Ambulatory Care

Postgraduate Year Two (PGY2)

Program Overview

The Ambulatory Care PGY 2 program at University of Utah Health develops clinically strong practitioners with the skills necessary to develop a patient centered pharmacy practice in ambulatory care, and provide education to patients, pharmacy students, physician assistant students, primary care medical residents, and other health care professionals

Program 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 that improves medication therapy. Residents who successfully complete an accredited PGY2 pharmacy residency should possess competencies that qualify them for clinical pharmacist and/or faculty positions and position them to be eligible for attainment of board certification in the specialized practice area (when board certification for the practice area exists

Program Description

The resident will provide clinical pharmacy services for the Sugarhouse Family Medicine Clinic within the University of Utah Community Clinics. Maintaining continuity practices in these clinics, the resident will spend one half day per week for 36 weeks of the year in up to three elective ambulatory care clinics, as a longitudinal experience. Up to 80 hours of observational rotation is available if the resident seeks a variety of experiences instead of specific electives. Each elective experience will be up to 12 weeks in length, and the resident will select the electives that are the best fit to their customized training plan. Unless the resident has significant PGY 1 experience in thrombosis management, this elective will be highly suggested. Developed rotations for electives include pulmonary, geriatrics, and cardiology, but choices for elective or observational experiences include but are not limited to: ARUP employee family health clinic, neurology, headache clinic, GI/hepatitis, thrombosis, primary care in a non-residency clinic, medication safety, quality improvement and health plans.

The resident may also elect to do one elective longitudinal rotation outside of the University of Utah Hospitals and Clinics with details and timing determined by the resident and residency director.

The program was initially accredited by ASHP in 2013.

The resident’s program will be individualized based on his or her previous experience. Residents are required to be involved in structuring their experience by helping the residency director schedule rotations and decide on projects and electives.

Program Educational Outcomes, Goals, and Objectives

The program uses the ASHP Outcomes, Goals and Objectives required for PGY 2 Ambulatory Care Residencies. The program uses all required Outcomes, Goals and Objectives.

Program Requirements

  • ASHP 2017 Accreditation Standard for Specialized Residency in Ambulatory Care Pharmacy Practice – Achieved for residency in 85% of Goals/Objectives.
  • Ambulatory Care Required Areas of Patient Management Checklist – see below
  • Orientation
    • Complete a health system, clinic, college and pharmacy services orientation (will be modified if resident has completed a PGY 1 at the University of Utah)
  • Rotations
    • Complete a set of rotational experiences designed to enable the resident to meet the residency program goals and objectives and meet the resident’s career goals and interests. The experiences are established between the resident and the RPD. The RPD must approve the elective experiences for the resident.
      • 12 month continuity ambulatory care experience at Sugarhouse Family Medicine Clinic.
      • One half day per week for 36 weeks of the year in up to three elective ambulatory care clinics, as a longitudinal experience. Each of the elective experiences will be up to 12 weeks in length, and the resident will select the electives that are the best fit to their customized training plan.
      • In lieu of electives, the resident may choose to develop a plan for multiple observational experiences to allow a broad overview of ambulatory care clinical opportunities. This may represent no more than 80 hours of total residency time. Evaluations are not completed for observational experiences.
      • Longitudinal experiences to facilitate a) staffing, b) leadership and medication policy processes; and c) projects, presentations and teaching.
  • Staffing
    • Residents are scheduled an average of 32 hours per month. This typically consists of one day each week staffing at the outpatient pharmacy or other community clinic pharmacies as needed (5 pm – 9 pm shifts), and one weekend per month (2 x 8 hour shifts) as a discharge pharmacist.
  • Research Project
    • The completion of a residency project is required. A presentation of this project is required at the Mt States Residency Conference, and/or a professional meeting as deemed appropriate by the RPD and the resident.
  • Presentations
    • Prepare and deliver an ACPE-accredited continuing education presentation for pharmacists and pharmacy technicians.
    • Prepare and deliver a presentation to physicians and allied health professionals at Family Medicine Grand Rounds or equivalent.
  • Didactic Lectures
    • Optional:
      • The resident may prepare and deliver lecture(s) to College of Pharmacy students as desired based on resident goals.
      • The resident may prepare and deliver lecture(s) to Physician Assistant students as desired based on resident goals.
    • Required:
      • The resident will deliver at least one lecture to Family Medicine Residents in the Wednesday Afternoon Teaching Sessions (WATS) and/or the Intern Survival Skills series.
      • The resident will participate in recitation teaching at the college of pharmacy for P1, P2 and P3 students in the fall and spring semester.
  • Experiential Teaching
    • The resident is expected to serve as a mentor and role model to pharmacy students and residents
    • The resident is expected to serve as the primary preceptor for at least two pharmacy students as deemed appropriate by the RPD and the resident
  • Residents’ Conference (Pharmacy)
    • Attendance at the weekly Residents’ Conference when deemed appropriate via the RPD and resident.
  • Family Medicine Conferences
    • Attendance at WATs and Survival Skills when deemed appropriate by RPD and resident.
    • Attendance at weekly Family Medicine Grand Rounds is suggested.
    • Attendance at monthly Clinic Quality Meeting is required.
  • Publication
    • Complete a research project and prepare it for publication in a peer-reviewed medical or pharmacy journal
    • The resident may also present the project as a poster abstract at local and/or national pharmacy/medicine meeting(s)
    • Prepare manuscript (with RPD and/or preceptor review*) for publication in appropriate peer-reviewed journal

