PGY-2 critical care residents devote much of their time to comprehensive training as a member of the interdisciplinary team. A breadth of learning experiences has been designed to increase and refine clinical competency, provide evidence-based pharmacotherapeutic care plans and develop confidence as an independent practitioner.
Direct patient care services allow a resident to provide patient-specific pharmaceutical care services. Responsibilities include development of individualized care and monitoring plans for various patient populations. After coaching, instruction and modeling by a preceptor, residents are assessed and constructively critiqued on how to further refine the delivery of evidence-based recommendations.
Drug information is provided to patients, physicians, nurses, pharmacists and other allied health professionals. Feedback is provided to enhance drug information-retrieval skills using a variety of resources and modalities.
Pharmacokinetic monitoring is provided to eligible patients. Residents serve as an information resource by providing recommendations for appropriate assay procedures, evaluation of serum drug concentrations and appropriate documentation in the medical record.
Required learning experiences
The PGY-2 Pharmacy Residency in Critical Care at Mayo Clinic Hospital — Rochester is designed to provide a diverse experience for the future clinician. Required learning experiences include:
|Coronary intensive care unit||4 weeks|
|Medical intensive care unit||8 weeks|
|Nutrition support service||4 weeks|
|Surgical intensive care unit (either cardiothoracic surgery or multispecialty)||4 weeks|
|Trauma and general surgical intensive care unit||4 weeks|
|Teaching (typically the second 4-week MICU rotation, but may be any ICU rotation that is repeated)||4 weeks|
|Medical emergency response||Longitudinal|
|Medication use evaluation and quality improvement||Longitudinal|
Elective learning experiences
Electives are available in a variety of settings that allow residents to tailor the program to their needs. The list below includes popular elective learning experiences that past PGY-2 critical care residents completed. Additional elective learning experiences may be available upon request.
- Cardiothoracic transplantation
- Critical care infectious diseases
- Critical care nephrology
- Emergency medicine
- Immunocompromised intensive care unit
- Neurology intensive care unit
- Solid organ transplantation
Teaching requirements and opportunities
Pharmacy residents are required to provide up to three formal continuing education presentations throughout the academic year at Mayo Clinic Pharmacy Grand Rounds. Pharmacy Grand Rounds are accredited through the Mayo Clinic School of Continuous Professional Development in collaboration with the Department of Pharmacy to provide Accreditation Council for Pharmacy Education (ACPE) and Accreditation Council for Continuing Medical Education (ACCME) credit types. This presentation venue affords pharmacy residents the opportunity to showcase pharmacology-related topics and expertise to interdisciplinary audience members, including pharmacists, physicians, nurse practitioners, physician assistants and certified nurse specialists.
Pharmacy Grand Rounds are broadcast to multiple Mayo Clinic and Mayo Clinic Health System sites across the United States and are available via live webcast at any Mayo Clinic facility. Regardless of location, learners can actively participate in assessment questions using state-of-the-art polling software on mobile devices, such as phones. Formal evaluations on presentation skills are provided to the resident for continual development.
Residents may have additional presentation requests by the interdisciplinary team while on specific learning experiences.
Teaching certificate and precepting
A teaching workshop is required for all residents who have not completed a previous certificate program. The goal of the workshop is to gain firsthand knowledge and development of teaching skills. The workshop highlights principles of pedagogy, matching teaching goals to classroom and testing activities, assessment of educational outcomes, and practice pearls for clinical teaching. Submission of a teaching philosophy and example learning experiences with evaluations are required for a certificate.
Under the direction of a preceptor, residents are afforded the opportunity to precept summer interns, Advanced Pharmacy Practice Experience (APPE) students and medical students from Mayo Clinic College of Medicine and Science. Additionally, the PGY-2 critical care resident facilitates precepting of a PGY-1 resident during an ICU learning experience. Evaluation and feedback on precepting skills is provided by a mentor to ensure continual teaching development. Residents interested in a future faculty position may elect to complete additional teaching experiences that focus on preceptor skill development.
Residents have the opportunity to participate on departmental or institutional committees to optimize the residency training experience. Through this experience, trainees gain appreciation for consensus-building and provide valuable input into practice decisions. A preceptor or committee member typically attends all meetings with the resident to provide guidance throughout the year.
Research certificate, project and resources
Pharmacy residents at Mayo Clinic make valuable contributions to evidence-based literature through completion of a required research project. Concurrent with development of a research project under the direction of subject matter experts and a mentor, each resident is enrolled in Mayo Clinic's pharmacy research curriculum to develop foundational research skills.
