Residency Program Director

Contact Information:
mlholtsman@ucdavis.edu 
Phone: 916-734-2659
UC Davis Health
Pharmacy Department
2315 Stockton Blvd, Room 1310
Sacramento, CA 95817

Mark Holtsman, Pharm.D.
Pain Management and Palliative Care PGY2 Pharmacy Residency Program Director
UCDH Pharmacy Inpatient Pain Management Service Co-Director
UCDH Anesthesiology and Pain Medicine Department Clinical Professor
UCSF School of Pharmacy Clinical Professor

Preceptor: Charity Hale, Pharm.D.

ASHP Directory listing:
https://accred.ashp.org/aps/pages/directory/residencyProgramInformation.aspx?ID=210208

UCDH PGY2 Pain Management and Palliative Care Pharmacy Residency 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 Aims

  • To train Pain Management and Palliative Care Pharmacists to provide high quality, compassionate, and cost-effective pharmaceutical care to patients with pain and distressing symptoms in a positive learning environment that promotes independence, critical thinking, creativity and a culture of mutual respect.
  • To prepare the graduating resident for clinical practice in the specialized pharmacy field of Pain Management and Palliative Care.
  • A graduate of this program should be competent to become a clinical specialist at a large health care institution, as well as adjunct or clinical faculty for a school of pharmacy. The program should also lay the groundwork for a future position as a Pain Management and Palliative Care pharmacy residency program director.

Program Overview

The Pain Management and Palliative Care PGY2 program at the University of California, Davis Medical Center (UCDH), is a one-year program specializing in the areas of Pain Management and Palliative Care Pharmacy Practice and is supported by the Department of Pharmacy. Pain Management and Palliative Care is a strong, well-established and progressive center of excellence at the UCDH. The UC Davis Center for Pain Medicine was named a Clinical Center of Excellence by the American Pain Society. Clinical Pharmacy Pain Management Services at UCDH are provided in the following areas: Acute Pain Service, Inpatient Pain Management Service, Inpatient Palliative Care Service, UCDH Pain Management Clinic, One Community Health and Home Hospice. The Pain Management and Palliative Care specialty residency will provide residents with a comprehensive training and educational experience as a Pain Management and Palliative Care Pharmacist.

UCDH AND PHARMACY SERVICES

UCDH Department of Pharmacy’s mission is to provide the highest quality and most cost-effective pharmaceutical care in an environment that fosters efficient patient-focused care, education and research.

UCDH 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 UCDH PGY2 Pain Management and Palliative Care Residency is designed to meet the educational goals and objectives, as outlined by the ASHP PGY2 Pain Management and Palliative Care Residency Accreditation Standards.

Educational Outcomes Required by the Accreditation Standards

  • 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

Adult Pain Management is the major area of focus, with an emphasis on analgesic pharmacology, pain assessment, symptom management, neuraxial analgesia, investigational analgesic therapies, prevention and management of drug toxicities and medication safety in the practice of pain management and palliative care pharmacy.

The Pain Management and Palliative Care PGY2 resident will provide specialty care in multidisciplinary settings and will interact with clinical pharmacists, pharmacy technicians, physicians, nurses, social workers, physical therapists, chaplains, medical students, medical residents, medical fellows, pharmacy students, pharmacy residents, patients, caregivers, and other clinical staff to provide comprehensive care to patients with pain and distressing symptoms. Activities will include providing pain management consultations, participating in palliative care and hospice rounds, providing drug information to physicians, nurses and patients, medication reconciliation and coordination of home and discharge medications including preparation of opioid tapering instructions when needed. This program is designed to meet the educational goals and objectives as outlined by the ASHP PGY2 Pain Management and Palliative Care Residency Accreditation Standards.

Program Structure

The Pain Management and Palliative Care PGY2 Residency program is a full-time, one-year commitment, beginning on August 1st and ending on July 31st. Clearance to start work by UCDHS 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

August

  • Orientation
  • Entering assessment
  • Establish customized learning plan and enter into PharmAcademic
  • Establish rotation schedule and enter into PharmAcademic
  • Selection of research project topic
  • Clinical rotation
  • Start Weekly Pain Clinic
  • Complete competencies

November

  • Clinical rotation
  • Conduct research
  • Quarterly Assessments of PMPC PGY2 Requirements CheckList, Mandatory Content CheckList, Longitudinal
  • Experiences, and progression of resident + document in Pharm Academic

February

  • Clinical rotation
  • Quarterly Assessments of PMPC PGY2 Requirements CheckList, Mandatory Content CheckList, Longitudinal Experiences, and progression of resident + document in Pharm Academic
  • Residency candidate interviews

May

  • Clinical rotation
  • UC Collaborative Annual Leadership Forum
  • Quarterly Assessments of PMPC PGY2 Requirements CheckList, Mandatory Content CheckList, Longitudinal Experiences, and progression of resident + document  in Pharm Academic

September

  • Clinical rotation
  • Preparation of research protocol
  • Select grand rounds or competency

December

  • ASHP Midyear Clinical Meeting (optional)
  • Conduct research

March

  • Clinical or Elective rotation
  • AAPM meeting
  • Compile research project results and prepare draft presentation to RPD

June

  • Clinical or Elective rotation

October

  • Clinical rotation
  • IRB submission of research project

January

  • Clinical rotation
  • Review residency candidate packets

April

  • Clinical rotation
  • Research project deliverables
  • Present research project presentation draft to RPD's and pharmacy staff

July

  • Clinical or Elective rotation
  • End of residency closeout
  • Completion of Mandatory Content (Appendix)
  • Completion of Residency program evaluation
  • Resident to upload portfolio to the S-drive and Pharm Academic

Longitudinal Activities

  • Grand Rounds Presentation or Competency Training
  • Journal Clubs
  • Administrative Projects
  • Completion of Therapeutic Content Areas found in Appendix
  • Committee assignments
  • Attend monthly Pain and Sedation meetings
  • Drug Information consultations
  • Self evaluation/reflection
  • Teaching Program (if not completed during PGY1)
  • Research project
  • Mentorship Program
  • Professional Society Involvement
  • Service requirements

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 and summative evaluation.

