pg2_2020

Residency Program Director:

Contact Information:
plpoole@ucdavis.edu
UC Davis Health
Pharmacy Department
2315 Stockton Blvd, Room 1310
Sacramento, CA 95817

Patricia Poole, Pharm.D, BCPS, AAHIVP
Manager, Educational Enterprise
UCDH Department of Pharmacy
Associate Professor,
UCSF School of Pharmacy
UC Davis School of Medicine

2020-2021 Resident:
Noelle Nelson

ASHP Residency Directory listing:

https://accred.ashp.org/aps/pages/directory/residencyProgramInformation.aspx?ID=209622

UCDH PGY2 Ambulatory Care Pharmacy Residency Purpose

PGY2 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) 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, in Ambulatory Care Pharmacy (BCACP).

Program Overview

The Post Graduate Year Two (PGY2) Ambulatory Care Pharmacy Residency at UC Davis Health (UCDH) is designed to provide PGY1 graduates the opportunity to accelerate growth beyond generalist practice and further the development of specialized care in areas specific to the needs of ambulatory patients. It is assumed that the resident has already achieved a basic level of competence commensurate with that of a PGY1 Pharmacy Residency. The PGY2 residency focuses on developing the knowledge, attitudes, training and skills necessary to cultivate pharmacists who are competent and compassionate practitioners who are prepared for a role as an ambulatory care pharmacist.

Graduates of the residency have the capability to design, implement, and secure collaborative interdisciplinary practice agreements necessary for establishment and ongoing management of ambulatory practice. Graduates are empowered to treat and appropriately triage the most complex chronic and acute illnesses presented by ambulatory patients, while providing care within the context of a long-term health care partnership with both patients and health care providers that emphasize health improvement and disease prevention. Completion of this PGY2 Ambulatory Care Residency will provide the practitioner the advanced critical thinking skills and clinical knowledge necessary to practice as an ambulatory care pharmacotherapy expert, to enhance ambulatory care services as a clinical coordinator, and/or to share skills with others by serving as an adjunct faculty member. Moreover, program graduates will be primed for ambulatory practice leadership to service as experts in medication prescribing.

Although the primary goal of the residency is listed above, there are options for emphasis in this residency program. With any one of the below areas of emphasis, an intensive immersion in direct patient care in the ambulatory environment is required to complete the residency. The resident may choose to emphasize in one of the following:

  • Management, which would include learning experiences tailored towards a future career as a pharmacy manager in Ambulatory or Specialty Pharmacy Settings
  • Transitions of Care, which would include an extended time of 12 weeks in TOC, as well as an inpatient rotation in Cardiology
  • Patient Centered Medical Home, which would include extended time in population management within the PCN clinics, Family Medicine clinics, and/or One community Health
  • Academia, which would include experiences with faculty from the UCSF School of Pharmacy and extended time as primary preceptor for students and residents in Family Medicine
  • Specialty Pharmacy, which would include a minimum of 12 weeks working with an established program to explore the clinical and administrative aspects of a successful specialty pharmacy 

Pharmacy Department Service

The PGY2 Ambulatory Care resident will be expected to provide pharmacy department service hours.  This expectation will be met primarily by providing staffing at One Community Health, UCDH transition of care afterhours and weekend staffing. The resident will also be expected to provide evening clinical coverage throughout the year.  A back-up pharmacist or the Residency Program Director will always be available on site or on-call, to advise and support the PGY2 Ambulatory Care resident as needed.  It is anticipated that the PGY2 resident will offset a staff pharmacist in a clinic setting, once competency is established.

Program Design

The UCDH PGY2 Ambulatory Care Residency is designed to meet the educational goals and objectives, as outlined by the ASHP PGY2 Ambulatory Care Residency Accreditation Standard.

