Cardiology Pharmacy Practice Residency Program

Philadelphia College of Pharmacy at The University of the Sciences in Philadelphia
In Conjunction With
The Hospital of the University of Pennsylvania and Presbyterian Medical Center

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Program Brochure (pdf)

Introduction

The Philadelphia College of Pharmacy (PCP) at The University of the Sciences in Philadelphia (USP) in conjunction with The Hospital of the University of Pennsylvania (HUP) and Presbyterian Medical Center (PMC) offers a one-year clinical residency in cardiology pharmacy practice. The cardiology residency is designed to provide clinical expertise in cardiac therapeutics, and understanding of the practical and administrative considerations of providing pharmaceutical services to cardiac patients, teaching experience, and experience in clinical research.

By the end of the one-year residency program, the resident will have gained experience, knowledge, and skills in cardiology pharmacy practice and will be prepared to provide clinical pharmacy services to cardiac patients.

Goals

1. To provide a structured environment for acquisition of knowledge and experience in the provision of clinical pharmacy services to patients in the cardiac care unit.

2. To develop teaching skills through participation in formal and informal training of pharmacy students, pharmacists, and other health care professionals.

3. To develop writing skills through activities such as preparation of case reports, review articles, and research results for publication.

4. To develop research skills through the development, completion, and presentation of a residency research project.

5. To provide the resident with a sense of professional responsibility through interactions with other health care practitioners and involvement in professional pharmaceutical organizations.

6. To develop oral presentation skills by preparing and delivering a residency project presentation to the Department of Pharmacy Practice and Pharmacy Administration faculty.
   

Objectives

By the completion of the residency pharmacy practice, the resident will be able to:

Patient Care Activities

Instructional Activities

Educational Activities

Administrative Activities

Research and Other Scholarly Activities

Faculty

Potential Preceptors (to be selected by the resident in conjunction with the Department of Pharmacy Practice and Pharmacy Administration Residency and Fellowship Program Coordinator.

Sarah A. Spinler, PharmD, FCCP
Professor of Clinical Pharmacy
Philadelphia College of Pharmacy
Adjunct Professor of Pharmacy in Medicine
Cardiovascular Division, Department of Medicine
University of Pennsylvania

Facilities

The primary training sites for the PCP Cardiology Pharmacy Practice Resident are HUP and PMC.

Hospital of The University of Pennsylvania

The Hospital of the University of Pennsylvania (HUP) holds the distinction of being the first teaching hospital built for a medical school in the United States. In the 1870’s, when the University of Pennsylvania moved from downtown Philadelphia to its present campus west of the Schukyll River, the medical faculty persuaded the trustees to build a hospital for the faculty of the School of Medicine; HUP was build in 1874.

The School of Medicine itself was established much earlier. The University of Pennsylvania School of Medicine was the first and only medical school in the thirteen original colonies when it was developed in 1765. In those pre-revolutionary days, its was known as the College of Philadelphia.

The founder of the School of Medicine was John Morgan, a Philadelphia physician who earned his medical degrees at the University of Edinburgh in Scotland. He, and other faculty members who had trained abroad, brought the medical teaching methods from Edinburgh to the United States, and put them into practice in our early School of Medicine. This became the model for most schools of medicine established thereafter.

In the years after the hospital was built, during the late nineteenth and early twentieth centuries, the School of Medicine was one of the first to encourage the development of specialties such as neurosurgery, ophthalmology, dermatology, and radiology.

By the twentieth century, American medicine had caught up with European medicine and was making important contributions to the biomedical sciences. The University of Pennsylvania School of Medicine and HUP were at the forefront of this movement and continue to be world renowned for their devotion to medical research, teaching, and the care of patients.

In 1987, the School of Medicine and the HUP incorporated and became know collectively as the University of Pennsylvania Medical Center. In July of 1993, in direct response to the dramatic change associated with health care reform, the University of Pennsylvania Health System (UPHS) was developed.

