PGY2 Solid Organ Transplant Residency Structure

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

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Orientation

PGY2 solid organ transplant (SOT) residents who completed a PGY1 residency at UHS will only undergo orientation specifically for the PGY2 SOT residency during the first month of the residency year. PGY2 SOT 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 Solid Organ Transplant 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, the transplant unit, and the transplant clinic. All items on the Inpatient Pharmacy Training List should be covered during this training period, and the completed checklist should be submitted to the Residency Program Director (RPD) at the end of the 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. 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.

Transplant Academic Pharmacotherapy

The resident will attend weekly Transplant Grand Rounds on Friday mornings, and will be provided the opportunity to present at least one formal Transplant Grand Rounds during the year.

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 also attend weekly Pharmacotherapy Rounds with fellow University of Texas College of Pharmacy residents on Friday afternoons. Attendance is strongly encouraged unless it interferes with urgent, necessary patient care obligations; excused absence requires approval by RPD and communication by resident to course coordinator. The resident will also be required to present one formal Pharmacotherapy Rounds (“Resident Rounds”) during the year.

The resident is required to present a minimum of one ACPE-approved continuing education program to the pharmacy staff during the residency year.

Other required academic activities include presenting at least one transplant-related lecture to pharmacy students and medical students, and facilitating labs (minimum number determined annually) for pharmacy students. The resident will assist with mentoring and precepting pharmacy students assigned to the transplant rotation. In addition, the resident will have the opportunity to teach about transplant medications in the Transplant Nursing Course and the Patient Pre-Op Class. The resident will also have numerous opportunities to participate in and lead discussions on transplant-related topics, patient cases, journal clubs, and in-services.

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.

Transplant Clinical Practice

The resident will provide clinical staffing on the transplant unit (10 weekends minimum) as scheduled by the 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 transplant rounds, verify orders and address clinical problems for patients on the transplant unit (and other critical care areas on week-ends as assigned). The resident will also carry the on-call pager for the transplant pharmacy as scheduled for investigational studies or after-hours patient discharges, not to exceed every other week.

Transplant Practice Management

The resident is required attend and actively participate in scheduled monthly Pharmacy & Therapeutics (P&T) and quarterly Drug Utilization Evaluation (DUE) Committee meetings throughout the year. The resident will also attend Transplant Clinical Management Team (CMT) meetings and Transplant Clinical Quality Assurance/Process Improvement (QAPI) meetings as scheduled. Required learning opportunities include conducting a transplant-related DUE and leading the development or modification of a transplant-related guideline or protocol. The resident is strongly encouraged to present results of transplant-related research projects and/or DUEs at DUE, P&T, CMT, QAPI, and/or pharmacy meetings. Examples of transplant-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 (required to attend 2 minimum with a formal presentation at 1 minimum), including but not limited to the ASHP Midyear Clinical Meeting, the Alcalde Southwest Regional Residency Conference, and the American Transplant Congress.

The resident will be required to submit a UTC Transplant Newsletter article as assigned. The resident will also have the opportunity to participate in an Organ Donor Awareness initiative.  In addition, the resident will have an opportunity to complete the requirements for a UT Leadership Certificate (optional).

The resident will work with the transplant pharmacy team throughout the year to cover topics such as:

  1. Transplant prescription funding sources, problems, and solutions Improving medication adherence in transplant Medication reconciliation in transplant
  2. In addition, the resident will actively participate in development, implementation, and revision of Collaborative Practice Agreements for transplant pharmacists at UTC.

Transplant Research Project

Successful completion of at least one transplant 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 a transplant 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 the UTHSCSA 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 or transplant meeting, specifically the American Transplant Congress. 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.

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.

Rotations

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

  1. Inpatient Transplant Medicine/Transplant Surgery
  2. Pediatric Transplant
  3. Must have at least one month with a focus on each of the following organ transplants, for a minimum of 5 months total during the year:
    • Kidney Transplant I & II
    • Liver Transplant I & II
    • Lung Transplant I & II
  4. Histocompatibility Laboratory/Microbiology Laboratory (2 weeks each)

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

  1. Bone Marrow Transplant (at South Texas Veterans Hospital)
  2. Critical Care Advanced—Medical
  3. Critical Care Advanced—Surgical
  4. Heart Transplant (at Methodist Hospital)
  5. HIV-Opportunistic Infections (Ambulatory Clinic or Inpatient)

A resident may choose to participate in no more than two off-site (i.e., outside UHS facilities) elective rotations per residency year.

Annual Structure