Pharmacy Residency Training Update 2005 ASHP Midyear Clinical Meeting

1. Pharmacy Residency TrainingUpdate 2005 ASHP Midyear Clinical Meeting

4. Practitioner Surveyors

6. New Pharmacy Residency Accreditation Standards Accreditation – protecting the public through meeting standards

7. Factors related to release of new Residency Accreditation Standards • IOM reports • JCAHO Roundtable/conference • Future of Residency Training Conference • ACCP/ASHP Partnership • Open Hearings & comment periods • ACPE draft standards

8. IOM - Core competencies for all health professionals JCAHO - improving education of health professionals • Patient-centered • Interdisciplinary teams • Evidence-based practice • Utilize informatics • Apply quality improvement

9. Pharmacy Residency Training in the Future: A Stakeholders’ Roundtable DiscussionJanuary 23-24, 2005 Stakeholders: ASHP AACP ACCP AMCP APhA Other invitees: ACPE, BPS, ASCP, NCPA, NACDS, VA

10. Strong Areas of Agreement • Accreditation by one national body that includes key stakeholders • All residencies should be accredited • Residencies help develop innovative practices • Colleges provide knowledge; residencies are becoming necessary to integrate knowledge into practice

11. Conclusions • ↑ need for residency trained individuals by 2015 • ↑ need for community residencies • Specialization in the profession needs clarity • PGY1 & PGY2 is appropriate model • Terms and vision need to be consistent, defined, endorsed and embraced by the profession

12. What’s happening now? CCP endorsed PGY1, PGY2 concept Published Conference proceedings AJHP September 1, 2005 New Standards Approved & Released: PGY1, PGY2 Programs continue to grow

17. New Pharmacy Residency Accreditation Standards PGY1 Pharmacy Residency Replaces Pharmacy Practice (2001) PGY2 Pharmacy Residency Replaces Specialized Pharmacy Practice (1994) and all supplemental standards (Goals & objectives remain) Standards not altered at this time: Managed Care Pharmacy Practice Managed Care Systems Residency Pharmacy Practice (with emphasis in Community Care)

18. PharmD Graduate Broad Patient/Practice FOCUS Narrow Basic DEPTH of knowledge, skills, abilities, experience Advanced

19. New Standards • Different terminology/concept PGY1/PGY2 • General training vs. advanced depth of training • Incorporates IOM core competencies • Duty hours • Participation in the match

20. PGY1 or PGY2?

21. PGY1 - 6 Core Competencies • Medication use process • Quality Improvement IOM • Patient-centered care IOM • Interdisciplinary Teams IOM • Evidence Based Practice IOM • Leadership and management • Project management • Education/training • Medical informatics IOM

22. PGY2 Specialized ≠ PGY2 • Either PGY1 or PGY2 training, depending on depth of training • If PGY1, must meet core competencies for PGY1 & provide a wide range of disease states • Must do PGY1 before PGY2 • Program directors – requirements changed • Systematic approach to training • Use – goals & objectives from previous supplemental standards – until each is updated

23. PGY2 RPD Requirements PGY2 Residency & 3 years or 5 years of experience in the area BPS - Board Certification Nuclear Nutrition Oncology Psychiatry Pharmacotherapy + added qualifications Infectious Diseases Cardiology

24. Does the new PGY1 standard define “PGY1 with emphasis in” ? No – Standards define PGY1 and PGY2 • PGY1 can occur in a wide variety of settings & with focused populations as long as PGY1 outcomes are achieved • PGY1 can customize programs to individual residents • PGY1 programs can market their strengths to residents (e.g., ambulatory, pediatrics)

25. Does the new PGY2 standard define equivalent experience for PGY2? No • PGY1 must be done prior to PGY2 • Extremely rare situation where equivalent experience would apply to the new PGY1-PGY2 standards • All “specialized” are not automatically PGY2; some may actually be PGY1 (e.g. ambulatory, pediatrics); must meet PGY1 outcomes

26. Are “duty hours” for pharmacy residencies different from medical residencies? No The new Pharmacy accreditation standards refer a program to ACGME duty hours guidelines Averaged over 4 week period: - 80 hrs/week - 1 day (24 hr) in 7 free - 10hr period free from daily activities

27. What about the 2 Year Programs? Pharmacotherapy Management with MS - Can still be two year programs • Must meet the outcomes of PGY1 and PGY2 over the course of the two years. • Can match one time for the entire two year period – if listed as a two year program with NMS.

28. Why a matching program for all ? • Prevent undue pressure on residents • Prevent premature decisions • Resulting in less than “optimal” placements • Equity for all programs • Equal time for all programs/applicants to decide the best fit

29. Match Process Resident Rank Order Submissions MaryBobJenniferMolly Hosp B Hosp B Univ A Hosp B Best Rx Univ A Best Rx Univ A Best Rx

30. Match Process Site Rank Order Submissions Univ A (2)Hosp B (1)Best Rx (1) Mary Mary Bob Bob Jennifer Jennifer Molly Molly

31. Match Process Mary Resident Rank Order Submissions Hosp B Best Rx Univ A Site Rank Order Submissions Univ A (2)Hosp B (1)Best Rx (1) Mary Mary Bob Bob Jennifer Jennifer Molly Molly Match: Mary w/ Hosp B

32. Match Process Resident Rank Order Submissions MaryBob Hosp B Hosp B Univ A Best Rx Bob matches with Univ A Site Rank Order Submissions Univ A (2)Hosp B (1)Best Rx (1) Mary Mary Bob Bob Jennifer Molly

33. Match Process Resident Rank Order Submissions MaryBobJennifer Hosp BUniv AUniv A Best Rx Jennifer matches with Univ A Site Rank Order Submissions Univ A (2)Hosp B (1)Best Rx (1) Mary Mary Bob Bob Jennifer Jennifer Molly Molly

34. Match Process Resident Rank Order Submissions MaryBobJenniferMolly Hosp B Univ A Univ A Hosp B Site Rank Order Submissions Univ A (2)Hosp B (1)Best Rx (1) Mary Mary Bob Bob Jennifer Jennifer Molly Molly Molly & Best Rx go unmatched

35. What can I do to make sure the “match” works? • Only rank your true preferences • Rank in the order you would normally make a verbal offer • Only rank applicants you would accept, if not DON’T place on the rank order list • Don’t second guess how an applicant will rank you and try to adjust to that • Interview a variety of applicants if not using the early commitment process

36. What if I have PGY1 and want to keep them for my PGY2 program, do they have to go through the match for the PGY2 program at my site? Early Commitment process available – part of the matching process To occur in November prior to the March match, otherwise in the match

37. What are some of the ways the “match” tries to be Flexible? • Couples • Both in Pharmacy Match • One in Pharmacy, one in Medical Match • Simultaneous matches • Multi-site Program: each site can have a separate NMS code • Revert positions at a site with multiple programs, to fill vacancies • Post match assistance

38. Misunderstanding ASHP makes money off of the matching program. Fact: It actually costs ASHP to run the matching program. ASHP pays per program and position to the matching service. All fees are paid directly to NMS, not ASHP.

39. When do the new accreditation standards go into effect? January 1, 2007 • Currently scheduled site visits to July 2006 will use the old standards • Sites scheduled for on site survey between July 2006 – Jan 2007, have the option of which standard for review • All new applications – use new standards • First all match - 2007

40. Where can I learn more? ASHP Residency web page: www.ashp.org

42. National Residency Preceptors Conference Washington, DC August 17-19, 2006

44. PharmD Graduate Broad Patient/Practice FOCUS Narrow Basic DEPTH of knowledge, skills, abilities, experience Advanced