmacist, UC Davis Health, Internal Medicine
Associate Professor of Clinical Pharmacy
Director, Greater Sacramento Area Experiential Program
University of California, San Francisco School of Pharmacy

Denise Roach, PharmD, BCGP
Pharmacist Supervisor, Inpatient Clinical Services
Assistant Clinical Professor, University of California, San Francisco School of Pharmacy

Florence Tan, PharmD, BCPS, BCGP
Clinical Pharmacist, UC Davis Health, Internal Medicine
Assistant Clinical Professor, University of California, San Francisco School of Pharmacy

Program Purpose

PGY2 pharmacy residency programs build on Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency programs to contribute to the development of clinical pharmacists in specialized areas of practice. PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings. Residents who successfully complete an accredited PGY2 pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification, if available.

Program Overview

The Internal Medicine Residency at the University of California, Davis Medical Center, is a one-year, PGY2 specialty residency in Internal Medicine Pharmacy Practice. The residency is supported by the Department of Pharmacy.

The PGY2 pharmacy residency in internal medicine is designed to transition PGY1 residency graduates from generalist practice to specialized practice focused on the care of adults with medical problems, across the continuum of care. Residency graduates are equipped to participate as integral members of interdisciplinary teams caring for internal medicine patients, assuming responsibility for the patient’s medication-related care. In that role they provide the team with evidence-based medication-related information and formulate that information into expert recommendations to the team for the use of medications and other therapeutic approaches.

Residents who successfully complete the PGY2 Internal Medicine Pharmacy Residency are prepared to step into an advanced pharmacist role within an Academic Medical Center with the skillset to provide evidence-based care to complex acutely and chronically ill patients, educate pharmacy learners as well as inter-professional team members and conduct clinical research. Graduates of the program will have developed competency to provide safe, high quality, multi-disciplinary pharmaceutical care to patients across the continuum of care. Additionally, the aim is for residents of this program to develop clinical, analytical, teaching, and leadership skills to practice and teach in a positive learning environment that promotes independent, critical thinking, creativity, and a culture of mutual respect.

UC Davis Health and Pharmacy Services

UC Davis Medical Center is a major academic health center located in Sacramento, California. Pharmacy services recruits, hires, and trains caregivers to provide progressive pharmacy services as collaborative team members to support optimal patient outcomes.

More about the Department can be found on our Webpage

Program Design

The UC Davis Health PGY2 Internal Medicine Residency is designed to meet the educational goals and objectives, as outlined by the American Society of Health-System Pharmacists (ASHP) PGY2 Internal Medicine Residency Accreditation Standard.

Educational Outcomes Required by the Accreditation Standard:

R1. Serve as an authoritative resource on the optimal use of medications.
R2. Optimize the outcomes of internal medicine patients by providing evidence based, patient-centered medication therapy as an integral part of an interdisciplinary team.
R3. Demonstrate excellence in the provision of training and educational activities for health care professionals and health care professionals in training.
R4. Demonstrate leadership and practice management skills.
R5. Contribute to the body of pharmacy knowledge in internal medicine.
R6. Evaluate, manage, and improve the medication-use process.

Program Structure

The PGY2 Internal Medicine Residency is a full-time, one-year commitment, beginning on July 1 and ending on June 30, unless alternative dates are pre-arranged. Clearance to start work by UC Davis Medical Center Employee Health and a Human Resources orientation meeting must be completed prior to July 1.

The UC Davis Health PGY2 Internal Medicine Residency is currently comprised of 9 required Block Rotations and 6 Elective Rotations. Electives may be added based on available resources and resident interest. Additional required Longitudinal Experiences are concurrent throughout the residency year.

UC Davis Medical Center PGY2 Internal Medicine Residency Learning Experiences:

The residency learning experiences will primarily be divided into block rotations and longitudinal learning experiences. The majority of rotations will be 4 weeks in duration. Rotation schedules will be determined based on availability and resident interests and will be designed to include all required CAGOs as well as a variety of clinical experiences and environments. Rotation schedules will be adjusted and updated quarterly, in conjunction with preparing the updated development plan.

• Rotations can be extended or repeated per the resident’s interests
• Each longitudinal experience will have some concentrated block time
• Project time will be coordinated throughout the year as arranged with the PGY-2 Internal Medicine program director

