PGY-1 Pharmacy Residency: Ambulatory Care Emphasis - West Texas VA Health Care System
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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 provide advanced patient care services in an ambulatory care setting, to pursue focused PGY-2 training and to obtain 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 WTVAHCS, collectively serving more than 33,000 veterans throughout West Texas and Eastern New Mexico. Clinical pharmacists can connect with patients across 53,000 square miles through Telehealth Technology, streaming live to Veterans at one of the Community-Based Outpatient Clinics (CBOC’s) and through our 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).

Pharmacy Services

  • Outpatient Pharmacy
  • Telehealth Services
  • Home-Based Primary Care (HBPC)
  • 40-bed Community Living Center (CLC)
  • 40-bed Residential Substance Abuse Treatment Program (DOM)
  • Anticoagulation Clinic
  • Chronic Disease State Management Clinic
  • Hepatitis C Clinic
  • Pain Management Clinic
  • Outpatient Mental Health

WTVAHCS PGY-1 Pharmacy Residency 

Program Structure

All required learning experiences will be performed at the George H. O’Brien, Jr. VAMC. There is an elective option available off-site. Our site is mostly an outpatient facility, but we also have a residential nursing home that houses short stay rehab and long-term care patients.  We do not have any acute care at our site, so the focus of the residency program is on ambulatory care and geriatrics.  Residents at our site will get experience in all the clinical areas that we currently practice in which are: anticoagulation, primary care (diabetes, hypertension, lipids, heart failure, COPD), pain management, geriatrics, and mental health.  The goal of our residency program is to have the residents be able to practice independently in all areas they are exposed to.

Desired Characteristics in Residency Candidates

The ability for residents to be flexible and adapt quickly to situations or changes in schedule will prove very beneficial. As with any residency program, we are seeking candidates that work effectively on interprofessional teams, are optimistic about the many benefits they will gain from being residency-trained and are committed towards the mission and goals of our program, including providing exceptional service to our veteran patients.

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 Program Director
300 Veterans Blvd
Attn: Dept of Pharmacy, Room 119
Big Spring, TX 79720
Tyson.Kubena@va.gov
Mertessa Espejo, PharmD
Residency Coordinator
300 Veterans Blvd
Attn: Dept of Pharmacy, Room 119
Big Spring, TX 79720
Mertessa.Espejo@va.gov

 

Pharmacy Practice Experience

WTVAHCS PGY-1 Pharmacy Residency

Learning Experiences

  • Ambulatory care
  • Geriatrics (Community Living Center and Home-Based Primary Care)
  • Mental health
  • Pain management
  • Pharmacy Management
  • Electives
    • Pain Management
    • Mental Health
    • Antimicrobial Stewardship/Hep C
    • Resident-Driven PACT Extension (Create and run a new clinical service)
    • Adult Medicine (Offsite rotation at Medical Center Health in Odessa, Tx)
    • Pharmacy Management

Duration of Learning Experiences

  • Core and elective learning experiences are typically 4-6 weeks
  • Longitudinal experiences
    • Daily outpatient pharmacy staffing
    • Monthly inpatient staffing
    • Grand rounds presentations (5 per year)
    • Quality improvement project

Feedback

Summative feedback is provided at least twice per learning experience, and quarterly on longitudinal learning experiences. Preceptors and residents can request weekly check-ins to assess the need for adjustment within the learning experience.