The UPHS is currently comprised of:
1) The flagship quaternary care Hospital of the University of Pennsylvania (HUP)
2) Presbyterian Medical Center and Pennsylvania Hospital which were purchased by the health system
3) Clinical Care Associates (CCA) comprised of more than 40 primary care physician practices (more than 140 primary care physicians) who are employees of the UPHS
4) An off-site multispecialty ambulatory care satellite facility
5) A wholly owned home infusion center, PENN Home IT, and
6) Three affiliate community hospitals (Chestnut Hill, Chester County, and Holy Redeemer Health System).

The UPMC is comprised of the Hospital of the University of Pennsylvania (700 beds), Presbyterian Medical Center (360 beds, acquired in July of 1995), and the University of Pennsylvania’s School of Medicine which includes the Clinical Practices of the University of Pennsylvania (CPUP).

The HUP continues to be a leader, ranked in the top 10 in the U.S. News and World Reports rating of Hospitals. The University of Pennsylvania Cancer Center is one of the 35 Comprehensive Cancer Centers designated by the National Institutes of Health (NIH). Research is one of the distinguishing factors of the UPHS, which is currently ranked #3 in the country for NIH funded research. The recent opening of a 144,000 square foot biomedical research building, the development of the Center’s first Institute for Human Gene Therapy and the completed construction of two more biomedical research buildings in the last two years assures UPHS’s dominance in clinical research for years to come.

Penn has received the 1999 Health System Clinical Effectiveness Award from VHA, a national network of leading community-owned hospitals. In 1998, HUP also won the National Quality Health Care Award from the National Committee for Quality Health Care, the 1998 Ernest A. Codman Award, sponsored by the Joint Commission for Accreditation of Healthcare Organizations (JCAHO), and the 1998 Excellence in Healthcare Awards, sponsored by Modern Healthcare and MMI Companies, Inc., for extraordinary innovations in improving the health of its patients.

Hospital of the University of Pennsylvania (HUP)

The HUP is located on the University of Pennsylvania campus in the University City area of West Philadelphia. The University of Pennsylvania School of Medicine established the hospital in 1874. Today, the hospital is a 700-bed, quaternary care, private university teaching and research institution, and is staffed by more than 3,400 employees, 1,000 physicians and 300 volunteers.

HUP serves as a major teaching site for the University of Pennsylvania Schools of Medicine, Dentistry, and Nursing, as well as the University of the Sciences in Philadelphia (formerly known as the Philadelphia College of Pharmacy and Science). The Children’s Hospital of Philadelphia (CHOP) is located adjacent to HUP, and utilizes HUP’s Neonatal Intensive Care Unit.

HUP is primarily a tertiary referral center, which provides general medicine and surgical services along with extensive subspecialty consultation services. HUP has a 12 bed cardiac care unit (CCU) and a 30 bed cardiac intermediate care unit (CICU).

Presbyterian Medical Center (PMC)

PMC brings to the health system expertise and developed programs in the areas of psychiatry and behavioral medicine, geriatrics, cardiology, subacute care and long term care. PMC currently owns or contract with more than 2500 long term care beds and thus provides a critical piece of the health system’s strategy for offering comprehensive services to the managed care marketplace.

PMC is a 350-bed tertiary-care facility, which serves as a major teaching institution for the University of Pennsylvania. PMC provides comprehensive medical and surgical care, which notably include cardiovascular, cardiothoracic, ophthalmologic, orthopedic, psychiatric, geriatric, and rehabilitative services. PMC has a 13-bed cardiac care unit, an 8-bed heart failure unit, as well as a 60-bed step-down, telemetry unit. The cardiologists affiliated with the Philadelphia Heart Institute at PMC offer a broad-range of services which include cardiac catheterizations/interventions, electrophysiologic procedures, a congestive heart failure management program, and cardiac rehabilitation

Pennsylvania Hospital

Founded by Benjamin Franklin in 1751, Pennsylvania Hospital was the first hospital in the Nation. Pennsylvania Hospital is a 515-licensed acute care facility. This institution provides a full-range of diagnostic and therapeutic facilities, functions as a major teaching institution, and clinical research institution to the health system. Pennsylvania Hospital is nationally recognized for high-risk maternal and fetal care, and is responsible for 4000 births each year.

