Preparing Graduates for Critical Care Clinical Specialist PositionsPGY2 residency programs build upon Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency training to develop pharmacist practitioners with knowledge, skills, and abilities as defined in the educational competency areas, goals, and objectives for advanced practice areas. Residents who successfully complete PGY2 residency programs are prepared for advanced patient care or other specialized positions, and board certification in the advanced practice area, if available.
OverviewRenown Regional Medical Center’s PGY2 Critical Care Pharmacy Residency is an American Society of Health-System Pharmacists (ASHP) accredited residency designed to provide a comprehensive experience in all aspects of critical care pharmacotherapy. Throughout the residency year there will be multiple opportunities to positively impact patient care and to respond to and participate in medical emergencies. These opportunities will arise as the resident participates in multidisciplinary rounding with each of our intensivist groups, interacting with the emergency department staff, and staffing independently during weekend coverage. Additionally, the resident is required to make substantial contributions regarding the provision of care to the critically ill and injured throughout the residency year, including completing a research project focused on critical care, precepting pharmacy students and mentoring PGY 1 pharmacy residents.
Required Learning Experiences
- Cardiac Intensive Care
- Trauma Intensive Care
- Medical Intensive Care
- Emergency Medicine
- Trauma Intensive Care II
- Longitudinal Experiences
Elective Learning Experiences
- Emergency Medicine II
- Cardiac Intensive Care II
- Medical Intensive Care II
- Infectious Diseases
- Pediatric ICU
Learning Experiences and Preceptors
Staffing with Zack Marcus, PharmD, BCCCP
The resident is required to fulfill the service commitment (staffing) designed to ensure that resident gains experience and can function as a competent practitioner. The goal of the staffing component of the residency is to provide experiences to ensure that the resident can function autonomously as a practicing staff, clinical, and ultimately a pharmacy clinical specialist. This is a longitudinal (12 month) experience designed to provide residents with exposure focusing on multidisciplinary rounding, per protocol management, order processing, assessment, and clinical training. Prior to independently staffing clinical shifts, the resident must have successfully completed training in anticoagulation, parenteral nutrition, pharmacokinetics, and be certified in BLS and ACLS.
Required Longitudinal Non-Direct Patient Care Learning Experiences
Management with Zack Marcus, PharmD, BCCCP
To better understand the inner workings of a large healthcare facility and community system, the resident will attend monthly code blue committee meetings and evidence-based content committee meetings quarterly. Additionally, the resident will be required to present monographs and DUE/MUE findings at P&T committee meetings. This rotation is intended to expose the resident to a variety of administrative activities including committee work, the departmental budget, inventory control, and inpatient pharmacy regulations. The practice management rotation will help the resident become familiar with the key principles utilized in hospitals and health systems for leadership.
Project with Zack Marcus, PharmD, BCCCP
During this longitudinal learning experience, the resident will identify a research project, apply for and achieve IRB approval, if necessary, collect and analyze data, provide appropriate education if a new process is implemented, present data at Western States Conference and complete a manuscript applicable for submission and publication.
Required Concentrated Direct Patient Care Learning Experiences (8 weeks each, unless otherwise specified)
Orientation (6 weeks) with Jessica Thompson PharmD, BCPS, BCIDP
This learning experience is designed to foster comfort and proficiency with the Epic EMR and the many intricacies of the main pharmacy and the aspects of distribution. Additionally, it allows the resident to become familiar with their new surroundings and wayfinding. The resident will also be introduced to the many policies and protocols that they will be implementing and following through the year. During orientation rotation, the resident is comprehensively trained and orientated to the hospital, the pharmacy and the residency program. Subsequent to satisfactory completion of Renown New Employee orientation and Epic training, the resident begins staffing. The staffing training will include central pharmacy staffing orientation/training and IV room staffing orientation. Full functioning as a pharmacist does not begin until the resident attains Nevada pharmacist licensure.
Trauma Intensive Care I with Zack Marcus, PharmD, BCCCP
This rotation is designed for the resident to become familiarized with the topics and rounding expectations that will pervade their training in the trauma intensive care unit. This training will center around large groups of penetrating and blunt force trauma, and the subsequent pharmacologic and medical issues that arise from these injuries. The resident will work toward assuming the role of the pharmacist and provide the services that the staffing pharmacist would normally including being a resource for the multidisciplinary team concerning medications and their appropriate uses, therapeutic and formulary alternatives, order entry and processing, pharmacokinetic monitoring and adjustment, pharmacy driven anticoagulation, and parenteral nutrition monitoring and adjustment.
