Internal Medicine PGY-2 Pharmacy Residency

Ascension St Vincent is a 500+ bed, level 1 trauma community teaching hospital that serves as a tertiary referral center for a large network of Ascension hospitals in Indiana. The hospital has an active Medical Education Department supporting medical residents and fellows in Cardiology, Family Medicine, General Surgery, Internal Medicine, Obstetrics/Gynecology, Pediatrics, Podiatry, and Transitional/Preliminary Medicine. The pharmacy department maintains affiliations with Butler, Manchester, and Purdue Universities. The internal medicine service is composed of hospitalist-based and traditional teaching teams, and the PGY2 Internal Medicine resident will work directly with the Internal Medicine, Family Medicine, Transitional and Preliminary medical residents. Ascension St. Vincent Indianapolis is home to many subspecialties including cardiology, nephrology, gastroenterology, and neurology and the internal medicine service serves as the primary admitting team for many of these patients. 

Located in Indianapolis, Indiana, Butler University is a nationally recognized university with six academic colleges: Arts, Business, Communication, Education, Liberal Arts and Sciences, and Pharmacy and Health Sciences. Butler is known for providing small classes, opportunities to engage directly with faculty, and real-world experience through internships, co-ops, research with faculty mentors, performances, and community engagement offerings.  Butler is ranked the No. 1 Regional University in the Midwest by U.S. News and World Report, No. 1 Most Innovative School, and received national rankings for first-year experience, study abroad opportunities and undergraduate research/creative projects. The College of Health Professions (CHP) takes passionate students and helps them transform into skilled pharmacists and physician assistants who are dedicated to their practice and their community. The college is home to many healthcare related degrees including the doctorate of pharmacy, masters in physician assistant studies and a bachelors of science in health sciences. The mission of CHP is to provide innovative and interprofessional educational experiences in the health sciences. Connecting with a liberal arts perspective, we develop life-long learners who serve society as dedicated health professionals, scholars, and community leaders.

Internal Medicine

The Internal Medicine Rotations (IM 1-4) are designed to provide the resident with the opportunity to develop the knowledge and skills about the clinical course, manifestations and therapy of core disease states through direct instruction, observation and modeling by the preceptor. The rotation allows some flexibility in focused topics to meet the interests of the resident. Residents will have the opportunity to apply this knowledge through active participation in the multidisciplinary team and focused projects relating to internal medicine with coaching and facilitation occurring by the preceptor. The Adult Inpatient Medicine Service (AIMS) consists of 8 traditional teaching teams (attending, 3 medical residents, and up to 3 medical students) and 12 hospitalist based accountable care units throughout the progressive and medical/surgical units. The internal medicine rotation is designed to provide the resident with the opportunity to develop the knowledge and skills about the clinical course, manifestations and therapy of core disease states through direct instruction, observation and modeling by the preceptor.  The PGY2 resident will be assigned to a teaching team for each of their rotations with additional unit based requirement added as they progress through the four rotations. During some of the internal medicine rotations (IM 2 and 4), the resident will serve as the primary preceptor for APPE students from Butler University.  This experience is designed to provide the resident with the experience of serving as the primary preceptor including creation of rotation materials, implementing rotation plan and giving feedback.  The rotation will focus on academia and precepting topics, yet allow some flexibility to meet the interests of needs of the resident

Infectious Diseases

This Infectious Diseases / Antimicrobial Stewardship rotation is designed to provide the resident with the opportunity to enhance their knowledge in the topics of microbiology, infectious disease states and their appropriate antimicrobial therapies, and strategies of promoting antimicrobial stewardship. The resident will have the chance to apply this knowledge after modeling by the preceptor by answering clinical questions from fellow providers and pharmacists and making direct recommendations to providers to optimize patient care.

Medical Intensive Care Unit (MICU)

The MICU rotation is designed to provide the resident with the opportunity to develop the knowledge and skills about the clinical course, manifestations and therapy of common critical care disease states through direct instruction, observation and modeling by the preceptor. Residents will have the opportunity to apply this knowledge through active participation in the multidisciplinary team and focused projects relating to critical care with coaching and facilitation occurring by the preceptor.

