PGY2 Specialized Residency: Critical Care

 

Welcome

Purpose

The UCSF PGY2 residency program in critical care is designed to train a pharmacist for a clinical specialist role in a critical care-centered practice setting such as medical, surgical, trauma, neuroscience or cardiac intensive care. Program graduates will possess necessary skills to function as an advanced practitioner in clinical and academic settings.

Description

The critical care residency is a one-year specialty residency that allows the resident to practice in a university-affiliated tertiary care, academic teaching hospital with 690 beds and five adult intensive care units on the main Parnassus campus. UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco, part of UCSF Health, are recognized by US News and World Report as the sixth best hospital in the nation and number one in the West Coast. We are a primary stroke center and have 24-hr cardiac catheterization labs. The program is affiliated with the Zuckerberg San Francisco General Hospital and Trauma Center, a Level 1 trauma center, where the resident will have the opportunity for offsite rotation experiences. Additional off-site rotation experiences are available based on resident interest.

The focus of the critical care pharmacy residency is to develop specialty expertise in critical care clinical practice in a variety of intensive care settings, where the resident will serve as a key member of the interdisciplinary care team. Teaching is also an integral component of the program as UCSF Medical Center is closely affiliated with the UCSF School of Pharmacy (SOP). The resident will have the opportunity to teach Doctor of Pharmacy students in SOP courses, including a critical care pharmacotherapy elective, and to precept Doctor of Pharmacy students and residents on critical care rotations and in high fidelity critical care simulation labs. The resident will also have the option to complete teaching and research certificate programs.

Learning experiences

Rotations

Rotation schedule

At a minimum, each resident will spend two-thirds of their time involved in direct patient care activities. Residents must complete 7 core rotations and 2 electives. Longitudinal learning experiences include research, teaching, a quality improvement project, and operational staffing.

Sequencing of learning experiences

Learning experiences are sequenced such that the resident completes onsite core learning experiences prior to electives and teaching focused learning experiences. Various electives are offered, including repeating one of the core rotations with greater autonomy and more advanced learning opportunities towards the end of the residency year.

Core rotations

  • Medical Intensive Care (minimum 5 weeks)
  • Surgical Intensive Care (minimum 5 weeks)
  • Cardiology-Cardiothoracic Surgery Intensive Care (minimum 5 weeks)
  • Neurocritical Care (minimum 5 weeks)
  • Emergency Medicine (minimum 4 weeks)
  • Trauma and Surgical Intensive Care (minimum 4 weeks)
  • Medical or Surgical Intensive Care 2 (Teaching Focus, minimum 4 weeks)

Electives

  • Adult Heart/Lung Transplant (minimum 4 weeks)

  • Adult Hematology/Oncology (minimum 4 weeks)

  • Adult Infectious Disease (minimum 4 weeks)

  • Adult Kidney Transplant (minimum 4 weeks)

  • Adult Liver Transplant (minimum 4 weeks)

  • Pediatric ICU/Neonatal ICU (minimum 4 weeks)

  • Cardiology and Cardiothoracic Surgery Care or Neurocritical Care 2 (minimum 4 weeks)

  • Consult services (minimum 2 weeks)

    • Acute Pain

    • Nephrology

    • Palliative Care

Staffing

Operational training

All residents receive comprehensive training in each of the operational areas during orientation, including formalized training in sterile compounding and aseptic technique. At the beginning of the residency year, residents are paired with an experienced preceptor who will oversee their operational staffing learning experience through the year and provide residents with summative feedback.

Staffing areas

Operational staffing occurs longitudinally and takes place approximately every third weekend spanning throughout the residency year for a total of 15 weekends, in addition to one major holiday and two minor holidays. Residents staff in 2 areas.

                  IV Satellite                  ICU Clinical Order Verification  

5 weekends

10 weekends

 

Research

 

Project selection

The Residency Program Director collects project proposal submissions from clinical pharmacists for consideration as a resident research project on an annual basis in the Spring. Projects are reviewed for feasibility, appropriateness of timeline, potential value that may focus on clinical pharmacist services, quality improvement initiatives such as drug safety, optimal medication use, cost effective drug use, and efficient, safe and effective medication preparation, delivery and administration. The Residency Program Director will reach out to the residents in early summer to start discussion of project selection.

