Postgraduate Education in the United States

1. Postgraduate Education in the United States Magaly Rodriguez de Bittner, PharmD Professor and Chair, Department of Pharmacy Practice and Science University of Maryland School of Pharmacy

2. Outline Overview of Pharmacy Education in the US Postgraduate Education Goals Type of Programs Number of Programs Requirements of the Programs Lessons Learned/Recommendations

3. Pharmacy Education Doctor of Pharmacy- PharmD 6-8 years of University (after finishing High School) Accredited by the American Council of Pharmaceutical Education (ACPE) Didactic/Laboratory/Experiential components Basic Sciences and Clinical Sciences-focus on Pharmaceutical Care Principles and Patient care Licensure-by examination Same exam in all states only portion that is different is the law exam

4. Postgraduate Education: Masters or Doctor in Philosophy(PhD) Goals: Completion of a predetermined course of study including didactic and laboratory components Gain the necessary knowledge and skills to become a researcher Completion of a Thesis with required publication

5. Post Graduate Education: Fellowships Goals: Gain research and project management skills Increase Clinical Skills in patient care or area of specialty

6. Postgraduate Education: Residencies Goals: 1. Expand knowledge, skills and attitudes concerning patient care and clinical skills 2. Increase confidence in providing Pharmaceutical Care 3. Gain experience under the supervision of a trained and experience practitioner (often an expert in the field) 4. Gain experience in a particular field of specialization 5. Develop project implementation/research skills

7. Residencies A 12 month advanced education and training experience, usually from July 1 to June 30 Resident is mentored under the guidance of an experienced preceptors Provides intensive focus on enhancing knowledge, skills, and abilities Stipend and benefits provided

8. Residency Types PGY1 (Pharmacy Practice) Broad scope Patient care in a broad range of patients with varying disease states Various practice areas � hospital, community, managed care PGY2 (Specialized) Focused practice area Examples: Oncology, internal medicine, and critical care Must do PGY1 residency to enter PGY2 residency Accredited vs. Non-accredited Residencies Candidate & Pre-Candidate Accreditation Status

9. Residencies Postgraduate Year 1 (PGY1) Duration of a year Managed Care, Community Pharmacy and Pharmacy Practice US: total of 771 Postgraduate Year 2 (PGY2) - Duration of a year Requires a successful completion of a PGY1 Usually in areas of specialty: Cardiology, Primary Care, Ambulatory care, Oncology, Administration, Critical Care, etc.. - US: total 466

10. PGY1 Pharmacy Practice Experience Provides evidence-based patient care in interdisciplinary teams Exercise practice management and leadership Provide medication-related education and training Manage and improve the medication use process Demonstrate project management skills Utilize medical informatics

11. Residencies: Locations Schools of Pharmacy Health Systems Ambulatory Care Government Agencies: Federal and State Pharmacy Associations Managed Care Organizations Community Pharmacies Pharmaceutical Industry

12. Residencies: Funding Schools of Pharmacy Health Systems Federal Government State Government Foundations Grants Contracts Research Programs Private Entities Combination of all

13. Residencies: Accreditation Standards Accredited by the American Society of Health Systems Pharmacy(ASHP) , sometimes in collaboration with other pharmacy organizations Strict and Comprehensive Standards Standardized experiences and evaluation process Strict Requirements for the site and the preceptors A one, three or six year accreditation cycle Requires a visit by an accreditation team

14. Key Qualities of an Excellent Residency Excellent quality of the preceptors Adequate number of qualified preceptors Preceptors provide role modeling Program is systematically designed Program uses an effective evaluation system Program provides adequate scope and depth of patient care services for resident learning Site promotes safety of medication use systems

15. Residency Application Materials Completed application Cover letter/letter of intent Curriculum Vitae (CV) Transcript Letters of recommendation

16. Resident Matching Program Orderly process for matching residency applicants with acceptable programs and for matching residency programs with acceptable applicants Only for ASHP-accredited programs or programs that have applied for accreditation Optional for commissioned officers with the Military or Public Health Service programs Administered by National Matching Service (NMS) - www.natmatch.com/ashprmp Both parties need to be signed up for the Match

18. Community Pharmacy Residency Programs Residencies conducted in a community pharmacy setting ~ 59 programs offering training at 102 sites Accredited as PGY1 Community Pharmacy Residency APhA/ASHP Partnership Develop and enhance advanced patient care services � MTM, Diabetes, Asthma, Hypertension, Dyslipidemia, Pain Management, etc.

19. Postgraduate Education: Benefits Specialized and advanced training Meet job market demands or gain market advantage Advancement of the Profession Advancement in Patient care Networking opportunities A one year residency is often equated to 2-3 years of experience in a traditional pharmacy setting

20. Postgraduate education: Challenges Funding Number of Applicants Number and availability of Qualified Preceptors/Directors Commitment of the Organizations and their leaders Job Opportunities

21. Questions and DISCUSSION