PGY2 Rotations

Research & Education > Education

Residency Schedule

PGY2 Internal Medicine residents’ schedule will be constructed to alternate residents on individual internal medicine rotations (I-IV). While one resident is on internal medicine, the other resident will be on another required or elective learning experience. PGY1 residents may overlap on services with PGY2 residents. When this occurs, preceptors and PGY2 residents will employ a layered learning approach in precepting the PGY1 resident.

PGY2 residents’ schedules are impacted depending on their status as an early commit from the PGY1 program or if they were matched from an external program. Early commit residents are exempt from a formal orientation learning experience, thereby opening access to a third elective learning experience during the residency year. PGY2 residents matching from an external PGY1 program have a three-week, dedicated orientation learning experience. By default these residents receive two elective learning experience choices. However, the possibility of a third elective is available, should the resident decide to shorten the duration of each Internal Medicine experience (IM-I through IV) by one week.

Required Rotations Elective Rotations* Longitudinal Experiences
Orientation** Emergency Medicine Addiction Management
Internal Medicine (I-IV) Informatics
Administration - Clinical Operations
Cardiology Medical Intensive Care Antimicrobial Stewardship
Endocrinology Nephrology Leadership Development
Infectious Diseases Palliative Medicine Literature Evaluation and Education
Population Health Pharmacy Practice/Staffing
Psychiatry/Neurologic Medicine Residency Project

*Elective rotations may change based on availability; new rotations may be created based on resident interests.
**Not required for early commit PGY1 residents

Rotation Overview

The following is a brief overview of required, elective, and longitudinal experiences offered to residents at Good Samaritan TriHealth Hospital. For full details of each learning experience, including goals, objectives, and activities, please refer to the Rotation Manual.

Residency & Department Orientation
Duration: 3 weeks
Available to: Required for all residents (exempt – PGY2 residents early committing from PGY1 program)
Location: GSH Central Pharmacy (primary), various inpatient settings (secondary)
Preceptor: Corey Wirth, PharmD, BCPS; Brittany Lohner, PharmD

A formal orientation program for all incoming residents is scheduled for late June/early July each year. New residents are to attend all corporate orientation dates as required per the terms of employment. This orientation period is designed to introduce residents to the Good Samaritan TriHealth Hospital (GSH) Department of Pharmacy policies and procedures and various practice settings throughout the hospital. During this time, the residents will meet with the Program Director to establish the individual Resident Development Plan. Additionally, the resident will become proficient in use of all pharmacy department software (EPIC, Thera-Doc, etc) and gain a baseline functional knowledge of the medication distribution system of the central pharmacy, IV room, investigational drugs, and services provided to all surgical areas.

Cardiology – Required
Duration: 4 weeks
Location: GSH (primary), various TriHealth facilities (secondary)
Preceptor: Jacob Cannan, PharmD, BCPS

The resident will work with the preceptor to provide safe and appropriate cardiovascular pharmaceutical care as a member of cardiology rounding teams. The primary cardiology team residents serve on is the telemetry and heart failure team. Residents focus on the optimization of cardiovascular care plans and providing in-depth education to patients to maximize their understanding of the care they have been provided. Additional opportunities exist to round with the electrophysiology or interventional cardiology teams. If so desired, residents can coordinate with their RPD to set up an off-site experience at Bethesda North TriHealth Hospital in their cardiovascular intensive care unit.

Emergency Medicine - Elective
Duration: 4 weeks
Location: GSH Emergency Department
Preceptor: Stacey McCoy, PharmD, BCPS

Located in the hospital district of downtown Cincinnati, the Emergency Department at GSH receives approximately 62,000 patient visits per year. While on this learning experience, the resident will focus on emergency medicine and transitions of care. Residents will work with all disciplines present in the ED to ensure appropriate intake of admitted patients. Direct patient care will be provided by way of patient interactions including interviews for medication histories, reconciliations, and education. Residents will work with prescribers to ensure appropriateness of empiric therapies started within the ED. Residents will be ACLS certified and respond to all medical emergencies. Additionally, residents will participate in ED discharge antibiotic surveillance. Any patient discharged from the ED who had a culture drawn during the encounter will be reviewed to ensure appropriate bug-drug match. Projects, presentations, and topic discussions are to be completed as assigned by the rotation preceptor.

