Required (4 weeks)

• Orientation
• Adult Medicine I
• Critical Care I
• Emergency Medicine I
• Infectious Diseases
• Ambulatory Care I
• Practice Management/Admin

Required (2 weeks)

• Transitions of Care
• Nutrition Support

Elective

• Adult Medicine II
• Critical Care II
• Ambulatory Care II
• Emergency Medicine II
• Oncology
• Cardiology
• Clinical Informatics

Required Longitudinal

• Residency Project
• Hospital Practice (Staffing)
• Indiana Pharmacy Resident Teaching Certificate (IPTeC)
• Anticoagulation Clinic
• Pediatric Pearls Lunch/Learn

Rotation Descriptions

Longitudinal Rotations:

Hospital Practice (Staffing): The role of the resident in this rotation is to develop both clinical and distributive skills. The resident will work every third weekend from 07:00 to 17:30 staffing from the clinical satellite office. In addition, the resident will staff from central pharmacy once weekly four hours in the evening, and one afternoon over the course of three, two-month blocks.

Anticoagulation Clinic: One afternoon per week over the course of three two-month blocks, the resident will see patients in the clinic and provide management of their anticoagulation. The resident will gain knowledge in overall anticoagulant management with an emphasis on warfarin therapy and adjustment of doses related to INR results obtained on each visit. Residents will develop patient counseling skills as well as pharmacotherapeutic skills essential for the management of patients on anticoagulants.

Required Rotations:

Orientation: General overview of the Pharmacy Services of Union Health. The primary focus is on the inpatient clinical and inpatient distribution roles at Union Health. The goal is to prepare the resident for the weekend clinical staffing requirements.

Administration: Overview of the pharmacy administration activities that can affect the safety, clinical, and financial outcomes and advance pharmacy services. Topic discussions include formulary management, reimbursement, cost containment/avoidance, and 340b drug pricing. As part of this rotation, residents will be required to complete a minimum of one MUE and one drug monograph.

Ambulatory Care I (Population Health): During the Ambulatory Care rotation, residents spend time in 12 primary care clinics with the Population Health Team that services nearly 50 primary care providers. Pharmacy residents work alongside the clinical pharmacists providing direct patient care and co-management of six chronic disease states under a collaborative practice agreement.

Pharmacy residents participate in care team huddles, serve as a drug information resource to the providers and office staff, and provide face-to-face and telephone visits with multiple patients daily.

In addition, pharmacy residents attend two interactive topic discussions per week and complete a journal club during the rotation block. Topics discussions include education on chronic disease state management, insurance, billing, and value-based models.

Adult Medicine: The Adult Medicine I rotation focuses on the comprehensive management of inpatient disease states. During this rotation, the pharmacy resident will work closely with the Family Medicine team, including first-year medical residents, upper-level medical residents, and an attending physician. The pharmacy resident will attend daily bedside rounds and table rounds with the team, participate in didactic topic discussions, and make recommendations for optimizing patient care. The resident will also assist with precepting pharmacy students when available to develop teaching and precepting skills.

Critical Care I: This acute care rotation provides the opportunity to round with an interdisciplinary team of healthcare providers, and actively participate in the care of a variety of acute and chronic conditions. Therapeutic principles will need to be applied as well as skills of problem identification and solving, documentation, communication, drug information, and interpersonal skills. The primary goal of this rotation is to enhance the knowledge of medication and disease states within the critically ill population and successfully apply this knowledge in order to positively impact patient care.

Emergency Medicine I: The Emergency Medicine rotation involves 4 weeks based in the Emergency Department providing patient care and clinical support to the ED staff. As a resident, you will review patients in the ED looking for opportunities for pharmacy involvement to optimize medication therapy and patient experience. You will also respond to medical emergencies, including code blue, code stroke, and other rapid responses. Other activities include IV compounding, answering drug information questions from providers and nurses, and participating in projects to optimize workflow as it pertains to medication utilization in the Emergency Department. The elective Emergency Medicine II rotation builds upon the skills and knowledge gained in EM I and provides more autonomous experiences to the resident.

Nutrition Support: The Nutrition Rotation allows the resident to gain experience and understanding of clinical pharmacy services regarding nutrition support, insulin management, and electrolyte replacement. The rotation takes place on the surgical and oncology unit, with the resident managing total parenteral nutrition (TPN), insulin consults, and electrolyte replacement consults throughout the hospital. The resident will work closely with the facility's dieticians, nursing staff, and physicians to promote safe and effective nutrition therapy and achieve optimal nutrition therapy outcomes as vital members of the healthcare team.

Transitions of Care: This rotation will allow the resident to work with the Transitions of Care Pharmacist in reviewing patient discharges. Discharge medication lists will be reviewed for the appropriateness of medication therapy, affordability of medication therapy, potential barriers to medication therapy, drug interactions, and to ensure medication changes reflect inpatient medication adjustments. The resident will be given opportunities to further develop his/her patient counseling skills. The resident will also participate in the organization's employee health program by educating employees on their medication regimens.

Elective Rotations:

Clinical Informatics: This rotation will include time for projects, informatics meetings, and technology training. Residents will gain an understanding of the basic informatics principles and best practices and how they relate to assessing, analyzing, and implementing pharmacy information systems and technology.

Cardiology: The Cardiology rotation is an elective rotation option in the PGY-1 pharmacy residency program. During this rotation, the pharmacy resident will attend daily bedside rounds with the Cardiology team to discuss and optimize patient care from a cardiac perspective. The resident will work closely with the team throughout the rotation to make recommendations on cardiology-related medications and to counsel patients on new medications. The resident may also observe cardiac cath lab procedures and interventions.

Oncology: Basic introductory to oncology. Learning chemo regimens, becoming familiar with NCCN guidelines. Working closely with nursing staff in the infusion area to learn the nursing side as well as interact with the patients and their families.

Emergency Medicine II: This rotation builds upon the skills and knowledge gained in Emergency Medicine I and provides more autonomous experiences to the resident.

Ambulatory Care II (Population Health): This rotation builds upon the knowledge and skillset obtained in Ambulatory Care I. The resident will have more independence in the clinics in providing direct patient care and management of chronic disease states.

Adult Medicine II: Adult Medicine II builds on the foundation that was established in Adult Medicine I with an elevated level of independence and expansion to a broader level of patient care, including critically ill patients on the family practice team. While Adult Medicine I has a primary focus on inpatient management of specific disease states, in Adult Medicine II there is a change in focus from specific disease states to comprehensive care management with more in-depth involvement in transitions of care.

Critical Care II: This acute care rotation builds upon the knowledge, skill, and experience from Critical Care I. It provides the resident with more independence and autonomy. There is also the opportunity to precept a student if one is present during the rotation.

Family Medicine: This elective rotation involves inpatient and outpatient management of Family Medicine patients. During this rotation, the Pharmacy Resident will work alongside our Family Practice Residents, and other clinical staff, to optimize therapy for our inpatient and outpatient services. The Resident will attend daily teaching rounds to offer interventions and assist with medication management, be involved with topic discussions and didactic presentations, assist with evidence-based medicine recommendations in the inpatient and outpatient setting, discharge medication review, patient education, device utilization education, etc. The resident will be involved in teaching FPR (Family Practice Residents) or precepting other pharmacy students as well. This rotation offers a unique opportunity to participate in our Addictions Clinic, including weekly staffing meetings, patient education, and assisting the Faculty or FPR in the clinic with medication-assisted treatments.