PGY-2 Solid Organ Transplant Residency

Purpose

PGY2 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) 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 or other advanced practice settings. Residents who successfully complete an accredited PGY2 pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification, if available.

Additional Program Description

The PGY2 Solid Organ Transplant Residency Program is designed to develop accountability; practice patterns; and expert knowledge, skills, attitudes, and abilities in each respective advanced area of solid organ transplant pharmacy practice. PGY2 solid organ transplant residents throughout the year will: acquire the needed knowledge for skillful problem solving of solid organ transplant related issues, refine their problem-solving strategies, strengthen their professional values and attitudes, and advance the growth of their clinical judgment. Specifically, this specialty residency is designed to train pharmacists to care for organ transplant recipients. Training will be focused in immunology, infectious disease, primary care, and critical care, with opportunities to care for patients in the inpatient and outpatient settings. The resident will also have the opportunity to care for pediatric transplant recipients during an elective rotation. Therefore, the solid organ transplant residency provides residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experiences and knowledge and transforming both into improved medication therapy for patients.

The resident must have previously completed a PGY1 residency or have an equivalent level of experience in hospital pharmacy practice prior to entering this specialized residency program. The residency is designed to provide a diverse experience, while focusing on the needs of the individual resident. Residents may tailor elective rotations to meet their particular goals and career needs. Residents are provided with formal written evaluations following each monthly rotation in order to provide for an optimal experience. Residents and advisors/RPD will complete a quarterly self-evaluation to assure compliance with self-determined goals and the ASHP Residency Learning System. Residents will rotate through adult inpatient and ambulatory experiences. Residents may elect to complete dedicated pediatric transplant learning experiences in the inpatient and/or outpatient setting.

Intended Outcomes

• Develop competent transplant clinical specialists with an understanding of rational drug therapy and the ability to utilize and expand their experience in clinical pharmacy practice, research, and education.
• Provide a broad scope of in-depth transplant experiences, which will lead to an advanced level of knowledge and enhance the resident's ability to design, implement, provide, and improve clinical pharmacy services.
• Develop future leaders in clinical transplant pharmacy practice and education.
• Provide the resident an opportunity to participate in clinical and evaluative research in the solid organ transplant population.
• Enhance and expand the resident's skills in the overall management of the complex, critically ill transplant recipient.

Program Design

Program Structure

The PGY2 Solid Organ Transplant Residency at MUSC is a one-year post-graduate training program designed to develop essential knowledge and skills for practice as a solid organ transplant pharmacist. The residency program provides the flexibility to adapt to the resident’s specific learning needs and goals.

The training is provided through month-long clinical rotations and longitudinal experiences.

Required Rotations

Learning Experience and Rotation Length

  • Orientation 1 month (July)*
  • Inpatient Heart/Lung Transplant/LVAD/Advanced Heart Failure 1 month
  • Inpatient Abdominal Transplant Surgery 2 months
  • Inpatient Cardiothoracic Surgery or Cardiovascular Intensive Care Unit 1 month
  • Ambulatory Adult Transplant Clinic 2 months

*July orientation month is modified for residents who completed PGY1 training at MUSC

Electives

5-6 months (depending on need for full orientation month). The resident may select any of the required rotations for additional months or other rotations per RPD discretion. Examples of elective rotations include:

  • Medical Intensive Care Unit
  • Medical/Surgical Intensive Care Unit
  • Internal Medicine
  • Infectious Diseases
  • Chronic abdominal transplant, inpatient and outpatient
  • Pediatric
    • Pediatric Transplant
    • Pediatric cardiac ICU
    • Pediatric ICU

Longitudinal Experiences

Specialty Pharmacy

Residents will gain experience providing care to transplant patients who receive medications from the MUSC integrated specialty pharmacy. PGY2 solid organ transplant residents will work for 8 hours each month in the MUSC Specialty pharmacy. Activities include, but are not limited to, prescription submission to insurance, prior authorization submissions, submitting appeals for insurance denials, peer to peer discussions with payors, writing letters of medical necessity, counseling patients on specialty medications, ensuring compliance with specialty regimens, ordering and reviewing labs for medication effectiveness, and other duties that involve obtaining affordable medications and monitoring specialty medications for transplant patients. Most patient care will involve hepatitis C medication procurement for patients who receive organs from hepatitis C positive donors..

On Call

Residents will participate in the Transplant Pharmacy On-Call service for weekend and holiday coverage. Residents will provide 24-hour availability of clinical pharmacy services related to transplant pharmacotherapy during their on-call assignments. Transplant pharmacy specialists will serve as the clinical back-up for the residents. PGY2 solid organ transplant residents will be expected to take call two weekends each month in addition to any assigned holidays

Research Project

Each resident will complete a major service or research project during the residency year. Project ideas will be generated by the transplant pharmacist group with assistance from the resident. Projects will address clinical and operational needs for Pharmacy Services and transplant patients at MUSC Health. The resident will present the results at a local, state, regional, or national meeting and they must write a manuscript suitable for publication describing the results of their project. Residents will be provided one working day each month during rotation hours to work on their project.

Medication Use Evaluation (MUE)

Each resident will participate in a group medication use evaluation during the spring to evaluate and implement measures to improve the quality of the medication-use process in solid organ transplant patients. Residents will write a manuscript and will present the results at a transplant quality meeting and/or the Pharmacy and Therapeutics Committee at MUSC Health.

Seminar

Each resident will present at least one ACPE-accredited seminar during the residency program. The goal of the seminar is to expand the resident’s communication skills, presentation technique, and knowledge in a solid organ transplant topic of their choosing.

