VA Salt Lake City Health Care System
PGY2 Ambulatory Care Residency
The VA Salt Lake City PGY2 Ambulatory Care Residency is a new program for the 2019-2020 academic year. It has joined the site’s already strong PGY1 and PGY2 psychiatric residency programs. Though new, the Ambulatory Care Residency has been designed, supported, and 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. The program is scheduled for its initial accreditation visit in June 2020.
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.
The resident will spend the first quarter 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, anticoagulation, gout, heart failure, and renal. In each area, emphasis will be placed on facilitating ability to independently see and manage complex patients. The resident will additionally participate with fellow PGY2 psychiatry residents in a longitudinal leadership seminar where they will develop and use soft skills in addition to their clinical skills to enable them to work through challenges and promote positive change and growth in future work environments.
Summary of Rotations and Requirements:
Required (Core) Learning Experiences:
- Patient Aligned Care Team (PACT) Clinical Pharmacist: The resident will spend his/her initial 12 weeks of residency 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 the gout and heart failure clinics. The resident will work with patients seen and managed in clinic during these 12 weeks longitudinally, to develop skills in continuity of care.
- Anticoagulation and Thrombosis Service: The resident will spend 4 weeks working with a nationally recognized anticoagulation and thrombosis service. This team approaches anticoagulation management in unique and interesting ways – having evolved with the needs of this rapidly changing field. CPSs in the service offer consultative services to inpatient and outpatient providers, serve as patient advocates and educators, and deliver anticoagulation drug therapy management utilizing novel methods, with a focus on population-based approaches to care. Patient care during the rotation will focus on the highest risk patients, such as those with LVADS. This rotation can be tailored to meet specific interests of the resident.
- Geri PACT: Eight weeks of the residency experience will be spent on the GeriPACT 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 working at one of our community based outpatient clinics – a more “rural” setting with fewer resources - building on and expanding skills learned in the main facility primary care 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 new Vulnerable Veteran Innovative PACT (VIP) team.
- Emergency Department: Knowing that infectious diseases, gout, chronic pain, substance abuse, hypertension, and many other primary-care-managed chronic diseases are often the reasons for patients’ presentations to the ED, the resident will have the opportunity to spend 4 weeks practicing with our ED pharmacists in this fast-paced and important learning environment. Recognizing that the ED is also (rightfully) an acute care environment, the resident will have scheduled time outside of the ED, with our infectious disease pharmacist participating in focused primary-care infectious disease topic discussions.
- Longitudinal Experiences: The resident will participate in formulary management throughout the year, attend leadership seminars 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 didactic case study series with trainees from other professions.
Possible Elective Learning Experiences:
- Transitions of Care
- Advanced PACT
- Rural Health/Population Management
- Academic detailing
- Custom experiences my be developed based on resident interest