PGY1 Community-Based Specialty Pharmacy

MaineHealth Pharmacy Residency: PGY1 Community-Based Specialty Pharmacy Appendix 2024-2025

Contact: Stefanie DiLoreto, PharmD

Email: stefanie.diloreto@mainehealth.org

SRAC: All PGY1 preceptors

Program Structure

The MH PGY1 Community-Based Specialty Pharmacy Residency program is a 12-month, advanced training program that fosters the development of skills in direct patient care, academic teaching, preceptor development, and clinical research. The program builds on Doctor of Pharmacy education to contribute to the development of clinical pharmacists with advanced training in specialty pharmacy. Residents will have the opportunity to gain experience in both clinic-based pharmacy practice and specialty pharmacy operations. 

The opportunities will include program enrollment, patient education, medication access, fulfillment, compounding, and more. Residents will be exposed to a wide variety of disease states and the intricacies of the specialty medications used to treat them. Residents will also become well-versed in URAC and ACHC specialty pharmacy accreditation standards and have the opportunity to be involved in projects with our quality improvement team.

Program Objective

The Specialty Pharmacy Residency prepares a resident to have intimate understanding of and ability to take a clinic role as a specialty pharmacist in any of the disease states offered as a part of their training, in addition to the essential knowledge of the enrollment, fulfillment, and insurance aspects of the specialty pharmacy operation.

Required Rotations

Descriptions of the required learning experiences can be found in PharmAcademic. The resident will gain the skills necessary to function as an independent clinical pharmacist during their required learning experiences with the expectation that the resident displays ownership of all aspects of the medication-use process. The resident will build relationships across the specialty team and involved clinics and will facilitate safe and high-quality direct patient care.

Elective Rotations

Elective rotations may be tailored to the resident’s interest and recognized areas for development. The rotations may be customized to the duration necessary for the resident, but typically range from 4-8 weeks. The elective learning experiences may be scheduled in the second half of the residency year. New experiences may be created on a case-by-case basis if the resident has interest in a practice area not covered by the offered rotations.

The program structure for required and longitudinal learning experiences is outlined below. An orientation period of 4 weeks will begin the residency, and will be tailored to the resident’s prior experience.

Pharmacy Practice Staffing

The resident’s service commitment is one 4 hour shift every week. The service commitment will consist of staffing within the Specialty Pharmacy fulfillment center or in another clinic or service need deemed by the RPD. Staffing may evolve based upon resident interest and departmental needs.

Research Project

The RPD/RAC will supply the resident with a list of possible research projects to consider within the Orientation rotation of the residency. Resident may propose an original research project, but must be vetted by specialty RAC and approved by RPD. Project selection and CITI training should be completed prior to the end of the orientation experience. Research project timeline will be determined by specialty RAC, RPD, and resident. 

Residents will be expected to complete at least one research project each year. Additional research projects may be approved by RPD/RAC if resident is on schedule to complete primary research project assigned during orientation. The results of the research project will be presented to a local, regional, or national meeting as appropriate. A completed manuscript will be submitted for the research project before graduation with the understanding that an article suitable for publication will require additional work that may occur after residency completion.

Teaching + Education

The resident will have various opportunities throughout the residency year to develop and strengthen their teaching and precepting skills. The resident will have multiple presentation opportunities throughout the residency year, including but not limited to, Pharmacy Grand Rounds, Specialty Pharmacy Lunch + Learns, presentations requested during clinical rotations, and more. The resident may also choose to present a lecture at the University of New England College of Pharmacy. Participation in a Teaching Certificate Program is optional and will be discussed on a case-by-case basis. The resident may co-precept an advanced practice pharmacy experience student, as scheduling allows.

Medication Use Evaluation

Each resident will complete one medication use evaluation (MUE) during the residency year. The resident will be provided with a list of potential MUE topics generated by the RPD and SRAC preceptors. The resident may add to the list of ideas, if it is feasible within the year-long residency program. The resident will conduct the MUE under the guidance of a preceptor. Results from the MUE will be presented to the appropriate stakeholders. If there is a lack of MUE needs during the resident’s year, the MUE may be substituted with a policy or protocol creation or work from the MMC Ambulatory P+T Subcommittee.

Resident Development Plan

The PGY1 Community-Based Specialty Pharmacy Residency Program utilizes the ASHP on-line evaluation tool PharmAcademic. Residents will complete two pre-residency questionnaires prior to the start of orientation that help the RPD design a residency year that is tailored to the specific needs and interested of the resident:

• ASHP Entering Interests Form
• Entering Objective-Based Self-Evaluation Form

The RPD uses the ASHP Entering Interests form and Entering Objective-Based Self-Evaluation form to create the resident’s development plan. The Residency Requirement Checklist and Development Plan will be discussed and modified, as necessary, through a collaborative effort between the RPD and resident. In addition, the resident may request scheduled modifications throughout the residency year and the RPD will make all efforts to accommodate these requests. The RPD will share changes to the Development Plan to scheduled preceptors and during associated SRAC meetings.

Evaluation Strategy

Residents’ schedules are entered into PharmAcademic. For each learning experience, the following assessments are completed:

Note: For learning experiences greater than 12 weeks in length, a documented summative evaluation is completed at the 3-, 6-, and 12 month points, if applicable.

Summative Evaluations

• Summative evaluations assess the resident’s mastery of the required ASHP residency objectives
• Summative evaluations of these objectives will be completed by both preceptors and resident based on the following scale:

• Summative evaluations will be completed using Criteria Based Feedback statements
• Preceptors and residents should complete their own summative assessments and then meet to discuss and review together prior to submission
  • Any changes to the evaluation should be made in PharmAcademic, then finalized
• Summative evaluations MUST be completed within 7 days of rotation completion. Evaluations completed past 7 days of rotation completion without excused waiver from RPD/preceptor may result in corrective action.
• Evaluations are cosigned by the rotation preceptor as well as the RPD. The RPD may send an evaluation back for revision for multiple reasons, including but not limited to:
  • Significant misspellings
  • Criteria-based qualitative feedback statements not utilized
• Signing an evaluation (both preceptors AND residents) indicates that the evaluation has been read and discussed

The resident will complete a PGY1 Community-Based Specialty Pharmacy Program evaluation in the last month of residency. Feedback will be discussed at the SRAC meeting and agreed upon changes will be incorporated into the next academic year.