PGY2 Critical Care Residency Structure

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

Orientation

PGY2 critical care residents who completed a PGY1 residency at UHS will only undergo orientation specifically for the PGY2 critical care residency during the first month of the residency year. PGY2 critical care 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 Critical Care 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 critical care units. 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. Training in Pediatric Advanced Cardiac Life Support (PALS), Advanced Trauma Life Support (ATLS), and Emergency Neurological Life Support (ENLS) is encouraged 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.

Critical Care Academic Pharmacotherapy

The resident will participate regularly in a critical care discussion group. This group will encompass disease state/topic discussions, journal clubs and BCCCP review sessions.

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. 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 programs to the pharmacy staff throughout the residency year.

Other required academic activities include presenting at least one critical care-related lecture to pharmacy students, and facilitating labs (minimum number determined annually) for pharmacy students. The resident will assist the critical care preceptors with the Surgical Intern Readiness Elective (SIRE) medical student lecture series, and mentoring and precepting pharmacy students and PGY1 residents assigned to critical care rotations. The resident will also have numerous opportunities to participate in and lead discussions on critical care-related patient cases, journal clubs, in-services, 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.


Critical Care Clinical Practice

The resident will provide clinical staffing for the critical care areas 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 rounds, verify orders and address clinical problems for patients in various intensive care units.

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.

Critical Care Practice Management

The resident will attend and actively participate in scheduled biweekly Residency Advisory Council (RAC) meetings, monthly Pharmacy & Therapeutics (P&T) and quarterly Drug Utilization Evaluation (DUE) Committee meetings throughout the year, as well as STICU Clinical Management Team (CMT), Neuro-ICU CMT and Morbidity and Mortality (M&M)/Journal Club meetings as requested. The resident is expected to present critical care-related topics when needed at these meetings. Learning opportunities include organizing and coordinating a P&T Subcommittee meeting, organizing and coordinating RAC meetings for a portion of the year designated by the RPD, conducting a critical care-related DUE and presenting results of critical care-related research projects at DUE, P&T, CMT, and/or pharmacy meetings. Examples of critical care-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 Society of Critical Care Medicine Annual Congress.

Critical Care 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.

Critical Care Research Project

Successful completion of at least one critical care 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 critical care 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, Residency Coordinator and/or a preceptor with expertise in the selected discipline. The research project proposal must be approved by the RPD/Coordinator, and if applicable, must also be approved by the 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 or critical care meeting. The research project must also be submitted in manuscript form to the RPD/Residency Coordinator and the resident is strongly encouraged to publish results of the project in a peer-reviewed journal.

Rotations

The length of each 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. Cardiology
  2. Emergency Medicine
  3. Medicine ICU I
  4. Medicine ICU II
  5. Neuroscience ICU
  6. Surgical Trauma ICU I
  7. Surgical Trauma ICU II

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

  1. Abdominal Solid Organ Transplant
  2. Cardiothoracic Surgery
  3. Infectious Diseases
  4. Lung Solid Organ Transplant
  5. Neurology/Stroke
  6. Neuroscience ICU II
  7. Palliative Medicine
  8. Pediatric/Neonatal ICU

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