Pharmacy residency

Administration

The administration rotation will provide residents with the opportunity to become familiar with policy development and review, the role of the pharmacy leader in ensuring patient safety, management techniques and budgeting. Residents will participate in various meetings on organizational and departmental levels. They will also work with the pharmacy director at Atlantic Health Morristown Medical Center or Atlantic Health Overlook Medical Center.

Infectious Diseases

The infectious diseases rotation will take place at Atlantic Health Overlook Medical Center or Atlantic Health 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.

Internal Medicine

The internal medicine rotation is available at Atlantic Health Morristown Medical Center or Atlantic Health Overlook Medical Center. Residents will round with the Medical Education team consisting of a faculty internist, PGY-2 or PGY-3 “senior resident,” two interns, and medical students. Residents will expand their knowledge by identifying the etiology, pathophysiology, and evidence-based treatments of common diseases such as diabetes, venous thromboembolism, acute coronary syndrome, heart failure, chronic obstructive pulmonary disease, and atrial fibrillation.

Advanced Heart Failure

This rotation is designed to give residents an opportunity to experience various patient care settings from the outpatient heart failure clinic to critical care areas (CCU, CVICU). Commonly encountered patient populations include heart failure with reduced ejection fraction, heart failure with preserved ejection fraction, ischemic and non-ischemic cardiomyopathy, genetic and alcohol induced cardiomyopathy, cardiac amyloidosis, cardiac sarcoidosis, cardiogenic shock patients, mechanical circulatory support patients (IABP, Impella, LVAD, ECMO), pulmonary hypertension patients, and pre and post heart transplant patients. Responsibilities of this rotation include patient chart review of inpatients on the advanced heart failure service, updating of iVents on patients on high-risk medications, heart transplant evaluations, identification and resolution of any medication-related issues, evaluation of medical regimens for appropriateness and patient counseling. Upon completion of this rotation, residents will better understand the role clinical pharmacists play in the management of advanced heart failure.

Ambulatory Care

The ambulatory care rotation is designed to introduce pharmacy residents on the role of the pharmacist in an outpatient clinic. The residents are empowered to treat and appropriately triage the most complex chronic and acute illness presented by ambulatory patients, including those with multiple disease states and serious complications. This care is delivered within the context of a long-term health care partnership with the patient that emphasizes health improvement, wellness, and disease prevention.

Antimicrobial Stewardship

The purpose of the antimicrobial stewardship rotation is to further develop and enhance pharmacotherapeutic knowledge and skills in patients with infectious diseases. The resident will be responsible for daily monitoring/evaluating patients that are filtered through various alerts and reports, targeting specific antimicrobial stewardship tasks. These tasks may include the following: de-escalation of therapy, management of specific infectious syndromes, pharmacokinetic monitoring, monitoring restricted antimicrobial agents, multi-drug resistant organisms, drug shortages, etc. The resident will contact the primary team or infectious diseases physician to discuss recommendations for therapy modifications. Specific disease state topics will be discussed based on the patients being monitored. In addition, the resident will complete a retrospective evaluation of management of a specific disease state or utilization of a specific antimicrobial agent, as needed.

Cardiac Surgery ICU

The purpose of the cardiothoracic surgery rotation is to develop the resident’s skills in the identification and resolution of pharmacotherapeutic issues in care of cardiothoracic surgery patients. The resident will be responsible for identifying and resolving medication therapy issues for patients and will work toward assuming care of all patients on two units throughout the learning experience. The resident will actively participate in daily multidisciplinary rounds in CPACU and CVICU at Atlantic Health Morristown Medical Center.

Cardiac Care Unit

The cardiology rotation affords experiential education in the provision of clinical pharmacy services for patients on the adult cardiology service at Atlantic Health Morristown Medical Center. This includes focused time in the coronary care unit, heart failure unit, and general cardiology telemetry units. The resident will work closely with the preceptor to provide full clinical services for patients admitted to the cardiology service. These services include participation in physician patient care rounds, assessment of and recommendations for optimizing patient drug therapy, providing drug information to the health care team, and providing patient education when necessary.

