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

PGY-2 Critical Care Residency

Critical Care

Residency Program Director

Contact Information:
jjduby@ucdavis.edu 
Office: 916-734-3923
UC Davis Health
Pharmacy Department
2315 Stockton Blvd, Room 1310
Sacramento, CA 95817

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

2022-2023 Residents:
Michelle Zhao, PharmD
Isabel Mangaoang, PharmD

ASHP Online Residency Directory

Program Purpose

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.

Program Goals and Objectives

See Required Competency Areas, Goals, and Objectives for Postgraduate Year Two (PGY2) Critical Care Pharmacy Residencies

Program Aim
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.

Required Competency Areas, Goals, and Objectives

Learning Environment

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.

Committee Involvement

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.

Teaching & Learning Opportunities

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).

Rotation Opportunities:

Required Block Experiences (4-week)

Elective Block Experiences (4-week)

  • Surgical Intensive Care Unit I (SICU I)
  • Medical Intensive Care Unit I (MICU I)
  • Burns Surgery Service
  • Neurocritical Care Service
  • Surgical Intensive Care Unit II (SICU II)
  • Medical Intensive Care Unit II (MICU II)
  • Critical Care Pharmacy Triage
  • Pediatric Intensive Care Unit (PICU)
  • Cardiac Critical Care (CTICU, CCU)
  • Infectious Diseases (ID)
  • Emergency Medicine
  • Acute Pain*
  • Parenteral Nutrition*
  • Focused Research*
  • Toxicology*

Longitudinal Rotations (52 weeks, required)

  • Research and Scholarship
  • Practice Management

*typically, 2-week rotations

Staffing

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 and Scholarship

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.

