Contact Information:
wedager@ucdavis.edu 
Phone: 916-703-4025
UC Davis Health
Pharmacy Department
2315 Stockton Blvd, Room 1310
Sacramento, CA 95817

William E Dager, Pharm.D, BCPS
MCCM, FCCP, FASHP, FCSHP
Pharmacist Specialist
UC Davis Medical Center
Clinical Professor of Pharmacy,
UCSF School of Pharmacy
Clinical Professor of Medicine,
UC Davis School of Medicine

2020-2021 Resident:
Sutton Watson, Pharm.D.

Preceptors:
A. Josh Roberts, Pharm.D., BCCPS, BCPS (AQ – Cardiology)
Hahyoon Kim, Pharm.D., BCCPS

ASHP Directory listing:
https://accred.ashp.org/aps/pages/directory/residencyProgramInformation.aspx?ID=200266

UC Davis Health PGY2 Cardiology 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, if available.

2020 Resident Testimonial

This Residency gave me the opportunity to work independently as a clinician and teacher and to become comfortable working and thinking in the gray. Cait E. Kulig, Pharm.D. 2020 PGY2 Cardiology Pharmacy Resident

Program Overview

The Post Graduate Year Two (PGY2) Cardiology 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 related to cardiovascular conditions and other commonly related co-morbidities that can coexist. It is assumed that the resident has already achieved a basic level of competence commensurate with that of a PGY1 Pharmacy Practice Residency. The PGY2 residency focuses on developing the knowledge, attitudes, training and most of all critical skills necessary to cultivate pharmacists to be competent and compassionate practitioners who are prepared practice at a high level and in multiple settings.

Graduates of the residency have the capability to manage very complex acute and chronic conditions in a multitude of settings including critically ill adult and pediatric patients in both medical and surgical settings. This includes chronic conditions and situations that may be life determining in complex situations. Completion of this PGY2 Cardiology Residency that has a focus on the acutely or critically ill patient populations will provide the practitioner the advanced critical thinking skills and clinical knowledge necessary to practice in a large variety of settings that may include teaching, research, leadership or management. Although the primary goal of the residency is listed above, there are several options and electives offered to allow the resident to have emphasis in reaching individualized practice or training goals. The resident will be provided exposure and have the ability for additional experience in the following areas: Acute and critically ill adult cardiology practice which include learning experiences tailored towards a future career as a bedside clinician in acute and critical care settings.

  • Cardiothoracic surgical practice which includes peri-operative, intra-operative and post-operative management.
  • Academic practice which would include experiences with students and faculty from the UCSF and California Northstate Schools of Pharmacy
  • Specialty Pharmacy practice settings that include pediatrics, nutrition, emergency care, transplant and other critical care settings.
  • Yearlong training involving advanced practice, research and additional skills key to a successful practice.

    Day in the Life of a Cardiology Resident

    During a typical day on the Cardiology Service, the pharmacy resident will pre-round in the morning before attending rounds with the team. The pharmacy resident acts as an integral part of the interdisciplinary team and serves as the medication expert. After rounds, the pharmacy resident takes on an active role in teaching the various pharmacy residents and students that are on rotation with the Cardiology team through answering questions, facilitating patient presentations, and leading topic discussions. The Cardiology pharmacy resident also takes the lead in facilitating medication histories and helps triage orders and Vocera calls. Though support is always there if needed, the pharmacy resident quickly becomes an integral part of the Cardiology pharmacist team. It is not uncommon to see the pharmacy resident scrubbing into the OR to help assist the team with complex anticoagulation questions during emergent surgeries in real-time. Aside from these daily tasks, the resident also participates in the Thrombosis Subcommittee, facilitates a monthly journal club, and participates in other longitudinal activities such as didactic teaching, developing a monograph, and Grand Rounds, among others.

    UC Davis Health and Pharmacy Services

    UC Davis Health 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: https://www.ucdmc.ucdavis.edu/pharmacy

    Program Design

    The UC Davis Health PGY2 Cardiology Residency is designed to meet the educational goals and objectives, as outlined by the ASHP PGY2 Cardiology 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 multidisciplinary activities involving several patient care settings with exposure to a wide variety of disease states. Specifically, patient care is provided to patients undergoing most cardiology related invasive procedures done in cardiac catheterization or open heart surgeries. Additional areas include patients with advanced heart failure that involve heart transplants or placement of cardiac assist devices. Daily activities will include rounding with specialty medical teams, seeing patients, assess and implement management plans, educate patients and practitioners and develop any identified areas for improvement. 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 Cardiology Residency is a full-time, one-year commitment, beginning on July 1st and ending on June 30th, unless alternative dates are pre-arranged. Clearance to start work by UC Davis Health Employee Health and a Human Resources orientation meeting must be completed prior to August 1st.

