PGY-2 Ambulatory Care | UC Davis Pharmacy

PGY-2 Ambulatory Care Residency

pgy2 am care

Residency Program Director

Contact Information:
rwittenberg@health.ucdavis.edu
UC Davis Health
Pharmacy Department
2314 Stockton Blvd, Room 1310
Sacramento, CA 95817

Becks Wittenberg, PharmD, BCACP, AAHIVP
Senior Pharmacist, Infectious Diseases Specialty
Associate Professor, UCSF School of Pharmacy, UC Davis School of Medicine

2025-2026 Residents:
Maria Golovkina, PharmD
Sunwoo Oh, PharmD
Rui Hua Zheng, PharmD

ASHP Residency Directory listing

Program Purpose

PGY2 pharmacy residency programs build upon Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency training to develop pharmacist practitioners with knowledge, skills, and abilities as defined in the educational competency areas, goals, and objectives for advanced practice areas. Residents who successfully complete PGY2 residency programs are prepared for advanced patient care, or other specialized positions, and board certification in the advanced practice area, if available.

Program Structure

The PGY2 Ambulatory Care Pharmacy Residency is a full-time, one-year commitment, typically beginning on July 1 and ending June 30. Clearance to start work by UC Davis Health Employee Health and a Human Resources orientation meeting must be completed prior to the established residency start date.

Program Overview

The Post Graduate Year Two (PGY2) Ambulatory Care Pharmacy Residency at UC Davis Health 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.

The PGY2 residency has a strong emphasis on developing leaders in pharmacy who are poised to contribute to the development and expansion of ongoing or new ambulatory care service lines. Graduates of the residency have the capability to design, implement, and secure collaborative interdisciplinary practice agreements necessary to establish new areas of ambulatory practice and expand current clinical practice. Graduates are empowered to treat and appropriately triage the most complex chronic and acute illnesses presented by ambulatory patients. Patient care is provided within the context of a long-term health care partnership with both patients and health care providers that emphasizes 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 – Includes learning experiences tailored towards a future career as a pharmacy manager in Ambulatory or Specialty Pharmacy Settings

  • Academia – Includes experiences with faculty from the UCSF School of Pharmacy and extended time as primary preceptor for students and residents
  • Clinical – Includes a minimum of 8 weeks in a clinical focus area to explore the clinical and administrative aspects. Examples include a focus in primary care (with extended time in various primary care clinics, population health, geriatrics, or the rental transplant clinic) or a focus in a disease state specialty (may be tailored to include ambulatory care clinic and inpatient experiences that focus on that disease state).
  • National Recognition – We are proud to share that the UC Davis Health PGY2 Ambulatory Care Residency Program was selected as a recipient of the 2024 ASHP Pharmacy Residency Program Excellence Award – a prestigious national honor recognizing residency programs that demonstrate a sustained commitment to excellence in the training and mentorship of pharmacy residents.

    In awarding this honor, ASHP highlighted our program’s resident-led service expansion learning experience, which empowers residents to lead ambulatory care clinic pilot projects. These resident-led clinic pilots ultimately expand the footprint of pharmacists in ambulatory care, and in turn expand patient access to care across our health system.

UC Davis Health and Ambulatory Care Pharmacy Services

UC Davis Health is a nationally recognized academic medical center offering primary care for all ages, specialty care in over 150 fields, and the latest treatment options and expertise for the most complex health conditions. Some highlights include:

  • Rated Sacramento’s top hospital
  • Nationally ranked in multiple specialties
  • Home of the nationally ranked Children’s Hospital
  • Receiving top honors for nursing excellence
  • HIMSS level 7 recognition for advanced technology that improves care
  • Region’s only Level I trauma center for both adults and pediatrics
  • Regional burn center
  • NCI-designated comprehensive cancer center

Ambulatory care pharmacists manage patient care under collaborative practice agreements in a variety of disease states and interdisciplinary clinic settings, including:

  • Primary Care in the UC Davis Primary Care Network
  • Specialty Clinics across UC Davis Health
    • Allergy
    • Cardiology
    • Dermatology
    • Endocrinology
    • Gastroenterology
    • Hepatology
    • Infectious Diseases
    • Neurology
    • Oncology
    • Pain
    • Pediatrics
    • Pulmonology
    • Rheumatology
    • Solid Organ Transplant (Renal and Liver)

Program Design

The UC Davis Health PGY2 Ambulatory Care Residency is designed to meet the educational goals and objectives, as outlined by the ASHP 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 UC Davis Health pharmacist-run primary care and specialty clinics.

