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Rotations (PGY-2)

Atlantic Health System’s specialty pharmacy residency programs feature the following rotations: 

PGY-2 Critical Care

PGY-2 Emergency Medicine

Required

Required

Cardiothoracic Surgery

EM Academic

Emergency Medicine

EM Community

Infectious Diseases

EM Infectious Disease

Medical Intensive Care I

EM Overnight

Medical Intensive Care II

EM Urgent Care

Neurosciences Intensive Care

Orientation/Resuscitation

Transitional Critical Care

Pediatric Intensive Care

Trauma/Surgical Intensive Care I

Toxicology

Trauma/Surgical Intensive Care II

Trauma/Surgical Critical Care

Electives

Electives

Pediatric Intensive Care

Cardiology

Teaching & Learning (Rutgers)

Medical Intensive Care

Toxicology

Transitions of Care

Longitudinal

Longitudinal

Clinical Staffing

EM Pharmacy Practice

Practice Management

Pre-Hospital care

Research

Research

 

PGY-1 Critical Care

Required Rotations

Cardiothoracic Surgery

The Cardiothoracic Surgery is a one-month rotation at Morristown Medical Center, known for having the largest cardiac surgery program in New Jersey. The rotation consists of a 14-bed CPACU and 10-bed CVICU that services post-operative cardiac and thoracic patients. The resident will work with a multidisciplinary team that includes but is not limited to cardiac surgeons, intensivists, physician assistants, nurse practitioners, respiratory therapists, and case managers. The resident will be responsible for identifying medication therapy issues and developing pharmacotherapy plans for patients following coronary artery bypass surgery, valve replacement, Maze procedure, and many others.

Emergency Medicine

Emergency Medicine at Morristown Medical Center is a month-long rotation where the CC resident will be exposed to various critical disease processes at the point of entry to the hospital. Through code response (cardiac arrest, STEMI, stroke, trauma) and patient care during critical procedures (RSI, moderate sedation, arrhythmia management) the resident will understand and embody the role of the pharmacist at the bedside. In addition, an emphasis will be made on the importance of transition of care management between the Emergency Department and ICU environments. There will be opportunities to provide education to other disciplines in an academic emergency department that is responsible for the training of emergency medicine physicians, nurses, and pharmacists.

Infectious Diseases

The infectious diseases rotation will take place at Overlook Medical Center or Morristown Medical Center. Residents will follow patients on the Infectious Diseases Consult Service and participate in the daily rounds with the ID team. During this rotation, residents will learn evidence- and guideline-based pharmacotherapeutic approaches for the treatment of common infectious disease conditions and will also perform pharmacokinetic monitoring of antimicrobials.

Medical Intensive Care I

The Medical Intensive Care I learning experience is a one-month rotation at Overlook Medical Center that focuses on establishing the core concepts of critical care pharmacotherapy.  The resident rounds in a 20-bed MICU with an academic teaching team led by a pulmonary critical care attending.  The resident guides the team in drug selection and dosing, antimicrobial management and stewardship, therapeutic drug monitoring, and drug information.  The resident gains exposure to a wide variety of disease states and topics including sepsis and septic shock, acute respiratory failure (asthma, COPD, acute respiratory distress syndrome), decompensated heart failure and cardiogenic shock, substance withdrawal syndromes, hemodynamics, and many others.  MICUI directs the resident to key landmark trials in critical care medicine and prepares the resident for the advanced MICUII learning experience.

Medical Intensive Care II

Medical Intensive Care II emphasizes the understanding and management of problems specifically related to critically ill medical patients. Identification of patient problems and application of clinical therapeutics to the critically ill patient will be stressed. Specific topics discussed include hemodynamic and physiologic monitoring, pharmacokinetic monitoring and infectious problems in critically ill patients.  During the critical care rotation, residents will round with the medical team in a 10-bed MICU at Morristown Medical Center.

