PGY-2 Critical Care Residency | Department of Pharmacy Services | UC Davis Health

Residency Program Director

Program Purpose

PGY2 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) 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 applicable.

Program Overview

The PGY2 Critical Care Residency at UC Davis Health (UCDH) is a one-year, PGY2 specialty residency in pharmacy practice. The residency is supported by the Department of Pharmacy.

Critical care is a diverse and advanced area of practice and research at UC Davis Health. 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 Health delivers well-established clinical programs to a range of medical and surgical services. The aim of the PGY2 Critical Care Residency is to develop clinical pharmacists with the passion, perseverance, and skills to serve as integral members of the critical care team and community. Graduates of the program are expected to be leaders in the field through practice, research, and teaching.

Program Design

The PGY2 Critical Care Residency focuses on core critical care experiences (e.g. surgical, medical, neurocritical care) and supportive care services (i.e. nutrition, infectious diseases). Residents are integral members of a multi-disciplinary team of clinical pharmacists, physicians, nurses, dietitians, respiratory and physical therapists. Daily activities include participating in rounds, therapeutic drug monitoring, providing drug information, and medical emergency response.

The UC Davis Health PGY2 Critical Care Residency is designed to meet the educational goals and objectives, as outlined by ASHP and 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.

Program Structure

The PGY2 Critical Care Residency is a full-time, 52-week commitment. Clearance to start work by UC Davis Health Employee Health and Human Resources must be completed prior to the established residency start date.

UC Davis Health PGY2 Critical Care Residency Learning Experiences:

Residency learning experiences will primarily be divided into block rotations and longitudinal learning experiences. Most rotations will be 4 weeks in duration. Rotation schedules will be determined based on availability and resident interests. Rotation schedules will be adjusted and updated with the resident at each quarterly and summative evaluation. The program is individualized to meet each resident’s needs, taking into consideration previous clinical experiences and future professional goals.

UC Davis Health PGY2 Critical Care Resident’s Role in Teaching
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 APPE students (UCSF) and PGY1 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 didactic 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).

Committee Involvement
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.

Research & Scholarship
Research is an integral element of providing and improving patient care at UC Davis Health. All PGY2 residents are required to complete a research project during their residency and present their research at a regional, state or national conference. In preparation for conducting their research project, the resident will complete UC Davis Health IRB-required training and certification. The resident will prepare a project proposal, which will be reviewed and approved by the UC Davis Health Pharmacy Research Oversight Committee. The resident is also provided opportunities to present their research at one or more regional pharmacy residency conferences and submit their project as an abstract to a critical care professional meeting (e.g. SCCM Congress). Upon completion of the project, PGY2 residents are required to summarize their research project in a manuscript suitable for submission to a journal for publication.

Critical Care Case Conference/Topic Content
The PGY2 Critical Care Residency is designed to provide a broad range of experiences in a variety of practice settings. Required learning experiences have been designed to meet the appendix content requirements, as outlined by ASHP. A content checklist is provided to each resident to document exposure to the required content and patient experiences. This activity will be documented in PharmAcademic as a longitudinal learning experience and progress will be reviewed quarterly with each resident as part of their individual development plans.

Professional Development
The PGY2 Critical Care resident is encouraged to maintain an active role in pharmacy and critical care professional organizations. Residents are strongly encouraged to become a member of the Society of Critical Care Medicine (SCCM) and attend their annual Congress meeting in the spring. The resident will be provided with a travel stipend from the institution and professional leave time to facilitate participation in professional development activities.

Residents will also participate in the Northern California chapter of the Society of Critical Care Medicine (NorCal SCCM). As part of this group, residents will participate in monthly virtual pharmacy journal clubs and present a journal club article once in the fall. Additionally, the residents will present their critical care research project at the NorCal SCCM Annual Research Symposium in early summer.

Pharmacy Department Staffing & Competencies
Critical care residents are embedded members of the multidisciplinary team 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 EMR. 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, Burns). 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, Burns) every third weekend and up to 2 major holidays. Additionally, residents may be called upon to provide coverage for the clinical service for which they are currently on rotation and independently staff the Critical Care Pharmacy Triage service.

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, including ACLS.

Resident Portfolio
Each resident must maintain a portfolio containing all information from the residency year including but not limited to required deliverables documenting successful residency completion, copies of papers or projects done during rotations, lectures given, research project manuscript, MUE and/or guideline or protocol development. The portfolio shall be maintained in Pharm Academic and/or in the resident’s folder on the Pharmacy Department shared drive.

Resident Personnel Policies:
The following policies are in the Pharmacy Resident Personnel Manual which will be provided to all incoming residents and residency applicant.
The following policies can be located in the Pharmacy Resident Personnel Manual

• Resident Qualifications
• Licensure policy
• Leave policies
• Early Commitment Policy
• Pre-employment drug testing
• Health insurance and Benefits
• Moonlighting
• Duty hours/tracking of duty hours
• Dismissal policy and consequences of failure to progress

Requirements for Successful Completion of the Residency:

Residency Graduation Requirements:

• California Pharmacist Licensure Per Pharmacy Resident Manual Policy
• A minimum of 52 weeks of training inclusive of vacation, professional, and sick leave
• Completion of the Appendix to Required Competency Areas, Goals, And Objectives for Postgraduate Year Two (PGY2) Critical Care Pharmacy Residencies
• Completed Duty Hours log
• Completion of assigned competencies, including ACLS
• Completion of weekend staffing contributions (approx. every 3rd weekend)
• Completion of weekday staffing contributions as outlined in residency manual
• Completion of all required rotations/learning experiences
  • No outstanding “Needs Improvement” on any required rotation goals or objectives
  • Minimum of 80% of objectives marked as “Achieved” by the end of the residency year
  • 100% of Patient Care Competency Area R1
• Completion of research project (IRB approval, complete abstract/manuscript, closeout if data collection complete)
• Completed institutional protocol, guideline, or monograph
• Presentation of research project at UC Pharmacy Collaborative Conference (regional research conference)
• Attendance at second pharmacy conference (to be in area of resident interest)
• Complete and deliver Grand Rounds (or equivalent) to selected audience
• Active participation in committee meetings and projects as assigned
• Active participation in annual residency program CQI meeting
• Completed end-of-year self-assessment
• Exit interview with RPD and completed resident closeout in PharmAcademic
• Completion of deliverables for Competency Area Goals and Objectives (CAGO) requirements (see below table)