Internal Medicine Residency Program Annual Structure [PDF].

PGY2 Internal Medicine residents who completed a PGY1 residency at University Health will only undergo orientation specifically for the PGY2 Internal Medicine residency during the first month of the residency year.

PGY2 Internal Medicine 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 Internal Medicine 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, the inpatient pharmacy and the Internal Medicine department. All items on the Internal Medicine Competency/Training 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 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 first day of the second month of residency.

The resident will participate in the University of Texas College of Pharmacy residents’ weekly Pharmacotherapy Seminar (discussion group) on Friday afternoons. The resident will be required to lead the discussion on at least one internal medicine topic, as assigned by the group coordinator.

The University of Texas College of Pharmacy residents’ weekly Pharmacotherapy Rounds, also on Friday afternoons, will be attended by the resident. This activity 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.

Other required academic activities include regular internal medicine topic discussions, pharmacy journal clubs and facilitating labs (minimum number determined annually) for pharmacy students. The resident will assist internal medicine preceptors in mentoring and precepting pharmacy students assigned to internal medicine rotations. The resident will also have numerous opportunities to participate in and lead discussions on internal medicine-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 (TLFP) requirements will be completed throughout the year, including attendance at the UT Academic Training Conference

The resident will provide clinical staffing on medicine units as scheduled by the RPD based on staffing needs, not to exceed 16 hours per two-week period. During scheduled clinical staffing, the resident will have the opportunity to perform comprehensive medication regimen reviews, therapeutic drug monitoring, verify orders and address clinical problems for patients on medicine units.

The resident is required to attend and actively participate in scheduled monthly Residency Advisory Council (RAC) meetings, Pharmacy & Therapeutics (P&T) meetings, Medication Safety Committee meetings, and quarterly Drug Utilization Evaluation (DUE) Committee meetings throughout the year. The resident will also be a non-voting member of a P&T subcommittee (specialty as assigned). Attendance at other Internal Medicine meetings as directed by residency leadership.

The resident is expected to present internal medicine-related topics when needed at these meetings. Learning opportunities may include:

1. Organizing and coordinating a P&T Subcommittee meeting
2. Organizing and coordinating RAC meetings for a portion of the year designated by the RPD
3. Conducting an internal medicine-related DUE
4. Preparing or revising a treatment guideline or protocol
5. Presenting results of internal medicine-related research projects at DUE, P&T and/or pharmacy meetings

Examples of internal medicine-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 including but not limited to the ASHP Midyear Clinical Meeting, the Alcalde Southwest Regional Residency Conference, and Celebrating Pharmacy Research Excellence Day.

Successful completion of at least one internal medicine 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 internal medicine 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.

This longitudinal rotation is structured to provide the resident with 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.

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. General Internal Medicine I
3. General Internal Medicine II
4. Infectious Diseases (Consults or Stewardship)
5. Inpatient HIV Service
6. Internal Medicine VA
7. Medical Intensive Care Unit
8. Oncology Internal Medicine

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

1. Academia
2. Advanced Internal Medicine Practice
3. Ambulatory Care
4. Emergency Medicine
5. Family Medicine
6. HIV Clinic
7. Hospitalist Medicine
8. Neurology
9. Transplant Medicine