Ambulatory Care Pharmacy Residency

The postgraduate year-2 (PGY2) ambulatory care pharmacy residency at The University of Kansas Health System is designed to provide year-1 (PGY1) graduates the opportunity to accelerate growth beyond generalist practice and further the development of practice specific to the needs of ambulatory patients. The resident will have already achieved a basic level of competency commensurate with that of a PGY1 pharmacy practice resident. The PGY2 residency focuses on developing the knowledge, attitudes, training and skills necessary to cultivate pharmacists who are competent and compassionate practitioners who are prepared for a role as an ambulatory care pharmacist.

Graduates of the residency have the capability to design, implement and secure collaborative interdisciplinary practice agreements necessary for establishment and ongoing management of ambulatory practice. Graduates are empowered to treat and appropriately triage the most complex chronic and acute illnesses presented by ambulatory patients while providing care within the context of a long-term healthcare partnership with patients and healthcare providers that emphasizes health improvement and disease prevention. Completion of the PGY2 ambulatory care pharmacy residency will provide the practitioner the advanced critical thinking skills and clinical knowledge necessary to practice as an ambulatory care pharmacotherapy expert, enhance ambulatory care services as a clinical coordinator, and/or share skills with others by serving as an adjunct faculty member. Moreover, program graduates will be primed for ambulatory practice leadership to serve as experts in prescribing medication.

Completion of this residency program prepares pharmacists for a wide variety of ambulatory care positions. Previous residents have taken positions as pharmacists in primary care clinics, specialty clinics such as gastroenterology, rheumatology and HIV, and assumed teaching roles with colleges of pharmacy and residency programs.

PGY2 pharmacy residency programs build on Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency programs to contribute to the development of clinical pharmacists in specialized areas of practice. PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care that improves medication therapy. Residents who successfully complete an accredited PGY2 pharmacy residency should possess competencies that qualify them for clinical pharmacist and/or faculty positions and position them to be eligible for attainment of board certification in the specialized practice area (when board certification for the practice area exists).

• Length of program: 12 months, starting in early July
• Number of positions: 2

• Annual salary: $48,000
• Benefits include PTO, paid holidays, health/dental/life/liability insurance
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The PGY2 ambulatory care pharmacy residency is tailored to the interests and career goals of each resident. A variety of practice settings are available.

Required learning experiences

The PGY2 ambulatory care pharmacy residents are required to complete the following learning experiences for the coordinating durations:

• Orientation (4 weeks)
• Ambulatory leadership (4 weeks)
• Research (2 weeks)
• Introduction to longitudinal clinic (6 weeks)
• Longitudinal clinic experience (1 day per week)
• Comprehensive care clinic 1 (6 weeks)
• Comprehensive care clinic 2 (6 weeks)
• Specialty care clinic (6 weeks)

Clinic learning experiences

Residents are required to complete 2 comprehensive care clinic rotations and a specialty care clinic rotation from the options listed below. All rotations are 6 weeks in length.

Comprehensive care clinics

In comprehensive care clinics the pharmacist evaluates the complete patient and not a specific disease or medication. While they may focus on a disease state, within their scope they provide care for the majority of the patient’s diseases.

