The PGY2 Critical Care Residency at UNC Medical Center is a 12-month ASHP-accredited program designed to provide a robust and diverse experience in critical care pharmacy. In addition to required components of a critical care training program set forth by ASHP, we strive to provide a wide variety of learning opportunities that can be tailored to help residents achieve their goals and prepare for future careers.
The structure of the clinical training component of the residency year is centered around a set of required core rotations that lay the foundation for critical care pharmacy practice. These rotations are chosen to provide fundamental and diverse exposure to the critical care setting, and to take advantage of the many experienced preceptors and challenging practice sites that UNC has to offer. The core required rotations are supported by a wide variety of available elective rotations that residents may choose from to customize their learning experience based on interests, challenge themselves in areas of inexperience, and/or solidify knowledge in a specific area.
- Orientation (1 month)
- Medicine ICU (2 months)
- Surgical ICU (1 month)
- Neurosurgical ICU (1 month)
- Cardiothoracic ICU or Cardiology ICU (1 month)
- Nutrition (longitudinal)
- Research (1 month)
- ICU Elective (3 months)
- Any Elective (2 months)
Available Elective Rotations
- Emergency Medicine
- Burn ICU, Pediatric ICU
- Cardiothoracic ICU
- Cardiology ICU
- Bone Marrow Transplant
- Solid Organ Transplant
- Benign Hematology Consults
- Infectious Disease Consults
Each resident will participate in a research project relevant to the practice of critical care medicine. Over the course of the year this project will give residents experience with generating and vetting research questions/hypotheses, crafting IRB submissions, building research timelines and data collection forms, data collection and analysis, presenting research results at a national or regional critical care meeting, and writing up project results as a manuscript for publication. Successful completion of each of these components through participation in one or more research projects is required for completion of the residency.
Process Improvement Project / MUE
Each resident will take a leadership role in identifying and bringing to fruition potential improvements in the medication use process related to critical care pharmacy. Examples of acceptable process improvement initiatives include but are not limited to: electronic medication use management (building / updating order sets or clinical pathways), updating or creating pharmacy guidelines relevant to critical care medicine, or implementing a new process in one or more ICUs (innovations to patient assessment, patient care rounds, etc.) Appropriate activities in this category will be identified with the assistance of the RPD and program preceptors.
Resident Writing Project (optional)
Each resident must submit a manuscript for publication for successful completion of the residency year. For many residents this will be their research project, but residents may opt to complete an alternative or additional writing project (i.e. case report, review article) with the assistance of one or more of the program preceptors.
Continuing Education Seminar
Each resident will complete and deliver a 45-minute ACPE-accredited continuing education presentation focused on a topic related to critical care pharmacy. The seminar is open to all members of the pharmacy community, including a remote WebEx audience from across the state of North Carolina.
Each resident may choose to attend a national critical care conference (Society of Critical Care Medicine, American Thoracic Society) or a national pharmacy conference (ASHP Midyear, ACCP), and is strongly encouraged to attend a local chapter meeting of SCCM in the spring (CVCSCCM). Participation in poster or platform presentations will be required at a minimum of one of these meetings.
Pharmacy Practice Responsibilities
Critical Care Pharmacy residents will receive training specific to staffing in all of the ICU settings and any shift that covers an ICU (evening/weekend), as well as the emergency department. Residents who are new to the program and institution may also receive limited training in operational areas in order to better understand workflow associated with medication delivery. Over the course of the year, pharmacy practice responsibilities will consist of:
- Three (3) one-week evening staffing blocks (Mon-Fri)
- Every third weekend (Sat-Sun) clinical staffing
Pharmacy practice responsibilities will include but are not limited to: verification of medication orders, clinical management of medication issues, follow-up of therapeutic drug monitoring, patient profile review, answering complex drug information questions, admission and discharge medication reconciliation, and participation in medical emergencies.
In addition to clinical staffing responsibilities, residents will also participate in the after-hours on-call program and the Code Blue response program. The on-call program is a rotating out-of-house pager that allows us to provide 24/7 clinical services at the Medical Center. The pager is used to triage clinical questions and for decision support in a number of clinical protocols. The Code Blue response program allows every resident the opportunity to be the primary responder at medical emergencies at the Medical Center for a portion of the year.
Critical Care residents will serve as teaching assistants in both semesters. In the fall, residents from multiple programs coordinate to provide teaching assistance for the Integrative Pharmacotherapy course. Residents primarily serve as evaluators of different clinical scenarios, giving pharmacy students feedback on performance. In the spring semester, critical care residents will serve as teaching assistants in the critical care elective. Each resident will also deliver one lecture during this elective, comprising 3 hours of classroom time.
Residents will coordinate and serve as instructors in the critical care group teaching that occurs every month among the learners on the various critical care rotations. Each resident will have one 90-minute block per month to teach a small group about different critical care topics using active learning techniques.
Practice-based teaching will occur in the form of direct precepting. Residents will frequently serve as co-preceptors or primary preceptors for pharmacy students and/or PGY1 residents when on the same rotation. This may include leading topic discussions and patient discussions, supervising the students on rounds, giving feedback to students on their performance, etc.
Residents will also participate in the Combined Critical Care Conference curriculum. Over the course of the year this will involve presentation of five (5) formal journal club presentations on landmark or relevant new literature, two (2) case conference presentations on a topic of their choosing, as well as two (2) interdisciplinary conferences with the Critical Care and EM programs from Duke and the Infectious Disease program at UNC.
Leadership / Committee Involvement
In addition to residency leadership and committee requirements, each resident will participate as a member of an interdisciplinary committee at the Medical Center. Available committees include the ICU Advisory Committee, Adult Sedation Committee, and Resuscitation Committee. Regular attendance at committee meetings is required.
Requirements for Program Completion:
In order to receive a certificate of Residency completion, residents must:
- Successfully complete all scheduled learning experiences
- Receive an evaluation score of “Achieved for the Residency” (ACHR) for at least 85% of PharmAcademic objectives
- Attend, participate, and/or present in all required educational activities, meetings, and conferences
- Complete a one year research project or a pre-specified part of a multi-year research project, including all of the following: data retrieval, data analysis, formal presentation (poster OR platform) at a local/regional/national forum, creation of a draft manuscript in publishable quality, project proposal submission, creation of a data collection tool, and IRB submission (if appropriate)
- Prepare and submit for publication consideration a minimum of one manuscript based on work conducted during the residency year. The submission, if successful, should be subject to the peer review process, so as to allow the resident to receive critical feedback on their manuscript
- Complete all staffing requirements, inclusive of weekday and weekend, day and evening responsibilities, to support the Department of Pharmacy's operational and clinical needs
- Complete all evaluations in PharmAcademic, ASHP's approved tool
- Provide a 30-60 minute (RPD determined) ACPE accredited CE program for pharmacists and pharmacy technicians within and outside the Department of Pharmacy