Orientation is a four-week learning experience occurring at the beginning of the PGY1 residency. Residents will be introduced to the staff and duties of the central inpatient pharmacy, as well as the cancer center and operating room (OR) satellites. While preparing for and completing the North American Pharmacist Licensure Examination (NAPLEX) and Multistate Pharmacy Jurisprudence Examination (MPJE), the resident will also complete computer training; IV room training and competencies; Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certifications; departmental anticoagulation, pharmacokinetics, antimicrobial stewardship and code certifications; and Collaborative Institutional Training Initiative (CITI) training.
Longitudinal staffing experience
The longitudinal staffing learning experience will consist of staffing in the central pharmacy department. Experience will be gained in medication order verification, drug information, pharmacokinetic consults and follow up dosing, anticoagulation consults and follow up dosing, checking of the pharmaceutical product and working as a team with other pharmacists and technicians. Practical experience will be gained and applied by providing pharmaceutical care to a patient population that ranges from birth to 100+ years of age.
Drug information and healthcare education
The drug information rotation is a required, longitudinal rotation where residents will work with preceptors in a variety of their existing rotations to identify drug information questions/requests throughout the year. The focus of this rotation is intended to hone the residents' skills in the provision of pharmaceutical and drug information to the hospital’s pharmacy, nursing, medical staff and patients. A major responsibility of the resident is to provide concise, applicable and timely responses to our staff and to work in concert with them to resolve problems related to drug therapy. Some examples of the types of drug information provided include in-services, responses to specific drug information questions and medication utilization evaluations.
The internal medicine learning experience will help the resident develop a thought process to effectively and efficiently collect pertinent patient information from a variety of sources. The resident will be able to identify and resolve medication related problems, generate a problem list and create a plan of care with appropriate monitoring for outcomes and adverse effects. A strong emphasis will be placed on physiology, pathophysiology and pharmacology.
Antimicrobial stewardship (AMS)
The AMS learning experience is designed to teach the resident the rationale and execution of an antimicrobial stewardship program in a health-system setting. The resident with work with both the infectious diseases pharmacists and physicians to optimize pharmacotherapy outcomes as it relates to AMS / infectious disease (ID). The experience incorporates elements of ID, AMS, infection control, pharmacokinetic management of antimicrobials, transitions of care and outpatient antimicrobial management.
Infectious diseases (ID)
During this elective learning experience, the resident will utilize patient-specific data, antimicrobial pharmacokinetic and pharmacodynamic principles, as well as microbiological culture and sensitivity results to optimize antimicrobial drug therapy regimens for patients on the ID consult service. The resident will round with the ID physicians, be responsible for monitoring patients on the ID consult service and have designated time with both the Microbiology Lab and Infection Control Departments.
This rotation will be focused on optimizing medication therapy in cardiovascular medicine working closely with cardiologists, nursing and additional healthcare providers. The emphasis of the experience will be the management of drug therapy in hospitalized cardiac patients in a cardiac step-down care setting, a cardiac procedure unit including cardiac catheterization and electrophysiology labs, and cardiovascular arrest and emergencies.
Geisinger Community Medical Center (GCMC) is a level 2 trauma center. During this rotation the focus will be participating in bedside medication selection and dosing for procedural sedation, rapid sequence induction (RSI), pediatric/adult codes and pediatric/adult alerts (level 1 and 2 traumas, sepsis, ST-segment elevation myocardial infarction (STEMI), pulmonary embolism response team (PERT) alerts and stroke alerts) alongside emergency medicine (EM) team. Along with the procurement and compounding of emergency medications for critically ill patients at bedside.
The residents will complete patient profile reviews and prepare therapy recommendations as they participate in bedside rounding as part of an interdisciplinary team of physicians, residents, PA-Cs, nursing and other specialties. They will engage in core topic discussions with their preceptor and colleagues and develop skills necessary to provide pharmacy services as part of the critical care team.
Advanced critical care
In the advanced critical care learning experience, residents will continue to build upon the skills learned in their initial critical care experience. In this rotation, the resident and preceptor will emphasize the development of resident independence during interdisciplinary rounds and management of day to day pharmacist responsibilities such as order verification, emergency response and drug information questions.
Trauma services will be a four-week learning experience for PGY1 pharmacy residents at Geisinger Community Medical Center (GCMC), a level 2 trauma center. Some of the core discussion topics include anticoagulation reversal, multi modal pain management in the trauma patient, hemorrhagic, distributive and neurogenic shock, traumatic brain injury (management of cerebral perfusion pressure, paroxysmal sympathetic hyperactivity), craniofacial trauma, open orthopedic and penetrating injury of the extremities and penetrating abdominal injury. The resident’s experience is designed to mirror the pharmacist role, responsibilities and spectrum of pharmaceutical care services in this environment.