Research training

PGY2 residents participate in the UCSF Research Certificate Program and will gain skills in: adhering to a research timeline, creating an appropriate study design and methodology, completing data collection and analysis and summarizing research findings. Residents are enrolled in the Designing Clinical Research course. This interprofessional curriculum within the Department of Epidemiology & Biostatistics guides residents through modification of their research proposal and creation of a version suitable for submission to the UCSF Institutional Review Board. For projects requiring more advanced statistics, residents also receive support to work with the Clinical and Translational Science Institute (CTSI) in order to complete analysis.

Residents will participate in a research certificate whereby they attend structured research sessions throughout the year in guiding the successful completion of the research project.

Poster & platform presentations

All projects are of a scope suitable for publication. Projects are presented as posters at the UCSF Department of Clinical Pharmacy Spring Research Poster Session. They are also presented as posters at the Vizient residency session that precedes the ASHP Midyear Clinical Meeting. The final presentation occurs in spring as a platform presentation at the SCCM NorCal Spring meeting and UC Collaborative Conference in California (both usually in May). Final research project write up should be in a format suitable journal submission.

Previous PGY2 Critical Care Research Projects

Kristine Keller

Anti-Xa versus aPTT monitoring for heparinized patients with left ventricular assist devices

Krupa Bhatt

Effects of a clonidine taper on the incidence of dexmedetomidine withdrawal in patients being weaned off of prolonged dexmedetomidine infusions

Sue Lee

Impact of antipsychotic therapy on QTc prolongation in critically ill patients

Joanne Smith

Quetiapine for ICU delirium: continuation at transition of care

Kristine Widboom

Use of activated recombinant factor VII (rFVIIa) for major bleeding in adults undergoing cardiothoracic surgery

Teaching

Teaching instruction

Teaching is a focus of the residency at UCSF, and residents receive a Teaching Certificate upon program completion if they complete the required elements of the program. The certificate recognizes the significant contributions and skills that are attained during the residency year. Residents receive training in teaching methodology, precepting and small group conference facilitation through a variety of educational seminars that are planned during the year.

Teaching experiences

Teaching opportunities may include the following:

  • Precepting of PGY1, APPE, and IPPE sudents on clinical rotations and project-based work
  • Interprofessional education through ICU Noon Conference and other non-pharmacist lectures
  • Large group teaching
  • Course coordination of the high-fidelity simulation lab
  • Northern California Critical Care Journal Club webinar presentation

Code response

Overview

PGY1 Pharmacy residents are integral members of the interprofessional emergency response care team. All PGY1 Pharmacy will become certified in Advanced Cardiovascular Life Support (ACLS), and receive hands-on code training by the Critical Care Pharmacy team. Residents respond to Code Stroke, Code Sepsis and Code Blue to ensure appropriate drug selection and administration, timeliness of medication retrieval and preparation, adjusting medication dosages and monitoring for response.

Simulation

The UCSF Residency Training Program has developed and implemented a longitudinal simulation curriculum for PGY1 Pharmacy residents to increase confidence and competence during various emergent situations. The program utilizes the Kanbar Center for Simulation and Clinical Skills, a high-fidelity simulation center on the UCSF Medical Center campus. Throughout the residency year, residents participate in 4 simulation lab sessions, each covering 4 cases. The clinical case scenarios become increasingly complex as the residency year progresses, and is intended to meet the advancing skill set of the residents. A clinical pharmacist content experts are invited to the sessions to lead the residents through a debrief of the simulation session and allow for discussion of advanced clinical topics.

Throughout the residency year, PGY2 resident will participate and then lead a total of 4 simulation lab sessions, each about 4 hours in length. The first session is an introduction for the PGY2 resident while the remaining three sessions is co-coordinated by the PGY2 resident. During the last session, PGY2 is responsible in writing a new case and also facilitating the debrief session.

Salary & benefits

Salary

$57,000 per year, paid monthly

Insurance

Medical/Dental/Vision Plan and Professional Liability Insurance

Vacation / professional / sick leave

All residents will receive 10 days of paid vacation, and 10 days of paid professional leave. Professional leave may be used to attend professional meetings, and for post-graduate or professional job interviews. Additionally, all residents will receive up to 12 days of paid sick leave per academic year.

Travel stipend

All residents are provided with a stipend to support travel, lodging, and registration fees for the purposes of professional conferences. The amount of the travel stipend is determined each year and may not cover all travel expenses.

Additional benefits

Residents will be provided with a UCSF white coat, scrubs, personal pager, iPad and access to the resident office workspace. Meal cards are provided with a value determined by the number of staffing hours assigned.