Emergency Medicine

Residents will have the opportunity to apply and expand pharmacotherapeutic knowledge through a variety of ways in an ED setting. They will be responsible for collecting and assessing patient information, reviewing medication orders, performing medication reconciliation, patient counseling, evaluating antimicrobial culture results, providing drug information and making recommendation to the ED team, reporting adverse drug events, acting as a liaison between pharmacy and the ED, and participating in a variety of patient codes.

Informatics

This elective rotation focuses on healthcare analytics. The resident is exposed to considerations of managing patient populations in inpatient, outpatient, community, population health, and managed care points of view. At the conclusion of the rotation, the resident will be comfortable working with post-adjudicated healthcare claims, financial data, and Electronic Medical Record extracts to discover ways in which to care better for our patient population.

Internal Medicine II

During this rotation, the resident will be provided more independence, while improving their skills regarding pharmacotherapeutic optimization of various disease states in the inpatient acute care setting. The resident may also have the opportunity to co-precept students on this rotation.

Neonatology

The overall goal of this one-month rotation in neonatal critical care is to enhance residents' competency in neonatal pharmacotherapy and to develop a philosophy of practice regarding the role of the clinical pharmacist as a member of the health care team. Residents will participate in the drug use decision-making process, develop clinical pharmacokinetic skills needed to ascertain the unique pharmacokinetic characteristics of this patient population, and refine nutritional knowledge specific to the neonatal patient.

Research Project

The research project provides an opportunity to complete a major research project and prepare a manuscript for publication during the one-year program. Residents will work with the residency advisor(s) and learn essential key points of research design. Last year's research projects: Evaluation of Atlantic Health patient first hyperkalemia targeted Med Warning implementation; Impact of crystalloid fluid choice in patient with sepsis; Impact of updated heparin algorithm layout/boluses on supratherapeutic aPTTs; Impact of reclassification of Serratia marcescens as a low-risk AmpC pathogen on treatment selection and outcomes in bacteremia; Analgesia-first sedation practice update; Safety and efficacy of desmopressin for intracranial hemorrhage associated with antiplatelet use.

Pharmacy Operations

According to American Society of Health System Pharmacists guidelines, each resident is required to complete a “staffing” component of the residency. 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 Atlantic Health Morristown Medical Center or Atlantic Health Overlook Medical Center.

Pharmacy Practice Management

Pharmacy practice management is a longitudinal rotation in which the resident works closely with the pharmacy leadership team. This rotation will focus on participation in the system-wide P&T committee, including meeting preparation/documentation and drug monograph development; participation in medication safety initiatives, such as ISMP best practices; and participation in IPPE preceptorship.

Cardiac Surgery

The Cardiac Surgery rotation is one-month in duration at Atlantic Health 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 Atlantic Health 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 Atlantic Health Overlook Medical Center or Atlantic Health Morristown Medical Center. Residents will follow patients that qualify for antimicrobial stewardship review and participate in interdisciplinary management of various infections. During this rotation, residents will build upon evidence- and guideline-based approaches for the management of common infectious disease conditions and will also perform pharmacokinetic monitoring of antimicrobials.

Medical Intensive Care I

The MICU I rotation at Atlantic Health may be fulfilled at either the 30-bed MICU at Atlantic Health Overlook Medical Center or 12-bed MICU at Atlantic Health Morristown Medical Center. The resident will serve as the pharmacy representative for the academic teaching service in the medical ICU (MICU). The resident will participate as an active member of the multidisciplinary team caring for critically ill patients in the MICU. Residents are responsible for providing evidence-based, patient-centered pharmacotherapy recommendations, answering medication information questions, and participating in emergency response.

