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West Texas VA Health Care System

 

PGY-1 Pharmacy Residency: Ambulatory Care Emphasis

Mission

The PGY1 pharmacy residency program at West Texas Veterans Affairs Health Care System (WTVAHCS) will prepare 2 pharmacy residents to function as clinicians, providing advanced patient care services in an ambulatory care setting, become eligible to pursue second year postgraduate training in a focused area of practice, and obtain the necessary qualifications to gain board certification.  WTVAHCS is a rural access health care system that serves Veterans, and provides the unique ability to engage each resident in ambulatory and geriatric patient care, project and practice management.

Facility The George H. O’Brien, Jr. Veterans Affairs Medical Center in Big Spring, TX is the core of the West Texas Veterans Affairs Health Care System (WTVAHCS), collectively serving more than 17,000 veterans throughout West Texas and Eastern New Mexico. Clinical pharmacists have the ability to connect with patients across 53,000 square miles of service area through state-of-the-art Telehealth Technology, streaming live to veterans at one of six Community-Based Outpatient Clinics (CBOC’s) and through our expanding Home-Based Primary Care (HBPC) program. Likewise, comprehensive residential care pharmacy services are provided for veterans admitted to the 40-bed Community Living Center (CLC) including a well-equipped dispensing pharmacy on station.

Pharmacy Services:

  • Outpatient pharmacy
  • Telehealth Services
  • Home-Based Primary Care (HBPC)
  • 40-bed Community Living Center (CLC)
  • 40-bed inpatient substance abuse treatment program
  • Anticoagulation clinic
  • Chronic Disease State Management Clinic
  • Hepatitis C Clinic

WTVAHCS PGY-1 Pharmacy Residency

 Program Purpose

This comprehensive program with a primary focus in ambulatory care consists of core learning experiences including primary care, anticoagulation, geriatrics, adult medicine, pharmacy management, inpatient/outpatient operations, and research. Various elective opportunities will be made available to complement resident interests. Upon completion, the resident will be a skilled clinical pharmacist capable of functioning autonomously and as an integral member of any interdisciplinary team, well-qualified to pursue PGY2 residency training and/or board certification.

Program Structure

The residency program is a 12-month program consisting of 8 weeks of elective rotations. These are flexible to allow the resident to attain individual goals. Residents will also gain teaching experience through precepting P4 pharmacy students.

Number of positions: 2 

Pay and Benefits

PGY-1 Salary ~$41,000

  • 13 days vacation and sick leave
  • 10 federal holidays
  • Health, life, vision, dental insurance options
  • Free parking
  • 2 lab coats with laundry service

  Conferences:

  • ASHP Midyear Clinical Meeting (optional)
  • TSHP ALCALDE Residency Conference (required)

Contact Information

Tyson Kubena, PharmD
Residency Director, Clinical Coordinator
300 Veterans Blvd
Attn: Dept of Pharmacy, Room 119
Big Spring, TX 79720
(432) 263-7361, EXT 4836
Tyson.Kubena@va.gov

 

Pharmacy Practice Experience
WTVAHCS PGY-1 Pharmacy Residency

Required Rotations:

Orientation (6 weeks)

Residents will become familiar with the outpatient and inpatient operations of the pharmacy during this rotation. Residents will gain experience and become proficient with the computerized order system, pharmacy policies, IV preparation, dispensing, verifying, and roles of pharmacists in these areas.

 Ambulatory Care (15 weeks)

Residents will be exposed to a variety of disease states and practice with our clinical pharmacy specialists in our ambulatory care clinics. These clinics are focused on diabetes, hypertension, hyperlipidemia, tobacco cessation, and anticoagulation.  Residents will also precept P4 pharmacy students in the advanced disease state management rotation.

 Geriatrics (12 weeks)

Residents will work with an interdisciplinary team including our clinical pharmacy specialists in Home Based Primary Care, and patients admitted to our 40 bed inpatient skilled nursing facility. Residents will review and interview patients and make recommendations to the treatment teams for optimization of therapy.