The Department of Pharmacy

The department consists of 100 full time equivalents (FTEs) comprised of 113 people (9 managers/administrators/secretaries, 42 full-time pharmacists, 46 supportive personnel, 8 residents, 1 pharmacoeconomics fellow and 6 pharmacy interns).

The pharmacy administrative staff is composed of the director, two associate directors, and six supervisors. The Department actively participates in numerous administrative and medical staff committees, including the Medical Board, Pharmacy and Therapeutics Committee, the Committee on Studies Involving Human Beings or IRB (1 pharmacy representative on each of the four IRBs), Drug Use and Effects Committee, Quality Assurance Committee, Infection Control Committee, Medical Records Committee, Antibiotic Subcommittee, Pharmacokinetics Quality Assurance Committee, Transfusion Committee, Hematology/Oncology Inpatient Unit Committee, Risk Management Committee, and other ad hoc committees. Areas with clinical pharmacy services include drug information, infectious disease, nutrition support, pharmacokinetics, medical critical care, surgical critical care, and oncology. PCP faculty and students provide clinical pharmacy services in ambulatory care, infectious diseases, medical critical care, cardiology intensive care and psychiatry.

The Pharmacy staff is the greatest resource of the Department. Through their collective efforts, the Department has consistently developed new programs aimed at improving internal efficiency, and patient care outcomes. The pharmacist intervention program logs over 12,000 interventions per year. Last year, nearly 4,400 adverse drug events were avoided, with a potential cost savings of approximately 1.4 million dollars. The staff has repeatedly adapted to change required in the new health care environment and are dedicated to continuous quality improvement, automation and teamwork.

Presbyterian Medical Center
A variety of inpatient and outpatient services are provided by the Department of Pharmacy which include unit-dose distribution, drug information, clinical pharmacokinetics, and an extensive antimicrobial management service. PCP faculty and students provide clinical pharmacy services in infectious diseases, geriatrics, internal medicine, and cardiology

Philadelphia College of Pharmacy

The Philadelphia College of Pharmacy is the oldest College of Pharmacy in the United States. Since its origin in 1821, the College has continued to be a leader in pharmacy education providing Entry-Level Doctor of Pharmacy degree, and Flexible Doctor of Pharmacy degree programs. Other pharmacy-related baccalaureate programs are offered in the areas of pharmaceutical technology and pharmaceutical marketing and management. The College also offers graduate degrees in Pharmaceutics, Pharmacology and Toxicology, and Pharmacy Administration. Additional post-graduate pharmacy training programs offered by the College include clinical residencies or fellowships in ambulatory care, critical care, managed care, pediatrics, and cardiology.

Components of the Program

Professional Skill Development

Service-related responsibilities will vary according to the rotation but shall be directed toward providing clinical pharmacy services at HUP and PMC. These may include development of rational drug therapy, pharmacokinetic consultations, provision of drug information, and prospective evaluation of drug therapy for efficacy, toxicity, and drug interactions. The resident will participate in one longitudinal care activity through cardiology clinical or anticoagulation services. In addition, the resident will become certified in basic life support and advanced cardiac life support. These activities will involve approximately 50-60% of the resident's time.

Instructional Activities

The instructional activities of the resident will include precepting Doctor of Pharmacy students on cardiology rotations at HUP and PMC, leading small group case discussions for Doctor of Pharmacy clinical clerkship students, lecturing in entry level and flexible Doctor of Pharmacy therapeutics courses and/or Flexible Doctor of Pharmacy courses, teaching clinical case studies in the Doctor of Pharmacy pathophysiology and therapeutics course, and participating in the Pharmacy Practice Seminar series. The resident will complete the Residency and Fellowship Teaching Certificate Program.

