Program Purpose Statement
The PGY2 Pain Management and Palliative Care Pharmacy Residency Program at the Hospital of the University of Pennsylvania (HUP) is designed to develop PGY1 Pharmacy Residency graduates into clinical specialists who can successfully manage all aspects of pharmaceutical care for patients with pain management and palliative care needs. Graduates of this rigorous program will be well equipped to care for patients with complex comorbidities needing acute and chronic pain management, palliative and hospice care, and patients with comorbid opioid use disorder in both inpatient and ambulatory settings.
Program Description
This residency is a full-time practice commitment and is 12 months in duration. The program offers comprehensive learning experiences in all types of pain. Residents will serve as an integral part of the interdisciplinary care teams, ensuring the safe and effective use of all medications, educating patients and caregivers, and facilitating smooth transitions between patient care settings. Residents will be able to make complex therapeutic recommendations in a broad variety of practice settings and for patients with a wide variety of pain syndromes, including chronic malignant and non-malignant pain, neuropathic pain, and pain related to neurologic and hematologic conditions. Residents will also get significant exposure to a well-established Opioid Stewardship Program and related efforts and opportunities.
Palliative care emphasis will be placed on symptom management throughout patients’ illnesses and at the end of life. All required learning experiences are 1 month (4 weeks) in duration except where noted in table below. Longitudinal experiences are designed to focus on pharmacy operations, opioid stewardship, palliative care clinic, clinical research, and professional development which includes opportunities to deliver formal and informal presentations, teach and mentor residents and students, and develop professional writing skills. The program will be tailored specifically for each resident based upon the resident’s goals, interests, and previous experience. Elective learning experiences are available to enhance the resident’s experience and knowledge in pain management, palliative care, and related areas. Electives may be structured as 2-week, or 1-month learning experiences as noted below. Elective rotation requests will be considered on an individual basis, with regards to resident interests and preceptor availability.
Residency Goals
Required Goals:
- In collaboration with the health care team, provide comprehensive medication management to patients requiring pain management and palliative care following a consistent patient care process.
- Ensure continuity of care during patient transitions between care settings for patients requiring pain management and palliative care.
- Demonstrate ability to manage formulary and medication-use processes for patients requiring pain and palliative care, as applicable to the organization.
- Demonstrate ability to conduct a quality improvement or research project.
- Lead a medication-use evaluation.
- Demonstrate leadership and management skills for successful self-development in the provision of care for pain management and palliative care patients.
- Demonstrate management skills in the provision of care for pain management and palliative care patients.
- Provide effective medication and practice-related education to patients requiring pain management and palliative care, caregivers, health care professionals, students, and the public (individuals and groups).
- Effectively employ appropriate preceptor roles when engaged in teaching students, pharmacy technicians, or fellow health care professionals in pain management and palliative care.
Elective Goals:
- Effectively fulfill the major functions of a specialty pharmacist, including intake, clinical management, fulfillment, and facilitating optimal outcomes.
- Lead a medication-use evaluation.
- Exhibits additional skills of a practice leader
Training Site
The primary site for rotations will be at the Hospital of the University of Pennsylvania (HUP), which is world-renowned for its clinical and research excellence, forging the way for newer and better ways to diagnose and treat illnesses and disorders. HUP is a 988-bed-academic teaching hospital and tertiary referral center located in the heart of Philadelphia.
Ambulatory rotations will primarily be conducted as The Perelman Center for Advanced Medicine (PCAM), which is designed to create an ideal environment for patient-focused care and collaboration among health professionals. The Perelman Center is a state-of-the-art, 500,000 square foot outpatient facility located on the corner of 34th Street and Civic Center Boulevard, adjacent to the Hospital of the University of Pennsylvania. Our pharmacy services extend into a multitude of areas including oncology, cardiology, anticoagulation, internal medicine, infectious diseases, gastroenterology, hepatology, neurology, dermatology, transplantation, and rheumatology.
We offer our home hospice rotation through Penn Care at Home, with the opportunity to do home visits.
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 keep reaching ahead to find new ways to improve the quality and length of life for everyone.
As hospital employees, residents are eligible to receive a full benefits package including standard comprehensive insurance coverage (medical, vision, prescription drug, life insurance, disability and dental) and 15 paid days off to be used for vacation, personal sick, interview days or other leave. HUP recognizes eight legal holidays and residents are required to work two holidays with the remaining six holidays taken in addition to the 15 PTO days. Financial support for conference attendance and poster production as well as statistical support for projects. Professional liability insurance is covered by the hospital as long as residents are working within the limits of their job description and following hospital policies and procedures. Transportation reimbursement via reduced cost SEPTA Pass or free onsite parking.
Learning Experiences
Required Rotations* |
Elective Rotations |
Longitudinal (see full list below) |
Orientation* |
Consult Psychiatry/MEND |
Professional Development
- Therapeutics Conference
- Grand Rounds
- Attend local/national meetings
- Multidisciplinary presentations
- Peer Review
- Precepting
- Teaching Certificate (Optional)
Clinical
- Oncology Pharmacy Teach Program, Toxicity Support – (six months)
- Palliative Care Clinic (five months)
Pharmacy Operations
Opioid Stewardship
- Medication Use Evaluation
- Guideline and Policy Review
- Committees
- Pain Pharmacy Secure Chat
|
Palliative Care I |
Noncancer Pain and Symptom Management (SMS) and Sickle Cell Clinic
|
Palliative Care II |
Emergency Department
|
HUP Cedar—Psychiatry and Detox Unit |
Medication Safety
|
Inpatient/Home hospice |
Infectious Disease Clinic
|
Ambulatory Care Neurology |
Pain Clinic
|
Anesthesia Pain Service (APS) |
Internal Medicine
|
Ambulatory Care Palliative Care/Oncology Supportive Care |
Addiction Medicine
|
Addiction Medicine |
Others as available/based on resident interest |
Research
Three weeks dedicated research time plus one project day /quarter |
*Residents may elect to repeat any of the required rotations as an elective as well, new learning descriptions and objectives will be created in this case.
