Marcie Lepkowsky, PharmD, BCGP
On behalf of UC San Diego Health, I would like to thank you for your interest in our PGY1 Acute Care residency program. We offer a great residency with fantastic preceptors and an impressive number of elective opportunities. Our program is designed to provide you with a variety of learning environments, patient populations, disease states, acuity, teaching opportunities and projects - all to help develop your clinical knowledge, skills, independence, and confidence. One of our goals is to provide you with professional growth that maximizes your marketability for future employment in the academic or community hospital settings, PGY2 opportunities, and academic/management endeavors. You will be able to choose from many electives in your area of interest or explore new areas that may grab your attention. The required and elective rotations will help you develop your skills and knowledge which you will be able to apply to any area of practice, including patient care, time management, prioritization, communication, utilization of resources and disease management, all in a supportive, nurturing, intellectually stimulating academic health care system. Residents will enjoy the longstanding, strong, collaborative nature of our medical and surgical interdisciplinary teams in providing evidence-based patient care, and will benefit from working with knowledgeable and dedicated preceptors. While you develop the skills that allow you to help optimize the health outcomes of your patients, your preceptors and I are committed to help you achieve your highest professional potential as an active, responsible, and vital member of the health care team.
Resident Positions Available
12 new residents are accepted each year
The current annual stipend is approximately $50,500
Pharmacist Intern License
Matched residents must be
licensed Pharmacist Interns in the State of California
prior to July 1.
Matched residents must be
licensed Pharmacists in the State of California
within 90 days of the start of the residency program.
- Applicants must participate in the ASHP Match and apply using PhORCAS at
Letters of Recommendation/Reference: 3 letters required, at least 2 of the references should be from preceptors who can directly comment on clinical and practice skills.
Letter of Intent: using a maximum of two pages and no less than an 11 point font and 1 inch margins, please address the following in your letter of intent:
Describe why you are a good fit for the UC San Diego Health PGY1 Acute Care Residency Program.
Marcie Lepkowsky, PharmD, BCGP
PGY1 Acute Care Pharmacy Residency Director
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 U C San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences students
- Recognition for its contributions, including research and publications, in all aspects of pharmacy practice
The UC San Diego Health Department of Pharmacy includes inpatient, ambulatory, transitional, 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, Jacobs Medical Center, Thornton Pavillion, 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 provides 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 Level III Neonatal Intensive Care Unit (NICU) is a highly specialized, nationally recognized center; the pharmacist is an active member of the NICU team, providing medication management for these extremely complicated patients. 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 five ambulatory care pharmacies, two Infusion Centers and multiple clinic sites. The department is staffed by over 200 full time employees of pharmacists, technicians, clerical and supportive personnel. Currently, we have 25 resident positions (twelve acute, four ambulatory care PGY1, one Community Pharmacy 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 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 HIV, CKD, transplant, family medicine, anticoagulation, and CHF, 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. The Department also has formal programs in the areas of Informatics and Antimicrobial Monitoring. In support of our decentralized clinical pharmacy services, the department operates 24-hour centralized drug distribution areas. 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 and chart system. Computer terminals are available in all patient care locations, within pharmacies and at the pharmacy clinical offices. A computerized physician order entry system (CPOE) is utilized. Pharmacists review and validate orders prior to dispensing.
Residency Program Purpose
The purpose of the UC San Diego PGY1 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, eligible for board certification, and eligible for postgraduate year two (PGY2) pharmacy residency training.
Pharmacy residents completing the UC San Diego Health Postgraduate Year One (PGY1) Acute Care Residency will be competent in the management of in-patients with a wide range of acuity, including medication therapy management for various disease states in a variety of acute care health care settings. They will have been responsible for achieving optimal drug therapy outcomes as part of interdisciplinary health care teams. Residents will participate in the ambulatory care setting in which a rotational and longitudinal experience will enhance their understanding of the importance of transitions of care, including the prevention of medication-related hospital readmissions. 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 participated in precepting students on rotation from the UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences. Residents will have demonstrated professional maturity by monitoring and evaluating their own progress, as well as the performance of their colleagues and preceptors. They will have been trained in research methodologies and leadership skills, developing organizational and time management skills, becoming proficient in the use of technology to support evidence-based medicine and patient-centered care, and will have participated in a Teaching Certificate Program. Graduates of this program will be prepared for adjunct faculty positions, direct patient care opportunities in the Acute Care setting, advanced PGY2 programs, and will be eligible to sit for board certification as a pharmacotherapy specialist.
