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 (5 weeks)
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.
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.
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.
Emergency Medicine (5 weeks)
Sinai Hospital is a 450 bed, urban, community hospital with a 55 bed emergency room which sees around 80,000-85,000 patient visits annually and is a Level II Trauma Center. The Emergency Department (ER-7) is divided into 7 specialty areas including Trauma, Emergent Care, Chest Pain Evaluation, Urgent Care, Pediatrics, Observation/Psych, and Fast Track/Rapid Evaluation Unit. The rotation will focus on the initial care of a wide range of disease states seen and medications used in the emergency department, including but not limited to, critical care, sedation/analgesia, infectious disease, cardiology, stroke, agitation/alcohol withdrawal, seizure disorders, hypertension, diabetes, and antidotes/toxicology. Patent care is provided by an array of disciplines consisting of physicians, nurses, care managers, social workers, and pharmacists. Discussions will be held about appropriate evaluation and treatment of patient-specific disease states, medication reconciliation, discharge counseling and instruction, and disposition of patients. Responsibilities will include verification of emergency department specific physician orders, responding to codes/traumas, answering drug information questions, attending ER-7 Medical Directors Committee Meetings, patient interviews, and reading and discussion of key Emergency Medicine Articles.
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 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.