Jeremiah J. Duby, PharmD, BCPS, BCCCP, FCCM
Critical Care Pharmacist, Specialist
PGY2 Critical Care Residency Program Director
UC Davis Medical Center
Associate Clinical Professor
Touro University, College of Pharmacy
UCSF, School of Pharmacy
Assistant Clinical Professor
UC Davis, College of Medicine
Michelle Zhao, PharmD
Isabel Mangaoang, PharmD
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.
See Required Competency Areas, Goals, and Objectives for Postgraduate Year Two (PGY2) Critical Care Pharmacy Residencies
The aim of the Critical Care Residency is to develop clinical pharmacists with the passion, perseverance, and skills to serve as integral member(s) of the critical care team and community. Graduates of the Program are expected to be leaders in the field through practice, research, and teaching.
The UC Davis Medical Center is an academic, tertiary care referral and Level I trauma center with over 116 licensed ICU beds, one of the highest proportions of ICU beds in the United States, and a reflection of the medical center's role as a major regional referral center for complex neurology, trauma, burns, and medical cases. There are seven, adult ICUs including medical, surgical, cardiology, cardiothoracic surgery, neurocritical care, and burns surgery. In addition, the UC Davis Children’s Hospital is a world-class pediatric tertiary and quaternary care “hospital within a hospital” that includes a Neonatal Intensive Care Unit (NICU), Pediatric Intensive Care Unit (PICU), and Level 1 Pediatric Trauma Center.
The Department of Pharmacy Services at UC Davis Medical Center delivers well-established clinical programs to a range of medical and surgical services. Our critical care residents are embedded members of the multidisciplinary team that provides direct care to a diverse population of critically ill patients daily. The Critical Care Residency Program is individualized to meet each resident’s needs, taking into consideration previous clinical experiences and future professional goals.
The critical care residents serve as active members of the ICU Committee and Code Blue Committee. They provide regular reports on adverse drug events that occur in the ICU and collaborate with physicians, nurses, and respiratory therapists to improve pharmacotherapy systems for critically ill patients. Further, the residents deliver analysis and recommendations to the Pharmacy and Therapeutics Committee and Pain and Sedation Committee as requested.
The Critical Care Program offers many opportunities for both clinical and didactic teaching. In the clinical setting, critical care residents serve as co-preceptors for pharmacy students (UCSF), PGY1, and non-critical care PGY2 residents. In addition, residents participate in staff development/education (e.g., nursing, pharmacy, medical students, house staff) and provide routine patient education. Finally, residents may elect to deliver 1 – 2 lectures for the UC San Francisco and Touro University Schools of Pharmacy.
The Scholarship of Teaching and Learning Program (STLP) is an elective opportunity that prepares residents to become effective clinician educators. Residents participate in a series of interactive lectures and small group exercises that are designed to develop skills necessary to educate and train patients, caregivers, and healthcare providers. Requirements for successful completion of the STLP program include clinical precepting (30 hours), inter-professional education (1 hour), public outreach (1 hour), small group facilitation (4 hours), didactic teaching (2 hour), and ACPE-accredited peer-to-peer presentation (1 hour).
Required Block Experiences (4-week)
Elective Block Experiences (4-week)
Longitudinal Rotations (52 weeks, required)
*typically, 2-week rotations
Critical care residents are embedded members of the multidisciplinary critical care team (i.e.i.e., MICU, SICU, NCC, Bburns) and train to provide comprehensive clinical and operational pharmacy services. Order verification and medication delivery are logical and expected extensions of bedside care. In practical terms, residents commonly translate their recommendations into provisional or “pended” orders in and order sets in EMR pending provider signature or rejection. They also provide prospective review and order verification. This closed-loop system of consultation, order verification, and medication delivery results in seamless bedside pharmacotherapy.
Operations staffing—beyond orientation and basic training—is integrated into the clinical role for each critical care service (e.g., MICU, SICU, NCC). In other words, clinical pharmacists are all expected to provide close operational support for critically ill patients. This role is focused on patients directly in the care of their team but includes cross-cover for other ICU services as needed.
Further, critical care residents participate in rapid and emergency response events (“code blue”) throughout the medical center. They are prepared through topic discussions and simulation labs and then supported (bedside) by a range of pharmacy staff with the goal of developing proficiency, confidence, and independence in this role.
The service requirement is clinical and operational support for an ICU service (e.g., MICU, SICU, NCC) every third weekend and 1 major holiday. Additionally, residents may be called upon to provide coverage for the clinical service for which they are currently on rotation and they independently staff the Critical Care Pharmacy Triage service.
Completion of competencies assigned to inpatient clinical pharmacists is expected, including BLS and ACLS.
Research is an integral element of providing and improving patient care at UCDMC. The driving ambition is for practical, sustainable solutions to bedside problems. Challenges and questions are the natural product of endeavoring to practice beyond the bounds of current understanding. The practical purpose is to apply discoveries from the patient to the patient. The principal purpose is clinical practice improvement, guideline development, and publication and presentation.
Appointment period: July 1 to June 30
Number of positions: 2
Stipend: $63,000 per year (paid monthly)
Health, Dental and Vision insurance for resident and dependents, 24 days of Paid Time Off (PTO), 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 sick leave is subject to approval by the RPD consistent with Medical House Staff Policies and Procedures.
Pharmacy Residency training programs at UC Davis Health are conducted under the licensed entity within UC Davis Health which is UC Davis Medical Center.