Rotations

Rotation Primary Preceptor Suggested Duration

Foundational Required Experiences

Primary Care 1 Karen Gunning 12 weeks
Primary Care 2 Karen Gunning 12 weeks
Primary Care 3 Karen Gunning 12 weeks
Leadership, Management and Policy Longitudinal Ben Berrett All year
Staffing Longitudinal Derrick Shepherd All year
Presentation, Project and Academic Longitudinal Karen Gunning All year

Elective Experiences

Electives are arranged based on the resident's interests. This can included experiences in other areas as well as a longer duration in an already scheduled area. In addition, there are many electives for the resident to choose from to gain experience and enhance their interests. The following are established electives (Electives are 1/2 day per week x 12 weeks)
Cardiology Ambulatory Care Adam Smith 12 weeks
Geriatrics Ambulatory Care Melissa Green 12 weeks
Thrombosis Ambulatory Care Sara Vazquez 12 weeks
Other electives can be developed based on the resident’s interests.    

Qualifications

Candidates must graduate from an ACPE-accredited pharmacy program with a doctor of pharmacy degree (or equivalent combination of education and clinical experience) with a minimum GPA of 3.1 on a 4.0 scale. Residents must have completed an accredited PGY1 pharmacy residency program. Applicants must be eligible for Utah licensure and are expected to obtain licensure as a pharmacist in Utah by September 30th of each program year. (The University of Utah Pharmacy residency programs do not sponsor visas.)

Recruitment and Selection

The following information must be submitted by the date specified on the residency application for the applicant to be considered for an onsite interview:

Completed PhORCAS registration
Curriculum vitae
Letter of intent
College of pharmacy transcripts
Three recommendations using the PhORCAS standard form

All residency programs at University of Utah Health use the Pharmacy Online Residency Centralized Application Service (PhORCAS). No paper applications will be accepted. Completed applications in PhORCAS are reviewed, and competitive applicants are invited to attend an on-site, full-day interview in January or February. The program participates in the Resident Matching Program of ASHP.

For more information contact

Karen Gunning, Pharm.D BCPS, BCACP, FCCP
Professor of Pharmacotherapy
PGY 2 Am Care Residency Program Director
30 S 2000 E Room 4982
Salt Lake City, UT 84112
Karen.Gunning@hsc.utah.edu
Phone: 801-587-9553

ASHP REQUIRED AREAS OF PATIENT MANAGEMENT

Required Competency Areas, Goals, and Objectives for Postgraduate Year Two (PGY2) Ambulatory Care Pharmacy Residencies. Copyright© 2017, Appendix pg 23. American Society of Health-System Pharmacists.

The resident will explain signs and symptoms, epidemiology, risk factors, pathogenesis, natural history of disease, pathophysiology, clinical course, etiology, and treatment of diseases and conditions in areas listed below. The resident will also have experience managing patients in these areas.

The resident will explain the mechanism of action, pharmacokinetics, pharmacodynamics, pharmacogenomics, pharmacoeconomics, usual regimen (dose, schedule, form, route, and method of administration), indications, contraindications, interactions, adverse reactions, and therapeutics of medications and non-traditional therapies, where relevant, that are applicable to diseases and conditions in the areas listed below.

The resident will explain various forms of non-medication therapy, including life-style modification and the use of devices for disease prevention and treatment, for diseases and conditions in the areas listed below.

From the list of 15 areas below, residents are required to have direct patient care experience in at least eight areas. When direct patient care is not possible, up to two of these eight areas may be covered by case-based application through didactic discussion, reading assignments, case presentations, and/or written assignments.

Cardiology
Dermatology
Endocrinology
Gastroenterology
Geriatrics
Hematology – Oncology
Infectious diseases
Men’s health
Nephrology
Neurology
Pediatrics
Psychiatry
Pulmonology
Rheumatology
Women’s health