• Primary care
• The primary care clinics offer pharmacist-led comprehensive medication management (CMM) services. The pharmacy resident will be part of the primary care pharmacy team that manages patients referred by providers to CMM services for a variety of reasons, including diabetes management, hypertension management, medication tapering, polypharmacy and management of other chronic diseases. The pharmacist independently completes patient appointments and makes changes to patients’ pharmacologic regimen as needed. The pharmacist is also involved in answering drug information questions from providers, providing population health services, contributing to ongoing clinic development and providing patient and/or provider education.
• Preceptors
• Mallory Freeman, PharmD, BCACP
• Pharmacy school: University of Kansas
• PGY1 pharmacy practice: Wesley Medical Center
• PGY2 ambulatory care pharmacy: Parkland Health and Hospital System
• Amanda Stefl, PharmD
• Pharmacy school: University of Iowa
• PGY1 pharmacy practice – ambulatory focus: Froedtert and Medical College of Wisconsin
• PGY2 ambulatory care pharmacy: Intermountain Healthcare
• Kaitlyn Jones, PharmD
• Pharmacy school: The University of Mississippi
• PGY1 pharmacy practice: Michael E. DeBakey VA Medical Center
• PGY2 ambulatory care pharmacy: TTUHSC / North Texas VA Health Care System
• Cystic fibrosis
• The cystic fibrosis (CF) clinic has integrated pharmacists who assist in providing long-term management for pediatric and adult patients living with CF. The pharmacy resident will play an integral role on the multidisciplinary care teams for both the pediatric and adult CF programs. Each care team consists of physician(s), nurse coordinator(s), dietitian, social work, respiratory therapy, psychology and pharmacy. The resident will have opportunities for direct patient care experiences in and outside of clinic. These opportunities include providing patients and family members with medication education, medication adherence assessment and support tools, as well as assessment for and management of side effects and drug interactions. CF is a complex disease affecting multiple organ systems and requires numerous medication therapies. The resident will serve as a medication information resource for all CF and non-CF related medication therapies for both the care team and patient. Additionally, the pharmacy resident will act as a liaison between the patient and/or care team and specialty pharmacy to assure optimal medication access.
• Preceptors
• Lindsey Fitzpatrick, PharmD, BCPS
• Pharmacy school: Creighton University
• PGY1 pharmacy practice: Mercy Medical Center
• Michelle Simonsen, PharmD, BCPS
• Pharmacy school: University of Kansas
• PGY1 pharmacy practice: The University of Kansas Health System
• Infectious diseases (HIV)
• The infectious diseases clinic has integrated pharmacists who assist with providing long-term management for HIV-positive adults. The pharmacy resident will gain direct patient care experience providing patients with education on medications, adherence and general HIV information. They will also discuss and assist in the management of other non-HIV medication-related issues. Additionally, the pharmacy resident will work with providers on HIV regimen simplification and optimization, drug-drug interactions and side effect management. The pharmacy resident will collaborate with the multidisciplinary team to provide drug information support and assist with retention of patient in care.
• Preceptors
• Megan Herrman, PharmD, BCPS, AAHIVP
• Pharmacy school: Sullivan University
• PGY1 pharmacy practice: The University of Kansas Health System
• Kelly Robertson, PharmD, BCPS, AAHIVP
• Pharmacy school: University of Kansas
• PGY1 pharmacy practice: The University of Kansas Health System
• Solid organ transplant
• The Center for Transplantation clinics offer care to kidney, pancreas, liver and heart transplant recipients. Clinical pharmacists see patients in the clinic in conjunction with transplant providers and work closely with social workers, dietitians and other multidisciplinary team members. Transplant pharmacists provide care for patients at all points of their transplant care, from their pretransplant evaluation to comprehensive medication management post-transplant. Residents will be involved in the full scope of pharmacists’ work along with teaching clinic staff and providers, answering drug information questions, providing recommendations and providing medication education to patients. The transplant pharmacists serve as integral members of the transplant team and are a resource for physicians, nurse practitioners, nursing and pharmacy staff.
• Preceptors
• Anh Vu, PharmD, BCPS (renal and pancreas transplant)
• Pharmacy school: University of Colorado
• PGY1 pharmacy practice: University of Pittsburgh Medical Center
• PGY2 solid organ transplant pharmacy: University of Pittsburgh Medical Center
• Keith Foster, PharmD, MPH (liver and heart transplant)
• Pharmacy school: Samford University
• PGY1 pharmacy practice: Medical University of South Carolina
• PGY2 solid organ transplant pharmacy: Medical University of South Carolina
• Psychiatry
• The psychiatry clinic provides pharmacist-led medication management services for patients with mental health concerns. The pharmacy resident will gain experience in independent management of psychotropic medications in an ambulatory setting. Patients are referred to the pharmacy service for a variety of reasons, including clozapine management, antidepressant titration, urgent mental health concerns, smoking cessation, pregnancy medication counseling and general medication management. In addition to patient management, the pharmacy resident will collaborate with other providers in the clinic to provide high-quality psychiatric care. Clinic providers look to the pharmacist to answer drug information questions and to make recommendations on the management of complex patients.
• Preceptor
• Abby Hampton, PharmD, BCPP
• Pharmacy school: Southern Illinois University Edwardsville
• PGY1 pharmacy practice: Dorn VAMC
• PGY2 psychiatric pharmacy: Clement J Zablocki VAMC
• Advanced heart failure
• The advanced heart failure clinic has pharmacist-led services that focus on anticoagulation management of patients with left ventricular assist devices and cardiovascular pharmacotherapy management. The pharmacy resident would be part of a multidisciplinary team, including attending physicians, medical residents and fellows, pharmacists, nurse coordinators, clinic nursing staff and several other allied health professionals (dietitians, social workers, etc.). Residents will also be involved in teaching clinic staff and providers, answering drug information questions, developing medication-related policies and procedures, and providing recommendations, counseling and education to patients.
• Preceptors
• Sara Tarnowski, PharmD
• Pharmacy school: Creighton University
• PGY1 community pharmacy: Cleveland Clinic
• Alissa Nathans, PharmD
• Pharmacy school: University of Tennessee
• PGY1 pharmacy practice – ambulatory focus: Regional One Health
• PGY2 ambulatory care pharmacy: Methodist University Hospital / UTHSC