    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
    • Inpatient Anticoagulation Service rotation

    October

    • Advanced Heart Failure Service rotation Conduct research

    January

    • Required or Elective rotation
    • Residency candidate interviews
    • Pharmacy School Student Lectures at CalNorthState School of Pharmacy

    April

    • Required or Elective rotation
    • UC Collaborative Research Conference

    August

    • Cardiology ICU Rotation (part 1) or Cardiothoracic Surgery
    • Preparation of research protocol
    • Select grand rounds or competency

    November

    • Elective rotation
    • Conduct research

    February

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

    May

    • Required or Elective rotation

    September

    • Cardiology ICU Rotation (part 1) or Cardiothoracic Surgery
    • IRB submission of research project
    • Quarterly development plan
    • Pharmacy Week Events
    • ACCP Annual Meeting (optional)
    • CSHP Seminar (optional)

    December

    • Cardiology ICU Part 2 (with precepting a student)
    • Quarterly development plan
    • Review residency candidate packets

    March

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

    June

    • Block Cardiology pharmacist time
    • End of residency closeout and program improvement evaluation
    • Residency Requirements checklist completed

    Longitudinal Activities

    • Competency presentation in cardiovascular medicine
    • Journal Club
    • Committee assignments – thrombosis committee
    • Monograph
    • Self-evaluation reflection
    • Teaching Program (if not completed during PGY1)
    • Mentorship program
    • Professional Society Involvement
    • Service requirements including evening staffing
    • Cardiology Grand Rounds and conferences – weekly pending topic
    • Weekend clinical staffing – every 3rd Sat & Sun (total of 34 weekend shifts) plus 2 of the 6 major holidays

    UC Davis Health PGY2 Cardiology 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 Cardiology program director

    Required Learning Experiences

    Type of Experience

    Overview

    Orientation/training

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

    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.

    Practice Management

    Longitudinal (12 months) Practice management will prepare the resident for the administrative role of a cardiology pharmacist. The activities of the experience categorically focus on improvement of clinical practice in cardiovascular related care.

    Teaching

    Longitudinal (12 months) The resident is expected to actively participate in precepting students and PGY-1 Pharmacy residents throughout their residency year and is required to give at least one didactic lecture.

    Quality Improvement

    Longitudinal (12 months) The resident will work with the Clinical Coordinator on selected Quality improvement project and attain additional exposure to departmental initiatives.

    Outpatient Cardiology Clinic

    Longitudinal (12 months) The resident will be a active participant in a selected heart failure clinic weekly during the residency experience.

    Inpatient Anticoagulation service

    Block
    (4 weeks)
    This rotation will focus on the management of anticoagulation and hemostasis. The resident will be involved in initiation, monitoring, adjusting, and reversal of anticoagulation therapies on patients admitted within the hospital.

    Cardiology Consult and Advanced Heart Failure Services

    Block
    (4 weeks)
    The resident will be expected to act as a medication expert in two consult services – general cardiology consult and advanced heart failure consult services – during this block for patients who are admitted to other services but needs assistance in cardiovascular issues.
    Inpatient Cardiology Service Block
    (4 weeks)
    The Cardiology rotation will focus on management of patients with critical cardiovascular disease. Patients admitted to this service may reside in either an ICU, telemetry-monitored, or floor setting.
    Inpatient Cardiology Service with precepting Block
    (4 weeks)
    This rotation will build on the Inpatient Cardiology Service learning experience. The resident will act as the primary preceptor for a 4th year pharmacy student on their cardiology rotation. This particular rotation will be scheduled for January of the residency year.
    Cardiothoracic Surgery Block
    (4 weeks)
    The rotation will focus on management of patients requiring a cardiac surgical procedure for a heart related problem. The resident will be exposed to management of post-op complications and device therapies i.e. VAD, ECMO, Impella, etc.
    Pediatric Cardiology/
    CT Surgery Service
    Block
    (4 weeks)
    The rotation provides residents with the opportunity to participate in the care of children admitted with congenital heart disease and/or cardiac diagnoses.
    Emergency Medicine Block
    (4 weeks)
    The focus of the rotation will be increasing the resident’s confidence in taking care of medical emergencies ranging from code participation, assisting with rapid sequence intubation, hypertensive emergencies, and strokes, among others.

