Ambulatory Care Pharmacy Residency Annual Program Structure [PDF].

PGY2 Ambulatory Care residents who completed a PGY1 residency at University Health will only undergo orientation specifically for the PGY2 Ambulatory Care residency during the first month of the residency year. PGY2 Ambulatory Care residents who did not complete a PGY1 residency at University Health will undergo orientation and training for the University of Texas at Austin College of Pharmacy, University Health, the PGY2 Ambulatory Care Pharmacy Residency, and the Pharmacy Department during the first month of residency.

Departmental and residency training will include orientation to policies and procedures, University Health computers, and the outpatient clinics and pharmacies. The resident will also be oriented to the ASHP Residency Accreditation Standards, Program Design and Conduct, and the required Competency Areas, Goals, and Objectives for PGY2 residency training. In addition, the resident will be oriented to the evaluation process and the PharmAcademic online evaluation system (if not utilized during PGY1 residency).

The resident must become licensed in the State of Texas as a Registered Pharmacist by August 1, or the 1st day of the second month of residency.

Rotations:

• Family Medicine I – 4 weeks (during Orientation)
• Transitions of Care I – 2 weeks plus every 3rd weekend longitudinally
• Family Medicine II – 6 weeks
• Ambulatory Care/Smoking Cessation – 6 weeks
• Anticoagulation – 2 weeks plus one half-day weekly longitudinally
• Advanced Clinical Practice – 8-12 weeks

Other rotations available on an elective basis (4-6 weeks each) include but are not limited to the following:

• Advanced Diabetes & Endocrinology
• Outpatient Cardiology
• Outpatient Cardiology
• Hepatology
• Cystic Fibrosis
• HIV/AIDS
• Residents may repeat a required rotation as an elective if interested
• Other electives may be available upon request

The resident will participate in the University of Texas College of Pharmacy residents’ weekly Pharmacotherapy Seminar (residents’ discussion group) on Friday afternoons. This activity is optional but encouraged if the resident has not yet received board certification. The resident will be required to lead discussion on at least one Seminar topic, as assigned by the group coordinator.

The resident will also attend weekly Pharmacotherapy Rounds with fellow University of Texas College of Pharmacy residents on Friday afternoons. Attendance is strongly encouraged unless it interferes with urgent, necessary patient care obligations. The resident will also be required to present one formal Pharmacotherapy Rounds (“Resident Rounds”) during the year.

The resident is required to present a minimum of one ACPE-approved continuing education program to pharmacy staff during the residency year. Other required academic activities include presenting at least one ambulatory care-related lecture to pharmacy students and facilitating labs (minimum number determined annually) for pharmacy students. The resident will assist the ambulatory care preceptors with teaching and preparing lectures for family medicine residents and medical students, as well as with precepting pharmacy students and PGY1 residents assigned to ambulatory care rotations.

The resident may elect to obtain an Academic Training Program Certificate if not completed during their PGY1 residency. The University of Texas College of Pharmacy Teaching and Leadership Fellows Program (TLFP) requirements will be completed parallel to the University Health residency program throughout the year and will include attendance at the UT Academic Training Conference.

The resident will attend and actively participate in scheduled monthly Residency Advisory Council (RAC) meetings, monthly Pharmacy & Therapeutics (P&T), and quarterly Drug Utilization Evaluation (DUE) Committee meetings throughout the year if it does not interfere with clinical activities. The resident will also attend and serve as scribe at the monthly Ambulatory Care Clinical Pharmacist Committee meetings. The resident is expected to present ambulatory care-related topics when needed at these meetings. The resident will attend other Ambulatory Care meetings as directed by residency leadership.

Required learning opportunities include leading the design or modification of an outpatient medication management guideline, protocol or patient education tool and creating an outline for starting an Ambulatory Care practice in a general or specialty area. The resident is strongly encouraged to present results of ambulatory care-related research projects and/or DUEs at DUE, P&T, CMT and/or pharmacy meetings. Examples of ambulatory care-related topics that may be addressed include:

1. Formulary and fiscal management
2. Pharmacy policies and procedures
3. Medication-related guidelines/protocols
4. Information technology and automation systems
5. Medication-use system evaluation
6. Adverse drug reaction reporting, trending and interpretation
7. Medication safety and medication error reporting, trending and prevention
8. Pharmacist intervention reporting and trending
9. Investigational drugs

The resident will have the opportunity to attend and participate in local, state and national professional association meetings (required to attend 2 minimum with a formal presentation at 1 minimum), including but not limited to the ASHP Midyear Clinical Meeting and the Alcalde Southwest Regional Residency Conference.

The resident will provide clinical staffing for the Transitions of Care pharmacy service (10 weekends minimum) as scheduled by the RPD based on staffing needs, not to exceed 16 hours per 2-week period. During scheduled clinical staffing, the resident will have the opportunity to provide care for patients on the Transitions of Care work list, including in-person inpatient visits, coordination of care with the healthcare team to address clinical problems, and post-discharge telephone calls.

This longitudinal rotation is structured to provide the resident experience in self-evaluation of their strengths, goals, progress throughout the residency, and areas for improvement. Self-evaluations will be completed and discussed between the resident and residency leadership on a quarterly basis, then incorporated into each resident’s personal development plan.

Successful completion of at least one ambulatory care research project is required to fulfill the requirements and to obtain a certificate of graduation from the residency program. Research will focus on the evaluation of an ambulatory care pharmacotherapy-related issue. The resident must adhere to the established timeline for the project to assure successful completion during the one-year residency. The research project topic may be an idea of the resident, from a suggested list, or individually assigned. The project will be directly supervised by the RPD, Residency Coordinator and/or a preceptor with expertise in the selected discipline. The research project proposal must be approved by the RPD/Coordinator, and if applicable, must also be approved by the UT Health San Antonio Investigational Review Board and the University Health Research Committee.

The research project will be presented as an abstract and as a platform presentation at the regional Alcalde Southwest Residency Leadership Conference in the spring. The resident is strongly encouraged to submit an abstract of the research project at a regional or national pharmacy meeting. The research project must also be submitted in manuscript form to the RPD/Residency Coordinator and the resident is strongly encouraged to publish results of the project in a peer-reviewed journal.

The length of each rotation is specified below, but may be flexible, depending on the needs and interests of the individual resident. The following rotations are required:

• Family Medicine I – 4 weeks (during Orientation0
• Family Medicine II – 6 weeks
• Ambulatory Care/Smoking Cessation – 6 weeks
• Transitions of Care – 2 weeks plus every 3rd weekend longitudinally
• Anticoagulation – 2 weeks plus one half-day weekly longitudinally
• Outpatient Transplant – 4 weeks
• Advanced Clinical Practice – 8-12 weeks

Other rotations available on an elective basis include but are not limited to the following:

• Endocrinology
• Cardiology
• Hepatology
• Cystic Fibrosis
• HIV/AIDS
• Resident may repeat a required rotation as elective if interested
• Other electives may be available upon request