Ambulatory Care Pharmacy Practice Residency

Justin Bouw, PharmD, BCACP, CDE

Justin Bouw, PharmD, BCACP, CDE

Welcome to the webpage for the UC San Diego PGY1 Ambulatory Care Pharmacy Residency Program! On behalf of UCSD Health, I want to thank you for your interest and for taking the time to learn about what makes our residency program great. We offer a well-rounded variety of required and elective learning experiences in the Ambulatory Care, Acute Care, and Academic environments. Our preceptors are extraordinary clinicians, teachers, and mentors and are fully committed to supporting you throughout the year in order to foster your professional growth and development. The combination of diverse learning experiences and projects, strong mentorship, and flexibility in scheduling will provide you with the formula to develop your pharmacotherapeutic skills, communication, independence and confidence. Our mission is to meet your individual professional goals within the structure of our ASHP-accredited program and make you a competitive clinician within a dynamic health care system. We know that you will feel our commitment to this mission as you integrate into our UCSD family and will thoroughly enjoy your experience as a pharmacy resident. We look forward to meeting you!

Program Summary

  • Residency Positions Available Per Year
    3 new residents are accepted each year
  • Stipend
    The current annual stipend is approximately $50,500.
  • Beginning Date
    July 1
  • Pharmacist Intern License
    Matched residents must be licensed Pharmacist Interns in the State of California prior to July 1
  • Pharmacist Intern License
    Matched residents must be licensed Pharmacist in the State of California within 90 days of the start of the residency program
  • Application Procedure
    1. Applicants must participate in the ASHP Match and apply using PhORCAS athttp://www.ashp.org/phorcas.
    2. Using a maximum of two pages and no less than an 11 point font and 1 inch margins, please respond to these questions in your personal statement/letter of intent:
      1. Describe how your experiences, strengths, and personality traits will help make you a successful resident in the UCSD PGY1 Am Care Residency Program.
      2. Describe your career goals and how they fit within the framework of the UCSD PGY1 Am Care Residency Program.
  • Application Deadline
    December 31  
  • Interview Dates
    2/5/18
    2/9/18

Elective Rotations

Program Contact

Justin W. Bouw, PharmD, BCACP, CDE
PGY1 Ambulatory Care Pharmacy Residency Co-Director
Ambulatory Care Clinical Pharmacy Manager
jbouw@ucsd.edu

Christopher Smith
Residency Coordinator
cjs002@ucsd.edu

Resident Contacts

Department of Pharmacy Mission Statement

The Pharmacy department provides excellent patient care through safe and effective drug therapy. It strives toward leadership in pharmacy practice education and research.

Department of Pharmacy Goals and Scope

  • Recognition as a national leader in the innovative use of resources and technology to provide the highest quality and most cost-effective patient care
  • Recognition for excellence in the clinical education of UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences students
  • Recognition for its contributions, including research and publications, in all aspects of pharmacy practice

Read more on Department of Pharmacy Goals and Scope

The UC San Diego Health Department of Pharmacy includes inpatient, ambulatory care, transitional care and home health patient care services. Our academic Health System serves as a primary teaching site for UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences IPPE and APPE students, UC San Diego School of Medicine students and other professional programs in the health sciences. The Hillcrest Medical Center, Thornton Hospital, Perlman Ambulatory Care Center, Moores Cancer Center, an NCI designated Comprehensive Cancer Center, and the Sulpizio Cardiovascular Center support a full range and scope of medical and surgical specialties as well as general medicine and surgery units. As part of the only academic health system in San Diego, the Sulpizio Cardiovascular Center is the only facility providing cardiovascular research, patient care services and programs in one location. Pharmacists are instrumental in providing patient-centered care and education, fighting heart and vascular diseases. The UC San Diego Regional Burn Center is a leader in making notable advances in burn therapy; the pharmacist is a member of the multidisciplinary team responding to the complex medical problems experienced by burn victims. The UC San Diego Center for Transplantation is the leading location for volume of solid organ transplants in the San Diego region. As a team member of this national hub of clinical expertise and research, the pharmacist is dedicated to improving organ transplant outcomes through optimal medication management at all points in the patient’s transitions of care. The 49-bed Neonatal Intensive Care Unit (NICU) is a highly specialized, nationally recognized center; the pharmacist is an active member of this Level III designated care center, providing medication management for these extremely complicated and frail patients. The UC San Diego Health operates the region’s first Level 1 Trauma Center, part of the San Diego Trauma System, a collaborative, life-saving, countywide effort of six hospitals, responding to the highest level of critical injury. Pharmacists and Pharmacist residents are an integral component of the multidisciplinary Trauma team.

