Orientation (4 weeks)
The Resident Orientation Learning Experience is designed to give the resident an overview of the pharmacy department at Sinai Hospital and teach the basic skills a clinical pharmacist should possess. These skills, along with an increased familiarity with pharmacy department processes, will benefit the resident significantly on their clinical practice learning experiences.
The learning experience includes:
- Central Pharmacy Orientation & Training
- Powerchart Training
- Total Parenteral Nutrition training
- Pharmacy Dosing Service
- Introduction to Clinical Learning Experiences
- Biostatistics Review
- Introduction to Drug Information resources
- Overview of the Institutional Review Board
Internal Medicine I (5 weeks)
The resident will be introduced to the care of acutely ill patients by rounding on a multidisciplinary internal medicine team. The rotation will help the resident effectively collect/analyze data, work with different specialties, and apply critical thinking skills to integrate pathophysiology and pharmacology to formulate therapeutic recommendations. The resident will also acquire knowledge and apply it to patients by participating in topic discussions. Upon completion of the rotation, the resident will be able to analyze patient information and formulate effective therapeutic recommendations independently.
Internal Medicine II (5 weeks)
The Internal Medicine II rotation is designed to build on the skills acquired during the Internal Medicine I rotation. The resident will be expected to apply knowledge gained from previous learning experiences to individual patients using critical thinking skills and evidence-based medicine to maximize drug therapy for the desired pharmacotherapy outcome. The resident will observe and participate in interactions between patients and multidisciplinary healthcare team members in the inpatient setting. Upon completion of the rotation, residents will be confident in their ability to assess patient outcomes in order to improve future decision making and guide practice management.
Infectious Disease (5 weeks)
The Infectious Disease learning experience is designed to introduce the resident to the pharmaceutical care of patients with infectious and related processes. The rotation will primarily focus on the pharmaceutical management of various infectious processes encountered in an inpatient setting, but subsequent outpatient management of these patients will be discussed as well. At the end of the learning experience, the resident will be expected to be familiar with the pharmacokinetics and pharmacodynamics of commonly used antibiotics, assess the infectious process and antibiotic regimen, and provide pharmaceutical management recommendations.
Critical Care – Medical ICU (5 weeks)
The learning experience in critical care pharmacy practice is designed to introduce the resident to the care of critically ill patients. The resident will observe how distributive and clinical pharmacy services can be integrated into a team approach to patient care. The resident will observe and participate in interactions between patients and multidisciplinary health care team members in the inpatient setting. The resident will develop competencies in the pharmacotherapeutic management of critically ill patients.
Pharmacy Administration (5 weeks)
The Pharmacy Practice Management learning experience is designed to further enhance the resident’s skills as an effective leader in the health care environment. The resident will work with the pharmacy leadership team to gain knowledge of medication safety measures, integration of information systems and automation, human resource management, financial and operational measures, and regulatory requirements
Throughout the learning experience, the resident will attend various interdisciplinary meetings with the preceptor. The resident will gain knowledge of how the organization is structured and how over arching decisions are made based on organizational strategies. Additionally, the resident will gain knowledge of the operational and financial goals of the organization. As an adjunct to learning, residents will review several case studies related to management skills and current topics. Residents will also develop skills to help them make ethical decisions.
Transitions of Care (5 weeks)
The Transitions of Care/Cardiology rotation is designed to introduce the resident to the integration of the acute care of patients with transitions of care activities. The resident will actively participate in interactions between patients, multidisciplinary healthcare team members in the inpatient setting, and pharmacy students. The resident will be expected to apply acquired knowledge to individual patients using critical thinking skills and evidence-based medicine to maximize drug therapy for the desired pharmacotherapy outcome. The resident will also utilize information gathering & patient counseling skills to minimize medication errors in patient transitions, formulate optimum discharge medication plans, and aid patients in achieving optimum medication adherence and disease management.
Ambulatory Care / Anticoagulation Clinic (longitudinal)
During the Ambulatory Care / Anticoagulation Clinic learning experience, the resident will be introduced to management of a pharmacist-run outpatient clinic. The Sinai Hospital Anticoagulation Clinic was established to provide ongoing monitoring and education to outpatients on warfarin therapy. Patients must be referred to the Anticoagulation Clinic by a physician who sets the parameters for the patient's warfarin therapy, such as goal INR and duration of treatment. The clinic pharmacists perform a fingerstick point-of-care PT/INR test and patient interview. Patient data is assessed and a dosing and monitoring plan is created and reviewed with the patient. At the initial patient visit, a patient history and medication list is obtained. Education about anticoagulation and the patient's indicated disease state is performed. Adverse drug reactions, drug interactions, and precautions are discussed. Residents are given the opportunity to function independently in the clinic by the end of the learning experience.
The distributive rotation includes staffing in the main, pediatric and oncology pharmacies. The majority of the rotation will be spent in the main pharmacy with some exposure to the other specialties. The resident will have orientation to the main pharmacy for approximately 3 weeks at the beginning of the residency program. After the resident becomes oriented, they will be required to staff in both the main and/or pediatric pharmacies. The schedule will be one evening every other week from 4PM to 7PM, and every third weekend. The distributive rotation can be modified to meet the skills and knowledge of the resident. The resident will be expected to participate as an active member of the pharmacy staff, by assisting colleagues and other health care professionals.
Clinical Pharmacy Administration (longitudinal)
This longitudinal experience is designed to give residents a chance to develop their professionalism and to learn about/participate in important clinical pharmacy-related functions of the health system that are not necessarily associated with direct patient care. The activities will emphasize the use of collaborative, multidisciplinary approaches to manage the medication formulary, manage the drug budget, and oversee/develop clinical pharmacy services. Good written communication and interpersonal skills are necessary. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments.
Medication Safety (longitudinal)
The medication safety rotation is designed to help residents better understand how hospitals and healthcare systems improve medication safety. Different principles, tools, available resources, and medication safety nomenclature will be introduced to the resident throughout the longitudinal rotation. Knowledge will be gained through the reading of multiple resources. Various activities will be performed throughout the year by the resident to help them become better acquainted with all aspects of medication safety. The rotation will have both required and elective activities that will be performed by the resident and discussed at the beginning of the year and rotation. By the end of the rotation, the resident will be able to apply knowledge about medication safety to improve patient care throughout the hospital or healthcare system.