Preparing Graduates for Ambulatory Care Clinical Specialist Positions

PGY2 residency programs build upon Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency training to develop pharmacist practitioners with knowledge, skills, and abilities as defined in the educational competency areas, goals, and objectives for advanced practice areas. Residents who successfully complete PGY2 residency programs are prepared for advanced patient care or other specialized positions, and board certification in the advanced practice area, if available.

Renown Regional Medical Center is part of an integrated health network serving a 17-county area surrounding the Reno, NV area. There are over 900,000 visits annually to Renown primary care and specialty doctors, urgent care and X-Ray & Imaging. Outpatient Clinical Pharmacists see patients for CDTM visits at 8 locations throughout Renown Health. Residents will collaboratively manage patient's medication therapy through CPAs covering a variety of disease states and conditions including anemia, anticoagulation, diabetes, hypertension, lipids, long-acting injectable antipsychotics, polypharmacy, and smoking cessation. 

The resident will gain valuable clinical, leadership and research skills through a variety of learning experiences and clinic settings.  Residents will serve as a preceptor for PGY1 pharmacy residents and PharmD students during Ambulatory Care rotations. Research and leadership skills will be developed through the completion of a longitudinal research project and through an Ambulatory Practice Management learning experience. The resident will gain experience in developing pharmacy services in an ambulatory pharmacy service line and to develop and monitor quality and stewardship initiatives.

Graduates of this program are prepared for competitive Ambulatory Care clinical pharmacist positions. 

Learning Experiences

Required Learning Experiences

  • Orientation (6 weeks)
  • Pediatrics (4 weeks)
  • Women’s Health (2 weeks)
  • Longitudinal experiences
    • Indigent Care
    • Staffing
    • Patient Care
    • Population Health/Transitions of Care
    • Practice Management
    • Project

    Elective Learning Experience

    • HIV (HOPES Clinic)

    Learning Experiences and Preceptors

    Required Longitudinal Direct Patient Care Learning Experiences

    Indigent Care with Israa Mahmood, PharmD, BCACP

    This learning experience is designed to develop the Pharmacy Resident's clinic skills in providing chronic disease state management in the initiation, monitoring, dosing, education, documentation, and physician communication for outpatients in the rural and indigent communities associated with Renown Medical Groups.  Pharmacy Residents will gain experience with consults for hypertension, hyperlipidemia, diabetes, hyperlipidemia, polypharmacy, smoking cessation, and chronic anemia. Pharmacy Residents will also work directly with providers and provide pharmacy education to the Medical Group as applicable.

    Staffing

    Patient Care with Jason Dent, PharmD, BCPS

    The purpose of this learning experience is primarily to enhance and develop the resident's ability to provide patient care that eases transition of care and provides optimal outcomes.  A focus in multidisciplinary communication, process improvement, and direct follow up with patients will enhance the resident's ability to provide optimal patient care.  Along with traditional responsibilities of providing direct patient care, the resident will be required to propose and implement a process to improve patient care.  The resident will mainly practice at Renown Regional but is expected to gain experience at community practice sites throughout the year. The Resident will be given the responsibility of prospectively following a personal panel of patients.  The resident will need to track these patients to assess for appropriate follow up lab work, medication adherence, and tolerability of medication changes the clinic has initiated. 

    Population Health/Transitions of Care with Courtney Church, PharmD, BCACP

    The purpose of this learning experience is to enhance the pharmacy resident's knowledge and to gain experience in population health management and transitions of care. The resident will work with an interdisciplinary team consisting of pharmacists, RNs, social workers, and community health workers. Additionally, the resident will work with preceptors on at least one longitudinal population health project. 

    Rural with Nathan Bozeat, PharmD, BCPS

    This learning experience is designed to develop the Pharmacy Resident's clinic skills in providing chronic disease state management in the initiation, monitoring, dosing, education, documentation, and physician communication for outpatients in the rural and indigent communities associated with Renown Medical Groups. Pharmacy Residents will gain experience with consults for hypertension, hyperlipidemia, diabetes, hyperlipidemia, polypharmacy, smoking cessation, and chronic anemia. Pharmacy Residents will also work directly with providers and provide pharmacy education to the Medical Group as applicable.

    Required Longitudinal Non-Direct Patient Care Learning Experiences

    Practice Management with Adam Porath, PharmD, BCPS, BCACP, FASHP

    This longitudinal rotation is intended to expose the resident to a variety of administrative activities associated with ambulatory care pharmacy including committee work, clinic scheduling, department budgets, and billing of ambulatory pharmacist services. The Practice Management rotations will assist the resident with becoming familiar with the business of ambulatory care practice and how to take a leadership role in advocating for pharmacist services.

    Project with Janeen Ibarreta, PharmD, BCACP

    Residents are required to develop and complete a major research project.  Residents will select a research topic based on their clinical interests.  Faculty and clinical staff will present project ideas during orientation. An appropriate associated preceptor will guide and supervise the resident throughout the year.  Following approval of the research topic and preceptor by the Residency Advisory Research Committee (RAC Research), residents will develop a formal research proposal.  The resident will submit the protocol for IRB approval. A completed research project form, formal proposal, completed IRB, poster presentation at Midyear, an oral presentation at the Western States Pharmacy Residents Conference and final written manuscript are required for successful completion of this longitudinal experience.


    Required Concentrated Direct Patient Care Learning Experiences (6 weeks each)

    Orientation (6 weeks) with Adam Porath, PharmD, BCPS, BCACP, FASHP

    The goal of the rotation is to become familiar with the residency program and organization's policy and procedures, work environment, and coworkers.  It is expected that the resident already has a solid foundation of general clinical pharmacy skills as evidenced by completion of an ASHP accredited PGY1 residency. The resident will be expected to begin staffing independently at the end or within a month after completion of the learning experience. 

    Pediatrics (4 weeks) with Adam Porath, PharmD, BCPS, BCACP, FASHP

    This rotation provides a broad exposure to ambulatory pediatric care provided at Renown Health. The resident will rotate through both primary care and several specialty clinic sites (i.e. endocrinology, pulmonology, heme/onc) during the rotation. While on heme/onc service the resident is expected to work with the Material Child (MC) pharmacist to review all outpatient pediatric chemo orders for Children's Infusion Services (CIS). While participating in primary and other specialty clinic the resident is expected to contribute to medication selection decisions based on indication, patient age, and weight.

    Women’s Health (2 weeks) with Adam Porath, PharmD, BCPS, BCACP, FASHP

    The rotation is designed to provide the resident with exposure to outpatient medication use provided in the setting of the Pregnancy Center and the Women's Health Clinic. A qualified pharmacist preceptor does not maintain an active practice in this area. As such, the resident will not be scheduled for this learning experience until they are determined to be ready for independent practice. Readiness for independent practice is reflected by a rating of achieved for residency (ACHR) for the majority of goals and objectives in Competency area R1.

    Elective Learning Experiences* (Optional)

    HIV (HOPES) with Jessica Thompson, PharmD, BCPS, BCIDP

    The HIV (HOPES) learning experience is a 4-week elective experience that may only be assigned to the resident in the second half of the residency year, after independent practice has been achieved.  The goal of the learning experience is for the resident to learn how to manage the basics of the medication and primary care needs of people living with HIV.   The resident will be paired with an HIV practitioner for HIV clinic at least two half-days each week.  The resident's role in the clinic will be to provide recommendations that take into consideration drug interactions, mutation/resistance profiles, barriers to acquiring treatment, treatment status, etc.

    *Other elective learning experiences may be developed based on resident interest and preceptor availability.