The objective of the PGY1 Residency Program at Regional One Health is to provide systematic training of the resident for the purpose of achieving professional competence in the delivery of patient-centered care in a wide variety of patient care settings and in pharmacy operational services. PGY1 residents acquire substantial knowledge required for skillful problem solving, refine their problem-solving strategies, strengthen their professional values and attitudes, and advance the growth of their clinical judgment. The instructional emphasis is on the progressive development of clinical judgment, a process begun during professional school years, but that requires further extensive practice, self-reflection, and shaping of decision-making skills fostered by feedback on performance. The specific program for each resident may vary in structure based upon the resident’s entry level of knowledge, skills, and interest. The PGY1 Residency Program is accredited by the American Society of Health-System Pharmacists.
The 12-month (2,000 hour minimum) program is composed of advanced pharmacy experience. Residents receive training and develop competence in managing and improving the medication-use process, providing evidence-based, patient-centered medication therapy management with interdisciplinary teams, exercise leadership and practice management skills, demonstrate project management skills, provide medication and practice-related education/training, and utilize informatics. To fulfill these requirements, practice experiences are offered in:
- Ambulatory Care
- Drug Information, Drug Policy Development, and Practice Management
- General Intensive Care
- Inpatient Rehabilitation
- Inpatient Drug Distribution
- Internal Medicine
- Nutrition Support
- Obstetrics and Gynecology
- Specialized Clinical Pharmacy Services (Anticoagulation and Pharmacokinetics)
- Trauma Intensive Care
During each experience, the resident is expected to perform independently and demonstrate proficiency in pharmacy practice. Clinical staff members with practice responsibilities in these areas serve as preceptors for the training experiences. Residents will spend seven months in ambulatory care, critical care, inpatient drug distribution, specialized clinical pharmacy services, medicine, drug information/drug policy development/practice management, and three months of electives from any of the above bulleted experiences. Three elective experiences permit the resident to expand abilities and skills in areas of particular interest. The broad scope of pharmacy services offered provides flexibility to pursue individual goals.
During the program, the resident must complete a self-directed research project. The scope, magnitude and type of project may vary widely according to individual interests but must be completed in a manner suitable for presentation and publication. The resident presents the research project at a regional residency conference in the spring.
The education component of the program enables the resident to develop teaching and training skills by participating in education programs for patients, pharmacy students, physicians, nurses, pharmacists, and other allied health practitioners.
Selected Pharmacy Services
- Ambulatory Care
The resident participates in the Anticoagulation Clinic and Hypertension/Diabetes Clinic by providing pharmacotherapy evaluation and management, as well as the Internal Medicine Consult Service. They also provide instruction in the pharmacy-managed, American Diabetes Association accredited Diabetes Self-Management Program to patients referred from their internists or obstetricians.
- General Intensive Care Service
The resident is a part of the multidisciplinary pulmonary medicine team caring for patients of the medical ICU service. Pharmacists provide input on antibiotic management, sedation and pain control, fluid, electrolyte and glucose management, and pharmacokinetic and pharmacotherapy consultations. There are teaching opportunities and discussions with the medical team and working with Doctor of Pharmacy students. Additionally, the resident will monitor patients in the unit on the cardiology, general surgery and trauma surgery services in the general ICU.
- High-Risk Obstetrics
The High Risk Obstetrics Center serves thousands of women in the community with complications during their pregnancy including diabetes, hypertension, deep vein thrombosis or embolism, epilepsy, advanced maternal age, and renal disease. The resident is a part of the obstetric team and interacts daily with the team, providing pharmacokinetic and pharmacotherapy consults. Residents also provide in-service presentations to the medical and nursing staff and serve as a source of drug information for pregnancy and lactation.
- HIV/AIDS Service
The resident will provide patient education to adult patients with AIDS and assist physicians with optimizing pharmacotherapy in both an inpatient and outpatient setting. Regional Medical Center has one of the largest HIV clinics in the state of Tennessee. The resident participates in multidisciplinary community outreach.