The UC San Diego Health Department of Pharmacy is responsible for service to these hospitals, as well as six ambulatory care pharmacies, two Infusion Centers and multiple clinic sites. In addition, a Pharmacy Home Infusion Service program is operated in support of the Home Health Care Program. The department is staffed by over 200 full time employees comprised of pharmacists, technicians, clerical and supportive personnel. Currently, we have 23 resident positions (twelve acute and three ambulatory care PGY1, and eight PYG2 residents) and 60 fourth-year SSPPS pharmacy students, all of whom participate directly in the provision of patient care.

Pharmacists and pharmacy residents serve as members of interdisciplinary patient care teams on inpatient medical, surgical and intensive care units, with special emphasis on oncology, HIV, transplant, trauma surgery, neonatology, infectious diseases, cardiovascular diseases and transitions of care. In the ambulatory care area our current areas of disease state emphasis are family medicine, anticoagulation, transplantation, diabetes, CKD, CHF, and HIV, with expanding emphasis on the Transitions of Care model. Responsibility for these patients is shared by the staff, full-time faculty, residents, fellows and students. Our Pharmacy Home Infusion Service staff, which includes pharmacists and nurses, provides care for a wide range of patients seen through the allied home health care programs. The Department also has formal programs in the areas of Informatics, Antimicrobial Monitoring and Investigational Drugs.

In support of our decentralized clinical pharmacy services, the department operates a 24-hour centralized drug distribution area. Drug distribution is provided through a house-wide, point-of-use unit dose system, which uses computer-actuated dispensing equipment and a barcode driven medication administration system. All UC San Diego Health patients (ambulatory care, inpatient, and home care) are included in an integrated, computerized patient information system. Computer terminals are available in all patient care locations, within pharmacies and at the pharmacy offices. A computerized physician order entry system (CPOE) has been implemented. Pharmacists review and validate orders prior to dispensing.

Residency Program Purpose

The purpose of the UC San Diego PGY1 Ambulatory Care Residency program is to build on Doctor of Pharmacy (PharmD) education and outcomes to contribute to the development of clinical pharmacists responsible for medication-related care of patients with a wide range of conditions. Residents completing the program will be eligible for postgraduate year two (PGY2) pharmacy residency training, and following one year of additional practice in ambulatory care, will be eligible to sit for the Board Certification in Ambulatory Care Pharmacy (BCACP). The ultimate goal of the program is to develop pharmacist practitioners who are compassionate healthcare team members and competent drug therapy experts in the ambulatory setting.

Pharmacy residents completing the UC San Diego Postgraduate Year One (PGY1) Pharmacy Practice Ambulatory Care Residency will be competent in the management of medication therapy for a wide variety of disease states in the ambulatory care and transitional care environment as part of an interdisciplinary team. These pharmacists will have demonstrated proficiency in communication and in educating other health care professionals, patients, students and the community on drug related topics. Residents will have opportunities in classroom teaching, facilitating educational conferences and precepting students on rotation from the UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences. Residents will have demonstrated professional maturity by evaluating and monitoring their own performance. They will be trained in research methodologies and leadership skills and will have completed a Teaching Certificate Program. Graduates of this program will be prepared for adjunct faculty positions, direct patient care opportunities, and advanced PGY2 programs.

Pharmacy residents completing this program will be proficient in the areas of:

  1. Providing patient-specific medication management services to promote ethical, compassionate, trusted patient care and positive patient outcomes in all settings (which will be focused on ambulatory and clinic-based patient care)
  2. Advancing practice and improving patient care; mastering marketable job skills, including organizational and time management skills
  3. Understanding leadership and management skills, developing personal organizational, prioritization and time management skills
  4. Teaching, education, and dissemination of knowledge, including effectively educating health care professionals, patients, students, and the community on medication-related topics.