Teaching Experience

Each resident will develop a 1-hour presentation to be delivered to practitioners outside of the department of pharmacy. This may include Transplant Grand Rounds, Internal Medicine Grand Rounds, or Heart Failure Conference/Cardiology Fellows Conference. The purpose of this experience is to learn how to present a topic to an interdisciplinary audience.

Each resident will be required to participate in the transplant/immunology elective at the MUSC College of Pharmacy. The resident will select a topic from the syllabus, prepare and teach a 2-hour didactic lecture to 2nd and 3rd year pharmacy students. The resident will be responsible for writing test questions for the students.

Each resident will be required to coordinate a monthly in-service immunosuppression/transplant protocol review for medical students, interns, and residents on the transplant surgery service.

Residents will participate in coordinating monthly group topic discussions for all learners on transplant rotations. These discussions will review core transplant topics in addition to other pertinent topics deemed necessary by the resident and/or preceptors. Residents will be responsible for coordinating a quarterly transplant journal club to review contemporary literature in transplant with preceptors, residents, and students.

Transplant Protocol

Each resident will participate in the development of at least one new transplant protocol. The resident will be required to work with an interdisciplinary team to develop this protocol. The final protocol will be presented to the transplant team at a quality meeting.

Optional Certificate Programs

Academician Preparation Program

The MUSC College of Pharmacy offers an optional certificate to residents in the Charleston area who are interested in enhancing skills needed in an academic environment. Residents are assigned a full-time faculty member as a mentor for this program. Additional requirements for APP include providing 2 hours of didactic lecture, developing one complex patient case, facilitating 5 small group discussions and/or laboratory exercises, and serving as the primary preceptor for 2 students on APPE rotations.

Research Certificate Program

The MUSC College of Pharmacy also offers a research certificate program for residents, consisting of live sessions aimed at improving residents’ ability to conduct, disseminate, and interpret research.

Core Preceptors

Holly Meadows, PharmD, BCPS, BCTXP
Clinical Pharmacy Manager, Ashley River Tower
Practice/Research: Transplant

Taylor Carcella, PharmD
Clinical Pharmacy Specialist/Transplant
Practice/Research: Transplant

Paige Dunton, PharmD
Clinical Pharmacy Specialist/Transplant
Practice/Research: Transplant

Caroline Perez, PharmD, BCPS
Clinical Pharmacy Specialist/Transplant
Practice/Research: Transplant

Jackie Hawn, PharmD, BCCCP
Cinical Pharmacy Specialist/CTICU
Practice/Research: Cardiothoracic Surgery

Barbara Wiggins, PharmD, BCPS, BCCCP, BCCP
Clinical Pharmacy Specialist/CVICU
Practice/Research: Cardiology

Krutika Hornback, PharmD, BCPS, BCIDP
Clinical Pharmacy Specialist/ID
Practice/Research: Infectious Diseases

Morgan Lange, PharmD
Clinical Pharmacist, Specialty Pharmacy
Practice/Research: Hepatitis C

Felicia Bartlett, PharmD, BCTXP
Clinical Pharmacy Specialist/Transplant
Practice/Research: Transplant

Kelsey Coffman, PharmD, MPH
Clinical Pharmacy Specialist/Transplant
Practice/Research: Transplant

Neha Patel, PharmD, BCPS
Clinical Pharmacy Specialist/Transplant
Practice/Research: Transplant

David Taber, PharmD, MS, BCPS
Clinical Research
Practice/Research: Transplant

Joe Mazur, PharmD, BCPS, BCCCP
Clinical Pharmacy Specialist/MICU
Practice/Research: Critical Care

Tracie Delay, PharmD, BCPS
Clinical Pharmacy Specialist, Internal Medicine
Practice/Research: Medicine

Megan Sell, PharmD, BCPS
Clinical Pharmacy Specialist, Pediatrics
Practice/Research: Transplant

Current Residents

PGY2 Solid Organ Transplant Pharmacy Residents

Requirements for Program Completion

Required Activities

(to receive a residency certificate)

All PGY2 residents have their PGY1 residency certificate on file.

Residents will complete or maintain ACLS certification and participate in medical emergencies.

Attain an “achieved” on 95% of the RLS objectives as assessed by the RPD on the last quarterly evaluation (June).

No NI’s may be present upon graduation of the program.

Complete all of the required month-long rotation experiences to the satisfaction of the rotation preceptor and RPD: orientation, ambulatory care (2 months), transplant surgery (2 months), heart/lung transplant/VAD/advanced heart failure, CVICU or CT surgery

Complete all assigned evaluations in PharmAcademic

Complete quarterly and end-of-year self-assessment (development plan) and review with RPD.

Participate in medication use evaluation(s). Provide a written document with methods, findings, and recommendations.

Complete a service or research project designed to improve the services of the Pharmacy ICCE. Prepare a manuscript suitable for publication in a peer-reviewed biomedical journal. Editorial assistance by the preceptor is required.

Present the research project at an approved local, national, regional or state meeting.

Complete disease-specific appendix for the PGY2 solid organ transplant residency.

Prepare and present an ACPE-approved continuing education seminar.

Prepare and present a didactic lecture to College of Pharmacy students in the transplant/immunology elective or other course as approved by the RPD.

Prepare and present a 1-hour lecture for presentation outside of the pharmacy department, which may include Transplant Grand Rounds, Internal Medicine Grand Rounds, Heart Failure Noon Conference, or other equivalent experience.

Prepare a transplant protocol in collaboration with other members of the transplant team

Complete all specialty staffing requirements as assigned

Complete all Transplant Pharmacy On-call Service requirements as assigned.

Evaluate 4 Grand Rounds presentations throughout the year