Endocrinology – Required
Duration: 4 weeks
Location: GSH Inpatient wards
Preceptor: Tamar Stalvey, PharmD, BCPS

Residents on the endocrinology service will focus on the provision of pharmaceutical care to internal medicine patients with complicated endocrine disorders. While the focus of the learning experience is optimal management of diabetes and its complications, the resident will also gain better understanding of the anatomy and physiology of other endocrine disorders as well as strategies to optimize their pharmacologic management. Disease states typically reviewed/managed include, but are not limited to: thyroid disorders (hypo/hyper), hypercalcemia/ hyperparathyroidism, metabolic bone diseases, pituitary disorders, Cushing syndrome, Addison’s disease, and diabetes insipidus. Opportunity exists to serve as a pharmacist in the endocrinology clinic within Good Samaritan Hospital.

Infectious Diseases – Required
Duration: 4 weeks
Location: GSH inpatient wards, Preferred Lab Partners Microbiology Lab
Preceptor: Colin Fitzgerrel, PharmD, BCPS, BCIDP

The infectious diseases rotation is a 4-week required rotation with three aspects of practice. The resident will provide direct patient care through daily rounding with the infectious diseases medical team. Through this, the resident will refine his/her approach to daily preparation to align oneself with a more narrow focus of practice. Residents will proactively review patients for response to antimicrobial treatment and learn to make adjustments to care plans based on culture data and other patient factors. Four days per week the resident will participate on the Antimicrobial Advisory Team providing antimicrobial stewardship services. Every patient in the hospital receiving any antibiotic will be reviewed for appropriateness of use (indication, dose, duration, etc.). The resident will meet with an infectious diseases physician to discuss patients and leave progress notes with appropriate recommendations. Finally, the resident will spend one half-day per week in the Preferred Lab Partners microbiology lab learning basic functionality of its services and how it relates to pharmacy practice. Additional opportunities exist to advance therapeutic knowledge through topic discussions and case presentations.

Internal Medicine I through IV – Required
Duration: 4-6 weeks
Location: GSH inpatient wards
Preceptor: Corey Wirth, PharmD, BCPS; Tamar Stalvey, PharmD, BCPS

The internal medicine rotations serve as the core of the PGY2 program. Each experience ranges from 4 to 6 weeks, and each experience focuses on medical care of adult inpatients. The primary responsibility of the resident during these learning experiences is to provide pharmaceutical services to the medical team through interdisciplinary rounds. This rotation stresses the importance of accurate application of therapeutics in patient care, and requires the resident to develop skills in proper drug therapy selection, patient monitoring, pharmacokinetics, patient education, drug administration, and delivery of pharmaceutical care. Core content will be covered by way of patient interactions, discussion of reading material and guidelines, and case presentations. Additional responsibilities include ensuring continuation of appropriate care through transitions of patients through the healthcare system. Each individual IM experience (i.e. I through IV) will have a different focus within the underlying themes of the experience, so as to optimally address residency objectives as depicted in the teach/evaluate grid.

Informatics - Elective
Duration: 4 weeks
Location: GSH primary, all TriHealth sites secondary
Preceptor: Howard Cobb, PharmD

The pharmacy informatics rotation is a four-week elective available to PGY1 and PGY2 residents. The goal of this learning experience is to introduce the resident to expand the resident’s understanding of clinical pharmacy management and the medication-use system of TriHealth and its constant evolution by applying pharmacy informatics principles, standards, and best practices. Further, residents will gain basic understanding of the language and concepts of information technology (IT), thereby equipping them to function in the interdisciplinary environment of informatics project teams. Residents will gain insight in the system-level applicability of all pharmacy software and hardware employed at TriHealth.

The resident will have the opportunity to explore common practice areas under the scope of an informatics pharmacist, such as:

  • Computerized Prescriber Order Entry (CPOE) for electronic medication ordering integrated with Electronic Health Records (EHRs) and pharmacy information systems.
  • Clinical decision support tools that bring best practice information and guidelines to clinicians at the time it is needed and rules-based systems for monitoring, evaluating, responding, and reconciling medication-related events and information.
  • Pharmacy information systems that allow electronic validation of medication orders in real time, provide the data flows needed to update both the medication administration record (MAR) and order-driven medication dispensing systems, and support such operational activities as supply chain management and revenue compliance.
  • Automated dispensing cabinets and robotics integrated and/or interfaced with pharmacy information systems.
  • Integrated medication administration management systems that enable bar code medication administration and use of “smart” infusion pumps.
  • Integrated medication surveillance applications for medication incident and adverse event reporting.