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 interviewing and managing patients in the clinic setting, providing additional phone based or web-based care to patients, reviewing clinic policies for appropriateness, and implementing quality assurance programs for current and new clinics. The ambulatory care resident will be expected to be proficient at working in the clinics they rotate through, 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.

UC Davis Health PGY2 Ambulatory Care Residency Learning Experiences

The residency learning experiences will primarily be divided into block rotations and longitudinal learning experiences. While most rotations will be 4 weeks in duration, the residency year will include at least one 12-week rotation to allow for ambulatory care residents to follow patients longitudinally, engage in continuity of care, and gain autonomy in the clinic setting. Rotation schedules will be determined based on availability and resident interests. Rotation schedules will be designed to include all required competency areas, goals, and objectives (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.

  • Rotations can be extended or repeated per the resident’s interests
  • Additional electives may be developed based on resident’s interests
  • Project time will be coordinated through the year as arranged with the PGY2 Ambulatory Care program director

Required Experiences

Length

Overview

Orientation/training

1 month (July) Orientation to UC Davis Health and PGY2 Ambulatory Care residency program. Activities may be adjusted, based on the resident’s previous experience and knowledge of UC Davis Health.

Specialty Ambulatory Care Clinic Part I and II

  • Allergy
  • Cardiology
  • Dermatology
  • Endocrinology
  • Gastroenterology
  • Hepatology
  • Infectious Diseases
  • Neurology
  • Oncology
  • Pediatrics
  • Pulmonology
  • Rheumatology
  • Renal Transplant (Renal and Liver)
Two Blocks
1 month each
The Specialty Ambulatory Care Clinic rotation will be a two-part rotation that will allow the resident to expand their breadth of clinical knowledge and learn the pharmacist’s role in a variety of specialty clinics. This is a selective rotation in which residents may choose to focus their learning in a single clinic each block, or may combine up to 3 specialty clinics in a block pending disease state complexity/compatibility and preceptor availability.

During Part I, the resident will work closely with the specialty pharmacist to gain understanding of the specialized medications and become familiar with the structure, goals, and practices of a specialty pharmacy service. This includes facilitating care of specialty patients, interacting with an interdisciplinary team, and abiding by regulatory agency guidelines. For Part II, the resident will serve as the primary preceptor for any pharmacy interns or PGY1s that are on rotation and take a primary role in facilitating the care of patients on the service.

Primary Care

  • Primary Care Network Clinics
  • Healthy Aging Clinic
  • Renal Transplant Clinic
1 month The focus of this rotation is primary care and it is a selective rotation which can be pursued in a variety of settings. The Primary Care Network Clinics focus on the pharmacist’s role in a patient centered medical home model and incorporate population health driven care. Experiences at the other clinics allow the resident to utilize their primary care skills in specific patient populations, namely the geriatric population in the Health Aging Clinic and a renal transplant population in the Renal Transplant Clinic.

Residents will be preferentially assigned to the Primary Care Network Clinics to facilitate their comfort for independent staffing in primary care. However, for those that have extensive experience in primary care, opportunities to practice primary care in specialized populations, such as geriatric patients or renal transplant patients, are available to continue to challenge residents.

Longitudinal Clinical Care

3 months This longitudinal experience allows the resident to select two clinic areas of interest to focus on. Through this longitudinal rotation, residents are expected to gain depth of clinical expertise and growth towards becoming an autonomous pharmacist with skills in facilitating all aspects of the service, delegation to pharmacy team members, and integration into the multidisciplinary team.

Ambulatory Care Management

1 month The resident will work directly with Ambulatory Care Management to improve the quality of care in specific ambulatory care areas. The resident may be involved in activities such as writing a proposal for new services and/or preparing 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.

Ambulatory Care Service Expansion

Yearlong This rotation will augment the skills and knowledge gained during the Ambulatory Care Management rotation. The resident will have the opportunity to participate in one or more aspects of ambulatory care service line expansion: shadow a clinic and interview staff to perform a needs assessment for pharmacist presence, development of a business case, discussion with clinic stakeholders in possible areas of expansion, and integration into the clinic and its care team as a pharmacist presence is piloted, and development of the clinic structure, workflow, and tools.

