Pharmacy Postgraduate Residencies - Learning Experiences

PGY2 Critical Care Pharmacy Residency

Medical/Surgical ICU

A state-of-the-art 30-bed intensive care unit at Cooper University Hospital is the practice site for this rotation. The resident will round with one of two multidisciplinary teams caring for medical, surgical, neurologic and cardiothoracic patients. The resident is responsible for working collaboratively with critical care nurses, physician residents, critical care fellows and ICU attending physicians to identify, prevent, and resolve medication therapy issues for patients with a wide variety of disease states. Common disease states and topics covered on this rotation include hemodynamics and shock, critical care infectious diseases, sepsis, respiratory failure, gastrointestinal bleeding, nutrition, stroke, among many others.

Trauma ICU

The Trauma Intensive Care Unit (TICU) is a 16 bed unit at Cooper University Hospital, a Level I Southern New Jersey Regional Trauma Center. The multidisciplinary team consists of an attending trauma surgeon, a fellow (critical care or surgery), residents (emergency medicine or surgery), medical students, a clinical pharmacy specialist, pharmacy students, a respiratory therapist, nursing staff, and nursing students. The resident will attend ICU rounds on a daily basis and function as an active member of the multidisciplinary team. The resident will design, monitor, and evaluate evidence-based patient-specific therapies for patients with conditions such as traumatic brain injury, aortic aneurysms, spinal cord injuries, pulmonary contusions, and closed and open fractures.

Cardiac ICU

The resident will provide pharmaceutical care to cardiac ICU patients with acute coronary syndrome, acute heart failure, hypertensive emergency/urgency, ventricular arrhythmias, atrial fibrillation, and infections. Therapy with antiplatelets, anticoagulants, antihypertensives, antiarrhythmics, and anti-infectives is emphasized. The resident actively participates in multidisciplinary rounds and transitions of care planning.

Nutrition Support

The Nutrition Support experience will allow the resident to collaborate with multidisciplinary practitioners to optimize nutrition support therapy for critically ill patients. In collaboration with other health professionals, residents will manage enteral nutrition and parenteral nutrition. Residents will perform initial nutrition support consultations, recommend therapeutic goals, develop patient-specific nutritional regimens including type of support, route, formulation, and provide follow-up to optimize the patients’ nutritional care. Additionally, the resident will participate in management of fluids and electrolytes, acid/base disturbances, hyperglycemia, and complications associated with nutrition support therapy.

Critical Care Scholarship and Education

This residency is designed to prepare trainees to be critical care clinical specialists/academicians. Beyond the research project that is completed longitudinally, the resident will be involved with another scholarly endeavor such as writing a review article or case report during this experience. The resident will contribute to critical care education through teaching in a Critical Care Therapeutics elective course and serving as a facilitator for interprofessional education/simulation activities. The resident will demonstrate skills required to function in an academic setting during this experience.

PGY2 Pharmacotherapy Residency

Internal Medicine (inpatient)

Cooper University Hospital has 5 adult internal medicine teaching teams and each team services about 10 to 15 patients. The resident will provide patient care during multidisciplinary rounds with an adult internal medicine teaching team. The team mostly consists of an attending physician, medical resident(s), medical intern, pharmacist and periodically pharmacy resident(s), medical student(s), pharmacy student(s), and physician assistant student(s). Under the guidance of the preceptor, the resident will provide pharmaceutical care, including medication reconciliation, medication counseling, answers to drug information questions, team in-services, therapeutic drug monitoring, and ensure safe transitions of care. The goal of this rotation is for the resident to develop the skills needed to identify and resolve medication therapy problems, using evidence-based medicine, and then effectively provide patient education and recommendations to the interdisciplinary team. The resident will also have the opportunity to be the primary preceptor for 1 or 2 APPE students completing their acute patient care rotation.

Ambulatory Care

Interprofessional Education Student Run Clinic

The setting for this rotation will be at the Cooper Rowan Clinic (CRC), an interprofessional student-run clinic, which serves uninsured/underserved adult patients. The resident will work collaboratively with medical and pharmacy students, medical residents, faculty practitioners, and peers to provide care to uninsured residents of Camden, New Jersey. In the 2013-2014 academic year, the clinic provided care to 285 patients in over 900 visits. This rotation experience focuses on introducing and reinforcing concepts related to leadership, patient care, teaching, and practice management. This experience will further develop the resident’s knowledge and the skills needed to provide coordinated and collaborative patient-centered care for a unique patient population. A strong emphasis is placed on the development of interprofessional communication skills and the ability to work collaboratively with attending physicians and medical residents, pharmacists, nurses, medical assistants, medical interpreters, and social workers, and other members of the healthcare team. The pharmacy resident plays a vital role in educating and training students, patients, and other health care practitioners. The resident will participate in practice-based teaching and model the following responsibilities for students: medication history-taking for medication reconciliation and all steps of a comprehensive medication management service including the assessment, documentation of care plan, and follow up evaluation decision-making. Additionally, the resident will provide feedback to learners at various stages of professional development, and verify patient understanding.