Application

General information

Appointment

July 8, 2019 to July 7, 2020

Positions available

PGY2 Critical Care Pharmacy (NMS 689452) – 2 positions

Recruitment

The Residency Program Director, Program Coordinator and residents recruit potential residency applicants at the following events:

  • American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting
    • Residency Showcase
    • Personnel Placement Services (PPS)
      • Applicants are encouraged to participate in PPS if possible

Requirements

Requirements for admission

Applicants must be eligible for licensure in California, posses a PharmD degree, completed or in the process of completing a PGY1 Pharmacy Residency program that is ASHP accredited, or in the process of accreditation (i.e. candidate or preliminary accreditation status).

Non-US and US citizens from foreign schools of pharmacy

Non-US citizens must be eligible to work and live in the US by obtaining an appropriate visa and must be eligible to work as a licensed pharmacist in California. We do not sponsor visas for foreign pharmacy residency applicants. Non-US and US citizens who graduate from a foreign school of pharmacy must first be certified by examination before the process of licensure in the US can begin. The Foreign Pharmacy Graduate Equivalency Committee ™ (FPGEC®) certificate program operates under the auspices of the National Association of Boards of Pharmacy®. The NABP® provides the FPGEC Certification Program as a means of documenting the educational equivalency of a candidate's foreign education, as well as the license and or registration to practice pharmacy. More information about this entire process is provided in these NABP® links: www.nabp.net.

How to apply

  1. Match: All applicants must register for The Match – ASHP Resident Matching Program.
  2. PhORCAS: Applications will be accepted through PhORCAS (Pharmacy Online Residency Centralized Application Service), a web-based pharmacy residency application system. The application deadline is December 31st.
  3. Cover Letter: A cover letter describing the elements of the program that most interest you and how each element relates to your personal goals is also required.
  4. Letters of Recommendation: We request a minimum of one (two is preferred) of your three references should come from a preceptor who you have worked with in a clinical setting, related to an APPE in acute or ambulatory care. The clinical preceptor should be able to comment on your scope of responsibility, total patient load, level of autonomy, clinical abilities, and organizational and time management skills. All 3-reference writers should use the standard PhORCAS template to submit their candidate recommendation and comment on a minimum of 7 of the 13 listed candidate characteristics.
  5. Supplemental Application Materials: Applicant must also include a cover letter addressing why he/she decided to pursue specializing in critical care pharmacy and how a Critical Care PGY2 Specialty Residency at UCSF will aid in his/her career goals. (NOTE: The cover letter should be uploaded in the Supplemental Information section in PhORCAS. Space is limited to a max of 5 MB and must be provided in the following format: .pdf, .doc, .txt, .rtf.)

On-site interviews

Application reviews

Each PGY2 applicant packet is screened and scored by members of the Critical Care team. Screeners assess the following: communication skills, clinical experience (breadth, performance, scope of activity), personal/environmental factors (maturity, confidence, motivation, and adaptability), and work experience, aggregate letters of recommendation, leadership/initiative, teaching (interest and/or experience), research (interest and/or experience), extracurricular involvement and academic performance. The screening score is used to determine if an on-site interview will be extended.

On-site interviews

The interview process is a full day which consists of shadowing of ICU pharmacist during ICU rounds, a campus tour, two ICU preceptors panel interviews, a personal interview with a pharmacy administrator and a personal interview with the Residency Program Director. Applicants are also asked to present a 30-min Powerpoint presentation. Lunch is provided and will be with current Critical Care PGY2 residents.

PGY2 Critical Care interviews will be held on the following dates for the upcoming interview cycle:

  • Friday, February 1, 2019
  • Friday, February 8, 2019
  • Monday, February 11, 2019
  • Friday, February 22, 2019
  • Tuesday, February 26, 2019

Contact

Fanny Li, PharmD, BCPS, BCCCP
Residency Program Director, PGY2 Critical Care
Critical Care Pharmacy Specialist, UCSF Medical Center
Associate Clinical Professor, UCSF School of Pharmacy

Education & Post-Graduate Training

Doctor of Pharmacy, University of California San Francisco (2005)
PGY1 Pharmacy Practice, University of Washington (2006)
PGY2 Critical Care, University of Washington (2007)

Contact

UCSF UC Hall Box 0622
533 Parnassus Ave
San Francisco CA 94143
FedEx only: use zip 94122

tel: 415-353-7523
[email protected]