Critical Care Pharmacy Residency Annual Program Structure [PDF].

PGY2 critical care residents who completed a PGY1 residency at University Health will only undergo orientation specifically for the PGY2 critical care residency during the first month of the residency year. PGY2 critical care residents who did not complete a PGY1 residency at University Health will undergo orientation and training for the University of Texas College of Pharmacy, University Health, the PGY2 Critical Care Pharmacy Residency, and the Department of Pharmacotherapy and Pharmacy Services during the first month of residency. Departmental and residency training will include orientation to policies and procedures, University Health computers, inpatient pharmacy, and critical care units. All items on the Critical Care Resident Orientation Checklist should be covered during this training period, and the completed checklist should be submitted to the Residency Program Director (RPD) at the end of the training period.

The resident will also be oriented to the ASHP Residency Accreditation Standards, Program Design and Conduct, and 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). Residents who are not previously certified will also be scheduled for training in Basic and Advanced Cardiac Life Support (BLS/ACLS) early in the residency. Training in Pediatric Advanced Cardiac Life Support (PALS), Advanced Trauma Life Support (ATLS) and Emergency Neurological Life Support (ENLS) is available and encouraged. 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.

The resident will participate regularly in a critical care discussion group. This group will encompass disease state/topic discussions, journal clubs and review sessions to prepare for Board Certified Critical Care Pharmacist examination.

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 but is interested in pharmacotherapy 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 required 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 critical care-related lecture to pharmacy students, and facilitating labs (minimum number determined annually) for pharmacy students. The resident will have the option to assist the critical care preceptors with the Surgical Intern Readiness Elective (SIRE) medical student lecture series, and mentoring and precepting pharmacy students and PGY1 residents assigned to critical care rotations. The resident will also have numerous opportunities to participate in and lead discussions on critical care-related patient cases, journal clubs, in-services, and continuing education programs.

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 University Health residency program throughout the year and will include attendance at the UT Academic Training Conference. There are two levels of participation: Clinical Educator Track for residents interested in pursuing clinical educator positions after residency (appropriate for most PGY1 residents) and Academia/Faculty Track for residents who desire faculty position with a college of pharmacy (appropriate for PGY2 residents and some select PGY1 residents).

The resident will provide clinical staffing for critical care areas as scheduled by the Residency Program Director (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 attend rounds, verify orders and address clinical problems for patients in various intensive care units.

The resident will maintain BLS and ACLS certifications and participate in management of medical emergencies. The resident will respond to “code blue” emergencies within University Hospital as delineated by the Resident Code Blue Response Program during scheduled weekday work hours and during clinical staffing on weekends and holidays.

The resident will attend and actively participate in scheduled monthly Residency Advisory Council (RAC), Pharmacy & Therapeutics (P&T), bimonthly Critical Care Clinical Practice Group (CCPG) and Drug Utilization Evaluation (DUE) and quarterly PGY2 RAC Committee meetings. Attendance at various ICU Clinical Management Team (CMT) and Morbidity and Mortality (M&M) meetings are by request. The resident is expected to present critical care-related topics when needed at these meetings. The resident will also meet with the RPD quarterly for a management/leadership related topic discussion. Learning opportunities include organizing and coordinating a P&T Subcommittee meeting, organizing and coordinating RAC meetings for a portion of the year designated by the RPD, conducting a critical care-related DUE and presenting results of critical care-related research projects at DUE, P&T, CMT, and/or pharmacy meetings. Examples of critical 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, the Alcalde Southwest Regional Residency Conference, Celebrating Pharmacy Research Excellence Day, and the Society of Critical Care Medicine Annual Congress.

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 critical 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 a critical 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. December will be given as a dedicated month to work on research data collection.

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 or critical care 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 usually one month, but may be flexible, depending on the needs and interests of the individual resident. The following rotations are required:

1. Cardiology
2. Emergency Medicine
3. Medicine ICU I
4. Medicine ICU II
5. Neuroscience ICU
6. Surgical Trauma ICU I
7. Surgical Trauma ICU II

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

1. Academia
2. Advanced Critical Care Practice
3. Abdominal Solid Organ Transplant
4. Cardiothoracic Surgery
5. Evening Critical Care
6. Infectious Diseases
7. Lung Solid Organ Transplant
8. Neonatal ICU
9. Neurology/Stroke
10. Neuroscience ICU II
11. Palliative Medicine
12. Pediatric ICU