- Internal Medicine
The resident is an integral member of one of the medicine teaching services caring for a large number of adult medicine patients with a wide range of complex medical conditions. Patients have high incidences of diabetes, hypertension, heart failure, asthma, obstructive lung disease, HIV, mental illness, and substance abuse. Responsibilities include general pharmacotherapy, antibiotic optimization, discharge continuity coordination, pharmacokinetics, and drug information & education. Pharmacy services require active daily participation in multidisciplinary patient care rounds and targeted formal written consultation in the patient’s medical record.
- Neonatal Intensive Care Service
The Sheldon B. Korones Newborn Center is one of the oldest and largest neonatal intensive care units in the United States, treating over 1300 premature or critically ill babies each year. The resident rounds daily with the multidisciplinary neonatal service and provides pharmacokinetic and pharmacotherapy consultations. The resident also provides in-service presentations to the medical and nursing staff.
- Nutrition Support Service
The resident is part of the interdisciplinary nutrition team. The service is a consult and clinical management service for patients receiving specialized nutrition support (parenteral and enteral nutrition). The resident is responsible for monitoring patients, writing daily progress notes, and collaboratively developing parenteral or enteral nutrition orders and managing pharmacotherapy as related to nutrition support.
- Inpatient Anticoagulation Service
This service provides evaluations for the management of anticoagulation therapy and warfarin education for all inpatients. Residents provide written consultations in the medical record on all patients receiving oral anticoagulation. Pharmacists coordinate the Low Molecular Weight Heparin Expedited Discharge Anticoagulation Program (LEAP). Pharmacists assist in heparin drip and low molecular weight heparin monitoring and management. Pharmacists may be consulted to collaboratively manage anticoagulation therapy. The Anticoagulation Service is provided 365 days a year.
- Inpatient Pharmacokinetics Service
This service provides written evaluations of all aminoglycosides and vancomycin drug concentration levels. This service also provides pharmacotherapy management when consulted. This is provided 365 days per year.
- Rehabilitation Medicine
The resident is an integral part of the multidisciplinary care at the Regional One Health Rehabilitation Hospital. The resident functions as the pharmacotherapist on the team offering comprehensive acute care, inpatient rehabilitation and outpatient treatment programs designed to speed recovery and maximize independence.
- Trauma Intensive Care Service
The resident is a part of the multidisciplinary trauma team. The team routinely interacts with general surgery, trauma, neurosurgery, and orthopedic services. Pharmacy residents provide antibiotic management, pharmacokinetic, anticoagulation, and pharmacotherapy consultations, as well as serving as a source of drug information. This is the only comprehensive Level I Trauma Center in the Mid-South Patients from a five-state area are treated in the center.
Practice Management and Drug Information Experience Activities
- Pharmacy and Therapeutics Committee
Residents actively participate in the Pharmacy and Therapeutics Committee and learn how to effectively conduct P & T activities and implement drug-policy decisions. Residents are assigned activities such as adverse drug reaction summaries, P & T minutes, drug monograph preparation and presentation, and health care provider notices.
- Drug Policy Development
Residents are responsible for maintenance of policy and procedures to ensure rational and safe medication use in the hospital.
- Pharmacy Newsletter
Residents are responsible for publishing a newsletter for the hospital and the pharmacy staff.
- Medication Use Evaluations
Residents conduct medication-use evaluations targeted at appropriate use or cost-effective therapies.
Applicants for the PGY1 Residency should hold a Doctor of Pharmacy or Master of Science in Hospital Pharmacy degree and must obtain licensure in the State of Tennessee no later than September 1. Application is via PhORCAS and requires three (3) individualized letters of reference in addition to standardized PhORCAS reference, transcript, CV, class ranking and letter of intent. A limited number of on site interviews will be offered. Deadline for application is January 1.
For more information or to connect with a current resident contact the Residency Program Director, Marilyn Lee, Pharm.D., BCPS, at firstname.lastname@example.org.