Pharmacotherapy PGYII

Description of Rotation or Educational Experience

This 4 week long required PGY2 rotation is designed to provide the resident with the background in drug therapy that will facilitate the selection of therapeutic treatment options and develop skills to provide quality health care through pharmacotherapy decisions that are patient focused, evidenced based, cost effective, and clinically sound. Three primary focus areas of the rotation experience are: how drugs work, information management and rational drug therapy selection for specific problems or diseases with an emphasis on chronic disease management. The setting for the rotation is the Family Medical Center.

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

Competencies

• Cardiology (hypertension, ischemic heart disease, dyslipidemia, heart failure, atrial fibrillation, thromboembolism)
• Endocrinology (diabetes mellitus)
• Gastrointestinal (gastroesophageal reflux disease, constipation)
• Infectious diseases (otitis media, urinary tract infections, upper/lower respiratory illness)
• Mental health (depression, anxiety, ADHD)
• Musculoskeletal (arthritis, chronic pain management)
• Neurology (headaches, stroke, dementia)
• Prevention (immunization, smoking cessation, substance abuse)
• Pulmonary (asthma, chronic obstructive pulmonary disease, chronic rhinitis)
• Women’s/men’s health (contraception, pregnancy care, osteoporosis, sexual dysfunction)

Objectives

• Make informed pharmacotherapy decisions that are patient focused.
• Develop and carry out medication management plans.
• Counsel and educate patients and their families about proper medication use including OTCs.
• Demonstrate proper use of common medications that require correct procedures.
• Provide pharmacotherapy aimed at health maintenance and prevention.

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.  Residents are expected to:

Competencies

• Cardiology (hypertension, ischemic heart disease, dyslipidemia, heart failure, atrial fibrillation, thromboembolism)
• Endocrinology (diabetes mellitus)
• Gastrointestinal (gastroesophageal reflux disease, constipation)
• Infectious diseases (otitis media, urinary tract infections, upper/lower respiratory illness)
• Mental health (depression, anxiety, ADHD)
• Musculoskeletal (arthritis, gout, chronic pain management)
• Neurology (headaches, stroke, dementia)
• Prevention (immunization, smoking cessation, substance abuse)
• Pulmonary (asthma, chronic obstructive pulmonary disease, chronic rhinitis)

Women’s/men’s health (contraception, pregnancy care, osteoporosis, sexual dysfunction)

Objectives

• Demonstrate an investigatory and analytic approach to pharmacotherapy.

• Know and apply the basic principles of pharmacology and clinical pharmacotherapy (see below)

-establish individualized therapeutic goals and evaluate therapeutic outcomes

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

Competencies

• Cardiology (hypertension, ischemic heart disease, dyslipidemia, heart failure, atrial fibrillation, thromboembolism)
• Endocrinology (diabetes mellitus)
• Gastrointestinal (gastroesophageal reflux disease, constipation)
• Infectious diseases (otitis media, urinary tract infections, upper/lower respiratory illness)
• Mental health (depression, anxiety, ADHD)
• Musculoskeletal (arthritis, chronic pain management)
• Neurology (headaches, stroke, dementia)
• Prevention (immunization, smoking cessation, substance abuse)
• Pulmonary (asthma, chronic obstructive pulmonary disease, chronic rhinitis)
• Women’s/men’s health (contraception, pregnancy care, osteoporosis, sexual dysfunction)

Objectives

• Make informed pharmacotherapy decisions that are patient focused.
• Develop and carry out medication management plans.
• Counsel and educate patients and their families about proper medication use including OTCs.
• Demonstrate proper use of common medications that require correct procedures.
• Provide pharmacotherapy aimed at health maintenance and prevention.

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care.  Residents are expected to:

Competencies

• Cardiology (hypertension, ischemic heart disease, dyslipidemia, heart failure, atrial fibrillation, thromboembolism)
• Endocrinology (diabetes mellitus)
• Gastrointestinal (gastroesophageal reflux disease, constipation)
• Infectious diseases (otitis media, urinary tract infections, upper/lower respiratory illness)
• Mental health (depression, anxiety, ADHD)
• Musculoskeletal (arthritis, gout, chronic pain management)
• Neurology (headaches, stroke, dementia)
• Prevention (immunization, smoking cessation, substance abuse)
• Pulmonary (asthma, chronic obstructive pulmonary disease, chronic rhinitis)

Women’s/men’s health (contraception, pregnancy care, osteoporosis, sexual dysfunction)

Objectives

• Demonstrate an investigatory and analytic approach to pharmacotherapy.

• Know and apply the basic principles of pharmacology and clinical pharmacotherapy (see below)

-establish individualized therapeutic goals and evaluate therapeutic outcomes

-practice cost-effective pharmacotherapy

-recognize, avoid and manage adverse drug reactions

-prescribe based on considerations in special populations

-prescribe appropriately according to renal and hepatic function

-therapeutic drug monitoring

-critically evaluate scientific literature and practice evidence-based medicine

-discuss sources for accessing unbiased drug information

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning.  Residents are expected to develop skills and habits to be able to :

Competencies

• Identify strengths, deficiencies and limits in one’s knowledge and expertise;

Objectives

• Use information technology to manage and access drug information

• Locate, appraise, assimilate and use evidence from scientific studies on drug therapy.

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.  Residents are expected to:

Competencies

• Incorporate considerations of cost awareness and risk-benefit analysis in patient care

Objectives

• Practice cost-effective pharmacotherapy.

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.  Residents are expected to demonstrate:

Competencies

• Accountability to patients, society, and the profession

Objectives

• Demonstrate a commitment to ethical principles when interacting with the pharmaceutical industry.

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. 

Competencies

• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds

Objectives

• Create and sustain a patient-provider relationship that is therapeutic, ethical and promotes patient participation in health care.

Teaching Methods

Small group discussion, case studies, chart reviews and one-on-one teaching.

Assessment Method

At the conclusion of each resident rotation, the residency coordinator sends a formative-type, rotation-specific performance evaluation form to the rotations’ supervising physician.  When the completed evaluation is returned, the resident physician and the resident’s faculty advisor review the evaluation and attest to reviewing it by signing/initialing the form.  Next, the program director reviews and attests to the document.  Once all three have reviewed and attested the evaluation, it is included in the resident’s permanent file.  Resident will evaluate the faculty supervising the rotation anonymously via New Innovations.

The resident is supervised by the faculty PharmD  preceptor.

Educational Resources

Micromedex, Lexi-Drug, DynaMed, Epocrates for PDA, Selected Readings from Primary Literature and Evidence-Based Guidelines, Applied Therapeutics, Pharmacotherapy, Drugs in Pregnancy and Lactation, Contraceptive Technology