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  1. 1. Geriatric Pharmacotherapy Residency (PGY-2) Kingsbrook Jewish Medical Center And Arnold & Marie Schwartz College of Pharmacy and Health Sciences Long Island University Brooklyn, New York Geriatric Pharmacotherapy Residency Program Goals The Kingsbrook Jewish Medical Center and the Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, offer a one-year ASHP accredited Specialty Residency Program in Geriatric Pharmacotherapy (PGY-2). The primary goals of this residency program are to prepare the resident to become a highly trained pharmacy professional with leadership skills who is a proficient specialist in geriatric pharmacotherapy, and is competent in publication and presentation scholarship, and clinical research and design. Upon completion of this advanced training program, the resident should be poised for careers in hospital practice, academia, or industry. The resident will receive comprehensive, intense, and individualized training in all aspects of geriatric pharmacotherapy from dedicated, passionate, and expert pharmacy faculty. Geriatric Pharmacotherapy Residency Position Description The resident will be responsible for providing comprehensive medication therapy management for geriatric patients in acute care, long-tem care, and ambulatory care settings, and will be able to follow patients through the continuum of care. To ensure that the geriatrics pharmacy resident experiences the entire spectrum of geriatric care, residency clerkships are divided into geriatric acute care (50%) and geriatric long-term care (50%). Geriatric acute care rotations include geriatric psychiatry, internal medicine, wound care, rehabilitation, and ambulatory care. The resident will complete a rotation in wound care, which includes experience in hyperbaric medicine. Elective opportunities include critical care, cardiology, surgery & nutrition, emergency medicine, and infectious diseases. In the long-tem care facility upon admission of all clients, the geriatric pharmacy resident will perform medication regimen reviews, medication reconciliation, and prescription drug plan formulary review. The resident will intensely participate in medication use evaluations, quality assurance reports, med-pass, adverse drug event and medication error reporting. On a monthly basis, the resident will provide medication regimen reviews to long-term care and assisted living patients. He/she will perform pharmacotherapy and pharmacokinetic consultations, and approve restricted antimicrobials. The resident will receive BCLS and ACLS training and certification, and participate in codes. An IRB approved scholarly research project is required. There is a faculty appointment with the Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University. Employment Information and Fringe Benefits Number of PGY-2 Positions: 1 geriatrics position Total PGY-1 & PGY-2 Class: 7 – 8 residents Total Faculty: 11 preceptors Start Date: July 1, 2008 Application Deadline: January 1, 2008 Estimated Stipend: $40,000 Benefits: Health insurance, meal stipend, 10 days paid vacation, 7 paid holidays, parking, educational travel stipend, personal computer and PDA, modern office space Required Conferences: ASHP Midyear, American Society of Consultant Pharmacists Annual Meeting, NY State Council of Health-System Pharmacists Annual Assembly 1
  2. 2. Residency Coordinators: Antonia Alafris, Pharm.D., CGP and Catherine Millares, Pharm.D., CGP Residency Director: Henry Cohen, MSc., Pharm.D., FCCM, BCPP, CGP The Kingsbrook Jewish Medical Center The pharmacy residency program will take place at Kingsbrook Jewish Medical Center, an 864-bed teaching, medical and pharmacy university-affiliated, non-profit, private community institution, comprised of a 326-bed acute care hospital and a 538-bed adult and pediatric skilled nursing long-term care facility. KJMC has a 10-bed medical/surgical and 10-bed cardiac intensive care unit, a step-down cardiac care telemetry unit, a 30-bed ventilator unit, a 20-bed traumatic brain injury and coma recovery unit, a 30-bed psychiatry unit, a pain management and treatment center, wound care and hyperbaric medicine center, a renal dialysis unit, a vascular laboratory, a cardiology suite, an endoscopy suite, a 911 receiving emergency department, surgical services including urology, orthopedics, vascular, gynecology, and ophthalmology, and multiple specialty ambulatory care clinics. The Department of Medicine maintains an independent medical residency program of over 50 medical residents and many board certified faculty. The surgical teaching program is affiliated with the SUNY Health Science Center Brooklyn Medical College. Other medical residency programs include orthopedics, podiatry, physical medicine and rehabilitation, and dentistry. The Rutland Nursing Home The Rutland Nursing Home is a 538-bed facility offering skilled nursing, rehabilitation and post acute care services. The nursing home has a specialty unit for ventilator dependent patients, and a 32-bed