Required Longitudinal Experiences

Length

Overview

Research and Scholarship

52 weeks 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.

Teaching

52 weeks The resident will serve in the layered learning model as a mentor and preceptor to PGY1 residents and pharmacy interns while on rotation. The resident will have opportunities to deliver a didactic lecture(s). The resident is expected to complete the teaching certificate offered at UC Davis Health if not completed during their PGY1 year at UC Davis Health or equivalent teaching certificate elsewhere.

Pharmacy Committee Chair Responsibilities

52 weeks Residents will have chair responsibilities to serve on a UCD committee, UC Collaborative committee, Vizient committee, or other committee, with consideration for the needs of the department and preceptorship.

Ambulatory Care Residency
Chair Responsibilities

52 weeks Residents will assist with either coordination for orientation, recruitment/interviews, or coordination of the ambulatory care resident staffing schedule.

Staffing/Service

52 weeks The staffing shifts will be weekend coverage for the Primary Care Clinic and Anticoagulation Clinic, as well as block staffing (intermittent weeklong coverage) of the Meds to Beds hospital program.

Elective Experiences

Length

Overview

Specialty Ambulatory Care Clinic III

1 month This third elective rotation in specialty pharmacy will allow residents to delve deeper into a specialty area they have already experienced or gain experiences in a new specialty setting. The resident will continue to build on gaining autonomy as a specialty pharmacist and gaining a deeper understanding of disease state management, clinic operations, and regulatory compliance.

Pain, Substance Use Disorder, and Opioid Stewardship Clinic

1 month This rotation focuses on specialized clinical care in the areas of chronic pain and substance use disorder management in the clinic setting, including withdrawal symptom management, medications for addiction treatment, opioid management, and multi-modal pain management.

Academiac Leadership

2 months For the resident with the emphasis in Academia, this rotation series provides the opportunity to work with a pharmacy faculty member at UCSF to learn the skills to practice in an academic environment.

Ambulatory Care Management II

1 month 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 Clinical

1 month For residents with the emphasis 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.

Management – Specialty Clinical and Operations

1 month For residents with an emphasis the management or specialty pharmacy, this experience provides the opportunity to participate in the management of specialty pharmacy clinics, and has a strong focus on the operations required to implement and sustain a specialty pharmacy program, including regulatory and accreditation aspects.

Behavioral Health

1 month Residents will participate alongside an interdisciplinary clinical team in the clinic and on the inpatient behavioral health unit to optimize therapy and transitions of care. Residents will gain familiarity with psychotropic medications and provide recommendations, monitoring, stewardship, and utilization of these medications.

Inpatient Cardiology

1 month Residents will manage the inpatient heart failure service to optimize therapy through guideline directed medical therapy and transitions of care. Residents will work directly with the heart failure attending, hospitalist, and heart failure coordinator on this attending only service. The resident will also cover patients with pulmonary hypertension and any additional patients followed by the hospitalist on service.

Inpatient Pediatrics

1 month Residents will develop pharmacotherapy and disease state knowledge in the acute, non-ICU pediatric population. This experience will emphasize the resident’s role as a pharmacist in a multidisciplinary team and allow them to gain autonomy as the primary pharmacy specialist on patient care rounds.

Solid Organ Transplant Inpatient/ Amb Care Hybrid

1 month Residents will manage patients on the solid organ transplant hospital service and post-transplant hospital discharge clinic. Residents will optimize therapy and transitions of care with a multidisciplinary team, with an emphasis on immunosuppressant pharmacotherapy and pathophysiology in this unique population.

Emergency Medicine

1 month The resident will work with the ED pharmacist attending on service to manage medications during codes/medical emergencies, verify orders, and give recommendations to the team. The ED may help the resident understand the transition from home to inpatient or from ED to home, in addition to allowing the resident to learn to work in a fast-paced and hands-on environment.

Toxicology/Poison Control

1 month The California Poison Control System is a 24-hour-a-day information hotline serving residents statewide in California. Residents will develop proficiency in clinical skills essential to toxicology and gain skills in managing poisoned patients.

Refill Clinic

1 month Review refill clinic protocols and assume the role of the pharmacist. Assist with insurance appeals, quality assurance projects or protocol updates.

