The PGY1/PGY2 pharmacy residency in pharmacotherapy is designed to produce a specialized practitioner with an advanced degree of proficiency and expertise in working with interdisciplinary teams to deliver pharmaceutical care to diverse populations from ambulatory to critically ill, pediatric to geriatric ages and presenting with varied and complex health problems. The intense focus on direct patient care of this residency develops a specialist of great flexibility in the direct patient care arena, an individual who can move from one specialized area of practice to another with confidence and ease. While other clinical specialized residencies build a knowledge base and decision-making skills in one area of focus, the pharmacotherapy residency graduate refines the decision-making skill in such a way that it is transferable across practice areas and then supplements that skill with strong knowledge acquisition in a broad range of disease states.
The scope and depth of residency graduates’ knowledge of the broad sweep of diseases and their treatment, combined with extensive patient care experience as outlined in the appendix, produces a pharmacist who can successfully serve health care organizations as an authoritative resource for information about medications and for decision-making affecting the care of patients. This includes contributions to formulary decision-making.
Groomed for practice leadership, pharmacotherapy residency graduates can be expected to continue their pursuit of expertise in practice; to possess advanced skills to identify the pharmacotherapy and medication-use training needs of other health care professionals; to deliver effective training to those health care professionals; and to contribute to the pharmacy literature.
The first year of the program strengthens baseline pharmacotherapeutic knowledge, clinical judgement, and problem-solving skills across a broad range of treatment areas. The second year builds upon these competencies to develop the resident’s abilities to deliver appropriate care in medically complex situations as well as to participate in health-system level of care via contributions to practice management. The combined program provides continuity between the PGY1 and PGY2 years, which allows the resident to gain both depth and breadth of exposure to a multitude of practice environments as well as the opportunity to complete a more comprehensive research project.
The graduating pharmacotherapy resident will be prepared to enter clinical practice as a pharmacotherapy specialist in acute or ambulatory care, academia as a school of pharmacy faculty member, or even practice management as a clinical manager. The graduate will be skillful in working as a member of multidisciplinary teams and in navigating the intricacies of care transitions. The resident will also have the baseline level of skills and experience to execute meaningful point-of-care research and to design and execute teaching activities in affiliation with a school of pharmacy.
RPD Contact Information:
Jesica Mangun, PharmD, BCPS
Residency Program Director, Combined PGY-1/PGY-2 Pharmacotherapy Residency
Clinical Pharmacist Practitioner, Family Medicine
PGY1 Required Rotations
- Orientation (1 month)
- Family Medicine Inpatient Service (1 month)
- Acute Care Medicine (1 month)
- Ambulatory Care (1 month)
- Critical Care (1 month)
- Pediatrics (2 months)
- Pharmacy Administration (1 month)
- Drug Information (1 month)
- Research (1 month)
- Elective (2 months)
PGY2 Required Rotations
- Orientation (1 month)
- Family Medicine Inpatient Service (1 month)
- Inpatient Psychiatry or Emergency Medicine (1 month, if not completed in PGY1 year)
- Acute or Ambulatory Care Infectious Diseases (1 month)
- Ambulatory Care Medicine (2 months)
- Critical Care (1 month)
- Hematology/Oncology (2 months)
- Elective (2 months)
- Research (1 month)
- Longitudinal Ambulatory Care Clinic (one half-day per week for the full year)
The pharmacotherapy resident must complete an average of 400 hours of staffing during the course of each residency year. This commitment is fulfilled by staffing every third weekend and for three concentrated weeklong blocks distributed over the course of each year. The weekend staffing component will occur in the Pediatric Decentralized Pharmacy in the PGY1 year. This will shift in the PGY2 year to staffing in clinical specialist pharmacist positions. Staffing activities during both years include, but are not limited to, verifying patient-specific orders and medications, providing pharmacokinetic consults according to departmental policy, answering in-depth drug information questions, attending all adult codes as the pharmacy member of the code team, providing patient education, and performing transitions of care responsibilities. Additionally, residents are responsible for staffing during one of three major holiday blocks (Thanksgiving, Christmas, or New Year’s) and one minor holiday (Labor Day, MLK or Memorial Day). These requirements may be changed annually based on the needs of the department.
