Pharmacy Residency: Emergency Medicine
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Emergency Medicine is a relatively popular choice for PGY2 Residency in Pharmacy. Here, we will consider a general overview of the residency, briefly consider programs where one can take on this residency, the requirements, and then look at the typical life of a resident, including core rotations.
An Emergency Medicine Pharmacy Residency is designed to develop a pharmacist’s expertise across emergency settings, of which there are multiple. These settings include the emergency department, the ICU, SICU, and even disaster response and mass casualty incidents. A resident will therefore form part of an interdisciplinary team and work closely with all of: medical residents, senior physicians and surgeons, other pharmacists both from this specialty and outside it, and other healthcare professionals. Typically residents will be expected to take on a significant amount of teaching work, both through teaching Doctor of Pharmacy students and emergency medicine residents, nurses, and faculty. You should expect to precept Doctor of Pharmacy students and PGY1 residents as they move through emergency medicine rotations. A core range of activities skills and areas covered will include each of the following:
- Emergent medication procurement, preparation, administration
- Prospective ED order verification
- Discharge culture follow-up
- Clinical consultations for ED/CDU/ACU patients
- Bedside direct patient care participation (e.g., resuscitation, intubation, procedural sedation, STEMI, ECMO, stroke, sepsis)
- Vaccine screening and administration
- Formulary, medication safety, and quality improvement projects
- Emergency care of unique patient populations (including transplant, oncology, psychiatry, substance use disorders, toxicology, pulmonary hypertension)
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A number of programs are offered across the US, illustrating the popularity of this pharmaceutical specialty. A sample includes Stanford Health Care, in Palo Alto; University of California Davis Medical Center in Sacramento, and UCSF Medical Center in San Francisco. These are just a few of the programs available in California – you can of course find the full range of programs that offer this residency on the NMS website, where you can also filter by location and see details of core staff.
In order to apply, a candidate must have a Doctor of Pharmacy degree from an ACPE accredited school of pharmacy. Before beginning an Emergency Medicine PGY2 Residency, all residents must have successfully completed an ASHP-accredited PGY1 pharmacy residency program.
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The following outcomes are taken from Johns Hopkins’ program, and provide a summary of the much more detailed ASHP outcomes document.
- To develop competent emergency medicine pharmacy specialists who are able to meet the needs of emergency medicine patients while acting as a fully integrated member of the interdisciplinary emergency medicine team.
- To expose the resident to a wide variety of emergency department chief complaints and illnesses and associated management in order to ensure broad foundational evidence-based pharmacotherapy knowledge and skills.
- To provide experiences which develop skills in teaching other health care professionals and those in training to become healthcare professionals.
- To provide opportunities for the resident to develop medical literature evaluation skills and medical literature writing skills.
- To provide the resident opportunities to develop skills necessary to conduct emergency medicine pharmacy research.
- To provide the experience necessary for the future clinical practitioner to exercise leadership in emergency medicine quality and safety improvement initiatives within a health system.
- Participate in the development or planning of organisational plans for the management of mass casualty events or other emergency scenarios that impact the health system.
Life as a Resident
The following are likely to be core rotations within the year:
- Adult Emergency Medicine (AED) (minimum of 6 months over the course of the residency year)
- Medical Intensive Care (MICU) (1 month)
- Pediatric Emergency Medicine (PED) (1 month)
- Poison Center Toxicology (1 month)
Additionally, expect the following education and training experiences:
- Pharmacotherapy Rounds, in which all residents will provide a 30-minute presentation that is APCE accredited.
- Journal Clubs and/or Topic Discussions, in which a resident will work through all required topic discussions for the year.
All residents must also take on teaching – the format of this will differ from university to university.
A rough overview schedule might be:
July – Department of Pharmacy Orientation
Aug- Adult Emergency Medicine
September – Poison Center Toxicology
October – Adult Emergency Medicine
November – Antimicrobial Stewardship (elective)
December – MICU
January – Adult Emergency Medicine (with Student)
February – Bayview Adult Emergency Department
March – PICU (elective)
April – Pediatric Emergency Medicine
May – Adult Emergency Medicine
June – Adult Emergency Medicine