Required Learning Experience	Type of Experience	Overview
Orientation/ Training	Block (4 weeks)	Orientation to UC Davis Medical Center and PGY2 Internal Medicine residency program. Duration may be adjusted, based on the resident’s previous experience and knowledge of UC Davis Medical Center. Orientation will also prepare the resident for weekend internal medicine and evening service coverage.
Research and Scholarship	Longitudinal (12 months)	The resident will be expected to complete a project selected and agreed upon by the resident and RPD. Attention to the deliverables set forth by the Pharmacy Research oversight committee facilitates successful completion of the project.
Topical Learning	Longitudinal (12 weeks)	The resident is expected to actively participate in the National Internal Medicine Journal Club Series. Topics covered in the series will contribute toward the required Items in the Disease State Appendix, included in the program Competency Areas document. ASHP-PGY2-Internal-Medicine-CAGOs-COC-Approved (PDF)
Grand Rounds	Longitudinal (12 weeks)	The resident will work with the RPD on a selected topic and prepare an ACPE accredited pharmacy grand rounds presentation with guidance from a content expert and the resident’s mentor.
Internal Medicine I, II, and III	Block (4 weeks each)	The resident will join the patient and disease state focused discussion with the academic team on daily rounds, facilitate the integration of pharmacy services, provide patient-centered comprehensive medication management, and drug therapy optimization for adult internal medicine patients. The resident will be involved in the patient discharge planning process, medication education, medication procurement and/or solving medication access barriers.  Longitudinally, the resident will be responsible for the retrieval and understanding of drug or disease state information, patient or disease presentation, precepting other learners or health care providers.  Furthermore, the resident will evaluate institution protocols, modify, or formulate new ones as needed. A case conference will be presented in each of the 3 blocks.
Hospitalist Service	Block (4 weeks)	Following completion of the Internal Medicine I rotation, the resident will complete the Hospital Medicine Rotation and work with attending physicians (i.e. hospitalists) in the acute care setting. The resident will actively participate in interdisciplinary discharge rounds, order verification, monitoring for safe and effective medication therapy, medication reconciliation/transitions of care, medication education, and precepting pharmacy learners on rotation as applicable.
MICU/ Pulmonary Hypertension	Block (4 weeks)	The resident will function independently as the pharmacy representative for the MICU team by selecting, recommending, and monitoring appropriate patient specific pharmacotherapy. Additionally, the resident will be exposed to efficacy trials for medical management of pulmonary hypertension in newly diagnosed patients.
Infectious Diseases Stewardship	Block (4 weeks)	In collaboration with the infectious diseases pharmacist and physician, the resident will contribute to improving outcomes for patients with infectious diseases, optimizing selection/dosing/duration of antimicrobial therapy, and preventing emergence of antimicrobial resistance and adverse effects related to antimicrobials.
Nephrology	Block (4 weeks)	The resident will work with the inpatient nephrology consult team to manage patients with chronic kidney disease and acute kidney injuries. The resident will learn more about drug dosing and modalities of hemodialysis. Residents will actively participate in rounds and discuss medication recommendations with specially trained nephrology pharmacists.
Cardiology Advanced Heart Failure	Block (4 weeks)	The resident will act as a medication expert for the advanced heart failure service, including patients with implanted left ventricular assistive devices.
Clinics (OCH, HIV/ ID, CHF, SOT, Geriatrics)	Longitudinal (2 clinics for 6 months each)	The resident will serve as an effective member of a multidisciplinary team in the ambulatory care clinic and be directly involved in evaluating patients, providing recommendations for therapeutic changes, and addressing issues surrounding patient access to medications.
Medication Safety	Longitudinal (10 weeks each)	The resident will establish a process to identify and review reliable sources of information, assess the organization's vulnerability to medication errors, and design targeted action plans to address key vulnerabilities. The resident will also participate in assessing organizational safety culture through periodic tracers and routine evaluation of adverse events reported to the online incident reporting system (RL Solutions).
Pharmacy Leadership	Block (4 weeks)	The resident will learn principles and tools needed to manage the provision of acute care pharmacy services, including clinical and distributive operations, human resource management, and strategic planning in the areas of adult acute care pharmacy practice.
Emergency Medicine with Geriatric Focus	Block (4 weeks)	The resident will participate in activities required on the service such as responding to all medical and trauma codes that arrive in the emergency department. The resident will work in the multidisciplinary field with an emphasis in geriatric emergency medicine.
Academia	Block (4 weeks)	The resident will learn skills including, but not limited to, developing an academic CV, participating in committee work, exercising scholarly and creative skills, developing a syllabus, creating a teaching portfolio and teaching materials. The resident will have opportunities to teach courses, precept/mentor students, and aid in all aspects of course and rotation organization and preparation.
Transplant	Block (4 weeks)	The resident will become proficient in all areas of care for solid organ transplant recipients across the continuum of care. Residents will design medication regimens and provide patient education pre-transplant, peri-operatively, and post-operatively.
Trauma ICU	Block (4 weeks)	The resident will participate in rounding, order verification, coordinating and troubleshooting medication delivery, and code blue responses for patients admitted to trauma (SICU). The resident will also triage and assess complex problems and manage therapeutic drug monitoring.
Behavioral Health	Block (4 weeks)	The resident will participate alongside an interdisciplinary clinical team on the inpatient behavioral health unit to optimize therapy and transitions of care. The resident will gain familiarity with psychotropic medications and provide recommendations, monitoring, stewardship, and utilization of these medications.
Hematology/ Oncology	Block (4 weeks)	As part of the heme/onc inter-professional team, the resident will coordinate cancer treatment, supportive care and oversight of complex medication regimens for patients admitted to the service. The resident will focus on symptom management and management of complications of chemotherapy.