These activities will involve approximately 25% of the resident's time, or approximately 500 total instructional hours per year. For example, instructional hours will be counted as follows:
Clinical Precepting:

Scholarly Activity / Research

The resident will prepare, complete and present (external to the College) an investigational protocol in the cardiac patient population. The resident will also be involved in various stages (protocol design and writing, grant submission, patient enrollment, data collection, data analysis, abstract preparation and presentation, manuscript preparation) of selected ongoing research projects of the primary preceptor.

Pending opportunity, the resident will be involved in preparation of case reports or review manuscripts. In addition, preparation and presentation of the residency research project to the Department of Pharmacy Practice during the Seminar in Professional Practice series is required. These activities will involve approximately 15-25% of the resident's time.

Professional Growth/Service

The resident is a member of the Department of Pharmacy Practice/Pharmacy Administration and will participate in departmental activities including faculty meetings, committees and exam proctoring. The resident is encouraged to attend professional meetings. There is no hospital pharmacy staffing requirement for this program.

Proposed Schedule

It is anticipated that the resident will spend a minimum of 2000 hours annually in program-related activities. An individualized schedule will be tailored to the needs and interests of the resident. Goals and objectives will be developed for each rotation.

Clinical practice experiences will include a minimum of 6 months (total) in the following areas:

Elective practice experiences may include:

Evaluation

An advisory committee shall be named for the resident within the first month of the program. Membership for the committee shall consist of the primary preceptor and at least two other individuals. The function of the advisory committee is to review and approve the objectives of the residency program, review and approve the schedule of activities, meet to evaluate the data information in the quarterly reports, and provide verbal feedback to the preceptor and resident which can assist them in completing program objectives.

Within the first 2 months of beginning the program, the resident shall submit a copy of the residency objectives detailing rotations and preceptors, educational activities, and scholarly activities, that were reviewed and approved by the advisory committee, to the Chair of the Department of Pharmacy Practice and Pharmacy Administration. For evaluation purposes, the resident will submit a quarterly report to the advisory committee, which will meet with the resident quarterly. An evaluative summary, written by the preceptor, must accompany each report. Copies of the quarterly reports and evaluative summaries will be given to the Chair of the Department. The resident will verbally report his/her activities to the Department at the January Department meeting.

At the end of the residency, a summary of accomplishments and an evaluation of the experience will be completed by the residency. After review by the advisory committee, this document should be submitted to the Chair of the Department by June 30th.

Qualifications And Application Requirements

Salary and Benefits

The resident will be an employee of the USP and will receive an annual stipend distributed over the 12-month period of the program by the payroll department at the USP ($36,000). Health, dental, disability and life insurance will be provided through the plan available to employees of the College. Nine standard University holidays, 8 vacation days, 2 floating holidays and 5 sick days will be provided during each 12-month period of the program. The resident will not be financially compensated for unused leave time. The resident is encouraged to attend professional meetings and receives annual travel support of $1000. The resident will receive an appointment as Resident and Clinical Instructor in the Department of Pharmacy Practice/Pharmacy Administration.

The resident is invited to participate, at no cost, in course work and continuing education programs sponsored or provided through the USP. Coursework may be taken as a non-matriculated student with the approval of the preceptor and advisory committee.

Secretarial support for typing of resident-related materials and correspondence will be provided. Audiovisual services will be available through the Information Science Department at the Joseph W. England Library of USP. These services include 35 mm slides, portable video projector and lap top computer, overhead transparency materials, poster and lettering supplies, as well as access to a collection of tapes and slides. In addition to audiovisual services, the Library provides Internet access, e-mail accounts, literature searches, photocopy services (300 copies/month), and an extensive collection of journals and references.

Through the Department of Pharmacy Practice/Pharmacy Administration and USP, the resident has access to a wide variety of computer software programs. Departmental and USP holdings include several word processing, spreadsheet, database, statistical, and pharmacokinetics programs. The department has an IBM compatible computer and laser printer that the resident may use. Additional IBM hardware and software are available in the England Library Learning Resource Center.

Certification

Upon approval of the primary preceptor, advisory committee and Department Chair, the resident will be awarded a certificate of completion from the Philadelphia College of Pharmacy, University of the Sciences in Philadelphia.

Last Updated: 5/8/06