  • Hua CT, Firestone RL, Duby JJ. Effect of Insulin Delivery Strategies on Glycemic Control and Nursing Exposure in Critically Ill Patients With COVID-19: An Observational Cohort Study. Diabetes Care. 2022 Aug.
  • Verkerk BS, Lesch C, Cham S, Berger K. Cryoprecipitate for Alteplase-Related Hemorrhagic Conversion of Acute Ischemic Stroke. J Pharm Pract. 2022; May.
  • Verkerk B, Lam T, Firestone RL, Duby JJ, Schirin Tang. Intensity of Therapeutic Paralysis in ARDS Does Not Correspond with Lung-Protective Ventilation. Critical Care Medicine: 2022: 50(1):544-544.
  • Coleman LE, Lee JA, Cocanour CS. Chapter 3: Management of Acute Pain in the Intensive Care Unit. In: Vincent JL, Moore F, Bellomo R, Marini J, eds. Textbook of Critical Care. 8th ed. Elsevier; 2022:13-19
  • Falksen JA, Duby JJ, Wilson MD, Fine JR, Cocanour CS. Effect of Delay and Disruption in Venous Thromboembolism Prophylaxis in Trauma Patients: Case-Control Study. J Am Coll Surg. 2022 Jul 1;235(1):34-40
  • Hsu EH, Young S, Clayton N, Lee J, Hauser N, Penn B, Sen S. Disseminated Mycobacterium abscess Infection in a Burn Patient. J Burn Care Res. 2022 May 17;43(3):742-745.
  • Schlobohm CJ, Zhu E, Duby JJ. Continuous infusion versus intermittent infusion vancomycin in a burn center intensive care unit. Burns. 2021 Nov;47(7):1495-1501.
  • Young SR, Duby JJ, Louie EL, Palmieri TL. Impact of Multimodal Analgesia in Critically Ill Burn Patients. J Burn Care Res. 2021 Sep 30;42(5):986-990
  • Rife T, Zhao M, Im J, Pennington D. Evaluating implementation of a combination opioid and benzodiazepine new start consult at the San Francisco Veterans Affairs Health Care System. J Am Coll Clin Pharm. 2021; 4(7):808-818.
  • Duby JJ, Schomer KJ, Oyewole V, Christian V, Young SR. Norepinephrine Dosing Error Associated with Multiple Health System Vulnerabilities. PSNet. May 2021
  • Kulig CE, Schomer KJ, Black HB, Dager WE. Activated Partial Thromboplastin Time Versus Anti-Factor Xa Monitoring of Heparin Anticoagulation in Adult Venoarterial Extracorporeal Membrane Oxygenation Patients. ASAIO J. 2021 Apr 1;67(4):411-415
  • Stoianovici R, Brunetti L, Adams CD. Comparison of Melatonin and Zolpidem for Sleep in an Academic Community Hospital: An Analysis of Patient Perception and Inpatient Outcomes. J Pharm Pract. 2021 Feb;34(1):44-50.
  • Castillo R, Chan A, Atallah S, Derry K, Baje M, Zimmermann LL, Martin R, Groysman L, Stern-Nezer S, Minokadeh A, Nova A, Huang W, Cang W, Schomer K. Treatment of adults with intracranial hemorrhage on apixaban or rivaroxaban with prothrombin complex concentrate products. J Thromb Thrombolysis. 2021 Jan;51(1):151-158.
  • Fazio S and Firestone RL. Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression. PSNet. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2020.
  • Schomer KJDuby JJ; Firestone RL, Louie EL, Sebat CM, Love DM, Cocanour CS, Albertson TE.  Effect of Flumazenil on Hypoactive Delirium in the ICU: A Double-Blind, Placebo-Controlled Pilot Study. Critical Care Explorations. 2(3): e0085, March 2020.
  • Haratipour P, Minard C, Nakhjiri M, Negahbani A, Chamberlain B, Osuna J, Upton T, Zhao M, Kashemirov B, McKenna C. Completing the β,γ-CXY-dNTP stereochemical probe tool-kit: Synthetic access to the dCTP diastereomers and 31P and 19F NMR correlations with absolute configurations. J Org Chem. 2020;85(22):14592-14609.
  • Korzewski M, Madden L, Schomer K, Van Leuven, K. Heparin Flush Use in Transfemoral Cerebral Angiography Survey. Journal of Radiology Nursing. 2020 Sept; 39(3): 199-206.
  • Dzierba AL, Pedone T, Patel MK, Ciolek A, Mehta M, Berger K, Ramos LG, Patel VD, Littlefield A, Chuich T, May HB, Muir J, Verkerk BS, Poon T, Der-Nigoghossian C, Nikolos P, Gunther M, Shah J, Witenko CJ. Rethinking the Drug Distribution and Medication Management Model: How a New York City Hospital Pharmacy Department Responded to COVID-19. J Am Coll Clin Pharm. 2020 Aug 12.
  • Verkerk BS, Berger K, Lesch CA. Aminocaproic Acid for the Reversal of Alteplase: A Case Series. J Pharm Pract. 2020 Dec;33(6):919-925.
  • Wright M, Lee JA. Multimodal Analgesia and Discharge Opioid Requirements in Burn Patients. J Burn Care Res. 2020 Sep 23;41(5):963-966.
  • Lee JA, Erstad BL, Mir HR. Pharmacologic Analgesia. In: American College of Surgeons Trauma Quality Programs Best Practices Guidelines for Acute Pain Management in Trauma Patients. Nov 2020.
  • Fazio S and Firestone RL. Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2020.
  • Hwang T, Alvarez A, Morris A, Li F, Caffarini E, Meckel J, Firestone RL, Kohn M, Chang S. Evaluation of Angiotensin II Versus Usual Care in the Treatment of Refractory Vasodilatory Shock. Critical Care Medicine. 49(1):182, January 2021. SCCM Research Snapshot 385.
  • Narayanan N, Adams CD, Kubiak DW, Cheng S, Stoianovici R, Kagan L, Brunetti L. Evaluation of treatment options for methicillin-resistant Staphylococcus aureusinfections in the obese patient. Infect Drug Resist. 2019 Apr 17;12:877-891.
  • Firestone RL, Parker PL, Pandya KA, Wilson MD, Duby JJ. Moderate-Intensity Insulin Therapy Is Associated withReduced Length of Stay in Critically Ill Patients with Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State. Crit Care Med. 2019 Mar 7.
  • Hamrick KL, Beyer CA, Lee JA, Cocanour CS, Duby JJ. Multimodal Analgesia and Opioid Use in Critically Ill Trauma Patients. J Am Coll Surg. 2019 Feb 20.
  • Lee JA, Duby JJ, Cocanour CS. Effect of early and focused benzodiazepine therapy on length of stay in severe alcohol withdrawal syndrome. Clin Toxicol (Phila). 2019 Feb 7:1-4.
  • Bouajram RH, Sebat CM, Love D, Louie EL, Wilson MD, Duby JJ. Comparison of Self-Reported and Behavioral Pain Assessment Tools in Critically Ill Patients. J Intensive Care Med. 2018; Jan 1.

  • Invited speaker, California Society of Health-System Pharmacists, Pacific Coast Preceptor Conference Gen Z, The Next Generation - Where No Preceptor Has Gone Before, May 2022
  • Invited speaker, American Society of Health-System Pharmacists, National Pharmacy Preceptors Conference. Gen Z, The Next Generation - Where No Preceptor Has Gone Before, October 2022
  • Self-guided, online learning activity. Defining Authorship and Contributorship. Research Skills Certificate. ASHP. https://elearning.ashp.org/products/9795/research-skills-certificate. May 2022 - Present.
  • Self-guided, online learning activity. Introduction to Title and Abstract Writing. Research Skills Certificate. ASHP. https://elearning.ashp.org/products/9795/research-skills-certificate. May 2022 - Present.
  • Self-guided, online learning activity. How to Build Tables and Graphs. Research Skills Certificate. ASHP. https://elearning.ashp.org/products/9795/research-skills-certificate. May 2022 - Present.
  • Podium presentation. Implications of Vitamin D During Critical Illness. Annual Congress. Society of Critical Care Medicine. April 19, 2022.
  • Continuous Versus Noncontinuous Glucose Monitoring - Other Factors That Affect Your Glucose. Rachelle Firestone. 50th Critical Care Congress, Society of Critical Care Medicine. February 2020.
  • Recurrent INR Rebound After Warfarin Reversal in the Setting of Traumatic Intracranial Hemorrhage. Robyn Stoianovici. Research Snapshot Theate 50th Critical Care Congress, Society of Critical Care Medicine. February 2020.
  • Impact of Multimodal Analgesia on Critically Ill Burn Patients. Sierra Young. 52nd Annual Meeting. American Burn Association.
  • Hypertonic sodium chloride versus combination hypertonic sodium chloride and sodium acetate in patients with traumatic brain injury. Robyn Stoianovici.Presented at the 48th Society of Critical Care Medicine Critical Care Congress; 2019 Feb; San Diego, CA.
  • Bedside Pharmacologic Management. Bedside Pharmacological Management. Jeremiah Duby (program coordinator and moderator). Pre-Congress Symposium. Critical Care Congress. Society of Critical Care Medicine.
  • Focusing Fire or Watchful Waiting: Substance Withdrawal in the ICU. Jeremiah Duby. Pre-Congress Symposium.  Critical Care Congress. Society of Critical Care Medicine.
  • Understanding and Navigating the Realities of Drug Shortages in the ICU. Roundtable Topic Discussion.  Critical Care Congress. Jeremiah Duby (topic facilitator). Society of Critical Care Medicine.
  • How We Miss Withdrawal in the ICU. Critical Care Congress. Jeremiah Duby. Society of Critical Care Medicine.

