Introduction

The Duke University Hospital Postgraduate Year Two (PGY2) Internal Medicine Pharmacy Residency Program is designed to develop independent practitioners that have the knowledge and accumulated experience necessary to provide excellent care in acute care pharmacy practice. The Internal Medicine Residency Program builds upon the general competencies achieved during a PGY1 residency; expanding the resident’s ability to provide care for complex patients in a variety of acute care settings. Training focuses on a full range of disease states and disorders, along with the literature supporting medication management of such conditions.  Rotations are designed to ensure experience is gained with the highest acuity patients in each sub-specialty area. In addition, residents are able to conduct research independently and should be confident educators in the multidisciplinary and pharmacy training environment. Graduates will be prepared to attain board certification (BCPS).

Purpose

PGY2 residency programs build upon Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency training to develop pharmacist practitioners with knowledge, skills, and abilities as defined in the educational competency areas, goals, and objectives for advanced practice areas. Residents who successfully complete PGY2 residency programs are prepared for advanced patient care or other specialized positions, and board certification in the advanced practice area, if available. 

The purpose of the PGY2 Internal Medicine Pharmacy Residency Program is to prepare the resident to excel in the care of complex internal medicine patients in any setting.  Excellence will be achieved by: 

• Demonstrating accountability for patient care
• Modeling excellence in internal medicine pharmaceutical care
• Serving as professional role models for pharmacy students and PGY1 residents
• Participating in clinical research and performance improvement projects focused on internal medicine pharmacotherapy
• Facilitating and leading internal medicine pharmacotherapy discussions in Internal Medicine Pharmacy Conference

Outcomes

Goal R1.1: In collaboration with the health care team, provide safe and effective patient care to internal medicine patients following a consistent patient care process.

Goal R1.2: Ensure continuity of care during internal medicine patient transitions between care settings.

Goal R2.1: Demonstrate ability to manage formulary and medication-use processes for internal medicine patients, as applicable to the organization.

Goal R2.2: Demonstrate ability to conduct a quality improvement or research project.

Goal R3.1: Demonstrate leadership skills for successful self-development in the provision of care for internal medicine patients.

Goal R3.2: Demonstrate management skills in the provision of care for internal medicine patients.

Goal R4.1: Provide effective medication and practice-related education to internal medicine patients, caregivers, health care professionals, students, and the public (individuals and groups).

Goal R4.2: Effectively employ appropriate preceptor roles when engaged in teaching students, pharmacy technicians, or fellow health care professionals in internal medicine.

Goal E3.1: Participate in the management of medical emergencies.

The Residency Experience

This residency is designed to provide diverse clinical experiences and prepare graduates to excel in the care of acute care medicine patients.  Residents will refine their skills in the internal medicine environment via a well-established integrated clinical practice model with increased autonomy and responsibility for managing patient care practice. Required rotations  include  internal medicine (teaching and hospitalist coverage),  cardiology,  critical care medicine, infectious diseases and transitions of care.  Elective experiences include neurology, emergency medicine, abdominal transplant, advanced pulmonology, ambulatory care and more depending on the specific interests of the resident. The resident will actively participate in interdisciplinary rounding, conferences, committees, journal clubs, in-services and research. Teaching opportunities are available with local Colleges of Pharmacy and Duke School of Medicine.

Teaching Activities

• Didactic lectures at local schools of pharmacy or inter-professional schools at Duke University

• In-services to pharmacy, medical, and nursing staff

• Continuing education lectures to pharmacy staff

• Co-preceptor of Pharm.D. students and PGY1 residents on rotation

Research

The ongoing development of research skills is an essential component of a residency program. The resident completes a formal residency project suitable for publication in a selected area of pharmacy practice. Duke provides statistician support for the research project. Resident research projects are presented at a regional or national conference.

Staffing Experience

Staffing will be incorporated into the residency experience in decentralized areas within the Clinical and Patient Care Service Division. PGY2s will be invited to staff every 3rd weekend. Activities include verifying medication orders, providing pharmacokinetic consults, responding to drug information questions, providing patient education, and attending medical emergencies.