Specialty care clinics

In specialty care clinics the pharmacist provides care to patients with a focus on a specialized disease. While they may evaluate the complete patient, the focus is on a specific disease or set of diseases.

• Multiple sclerosis
• The multiple sclerosis clinic has pharmacists integrated into its team to manage medication therapy decisions, provide education, manage medication initiation, support adherence and mitigate adverse events. The pharmacy resident will have direct patient care experience through patient appointments to evaluate patients for appropriateness of medication, make drug therapy recommendations, manage patient side effects, evaluate labs, perform medication follow-up and answer medication questions from providers/staff. In addition, they will be involved in nursing and patient education opportunities.
• Preceptors
• Kelsey Morris, PharmD, MSCS
• Pharmacy school: University of Nebraska Medical Center
• PGY1 pharmacy practice: Kansas City VA Medical Center
• Megan Snodgrass, PharmD, MSCS
• Pharmacy school: University of Missouri – Kansas City
• PGY1 community pharmacy: St. Louis College of Pharmacy
• Rheumatology
• The rheumatology clinic has integrated pharmacists who care for patients with various rheumatologic conditions. The pharmacy resident will be a part of the care team helping to determine the best therapy for patients, educate patients on new therapy, and teach patients how to administer injections as well as monitor efficacy and safety of specialty medications. The pharmacy resident will serve as a resource for patients, providers, clinic staff members, infusion pharmacists, specialty pharmacies and other multidisciplinary clinics.
• Preceptors
• Jenna Beatty, PharmD, BCACP
• Pharmacy school: University of Iowa
• PGY1 pharmacy practice: Froedtert and Medical College of Wisconsin
• PGY2 ambulatory care pharmacy: Froedtert and Medical College of Wisconsin
• Elizabeth Barron, PharmD, BCPS
• Pharmacy school: University of Kansas
• PGY1 pharmacy practice: The University of Kansas Health System
• Gastroenterology (IBD)
• The gastroenterology clinic has integrated pharmacists who provide care to all GI patients with a primary focus on those with inflammatory bowel disease (IBD). The pharmacy resident is expected to work closely with the IBD multidisciplinary team, which includes pharmacists, physicians, nurse practitioners, nurses, dietitians, as well as retail pharmacy, specialty pharmacy and infusion teams, to ensure optimal patient care. Resident responsibilities include recommending optimal therapies, providing medication and injection education, assisting with medication access and affordability, assessing medication safety and efficacy, ensuring patient compliance and answering drug information questions.
• Preceptors
• Lauren Fox, PharmD, BCACP
• Pharmacy school: University of Kansas
• PGY1 pharmacy practice: CoxHealth
• PGY2 ambulatory care pharmacy: CoxHealth
• Cassandra Effken, PharmD, BCPS
• Pharmacy school: Drake University
• PGY1 pharmacy practice: Ralph H. Johnson VAMC
• PGY2 ambulatory care pharmacy: The University of Kansas Health System
• Hepatology
• The pharmacist integrated in hepatology clinic provides medication management for patients with liver disease, including hepatitis B, hepatitis C and Wilson’s disease. The pharmacy resident will be an integral patient of the patient care team, helping to determine the appropriate therapy for patients, providing in-depth medication education for patients starting on therapy, monitoring for drug-drug interactions and managing other chronic medication related issues. The pharmacy resident will also serve as a resource to other clinic providers, staff members and clinical pharmacists to field and answer any drug information questions.
• Preceptor
• Sarah Tate, PharmD, BCPS
• Pharmacy school: University of Kansas
• PGY1 pharmacy practice: The University of Kansas Health System
• Women's health (infertility)
• The advanced reproductive medicine clinic has integrated pharmacists who assist with providing reproductive endocrinology and infertility services. The pharmacy resident will assist with providing therapy recommendations and education for patients seeking infertility treatment and fertility preservation. The pharmacist resident will assist pharmacist-led management of conditions related to infertility and prenatal care (e.g., thyroid disorders, hypertension, hyperglycemia, vitamin deficiencies, etc.) along with evaluating medication regimens for pregnancy safety, answering drug information questions, managing conditions, coordinating care with outside physicians and assisting with medication access.
• Preceptor
• Leslie Coons, PharmD, BCACP
• Pharmacy school: University of Kansas
• PGY1 pharmacy practice: VA North Texas Health Care System
• PGY2 ambulatory care pharmacy: University of North Texas System College of Pharmacy
• Movement disorders and Parkinson’s disease
• The Parkinson’s disease and movement disorder clinic has an integrated pharmacist who assists with education and clinical assessments for patients with Parkinson’s disease and other movement disorders. The pharmacy resident will be involved in answering drug information questions as well as educating physicians and staff. The pharmacy resident will be part of a multidisciplinary team, including physicians, clinic nursing staff, allied health professionals (clinical psychologist, speech therapist, occupational therapist, etc.) and research team. Residents will also be involved in providing recommendations for fall risk in certain populations.
• Preceptor
• Steven Swank, PharmD, BCACP
• Pharmacy school: Butler University
• PGY1 pharmacy practice: Indiana University Health
• PGY2 ambulatory care pharmacy: University of Cincinnati