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
  • Select grand rounds or competency
  • Initial quarterly development plan

November

  • Clinical rotations
  • Conduct research
  • Residency candidate interviews for Early Commitment

February

  • Clinical rotations
  • Residency candidate interviews for The Match

May

  • Clinical rotations
  • UC Collaborative Research Conference

August/September

  • Clinical rotations
  • Preparation of research protocol
  • IRB submission of research project

December

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

March

  • Clinical rotations
  • Compile research project results and prepare draft presentation to RPD

June

  • Clinical rotations
  • Manuscript deliverables

October

  • Clinical rotations
  • Conduct research
  • Pharmacy Week Events
  • Quarterly development plan

January

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

April

  • Clinical rotations
  • Research project deliverables
  • Quarterly development plan

 Final week

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

Longitudinal Activities

  • Research Project
  • Grand Rounds Presentation
  • Choice of one of the following Secondary Projects:
  • Protocol
  • Collaborative Practice Agreement (CPA)
  • Guideline
  • Staff Competency Presentation
  • Medication Use Evaluation (MUE)
  • Drug Monograph
  • Continuous Improvement (CQI) project and presentation
  • Residency Learning Experience Development
  • PGY2 Ambulatory Care Disease State Appendix
  • Pharmacy committee chair roles
  • Ambulatory care residency chair roles
  • Attend monthly Ambulatory Care Residency meetings
  • Self-evaluation reflection
  • Teaching Program (if not completed during PGY1)
  • Pharmacy mentorship program
  • Staffing/service requirements

UC Davis Health PGY2 Ambulatory Care Resident’s Role in Teaching:
UC Davis Health 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 UC Davis Health PGY1 pharmacy residents. The PGY2 resident will also have an opportunity to participate in multidisciplinary teaching with the UCD School of Medicine faculty, fellows, residents, and students.

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 a 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 UC Davis Health PGY2 residents are required to complete a research project and present their research in a podium presentation at the UC Pharmacy Conference or other regional meeting. In preparation for conducting their research project, the resident will be 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 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 a poster suitable for submission.

Pharmacy 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. Residents have served on the Ambulatory Care Sub-Committee P&T, P&T Committee, UC-Wide Specialty Clinical Subgroup, UC-Wide Ambulatory Care Subgroup, and Vizient Committees.

Ambulatory Care Residency Chair Assignments:
The PGY2 Ambulatory Care resident will continually contribute to the residency program to better understand the operations of the residency program director and ASHP accreditation standards. Areas of focus are orientation, recruitment and interviews, and staffing.

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 UC Davis Health. Staffing includes afterhours experiences in transitions of care and weekend experiences in the Primary Care Clinic and Anticoagulation Clinic. The PGY2 Ambulatory Care resident will provide preceptorship to PGY1 residents during staffing. 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 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 prior to employment 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, protocols developed, P&T drug monograph, and MUE. The portfolio shall be maintained in the resident shared drive.

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
  • California licensure requirements
  • Moonlighting
  • Duty hours/Tracking duty hours
  • Professional, family, and extended leave policies
  • Dismissal policy and consequences of failure to progress

Criteria for Successful Completion of the PGY2 Ambulatory Care Residency

  • California Pharmacist Licensure Per Pharmacy Resident Manual Policy
  • A minimum of 52 weeks training inclusive of vacation, professional, and sick leave
  • Completion of assigned competencies, including BLS, ACLS, and/or PALS as appropriate
  • Complete requisite training during Orientation to independently staff
  • Completion of weekend staffing contributions (approx.. every 3rd weekend)
  • Completion of weekday staffing contributions as outlined in the residency manual
  • Active participation in committee meetings and projects as assigned
  • Completion of all required rotations/learning experiences
  • “Achievement for the Residency” of at least 80% of program objectives by the end of the residency year, with 100% “ACHR” for Patient Care Competencies R1. No objectives may have a final assessment of “Needs Improvement.” (Program objectives may be ACHR by the RPD throughout the year and/or at resident closeout.)
  • Completion of Deliverables as outlined in the Residency Program Deliverable Tracker (see below)
  • Completion of the PGY-2 Ambulatory Care Disease State Appendix to the minimum standard, as appropriate (see below)
  • Completion of residency research project (with guidance from Research Oversight Committee)
  • Presentation of residency research project delivered as a podium presentation at Regional conference. Attendance to the Regional conference in support of peers’ research.
  • Manuscript preparation of research/QI project, and submission to selected journal
  • Complete and deliver Grand Rounds, Preceptor Development, or equivalent to selected audience
  • Completion of one of the following secondary projects:
    • Protocol – development of new protocol or major revision of existing protocol
    • CPA – development of new CPA or major revision of existing CPA
    • CQI project (plus presentation)
    • Guideline – new guideline development or guideline update
    • Staff Competency (Short Recorded Presentation for UCD Pharmacy Website)
    • MUE
    • Drug Monograph
  • Development or major revision of new Residency Learning Experience
  • Active participation in the residency close out & annual quality improvement program evaluation at the end of the year
  • Completion of end-of-year self-assessment and residency program assessment
  • Resident closeout completed in PharmAcademic, confirming all tasks are completed
Learning Experience and Associated Activity Deliverable Frequency
CAGO R1.1.5 (Creating) Design, or redesign, safe and effective patient-centered therapeutic regimens and monitoring plans (care plans) for ambulatory care patients.
 