 Substance Abuse Residential Rehabilitation Treatment Program (4 weeks)

Residents will participate in care for patients admitted to our inpatient 40 bed substance abuse treatment program. Residents will attend treatment meetings with an interdisciplinary team and also have the opportunity to attend/teach group classes.

 Management (4 weeks)

Residents will be exposed to the tasks affecting overall pharmacy operations and management initiatives. The resident will review and discuss financial, workload, and staff management. Other areas covered include: clinical resource management, pharmacoeconomics, drug procurement, and quality improvement.

 Longitudinal Rotations

 Staffing

Residents will staff outpatient pharmacy areas for one hour each Monday-Friday. Residents will also staff inpatient once a month, take a weekend of call once a month, and work the 8:00-5:30 shift once a month.

 Residency Project

The residency project teaches the resident project management skills. It requires the development of an idea into a feasible project, writing a proposal, obtaining the necessary approvals, implementing the project, analyzing the results, and writing a manuscript suitable for publication.

 Electives (2)

    • Pain Management- Work with pain management pharmacist to review and make recommendations for patients with chronic pain.
    • Mental Health- Attend clinic with psychiatrists and psychologists in an outpatient mental health setting.
    • Antimicrobial Stewardship/Hep C- Work on projects in antimicrobial stewardship with clinical pharmacy specialists and also participate in the management of Hepatitis C patients.
    • Nutrition/MOVE program- Attend clinic with dietitians and learn how to manage patients on a weight loss program.
    • Resident-Driven PACT Extension- Opportunity for the resident to create and run a new ambulatory care clinical service that the pharmacy does not currently offer.
    • Urgent Care- Perform medication reconciliation on patients coming into urgent care, and collaborate with the urgent care physician to optimize patient care.
    • Offsite rotation- Adult medicine at Medical Center Health system in Odessa

 

Residents
WTVAHCS PGY-1 Pharmacy Residency  

Current Residents

 Cynthia Bartha, Pharm.D., PGY-1 Pharmacy Resident

            Dr. Bartha is originally from Chicago, Illinois. She received her Doctor of Pharmacy degree from South Dakota State University in Brookings, South Dakota in May of 2016. Her clinical interests include pain management, anticoagulation, and chronic disease state management. She enjoys hiking, traveling, cooking, and spending time with family and friends. After residency, she plans to pursue a clinical pharmacy position in an ambulatory care setting.

 Mertessa Espejo, Pharm.D., PGY-1 Pharmacy Resident

            Dr. Espejo is originally from Sacramento, California.  She received her bachelor’s degree from California State University in Psychology and earned her Pharm.D. from the University of Colorado, Denver.  Dr. Espejo’s interests include chronic disease state management and pharmacy management.  She plans to specialize in Ambulatory Care pharmacy and a clinical coordinator role for pharmacy run clinics. 

Past Residents

 Vivan Bui, Pharm.D.

            Dr. Bui is originally from Southern California. She received her Doctor of Pharmacy degree from the University of the Pacific. Her residency project was titled: New metformin prescribing recommendation: Evaluating metformin use based on estimated glomerular filtration rate over traditional serum creatinine contraindications. She is currently serving as a clinical pharmacist at Kaiser California.

Chantal Kneifel, Pharm.D.

             Dr. Kneifel is originally from Texas. She received her Bachelor’s degree in Neuroscience from Baylor University prior to receiving her Doctor of Pharmacy degree from MCPHS University in Boston, Massachusetts. Her residency project was titled: Effects on antibiotic prescribing rates after physician and nurse education on upper respiratory infections. She is currently serving as the clinical pharmacy specialist in the Hepatitis C clinic at the West Texas Veteran Affairs Health Care System in Big Spring, Texas.

 

Preceptors
WTVAHCS PGY-1 Pharmacy Residency

 

Alyssa Wanner, Pharm.D.

 Dr. Alyssa Wanner, Pharm.D. earned her Doctor of Pharmacy degree from the University of Cincinnati College of Pharmacy in 2010. After graduation, she completed a residency at the Cincinnati VA Medical Center. She began as a clinical pharmacy specialist with the PACT/ambulatory care medication management at the West Texas Veterans Affairs Health Care System after completing her residency. Her current clinical interest is diabetes. Dr. Wanner serves as the preceptor for the PACT/Primary care portion of the Ambulatory Care PGY-1 rotation.