Residency Requirements and Presentations

  • Satisfy goals and objectives of each learning experience
  • Bimonthly grand rounds presentations
  • Drug information questions
  • Journal clubs
  • Quality improvement project (Presented to Alcalde Leadership Conference)

Staffing Responsibilities

  • Outpatient pharmacy lunch coverage (1 hour daily)
  • Late shift coverage (every other week)
    • Process medication orders until walk-in clinic closes
  • CLC staffing (one Friday every month)

Teaching Opportunities

  • Precept and lead topic discussions for P4 pharmacy students
  • Educate healthcare providers through bimonthly grand rounds presentations
  • A teaching certificate can be obtained online with modules provided through ASHP and the presentations already built into the program. (optional)

Resident Office

  • Residents have a dedicated office space, located within the pharmacy

Interviews

  • Phase 1 interviews will be conducted in person
  • Phase 2 interviews will be conducted via video conference (preferred) or phone

 

WTVAHCS PGY-1 Pharmacy Residency

Application Process

Candidates should complete a standard application in the Pharmacy Online Residency Centralized Application Service, PhORCAS, at https://portal.phorcas.org/

 Code: 74062

 NMS Code: 233913

 Deadline: 11:59pm on the first Friday of January

Applicant Requirements

  • U.S. citizenship
  • Pharm D degree from an accredited School of Pharmacy
  • On-site interview
  • License to practice pharmacy (in any state) within 90 days of start date

Applicant Materials submitted to PhORCAS

  • Three letters of recommendation
  • Residency Application Form
  • Curriculum Vitae
  • Pharmacy School Transcripts
  • 2 samples of written work completed only by applicant (journal club or drug information question)

Position appointment

Appointment is contingent upon satisfactory completion of physical exam (including drug test). Applicants must meet all requirements for federal employment.

Preceptors

Our pharmacy team is comprised of staff and clinical pharmacists, with diverse backgrounds including but not limited to geriatrics, mental health, pain management, hepatitis C management, anticoagulation and primary care with varying years of pharmacy experience. The pharmacists on our team are experienced preceptors and are willing to help residents with questions throughout the learning and growing process of residency.

Past Residents

Past residents have gone on to complete PGY2s in Academia and Mental Health.  Additionally, they have accepted positions as clinical pharmacy specialists in Ambulatory Care, Mental Health, Pain Management, Hepatitis C, and Academia.

FAQs

  • What does a day look like as a resident?

This changes as the year progresses and is based on the resident’s previous experience.  Residents begin each learning experience with a lighter workload, and this is increased as experience is gained.  Independence in each area of practice is the goal of the program, and towards the end of each learning experience the resident should be functioning in the role of the preceptor.

  • How do residents/pharmacists fit in with the health care system? How are pharmacists viewed by other staff?

The pharmacy staff has a positive relationship with the other services in the facility.  Pharmacy services and expertise are utilized frequently by the providers and nurses at the site.  Since the residents work with the pharmacy service, they are viewed as a part of the pharmacy team. 

  • What is the environment/culture like in the pharmacy and hospital overall?

The pharmacy culture is very focused on teamwork.  We follow the approach at our pharmacy that no one is above any position and anyone can fill in any position to help if needed.  Due to this we have a staff that works very well together.  As far as the facility overall, the staff is dedicated to helping take care of our patients and will work as a team to make sure they get the highest level of care.

  • What is the Resident-Driven PACT elective learning experience?

The Resident-Driven PACT extension allows residents to create their own clinic that the facility does not currently have. One example is a Polypharmacy clinic, where a past resident obtained the names of patients that had 25+ medications. She reviewed charts and called patients to see if they wanted a consultation on their medications. She made recommendations based on her findings and provided education to the patients on their medications.

  • Is schedule flexible to change elective rotations?

There is some flexibility for onsite elective learning experiences as the resident’s preference develops throughout the residency year. Offsite rotations cannot be changed after they have been set up.

  • How are the projects typically decided? Does the resident ultimately get to choose or are they appointed to a subject?

At the beginning of the residency year, residents are asked what areas of interest they have for their project.   The pharmacy staff maintains a list of potential resident projects and they are matched to the interests of the resident. 

  • What sets your program apart from others?

This program has an ambulatory focus. If ambulatory care or an ambulatory care specialty (i.e. mental health or pain management) is an area of interest, this program offers more experience in these fields than a traditional PGY1 has the opportunity for.




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