Pharmacy Residency: Internal Medicine
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Internal Medicine is a popular PGY2 residency, itself of course mapping across to the huge specialty of Internal medicine. As such there are a number of programs available across the US, and they each offer a broad range of experience. Here we will work through an overview of the residency, consider core outcomes, and look at the rotations and make-up of the year for a resident within this field.
The PGY2 Pharmacy Residency in Internal Medicine has been constructed with the intention of transitioning graduates of PGY1 residency from being generalists into being specialists focused on the care of adults with medical problems – with a particular focus on inpatients. Graduates are therefore expected to act as core parts of the wider interdisciplinary team, with a number of different healthcare professionals caring for patients, including physicians, nurses and nurse practitioners, PAs, and other pharmacists. The role of a specialist pharmacist here is to provide this wider team with evidence-based medication-related information, and to take said information into craft expert recommendations to the team for the use of medications and other therapeutic approaches. A graduate of this program will have broad, deep and robust patient care experience, built atop of strong knowledge of both medical problems and their treatment and management, and thus be able to act as an invaluable source of information for a wider healthcare organisation when decisions regarding patient care must be made. Typical work for a graduate of this residency might include the creation of medication-use policy development – like the development of guidelines and protocols, conducting medication-use evaluations, participating in the formulary decision process, and of course organising the implementation of the protocols that they have been responsible for. A pharmacist within this field will therefore be able to understand and recognise the needs of other health professionals that care for internal medicine patients, create optimal management protocols for them, and teach these same protocols.
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There are a significant number of programs offering this residency across the US, including the University of Arizona’s RK Colt College of Pharmacy, the University of California Davis School of Health, University of California San Diego, and Johns Hopkins.
All applicants must have completed their PGY1 year by the time they begin the PGY2. Applications are conducted through PhORCAS and the NMS conducts the Match process. You must submit the following through PhORCAS: letter of intent, CV, transcripts, and at least three letters of recommendation.
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The following outcomes are an abridged version of the wider outcomes that can be found through the ASHP:
– Serve as an authoritative resource on the optimal use of medications.
– Optimise the outcomes of internal medicine patients by providing evidence based, patient-centred medication therapy as an integral part of an interdisciplinary team.
– Demonstrate excellence in the provision of training and educational activities for healthcare professionals and health care professionals in training.
– Demonstrate leadership and practice management skills.
– Contribute to the body of pharmacy knowledge in internal medicine.
– Evaluate, manage, and improve the medication-use process.
Life as a Resident
A resident will be expected to take an active part in patient care, although all patient care will take place under the supervision of a preceptor and attending pharmacists. That said, expect to work with a high level of independence, and thus to spend a significant amount of time speaking with those from other medical and healthcare fields. You will also become used to discussing your patient plan, or recommendations regarding medications, to other pharmacists. Alongside this are academic responsibilities, which are likely to include training pharmacy students (often acting as a preceptor for students on certain rotations). You will also likely lead student topic discussions, help with OSCEs, and deliver lectures and larger classroom sessions. Expect to also deliver numerous presentations over the course of a year, including a formal presentation.
In terms of rotations, the following schedule is taken from one US university, but is typical for this program:
Core rotations are
- General Internal Medicine (4 months)
- Cardiology (1 month)
- Infectious Diseases (1 month)
- Medical Intensive Care (1 month)
Elective rotations are:
- Solid Organ Transplant
- Emergency Medicine
- Research and Academia
- And other electives based on resident’s interests
Longitudinal learning and work includes:
- Research Project
- Medication Use Process
- Weekend clinical staffing