pediatric long-term care unit for children with developmental and metabolic disorders. The nursing home operates an Adult Day Health Care Center. Each nursing home patient care unit is staffed by a physician or physician extender. Pharmacy Services & Medication Safety through Advanced Technology The Department of Pharmacy is fully computerized, provides 24-hour pharmacy services and utilizes a robotic dispensing system. The Pharmacy Department employs over 40 professional and support personnel. The pharmacy department dispenses over 10,000 unit dose medications daily. The pharmacy provides the nursing home facility with 24-hour unit dose dispensation, parenteral medications, 24-hour pharmacy services, and supports the LTC P&T Committee. The hospital has a closed loop technologic drug distribution and administration system. Prescribers utilize the Computerized Physician Order Entry (CPOE) system, medication orders simultaneously interface into the Pharmacy Computer System, Pharmacists validate these orders, the Pharmacy Robot dispenses medications using barcode technology, and Nurses administer medications using barcode scanners. Computer terminals are located throughout the hospital, and on medication carts. An Emergency Medicine Satellite Pharmacy and a Clinical Pharmacist are responsible for medication utilization and delivery to the Emergency Department. Pharmacotherapy Services The 18-member Pharmacotherapy Team employs highly skilled Clinical Pharmacists, who have completed either postgraduate Pharm.D. Degree with a pharmacotherapy specialty residency; a 6-year Pharm.D. Degree with 2 years of pharmacy residency training; or extensive equivalent experience. Clinical Pharmacists specialize in the following settings: Critical Care, Surgery & Nutrition, Emergency Medicine, Internal Medicine, Infectious Diseases, Cardiology, Psychiatry, Geriatrics, Long-Term Care, Wound Care, and Ambulatory Care. The department has two ASHP accredited specialty residency programs in Critical Care Pharmacotherapy, and Geriatric Pharmacotherapy, one ASHP-pending accreditation specialty residency program in Internal Medicine, and a Medication Safety Pharmacy Fellow. The Pharmacotherapy team is highly respected, and is an elite healthcare team within the medical center. A summary of annual Pharmacotherapy Services highlights is listed in the table below. Clinical Pharmacy Service Annual Highlights 1 Pharmacotherapy Services • Clinical Pharmacists perform > 18,000 pharmacotherapy . interventions 2
  3. 3. • Pharmacotherapy interventions lead to > $5 million in costs savings 2 Restricted Antibiotic Consult Service • Clinical Pharmacists approve over 8,000 restricted antibiotics . 3 Adverse Drug Events Consult Service • Over 700 ADEs are detected, reported, and managed . 4 Pharmacokinetic Consult Service • All Aminoglycoside orders require a Clinical Pharmacist’s . review, written note, and follow up 5 Clinical Pharmacology Consult Service • Physicians request formal written pharmacotherapy consults . 6 Oxandrolone Consult Service • All Oxandrolone orders require a written pharmacotherapy . consult to determine feasibility of use and monitoring 7 Ambulatory Care Services • Pharmacist-lead clinics are provided for anticoagulation . (warfarin), diabetes, and smoking cessation 8 Ventilator Weaning Service • Pharmacotherapy interventions have helped decrease the . length of stay by 2 – 3 days Clinical Rotations The resident will have the unique opportunity to practice geriatric medicine in several settings including acute care, long-term care and ambulatory care. The resident will participate in daily nursing morning report, daily physician morning report, daily patient-care teaching rounds, daily formal medical grand round lectures, and pharmacy-led clinical pharmacology rounds. Our 11-member Pharmacy Residency Faculty, allow us to offer a diverse variety of clinical clerkships, and one-to-one faculty-to-resident training. Extended clinical rotations in Long-Term Care Medicine and other rotations allow the resident to develop a higher level of pharmacotherapy experience and skill. The resident in collaboration with the Residency Program Director can design a one year residency program that focuses on areas of personal interest by choosing elective rotations and certain clerkships for 2-month rotations. Geriatrics Required Rotations Duration Elective Rotations 1. Long-Term Care Medicine 5 months 1. Emergency Medicine 2. Geriatric Psychiatry 2 months 2. Clinical Pharmacokinetics 3. Internal Medicine 1 month 3. Infectious Diseases 4. Wound Care & Diabetes 1 month 4. Critical Care 5. Surgery & Nutrition 5. Ambulatory Care 1 month 6. Rehabilitation Medicine 6. Research & Design 1 month Kingsbrook University – Courses for Pharmacy Residents In order to strengthen the Pharmacy Residents fundamental skills in Physical Assessment, Clinical Pharmacokinetics, Biostatistics, and Pharmacotherapy, we offer a condensed 2 week course on these subjects. Courses, workshops, and laboratory sessions are taught by Pharmacy Faculty. Residents are expected to develop a minimal skill set prior to beginning their clinical rotations. Biostatistics Physical Assessment Pharmacokinetics Pharmacotherapy 1 college credit equivalent 1 college credit equivalent 1 college credit equivalent 1 college credit equivalent ANOVA HEENT and Neck Exams Aminoglycosides Infectious Diseases Correlation Statistics Lungs and Thorax Exams Vancomycin Cardiac Diseases Power Statistics Cardiac Exams Phenytoin Pain Management Kaplan-Meier Curves Abdominal Exams Valproic Acid Diabetes Frequencies Neurology Exams Digoxin Stroke 3