Program Overview

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Required Learning Experiences

  • Orientation
  • Family Medicine Clinic
  • Anticoagulation Management Clinic
  • Heart Failure – Transitions of Care Rotation
  • Student Run Free Clinic
  • Solid Organ Transplant Clinic
  • Antiretroviral Clinic (HIV/Owen Clinic)
  • Diabetes Self-Management Education (DSME) Clinic
  • Teaching Conferences (P4 Student APPE Ambulatory Care Conferences)
  • Administration Rotation
  • Operations (average of 2 weekends a month)
  • Teaching Certificate Program
    • Patient Directed Group Teaching: 1
    • Small Group Teaching: 5
    • Small Group Facilitation: 10-12 weeks of Am Care Conferences
    • Journal Club: 1
    • Large Group Formal Presentation (i.e. Grand Rounds): 1
    • Morbidity and Mortality Presentation: 1
    • Family Medicine Resident In-Service: 1
    • Teaching Philosophy (initial and final)
    • Teaching Portfolio

Supplemental experiences: Electives

Residents have the opportunity to choose three electives. Residents may choose to duplicate a required learning experience or choose an elective. We offer elective training in a wide range of medical and surgical specialty areas, in both the inpatient and ambulatory care settings. There are currently more than 25 electives to choose from for these elective experiences.

Longitudinal Clinic Experiences

The resident will have four (4) 3-month longitudinal learning experiences in which to participate throughout the year. Participation in the Anticoagulation, Student-run Free Clinic, and Ambulatory Care Conferences, are required. One elective longitudinal is available and there are a variety of options to choose from.

Teaching

The UC San Diego Health is an Introductory Pharmacy Practice Experience (IPPE) and Advanced Pharmacy Practice Experience (APPE) site for PharmD candidates from the UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS). Residents, clinical staff and faculty serve as preceptors for the pharmacy students during these educational opportunities. In addition, Ambulatory Care residents serve as facilitators for the 4th year APPE Ambulatory Care conferences. Didactic lectures at the SSPPS may be available and residents are encouraged to participate. The residents also provide lectures and presentations to physicians, nurses, pharmacists, pharmacy students, other allied health care providers and patients during their learning experiences.

Teaching Certificate Program

Residents participate in the San Diego Pharmacy Residency Leadership (SDPRL) Teaching Certificate Program which includes a seminar series attended with residents from other county- wide residency programs. Seminar topics will focus on teaching and preceptor development skills. Seminar attendance is mandatory and may include weekend programs. One excused absence is allowed provided the make-up assignment is completed within one week of being received.

Research Project

The resident will be responsible for conducting 1 research project throughout the academic year that will be completed and presented at the Western States Conference or an equivalent conference. If time allows, the resident will be involved with the initiation of a second project. This initiation phase will involve defining the study design, writing up the protocol and beginning the IRB approval phase. The purpose of starting a second project is to facilitate subsequent residents who can then finish the projects that were started the previous year. A list of project ideas will be generated from the preceptors and the resident is expected to select a project during the first month of the residency year.

Publication

The resident will be required to write a manuscript suitable for publication by the end of their residency year. The purpose of this requirement will be the development of scientific writing and communication skills. The types of publishable literature can include any of the following types of manuscripts:

  • Case reports with a review of the literature
  • Primary research /original research
  • Medication Use Evaluation
  • Meta-analysis of a disease state or therapy
  • Review article

Operations

Staffing will be incorporated into the residency experience with weekend shifts that provide the opportunity for PGY1 residents to cover patients followed by the transitions of care program, as well as learning the roles and responsibilities of pharmacists in the discharge pharmacy. The PGY1 residents will be required to staff 20 weekends, which includes 1 minor holiday weekend AND 1 major holiday (Thanksgiving, Christmas, or New Year’s). Ten (10) of the weekends will cover the Discharge Pharmacy and ten (10) will cover the TOC program. The resident will get 13 paid days for holidays and 12 sick days for the academic year. Vacation time will be in accordance with GME rules and will be defined as 20 days of vacation PLUS 5 days for professional leave to attend meetings or conferences.