Academic Administration

The Academic Administration rotation is conducted at Butler University College of Health Professions. This required rotation will provide the resident with the knowledge and skills necessary to function in an academic setting. This four week rotation experience for the pharmacy resident provides general exposure and a fundamental introduction to academic pharmacy and academic pharmacy administration. The resident may participate in various academic functions on Butler University’s campus throughout the rotation. 

Longitudinal Clinic

The Internal Medicine (IM) clinic experience takes place in the Ascension St. Vincent Joshua Max Simon Primary Care Center. This clinic is designed to provide primary care to uninsured, underinsured, and underserved patient populations from diverse socioeconomic and cultural backgrounds. IM clinic includes patients 18 years and older, many with multiple chronic conditions that have gone untreated or undertreated due to lack of healthcare access for some time. In addition, this clinic serves as the outpatient clinic training site for medical residents completing post-graduate training in Internal Medicine. The clinic is made up of the practices of both resident and faculty physicians, with faculty physicians also providing oversight for the resident physicians while they practice. Because of the diversity in patient populations and disease states seen in the IM clinic, it is anticipated that the resident will have the opportunity to participate in the care of patients with therapeutic concerns from many topic areas.

Advanced Practice Projects

As part of this experience, the PGY2 resident will complete three practice based projects: a policy/guideline/protocol, a drug class review or drug monograph and a medication use evaluation.  In collaboration with the preceptor, the PGY2 resident will help identify the specific topic for each project based on the needs of the organization.  The projects may be interconnected and one project may be the result of the findings and recommendations of another project (i.e. protocol or policy based on the findings of the MUE).

Education/Academia

This learning experience will take place at Ascension St. Vincent and Butler University College of Health Professions. This experience is designed to allow the resident to gain experience in participating in, designing, and providing a variety of education to a wide range of learners (including but not limited to pharmacy and physician assistant students, PGY1 pharmacy residents, medical residents, and multidisciplinary team members). As a Butler University Affiliated Residency, the resident will participate in the Butler University Longitudinal Academic Experiential Program for Residents (LAEP) and the Academic Leadership Certificate Program.  The PGY2 resident will participate in 2 semesters of small group facilitation (Case Conference), one didactic lecture to pharmacy or physician assistant students based on the needs of the college, primary preceptor for at least 2 APPE pharmacy students, and co-coordination of the Internal Medicine Therapeutics Elective.  Non-Butler education includes a grand rounds presentation and an in-service for the internal medicine or family medicine medical residency programs.

Practice Management

The Practice Management rotation has three main activities associated with the experience: participation in a committee or workgroup, coordination and updating the Internal Medicine Website and Medication Safety.  The resident will work as part of a multidisciplinary committee on the Infection Disease Expert Review Panel (ERP committee).  As a member of the committee, the PGY2 resident will review relevant materials prior to meetings, participate in market level stewardship discussions and planning, and progress throughout the experience to facilitating the meetings.  The Internal Medicine website is a resource used by providers and pharmacists across the state.  The PGY2 resident is responsible for evaluating current content for potential updates, working with content experts on appropriate updates and facilitating updates completed by students and PGY1 residents.  During the Medication Safety portion of this experience, the PGY2 resident will complete monthly Safety Event Investigations and coordinate with the Medication Safety team for needed changes based on their review.

Residency Project

The IM Resident will conduct a project pertaining to internal medicine pharmacy practice.  The residency program utilizes a flipped project style where the outgoing PGY2 IM will start a project in the second half of their residency year to be finished by the incoming PGY2 IM resident during the first 6 months of their residency. The new resident will then develop their own project and topic to start in the second half of their year that will be passed along to the next resident.

Staffing

The PGY2 resident staffs in a de-centralized role on a medical, surgical or cardiac floor every third weekend.  Additionally, the resident staffs one minor and one major holiday each year.