HIV Clinic

The resident will participate in the care of HIV infected patients at the Early Intervention Program (EIP) Clinic at Cooper University Hospital. The EIP clinic provides medical care and support services for approximately 800 HIV infected adult patients annually. Under the guidance of the preceptor, the resident will provide pharmaceutical care and medication counseling to clinic patients and drug information to providers, and other clinic support staff as needed. The resident will participate in general HIV clinic, HIV/Hepatitis C virus co-infected clinic, primary care clinic, and the infectious diseases fellows clinics, as well as attend weekly EIP management meetings. Knowledge of antiretroviral agents and antimicrobial therapy is emphasized, as well as, hepatitis C virus therapies, psychiatric medications, and general chronic ambulatory medicine pharmacotherapy.

Medication Management Clinic

The pharmacy resident manages medication therapy for chronic conditions that include diabetes mellitus, hypertension, and dyslipidemia and others at the Philadelphia VA Medical Center’s physician-referred, pharmacist-run disease-state management/medication management clinic. The resident’s responsibilities include: initiating and adjusting medication therapy for anticoagulation therapy and diabetes and related complications; providing drug information to healthcare providers; educating patients and caregivers; obtaining pertinent subjective and objective data to determine effects of medication changes which includes recommending appropriate lab tests and obtaining pertinent physical exam findings.

Internal Medicine Clinic - UPHS

The University of Pennsylvania Health System (UPHS) has clinical pharmacists providing services at Penn Internal Medicine Associates and Edward S. Cooper Practice of General Internal Medicine. Clinical pharmacists assist with chronic diseases state management, provide medication counseling and education, and participate in a multidisciplinary initiative to improve transitions of care. The pharmacy resident will participate in two types of office visits throughout this rotation. The first type of visit is focused around transitions of care, in which the pharmacy team and medical team collaborate to care for up to 20 patients per week. The primary focus of the pharmacist during this type of visit is medication reconciliation. The second type of visit is focused on chronic disease state and medication management in which the pharmacy team cares for up to 42 patients per week. Patients are referred to the pharmacy team by physicians or nurse practitioners for a variety of reasons, including hypertension management, diabetes management, medication reconciliation, and medication adherence. The pharmacy resident will work with the clinical pharmacist to provide care to these patients on an ongoing basis until goals of care are achieved. The pharmacy resident will work collaboratively with primary care providers to ensure continuity of care. In addition to direct patient care, the pharmacy resident will participate in drug information services, quality improvement initiatives, and topic discussions with clinical pharmacists and pharmacy students.

Internal Medicine Clinic - Cooper

Residents will have the opportunity to help with the development of new ambulatory care pharmacy services within the Cooper Health System’s Advanced Care Center, A Patient-Centered Medical Home (PCMH) and Internal Medicine residency training site that provides a variety of innovative services to the Medicaid and Medicare beneficiaries of Camden, New Jersey. Clinical pharmacists provide a wide variety of patient care, drug information, and educational services while co-precepting with medical attendings during Internal Medicine Resident office hours. Pharmacy residents will also participate in a high-risk hospital follow-up clinic as part of an interprofessional team that works to customize transitions of care services for individual patient’s needs. There are ample opportunities for providing educational in-services, conducting quality improvement projects and designing new services on this rotation.

Academia

The academia rotation provides a learning opportunity for the resident to gain experience in the 3 main roles of a faculty member: teaching, service, and scholarship. Teaching includes didactic small and/or large classroom teaching. Service includes participation on committees at the Department, College, and University levels at the Philadelphia College of Pharmacy, University of the Sciences. The resident will also be involved in a research and/or scholarship experience outside of their longitudinal residency research project.

Critical Care

A state-of-the-art 30-bed intensive care unit is the practice site for this rotation. The resident will round with one of two multidisciplinary teams caring for medical, surgical, neurologic and cardiothoracic patients. The resident is responsible for working collaboratively with critical care nurses, physician residents, critical care fellows and ICU attending physicians to identify, prevent, and resolve medication therapy issues for patients with a wide variety of disease states. Common disease states and topics covered on this rotation include hemodynamics and shock, critical care infectious diseases, sepsis, respiratory failure, gastrointestinal bleeding, nutrition, stroke, among many others.

Pediatrics

The general pediatric team at Children’s Regional Hospital at Cooper University Health Care includes the attending physician, residents, interns, medical students, pharmacist, pharmacy students, and social workers. The pediatric intensive care unit (PICU) team includes the attending physician, residents, pharmacist, pharmacy students, respiratory therapists, and social workers. Nurses caring for the patients may also participate in daily patient care rounds. The clinical pharmacist attends patient rounds directly with the physicians, pharmacy students, nurses and other healthcare providers. Under the supervision of the preceptor, the pharmacy resident ensures all medications have indications, dosed appropriately, verify no drug-drug interactions, review monitoring parameters, assess adverse drug events and reduce medication errors. The resident also consults with the medical team regarding optimization of medication therapy. Furthermore, medication reconciliation is completed for all high-risk patients. All patients are screened for missing vaccinations. Discharge counseling is provided on a case-by-case basis. The resident may assist in rapid response/code situations when available.

Contact:

James M. Hollands
Vice Chair and Associate Professor of Clinical Pharmacy
Philadelphia College of Pharmacy 

Address:

Office Location: Griffith Hall,
Room 1080
University of the Sciences
600 South 43rd Street
Philadelphia, PA 19104-4495

Phone:

215-596-8882

Email:

j.hollands@usciences.edu