Pharmacy Residency

Required Projects and Presentations:
Residency Project for presentation at the MidSouth Pharmacy Residents Conference
Prepare and present 1 Medication Use Evaluation (MUE)
Attend P&T Committee meetings
Attend and take minutes for a hospital committee throughout the year
Prepare a Drug Monograph and Therapeutic Review for presentation at a P&T Committee meeting
Prepare a PharmaGram
Conduct two Journal Clubs
Prepare and present a Continuing Education (CE) presentation to the West Tennessee Pharmacists Association
Prepare and present a lecture in conjunction with Union University College of Pharmacy
Prepare and present a lecture to the University of Tennessee Family Practice Residents
Complete a drug information question quarterly

Ambulatory Care:
The role of the ambulatory care pharmacist is in collaboratively managing patients on antithrombotic therapy in the Jackson-Madison County General Hospital Anticoagulation Clinic and at the University of Tennessee Family Practice Center. The pharmacist also provides patient education and disease state management at the LIFT Disease Management Clinics. The pharmacist precepts APPE students, participates in educational activities for patients such as health fairs and education classes, and completes medication use evaluations related to antithrombotic medications.

Cardiology:
The clinical pharmacy specialist in the CVICU is responsible for ensuring safe and effective medication use for all patients admitted to the CVICU as well as CV surgery patients that are transferred to the step-down unit. Routine responsibilities include: IV-to-SQ insulin transition and subsequent dosing, pharmacokinetic drug dosing, renal dose adjustments, IV-to-PO conversions, antibiotic stewardship, and general patient workup. The pharmacist also provides drug information and education to healthcare professionals as well as patients and caregivers as necessary.

Critical Care:
The clinical pharmacy specialist in the ICU is responsible for ensuring safe and effective medication use for all patients admitted to the MICU. Routine responsibilities include: active participation in multidisciplinary rounds, pharmacokinetic drug dosing, IV-to-SQ insulin transition for DKA patients, renal dose adjustments, IV-to-PO conversions, antibiotic stewardship, and general patient workup. The pharmacist also provides drug information and education to healthcare professionals as well as patients and caregivers as necessary.

Emergency Medicine:
The role of the ED pharmacist is to actively participate in the care of emergency department patients by order entry and verification, medication preparation and delivery, pharmacokinetic drug dosing, antibiotic stewardship, attending/participating in code events, neuro alerts, team hearts, and other bedside emergencies, medication reconciliation, making pharmacotherapeutic recommendations, and interacting with physicians and nurses. In addition, the ED pharmacist participates in the education of pharmacy students as well as department physician and nursing staff. The pharmacist also participates in the further advancement and development of pharmacy services in the emergency department by attending related committees. Attendance of any scheduled sepsis, stroke, and departmental team meetings will be required during the rotation month.

Hospital Pharmacy Practice:
The pharmacist is responsible for ensuring that medication use is safe and effective for the inpatient population at Jackson-Madison County General Hospital. Initial medication computer order entries by qualified staff are verified by the pharmacist and printed labels are examined. The medication labels are appraised by comparing them to the medications that have been selected and prepared by technicians for individual patients, as well as unit dose items for delivery to Pyxis systems. The pharmacist answers medication related questions and oversees technician activities. Clinical services, including pharmacokinetic monitoring, are also performed by the pharmacist. The precepting pharmacist introduces the resident to proper procedures and models them initially. The resident behaviors are directed, observed, supervised, assessed, and evaluated. The ultimate goal is for the resident to become an independent practitioner and be able to perform the full extent of the duties of the pharmacist unsupervised.

Infectious Diseases:
The role of the antimicrobial stewardship pharmacist is the daily review of patients identified by antimicrobial stewardship software, sepsis consults, and pharmacokinetic consults. The pharmacist also rounds with APPE students on patients identified and reviewed, completes medication use evaluations (MUEs) related to antimicrobials, participates in the Antimicrobial Stewardship Committee, and prepares reports related to antimicrobial stewardship as well as the JMCGH Antimicrobial Stewardship Dashboard.

Internal Medicine:
The clinical pharmacist on the team is responsible for ensuring safe and effective medication use for all patients admitted to the team. Routine responsibilities include: gathering and accurately analyzing patient information, documenting appropriately in the patient’s chart, managing pharmacokinetic consults, adjusting medication doses when appropriate, making IV to PO conversions, designing evidence-based treatment and monitoring plans, conducting Applied Therapeutics sessions and evaluating student performance, precepting APPE clerkship students, and providing education to patients and/or staff as needed.

Management:
The director of pharmacy oversees pharmacy operations along with the assistant directors and coordinators. Responsibilities of the pharmacist include budget, personnel management, legal/regulatory compliance, and strategic planning. The pharmacy director also serves on the Pharmacy & Therapeutics Committee, the Residency Advisory Committee, and precepts APPE students for Advanced Institutional and Management Rotations.