Emergency Medicine I with Heather Townsend, PharmD, BCPS, BCCCP
This experience will provide exposure to the diverse patient population that presents to the emergency department (ED), and the unique role the ED pharmacist has in this practice setting. Residents will be challenged in direct patient care activities and in the busy environment to make decisions quickly and utilize drug information resources efficiently. The practice environment will require daily interactions with patients, ED physicians, medical attendings, surgeons, nurses, social workers, respiratory therapists, pharmacy staff, and other healthcare professionals as necessary to optimize pharmacotherapy.
Medical Intensive Care with Tiffany Kliewer, PharmD, BCCCP
TThe Medical Intensive Care Unit (MICU) rotation involves the provision of pharmaceutical care to medically complex patients. The critical care resident will have the opportunity to participate in daily rounds with the MICU Multidisciplinary Team; which is comprised of a hospitalist, pulmonologist, clinical pharmacist, nurse manager, bedside nurse, respiratory therapist, case manager, social worker, and dietician.
Cardiac Intensive Care with Mike Thuyns, PharmD, BCPS, BCCP, BCCCP and Nikki Noroian, PharmD, BCPS, BCCCP
This learning experience is based on the experiences of the cardiac intensive care patient. The resident must continue to gain experience and confidence within the realm of cardiac emergencies, surgeries, and chronic disease states. As the resident progresses through the multiple rotations they will be required to show proficiency in the management of these different disease states and the overall care of the critically ill cardiac patient. As proficiency is demonstrated more responsibilities will be given/required until the resident is able to effectively staff as a clinical pharmacist in this arena.
Trauma Intensive Care II (4 weeks) with Zack Marcus, PharmD, BCCCP
This is the second installment of training for the resident in the trauma intensive care unit, and will draw from the experience and training gained in the first 8 week block. This learning experience allows for the resident to develop their skills as a practitioner and gain confidence as the primary resource for the multidisciplinary team. The resident is expected to function independently with minimal support from the primary preceptor. This final rotation allows the preceptor to assess and address any final details prior to the completion of the residency.
Elective Learning Experiences* (Select 2, 2 to 4 weeks each)
Cardiac Intensive Care II with Mike Thuyns, PharmD, BCPS, BCCP, BCCCP
Emergency Medicine II with Heather Townsend, PharmD, BCPS, BCCCP
Medical Intensive Care II with Tiffany Kliewer, PharmD, BCCCP
Infectious Diseases with Jessica Thompson, PharmD, BCPS, BCIDP
This rotation is designed to provide the PGY1 resident with an understanding of core ID principles. The resident will learn how to integrate knowledge of disease states and antibiotics to provide evidence-based treatment of patients with infections. The resident will participate in infectious diseases rounds, participate in antibiotic stewardship, and gain the skills needed to manage the pharmacokinetics service. The overall goal of the resident is to learn how to provide safe, appropriate, and cost-effective treatment to improve healthcare outcomes
Pediatric ICU with Carol Vollmer-Johnson, PharmD, BCPPS
This experience will provide exposure to a diverse pediatric population, and the unique role that the pharmacist has in medication safety and dosing for pediatrics. The resident will have exposure rounding with both the PICU and Pediatric teams on a daily basis, and will be responsible for pediatric code response, order verification, drug information, and pharmacokinetic monitoring while present. The resident is expected to be on rotation four days per week for approximately 8-10 hours a day which may vary in time based on needs and learning experiences. The resident will be expected to complete one project during the rotation that includes teaching staff.
Parenteral Nutrition with Michelle Barcelon, PharmD, BCPS, BCCP
Renown's Pharmacy Department is a leader in parenteral nutrition management with liberal protocols for pharmacist management. During this rotation, you will have the opportunity to perform the role of the pharmacist including nutritional assessments, formulate and adjust parenteral nutrition solutions for different patient populations, including the elderly and critically ill.
*Other elective learning experiences may be developed based on resident interest and preceptor availability.