Longitudinal clinic

Residents will have a longitudinal clinic experience. The resident will spend their first 6-week rotation (Introduction to longitudinal) in this area and will continue 1 day per week throughout the remainder of the year.

Additional elective learning experiences

Additional opportunities may be available based on the schedule and interests of the resident.

• Hematology/oncology clinic (4 weeks)
• Comprehensive or specialty care clinic rotations that the resident has not yet completed (6 weeks)

The PGY2 ambulatory care resident will work in The University of Kansas Health System outpatient pharmacy 1 of every 4 weekends (Saturday and Sunday), 1 major and 1 minor holiday.

Research

• Each resident will complete 2 research projects. The goal is to enhance the personal and professional growth of the resident while benefiting the pharmacy department through pharmacy practice.
• Examples of previous projects
• Evaluation of Hepatitis B Vaccine Dosing Strategies in Human Immunodeficiency Virus Infected Adults
• Cohesive Comprehensive Annual Assessments in a Pediatric Cystic Fibrosis Clinic
• Evaluating Pharmacist-led, Polypharmacy-focused Comprehensive Medication Management Visits
• Utilization, Efficacy and Impact of Off-label Dosing of Biologics in Irritable Bowel Disease Patients
• Evaluation of Pharmacist Intervention, Medication Compliance and their Impact on Long-Term Outcomes for Patients with Cystic Fibrosis on CFTR Modulator Therapy
• Impact of Pharmacist-Managed Anticoagulation in Patients with Left Ventricular Assist Devices
• Residents will present research findings within the health system and at regional and national meetings. Residents will also prepare a manuscript suitable to submit for publication.

Teaching and precepting

• The resident will present two 1-hour seminars.
• Residents have experiences precepting students and residents on rotation.
• Residents are required to coordinate and present at least 1 class session for the ambulatory care elective at the University of Kansas School of Pharmacy.
• Residents have the option of presenting additional didactic lectures at the University of Kansas School of Pharmacy as available.
• Residents will prepare and present drug- and/or disease-focused lectures to ambulatory, hospital, pharmacy and multidisciplinary staff.
• Residents have the option of completing a teaching certificate program through the University of Kansas School of Pharmacy.

PhORCAS

Requirements

• Graduation from an ACPE-accredited PharmD program
• Completion of an ASHP-accredited PGY1 residency before the beginning of the PGY2 residency year
• Eligibility for licensure in Kansas

Deadlines

• All application materials must be received by January 2
• Must have a valid pharmacy license in the state of Kansas prior to August 15

Checklist for application

• Letter of intent
• Topics to consider: Why you want to pursue a residency and career in ambulatory care, why you have chosen The University of Kansas Health System and personal goals that the program would help accomplish
• Completion of essay questions
1. What do you hope to gain from completing this residency program?
2. Have you ever felt like you were being asked to do work that was below your level of qualification? How did you handle this situation?
3. How do you fit into your current residency program?
• Curriculum vitae
• College transcripts
• 3 letters of recommendation and/or PhORCAS forms
• PhORCAS residency program application
• ASHP resident matching program registration

National Matching Services (NMS) Code: 752665

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