  4. 4. Faculty Appointment at Long Island University and Teaching Responsibilities The resident will receive a university faculty appointment at the Clinical Assistant Professor of Pharmacy Practice rank with the Division of Pharmacy Practice at the Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University. At the university, the resident will teach pharmacotherapy recitations or physical assessment laboratory. At the hospital, the residents will precept Pharm.D. students during their clerkships. The Resident will lead Clinical Pharmacology Rounds for Pharmacy Students as the Attending Pharmacotherapist and teach pharmacotherapy to Pharm.D. students both in the class room and bedside settings. Lecture Opportunities The resident will be taught oral communication and presentation skills, and Power Point slide development. Throughout the residency program, residents will formally present to faculty and colleagues’ journal clubs with comprehensive disease or drug reviews, and reviews of pharmacotherapy topics. There will be ample opportunity to lecture at professional society meetings, medical, nurse practitioner and physician assistant programs in the tristate area, the universities active continuing education programs, and the hospital’s pharmacy, nursing, and medical staffs. Residency Research Project and Publishing Requirements The resident is required to complete one rigorous scholarly geriatrics research project. The resident will be responsible for preparing a research proposal including justification for the project and study methodology, determination of a power analysis, application of appropriate statistical analysis, development of a budget, receiving IRB approval, collaborating with research-intensive medical residents, presenting via poster or platform presentation, and publishing the results as an abstract and manuscript. Pharmacy Practice Management The resident will have opportunities to provide off-hour clinical pharmacy services including responding to codes, emergency medicine pharmacy satellite coverage, infectious disease approvals, clinical pharmacology consultations, medication regimen review, renal dosing, and drug information. On off-hours, the residents will hold supervisor responsibilities including overseeing the pharmacy operation and clinical pharmacy services. Qualifications and Application Procedure In order to apply for this ASHP-accredited geriatrics pharmacy practice specialty residency program (PGY2), you must be a graduate of an ACPE accredited college of pharmacy, and you should possess a Pharm.D. degree, or a Post-BS Pharm.D. degree or equivalent experience, and have completed an ASHP-accredited Pharmacy Practice Residency (PGY-1). Pharmacy licensure or eligibility for licensure in NY State is required. Applicants must submit the following: 1. Complete the “KJMC Application for Admission – Pharmacy Practice and Specialty Residency Programs Form.” 2. Curriculum vitae (6 copies), which includes your education history, employment history, a list of pharmacy clerkships and preceptors, publications and presentations. 3. All official college transcripts. 4. Three letters of recommendation – two from primary preceptors from recent pharmacy residency clerkships. Provide a list with names, addresses, E-mail addresses and telephone numbers of the individuals sending recommendations on your behalf. Please do not use the ASHP Residency Applicant Recommendation Request Form. 5. A brief letter of intent describing why you want to complete an Internal Medicine Pharmacy Practice Specialty Residency and why you want to complete it at Kingsbrook Jewish Medical Center. 6. A succinct essay describing three clinical pharmacy scenarios in which you intervened and provided medication therapy management that had impact. Application data is due by January 1, and should be submitted to: Henry Cohen, M.S., Pharm.D., FCCM, BCPP, CGP, Chief Pharmacotherapy Officer, Department of Pharmacy, Kingsbrook Jewish Medical Center, 585 Schenectady Avenue, Brooklyn, New York, 11203. An on-site interview at the applicant’s expense and 4
  5. 5. participation in the ASHP Residency Match Program is required. For more information please call Dr. Cohen at 718-604-5373 or E-mail him at: Kingsbrook Jewish Medical Center is committed to the directives of the Equal Employment Opportunity and Affirmative Action programs and policies in conformance with the principles of the Equal Employment Opportunity Commission. 5