Clinical On-Call Program
The department of pharmacy provides an on-call paging service to our physicians, nurses, and other clinical staff. While this service does not have an in-house on-call component, all residents participate in answering on-call drug information requests 24 hours a day. The covering resident fields medicine, surgery, oncology and pediatric questions. The types of questions that are referred to the on-call service are those that require significant time to research or a specialized knowledgebase. The pharmacotherapy resident will participate in on-call coverage during both the PGY1 and PGY2 years, rotating among the rest of the UNC resident class. While on-call, the resident will be available over a 24-hour period, will have specified back-up pharmacists to assist with difficult questions, and will be expected to document on-call activities in the electronic medical record according to processes described in the residency manual. The resident will cover the on-call pager approximately 25 days per year.
Research and Publication
The pharmacotherapy resident is required to complete a medication use evaluation (MUE) and a pharmacotherapy research project during the 24-month combined program. The MUE is typically performed as a group project with one to three co-residents and spans the period from fall to spring of the PGY1 year. The estimated time spent on MUE activities is 40 hours, and the required deliverables are a manuscript and poster or platform presentation delivered at the spring Research in Education and Practice Symposium (REPS). The pharmacotherapy research project occurs longitudinally during both years of the program. The expectations for this extended project are to develop research criteria, achieve study approval from the hospital IRB, collect data, analyze results, and present findings at either REPS or an appropriate subspecialty societal meeting. Additionally, the proposed methodology for the project will be presented at the ASHP Midyear Clinical Meeting during the PGY1 year. In addition to conducting and presenting research, residents are required to submit a manuscript for publication during both the PGY1 and PGY2 year.
The pharmacotherapy resident will complete a drug monograph or drug class review during the PGY1 year as a component of the required Drug Information rotation. Development or revision of a departmental treatment guideline, protocol, or policy is required in the PGY2 year and is typically identified during a clinical rotation or via participation in departmental committees. The finalized guideline, protocol, or policy will be presented at the Acute Care Services Pharmacy Practice Counsel for approval and inclusion on the intradepartmental Clinical Resources webpage. The anticipated length of time to complete development or review of a treatment guideline, protocol, or policy is 10 hours.
Required professional education includes two 45-minute ACPE-approved continuing education presentations, one delivered during each year of the program, and three hour long case conference presentations, two of which occur in the PGY1 year and the third during the PGY2 year. Case conferences are interactive, didactic, and case-based weekly educational sessions presented by PGY2 and PGY1 residents to an audience consisting of PGY1 residents. Each case conference session has a designated clinical specialist to provide guidance and topic expertise. The PGY1 resident is also required to attend weekly case conferences, while the PGY2 resident has the option to attend depending on availability and interest in the topic area. Each case conference session requires approximately 8 hours of preparation, and the average time to prepare each CE presentation is 20 hours.
Both PGY1 and PGY2 residents are incorporated into a layered learning practice model with student pharmacists, coresidents, and clinical specialists, which affords residents the opportunity to enhance their precepting skills. Precepting expectations vary by rotation and are determined by the primary preceptor based on each learner’s relative experience. Other educational opportunities include multidisciplinary teaching in the outpatient and inpatient settings, pod discussions, case conferences, and student seminars. Pod discussions are group topic discussions held among learners on rotation in similar practice areas and are led either by residents or a preceptor specializing in that topic. There are four student seminars presented each month covering a variety of timely topics with a focus on providing useful information for UNC practitioners. The resident is required to attend and evaluate a number of pharmacy student seminar presentations throughout the year.
All residents attend the North Carolina Association of Pharmacists Residency Conference in July and REPS in May. The majority of residents also elect to attend the ASHP Midyear Clinical Meeting in December, though they also have the option to attend an alternative professional meeting, such as the American College of Clinical Pharmacy (ACCP) Annual Meeting. A travel stipend is awarded annually to assist with the cost of meeting registration and associated travel expenses.
Each resident will earn an appointment with the UNC Eshelman School of Pharmacy as a Clinical Instructor and will serve as a teaching assistant for one or more selected School of Pharmacy courses. Course assignments will be based on school needs in combination with the resident’s interest areas. Residents spend an estimated 50 to 100 hours per semester on teaching assistant responsibilities, depending on the course.