This curriculum includes a combination of live, application-based workshops taught by experienced pharmacist researchers and completion of a certificate program provided by Mayo Clinic's Center for Clinical and Translational Science (CCaTS). The certificate program, funded by the National Institute of Health (NIH), is designed to address the development and implementation of national standards and best practices for translation, from basic discovery to clinical and community-engaged research. Pharmacy residents complete the CCaTS Research Applications for Practice Improvement Decisions (RAPID) Program to obtain a certificate. The RAPID Program comprises approximately 60 hours of online coursework, including the following modules:
- Fundamentals of clinical and translational science
- Introduction to clinical epidemiology
- Statistics in clinical research
The live research workshops, offered at the beginning of the academic year, allow the pharmacy resident to learn directly from and with research experts on a variety of topics, including:
- Authorship considerations and guidelines
- Institutional review board introduction and submission considerations
- Development of a research proposal and protocol
- Research timeline development and management
- Database development and basics of data management
- Introductory course on statistical software
- Abstract, poster and manuscript preparation and writing
Pharmacy residents are afforded additional research support in the form of statistical expertise and discretionary funds. A partnership between the Department of Pharmacy and the Division of Biomedical Statistics and Informatics provides a dedicated biostatistician for pharmacy resident consultation. Upfront collaboration with these experts assists in the refinement of the study question, methodology, statistical sample size calculation and justification, and plans for data analysis. Each pharmacy resident is also afforded discretionary research funds to offset electronic data pulls, abstract and manuscript publication fees, equipment, and other research-associated costs.
During the academic year, students will have time devoted specifically to research projects. Residents are encouraged to publish their research results in a peer-reviewed journal.
Medication use evaluation and quality improvement training
All residents are required to complete a medication use evaluation (MUE) and accompanying quality improvement (QI) project during the residency year. The goal of the MUE-QI project is to develop a systematic process designed to determine, improve and maintain the appropriate and effective use of medications. Residents are afforded a mentor along with dedicated QI education and training resources through the Mayo Clinic Quality Academy.
As part of the PGY-2 critical care program's longitudinal MUE-QI learning experience, it is expected that residents achieve Bronze certification through the Mayo Clinic Quality Academy. Additionally, the resident is encouraged to achieve Silver certification through partnership with critical care physician fellows undergoing similar training.
Advanced life support, code participation and simulation center education
Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) certification are required for PGY-2 critical care residents. Education and training for BLS and ACLS are provided free of charge.
Additional pharmacy department training on code cart basics and code-specific competencies are required for residents who carry housewide code pagers. Various pharmacy residents and pharmacists are assigned code pagers throughout the year.
Required learning experiences may be augmented through training at the Mayo Clinic Multidisciplinary Simulation Centers. Simulation-based education provides a controlled or simulated environment created to imitate real-life patient care settings where learners can practice and master skills without putting patients at risk.
During the residency, students have the opportunity to attend professional meetings for the purpose of networking, professional development and service to the profession. Funding for travel-related expenses, such as airfare, hotel and registration fees, is provided by the residency program.
PGY-2 residents are required to attend the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting. Additional meetings are based on the discretion of the residency program and available funds. Typically, residents are allotted a maximum of 10 professional travel days a year.
All PGY-2 residents provide approximately 16 hours of staffing a month. Staffing may include a combination of weekend and evening experiences to maintain operational and clinical pharmacy competency and knowledge. No formal on-call program exists.
Core standards for resident performance have been established by ASHP to provide clear expectations. The PharmAcademic evaluation system is used to ensure that residents receive ongoing feedback that facilitates the development of their skills throughout the year. This feedback utilizes consistent assessment criteria and provides a mechanism for improving skills.
In addition to required learning experience evaluations, residents have a one-on-one quarterly evaluation with their respective residency program director to document achievements, progress of graduation requirements, and tailoring of the program to meet their needs. Residents also are asked to evaluate each of their preceptors as well as each learning experience to help improve the experience for future residents.
Graduation and certification
Upon successful completion of the residency, graduates receive a certificate of completion from Mayo Clinic School of Health Sciences and the Department of Pharmacy, Mayo Clinic.
The Department of Pharmacy and Mayo Clinic School of Health Sciences are committed to developing and maintaining the best education programs. The curriculum and other aspects of this program are assessed constantly and changed as necessary to ensure the highest quality training.