Rotations

This rotation will expose the resident to the functions of clinical pharmacists in a Critical Care (mixed) ICU setting and to enhance the knowledge of therapeutics and the skills necessary to provide pharmaceutical care.

This rotation provides an opportunity for the pharmacy resident to practice clinical pharmacy in the emergency department under supervision of an emergency medicine clinical pharmacist. In addition to direct patient care, pharmacist responsibilities in the ED include: positive culture follow up on discharged ED patients, code blue coverage, stroke alerts, cardiac alerts, trauma alerts, code white and sepsis alerts. Patient volume in the ED is dependent on the day and the amount of patients the resident would be responsible for varies, but will not typically exceed four to five patients at a time. Upon rotation completion, the resident should be able to prioritize and triage patients, synthesize complex medication recommendations in a timely manner, and capable of working with a wide range of disease states and disorders.

The goal of this rotation is to expose the resident to a wide variety of infectious disease topics, with a focus on those more commonly impacting hospitalized patients. Reviewing patients, rounding with infectious disease providers, intense topic discussion, and identifying antimicrobial stewardship opportunities are central to this rotation. The resident will be responsible for an increasing number of patients throughout the rotation. The infectious disease service varies in patient volume but generally ranges from 15-22 patients. The resident will shadow an infectious disease provider at the Peak Vista clinic for an outpatient HIV experience. The resident will attend weekly microbiology rounds. Presentations and projects will vary depending on the needs of the pharmacy department and the resident’s interests, at a minimum the resident will present a topic to the microbiology staff and either a journal club or case presentation to the pharmacy staff. The resident is encouraged but not required to attend any educational events or meetings that the preceptor is attending related to infectious diseases. By the completion of this rotation the resident should have mastery of the common infectious disease states that afflict hospitalized patients and a foundational understanding of less common ones.

This rotation provides the opportunity for the pharmacy resident to actively participate in the provision of pharmaceutical care, solidify their knowledge base of common disease states, and enhance their ability to work on an interdisciplinary team. Resident will complete both didactic and experiential training through team rounding and topic discussions. Rotation projects and presentations will be assigned based on the needs of the Internal Medicine team and/or Pharmacy department.

This rotation is with the director of pharmacy (DOP). Experiences may include cost analysis, capital expenditure process, safety issues, policy development, Joint Commission continual readiness, and committee attendance.

This is a required, year-long, longitudinal rotation that seeks to engage the resident in developing clinical writing and decision making skills. This rotation is comprised of various committee assignments and presentations, Medication Use Evaluations (MUE), and policy and/or protocol development. The resident will work closely with the Pharmacy and Therapeutics (P&T) Committee Secretary, pharmacy management and the Medication Safety Specialist to satisfy the requirements of this rotation.

This rotation is designed to make the pharmacy practice resident familiar with the daily activities and responsibilities of managing an ambulatory oncology practice. Emphasis will be placed on providing medication therapy management to patients with oncologic diagnoses. The resident will become familiar with standard of care chemotherapy regimens for breast, lung, prostate, and colon cancer, at a minimum. The resident, in collaboration with the clinical pharmacy specialist, will be responsible for chemotherapy education, supportive care medication management, implementation of treatment plans, modification of medications based on laboratory parameters, medication reconciliation, and drug information responses to providers, nurses, and patients. Concise and timely documentation of patient appointment and patient phone calls is essential. During the rotation, the resident will regularly interact with medical staff, nurse practitioners, and other health care providers involved in the care of patients.

This rotation provides an opportunity for the resident to become familiar with inpatient and outpatient oncology. Emphasis will be placed on developing an understanding of febrile neutropenia, oncologic emergencies, breast cancer, lung cancer, prostate cancer, colon cancer and the standards of care for each. Two of the four weeks will be spent focusing on inpatient care. During which time residents will participate in rounds daily, working closely with the oncologist to provide pharmaceutical care for the patients on the unit. Prior to rounds the resident will be expected to work-up patients in order to provide recommendations to the oncologist. The typical patient load for inpatient oncology averages between 5-13 patients daily. Residents will be required to work up non-oncology (overflow patients) as well as oncology patients. Recommendations for non-oncology patients will be provided to the primary physician managing the patient. Residents are also expected to complete follow-up for patient care and communicate any pertinent interventions to the pharmacist managing patients that day. The residents will present patients to the preceptor or designee daily at an agreed time unless otherwise specified. The resident will spend one week focused in outpatient oncology, shadowing an outpatient oncology pharmacist, an outpatient nurse, and a chemotherapy pharmacy technician. This will allow the resident to receive a complete overview of the care provided in the outpatient oncology unit. The final week of the rotation the resident will shadow the ambulatory pharmacist, an NP or PA, and an oncologist in the ambulatory setting (at CHMG oncology office). The order in which these activities take place may vary depending on the primary preceptor’s schedule and availability of other staff members.

This rotation will expose the resident to the functions of clinical pharmacists in a Pediatric Intensive Care (Mixed) setting and to enhance the knowledge of therapeutics and the skills necessary to provide pharmaceutical care. Responsibilities include rounding with the multidisciplinary team, profile review, pediatric TPN writing, Vancomycin, aminoglycoside, methadone, and anticoagulation consults, asthma education, discharge counseling, drug information, pediatric code blue, PET, and trauma attendance, and antimicrobial stewardship. The resident will participate in a variety of topic discussions on pediatric critical care topics. Patient volume varies depending on the time of year. Upon completion of the rotation the resident should be able to provide evidence-based care to critically ill pediatric patients.