Neurosciences Intensive Care

The Neurosciences Intensive Care (NeuroICU) rotation is a one-month learning experience at Overlook Medical Center, the flagship site of the Atlantic Neuroscience Institute and a designated Comprehensive Stroke Center.  Residents help manage pharmacotherapy for a spectrum of critically ill neurologically injured patients ranging from acute ischemic stroke, ruptured brain aneurysms, intracranial hemorrhage, status epilepticus, post-operative neurosurgical oncology patients and many others.  The resident works collaboratively with a multidisciplinary team of neurosurgeons, neurointensivists, advanced practice providers, and nurses to deliver the highest quality care in our renowned NeuroICU.  Residents will focus on drug selection and dosing, identification of drug interactions, therapeutic drug monitoring, and management of drug-related adverse events.

Transitional Critical Care

Transitional critical care is a one-month learning experience at Overlook Medical Center in the medical intensive care unit that prepares the resident for independent practice.  During the final month of training, the resident manages patients on the MICU teaching service without pre- or post-rounding and responds as the sole pharmacist to code blue and code stroke situations.  Preceptors are available for questions or consults, but are not routinely following patients on a daily basis.  The goal is to simulate an environment where the resident becomes accustomed to making decisions on their own.  The resident is also expected to prepare and organize educational topics for medical residents and learners on rotation with the MICU multidisciplinary team.

Trauma/Surgical Intensive Care I

Surgical Intensive Care Unit I (SICUI) rotation is a month-long learning experience at Morristown Medical Center. The SICU is a 22-bed unit for critically ill trauma and surgery patients. The multidisciplinary team consists of a trauma attending, surgical resident, emergency medicine resident, clinical pharmacy specialist, bedside nurse, and respiratory therapist. The resident will be exposed to a wide variety of disease states commonly encountered in the adult SICU setting and will become familiar with the pharmacokinetics/pharmacodynamics of the drugs used in this setting. Common disease states in which residents will be expected to gain proficiency through literature review, topic discussion, and/or direct patient care experience may include, but are not limited to traumatic brain injury/intracranial hemorrhage, surgical antimicrobial prophylaxis, surgical infectious complications, nutrition and fluid/electrolytes management.

Trauma/Surgical Intensive Care II

Trauma/Surgical Intensive Care II (SICUII) rotation is a month-long learning experience at Morristown Medical Center SICU. The resident will continue to be a part of the multidisciplinary team caring for trauma and surgery patients. This rotation will have a larger focus on nutrition in critically ill patients, spending time with SICU dietitian and designing and redesigning nutrition regimens in those patients. 

Elective Rotations

Pediatric Intensive Care

This rotation is designed to provide residents with an understanding of disease states and conditions commonly seen in the pediatric intensive care unit.  Emphasis will be placed on the therapeutic management of pediatric intensive care patients and the unique pharmacological/pharmaceutical requirements of these patients.  This rotation will also provide an opportunity to participate in pediatric emergencies as well as in the management of enteral and parenteral nutrition.  

Toxicology

This month-long learning experience is designed to build upon prior rotation experiences and develop new skills in toxicology through the care of toxicologic patients at the NJ Poison Control Center (PCC), bedside care at MMC ED, and topic discussions. The resident will also be exposed to the role of the PCC in the healthcare and the community. Emphasis will be placed on physical exam and patient evaluation, pharmacodynamics and toxicokinetics, supportive care, and antidote therapy.

Teaching and Learning (Rutgers)

The Teaching and Learning Certificate Program affiliated with Rutgers University Ernest Mario School of Pharmacy is a longitudinal experience designed to educate pharmacy professionals on teaching styles and methodology related to multiple facets of didactic and clinical teaching.  Residents attend lectures or seminars with Rutgers faculty on a monthly basis.  They are expected to create their own teaching philosophy, design a rotation, and serve as the primary preceptor for a pharmacy student at their respective sites.  The Teaching and Learning program is an excellent opportunity to network with other pharmacy residents and pharmaceutical industry fellows from across the state of New Jersey.  Residents are encouraged to participate unless they have received a teaching certificate from a different program during their PGY-1 year.