Educational Outcomes Required by the Accreditation Standard:

R1. Patient Care
R2. Advancing Practice and Improving Patient Care
R3. Leadership and Management
R4. Teaching, Education, and Dissemination of Knowledge
Electives may be added based on available resources and resident interest

This residency will offer the resident the opportunity to rotate through several ambulatory care environments and disease states. Specifically, patient care is provided in the pharmacist-run clinics of Anticoagulation, Cardiology, HIV/AIDS, PCMH, TOC, Specialty clinics, and CMM. Patient care is provided in multidisciplinary settings, and ambulatory care pharmacy residents will interact with clinical pharmacists, pharmacy technicians, physicians, nurses, discharge planners, dietitians, respiratory therapists, patients, and caregivers to provide comprehensive care to patients in ambulatory care. Daily activities will include seeing patients, providing phone based or web based care to patients, reviewing clinic policies for appropriateness, and implementing quality assurance programs for current and new clinics. Residents will help create reports and review outcomes of the current programs. The ambulatory care resident will be expected to be proficient at working in the clinics they are working with and, from time to time, will be expected to work as a pharmacist in that setting in order to understand firsthand the best way to implement policies/procedures that affect staff and to provide professional growth.  Residents and RPD’s will determine the need to shorten or lengthen certain rotational opportunities and target areas for growth as the residency progresses.

Program Structure

The PGY2 Ambulatory Care Residency is a full-time, one-year commitment, beginning on July 1st and ending June 30th, unless alternative dates are pre-arranged.

Proposed Calendar of Activities

Quarter 1

Quarter 2

Quarter 3

Quarter 4

July

  • Orientation/training
  • Entering assessment
  • Establish residency goals/customized learning plan
  • Selection of research project topic
  • Clinical rotation

November

  • Clinical rotation
  • Conduct research

February

  • Clinical or Elective rotation
  • Residency candidate interviews

May

  • Clinical or Elective rotation
  • UC Collaborative Research Conference

August/September

  • Clinical rotation
  • Preparation of research protocol
  • Select grand rounds or competency

December

  • ASHP Mid-year Clinical Meeting (if recruiting)
  • Conduct research

March

  • Clinical or Elective rotation
  • Compile research project results and prepare draft presentation to RPD

June

  • Clinical or Elective rotation

October

  • Clinical rotation
  • IRB submission of research project
  • Quarterly development plan
  • Pharmacy Week Events

January

  • Clinical rotation
  • Quarterly development plan
  • Review residency candidate packets

April

  • Clinical or Elective rotation
  • Research project deliverables
  • Quarterly development plan

 Final week

  • End of residency closeout and program improvement evaluation
  • Residency Requirements checklist completed

Longitudinal Activities

  • Grand Rounds Presentation or Competency Training
  • Journal Club
  • Administrative Projects/CPA
  • Appendix of Therapeutic Areas of Practice
  • Committee assignments
  • Attend monthly Amb Care meetings
  • Drug Information Review
  • Self evaluation reflection
  • Teaching Program (if not completed during PGY1)
  • Research project
  • Mentorship program
  • Professional Society Involvement
  • Service requirements

UCDH PGY2 Ambulatory Care 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.  A minimum of 8 months will be spent in direct patient care experiences. Rotation schedules will be adjusted and updated quarterly, in conjunction with preparing the updated development plan.

Required Learning Experiences

Type of Experience

Overview

Orientation/training

Concentrated
(3 days)
Orientation to UCDH and PGY2 Ambulatory Care residency program.  Duration may be adjusted, based on the resident’s previous experience and knowledge of UCDH.

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 Research oversight committee facilitates successful completion of the project.

Ambulatory Care Management

Block
(4 weeks)
Work directly with Ambulatory Care Management to improve the quality of care in specific ambulatory care areas. The resident will also be required to write one or more proposals for new services and prepare to start a new service,  including identification of stakeholders, setting up the logistics and implementing the program as well as doing a reassessment of the plan and making any necessary changes.  May be extended to 12 week block experience if resident emphasis is management.

