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:
Internal Medicine (5 weeks)
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
The internal medicine learning experience is designed to introduce the resident to the primary care of patients with a wide variety of clinical problems including but not limited to diseases of the cardiovascular, respiratory, gastrointestinal, renal, neurologic, hematologic, infectious and endocrine systems. 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 observe and participate in interactions between patients and multidisciplinary health care team members in the inpatient setting. Upon completion of the learning experience, the resident will be confident in his or her ability to assess patient outcomes to improve future decision making and guide practice management.
Surgery (5 weeks)
The general surgery services at Sinai Hospital are comprised of two teaching services, red and blue. Each service provides the breadth of the field of surgery but may have a distinct focus on one or more areas of surgery: trauma surgery, emergency general surgery, pediatric surgery, breast and endocrine surgery, surgical oncology, hepato-biliary surgery, vascular surgery, thoracic surgery, gastric bypass surgery, advanced minimally invasive surgery.
On each service, a surgical resident works with a complement of experienced midlevel providers (nurse practitioners and physician assistants) as well as physician assistant students, physician assistant residents in surgery and medical students, as they rotate on their respective services. The surgical staff along with a clinical pharmacist attends and participates in daily morning patient care rounds in order to assess, evaluate and develop a patient-specific care plan. The pharmacy resident will follow the patients on the surgery service. They are also responsible for identifying and resolving medication related issues, providing drug information and completing appropriate follow-up for all recommendations.
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.
Psychiatry (5 weeks)
The psychiatry learning experience is designed to introduce the resident to the pharmaceutical care of patients with mental illnesses. The rotation will primarily focus on the short-term management of psychiatric disorders encountered in an acute care inpatient setting, though care of patients transitioning to outpatient and day hospital settings will also be incorporated. 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 learning experience will involve participation with the interdisciplinary healthcare team as well as development of pharmacist-patient relationships. The resident is responsible for identifying and resolving medication therapy issues as well as providing pharmaceutical management recommendations for both psychiatric and somatic issues.
Ambulatory Care / Anticoagulation Clinic (5 weeks)
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.
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.
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.
Drug Information (longitudinal)
Drug Information is a required learning experience for the pharmacy practice resident. The resident will be expected to utilize critical thinking skills and evidence-based medicine in the retrieval and analysis of appropriate drug information resources. This is a longitudinal experience encompassing several different learning opportunities throughout the year, which include:
Four journal clubs
- Formulary review to be presented to the Pharmacy and Therapeutics Committee
- AHFS class review to be presented to the Pharmacy and Therapeutics Committee