 

Jason Cornish, Pharm.D.

 

Jenna Kubena, Pharm.D., CGP

             Dr. Jenna Kubena, Pharm.D., CGP earned her Doctor of Pharmacy degree from Texas Tech University Health Sciences Center School of Pharmacy in 2009.  After graduation, she took a position as the inpatient and community living center consultant pharmacist with the West Texas Veteran Affairs Health Care System. Additionally, she has clinical experience with the Veteran Affairs Geriatric Scholars Program to expand her knowledge in geriatric care. Dr. Kubena has a clinical interest in geriatrics and serves as the preceptor for the Geriatrics PGY-1 rotation.

  John Hoyng, Pharm.D.

            Dr. Hoyng, Pharm.D. earned his Bachelors of Science in Biology and Doctor of Pharmacy degree from Texas Tech University Health Sciences Center School of Pharmacy in 2012. After graduation, he took a position as the outpatient and inpatient anticoagulation clinic pharmacist with the West Texas Veterans Affairs Health Care System. In 2014, he transitioned into a clinical pharmacist position with the PACT/ambulatory care medication management team. Dr. Hoyng serves as the preceptor for the PACT/ambulatory care medication management rotation and anticoagulation rotation of the Ambulatory Care PGY-1 rotation.

Dustyn Williams, Pharm.D.

            Dr. Dustyn Williams, Pharm.D. earned his Doctor of Pharmacy degree from Texas Tech University Health Science Center school of Pharmacy in 2012. After graduation, he took a position as the Home Based Primary Care and Domiciliary pharmacist with the West Texas Veterans Affairs Health Care System. Additionally, he has had clinical experiences in anticoagulation. His current clinical interests include both geriatrics and primary care. Dr. Williams serves as the current preceptor for the Home Based Primary Care and Domiciliary/Mental Health PGY-1 residency rotations.

 Heather Cave, Pharm.D.

         Dr. Heather Cave, Pharm.D. earned her Doctor of Pharmacy degree from Texas Tech University Health Science Center school of Pharmacy in 2011. After graduation, she took a position as the anticoagulation clinical pharmacist at Abilene Behavioral Health in Abilene, TX. She then expanded her clinical experiences by working as an inpatient clinical pharmacist at Rolling Plains Hospital in Sweetwater, TX and also at the Hendrick Medical Center in Abilene, TX. She then took a position as a clinical pharmacy specialist with the West Texas Veteran Affairs Health Care System in Big Spring, TX and serves as an anticoagulation and PACT/ambulatory care medication management pharmacist. Her clinical interests include diabetes management, infectious disease, and geriatrics. Dr. Cave currently serves a preceptor for the anticoagulation rotation of the Ambulatory Care PGY-1 residency rotation.

Tyson Kubena, Pharm.D.

            Dr. Tyson Kubena, Pharm.D. earned his Doctor of Pharmacy degree from Texas Tech University Health Science Center school of Pharmacy in 2008. After graduation, Dr. Kubena has taken on various clinical roles within the West Texas Veteran Affairs Health Care System including: anticoagulation, geriatrics, adult medicine, and chronic disease state management. His current clinical interests include: diabetes, hypertension, and hyperlipidemia. He currently serves in the role of clinical coordinator and residency director for the West Texas Veteran Affairs Health Care System.

Wendy Brown, RPh

            Wendy Brown earned her Bachelors of Pharmacy degree from the University of Texas in 1988. After graduation, she completed a residency with the University of Texas/Audie Murphy Veterans Affairs Medical Center. Her clinical experiences include mental health, inpatient pharmacy with the general medical and surgical floors, ambulatory care, and pharmacy management. She currently serves as the Associate Chief of Pharmacy Services at the West Texas Veteran Affairs Health Care System. Her current clinical interests include mental health, quality improvement, and pharmacy management.

 

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