Medication Safety:
The pharmacist is responsible for reviewing falls and medication use variances that occur at JMCGH and recommending patient-specific and system-level changes. The pharmacist also reviews external sources of information (e.g., ISMP Quarterly Action Agenda) and makes recommendations for system improvement. Selected triggers are reviewed daily for potential medication errors. In addition, the pharmacist attends the Safety Huddle every morning for an inter-professional review of events that occurred in the previous 24 hours and information sharing regarding future challenges. When possible, the pharmacist attends the following monthly committee meetings: Medication System Variance Committee, Pharmacy Safety Committee, and P&T Committee. The pharmacist prepares and presents variance and ADR reports to the committees.

Neonatal/Pediatrics:
The pediatric clinical pharmacy specialist is responsible for ensuring safe and effective medication use for all patients admitted to the neonatal intensive care and general pediatric patient care areas. Routine responsibilities include active participation in multidisciplinary rounds, general patient workup which includes designing evidence based treatment and monitoring plans, pharmacokinetic drug dosing, renal dose adjustments, antibiotic stewardship, evaluating processes to improve medication safety and reduce medication errors and facilitating timely delivery and administration of ordered medications. The pharmacist will be responsible for conducting Applied Therapeutics sessions and evaluating student performance as well as precepting APPE clerkship students. The pharmacist also provides drug information and education to healthcare professionals as well as patients and caregivers as necessary.

Nutrition Support:
The role of the Nutrition Support pharmacist is to daily review and implement/redesign TPN regimens for all physician-consulted nutrition support patients. Routine responsibilities include: determining appropriateness of TPN for all physician-consulted nutrition support patients, designing and implementing TPN regimens, monitoring and adjusting TPN regimens based on new medication/lab changes, ordering appropriate monitoring labs, ordering electrolyte boluses when needed, weaning/discontinuing TPN when patient is able to maintain adequate PO intake/tolerate tube feeds, and rounding on each patient daily.

Oncology:
The role of the oncology pharmacist is strikingly broad and increasingly complex. Core functions of the oncology pharmacist include, but are not limited to, chemotherapy order review, verification, and dispensing; therapy monitoring (including therapeutic drug monitoring and lab work interpretation prior to chemotherapy verification); renal drug monitoring; IV to PO conversions; poly-pharmacy consults; symptom management and supportive care recommendations for oncology patients; protocol and policy development; formulary management; guideline, order set development, and maintenance of the oncology medication-related EHR system (Aria/Looking Glass); medication safety; and maintenance of standards for oncology related accreditations (QOPI/Commission on Cancer). The pharmacist is responsible for generating, interpreting, and disseminating cancer-related information for patients, caregivers, and other healthcare providers upon request, as well as precepting APPE clerkship students.

Palliative Care/Pain Management:
The role of the outpatient pain management ambulatory care pharmacist is to collaboratively manage patients with chronic pain at the Jackson Clinic. The pharmacist also provides patient education.
The role of the inpatient palliative care pharmacist at Jackson-Madison County General Hospital is to serve as the pharmacy expert on an interdisciplinary team as well as serving as a consultant for Hospice of West Tennessee when needed. The pharmacist also precepts APPE students and attends pharmacist development programs when available.

Surgery:
The role of a surgery pharmacist is vast and expanding. Daily duties include pre-op and post-op antibiotic review and verification, medication preparation for the day’s surgical cases, management of therapy for backordered medications, making recommendations regarding medication management intra-operatively, and Pyxis Anesthesia system management and care. The pharmacist also attends regular Department of Surgery and Department of Anesthesia meetings, as well as provides drug information and education to healthcare professionals as necessary.

Application Procedure
Jackson-Madison County General Hospital utilizes the Pharmacy Online Residency Centralized Application Service (PhORCAS). All of the application materials will need to be uploaded there. For more information, visit www.ashp.org/phorcas. The deadline to submit an application is January 6, 2019.

Application Requirements Include:
Pharm.D. degree from an ACPE-accredited College or School of Pharmacy & eligible for state licensure
U.S. Citizenship
Completed PhORCAS residency application to include the following:
Current Curriculum Vitae
Transcripts from College or School of Pharmacy Attended
Letter of intent/Personal Statement
Three (3) letters of recommendation (the recommendation letter format in PhORCAS is sufficient)
Formal interview to be arranged by residency director
Participation in the ASHP Residency Matching process
Residency Program Code: 54007
ASHP Match Number: 183913

Contact Information
Jamie Hopkins, Pharm.D.
PGY-1 Pharmacy Residency Program Director
Jamie.Hopkins@wth.org
(731) 541-6800