Carroll Pharmacy Residency About the Program

Antibiotic Stewardship/Infectious Disease Rotation

The resident will learn to optimize the management of patients with acute infectious diseases with an emphasis on antimicrobial stewardship (AMS). The Antimicrobial Stewardship team is scheduled for 4 hours daily, Monday through Friday. AMS services include prospective audit and review, dose optimization, restricted antimicrobial review, and antimicrobial recommendations. Concepts including antimicrobial spectrum, resistance mechanisms, antibiogram data, and evidence-based treatment guidelines will be reinforced and incorporated into recommendations. Additional activities during the rotation may include Medication Use Evaluation (MUE), monograph development, and Journal Club. 

Distribution Rotation

The resident will master the pharmacist’s role in pharmaceutical distribution within a hospital with a decentralized model. The resident will gain experience with working in pharmacy operations including order verification, preparing IV medications, and facilitating the medication reconciliation process. The resident will also gain skills in utilizing and trouble-shooting pharmacy technology (e.g. automatic dispensing cabinets). The resident will communicate with providers about medication related problems identified and improve upon their overall problem-solving skills. Staffing is required one evening per week and every fourth weekend.

Internal Medicine Rotation

The resident will strengthen their pharmacotherapy skillsets to serve patients on a 24-bed internal medicine telemetry unit within a multidisciplinary healthcare team. The resident will enhance their knowledge of evidence-based guidelines and latest literature for common acute care conditions, such as atrial fibrillation, venous thromboembolism, heart failure, chronic obstructive pulmonary disease, diabetes mellitus, etc. The resident will also practice transitions of care services in collaboration with the Medication Management clinic and CTO pharmacist for patients at high risk of readmission.

Anticoagulation Clinic Rotation

The resident will learn to manage patients in the anticoagulation management service based on current protocols and guidelines. The AC clinic operates Monday through Friday. Activities will include performing finger sticks and operating the CoaguChek device for the AC clinic in addition to determining an appropriate plan for anticoagulant dosing and management of anticoagulation peri-procedurally. Resident may also assist in precepting Advanced Pharmacy Practice Experience (APPE) students.

Critical Care Rotation

The resident will learn to care for patients in a 12-bed intensive care unit based on current protocols and guidelines. Disease states commonly encountered include shock, hospital-acquired and ventilator-acquired pneumonia, acute decompensated congestive heart failure, and diabetic ketoacidosis. The resident will develop pharmacotherapeutic management plans for critically ill patients and participate in daily multidisciplinary rounds.

Administration Rotation

The administrative rotation looks to provide pharmacy residents experience in administrative duties, financial and human resource management knowledge, scheduling, drug diversion tactics, technological implementation, purchasing and inventory control, and strategic planning. Residents will work with various members of the leadership team to gain exposure to the various administrative areas of pharmacy practice. The resident will be expected to exhibit leadership skills and contribute to management activities by the end of the rotation.

Medication Safety Rotation

The Medication Safety Rotation is a 3-week rotation at Carroll Hospital. By the end of this rotation, the resident will be able to demonstrate the ability to analyze adverse drug event reports and make systematic recommendations to minimize the risk of future repeated events. The resident will have the opportunity to learn about the activities of the risk management department, quality department and regulatory department as they pertain to medication safety issues. The resident will gain experience in identifying ways to enhance the medication use system to minimize the risk of adverse drug events.

intermediate Care Rotation

The resident will learn to identify and integrate essential patient information to meet inpatient goals for optimal medication utilization. The Intermediate Care unit (IMC) is a step-down unit from Intensive Care, where high acuity adult patients require close monitoring. With less functionality, patients may have chest tubes, feeding tubes, non-titrated cardiac infusions, chronic ventilatory support with tracheostomies, new cardiac stents, parenteral nutrition and PCA pain pumps. Primarily located directly on the IMC Unit, the resident will practice therapeutic drug monitoring services (e.g. vancomycin, aminoglycosides), renal dosing, inpatient warfarin management, DOAC monitoring, IV to enteral conversions, drug information questions and other clinical interventions. Rounds are done daily with providers, nurses, and care managers in a multidisciplinary approach to achieve high quality patient outcomes.

Medication Management Rotation

The Medication Management rotation is an elective 4-week rotation providing pharmaceutical care to patients in the community surrounding Carroll Hospital. Through this rotation, the resident provides care to patients who are at high risk of hospital resource utilization by completing comprehensive medication reviews, targeted medication reviews, and chronic disease management. The rotation is designed to provide experiences caring for patients through in-person and telephonic consultations. The hours of this rotation are 0800-1630 Monday through Friday. The resident will work directly with the preceptor on Monday, Tuesday, Thursday, and Friday in the Medication Management Clinic. On Wednesday, the resident will work independently providing patient care under the supervision of a qualified pharmacist.

Ambulatory Care Rotation

During the ambulatory care rotation, the resident will partner with the primary care pharmacist in various provider offices. Core components of this rotation include the identification and management of potential drug therapy problems, the design and modification of drug regimens, provision of drug information, and pharmacist-driven disease management. Upon completion of this rotation, the resident will be confident in their ability to participate in therapeutic decision-making and to develop patient-centered, evidence-based medication regimens and monitoring plans. The resident will gain experience in performing medication reconciliation, patient/caregiver education, documentation in medical record, and collaboration with other healthcare disciplines. The resident will be exposed to a variety of patient interactions including in-person, telehealth, and telephonic consultations.

Pharmacy Informatics Rotation

This required core rotation is not at CHC but will be completed at SHB.

PGY1 Rotation Experiences

• Infectious Disease
• Intermediate Care
• Internal Medicine
• AC Clinic
• Critical Care
• Emergency Medicine
• Pharmacy Administration
• Medication Safety
• Distribution (long)
• Clinical administration (long)
• Electives: 1 on site and 1 option for off-site