  • Board Certified Critical Care Pharmacy (Jessica Falksen, 2022)
  • Board Certified Critical Care Pharmacy (Carolyn Hua, Stanford, 2022)
  • Medication safety catch of the year for 2021 (Jessica Falksen)
  • UC San Francisco School of Pharmacy’s Class of 2022 Apples for Preceptor Award (Rachelle Firestone, Jeremiah Duby)
  • UC San Francisco School of Pharmacy’s Master Preceptor Program, 2022 graduate (Rachelle Firestone)
  • UCD Healthcare Quality Forum High Value Care Award March 2022 (Kendra Schomer)
  • UC Davis Health Excellence Award, March 2022 (Rachelle Firestone)
  • UC Davis Health Great Catch Awards, January 2022, November 2021, October 2021, September 2021 (Rachelle Firestone)
  • Presidential Citation. Society of Critical Care Medicine. Spring 2021.
    • Jeremiah Duby
  • Most Impactful Research Project. UC Pharmacy Collaborative Spring 2021.
    • Tommy Lam (PGY1 resident), Brittany Verkerk (primary preceptor)
  • Nursing Excellence Award. UCDH. Spring 2021.
    • Jeremiah Duby
    • Kendra Schomer
  • Great Catch of the Year Award. UCDH. Spring 2021.
    • Robyn Stoianovici
  • The Daisy Foundation United in Caring team award. Medical ICU UCDH. Fall 2020.
    • Rachelle Firestone
  • Presidential Citation. Society of Critical Care Medicine. Spring 2020.
    • Jeremiah Duby
  • Fellow of the American College of Critical Care Medicine (FCCM). Spring 2019.
    • Jeremiah Duby
  • Board Certification: Board Certified Critical Care Pharmacist (BCCCP)
    • Robyn Stoianovici
  • Best Research Design. Multimodal analgesia and discharge opioid requirements in burn patients. UC Collaborative Conference. 2019.
    • Michael Wright (PGY1), Jin Lee (primary preceptor)
  • Best in Category Award: Critical Care. Impact of a Bundled Approach to Procedural Pain Management in Burn Patients. Annual Meeting. American Burn Association.
    • Sierra Young (PGY1), Erin Louie (primary preceptor), Jeremiah Duby
  • Most Impactful Research Impact of Multimodal Analgesia in Critically Ill Burn Patients.  UC Collaborative Conference. 2019.
    • Sierra Young (PGY2), Erin Louie (primary preceptor), Jeremiah Duby
  • Presidential Citation. Society of Critical Care Medicine. Spring 2018.
    • Jeremiah Duby

Appointment period: July 1 to June 30

Number of positions: 2

Stipend: $63,000 per year (paid monthly)

Fringe Benefits: 
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.

UC Davis Health Resident Program

Pharmacy Resident Medical Staff Personnel Policy

Requirements for Successful Completion of the Residency

  • California licensure obtained per residency policy
  • Successful completion of all required 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 R1A minimum of 12 months training inclusive of standard vacation, professional and sick leave
  • Completed Duty Hours log
  • Completion of the Appendix to Required Competency Areas, Goals, And Objectives For Postgraduate Year Two (Pgy2) Critical Care Pharmacy Residencies
  • Pharmacy PGY2 Critical Care competency presentation
  • Research Project:
    • Complete abstract, poster, manuscript
    • IRB approval
    • IRB Closeout (n/a if data collection is ongoing at the time of residency completion)
  • Presentation of research project at UC Collaborative
  • Completed institutional protocol, guideline, or monograph
  • Completed end-of-year self-assessment
  • Resident closeout completed in PharmAcademic, confirming all resident tasks are completed

Pharmacy Residency training programs at UC Davis Health are conducted under the licensed entity within UC Davis Health which is UC Davis Medical Center.