Program Purpose Statement
The PGY2 Critical Care pharmacy residency program builds on Doctor of Pharmacy (PharmD.) education and PGY pharmacy residency programs to contribute to the development of clinical pharmacists in critical care practice. The PGY2 critical care residency provides residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings. Residents who successfully complete an accredited PGY2 critical care pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification.
- Develop into an independent, competent, critical care practitioner with the ability to work with a multidisciplinary team to provide pharmaceutical care to patients in a range of critical care settings.
- Develop the knowledge and clinical skills to provide evidence-based pharmacotherapy recommendations for critically ill patients.
- Formulate a research question, develop methods and complete a short-term research project.
- Develop teaching and communication skills necessary to provide education to multidisciplinary critical care providers and trainees.
- Develop the essential skills necessary of a practice leader.
ICU Training Site
The Hospital of the University of Pennsylvania (HUP) Intensive Care Units (ICUs) are fully staffed by registered nurses, respiratory therapists, clinical nutritionists, pharmacists, medical students, residents, advanced practitioners, and fellows under the supervision of the attending medical physicians. There are currently 122 adult ICU beds within our CTSICU, NICU, SICU, MICU and CCU intensive care units. HUP is also home to a 45 bed ED, 17 bed “fast track” care area, and 17 bed ED Observation Unit with approximately 61,000 patient visits per year. HUP's reputation as a world leader in medical research and clinical care attracts the highest quality medical specialists from around the world. The supportive and collaborative environment encourages physicians and staff to continuously seek new ways to improve the quality and length of life for all patients.
Required Rotations (36 weeks)
- Orientation – (four weeks)
- Consists of hospital and departmental training including pharmacokinetic and code training. BLS and ACLS will be scheduled during this time if not already certified. The resident will also be trained on the pharmacy teams covering the intensive care units as this is where their primary weekend staffing responsibility will fall.
- Medical ICU – (eight weeks)
- The medical intensive care unit consists of a 24-bed ICU and a separate 8-bed ICU, both under the direction of the Pulmonary, Allergy, and Critical Care medicine division. The 24-bed unit is divided into two teams, consisting of multidisciplinary practitioners including physicians, nurses, clinical dieticians, pharmacists, and physical therapists. The 8-bed unit is a non-teaching service managed by advanced practice providers. The resident will participate in daily patient care rounds on one of the teams with the goal to develop proficiency in proactively solving problems and communicating effectively with all members of the healthcare team.
- Surgical ICU – (four to eight) weeks
- The surgical ICU consists of 24 beds staffed by two multidisciplinary teams. The resident will be assigned to one team with the primary focus of optimizing pharmaceutical care for those patients. One rotation (4 weeks) in the HUP SICU is required. If the elective Trauma SICU experience (4 weeks) at PPMC is not selected, an additional 4-week HUP SICU rotation is required. Common disease states encountered in the SICU include: necrotizing fasciitis, skin and soft tissue infections, wound infection, pancreatitis, intra-abdominal infection, sepsis, alcohol withdrawal, CRRT, and pain, agitation, and delirium.
- Cardiac Care Unit – (four weeks)
- The Cardiac Care Unit consists of a 12-bed ICU under Cardiovascular Medicine. The unit is divided into two teams, Heart Failure and General Cardiology, with two attending physicians, but one set of fellows and residents. The resident will participate in daily patient care rounds with both teams with the goal to effectively and efficiently provide recommendations to the teams. Common disease states include cardiogenic shock, ACS, VAD, arrhythmias, valvular disease, tamponade, ablations, impella devices, and balloon pumps.
- Emergency Department – (four weeks)
- The Department of Emergency Medicine provides clinical care in many exciting and diverse venues, offering a remarkable breadth and depth of care for our patients. Its clinical services include disaster preparedness, emergency medical services, emergency ultrasound, hyperbaric medicine, observation medicine, resuscitation and critical care, toxicology, quality improvement and safety, trauma, and travel medicine. There is a high level of acuity in the HUP ED with a high admission rate to the hospital. The department has developed prioritized care for patients with cardiologic, neurologic, oncologic and traumatic emergencies. The resident will work parallel with a preceptor with an expectation to take over the responsibility of the primary pharmacist towards the end of the rotation.