This rotation will expose the resident to the functions of clinical pharmacists in a medical surgical pediatric setting and to enhance the knowledge of therapeutics and the skills necessary to provide pharmaceutical care. Resident responsibilities on service are profile review, pediatric TPN writing, Vancomycin, aminoglycoside, methadone, and anticoagulation consults, asthma education, discharge counseling, complex patient rounds, drug information, pediatric code blue, PET, and trauma attendance, antimicrobial stewardship, peripheral monitoring and therapeutic interchanges. The resident will participate in a variety of topic discussions on pediatric topics. Patient volume varies depending on the time of year. Upon completion of the rotation the resident should be able to provide evidence-based care to pediatric patients.

This rotation will expose the resident to the functions of clinical pharmacists in a Neonatal Intensive Care setting and to enhance the knowledge of therapeutics and the skills necessary to provide pharmaceutical care. Responsibilities include rounding with the multidisciplinary team, profile review, neonatal TPN writing, Vancomycin, aminoglycoside, methadone, and anticoagulation consults, asthma education, discharge counseling, drug information, pediatric code blue, and trauma attendance, and antimicrobial stewardship. The resident will participate in a variety of topic discussions on neonatal critical care topics. Patient volume varies depending on the time of year. Upon completion of the rotation the resident should be able to provide evidence-based care to critically ill neonates.

This rotation provides the resident the opportunity to gain understanding of the complex needs of the pregnant patient with a primary focus on high risk pregnancy/maternal-fetal medicine patients. Upon rotation completion, the resident should be able to recommend pharmaceutical interventions for pregnant patients with a variety of disease states and have a thorough understanding of the pharmacokinetics and pharmacodynamics of the pregnant patient and the postpartum/breastfeeding patient.

This rotation will expose the resident to the functions of clinical pharmacists in a cardiac surgery and cardiology setting and to enhance the knowledge of therapeutics and the skills necessary to provide pharmaceutical care.

This rotation will expose the resident to the functions of clinical pharmacists in a Trauma/Surgical ICU setting and to enhance the knowledge of therapeutics and the skills necessary to provide pharmaceutical care.

This rotation provides residents the opportunity to learn and work in unique area of pharmacy practice. The Investigational Drug Service (IDS) manages investigational medications for the majority of UCHealth Memorial Hospital’s inpatient and outpatient clinical trials.

• Orientation (July)
• Medical ICU I and II (8 weeks)
• Surgical/Trauma ICU
• Emergency Medicine I and II (8 weeks)
• Neuro ICU
• Cardiothoracic Surgery ICU
• Research/Medical Writing

(choose three)

• Infectious Disease
• Toxicology
• Burn ICU (at University of Colorado Hospital)
• Bone Marrow Transplant/Solid Organ Transplant (at University of Colorado Hospital)
• Cardiology/Cardiac ICU
• Pediatric ICU
• Pediatric ED

• Teaching: Critical Care Elective in Denver (Spring), precepting students, ACLS teaching of nurse practitioners, medical students and residents quarterly, EMS/firefighter/ED staff lectures quarterly, quarterly ICU education newsletter, teaching certificate (if not already received)
• Leadership/administration: Monthly session with RPD, PGY-2 preceptors and Director of Pharmacy/Management
• Staffing: Every 4^th weekend in the ICU, one ED day shift per month, one evening ICU shift per week (except prior to the weekend worked), one major holiday per year
• Research/projects: One research project suitable for publication presented at the Mountain States Residency Conference (or similar platform), one medication use evaluation presented at ASHP Midyear Clinical Meeting (or similar platform), one P&T monograph, participation in multidisciplinary trauma research projects
• Other activities: participation in Critical Care/ED weekly conference (Society of Critical Care Medicine (SCCM) journal club, ED/critical care journal review, rapid case presentation, etc.), response to inpatient codes, stroke alerts and MET team calls, ADR reporting/RCAs for critical care areas, on-call coverage for mobile stroke unit (M-F 7a-5p), attend SCCM Annual Congress (or similar meeting)

Rotations are decided among the residents during orientation. Residents schedule their required and elective rotations which is then reviewed among the preceptors and program directors.

PGY1 residents carry the code pager one week per month. The pager is only carried while in house from 8 a.m. to 5 p.m. If a resident is staffing or has other commitments the code pager may be covered by another resident.

PGY2 Critical Care residents will carry the code pager throughout the year.

All PGY1 residents complete a teaching certificate through the University of Colorado. Residents will also have the opportunity to precept students from a variety of different colleges of pharmacy if they are on rotation at the same time a student is scheduled.

Research projects are selected by the residents. Preceptors will provide the residents with proposals for various research projects. Residents may discuss with preceptors and ultimately decide on their own projects. MUEs are assigned to each resident by the program director.

All PGY1 residents are assigned a facilitator who will act as a mentor for the resident. Facilitators are chosen by the program director and are designed to provide the resident with someone to guide them throughout the year.

Rotations can be completed at other UCHealth facilities but they must be coordinated with the program director.