Medical Intensive Care II

The Medical Intensive Care Unit II (MICUII) rotation is a secondary learning experience to the MICUI rotation and may be fulfilled at either the 30-bed MICU at Atlantic Health Overlook Medical Center or 12-bed MICU at Atlantic Health Morristown Medical Center. The resident will serve as the pharmacy representative for the academic teaching service in the medical ICU (MICU). The resident will participate as an active member of the multidisciplinary team caring for critically ill patients in the MICU. Residents are responsible for providing evidence-based, patient-centered pharmacotherapy recommendations, answering medication information questions, and participating in emergency response.

Cardiology/Cardiac Intensive Care

The cardiology rotation is designed to give residents an opportunity to experience various cardiology and cardiac critical care areas like heart failure and the cardiac care unit (CCU). Responsibilities of this rotation include, but are not limited to, attending rounds daily in the CCU, identification and resolution of any medication-related issues, evaluation of medical regimens for appropriateness and patient counseling. Upon completion of this rotation, residents will better understand the role clinical pharmacists play in the management of acute care cardiology.

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.

Clinical Staffing

The PGY-2 Critical Care Clinical Staffing rotation is a longitudinal learning experience at Atlantic Health 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.

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 Atlantic Health 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.

Emergency Medicine I

This is a month-long rotation at Atlantic Health Morristown Medical Center. The resident will be a part of the multidisciplinary team that cares for patients in the emergency department. The primary focus of this rotation will be critically ill patients. Residents are expected to take an active role in the care of critically ill patients. Medical emergencies will include but, are not limited to, stroke, MI, cardiac arrests, and trauma alerts. The goal of this rotation is to introduce the resident to the resuscitation workflow and patient population with a focus on collection and analysis of patient information.

Emergency Medicine II

This month-long rotation will focus on the care of critically ill patients and those presenting to the ED with infectious complaints. The primary focus of this rotation will be critically ill and infected patients. Residents are expected to take an active role in the care of critically ill patients. Medical emergencies will include but, are not limited to, stroke, MI, cardiac arrests, and trauma alerts. The goal of this rotation is to reinforce and build upon infectious disease concepts on empiric treatment and application to the ED workflow and patient population with a focus on collection and analysis of patient information.

Emergency Medicine III

The focus of this month-long rotation will be exposure to solidify learning on non-emergent conditions that may present to the emergency department. The goal of the topics discussed on this rotation is to reinforce and build upon an understanding of outpatient treatments and the care of patients that will be discharged from the emergency department. The overall goal of the rotation is to allow the resident to practice nearly independently in preparation for completion of the residency.

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 Atlantic Health 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.

Cardiology/Cardiac Intensive Care

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 Atlantic Health Morristown Medical Center.

Neurosciences Intensive Care

The Neurosciences Intensive Care (Neuro-ICU) rotation is a one-month learning experience at Atlantic Health 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 Neuro-ICU. Residents will focus on drug selection and dosing, identification of drug interactions, therapeutic drug monitoring, and management of drug-related adverse events.

Emergency Medicine Practice Management

Practice management is a year-long longitudinal rotation that encompasses a variety of clinical, operational, and academic activities to build the resident's skill set. The resident will work closely with preceptors to develop and complete the following: i) Formal didactic lecture presented to the RN Hire Learners, ii) Formal didactic lecture presented to the Emergency Medicine Program's conference day, and iii) medication use evaluation. Additionally, the resident will provide service to the Atlantic Health Morristown Medical Center Sepsis Committee, attend Critical Care Pharmacy monthly meetings, review adverse event reports related to the Emergency Department, and may provide service to other committees based on institutional need. The resident may also participate in longitudinal assignments including development of drug monographs, clinical practice guidelines, or multidisciplinary education.

Medication Use Evaluation (MUE)

The MUE rotation is a 6-month longitudinal rotation that will have the resident plan, develop, and complete an administrative project. The goal of the project will be to analyze the use of medication(s) in the treatment of disease to try to improve outcomes for our patient population