Curriculum

Orientation and Training is a required learning experience that will provide an overview and orientation to the residency program. Additionally, the resident will receive training in the central pharmacy with a focus on distributive operations and regulatory workflow. A minimum of three full days within the first week of orientation will be dedicated to orientation to the residency program and related requirements, policies, and procedures.

Following introduction to the residency program policies and procedures, residents will begin orientation and training in the central pharmacy. This training is designed to be consistent with the schedule, standards, and expectations of any new clinical pharmacist at BIDMC who would be scheduled for a shift in the distributive (central) pharmacist role.

The curriculum includes, but is not limited to, achieving competence in operations of the BIDMC Department of Pharmacy, departmental workflow, use of departmental and hospital information systems and technology, knowledge and application of departmental and hospital policies and procedures, and the skills needed to serve as a clinical pharmacist during the service requirements of the residency.

The PGY1 pharmacy resident will train for a minimum of fourteen (14) shifts in the centralized pharmacy to learn the core functions and responsibilities of pharmacists in this practice area. A training checklist and other documents are provided to provide more detail relative to the content and competency requirements in this role.

The Pharmacy Practice learning experience provides the resident the opportunity to develop essential practice skills in the role and responsibilities of a Clinical Pharmacist in one or more of the medical center’s decentralized, clinical practice sites. This learning experience builds upon the fundamental knowledge gained through their initial training and work in the central pharmacy and facilitates the resident to advance their training and practice to be able to independently practice as a decentralized Clinical Pharmacist.

The role of a decentralized Clinical Pharmacist in an assigned practice area includes the medication management and oversight of 60-100 patients on one or more floors including providing prospective order verification, therapeutic drug monitoring, patient education, and drug information to the multidisciplinary team. The focus of training will be geared towards the routine operational and clinical responsibilities of the decentral pharmacist and increasing confidence with institutional policy, procedures, and clinical practice.

The Infectious Diseases (ID) learning experience is a required, five-week learning experience. Residents may spend time with two different ID teaching teams: one focusing on the immunocompromised patient and the other on the immunocompetent patient. Each team includes an attending physician and two ID fellows. Additional team members may include medical interns, medical residents, medical students, pharmacists and/or pharmacy students. The ID consult service sees a wide variety of patients from many different backgrounds (medical service, critical care, oncology, HIV, etc.).

The resident works with the ID consult team at daily rounds, maintaining a responsibility to optimize anti-infective therapy for the consult patients. This includes dosing recommendations based on organ function, avoidance or mitigation of adverse reactions, and daily monitoring of anti-infective therapies, including performing kinetics consultations. While on the learning experience, the resident will also participate in the P&T Antimicrobial Subcommittee as well as in current medication use evaluations and other research activities within the Pharmacy and ID Departments.

Internal Medicine (IM) is a required, five-week learning experience. The goal of the IM learning experience is for residents to develop skills and competencies in the provision of pharmaceutical care for a diverse population of IM patients, enabling them to effectively participate in therapeutic decision making, drug therapy selection, monitoring of acutely ill patients, and providing patient education.

Typically pharmacy residents will round on one of 4 internal medicine teaching teams. Each of the teaching teams includes an attending physician, a PGY2 or PGY3 medical resident, 2 PGY1 medical interns, and medical students (MSIII or MSIV). Other disciplines on the team include the clinical pharmacist and pharmacy students. Teaching teams typically are responsible for 15-18 medicine patients.

The clinical pharmacist on the team, and in turn the pharmacy resident, is responsible for ensuring safe and effective medication use for all patients. This involves active participation in daily rounds and collaboration with other pharmacy, nursing, and physician personnel as appropriate. The pharmacy resident assumes an active role in assisting the team with medication reconciliation issues, including obtaining accurate home medication lists, and providing patient counseling at the time of discharge.

Strong communication and interpersonal skills, as well as time management skills are necessary to succeed during this learning experience. Residents will have opportunities to further refine these abilities and further develop their clinical knowledge, ability to provide patient care, develop a working relationship with an interprofessional health care team, identify and interpret health literature, and educate patient and providers while on this learning experience.

The Internal Medicine Subspeciality learning experience may be completed in any of the following settings: cardiology, neonatal ICU (NICU), transplant, medical oncology.

