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 in Lancaster, Pennsylvania, part of Penn Medicine.
  • The residency focuses on promoting population health, caring for medically complex patients with psychosocial needs, and serving the underserved community of Lancaster.
  • The focus of the residency is to expose the resident to a well-rounded ambulatory experience with rotations focused on disease states encountered in any type of primary care setting, without a focus on very specialized pharmacotherapy management.
  • 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 a way to keep LG Health ambulatory clinicians accountable, current, job-satisfied, and dedicated to the profession.

Message from Residency Program Director

Thank you for your interest in our PGY2 Ambulatory Care Pharmacy Residency. The preceptors of this program and I eagerly await new residents and their energy, talent, and commitment to our profession. Our vision is to help you transition into a confident and empowered ambulatory care pharmacist ready to practice in a variety of primary care settings. In addition, we hope to instill in you a dedication to community and population health. We look forward to hearing from you.

Learning Experiences

  • Rotations are primarily longitudinal or block longitudinal.
  • There are five required longitudinal rotations that take place throughout the residency year.
  • There are five required block longitudinal rotations.
  • There are multiple elective block longitudinal rotations available from which the resident will have an opportunity to choose 2-3 offerings based on interest.

Required Learning Experiences

Anticoagulation

Crooked Oak Pharmacy Services Clinic (COPSC) and Norlanco Pharmacy Services Clinic (NPSC) are two pharmacist-led anticoagulation clinics. The learning experience will focus on the care of patients on anticoagulation for the treatment or prevention of thrombosis, utilizing a collaborative drug therapy management agreement. The resident will provide direct patient education, perform point of care INR testing, evaluate appropriate laboratory studies, adjust warfarin dosing and monitor for adverse events. The resident will also work with providers to transition patients to and from the direct oral anticoagulants, and create care plans for periprocedural disruptions in anticoagulation therapy. The resident will communicate with other ambulatory care providers, nursing, retail pharmacies, and family to disseminate the information necessary to ensure the safe and effective use of these high-risk anticoagulants.

The Heart Group learning experience is focused in anticoagulation management and will expose the resident to a variety of cardiac conditions requiring anticoagulation. The Heart Group is a large, multidisciplinary cardiology practice consisting of 29 cardiologists with differing areas of expertise. The service manages more than 1,850 patients on warfarin therapy. The resident will manage warfarin utilizing a collaborative drug therapy management agreement and serve as a pharmacy resource within the practice.

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

Family Medicine Crooked Oak, Lincoln, Norlanco, Twin Rose, Internal Medicine, and Walter Aument Family Health Center are outpatient family medicine practices located throughout Lancaster County. Due to the geographical distribution of these practices, a wide array of patient populations are served. This includes patients with difficulty affording medications, geriatric populations, multiple comorbid disease states, Spanish-speaking, and varying degrees of health literacy. The resident will provide chronic disease state management to patients via collaborative drug therapy management (CDTM) agreements established with providers. Based on the patient encounter, various risk assessments and history, the resident will create a personalized treatment plan for each patient. Other activities may include, but are not limited to, patient education, responding to drug information requests, medication adherence screening, and provider/staff education.

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.

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.

Required Block Longitudinal Experiences

Care Connections

Cardiovascular Diseases

Community Pharmacy Practice

Endocrinology

Geriatrics

Elective Block Learning Experiences

Family Medicine Transitions of Care

Hematology/Oncology

Infectious Diseases

Pain Management

Psychiatry

Rheumatology

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 PGY-2 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
  • 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 LGH 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, PA enjoys a high quality living standard at a surprisingly low cost

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