Longitudinal Rotations

Clinical Staffing

The PGY-2 Critical Care Clinical Staffing rotation is a longitudinal learning experience at Overlook Medical Center consisting of both clinical and operational responsibilities every other weekend throughout the year.  The resident participates in order verification and dispensing activities during the beginning of the program.  As the resident progresses, they prioritize weekend clinical duties including rounding with the medical ICU team and providing pharmacy coverage for Code Blue and Code Stroke situations.  The resident also performs the role of the Clinical Surveillance Pharmacist (CSRP) on weekends by reviewing OMC’s clinical monitoring tool to identify opportunities for therapeutic drug monitoring and other clinical interventions.   

Practice Management

Practice Management is a longitudinal learning experience designed to hone the resident’s skills beyond direct patient care.  Residents will actively participate in the Critical Care Committee at Overlook Medical Center, complete a medication use evaluation, present a formal lecture for medical residents during their education series, and prepare and present a one-credit hour ACPE-approved continuing education presentation on a critical care topic.  As a result of these experiences, residents will have the opportunity to contribute to critical care practice both within and outside Atlantic Health System.

Research

The research learning experience provides an opportunity for the resident to complete a clinical research project related to critical care medicine.  The resident will utilize research skills obtained from PGY-1 residency training to take the lead role executing a longitudinal research project from start to finish.  The resident will work with at least one pharmacy research advisor who will guide them through the process of completing the project from study design, Institutional Review Board submission, data collection/analysis, and manuscript preparation.  Resident research will be presented locally as well as at the ASHP Midyear Clinical Meeting, Eastern States Residency Conference, and other professional meeting platforms (if applicable).  By the end of the residency year, the resident is expected to have a completed research manuscript in submission-ready form for peer-reviewed publication.     

 

PGY-2 Emergency Medicine Rotation

Required Rotations

Emergency Medicine Academic

A layered learning model will be applied where the EM resident acts as the “senior” resident reporting to the EM pharmacist preceptor. There will be either a PGY-1 resident or student assigned to the EM resident with the goal to develop a teaching style and gain experience as a preceptor.

Emergency Medicine Community

This emergency medicine pharmacy rotation at Overlook Medical Center Summit and Union campus is to provide the PGY-2 resident the opportunity to work as part of the interdisciplinary team in a community teaching hospital and a satellite Emergency Department. The 48-bed and 20-bed emergency departments for the Summit and Union campus respectively, services a wide range of patient populations from pediatrics to adults and specializes in neurological care including stroke management.  The purpose of this rotation is to allow the resident to further develop and enhance pharmacotherapeutic skills required for provision of care in emergent treatment of patients.  In addition, this rotation will focus on strengthening independence for the resident to manage all clinical and operational responsibilities.  

Emergency Medicine Infectious Disease

This month-long rotation will focus on the care of patients presenting to the ED with infectious complaints. Emphasis will be placed on designing appropriate empiric antimicrobial regimens based on most common pathogens and local susceptibility information. The EM resident will continue to be responsible for code response and will also focus on monitoring patients that are presenting as septic.

Emergency Medicine Overnight

The goal of this rotation is to provide experience with temporal differences when working in the Emergency Department. The resident will be prepared to manage time and schedule to better prepare for expansion in the Emergency Department workforce into this shift schedule.

Emergency Medicine Urgent Care

The focus of this rotation will be exposure to solidify learning on non-emergent conditions that may present to the emergency department. Topic discussions will reinforce knowledge about medical conditions that will most likely not require hospital admission but will require medication therapy.

Orientation/Resuscitation

During this first rotation encompassing the first two months of residency, the Emergency Medicine resident will become familiar with policies and procedures that govern medication utilization at Morristown Medical Center. While orienting to the hospital, a focus will be placed on response to emergency situations and workflow in the Emergency Department. This will prepare the resident for staffing in the Emergency Department.