Additionally, residents are offered the option to pursue completion of a teaching certificate during either the PGY1 or PGY2 year. An application process is necessary to join the teaching certificate program, and if accepted, residents will be provided guidance on lectures, portfolio development, and Pharmaceutical Care Lab participation to receive their certificate.
Pharmacotherapy residents are offered the option to pursue completion of a leadership certificate via participation in the UNCH Pharmacy Residency Leadership Certificate Program. An application process is necessary to join the leadership certificate program, and if accepted, residents will be provided guidance on leading topic discussions, leadership in motion projects, mentorship, and other activities to receive their certificate. The Leadership Certificate Program may be completed in either the first or second year.
Residents participate in activities involving community outreach through participation in Student Health Action Coalition (SHAC). The SHAC clinic is the oldest student-coordinated health service in the U.S., providing free multidisciplinary, comprehensive medical care to the underserved community of Chapel Hill. Our residents volunteer at the clinics an average of 1-2 times during the year, helping to provide care for the patients. Participation in the clinics provides an excellent opportunity for residents to help disadvantaged patients with medication-related issues, physicians with treatment decisions, and to precept students during the medication dispensing and counseling process.
Evaluations are a large part of the residency process. At UNC, we use the ASHP-endorsed online evaluation system, PharmAcademic. Evaluations are built for each rotation as well as for presentations, research, staffing, and longitudinal components of the program. Additionally, quarterly evaluations are held with the program director and mentor to ensure progress on long term goals.
Requirements for Receipt of Certificate
Residents are required to meet all requirements of the program in order to receive their certificate at the end of the 24-month program. In particular, the pharmacotherapy resident is expected to:
- successful completion of all required rotations
- completion of a one year research project or a prespecified part of a multi-year research project and submission of it in manuscript form to the RPD
- deliver 2 ACPE approved CE presentations (1 in each year)
- completion of all staffing responsibilities (approximately 400 hours per academic year)
- submission of a manuscript to a journal or a similar activity, as approved by the RPD
- completion of all evaluations in Pharmacademic and the submission of all handouts/presentations completed throughout the year
- 85% of all goals and objectives must be marked by preceptors or RPD as ACH or ACHR within Pharmacademic
Can I apply for both a PGY1 Pharmacy Practice Residency as well as the 24 month combined PGY1/PGY2 Pharmacotherapy Residency Program?
What residency certificate(s) will I receive at the conclusion of the program?
Residents who successfully complete the PGY1 and PGY2 year will be awarded with both a PGY1 certificate in pharmacy practice and a PGY2 certificate in pharmacotherapy. Therefore, close coordination with the PGY1 RPD and Pharmacotherapy RPD is incorporated.
What is the difference between Pharmacotherapy versus Internal Medicine?
Internal Medicine programs primarily prepare pharmacists to care for adults in the acute care setting. Although general medicine is a large part of Pharmacotherapy training, the residency develops pharmacists to provide comprehensive care to a broader range of patients (including pediatrics, geriatrics, men’s and women’s health) in the critical care, acute care and ambulatory care environments. The program allows flexibility for the resident to tailor the 24 month experience to his/her interests and career goals.
Will I have the opportunity to serve as a Clinical Pharmacist Practitioner?
PGY2 residents will have the opportunity to apply for a Clinical Pharmacist Practitioner (CPP) license. The CPP is a designation by the North Carolina Medical Board and Board of Pharmacy conferring approval to provide collaborative drug therapy management, including ordering labs and medication prescribing, under the direction of a licensed physician. Serving as a CPP enhances the longitudinal clinic experience by allowing the resident to better embed within the clinic, work more closely with a supervising physician, develop proficiency in clinic logistics, engage in the CPP licensing and privileging process, extend pharmacy care, and develop more autonomy.
What future career opportunities will the residency afford?
A majority of residents pursue clinical opportunities in ambulatory care settings (i.e. primary care clinics, transitions of care clinics, specialty clinics) and in acute care settings (i.e. internal medicine and family medicine inpatient services). In these roles, a majority of our graduates are now involved in residency training at their own institutions. Others have pursued academic careers at schools of pharmacy. Opportunities for residents upon completion of the UNC Training Program are abundant and represent a wide scope of practice styles and settings.