CAGO R1.1.7 (Applying) Document direct patient care activities appropriately in the medical record, or where appropriate
Primary Care I – R1.1.5
Analyze and assess information by reviewing patient charts for encounters, labs, vitals, referral information and conducting appropriately thorough patient visits. Devise treatment plan based on patient specific information collected
 
Primary Care I – R1.1.7
Utilize EMR and effective written communication to collaborate with physicians and other healthcare providers, both through staff messages and developing SOAP notes. SOAP notes should accurately reflect patient discussion and decision making process that contributed to the treatment plan.
One de-identified SOAP note from the primary care I rotation
 
MRNs should reflect patients for whom current residents have written SOAP notes in the electronic medical record. The corresponding notes may be found in the chart and should be a representative sample of both care plans and other notes that reflect the breadth of resident documentation in EMR.
 
MRN 1:
Completed once over the course of the Primary Care I rotation
Staffing Primary Care – R1.1.5
Design safe and effective patient-specific treatment regimens for primary care disease state based off clinical guidelines and primary literature. Create an appropriate patient-specific monitoring plan. Arrange patient education and follow up actions based on shared decision making, health literacy, and therapeutic quality of life goals. Identify and mitigate potential drug-related problems. Support preventative care and patient empowerment for overall health and wellness.
 
Staffing Primary Care R1.1.7
Demonstrate ability to appropriately, effectively, and accurately document direct patient care activities in EMR in SOAP note format. Demonstrate ability to communicate through EMR to interdisciplinary care team members in a timely manner. Demonstrate ability to appropriately and concisely document relevant patient information during clinic, telephone, and video visits.
Four deidentified SOAP notes from Staffing Primary Care LE
 
MRNs should reflect patients with which current resident have written SOAP notes on in the electronic medical record. The corresponding notes may be found in the chart and should be a representative sample of both care plans and other notes that reflect the breadth of resident documentation in EMR.
 
MRN 1 (quarter 1):
 
MRN 2 (quarter 2):
 
MRN 3 (quarter 3):
 
MRN 4 (quarter 4):
Completed four times over the course of 52 weeks (about once per quarter)
Longitudinal Clinical Experience – R1.1.5
Design safe and effective patient-specific treatment regimens for specialty disease state based off clinical guidelines and primary literature. Create an appropriate patient-specific monitoring plan. Arrange patient education and follow up actions based on shared decision making, health literacy, and therapeutic quality of life goals. Prepare for potential drug-related problems. Support preventative care and patient empowerment for overall health and wellness.
One deidentified SOAP note from the longitudinal clinical experience
 
MRNs should reflect patients with which current resident have written SOAP notes on in the electronic medical record.
 
The corresponding notes may be found in the chart and should be a representative sample of both care plans and other notes that reflect the breadth of resident documentation in EMR.
 
MRN 1:
Completed once over the course of the Longitudinal Clinical rotation
CAGO R1.2.1
(Applying) Design and/or deliver programs for patients that focus on health improvement, wellness, and disease prevention (e.g. immunizations, health screenings)
Primary Care I
Identify both non-pharmacologic and pharmacologic options for patients to optimize and promote their wellness. Counsel patients on these options, which may include but are not limited to diet, lifestyle, smoking cessation, and vaccinations. Coordinate care with the appropriate ancillary healthcare providers as appropriate.
One deidentified SOAP note from the primary care I rotation
 
MRNs should reflect patients with whom current residents have provided counseling and education to patients regarding diet, lifestyle changes/exercise, smoking cessation, and vaccinations to promote disease prevention. SOAP notes in EMR should show evidence of these efforts.
 
