PGY2 Emergency Medicine Residency Structure

Longitudinal experiences include those that occur over the majority of the residency year and include emergency medicine academic pharmacotherapy, clinical practice, practice management, and research project. Patient care rotations usually occur over four weeks. Each learning experience has written goals, objectives, and learning activities.

Orientation

PGY2 emergency medicine residents who did not complete a PGY1 residency at UHS will undergo orientation and training for the University of Texas College of Pharmacy, University Health System, the PGY2 Emergency Medicine Pharmacy Residency, and the Pharmacy Department during the first month of residency. Departmental and residency training will include orientation to policies and procedures, UHS computers, the inpatient pharmacy, and the emergency department. All items on the Inpatient Pharmacy Training List should be covered during this training period. The resident will also be oriented to the ASHP Residency Accreditation Standards, Program Design and Conduct, and the required Competency Areas, Goals, and Objectives for PGY2 residency training. In addition, the resident will be oriented to the evaluation process and the PharmAcademic online evaluation system (if not utilized during PGY1 residency). Residents who are not previously certified will also be scheduled for training in Basic and Advanced Cardiac Life Support (BLS/ACLS) early in the residency. Training in Pediatric Advanced Cardiac Life Support (PALS) and Advanced Trauma Life Support (ATLS) is strongly recommended as well. The resident must become licensed in the State of Texas as a Registered Pharmacist by August 1, or the 1st day of the second month of residency.

Emergency Medicine Academic Pharmacotherapy

The resident will participate in the University of Texas College of Pharmacy residents’ weekly Pharmacotherapy Seminar (residents’ discussion group) on Friday afternoons. This activity is optional but encouraged if the resident has not yet received board certification. The resident will be required to lead discussion on at least one topic, as assigned by the group coordinator.

The resident will attend weekly Pharmacotherapy Rounds with fellow University of Texas College of Pharmacy residents on Friday afternoons. This activity is required unless it interferes with urgent, necessary patient care obligations. The resident will also be required to present one formal Pharmacotherapy Rounds (“Resident Rounds”) during the year.

The resident will also attend weekly Emergency Medicine Grand Rounds at the University of Texas Health Science Center School of Medicine with physician residents on Wednesday mornings while on emergency medicine rotations. This activity is optional but encouraged if the lectures are relevant to emergency medicine pharmacotherapy. The resident will be required to present one Emergency Medicine Grand Rounds lecture during the year. This is typically an adaptation of the Pharmacotherapy Rounds presentation revised to pertain to an audience of physicians.

The resident will also have numerous opportunities to participate in and lead discussions on emergency medicine-related topics, patient cases, journal clubs, in-services, newsletters, and continuing education programs.

The resident may elect to obtain an Academic Training Program Certificate if not completed during their PGY1 residency. The University of Texas College of Pharmacy Academic Training Program requirements will be completed throughout the year, including attendance at the UT Academic Training Conference.

Emergency Medicine Clinical Practice

The resident must become licensed in the State of Texas as a Registered Pharmacist by August 1, or the 1st day of the second month of residency. The resident will provide clinical staffing in the emergency department (ED) as scheduled by the Residency Program Director (RPD) based on staffing needs, not to exceed 16 hours per 2-week period. During scheduled clinical staffing, the resident will have the opportunity to attend emergency medical and trauma resuscitations, verify orders and address clinical problems for patients in the ED (and other critical care areas on week-ends as assigned).

The resident will maintain BLS and ACLS certifications and participate in the management of medical emergencies. The resident will respond to “code blue” emergencies within University Hospital as feasible during scheduled weekday work hours and clinical staffing weekends. 

For the last month of the residency, the resident will complete a clinical staffing rotation in the ED. The resident will assume all routine responsibilities of the ED pharmacist in charge during the rotation.

The resident may also be required to staff when extenuating circumstances demand, but not more than three days per residency year. While there are no specific criteria defining extenuating circumstances, the individual situation is evaluated and efforts are made to minimize time away from the resident’s current rotation. Approval to require a resident to staff must be obtained from the RPD.

Emergency Medicine Practice Management

The resident will attend and actively participate in scheduled monthly Pharmacy & Therapeutics (P&T) and quarterly Drug Utilization Evaluation (DUE) Committee meetings throughout the year. The resident is expected to present emergency medicine-related topics as requested at these meetings. Learning opportunities include conducting an emergency medicine-related DUE, and presenting results of emergency medicine-related research projects and/or DUEs at DUE, P&T, CMT, and/or pharmacy meetings. Examples of emergency medicine-related topics that may be addressed include:

  1. Formulary and fiscal management
  2. Pharmacy policies and procedures
  3. Medication-related guidelines/protocols
  4. Information technology and automation systems
  5. Medication-use system evaluation
  6. Adverse drug reaction reporting, trending, and interpretation
  7. Medication safety and medication error reporting, trending, and prevention
  8. Pharmacist intervention reporting and trending
  9. Investigational drugs

The resident will have the opportunity to attend and participate in local, state, and national professional association meetings, including but not limited to the ASHP Midyear Clinical Meeting and the Alcalde Southwest Regional Residency Conference.

Emergency Medicine Professional Development

This longitudinal rotation is structured to provide the resident experience in self-evaluation of their strengths, goals, progress throughout the residency, and areas for improvement. Self-evaluations will be completed and discussed between the resident and residency leadership on a quarterly basis, then incorporated into each resident’s personal development plan.

Emergency Medicine Research Project

Successful completion of at least one emergency medicine research project is required to fulfill the requirements and to obtain a certificate of graduation from the residency program. Research will focus on the evaluation of an emergency medicine pharmacotherapy-related issue. The resident must adhere to the established timeline for the project to assure successful completion during the one-year residency. The research project topic may be an idea of the resident, from a suggested list, or individually assigned. The project will be directly supervised by the RPD and/or a preceptor with expertise in the selected discipline. The research project proposal must be approved by the RPD, and if applicable, must also be approved by UT Health San Antonio Investigational Review Board and the UHS Research Committee.

The research project will be presented as an abstract and as a platform presentation at the regional Alcalde Southwest Residency Leadership Conference in the spring. The resident is strongly encouraged to submit an abstract of the research project at a regional or national pharmacy meeting. The research project must also be submitted in manuscript form to the RPD and the resident is strongly encouraged to submit the manuscript for publication in a peer-reviewed journal.

Rotations

The length of each patient care rotation is usually one month unless otherwise noted, but may be flexible, depending on the needs and interests of the individual resident. The following rotations are required:

  • South Texas Poison Center (2 weeks)
  • Adult Emergency Medicine (2 months)
  • Trauma & Emergency Surgery (2 months)
  • Pediatric Emergency Medicine
  • Surgical ICU
  • Medicine ICU

Other rotations available on an elective basis include but are not limited to the following:

  • Neurosurgical ICU
  • Pediatrics (Medicine or ICU)
  • Infectious Diseases
  • Adult Medicine
  • Neurology
  • Cardiology
  • Cardiothoracic Surgery

Annual Structure