UC Davis Medical Center PGY2 Internal Medicine Resident’s Role in Teaching:
UC Davis Medical Center offers many opportunities for both clinical and didactic teaching. The resident will be responsible for assisting preceptors with clerkship teaching for University of California, San Francisco pharmacy students. As opportunities present, the resident will be engaged in teaching and precepting before assuming the primary preceptor role for UCSF pharmacy students in the latter part of the residency.

The resident will be required to prepare an ACPE accredited pharmacy grand rounds presentation or pharmacy competency presentation. In addition, the PGY2 Internal Medicine resident may choose to participate in academic teaching, as requested by regional schools of pharmacy, with the approval of the PGY2 Internal Medicine Residency Program Director.

Residency Research Project:
All UC Davis Medical Center PGY2 residents are required to complete a research project and present their research in a podium presentation at the UC Collaborative Conference or other regional meeting. In preparation for conducting their research project, the resident will complete UC Davis Health IRB-required training and certification. The resident will prepare a project proposal, which will be reviewed and approved by the UC Davis Medical Center Pharmacy Residency Oversight Committee (PROC). The resident will also submit their project to the Pharmacy and Therapeutics Committee. They will submit the project to the IRB for review, before embarking on their research. Upon completion of the project, the resident will be required to prepare a manuscript suitable for publication. PGY2 residents will submit their manuscripts for publication and prepare an electronic poster suitable for submission.

Committee Assignments:
The PGY2 Internal Medicine resident will participate in various committee activities, as assigned by the PGY2 Internal Medicine residency director. Assignments will be determined based on current department initiatives. The purpose of the resident’s committee involvement is to ensure the resident gains exposure to the pharmacist’s role in inter-professional leadership. 

Professional Development:
The PGY2 Internal Medicine resident is encouraged to maintain an active role in pharmacy professional organizations. The resident will be provided with some financial support from the institution and professional leave time to facilitate participation in professional development activities.

Pharmacy Department Service:
The PGY2 Internal Medicine resident will be expected to provide approximately 400 hours of pharmacy department service. This expectation will be met primarily by providing Internal Medicine Service pharmacist coverage every third weekend plus one major holiday (Thanksgiving; Christmas Eve; Christmas Day; New Year’s Eve; New Year’s Day) as well as providing 120 hours of evening Department of Pharmacy support.

Required Competencies:
Residents function as licensed pharmacists in patient care activities. As such, minimum knowledge in a variety of areas must be assured. Within one month of starting the Residency, the resident must complete competencies required of all clinical pharmacists. Basic Cardiac Life Support (BCLS) certification is required, and Advanced Cardiac Life Support (ACLS) training will be provided if not already certified.

Resident Portfolio:
Each resident must maintain a portfolio containing all information from the residency year including but not limited to: copies of papers or projects done during rotations, lectures given, research project manuscript and secondary projects. The portfolio shall be maintained in PharmAcademic and/or in the resident's folder on the Pharmacy Department shared drive.

Benefits:
Health, dental and vision insurance for the resident and dependents, paid time off (PTO), extended sick leave, and professional development days. Use of leave must be arranged in advance with the RPD.

Travel funds (~$2500) are included in the base salary. There is a stipend for scrubs.

Resident Personnel Policies:
The following policies can be located in the Pharmacy Resident Personnel Manual

• Resident Qualifications
• Early Commitment Policy
• Pre-employment drug testing
• Health insurance and Benefits
• Licensure requirement for 2/3 of the residency year
• Moonlighting
• Duty hours/tracking of duty hours
• Professional, family, and extended leave policies
• Dismissal policy and consequences of failure to progress

Requirements for successful completion of the residency:

• California license obtained per residency policy and completion of a minimum of 2/3 of the residency as a licensed CA Pharmacist (deadline for CA pharmacist licensure: October 1)
• A minimum of 12 months training inclusive of standard vacation, professional and sick leave
• Completion of all required rotations/learning experiences
• All required residency goals and objectives evaluated at least once, without any “needs improvement” (At least 80% of G&Os must be “Achieved for the Residency”. Some G&Os may be checked off by the RPD at resident closeout.)
• Resident closeout completed in PharmAcademic, confirming all tasks are completed
• Completion of a research project, manuscript and manuscript submission for publication
• Presentation of research project at a regional, state or national conference.
• Completion of secondary project as assigned, such as monograph or QI initiative
• Completion of all required items on the Internal Medicine Residency Appendix of diseases and conditions
• Completed staffing requirements as outlined by the residency program description
• Pharmacy Grand Rounds presentation

Pharmacy Residency training programs at UC Davis Health are conducted under the licensed entity within UC Davis Health which is UC Davis Medical Center.