FAQ

Residency Showcase FAQ

1) What sets the DRMC PGY1 program apart from other programs?

• Autonomy of pharmacy - many protocols are in place to allow pharmacists to practice at the top of their license (ex. vancomycin dosing, aminoglycoside dosing, heparin dosing, TPN dosing, epoetin dosing, renal dosing adjustments, antimicrobial stewardship, IV to PO substitutions, etc.)

• Unique relationship with medical teams - physicians and nursing relies on pharmacy heavily and interprofessional relationships are strong

• Flexibility in rotations - opportunity to elongate or shorten rotations as informed by resident’s passions

• Great pharmacy culture - nurturing, encouraging, “big family” nature
  

2) What effects have COVID-19 had on the program?

• All employees are required to wear surgical masks when on hospital grounds

• When involved in patient care, N95 mask and face shield are required

• During code blues, pharmacy no longer enters the room and stands at bedside assisting the medical team - waits outside the room and compounds medications as needed for the team

• When rounding, typically stand outside patient rooms rather than going to the bedside

• Ambulatory care rotation pushed to the end of the year as face-to-face visits are limited with patients
  

3) What is the process for receiving feedback from preceptors/management?

• Informal feedback on a daily basis

• Open-door policy with residency program director and clinical coordinator

• Weekly check-in meetings with residency program director and clinical coordinator

• Midpoint and final evaluations with preceptors
  

4) What is the culture of the department? How are the relationships between pharmacy staff?

• Staff pharmacists and technicians are always willing to help residents - friendly, open, welcoming

• Everyone works hard and everyone helps out -- great dynamic between co-workers
  

5) How is the relationship between pharmacy and physicians?

• Very well-integrated - physicians are used to pharmacy presence and often defer to us when asking for recommendations regarding medications (esp as it pertains to antibiotics, anticoagulation, etc.)

• When rounding, pharmacy is very much a part of the team and our input is actively sought out

• Wonderful interprofessional dynamic - very progressive environment
  

6) What is the process of setting and modifying the rotation schedule as clinical practice interests may change?

• At the start of the residency, residents sit down with RPD and clinical coordinator to draft a tentative schedule mapping out rotations for the year.

• During weekly check-ins with RPD and clinical coordinator, can request elongation or shortening of any rotation that you’re currently on as clinical interests evolve

• Very flexible in customizing the residency to tailor to your passions
  

7) What does a standard day on rotation look like?

• Neonatal Intensive Care (NICU) rotation

  • 7:00 arrive at work

  • 700-9:30 pre-round on infants -- set up monitoring cards (typically gentamicin and TPN dosing cards), prepare recommendations for TPN to present at rounds, inventory neonatal morphine count, answer any questions from nursing staff

  • 9:30-10:30 attend rounds with physician and nurse practitioner on neonates requiring TPNs

  • 10:30-1:00 begin “seeing” all patients - verifying orders, reading notes, updating monitoring cards with relevant information (also for pediatric patients and L&D/OB patients)

  • 1:00 CAPS TPN order due

  • 1:00-3:30 continue “seeing” patients until the end of the shift. Topic discussions and other presentations can be sprinkled in throughout the day with preceptors.

• Critical Care (ICU) rotation

  • 7:00 arrive at work

  • 7:00-8:30 verify orders, set up monitoring cards, pre-round as needed

  • 8:30-11:30 Round with the intensivists and residents on ICU patient census

  • 11:30-3:30 After rounding, de-brief with preceptor as needed and continue verifying orders, following up on monitoring cards (vancomycin, heparin, TPN, epoetin), answering phone calls from nurses and physicians as needed

• Infectious Disease rotation

  • 8:00 arrive at work

  • 8:00-12:00 verify orders, vancomycin monitoring cards, pre-round as needed

  • 12:00-2:00 pm Round with the Infectious diseases team which consist of ID physician, Medical residents, Pharmacy student, and ID pharmacist

  • 2:00- 4:30 perform daily antimicrobial stewardship on the ASP tab and work on vancomycin monitoring cards. Answer phone calls from nurses and physicians as needed.

• Oncology rotation

  • 8:00 arrive at work

  • 8-4:30 The rotation varies based on your experience with oncology.

    • Week 1: shadow technician and learn how to Prepare and Compound IV hazardous and chemo drugs. Shadow oncology team and nurses to learn the workflow of the oncology center.

    • Week 2 to 6: Verify chemotherapy orders. Manage premedications and infusion site reactions. Work closely with Oncology physicians and nurses to develop treatment plans. Weekly topic discussions and answering phone calls from nurses and physicians as needed.

• Emergency Department (ED) rotation

  • 12:00pm arrive at work

  • 12:00 - 1:00pm assist pharmacy operations in the basement for the 1st hour of shift to help cover lunches.

  • 1:00 -8:30pm

    • arrive in the ED and clear all ED orders.

    • Check crash carts, code medications (epinephrine, sodium bicarbonate, dextrose, and calcium chloride syringes), regular insulin and rapid sequence intubation kits (etomidate, succinylcholine, rocuronium)]

    • Evaluate the most critical patients and labs. Make IV medications as needed for immediate use and ensure the timely delivery of STAT medications to the ED. Respond to all questions from medical attendings and residents. Initiate Vancomycin and Heparin drips per DRMC protocols for the ED.

    • Lead all trauma codes and alerts, as well code blue (after 5:30 pm). There will be no ICU pharmacist staffing after 5:30pm, so the ED pharmacist is responsible for all code blues hospital-wide.