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PGY2 Ambulatory Care Residency

The VA Salt Lake City Healthcare System PGY2 Ambulatory Care Residency Program was started in the 2019-20 academic year. It joined the already strong PGY1 pharmacy practice and PGY2 psychiatric residency programs. The ambulatory care program has been designed, is supported, and was long-anticipated by preceptors who have several years of both practice and residency-precepting experience.

Residents in this program will join a strong primary care work-force where pharmacists are fully integrated and practicing under scopes of practice that allow focus on the full spectrum of chronic disease management needs of patients. 

Program purpose

PGY2 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education and PGY1 pharmacy residency programs to contribute to the development of clinical pharmacists in specialized areas of practice. PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings. Residents who successfully complete an accredited PGY2 pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification, if available.

Program description

The resident will spend 10 weeks near the beginning of the residency year as a patient aligned care team (PACT) pharmacist for several providers in the centralized primary care clinic. He or she will have the opportunity to follow up with patients seen during this learning experience longitudinally, to provide continuity of care in patient relationships.

While maintaining this longitudinal panel, the resident will move through various ambulatory learning experiences, working with our team pharmacists in multiple clinics including geriatrics, substance use disorder, chronic pain, gout, endocrinology, metabolic and obesity, and women’s health. In each area, emphasis will be placed on facilitating ability to independently see and manage complex patients.

The resident will additionally participate with fellow VASLCHCS residents in a residency wellness and mentorship program and will participate with interprofessional trainees in the Musculoskeletal Clinic Centers of Excellence Program and in a series of trainee-led patient case conferences.

Scope

Our residents will have the opportunity to apply for a scope of practice after demonstrating satisfactory progress on patient care objectives. This will be considered after completion of the resident's first required rotation. Once awarded a scope, residents will have the ability to place, adjust, and discontinue orders in the electronic medical record after staffing with their primary preceptor.

The purpose of awarding residents a scope of practice is to support autonomy and growth, preparing residents for independent practice following completion of the program. Residents will undergo peer review throughout the year, in compliance with the facility's policies and procedures for pharmacists with similar credentialing privileges.

Summary of rotations and requirements

Required (Core) learning experiences

Patient Aligned Care Team (PACT)

The resident will spend 10 weeks of his/her residency year as the Clinical Pharmacy Specialist for several PACT teams in the primary care clinics on VASLCHCS’s main campus. He/she will provide chronic disease management and patient/caregiver education while developing proficiency in working as part of an interprofessional team in a primary care setting.

During this rotation, the resident will also spend time in gout, endocrinology, and metabolic and obesity clinics. The resident will work with patients seen and managed in clinic during this rotation longitudinally, to develop skills in continuity of care.

Geri PACT

Seven weeks of the residency experience will be spent on the Geriatrics PACT team, gaining experience in managing healthcare in our oldest veterans. The resident will have the opportunity to participate in the Geri-assessment clinic and in daily geriatric clinics.

Community Based Outpatient Clinic

The resident will have the opportunity to spend 4 weeks expanding skills learned in the main facility primary care clinics in a setting with fewer resources – in a more “rural” setting –  working at one of our community based outpatient clinics.

Primary Care Substance Abuse/Primary Care Behavioral Health

The resident will spend 4 weeks working closely with our most vulnerable veteran population – those suffering from substance abuse, mental health conditions, homelessness, and other difficult ailments. This will be a truly unique opportunity to work with our Vulnerable Veteran Innovative PACT (VIP) team.

Women’s Health

Six weeks of the residency experience will be spent working in the women’s health clinic, gaining proficiency in addressing women’s specific health concerns. This rotation will also encompass time working with our transgender population.

Chronic Pain

The chronic pain rotation is a core rotation designed to help the resident develop proficiency in managing complex chronic pain patients in an ambulatory care setting. In filling the role of chronic pain pharmacist, the resident will independently provide chronic pain management and patient/caregiver education, including the development and monitoring of the overall pain treatment regimen, which includes pharmacologic and non-pharmacologic treatment options, facilitate case management when appropriate, and make medication adjustments for diagnosed and treated patients referred to PharmD by pain and/or primary care providers for management.

In addition to staffing the chronic pain clinic, the resident will spend ½ day per week in the following, specialized primary care and specialty clinics for experience in management of more specialized diseases causing pain: Musculoskeletal (MSK) Centers of Excellence and MSK PACT, PACT gout clinic, and neurology headache clinic.

Longitudinal Experiences

The resident will participate in formulary management throughout the year, attend residency wellness and mentorship meetings with other VASLCHCS residents, perform an outcomes analysis project, participate in the Musculoskeletal Centers of Excellence program with residents from other training disciplines, teach at local pharmacy schools, and participate in an interprofessional trainee-led patient case conference series.

Possible elective learning experiences

  • Advanced PACT
  • Anticoagulation
  • Emergency Department
  • Endocrinology
  • Hematology/Oncology
  • Rehab Medicine
  • Rheumatology/Neurology
  • Transitions of care
  • VA Primary Care Introduction
  • Custom experiences may be developed based on resident interest

Contacts

Kelly Eldredge, PharmD, BCACP – VA Salt Lake City PGY2 Ambulatory Care Residency Director
VA Salt Lake City HCS Pharmacy Administration 119
500 Foothill Drive, Salt Lake City, UT 84148

Email: kelly.eldredge@va.gov

Accreditation status

Full eight-year accreditation through the American Society of Health Systems Pharmacists (ASHP)

Application process

Early commitment from the PGY-1 program into the PGY-2 program is highly encouraged. Open PGY-2 slots are matched through PhORCAS. Application materials must be submitted using PhORCAS (see application deadline in the PhORCAS portal). The Postgraduate Year Two (PGY2) Ambulatory Care Pharmacy Residency NMS Code is 787065. If selected, an on-site interview is required and is usually scheduled for late January or February.

Note: This residency site agrees that no person at this site will solicit, accept, or use any ranking-related information from any residency applicant.

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