Residency Experience Descriptions
The first two rotations are always Orientation, followed by Therapeutic Drug Monitoring (TDM). Prior to midyear, the resident will complete 1 – 2 Internal Medicine rotations and at least one election. After Midyear and the staffing week, the resident ill have their CCU rotation and all remaining rotations.
Other rotation descriptions are available upon request.
This is the first rotation every resident will complete. It is scheduled at the beginning of the residency year to train the resident in distributive functions of the department. This is also scheduled to introduce the incoming resident to Sentara RMH, the Department of Pharmacy Services, and to outline expectations of the residency year. All new residents are expected to attend meetings scheduled during the orientation program.
Therapeutic Drug Monitoring
This rotation is scheduled immediately after orientation. This period is used to train residents to receive certification in therapeutic drug consults. These consults include: Heparin, Warfarin, Vancomycin, Aminoglycoside, and Direct Thrombin Inhibitor certifications. Parenteral Nutrition and Insulin Certifications are also including and are completed later in the residency year.
Internal Medicine with a focus on Cardiology
This rotation requires the resident to become an integral member of the multidisciplinary patient care team. Residents will assume care of patients on the Telemetry and Progressive Care units. The resident will assess patients daily, provide patient specific pharmaceutical care services, and participate in multidisciplinary rounds. Additionally, the resident will manage pharmacokinetic and anticoagulation plans, develop pharmacotherapy plans, monitor drug therapy outcomes, provide drug information and education, and provide discharge medication counseling on target patients.
Internal Medicine with a focus on Nephrology
Residents will assume care of patients followed by the nephrology team. Residents will also be exposed to the dialysis unit and managing medications affected by dialysis. The resident will assess patients daily, provide patient specific pharmaceutical care services, and participate in multidisciplinary rounds. Additionally, the resident will manage pharmacokinetic and anticoagulation consults, develop pharmacotherapy plans, monitor drug therapy outcomes, provide drug information and education, and provide discharge medication counseling on target patients.
Internal Medicine with a focus on Surgery
This rotation teaches residents how to care for patients post-surgery. Residents are invited to round with the general surgery physician assistants/nurses and wound nurses to become more engaged in the rotation. Daily, the resident will manage pharmacokinetic, anticoagulation, parenteral nutrition, and insulin consults, develop pharmacotherapy plans and monitor drug outcomes.
Internal Medicine with a focus on Oncology Supportive Care/Palliative Care
This rotation provides an opportunity for the resident to participate in in-patient palliative care and oncology supportive care. In addition to optimizing patient care, the resident will also focus on acute and chronic pain management, and symptom management. Every morning, the resident will attend rounds with the Palliative Care team providing an opportunity for the resident to evaluate drug information questions and optimize opioid dosing and perform equianalgesic conversions.
The critical care unit (CCU) provides residents with the opportunity to offer pharmaceutical care to critically ill patients. The resident will participate in interdisciplinary bed-side rounds with the CCU team and will be directly involved in drug selection, dosing, and monitoring. Cardiothoracic surgery patients are brought to the CCU for post-operative recovery. This also allows residents to build knowledge about critical medications and their application to cardiovascular disease states. Topic discussions include reviews of critical care literature which is applied in clinical practice.
Drug Information/Medication Safety
During this rotation, the resident will evaluate drug information requests from various healthcare professionals in the hospital. The resident will review incident reports regarding medication administration and perform follow-up services that include development of processes to reduce the recurrent of such incidences. Facilitation of the medication use process will allow residents to learn the role of a pharmacist in the hospital performance evaluations and medication safety. Topic discussions are completed to further understand the role of core measures and steps taken to handle incidences in the acute care setting.
This rotation allows for residents to focus on management of infectious diseases and antimicrobial optimization. The resident will work with the Infectious Disease physician and participate in the hospital’s antimicrobial stewardship program. Topic discussions will include reviews of clinical guidelines to help the resident develop knowledge in infectious disease pharmacology and pharmacodynamics.
Pharmacy Management, Leadership and Informatics
With Dr. Early, the resident will attend management meetings, discuss developmental planning processes and financial management of the pharmacy. Topic discussions will include budgeting, human resources, evaluations and leadership techniques in leading the pharmacy department. Dr. Shinaberry’s portion of the rotation will review the role of informatics in pharmacy. Tasks will include developing reports and workflow processes to improve workflow in the pharmacy.