Medical Intensive Care – Elective
Duration: 4 weeks
Location: GSH MSICU
Preceptor: Nancy Wuestefeld, PharmD, BCCCP

The critical care rotation is a 4-week elective for PGY2-IM residents. The experience focuses on providing pharmaceutical care to critically ill surgical and medical patients. The resident’s primary responsibility during this learning experience is to provide pharmaceutical knowledge to the interdisciplinary team through daily rounds. The resident will assess each patient before and after rounds to ensure appropriate care is given so as to provide patients with the best possible outcomes. Through this, residents will develop clinical knowledge necessary to gain confidence in recommending appropriate drug therapy in the critical care setting. Advanced understanding of disease states and treatment modalities will be gained through discussions and projects assigned by the rotation preceptor. Additionally, residents will gain familiarity with the management of medical emergencies through participation on the code response team.

Nephrology – Elective
Duration: 4 weeks
Location: GSH
Preceptor: Nancy Wuestefeld, PharmD, BCCCP

Through rounding with the nephrology team, the pharmacy resident will gain better understanding of the anatomy & physiology of the kidneys and the pharmacokinetic effects varying degrees of kidney dysfunction create. Residents will play a key role in the management of fluid and electrolyte imbalance, the proper dosing of renally eliminated medications, and management of parenteral nutrition. Residents will also participate in the care of patients requiring different modalities of renal replacement therapy (e.g. hemodialysis, CRRT, etc.). In addition to clinical responsibilities, a significant portion of this learning experience is dedicated to educational understanding of the anatomy & physiology of the kidneys, including the renin-angiotensin-aldosterone system. Opportunity exists to participate in the care of ambulatory patients at the TriHealth Kidney and Hypertension Center.

Palliative Medicine
Duration: 4 weeks
Location: GSH
Preceptor: Luke Markham, PharmD, BCPS

The resident will gain experience through participation in daily rounds with the Palliative Care Team. Many disease states and settings will be observed, assessed, and managed including end of life care, cancer, trauma, substance abuse and addiction, chronic pain, and hospice care. Education to patients, their caregivers, and clinical staff are crucial elements of the rotation as pain management may have a direct impact on a patient’s overall outcome. Perception of pain, definitions of types of pain, patient safety, and hospital performance as they relate to patient outcomes will be an integral theme of the rotation.

Population Health – Elective
Duration: 4 weeks
Location: GSH (primary), TriHealth Baldwin (Secondary)
Preceptor: Carolyn Vance, PharmD, BCACP

The population health service line is one of the newest endeavors of TriHealth Pharmacy. Residents on this experience will work with the pharmacy manager of population health to address gaps within continuity of care as patients transition from the inpatient to outpatient setting. Residents will spend the majority of their time conducting direct patient outreach to ensure patient accessibility to care, understanding of care, and adherence to medications. Further, residents will analyze provider performance in their management of targeted disease states so as to identify and correct deficiencies of provided care.

Psychiatry & Neurologic Medicine – Elective
Duration: 4 weeks
Location: GSH
Preceptor: TBD. Physician-led experience; Resident Independent.
Coordinated by Colin Fitzgerrel, PharmD, BCPS, BCIDP
Physician Contact: Tammy Wilkins, MD

The psychiatry and neurologic medicine elective rotation provides the resident the opportunity to explore medical management of mental illnesses. The resident will play a vital role in the assessment and modification on psychiatric medication regimens as a member of the interdisciplinary team in the inpatient psychiatry ward at GSH. The resident will participate in daily rounds and psychiatric consultative services throughout the hospital. Additionally, the resident may get the opportunity to observe cognitive behavioral therapy (CBT) groups, the day treatment program, and/or electroconvulsive (ECT) therapy. The resident’s primary responsibility is the optimization of drug therapy in adult patients with mental illnesses, particularly focusing maintaining balance between efficacy and side effects. The resident will discuss patients and/or therapeutic topics with the preceptor daily so as to garner better insight into pharmacy practice in this patient setting.

Longitudinal Learning Experiences

Longitudinal experiences can be either required or elective, and vary in duration from 3 to 12 months.

Addiction Management – Elective
Duration: 3 months
Location: GSH (Primary), BrightView (Secondary)
Preceptor: Stacy McCoy, PharmD, BCPS

The addiction management longitudinal rotation is offered as a two-part experience. First, residents will assist in the management of emergency department patients seeking addiction treatment. In the face of the opioid epidemic, patients are relying on local emergency departments for both acute overdoses and as a resource for when they are ready to seek the help they need to overcome their addiction. Residents will take call from the emergency department when patients with opioid use disorder present and assist with the initiation of Medication-Assisted Therapy, as well as provide patient education regarding available addiction management resources.