MRN 1:
Completed once course of the Primary Care I rotation
Staffing Primary Care
Provide counseling and education to patients regarding diet, lifestyle, smoking cessation, and vaccinations to promote disease prevention. Demonstrate ability to educate patients with varying degrees of health literacy on the importance of preventative health measures via answering patient questions and referring to clinical guidelines as needed Exercise proactive clinical judgment via identifying and recognizing which patients are ideal candidates who could benefit from preventative health education Compare educational strategies for implementing population health efforts for wellness, health improvement, and disease prevention. Demonstrate involvement in the roll out of sustainable preventative health initiatives.
Two deidentified SOAP notes from the Staffing Primary Care LE
 
MRNs should reflect patients with whom current residents have provided counseling and education to patients regarding diet, lifestyle changes/exercise, smoking cessation, and vaccinations to promote disease prevention. SOAP notes in EMR should show evidence of these efforts.
 
MRN 1 (1st half year):
 
MRN 2 (2nd half year):
Completed twice over the course of 52 weeks (about once every 26 weeks)
Primary Care I – R1.1.5
Analyze and assess information by reviewing patient charts for encounters, labs, vitals, referral information and conducting appropriately thorough patient visits. Devise treatment plan based on patient specific information collected
 
Primary Care I – R1.1.7
Utilize EMR and effective written communication to collaborate with physicians and other healthcare providers, both through staff messages and developing SOAP notes. SOAP notes should accurately reflect patient discussion and decision making process that contributed to the treatment plan.
One de-identified SOAP note from the primary care I rotation
 
MRNs should reflect patients with which current resident have written SOAP notes on in the electronic medical record. The corresponding notes may be found in the chart and should be a representative sample of both care plans and other notes that reflect the breadth of resident documentation in EMR.
 
MRN 1:
Completed once over the course of the Primary Care I rotation
CAGO R2.1.1
(Creating) Prepare or revise a protocol (e.g. workflow, scope of practice, collaborative practice agreement, or clinical practice protocols) related to ambulatory care
Justification of Service Expansion and Optimization
Explain strategies for establishing a collaborative practice agreement. Explain the role of collaborative practice agreements in defining the scope of an individual ambulatory care pharmacy specialist’s practice. Explain the legal environment in which collaborative practice agreements are possible. Explain the importance of medication-safety, use of technology, and optimal resource utilization to proposals.
 
Develop a protocol or collaborative practice agreement utilizing evidence-based practices, internal and external stakeholder buy-in. Rearrange protocol or collaborative practice agreement based on experiential and stakeholder feedback to optimize workflow and value of services provided.
Examples of resident participation in the preparation or revision of a protocol.
 
Possible examples include:
 
• Collaborative Practice Agreement
• Service Line Charter
• Clinical/Operational Reference Guide and/or Job Aide(s)
Completed at least once over 52 weeks
CAGO R2.1.2
(Applying) Contribute to the development of a new ambulatory care pharmacy service or to the enhancement of an existing service
Justification of Service Expansion and Optimization
 
Discover the quality and/or safety metrics applicable to assess current ambulatory care pharmacy program to measure if goals are met. Illustrate human resource needs for the realistic justification of service enhancement or development of new service line. Modify the approach, services, and/or strategic vision based on experiential and stakeholder feedback to guide the service line and meet the needs of the program. Demonstrate an effective clinic roll out and/or enhancement considering relevant resources, timeline, service line needs, and nuances of pharmacy practice.
Examples of resident participation in the development of a new ambulatory care service or to the enhancement of an existing service.
 
Possible examples include:
 
• Business Case Proposal
• SBAR
• Ppt on metrics/impact of service line
Completed at least once over 52 weeks
Management – Ambulatory Care
Explain the components of a marketing plan, new service lines, key stakeholders, various tasks involved in managing the implementation of a new service or program, and the legal environment in which collaborative practice agreements are possible. Accurately predict system and human resource needs for developing and implementing a new or enhanced service. Discover the quality and/or safety metrics applicable to assess current ambulatory care pharmacy program to measure if goals are met. Use modeling to predict the financial outcome(s) of implementing a proposed new or enhanced service on meeting unmet customer needs.
Examples of resident participation in the development of a new ambulatory care service or to the enhancement of an existing service.
 