Internal Medicine (IM) is a required, five-week learning experience. The goal of the IM learning experience is for residents to develop skills and competencies in the provision of pharmaceutical care for a diverse population of IM patients, enabling them to effectively participate in therapeutic decision making, drug therapy selection, monitoring of acutely ill patients, and providing patient education.

Typically pharmacy residents will round on one of 4 internal medicine teaching teams. Each of the teaching teams includes an attending physician, a PGY2 or PGY3 medical resident, 2 PGY1 medical interns, and medical students (MSIII or MSIV). Other disciplines on the team include the clinical pharmacist and pharmacy students. Teaching teams typically are responsible for 15-18 medicine patients.

The clinical pharmacist on the team, and in turn the pharmacy resident, is responsible for ensuring safe and effective medication use for all patients. This involves active participation in daily rounds and collaboration with other pharmacy, nursing, and physician personnel as appropriate. The pharmacy resident assumes an active role in assisting the team with medication reconciliation issues, including obtaining accurate home medication lists, and providing patient counseling at the time of discharge.

Strong communication and interpersonal skills, as well as time management skills are necessary to succeed during this learning experience. Residents will have opportunities to further refine these abilities and further develop their clinical knowledge, ability to provide patient care, develop a working relationship with an interprofessional health care team, identify and interpret health literature, and educate patient and providers while on this learning experience.

Medication Safety and Quality is a required learning experience at BIDMC that provides the resident the opportunity to gain an understanding of basics on medication safety and quality as well as pertinent regulatory regulations within a hospital setting. The purpose of the learning experience is to equip residents with the knowledge, skills, and strategies necessary to apply medication safety concepts within the healthcare setting and understand quality measures within a pharmacy department. Through discussions with preceptors and members of the Pharmacy Department, completion of projects, as well as attending and often leading various meetings, the resident will have the opportunity to learn about the pharmacy's role in: o    Stakeholder engagement. o   Identifying and implementing strategies to reduce medication errors and patient harm o   Quality improvement and assurance o   Regulatory preparedness o   Interdisciplinary project management o   Effective communication Residents will work primarily with the learning experience preceptors, engage in projects, attend relevant meetings, and collaborate with members of the Pharmacy Department and external stakeholders throughout the medical center.

The Critical Care learning experience is a required five (5) week learning experiences intended to introduce the pharmacy resident to foundational topics of caring for critically ill patients. Residents will gain experience and knowledge in the pharmaceutical care and disease states specific to the critical care setting. The Critical Care learning experience may be completed in any of the following specialty settings:

• Medical Intensive Care (MICU/FICU)
• Cardiovascular Intensive Care (CCU)
• Neuroscience Intensive Care (NSICU)
• Surgical Intensive Care (SICU)
• Trauma/Surgical Intensive Care (TSICU)

Regardless of practice setting, the resident will have the opportunity to round with an interdisciplinary team composed of the following team members: attending physician and fellow, medical residents, medical interns, medical students, clinical pharmacist, nursing staff, and additional allied healthcare professionals (ex. dietitian, respiratory therapist, etc.) as needed. While on the learning experience the resident will assume the role of clinical pharmacist for their assigned patients including evaluation and management of patient's medications and will be responsible for identifying and resolving medication-related issues, providing responses to drug information questions from the team, performing therapeutic drug monitoring, providing informal education to the team on pharmacy-related topics, and monitoring all aspects of medication therapy in relation to end organ damage (ex. lung, kidney, liver, etc.).

• Cardiovascular Medicine
• Ambulatory Care Clinics:
  • General Cardiology/Heart Failure
  • Infectious Diseases/OPAT
  • Hematology/Oncology
  • Pain/Palliative Care
  • Primary Care
  • Solid Organ Transplant
• Emergency Medicine
• Hematology/Stem Cell Transplant (BMT)
• Hepatology
• Infectious Diseases
• Infectious Diseases II: Antibiotic Consult Service or Stewardship
• Oncology
• Oncology Infusion
• Solid Organ Transplant
• Specialized ICUs:
  • Cardiac Intensive Care
  • Medical Intensive Care
  • Surgical Intensive Care
  • Trauma Intensive Care
  • Neonatal Intensive Care