* One-month experience; activities may vary based on in-coming early commitment status
‡ Available as two-week, or one-month experience, only two rotations that are two weeks in duration can be elected, all others must be four weeks in duration
Longitudinal Experiences
Professional Development:
- Attend Vital Talk Training
- Assist in the mentoring of pharmacy residents, students and staff
- Develop presentation for Pharmacy Therapeutics Conference (Journal Club)
- Attend ambulatory care, APS (Acute Pain Service) and Palliative Care conferences based on topic schedule and in discussion with the preceptor and/or RPD
- Present one topic Ambulatory Care Topic Discussion and one topic within the Oncology Topic Discussion series
- Provide an ACPE-accredited presentation at Pharmacy Grand Rounds
- Attend Palliative Care Fellow School weekly and present three educational sessions (20 minutes each) over the year (Topic, Case, Research update)
- Serve as primary preceptor for an IPPE student, APPE student or PGY1 resident rotation rotation
- Attend the ASHP Mid-year clinical meeting
- Teaching Certificate (as applicable)
- Peer review on one Journal article as able based on Journal requests
- Optional meetings for attendance/presentation: local or national pharmacy or pain/palliative care specialty meetings, as funding allows
- AAHPM Annual Meeting; PainWeek; APhA Pain Institute; APhA Substance Use Summit; ASAM Meeting, AMERSA Meeting; AAPP Meeting, etc.
Oncology Teach Program, Toxicity Support:
- This longitudinal rotation intends to introduce and familiarize the resident to the most common cancers and the acute and chronic toxicity issues patients have related to the therapies they are on and general progression of their disease.
- The goal of this experience is for the resident to become familiar with toxicity management among the most common cancers, while also helping to manage symptoms related to their disease and overall well-being.
- The resident will be able to hone their palliative care skills in the context of enhancing clinical and critical thinking skills with increasing confidence and competence within oncology pharmacy.
- This will occur in the first six months, follow by the longitudinal clinic experience
Palliative Care Clinic (5 months; Feb-Jun)
- This will be a second half of the year experience as an extension from the Ambulatory Care II – Palliative Care/Supportive Oncology Clinic rotation experience. This will span Feb-June with full day clinic every other week. The specific day of the week for the clinic experience will be based on resident and clinic availability and preference.
- The goal of this longitudinal aspect for the Palliative Care Clinic experience is to provide the opportunity for continuity in managing patient care and becoming more integrated in the clinic workflows. This will improve the resident’s ability to provide follow up visits and develop patient relationships.
- The resident will work with the outpatient Palliative Care Team to identify and schedule patients for follow-up, provide methadone initiation and titration follow up calls, and to integrate additional opportunities for chemo-teach follow-ups and patient education.
Research/Scholarly Activities:
- Identify or choose a pain management or palliative care specific research question and complete a research project including study design, statistical analysis, data collection and results analysis
- Submit a pain management/palliative care-related abstract to a national meeting
- Participate in pain management or palliative care-related research project
- Develop a pain management or palliative care-related poster and/or platform presentation for a national meeting (SPPCP Virtual Conference)
- Prepare a manuscript suitable for publication in a professional journal
Opioid Stewardship
- Complete one medication use evaluation and present a poster at Vizient on MUE project
- Review therapeutic guidelines and policies assigned.
- Participate in HUP Inpatient Pain Committee meetings
- Prepare and present HUP Opioid Prescribing Data
- Participate in quarterly review and follow up of pain-related safety events
- Attend monthly Opioid Stewardship Task Force meetings
- Cover Pain Pharmacy Secure Chat On-Call starting in the first quarter of the residency year and for duration of the year as part of Pharmacy Operations staffing requirement. Once on-call coverage begins, weekend coverage rotates every 3 weeks between on-call and pharmacy operations
Pharmacy Operations:
- Function as a unit based clinical pharmacist during weekend staffing coverage in a general practice area, responsibilities include:
- Order verification
- Medication distribution
- Pharmacokinetic consult recommendations
- Drug information resource for health care providers
- Emergency response participation at all codes, anesthesia stats, and rapid response calls for assigned units
- Complete at least 24 weekend shifts as a unit based clinical pharmacist/covering Pain Secure Chat On-Call
Program Director
Tanya Uritsky, PharmD, BCPP, FPPCP
Opioid Stewardship Coordinator
Hospital of the University of Pennsylvania
Tanya.Uritsky@pennmedicine.upenn.edu
Program Coordinator
Emily Casey, PharmD
Clinical Pharmacy Specialist, Pain Management and Substance Use
Hospital of the University of Pennsylvania
Emily.Casey@pennmedicine.upenn.edu
Application Requirements
Candidates interested in the program should submit the following to the RPD (not currently via PhORCAS until accredited) by the deadline of January 2nd:
- Academic transcripts from your pharmacy school (including pre-pharmacy college training)
- Letter of intent addressing why you have chosen the Hospital of the University of Pennsylvania, why you have chosen to pursue specialized training in pain management and palliative care and your residency and career goals.
- Curriculum vitae
- Three letters of recommendation (at least one from a clinical rotation preceptor)
- Completion of an accredited PGY1 Residency program