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Purpose Statement

  • A PGY2 pharmacy residency program builds on Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency program experience to contribute to the development of clinical pharmacists in specialized areas of practice
  • PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge, incorporating both into the provision of patient care or other advanced practice settings
  • Residents who successfully complete an accredited PGY2 pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification, if available

Program Overview

  • The residency takes place in a network of primary care and specialty practices serving the greater Lancaster region in a teaching health system, Penn Medicine Lancaster General Health, in Lancaster, Pennsylvania.
  • The residency focuses on promoting population health, caring for medically complex patients with psychosocial needs, and serving the underserved community of Lancaster.
  • The goal of the residency is to expose the resident to a well-rounded ambulatory experience with ;earning experiences focused on the spectrum of primary care medicine 
  • The residency is geared to nurturing and rearing competent and confident clinicians who will be a valuable asset to the Lancaster General Health Physicians (LGHP) ambulatory pharmacist team.
  • The residency is geared to nurturing and rearing competent and confident ambulatory pharmacist clinicians 

Learning Experiences

Learning experiences are primarily longitudinal, and the resident will have an opportunity to choose elective learning experiences based on interest

  • Rotations are primarily longitudinal or block longitudinal.
  • There are 8 required core experiences that take place throughout the residency year.
  • There are multiple elective experiences available from which the resident will have an opportunity to choose 2 offerings based on interest.

Required Core Learning Experiences

Anticoagulation

Pharmacist–led anticoagulation management is utilized by over seven LG Health Physicians family medicine practices, a multi-disciplinary cardiology practice, and a mechanical circulatory support (MCS) device clinic. Warfarin management is provided through an anticoagulation collaborative drug therapy management (CDTM) agreement. The pharmacists are also dedicated to anticoagulation stewardship and patient education. The resident is a resource for other healthcare providers.

Cardiovascular Diseases

The PGY2 resident will care for patients and be a resource for providers at a large cardiology practice. The resident will provide direct patient care in the Heart Failure (HF) and outpatient diuretic clinics. The pharmacists in these clinics utilize a collaborative drug therapy management (CDTM) agreement to perform medication titration of HF guideline directed medical therapy (GDMT), and protocols for the initiation of intravenous diuretic therapy.

Care Connections

Care Connections is a community care team providing an innovative, intensive, and temporary primary care medical home for high-risk patients striving to meet the needs of individuals who have been admitted to the hospital multiple times due to a combination of behavioral health and medical challenges. The resident will perform various roles involving comprehensive medication management and transition of care services as part of a multi-disciplinary team that includes, but is not limited to physicians, fellows, nurse practitioners, nurse case managers, patient care navigators, chaplains, and social workers.

Endocrinology

During this experience, the resident will work with patients of Diabetes and Endocrinology Specialists (DES). The pharmacist primarily works with patients with diabetes. The pharmacist works with the provider(s) to titrate and/or adjust medication regimens to more rapidly achieve therapeutic goals. These patients require closer follow up than the usual interval of 3-12 months. Some patients referred have been declined for surgery until they reach specific diabetes control parameters. The pharmacist works with these patients to reach goals required to be approved for surgery.

Geriatrics

The PGY2 resident works closely with geriatricians, nurse practitioners, and social work in a clinic-based setting to help build awareness in caring for the ambulatory older adult population. The resident pharmacist will conduct visits with older adults for various consults, such as chronic disease state management, polypharmacy and deprescribing, and additional counseling and patient education opportunities. A focus on seeing the importance of transitions of care for older adults, exposure to common “bread and butter” geriatric disease states, review and participation in advanced care planning, and end-of-life discussions will be seen during the learning experience. Additionally, the resident will be able to provide journal clubs, in-services, and/or case presentations to advocate for our growing population of elderly patients.

HIV/Infectious Diseases

During this experience, the resident will work at two sites: Comprehensive Care and the Tuberculosis Clinic. Comprehensive Care is dedicated to caring for those who are HIV positive, taking pre-exposure prophylaxis therapy, transgender, and family members of someone living with HIV. The multidisciplinary team consists of but is not limited to physicians (family medicine specialists and certified HIV specialists), nurses, social workers, nutritionists, and pharmacists. The Tuberculosis Clinic is held at the local branch of the Pennsylvania Department of Health. Patient populations commonly seen include latent tuberculosis treatment and active tuberculosis.