    Elective Learning Experiences

    Type of Experience

    Overview

    MICU

    Block
    (4 weeks)
    The MICU learning experience provides the resident with the opportunity to participate in the care of unique patient populations with life-threatening critical illnesses.

    Solid Organ Transplant

    Block
    (2 weeks)
    The resident will follow patients on the solid organ transplant (kidney) hospital service and post-transplant hospital discharge Tuesday clinic service throughout the entire month.

    Surgical Intensive Care (SICU)

    Block
    (4 weeks)
    The rotation will engage learners in the pharmacotherapy of critically ill patients as essential members of the Surgical Critical Care (SCC) team. The SCC service is the primary ICU service for trauma patients and non-trauma surgical patients that require surgical intervention and critical care.

    Hematology

    Block
    (4 weeks)
    The rotation will provide resident with experience in managing patients with various non-malignant hematologic disorders including massive bleeding and hemostasis approaches, advanced anticoagulation therapy, hemophilia, sickle cell disease, myelodysplastic syndrome and clotting disorders/ hypercoagulable states.

    Cardiology Service Based Experience

    Block
    (4 weeks)
    The resident may need to complete this rotation if not all the CAGOs are not achieved for residency during the last month of residency year while staffing as one of the cardiology pharmacists.

    Infectious disease*

    Block
    (4 weeks)
    The resident will work with patients followed by the ID consult service and ensure that they are receiving appropriate antimicrobial therapy and all necessary assessments are completed.
    Parenteral nutrition* Block
    (4 weeks)
    Resident will have opportunity to manage parenteral nutrition in critically ill and stable patients.

    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.

    *These rotations will be strongly encouraged if the incoming resident did not complete these learning experiences as a PGY1 Resident.

    Assignment of Education Goals and Objectives to Specific Learning Experiences – see learning experiences and objectives outlined in PharmAcademic.

    UC Davis Health PGY2 Cardiology 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, The resident will also be involved in team based didactic cardiology lectures for CalNorthState School of Pharmacy. The resident will be engaged in teaching and precepting early in the residency and 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 pharmacy competency presentation. In addition, the PGY2 Cardiology Care Resident may choose to participate in academic teaching, as requested by regional schools of pharmacy, with the approval of the PGY2 Cardiology 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 Collaborative 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 Health 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 Cardiology resident will participate in various committee activities, as assigned by the PGY2 Cardiology 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 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 cardiology pharmacists play a key role at UC Davis Health include:  Thrombosis Subcommittee Meeting, Pharmacy and Therapeutics committee, LVAD selection committee and transfusion committee.

    Professional Development:
    The PGY2 Cardiology resident is encouraged to maintain an active role in pharmacy professional organizations.  The resident is strongly encouraged to become a member and become involved in a related committee within their selected organization 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 Cardiology resident will be expected to provide pharmacy department service hours.  This expectation will be met primarily by providing staffing in activities related to cardiac related patient care services every third weekend plus shift coverage of two major holidays (Thanksgiving, Christmas Eve, Christmas Day or New Year’s Day). They will also be expected to provide evening clinical coverage for a limited number of evenings throughout the year.  It is anticipated that the PGY2 resident will offset a cardiology pharmacist in a clinical 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 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 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.

    Vacation, Holidays, Sick and Professional Leave:
    21 days of Paid Time Off (PTO), 6 days Extended Sick Leave, and 4 days for Professional Development.

    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 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 resident tasks are completed
    • Project written up for potential Abstract submission to a major cardiovascular focused or pharmacy meeting
    • Preparation of manuscript and virtual poster for research project, suitable for publication
    • Presentation of research project at UC Collaborative Conference (or equivalent)
    • Drug monograph or other P&T activity completed (a secondary project)
    • Attend thrombosis subcommittee and complete any assigned projects for the committee
    • Completion of the PGY-2 Cardiology Residency Disease State Appendix to the minimum standard
    • Completed staffing requirements on a minimum of 36 weekend days (or similar staffing if modified by the program director) as outlined by the residency program description
    • Pharmacy Competency presentation
    • Completed end-of-year self-assessment
    • A minimum of 12 months training inclusive of standard vacation, professional and sick leave