Professional meetings

Residents will be required to attend various professional meetings throughout the year, which may include CSHP’s (California Society of Health-System Pharmacists) Seminar and/or ASHP’s (American Society of Health-System Pharmacists) Midyear meeting at which they will participate in recruitment efforts. Residents will present their residency project at a professional meeting.

Presentations

Residents are required to give educational lectures to pharmacists, faculty, preceptors, residents and students throughout their residency year as well as to other health care professionals as assigned while on rotations:

  • Grand Rounds:

    Residents will present a 1-hour continuing education lecture to pharmacists, faculty, preceptors, residents, students and technicians based on a current or controversial drug-related topic, new drug or new drug application in which there is current literature for evaluation and discussion. Allied health professionals are welcome to attend. Presentations are accredited for continuing education through California Accreditation for Pharmacy Education (CAPE). This Grand Rounds presentation is offered once at the Hillcrest Medical Center and once in La Jolla.

  • Journal Club:

    Residents are required to critique and present an article regarding a current or controversial drug therapy topic.

  • M&M / Medication Safety Related Topic
    Residents may provide one medication safety related topic presented to pharmacists, faculty, preceptors, residents, students, and technicians. The resident will be assigned a topic and present during their Administration rotation. Topics will be assigned by the M&M preceptor, Medication Safety Specialist.

  • Outreach Presentation:

    Residents participate in a community outreach program addressing the public regarding an area of disease prevention and wellness promotion.

  • In-services:

    Residents are required to provide several medication and/or disease state inservices to medical teams, students, pharmacy preceptors and pharmacy staff as assigned. Topics will be based on requests by the nursing or medical staff, recommendations from the resident or assigned by the preceptor.

Program Outcomes

Our Ambulatory Care (PGY1) Pharmacy residents completing this program will be advanced practitioners proficient in the areas of:

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Patient Care

Graduating residents will have been active members of health care teams and will have provided patient-centered, evidence-based, pharmacy care to their patients. They will have developed skills in creating patient-specific medication regimens and monitoring plans to obtain optimal outcomes. Residents will have become proficient in documenting and communicating medication-related matters to appropriate team members and will have assisted other health care professionals in ensuring appropriate follow-up care and ensuring continuity of care during patient transitions between care settings. Residents will understand and have had practice experience in all aspects of the distribution process to support safe and effective drug therapy.

Advancing Practice and Improving Patient Care

By consistently using an efficient and comprehensive pharmacy practice methodology, graduating residents are leaders in medication safety and have enhanced patient outcomes by integrating patient- and disease-specific pharmacotherapy. Residents will have identified areas for improvement of the medication-use system and will have participated in the design and implementation of improvement recommendations. Graduating residents will have engaged in a practice-related investigation project utilizing project management skills. Residents will gained experience with the IRB process, designing data collection and analysis tools. Residents will have worked with their preceptors and project PI’s to develop critical thinking skills when evaluating and discussing project results. Residents will have documented their work in manuscript format and presented their project at a professional meeting.

Leadership and Management

Graduating residents will have effectively strengthened their knowledge, skills, and abilities in key areas of pharmacy practice management and leadership. These areas include an understanding of medication distribution systems, and the medication use processes, including financial implications as a part of their Administrative Rotation. Residents will have participated in organizational committees and will have improved their understanding and application of decision-making processes. Residents will have attended an Administration and Medication Safety Topics Seminar which will have introduced key aspects of pharmacy administration and safe medication practices from departmental leaders. Residents will have gained experience is self-reflection and self-evaluation as part of a process of ongoing personal and professional performance improvement.

Teaching, Education, and Dissemination of Knowledge

Graduating residents will have become proficient in educating health care professionals, students and patients on medication-related topics. Residents will have become leaders as drug information resources. Residents will have participated in the San Diego Pharmacy Residency Leadership Teaching Certificate Program, which will have cultivated their teaching, precepting and facilitation skills. Residents will gain insight into self-assessment to appropriately assess the effectiveness of their educational and teaching endeavors. Residents will have attended a Teaching Skills Development Lecture series and created an introspective personal teaching philosophy.

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