Pediatric Intensive Care

This rotation is designed to provide residents with an understanding of disease states and conditions commonly seen in the pediatric intensive care unit. Emphasis will be placed on the therapeutic management of pediatric intensive care patients and the unique pharmacological/pharmaceutical requirements of these patients. This rotation will also provide an opportunity to participate in pediatric emergencies as well as in the management of enteral and parenteral nutrition.

Toxicology

This month-long learning experience is designed to build upon prior rotation experiences and develop new skills in toxicology through the care of toxicologic patients at the NJ Poison Control Center (PCC), bedside care at the Morristown Medical Center Emergency Department , and topic discussions. The resident will also be exposed to the role of the Poison Control Center in the healthcare and the community. Emphasis will be placed on physical exam and patient evaluation, pharmacodynamics and toxicokinetics, supportive care, and antidote therapy.

Trauma/Surgical Critical Care

Surgical Intensive Care Unit (SICU) rotation is a month-long learning experience at Morristown Medical Center. The SICU is a 22-bed unit for critically ill trauma and surgery patients. The multidisciplinary team consists of a trauma attending, surgical resident, emergency medicine resident, clinical pharmacy specialist, bedside nurse, and respiratory therapist. The resident will be exposed to a wide variety of disease states commonly encountered in the adult SICU setting and will become familiar with the pharmacokinetics/pharmacodynamics of the drugs used in this setting. Common disease states in which residents will be expected to gain proficiency through literature review, topic discussion, and/or direct patient care experience may include, but are not limited to traumatic brain injury/intracranial hemorrhage, surgical antimicrobial prophylaxis, surgical infectious complications, nutrition and fluid/electrolytes management.

Elective Rotations

Cardiology

The cardiology rotation is designed to give residents an opportunity to experience various cardiology settings from the outpatient clinic (heart failure) to critical care areas (CCU, CVICU, cardiothoracic ICU). Responsibilities of this rotation include, but are not limited to, daily attending rounds in the CCU, identification and resolution of any medication-related issues, evaluation of medical regimens for appropriateness and patient counseling.

Medical Intensive Care

This rotation emphasizes the understanding and management of problems specifically related to critically ill medical patients. Identification of patient problems and application of clinical therapeutics to the critically ill patient will be stressed. Specific topics discussed include hemodynamic and physiologic monitoring, pharmacokinetic monitoring and infectious problems in critically ill patients.  During the critical care rotation, residents will round with the medical team in a 10-bed MICU at Morristown Medical Center.

Transitions of Care

This acute care rotation will demonstrate the pharmacist’s impact on improving outcomes, reducing readmissions and improving patient quality of life. The resident will practice transitioning the patient to and from different settings for a core set of disease states, which will include, but not limited to cardiac, pulmonary, endocrine and infectious diseases. He or she will also have an opportunity to manage patients independently while working with physicians, nurses and other medical providers. Activities will include obtaining medication history, monitoring and optimization of therapy during hospital stays, reviewing medication reconciliation on discharge, assisting with access to medications, and providing patient education on medications and disease states.

Longitudinal Rotations

Emergency Medicine Pharmacy Practice

The staffing component of the residency is completed by staffing in the ED and practicing from the ED pharmacy satellite. The residents will gain proficiency in distribution skills, incorporation of clinical services and development of personnel management skills. They also will develop insight into the operations, policies and procedures of acute care facilities. Residents will be scheduled to staff every other weekend at Morristown Medical Center.

Pre-Hospital Medicine

In conjunction with Atlantic Mobile Health, the Emergency Medicine resident will participate in the treatment of patients by paramedics. The objective will be for the resident to become familiar with protocols and medication utilization in the pre-hospital environment.

Research

The Emergency Medicine resident will design, administer, and lead the research team to complete a project that will add to current literature on medication utilization in the Emergency Department. Research time will be assigned in December for time intensive tasks. A medication utilization or disease state review may also be completed during the residency year