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Ambulatory Care

Ambulatory Care

About this PGY2 Pharmacy Residency Program

The University of Utah Hospital is a 489-bed level 1 trauma center that serves critical and acute care patient’s regional referral hospital for five intermountain states. Decentralized pharmacists are responsible for providing pharmaceutical care on all patient care areas and are supported by automated dispensing, centralized IV admixture and unit-dose order entry. The University Community Clinics include 14 ambulatory care centers with 11 pharmacies, employing embedded primary care pharmacists, including a manager of this service and clinical technicians. Specialty clinics at the University of Utah Medical Center employ specialty ambulatory care pharmacists, and pharmacists in the thrombosis center. In addition, the Pharmacy Ambulatory Care Support Services center ambulatory care service has pharmacists providing refill and prior authorization services, as well as specialty pharmacy support and transition of care support.

One resident will provide clinical pharmacy services for the Sugarhouse Family Medicine Clinic and one resident will provide clinical pharmacy services for the Madsen 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 24 weeks of the year in two elective ambulatory care clinics, as a longitudinal experience. 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 thrombosis management, geriatrics, internal medicine, pulmonology, neurobehavior home care, and cardiology, but choices for elective or observational experiences may be developed if the resident has already completed experiences in these areas during their PGY 1 residency.

The resident may elect to do one of their elective longitudinal rotations 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.

Craft night participates showing their crafts
Residency Craft Night
Group photo
Prior PGY2 Ambulatory Care Residents

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.

Purpose

Our PGY2 pharmacy residency programs build on Doctor of Pharmacy (PharmD) 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 our PGY2 residency programs are prepared for advanced patient care or other specialized positions, and board certification in the advanced practice area, if available.

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

  1. ASHP 2017 Accreditation Standard for Specialized Residency in Ambulatory Care Pharmacy Practice - Achieved for residency in 85% of Goals/Objectives.
  2. Ambulatory Care Topic Checklist - see appendix.
  3. Orientation
    1. 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)
  4. Rotations
    1. 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.
      1. Orientation - 4 weeks
      2. 11 month continuity ambulatory care experience at Sugarhouse Family Medicine Clinic or Madsen Family Medicine Clinic. (divided into three primary care blocks)
      3. One half day per week for 24 weeks of the year in two elective ambulatory care clinics, as a longitudinal experience. Each of the elective experiences will be 12 weeks in length, and the resident will select the electives that are the best fit to their customized training plan.
      4. Yearlong longitudinal experiences to facilitate a) staffing, b) leadership and medication policy processes; and c) projects, presentations and teaching.
  5. Staffing
    1. 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.
  6. Research Project
    1. 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.
  7. Presentations
    1. Prepare and deliver an ACPE-accredited continuing education presentation for pharmacists and pharmacy technicians.
    2. Prepare and deliver a presentation to physicians and allied health professionals at Family Medicine Grand Rounds or equivalent.
  8. Didactic Lectures
    1. Optional:
      1. The resident may prepare and deliver lecture(s) to College of Pharmacy students as desired based on resident goals.
      2. The resident may prepare and deliver lecture(s) to Physician Assistant students as desired based on resident goals.
    2. Required:
      1. 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.
      2. The resident will participate in recitation teaching at the college of pharmacy for P1, P2 and P3 students in the fall and spring semester.
  9. Experiential Teaching
    1. The resident is expected to serve as a mentor and role model to pharmacy students and residents
    2. 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
  10. Residents’ Conference (Pharmacy)
    1. Attendance at the weekly Residents’ Conference when deemed appropriate via the RPD and resident.
  11. Family Medicine Conferences
    1. Attendance at WATs and Survival Skills when deemed appropriate by RPD and resident.
    2. Attendance at weekly Family Medicine Grand Rounds is suggested.
    3. Attendance at monthly Clinic Quality Meeting is required.
  12. Residency Program Portfolio
    1. The purpose of this portfolio is for the resident to reflect on his/her experience during the residency, and to keep in a central location documentation of resident experiences. The journal will be reviewed with the RPD on a quarterly basis and/or as needed.
    2. The portfolio shall be kept electronically on the resident shared drive.
  13. Publication
    1. Complete a research project and prepare it for publication in a peer-reviewed medical or pharmacy journal
    2. The resident may also present the project as a poster abstract at local and/or national pharmacy/medicine meeting(s).
  14. Evaluations
    1. ASHP Residency Learning System
      1. Integrated into Pharm Academic www.pharmacademic.com
    2. Complete a preceptor evaluation and a summative self-evaluation, as well as a rotation evaluation following each rotation.
    3. As warranted: Student-Teaching and Faculty Peer-Teaching Evaluations
    4. CE Speaker Evaluation (see Common Residency Manual)
  15. Recruitment
    1. Participate in the recruitment and selection of future resident at ASHP and other venues as appropriate.

Rotations

Foundational Required Experiences

Rotation Primary Preceptor Suggested Duration
Orientation to clinics and staffing Karen Gunning 4 weeks
Primary Care 1 Karen Gunning 16 weeks
Primary Care 2 Karen Gunning 16 weeks
Primary Care 3 Karen Gunning 16 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 (2 required)

Electives are arranged based on the resident's interests. This can include 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)

Rotation Primary Preceptor Suggested Duration
Cardiology Ambulatory Care Adam Smith 12 weeks
Geriatrics Ambulatory Care Melissa Green 12 weeks
Family Medicine Ambulatory Care Elizabeth Bald
Karen Gunning
Hanna Raber
12 weeks
Internal Medicine Ambulatory Care Kristi Smith 12 weeks
Internal Medicine/Geriatrics Ambulatory Care John Gardner 12 weeks
Neurobehavior HOME Program Ambulatory Care Elizabeth Bald 12 weeks
Pulmonology Ambulatory Care Melissa McCarty 12 weeks
Thrombosis Ambulatory Care Sara Vazquez 12 weeks
Pulmonology Ambulatory Care Melissa McCarty 12 weeks
**Other electives can be developed based on the resident's interests or if the resident has had extensive experiences in the above areas.    

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 will be interviewed virtually. The program participates in the Resident Matching Program of ASHP.

Karen Gunning, PharmD BCPS, BCACP, FCCP

PROGRAM DIRECTOR

Contact Information

Karen Gunning, PharmD, BCPS, BCACP, FCCP
Professor of Pharmacotherapy
University of Utah College of Pharmacy
30 S 2000 E Room 4982
Salt Lake City, UT 84112
Karen.Gunning@pharm.utah.edu
Phone: 801-587-9553

Hanna Raber, PharmD, BCPS, BCACP

PROGRAM COORDINATOR

Contact Information

Hanna Raber, PharmD, BCPS, BCACP
Assistant Professor (Clinical)
University of Utah College of Pharmacy
30 S 2000 E Room 4982
Salt Lake City, UT 84112
Hanna.Raber@pharm.utah.edu
Phone: 801-585-1845
 

APPENDIX - 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.

  1. Cardiology
  2. Dermatology
  3. Endocrinology
  4. Gastroenterology
  5. Geriatrics
  6. Hematology – Oncology
  7. Infectious diseases
  8. Men’s health
  9. Nephrology
  10. Neurology
  11. Pediatrics
  12. Psychiatry
  13. Pulmonology
  14. Rheumatology
  15. Women’s health