Service Requirements

Longitudinal
(12 months)
The resident will oversee the staffing schedule for the year for all Ambulatory Care residents. The staffing shifts will be in after-hours/weekend coverage for TOC, One Community Health and/or the Anticoagulation and Specialty clinics.

Patient Center Medical Home (PCMH)

Block
(4 weeks)
Focused on the model of pharmacy care within a PCMH and the pharmacist’s role on the team.  The resident will work closely with Medical Directors in Primary Care clinics to align the pharmacist’s role with the clinics vision and goals. There is an opportunity to work one day per week in the PCMH addiction clinic.

Specialty Clinics

  • Neurology
  • ID
  • Transplant
  • GI/Rheum
  • Oncology
  • Pulmonary Clinic
  • Multi-Specialty
Block
(4 weeks each )
There are a variety of specialty clinics for the resident to expand their breadth of clinical knowledge and learn the pharmacist’s role in Specialty clinics.  The resident will work closely with the Specialty pharmacist and will be expected to gain understanding of the specialized medications, regulatory agencies and practices for specialty pharmacies.

Elective Learning Experiences

Type of Experience

Overview

Academia I and II

Block
(4 weeks each)
Resident to work with a pharmacy faculty member at UCSF to learn the skills to practice in an academic environment.

International Rotation

Block
(2 weeks)
Residents who choose to participate will be offered a chance to provide pharmaceutical care to patients during a Medical Mission trip.

Transitions of Care I and II

Block
(4 weeks each)
For the resident with emphasis in TOC, an additional 4 weeks will allow the resident the opportunity to assume a greater role in directing the service and refining TOC skills.

Inpatient Cardiology

Block
(4 weeks)
For the resident with an emphasis in TOC, this rotation will expose the resident to transitions across the continuum for cardiology patients.

Management II

Block
(4 weeks)
For the resident with emphasis in Management, additional time with pharmacy managers will allow the resident the opportunity to assume a greater role in developing new services, the budget process and personnel management.

Management Specialty Pharmacy

Block
(4 weeks)
For residents emphasizing in management or specialty pharmacy, this experience provides the opportunity to participate in the management of specialty pharmacy clinics and dispensing processes, as well as the regulatory processes for specialty accreditation.
One Community Health Block
(4 weeks)
A rotation opportunity to work with the pharmacist specialist at One Community Health to gain skill in providing care to patients with HIV/AIDS in a Federally Qualified Health Center. The resident will practice under a variety of collaborative practice agreements and work with under-served populations.
Emergency Medicine Block
(2 weeks)
If TOC is chosen as an emphasis, a brief block in the ED may help the resident understand the transition from home to inpatient or from ED to home.
CMM Family Practice Block
(4 weeks)
The resident will spend time working with a trained pharmacist to master the main concepts of CMM.  After completing this rotation, they may use this experience, along with their experience with formulary management to improve the care at the University through in-services to medical residents or the development of training programs for nurses and pharmacists.
Refill Clinic Block
(4 weeks)
Review refill clinic protocols and assume the role of the pharmacist. Assist with insurance appeals, quality assurance projects or protocol updates.

Mentorship 1 & 2 (non-evaluated experience)

Longitudinal (12 weeks each) A mentor will be assigned to the resident and may provide information about his or her own career path, as well as provide guidance, motivation, emotional support, and role modeling.

UCDH PGY2 Ambulatory Care Resident’s Role in Teaching:
UCDH 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, University of the Pacific pharmacy students and UCDH PGY1 pharmacy residents.

The resident will assume the primary preceptor role for UCSF pharmacy students during their rotations in the latter part of the residency. The resident will be required to prepare an ACPE accredited pharmacy grand rounds presentation or department competency on an Ambulatory Care or Preceptor development topic, based on the resident’s interests and a department needs assessment. In addition, the PGY2 Ambulatory Care Resident may choose to participate in academic teaching, as requested by regional schools of pharmacy, with the approval of the PGY2 Ambulatory Care Residency Director.

