PGY2 Emergency Medicine Residency Structure

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

Orientation

PGY2 emergency medicine residents who completed a PGY1 residency at UHS will only undergo orientation specifically for the PGY2 emergency medicine residency during the first month of the residency year. 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 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 center. All items on the Inpatient Pharmacy Training List should be covered during this training period and 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, Advanced, and Pediatric Advanced Cardiac Life Support (BLS/ACLS/PALS) early in the residency. Training in 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.


Emergency Medicine Academic Pharmacotherapy

The resident will participate monthly in an emergency medicine/critical care discussion group. This group will cover disease state reviews, topic discussions, and journal clubs pertinent to both emergency medicine and critical care. The resident will participate in weekly emergency medicine topic discussion sessions and monthly emergency medicine pharmacy journal club.

The resident will participate in the University of Texas College of Pharmacy residents’ weekly Pharmacotherapy Seminar (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 emergency medicine topic, as assigned by the group coordinator.

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

In addition, the resident will participate weekly in the University of Texas Health Science Center at San Antonio Department of Emergency Medicine Grand Rounds on Wednesday mornings. This activity is required while on emergency medicine and trauma surgery rotations, unless the topics are categorically unrelated to emergency medicine pharmacotherapy. The resident will also be required to present one formal Department of Emergency Medicine Grand Rounds presentation during the year.

Other required academic activities include presenting at least one emergency medicine-related lecture to pharmacy students, creating at least six emergency medicine pharmacotherapy educational newsletters throughout the year, assisting the emergency medicine preceptors with mentoring and precepting pharmacy students and PGY1 residents assigned to emergency medicine rotations, and facilitating labs (minimum number determined annually) for pharmacy students. The resident will also have numerous opportunities to participate in and lead discussions on emergency medicine-related patient cases, journal clubs, in-services, and continuing education programs.

The resident is required to present one ACPE-approved continuing education program to the pharmacy staff throughout the residency year.

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 Hospital Practice

The resident will provide clinical staffing in the emergency department, with specific scheduling to be determined annually based on the number of residents and staffing needs, not to exceed an average of sixteen hours per two-week pay period over eleven months. During scheduled clinical staffing, the resident will have the opportunity to attend rounds, verify orders and address clinical problems for patients in the emergency department (and other critical care areas on week-ends as assigned).

The resident will maintain BLS, ACLS, and PALS 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.

Emergency Medicine 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 Emergency Medicine Clinical Management Team (CMT) and Trauma Multidisciplinary Team meetings as requested. The resident is expected to present emergency medicine-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 an emergency medicine-related DUE, prepare or revise an emergency medicine-related treatment guideline or protocol, and presenting results of emergency medicine-related research projects 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, the Alcalde Southwest Regional Residency Conference, and the Society of Critical Care Medicine Annual Congress.

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.

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

  • Adult Emergency Medicine I
  • Adult Emergency Medicine II
  • Adult Emergency Medicine III
  • Trauma & Emergency Surgery I
  • Trauma & Emergency Surgery II
  • Pediatric Emergency Medicine
  • Medicine ICU
  • Surgical ICU
  • Poison Control

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

  • Neurosurgical ICU
  • Pediatric ICU
  • Infectious Diseases
  • Adult Medicine
  • Neurology
  • Cardiology
  • Cardiothoracic Surgery

A resident may choose to participate in no more than one off-site (i.e., outside University Health System facilities) elective rotation per residency year.


Annual Structure