Possible examples include:
 
• Business Case Proposal
• SBAR
• Handout or presentation of QI findings, evaluation, and/or metrics/impact of service line
Completed at least once over 52 weeks
CAGO R2.2.6
(Creating) Effectively develop and present, orally and in writing, a final project report suitable for publication
Research and Scholarship
Effectively present research findings at a professional conference. Prepare a manuscript of project results and submit for publication.
1. Research/CQI platform presentation delivered at UC Collaborative Conference
 
2. Research/CQI manuscript
Completed at least once over 52 weeks
CAGO R4.1.2
(Applying) Use effective presentation and teaching skills to deliver ambulatory care related education to pharmacy or interprofessional attendees, including complex topics to expert drug therapy audiences
Grand Rounds
Utilizing a powerpoint format and active teaching and learning methods, deliver and defend the Grand Rounds Material
Grand Rounds powerpoint presentation
 
May also include any handouts developed to supplement grand rounds
Completed at least once over 52 weeks
Research and Scholarship
Present research findings at a professional conference and/or P&T sub-committee if applicable.
Research/CQI platform presentation
(delivered at conference and/or internal committee)
Completed at least once over 52 weeks
Specialty Ambulatory Care Clinic II
Demonstrate ability to gauge your audience and tailor learning to their level of learning and expertise, as well as their role in the health system and patient care. Utilize active learning active learning techniques to maintain interest and evaluate understanding. Establish professional verbal and non-verbal communication style and ability to synthesize complex information to an understandable format.
Educational presentation
 
Possible examples include:
 
• In-service to team (may be multidisciplinary, but not required)
• Fellows Lecture presentation
• Case Conference presentation
• AETC presentation
Completed at least once over the course of the rotation
Longitudinal Clinical Experience
Demonstrate ability to engage diverse audience and maintain interest with active learning techniques in various specialty and primary care settings. Establish professional verbal and non-verbal communication style and ability to synthesize complex information to an understandable format.
Educational presentation
 
Possible examples include:
 
• In-service to team (may be multidisciplinary, but not required)
• Fellows Lecture presentation
• Case Conference presentation
• AETC presentation
Completed at least once over the course of the rotation
CAGO R4.1.3
(Applying) Use effective written communication to disseminate knowledge related to ambulatory care.
Grand Rounds
ACreate powerpoint slides that will compile a useful written resource for audience and include auxiliary tables/charts as needed
Grand Rounds powerpoint presentation
 
May also include any handouts developed to supplement grand rounds
Completed at least once over 52 weeks
Research
Create an abstract that summarizes the research findings, as well as a finalized manuscript to be submitted for publication by the end of residency.
Research/CQI manuscript (including abstract) Completed at least once over 52 weeks
Specialty Ambulatory Care Clinic II
Demonstrate deep understanding of clinical topic via written materials tailored to the target audience. Establish unique visual aids that complement and add value to the verbal information presented.
Preparation and presentation of educational materials
 
Possible examples include:
 
• Topic discussion
• Journal club
• Patient case conference This is a distinct deliverable from the CAGO 4.1.2
Completed at least once over the course of the rotation
CAGO R4.1.4
(Applying) Assess effectiveness of education related to ambulatory care.
Grand Rounds
Utilize interact cases and or situational questions in order to assess the effectiveness of the teaching provided.
Audience assessment of Grand Rounds Completed at least once over 52 weeks

ASHP PGY2 Ambulatory Care Disease State Appendix

From the list of 15 areas below, residents are required to have direct patient care experience in at least eight areas. When direct patient care is not possible, up to two of these eight area may be covered by case-based application through didactic discussion, reading assignments, case presentations, and/or written assignments.

Direct Care Checklist Disease State Clinical Experience Discussion Experience
Description of Rotation or Patient Care Experience Date Preceptor on Record Description of Case-Based Activity Date Preceptor on Record
Cardiology
Dermatology 
Endocrinology
Gastroenterology 
Geriatrics
Heme-Onc
Infectious Disease 
Men’s Health
Nephrology
Neurology
Pediatrics
Psychology
Pulmonology
Rheumatology 
Women’s Health