Residency Research Project:
All UCDH 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 be complete UCDH IRB-required training and certification.  The resident will prepare a project proposal, which will be reviewed and approved by the UCDMC Pharmacy Residency Oversight Committee (PROC).  The resident will also submit their project to the Pharmacy and Therapeutics Committee. They will submit to IRB for review, before embarking on their research.  Upon completion of the project, the resident will be required to summarize their research project for the Departmental newsletter and prepare a manuscript. PGY2 residents will  submit their manuscript for publication and  prepare an electronic poster suitable for submission.

Committee Assignments:
The PGY2 Ambulatory Care resident will participate in various committee activities, as assigned by the PGY2 Ambulatory Care 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 ambulatory care pharmacists role in activities related to quality-improvement, medication safety, safe handling of hazardous drugs, guideline development and assessment/implementation of technology and automation within the institution and pharmacy department.  Committees in which ambulatory care pharmacists play a key role at UCDH include:  Thrombosis Subcommittee Meeting, Pharmacy and Therapeutics committee, Specialty Pharmacy Quality Management, and their sub-committees.

Ambulatory Care Service Project:
The PGY2 Ambulatory Care resident, if interested, may participate in a project designed to provide education and information to ambulatory care providers and/or patients on a topic related to wellness, screening and/or prevention of a chronic disease.

Professional Development:
The PGY2 Ambulatory Care resident is encouraged to maintain an active role in pharmacy professional organizations.  The resident is strongly encouraged to become a member of the California Society of Health Systems Pharmacists (CSHP), American Society of Health Systems Pharmacists (ASHP) and the American College of Clinical Pharmacists (ACCP) and attend their annual meetings. 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 Ambulatory Care resident will be expected to provide pharmacy department service hours.  This expectation will be met primarily by providing staffing at One Community Health, UCDH transition of care afterhours and weekend staffing,. They will also be expected to provide evening clinicalcoverage  throughout the year.  A back-up  pharmacist or the Residency Program Director will always be available on site or on-call, to advise and support the PGY2 Ambulatory Care resident as needed.  It is anticipated that the PGY2 resident will offset a staff pharmacist in a clinic setting, once competency is established.

Required Competencies:
Residents function as licensed pharmacist’s 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 ACLS training will be provided if the resident is not previously certified.

Resident Portfolio:
Each resident must maintain a portfolio containing all information from the residency year including yet not limited to: copies of papers or projects done during rotations, lectures given, research project manuscript, P&T drug monograph, and MUE. The portfolio shall be maintained in Pharm Academic.

Fringe Benefits:
Health, Dental and Vision insurance for resident and dependents, 21 days of Paid Time Off (PTO), plus 6 days Extended Sick Leave, and 4 days for Professional Development.  Travel funds (~$2500) are included in the base salary. There is a stipend for scrubs.Use of  leave is subject to approval by the RPD consistent with Medical House Staff Policies and Procedures.

Salary: $59,500

Resident Personnel Policies:
The following policies can be located in the Pharmacy Resident Personnel Manual located at https://hr.ucdavis.edu/employees/ucdh-resident

  • 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
  • Successful completion of all required learning experiences and associated assignments
  • Successful completion of all required rotations/learning experiences with no outstanding ‘Needs Improvement’ on any required rotation goals or objectives and a minimum of 80% reaching ‘Achieved’ by the end of the residency year
  • Completion of a research project
  • Presentation of research project at UC Collaborative Conference (or equivalent)
  • Preparation of manuscript and virtual poster for research project, suitable for publication
  • Completed staffing requirements as outlined by the residency program description
  • Pharmacy Grand Rounds or Competency presentation
  • Completion of the PGY-2 Ambulatory Residency Disease State Appendix to the minimum standard
  • Completed end-of-year self-assessment and residency program assessment
  • Resident closeout completed in Pharm Academic with portfolio attachments uploaded
  • A minimum of 12 months training inclusive of standard vacation, professional and sick leave