Population Health

Medication Therapy Management (MTM): Penn Medicine Lancaster General Health partners with third party payers to identify and address potential gaps in care. Gaps in care are addressed via targeted medication reviews (TMR) or comprehensive medication review (CMR). Examples include, but are not limited to, lack of recommended therapy based on patient disease state(s), medication adherence concerns, medication cost concerns, and therapies with increased risk to the patient via drug-drug, drug-disease, or other interactions. The resident conducts the TMR or CMR with the patient either in-person or via telephone. Medications are reviewed with the patient and identified gaps in care are communicated to the appropriate health care provider.

Ambulatory Collaborative Care Team (ACCT): The ACCT is a group that consists of a nurse care manager, social worker, community health worker and ambulatory clinical pharmacist. The team works with the high-risk patient population within the organization. These patients are deemed high risk due to criteria such as at least three chronic illnesses, frequent hospitalizations and/or psychosocial barriers. The pharmacist’s role is to evaluate the referred patient’s medication profile, recommend a personalized treatment plan, provide patient education and monitor for adverse effects. The pharmacist also assesses medication adherence, recommends cost effective medications, and addresses other medication-related concerns, as appropriate.

Practice Management

This longitudinal experience consists of one-two sessions/week at varying points during the residency year. The PGY2 resident will assist the ambulatory clinical manager in a variety of projects, monitoring department metrics, and leadership activities. The resident will also attend pertinent management meetings and huddles. This experience will allow for ongoing self-reflection of professional development and experience in clinical service management.

Primary Care

Pharmacists are embedded in over ten LG Health Physicians family medicine practices throughout Lancaster County. Due to the geographical distribution of these practices, a wide array of patient populations are served. These include patients with difficulty affording medications, geriatric populations, multiple comorbid disease states, Spanish-speaking, and varying degrees of health literacy. Chronic disease state management is provided to patients via CDTM agreements established with providers. Examples of our CDTMs include, but are not limited to, diabetes, hypertension, COPD and asthma.

Ambulatory Collaborative Care Team (ACCT): The ACCT is a group that consists of a nurse care manager, social worker, community health worker and ambulatory clinical pharmacist. The team works with the high-risk patient population within the organization. The pharmacist’s role is to evaluate the referred patient’s medication profile, recommend a personalized treatment plan, provide patient education, monitor for adverse effects, and addresses other medication-related concerns, as appropriate.

Research

The resident will be expected to complete both a primary research project and a medication use evaluation. At least one of these projects should be suitable for publication.

Service

The service learning experience will afford the resident the opportunity to contribute to the greater good of local communities within Lancaster County. Commitment to service is intended to enrich the learning experience by teaching civic duty, exposing the resident to real world situations, and developing community engagement while addressing local program specific needs.

Elective Learning Experiences

Advanced Family Medicine/Transitions of Care

Community Pharmacy Practice

Hematology/Oncology

Pain Management

Teaching Opportunities / Professional Development

Residents will have ample opportunities to provide medication and practice-related education to patients, caregivers, healthcare professionals. Residents with a strong interest in teaching may have additional teaching opportunities in precepting P4 pharmacy students and PGY1 pharmacy residents.

Teaching Certificate Elective: Our program also offers the opportunity to complete a teaching certificate through Shenandoah University (optional).

Our PGY2 pharmacy residency program offers numerous opportunities for professional development.

  • Ambulatory P&T Committee – yearlong committee member. The resident will present a monograph and/or other presentations.
  • Multidisciplinary organization committee – resident selection, yearlong committee member
  • Pharmacotherapy Grand Rounds – ACPE approved CE presentation to pharmacists
  • Morning Report – case-based presentation to family medicine residents and attending physicians
  • Family Medicine Residency Program – opportunities to work with and teach medical residents a variety of pharmacotherapy topics
  • Preceptor development activities
  • Rotation-specific presentations

Medication Use Evaluation (MUE)

The purpose of performing an MUE is to promote optimal medication therapy and ensure that such therapy meets current standards of care. The resident will have the opportunity to select a particular MUE that is of interest to him/her and aligns with the needs of the organization. The resident will present their MUE at the ASHP Mid-Year Clinical Meeting.

Major Research Project

Upon arrival at Penn Medicine Lancaster General Health, residents will receive a summary of the research projects available and will have the option of selecting one that meets his/her clinical/professional interests. The major research project will be on a topic suitable for publication and will be presented at the LG Health Research Day.

Conferences/Memberships

  • ASHP – Midyear Clinical Meeting, Annual Meeting
  • Southeast Pennsylvania Society of Health Systems Pharmacists
  • Eastern States Conference

Salary and Benefits

The resident salary is very competitive with excellent fringe benefits. Health care, dental, vision and free on-site parking are available. Lancaster County, Pennsylvania enjoys a high quality living standard at a surprisingly low cost.

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