- Heart and Vascular ICU – (four weeks)
- The Heart and Vascular ICU consists of 32 beds fully staffed by two multidisciplinary teams. The resident will be responsible for rounding and providing pharmaceutical care to one of the teams as assigned by the preceptor. Common procedures and disease states encountered in the HVICU include: valvular replacement and repair, CABG, cardiogenic shock, acute respiratory failure, VA and VV ECMO, VAD implantation, temporary ventricular assist devices, IABP, heart and lung transplant, endocarditis, aortic dissection, and heart failure.
- Neurosciences ICU – (four weeks)
- The NICU at HUP is a 22-bed ICU staffed by two fully supported teams. The resident will be responsible for rounding and providing pharmaceutical care to patients on one of the two teams. Common disease states encountered in the NICU include: subarachnoid hemorrhage, ischemic stroke, intracranial hemorrhage, status epilepticus, intracranial hypertension, CNS infections, and neurosurgical post-operative care.
- Leadership, Medication Use Policy, and Safety – (longitudinal)
- This rotation is based in the Center for Medication Use Policy (CMUP) which is staffed by 3 Drug Information Specialists and a Medication Safety Pharmacist. The resident will be responsible for participating in the submission of medication errors and adverse events, and assisting in the drafting and review of medication use policies, guidelines, and order sets relating to critical care where applicable. The resident will also review assigned safety nets and/or participate in a RCA if possible, with the potential to assist with a critical care related medication safety project.
Electives (12 weeks)
Depending on the elective, there are opportunities to have a brief two-week elective experience to gain exposure to a topic. The resident may also repeat any of the required rotations as an elective experience.
- Nutrition Support Services (*Highly encouraged unless PGY1 rotation exposure)
- Solid organ Transplant (Heart, Lung, Liver, or Kidney)
- Infectious Diseases (General ID, Oncology/Transplant ID, or Stewardship)
- Trauma Surgical ICU @ PPMC (**If chosen, not required to complete 8 weeks in the SICU)
- Pain & Palliative Care
The resident will have the opportunity participate in the following supplementary activities throughout the year and will work with their RPD and/or advisor to set up these activities:
- Conduct a Medication Use Evaluation and subsequent quality improvement plan
- Conduct a longitudinal research project including all steps of the research method and completion of a research manuscript
- Assist in the guideline review process of a critical care related institutional guideline
- Prepare and present presentations to the pharmacy department including: Therapeutics Conferences, Grand Rounds continuing education presentation, Critical Care conferences, and others as assigned
- Provide weekend staffing coverage to an ICU practice area
- Assist in the mentoring of pharmacy residents, students and staff
- Serve as primary preceptor for a PGY1 resident Therapeutics Conference Presentation
- Serve as primary preceptor to a PGY1 resident for the clinical on call program
- Provide in-service education to nursing, pharmacy and physician staff as needed
- Participate in department, hospital and clinical unit committees as assigned and interest dictates
- Attend critical care conferences including pulmonary/surgical critical care, cardiothoracic/cardiology and specialty conferences as assigned by the preceptor
- Attend the PGY2 CC RAC meeting to provide monthly resident progress update and serve as secretary
- Attend the Mid-year clinical meeting, and SCCM Congress (optional) as funding allows
- Submit abstract for poster presentation (research or case report) to SCCM or other national meeting (optional)
- Present SCCM journal club or other national journal club (ie. Neuro Critical Care Society, etc.) during residency year (optional)
- Participate in writing a review article (optional)
- Instruct pharmacy students in didactic coursework at the University of the Sciences in Philadelphia (optional)
- Participate in the Teaching Certificate Program at USP (optional)
- Serve as primary preceptor for an IPPE or APPE student rotation (optional)
Julia Weiner, PharmD, BCPS
Residency Program Director, Critical Care
Clinical Pharmacy Specialist, Surgical Critical Care
Hospital of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104
Candidates interested in the program should submit the following to Phorcas:
- Academic transcripts from your School of Pharmacy
- Letter of intent which addresses the following:
- Why you have chosen the Hospital of the University of Pennsylvania,
- Why you have chosen to pursue specialized training in critical care, and
- Your PGY2 CC residency as well as short & long-term career goals.
- Curriculum vitae
- Three letters of recommendation should be submitted through the Phorcas system from the following:
- Clinical rotation preceptor, preferably from an ICU rotation
- PGY1 Residency Program Director
- Other clinical preceptor
All required application materials should be submitted to Phorcas by the deadline of January 4th , 2021.