Required Rotations

Rotation

Duration of Rotation

Pain Management and Palliative Care Orientation

2 weeks

Introductory Inpatient Pain Management Service

4 weeks

Advanced Inpatient Pain Management Service

4 weeks

Precepting Inpatient Pain Management Service

4 weeks

Staffing Inpatient Pain Management Service

8 weeks

Inpatient Palliative Care Service

6 weeks

Intensive Chronic Pain Management Clinic

4 weeks

 

Longitudinal Rotations (Required)

Rotation

 Duration of Rotation

Academics

52 weeks

Drug Information

52 weeks

Research

52 weeks

Pain Management Clinic

52 weeks

 

Elective Rotations

Rotation

 Duration of Rotation

Acute Pain Service

4 weeks

Home Hospice

4 weeks

One Community Health

4 weeks

Medication Safety

4 weeks

Pediatric Pain Management and Palliative Care

4 weeks

Psychosomatic Medication Service

4 weeks

Resident’s Role in Teaching
UCDH offers many opportunities for both clinical and didactic teaching. The resident will be responsible for assisting preceptors with clerkship teaching for the University of California, San Francisco (UCSF) pharmacy students, UCDH PGY1 residents, and UCDH medical students. The resident will assume the primary preceptor role for UCSF pharmacy students and/or UCDH PGY1 residents 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 Pain Management or Palliative Care preceptor development topic, based on the resident’s interests and a department needs assessment.  In addition, the Pain Management or Palliative Care PGY2 Resident may choose to participate in academic teaching, as requested by regional schools of pharmacy, with the approval of the PGY2 Pain Management or Palliative Care Residency Director. The PGY2 resident may co-teach Interdisciplinary Courses in Pain Management and Palliative Care at the UCSF, School of Pharmacy and UCD, School of Medicine.

Residency Research Project
All UCDH 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 complete the UCDH IRB-required training and certification. The resident will prepare a project proposal, which will be reviewed and approved by the UCDH Pharmacy Residency Oversight Committee (PROC).  The resident will also submit their project to the either Pharmacy and Therapeutics Committee or Pain and Sedation Subcommittee. 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 be highly encouraged to submit their manuscript for publication and to prepare an electronic poster suitable for submission.

Committee Assignments
The Pain Management and Palliative Care PGY2 resident will participate in various committee activities, as assigned by the Pain Management and Palliative Care PGY2 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 Pain Management and Palliative Care pharmacists’ role in activities related to quality-improvement, medication safety, research, guideline development and assessment/implementation of technology and automation within the institution and pharmacy department. Committees in which the Pain Management and Palliative Care pharmacists play a key role at UCDH include:  Pain and Sedation Sub Committee, Inpatient Opioid Task Force, Inpatient Palliative Care Committee and PROC. The Pain Management and Palliative Care PGY2 resident will be required to complete a medication use evaluation or a drug formulary review, as assigned by the UCDH P&T Committee coordinator and Pain Management and Palliative Care PGY2 Director.

Service Project
The Pain Management and Palliative Care PGY2 resident will participate in a project designed to provide education and information to Pain Management and Palliative Care providers and/or patients on a topic related to pain management, symptom management and/or prevention of complications related to pain management.

Professional Development
The Pain Management and Palliative Care PGY2 resident is encouraged to maintain an active role in Pharmacy and Pain Management and Palliative Care professional organizations. The resident is strongly encouraged to become a member of the American Academy of Pain Medicine and attend their annual meeting in the early spring. 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 Pain Management and Palliative Care PGY2 resident will be expected to provide 4 weeks of pharmacy department service. This expectation will be met primarily by providing pain management pharmacist coverage during pharmacist's vacation days. A back-up Pain Management or Palliative Care pharmacist or physician will always be available on site or on-call, to advise and support the Pain Management and Palliative Care PGY2 resident as needed.

Required Competencies
Residents function as a 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.

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, or MUE. The portfolio shall be maintained in Pharm Academic and on the S-drive.

Sick Leave
Residents accrue 12 working days of sick leave each year. Use of sick leave is subject to approval by the RPD consistent with Medical House Staff Policies and Procedures.

Vacation, Holidays and Professional Leave
Residents earn 24 working days per year for vacation, holidays and professional leave. Use of leave must be arranged in advance with the RPD.

Resident Personnel Policies
The following policies can be found in the Pharmacy Resident Personnel Manual located at: https://hr.ucdavis.edu/employees/ucdh-resident

  • Resident Qualifications
  • 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 learning experiences and associated assignments
  • Successful completion of all required rotations/learning experiences with no outstanding ‘Needs Improvement’ on any required rotation goals or objectives and a minimum of 80% reaching ‘Achieved’ by the end of the residency year
  • Completion of a research project
  • Presentation of research project at UC Collaborative Conference (or equivalent)
  • Preparation of manuscript and virtual poster for research project, suitable for publication
  • Completed staffing requirements as outlined by the residency program description
  • Pharmacy Grand Rounds or Competency presentation
  • Completion of the required PGY2 Pain Management and Palliative Care Residency Content Areas in the Appendix
  • Completed end-of-year self-assessment and residency program assessment
  • Resident closeout completed in Pharm Academic with portfolio attachments uploaded to Pharm Academic and S-drive
  • A minimum of 12 months training inclusive of standard vacation, professional and sick leave
  • Drug monograph or other P&T activity completed