Pgy1 pharmacy residency | veterans affairs

VA PHARMACY SYSTEMS (3-WEEKS) The VA Pharmacy Systems (Inpatient and Outpatient Rotation) is a required three-week learning experience at the Salt Lake City VA Medical Center. It is an

in-depth orientation to current VA technology. The role of the preceptor is to provide the resident with a global understanding of our community hospital medication distribution system. The

resident will gain experience in the VA distribution process by utilizing multiple software and hardware packages including; Computerized Patient Record System (CPRS), Veterans Health

Information System and Technology Architecture (VISTA), ScriptPro, VISTA Chemotherapy Manager (VCM), Talyst and Pyxis. All learning activities will be geared towards proficiency with these

systems as they will be the foundation for future rotations, patient care activities, and resident projects. Learning activities may be facilitated by different pharmacy staff with expertise

in certain hardware or software applications. INTERNAL MEDICINE (6-WEEKS) This is a six-week experience where the resident will participate in the provision of pharmaceutical care to acute

care patients admitted to one of the three internal medicine teams on the Acute Medicine Floor. Most medicine teams consist of an attending, resident, two intern physicians and medical

students. Each internal medicine team cares for up to 20 patients. This rotation allows the resident the opportunity to apply pharmacy-related concepts to patient care as a member of a

multi-disciplinary health care team. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource

for the team. This will include, but is not limited to, performing admission and discharge medication reconciliations, developing pharmaceutical care plans for patients with complicated

medical histories as well as for those on high-risk medications, performing pharmacokinetic and pharmacodynamic assessments, screening medications for appropriate indications and dosing, and

proactively identifying drug interactions. The resident will create therapeutic regimens for individual patients utilizing the VA formulary when possible. These activities are expected to

be completed for every patient that is assigned to the resident. The resident’s patient load will vary based on the preceptor’s discretion. The resident is proactively involved in the

medication use process, including assisting nursing service with medication-related issues and working to promptly solve problems that impede the appropriate delivery of medications. Good

communication and interpersonal skills are necessary to promote efficient function of the team. The resident will be expected to communicate their findings and recommendations to the

appropriate clinician(s). PRIMARY CARE (6-WEEKS) This is a required six-week learning experience designed to teach residents how to apply pharmaceutical care as an integrated member of a

patient aligned care team (PACT) within the primary care clinics at VA Salt Lake City’s main campus. During the experience, residents are directly involved in the development and monitoring

of medication treatment regimens for patients, with emphasis placed on the independent assessment and development of pharmaceutical care plans for Veterans with chronic diseases. Focused

areas for clinical experience include: diabetes care, hypertension, hyperlipidemia, hypothyroidism, chronic kidney disease, gout, mental health and tobacco abuse. CRITICAL CARE (4-5 WEEKS) 

The VA Critical Care Rotation is with one of two preceptors in the surgical intensive care unit (SICU) or medical intensive care unit (MICU). Each location has unique learning experiences

that will be slightly different. The critical care rotation is a required four-week learning experience for the pharmacy practice resident. The resident will participate in the provision of

pharmaceutical care to acute care patients admitted to the MICU or SICU. The MICU and SICU share the same space but have distinct rounding services. The MICU service consists of an

attending, fellow, three residents, three intern physicians and a clinical pharmacist. The SICU is a team that consists of an attending, midlevel provider, and clinical pharmacist. The

resident is responsible for performing admission and discharge medication reconciliations, developing pharmaceutical care plans for patients with complicated medical histories as well as for

those on high-risk medications, performing pharmacokinetic and pharmacodynamic assessments, screening medications for appropriate indications and dosing, and proactively identifying drug

interactions. The resident will create therapeutic regimens for individual patients utilizing the VA formulary when possible. These activities are expected to be completed for every patient

that is assigned to the resident. The resident’s patient load will vary based on the preceptor’s discretion. MANAGEMENT (4-5 WEEKS) During this experience, the resident will gain insight

into the administration functions by participating in Veterans Affairs National Telecommunications System (VANTS) calls, interdepartmental meetings, or work with VA staff to complete

pharmacy administrative projects. Independent time will be given for longitudinal assignments, background reading, and other assignments as directed by the preceptor. The focus of the

rotation will be to understand essential elements of the VA organizational chart, pharmacy operations, human resources, budget, procurement, staff supervision, and other administrative

components as they present during the PGYI rotation. The resident will be expected to participate or lead administrative assignments until project conclusion. The resident will also be given

independent time to learn, evaluate, and make recommendations about current policy and procedures. In addition, the resident will have the opportunity to evaluate differences between

federal, state or VA regulations regarding pharmacy services. Rotation elements are dynamic given that national VA mandates change over time and the resident experience may vary depending on

current inspections, national policy directives, or other procedural changes occurring in the pharmacy. Independent work and time management skills are essential for success in this

rotation. INPATIENT PSYCHIATRY (4-5 WEEKS) The psychiatric pharmacy rotation is a four- to five-week rotational experience designed to develop resident’s knowledge and skills in the area of

provider/patient interaction, psychiatric disorders and psychotropic drug therapy on the inpatient psychiatry unit. Patients are most commonly admitted for mood disorders, PTSD,

schizophrenia, and/or substance use disorders. This is an interdisciplinary unit with 4 teams. Each team includes a psychiatrist, nurse practitioner, team nurse, and social worker. Each team

also has a mental health clinical pharmacist. Residents are exposed to trainees from other disciplines on the inpatient psychiatry unit and may be involved in assisting in pharmacy student

precepting. Residents are expected to provide patient and provider education, conduct medication histories and reconciliation on admission and discharge, and participate in team rounds.

Residents generally begin by shadowing the clinical pharmacist and by the end of the rotation are independently rounding on the team with coaching from their preceptor. In order to solidify

psychotropic drug therapy knowledge, residents conduct and participate in regular topic discussions. This rotation allows residents who are interested in the Salt Lake City VA PGY2

Psychiatric Pharmacy Residency to explore psychiatry.