The second part of the learning experience is conducted through a partnership with BrightView Health, the Cincinnati-area leader in the provision of comprehensive addiction services. Residents will spend one afternoon a week at a BrightView clinic working alongside physicians and nurse practitioners as they assess patients undergoing medication assisted therapy. Residents will gain better insight into the etiology of addiction, and the medical, psychosocial, and social needs of patients battling the disease.

Administration – Clinical Operations – Required
Duration: August-December or January-May
Available to: PGY1 (required), PGY2 (required)
Location: GSH (primary), various TriHealth (secondary)
Preceptor: Matt Bremer, PharmD

This learning experience is designed to give the resident the necessary experience to excel in areas of drug policy development, medication utilization evaluations, and process improvement and initiation. The resident will be assigned at least on MUE and may be assigned additional projects as needs arise. Residents will participate in medication-use management, departmental clinical operations management, continuous quality assessment of the various programs, and many other activities. As this is a longitudinal experience over the course of the residency year, meetings, projects, and discussions may occur while the resident is on other rotations, or during assigned project/longitudinal weeks.

Literature Evaluation & Education – Required
Duration: July through June
Location: GSH Inpatient Pharmacy
Preceptor: Colin Fitzgerrel, PharmD, BCPS, BCIDP

Throughout the residency year, pharmacy residents will lead journal club discussions each Thursday. This is a required learning longitudinal learning experience for PGY2 residents; PGY1 residents are also incorporated into the Journal Club calendar, but they are not formally evaluated in the context of this longitudinal learning experience. Rather, PGY1 residents are evaluated according to the current dedicated learning experience they are on.

Residents are expected to select appropriate articles for an inpatient pharmacy audience, lead presentations, and engage attendees in thought-provoking discussion. Typically, residents can expect to lead at least one journal club discussion every four weeks on a rotating basis. The goals of this longitudinal experience are to build primary literature evaluation skills, presentation skills, and knowledge of emerging evidence-based medicine.

Pharmacy Practice (Staffing) – Required
Duration: August-June
Available to: PGY1 (required), PGY2 (required)
Location: GSH Inpatient Pharmacy
Preceptor: Stacy McCoy, PharmD, BCPS; Brittany Lohner, PharmD (PiT)

The pharmacy practice/staffing learning experience is a requirement of the PGY2 Program. After the orientation process and once competent in the use of pharmacy software systems, PGY2 residents will provide clinical staffing services up to every third weekend. The PGY2 resident’s weekend staffing responsibilities include:

  • Active participation on interdisciplinary rounds on the internal medicine team on service
  • Provision of clinical pharmacy services to all patients of internal medicine teams off service
  • Management of transitions of care for all internal medicine team patients, focusing on admissions and discharges
  • Coordinating weekend educational activities of the pharmacy intern program
  • Assisting with central pharmacy distributive services when all internal medicine team activities are completed
  • In the absence of a PGY1 resident, the PGY2 resident will respond to all medical emergencies

The learning experience will aid the resident in refining skills required of an independent practitioner, such as communication, collaboration, and therapeutic applications. Staffing preceptors will coordinate feedback through direct and indirect oversight of the resident, through review of resident medical chart documentation (e.g. i-Vents), and through discussion of weekend Point Contacts (see chart above). Residents are permitted to seek guidance from preceptors and weekend point contacts at any time. Hours worked on weekends as part of the longitudinal pharmacy practice experience are in addition to those required for the current rotation the resident is on, but the ASHP Duty Hours policy must be adhered to.

Residency Project – Required
Duration: July-June
Location: GSH
PGY2 Residents – Corey Wirth, PharmD, BCPS plus project-specific advisors

Each resident is required to conduct a year-long project. The project can be of any subject of particular interest to the resident, but it must be submitted to the Institutional Review Board (IRB) for approval. Examples of projects include original research or expansion of pharmacy service lines. Medication Use Evaluations (MUEs) are not an acceptable form of residency project as they are otherwise assigned throughout the residency year. Potential research projects will be generated by the Residency Advisory Committee, but the resident is not required to choose from this list if they have a suitable project of his/her own. The resident will be assigned an advisor based on the subject matter of the project. Residents will choose their research topic during the first month of the residency program and submit it for review by the IRB no later than September. Data collection will begin as soon as IRB approval is gained. If adequate progress has been made, the resident is encouraged to submit his/her poster and current findings for presentation at the ASHP Midyear Clinical Meeting. The resident is required to formally present the conclusions from the research project at the Great Lakes Residency Conference in the spring. The resident is required to write a manuscript of the research project suitable for publication to graduate from the residency program.

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