Program Overview Acute Care
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- Central Pharmacy and CPOE Training Rotation: 5 weeks
- Administration: 5 weeks
- Ambulatory Care: one, five week block and one, six month longitudinal half day clinic
- Medicine: 10 weeks (5 weeks each at Hillcrest and La Jolla Hospitals)
- Adult ICU of your choice: 5 weeks
- Operations: longitudinal (20 weekends, which includes one major and two minor holidays)
- SSPPS Therapeutics Conference Facilitator: 1 quarter
- Pharmacy ART (Advanced Resuscitation Training)
- Administration and Medication Safety Topics Seminar Series
- Residency Project
- SDPRL Teaching Certificate Program
- Patient Directed Group Teaching/Outreach Presentation: 1
- Small Group Teaching: 5
- Small Group Facilitation: 10 weeks of Therapeutics Conference
- Journal Club: 1
- Large Group Formal Presentation: 1
- Patient Case: 1
- Nursing In-Service: 1
- Technician CE Presentation: 1
- Teaching Philosophy (initial and final)
- Teaching Log
Three elective experiences are included, two of which must be direct patient care electives. We offer elective training in a wide range of medical and surgical specialty areas, in the inpatient, ambulatory care and transitional care settings. There are currently more than 25 electives to choose from for these
The UC San Diego Health is an Introductory Pharmacy Practice Experience (IPPE) and Advanced Pharmacy Practice Experience (APPE) site for PharmD candidates from the UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS). Our residents, clinical staff and faculty serve as preceptors for the pharmacy students during these educational opportunities. In addition, our residents serve as facilitators for the 3rd year Therapeutics Conferences. The residents also provide lectures and presentations to physicians, nurses, pharmacists, pharmacy students, other allied health care providers and patients.
Residents participate in the San Diego Pharmacy Residency Leadership (SDPRL) Teaching Certificate Program, which includes a seminar series with residents from other county-wide residency programs. Seminar topics will focus on teaching and preceptor development. Seminar attendance is mandatory. Residents will develop their own Teaching Philosophy and will attend Preceptor Development seminars to prepare themselves to be effective teachers and preceptors for students, patients and health care professionals. Evaluation tools and their applications will be reviewed to assist the resident in self-reflection and in creating a meaningful evaluation processes for the learner. The resident learns to use evaluations to support the students’ growth and professional development by identifying activities and offering feedback in ways that encourage learners to revise and improve their understanding.
Residents will participate in the P-3 Therapeutics Course sequence of the SSPPS as facilitators in their Case Conferences. Residents facilitate the same students for an entire quarter, allowing opportunity and time for the Resident’s teaching skills to develop. Each resident prepares a case which is reviewed and edited by preceptors, with input from other residents during a pre-conference. As facilitators, residents are responsible for encouraging discussion and enhancing the learning experience by insuring that the students participate and provide an effective analysis of the case focusing on the areas of clinical importance. One of the primary functions of the case conferences is to help develop the ability of the student to apply the information learned in the basic and applied sciences to patient care.
Each resident helps design and complete one major project during the academic year under the guidance and in collaboration with a pharmacist preceptor/project PI. This project may be a Medication Use Evaluation (MUE), a Continuous Quality Improvement (CQI) project, pharmacokinetic evaluation, or another type of residency project. Residents gain experience in preparing IRB submissions, creating data collection tools, and analysis design. Projects are presented at a professional meeting. The project will be written in manuscript format and those suitable for publication will be submitted. Residents are encouraged to participate in the Vizient University Health System Consortium (UHC) Resident Poster Session held immediately preceding the ASHP Midyear. Problem-solving skills are also developed through day to day activities and a variety of other projects.
Residents complete a concentrated training rotation. During training the resident will work with members of the Pharmacy Staff in the Central Dispensing Area, as well as with several of the floor pharmacists to gain an insight into the clinical and distribution functions of the central and floor based practitioners. The resident will learn to manage and supervise the medication dispensing and delivery activities of the pharmacy technicians. During the training rotation the resident will be taught how to prepare and dispense medications following UC San Diego Health standards of practice, policies and procedures. The resident will be trained how to critically evaluate a medication order to interpret its appropriateness prior to preparing or permitting the distribution of the first dose, and when appropriate, incorporate P&T authority to adjust a dose. Emphasis will be placed on helping the resident to take ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use process. Residents also complete a longitudinal distribution and staffing rotation which averages one and a half weekends per month plus two minor and one major holiday. Residents receive instruction regarding automation and related technology as well as how to use information technology to reduce errors and improve medication safety. Once licensed, the resident will staff in the central pharmacy, on the medicine-surgery floors, and the medical and intensive care units. During the operations longitudinal rotation, the resident, under the guidance and supervision of preceptors and staff pharmacists, will develop their skills in supervising technicians, evaluating the appropriateness of medication orders, and understanding the department’s policies and procedures that govern the safe use of medications, including the preparation and dispensing of medications. The resident will review patient medication orders, prevent, identify and resolve medication-related issues, and validate appropriate medication orders via Computerized Prescriber Order Entry (CPOE) using the Epic system. The resident will develop medication regimens and monitoring plans, including pharmacokinetically monitored medications using Therapeutic Drug Monitoring (TDM) software and will communicate and document recommendations appropriately. The resident will develop their communication skills as they work with other practitioners, respond to drug-information questions and make evidence-based, patient-specific decisions regarding the medication management of their patients.
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.
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:
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.
Residents are required to critique and present an article regarding a current or controversial drug therapy topic.
M&M / Medication Safety Related Topic:
Residents are required to 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.
Residents participate in a community outreach program addressing the public regarding an area of disease prevention and wellness promotion.
Residents are required to provide several medication and/or disease state in-services 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 as assigned by the preceptor.
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PGY1 Acute Care Pharmacy residents completing this program will be competent in the areas of:
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.
• 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 have 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.
• 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.
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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