Jane E. Gault, M.A., PharmD Pharmacy Service Chief

Kelly S. Thomas, PharmD, BCPS, CDE Residency Program Director

The CAVHS Pharmacy Residency Program offers a wide variety of options for potential residency candidates. As the referral center for surrounding facilities in our region, CAVHS provides the opportunity to see a wide variety of patients. The CAVHS residency has enjoyed a rich history that dates back to 1974 and boasts the graduation of over 130 residents. Our graduates currently serve in various clinical roles including faculty positions at Colleges of Pharmacy, Clinical Coordinators, and clinical positions at various facilities. We appreciate the opportunity to show you all that a CAVHS residency can offer you.

FACILITIES

CAVHS is a two-campus, tertiary-care teaching hospital that serves Arkansas and acts as a referral center for our sister VA's in surrounding states. Over 100 pharmacists and technicians provide pharmacy services to this 534-bed facility with over 570,000 ambulatory care clinic visits per year. Pharmacists round with medicine, surgical, geriatric and cardiology teams and work in various outpatient clinics such as primary care, geriatrics, home care, infectious diseases, and women's health. Inpatient pharmacy services include decentralized unit dose and i.v. admixture that includes TPN and chemotherapy. CAVHS is physically connected to and has an academic affiliation with the University of Arkansas for Medical Sciences which is home to the state’s College of Pharmacy. Visit the CAVHS website for more information on this facility.

ABOUT THE PROGRAM
Accredited By

(Eugene Towbin North Little Rock Campus

Duration/Type: 12 mo/residency Number of Positions: 6 (4 PGY1 and 2 PGY2 in Am Care and Geriatrics) Application Deadline: January 15 Starting Date: July 1 Estimated Stipend: $38,000

Residency Special Features: The clinical focus of this residency includes medicine, surgery, ambulatory care, geriatrics, diabetes, anticoagulation, and home care. The resident participates in interdisciplinary teams in most practice areas. Exposure to pharmacy management and administration is a longitudinal experience. On-site electives are available in various practice areas such as oncology and infectious disease. Electives not available at the VA can be arranged through other affiliates such as Arkansas Childrens’ Hospital. Residents are also responsible for didactic and experiential teaching of pharmacy students from our affiliate College of Pharmacy.

Fringe Benefits: Thirteen days each of annual leave (vacation) and sick leave, paid leave and a travel allowance for professional meetings, ten paid holidays, health insurance, free parking, desirable work schedule, on-site library and easy access to academic library, on-line drug information resources, and state of the art patient medical record system. Special Requirements for Acceptance: U.S. citizenship, Pharm.D. degree.

APPLICATION INFORMATION

Application Deadline: January 15

Matching Information: http://www.natmatch.com/ashprmp/

Application Checklist:

• VA Employment Application Form (VA-10-2850c)
• CAVHS Residency Application
• Three Letters of Recommendations
• Curriculum Vitae
• Academic Transcript from an U.S. accredited pharmacy program
• Proof of U.S. citizenship
• Intern or Pharmacist license

CONTACT US

CURRICULUM

Primary Care (PCC)
Rotation Type: Required/ Ambulatory Care
The PCC rotation is a required learning experience for the pharmacy practice resident. The experience involves the provision of direct patient care for patients in the PCC program. The resident may also gain experience by working in the Women’s Health, Diabetes and HIV / AIDS Clinics. This is a month-long experience in which the resident will participate in the provision of pharmaceutical care to ambulatory patients followed in the Primary Care Clinic at either the Little Rock or North Little Rock campus. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for day-to-day supervision of a senior pharmacy student in conjunction with the preceptor.

Home-Based Primary Care (HBPC)
Rotation type: Elective/ Ambulatory Care
The HBPC rotation is a required learning experience for the pharmacy practice resident. The experience involves the provision of direct patient care for patients in the HBPC program. This is a month-long experience in which the resident will participate in interdisciplinary team meetings and make visits into patient’s homes. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident is also responsible for day-to-day supervision of a senior pharmacy student in conjunction with the preceptor.

Medication Dispensing/Orientation
Rotation type: Required/Ambulatory Care and Acute Care
The resident will gain experience in all aspects of medication dispensing, both from an inpatient and outpatient perspective. As the resident rotates through each of the four dispensing pharmacies (North Little Rock Inpatient Pharmacy, North Little Rock Outpatient Pharmacy, Little Rock Inpatient Pharmacy and Little Rock Outpatient Pharmacy) he/she will gain expertise and confidence providing pharmaceutical services. The resident will be directly responsible for all aspects of professional involvement and oversight of dispensing medications, security of medications, extemporaneous compounding, parenteral product preparation, quality control and procurement activities. In, addition, the resident will be introduced to the pharmacist’s clinical role at CAVHS. This rotation will lay initial groundwork in pharmacy policies and procedures to be used throughout the residency year.

Surgery
Rotation type: Required/ Acute Care
The surgery rotation is a required learning experience for the pharmacy practice resident. The experience involves the provision of direct patient care for patients on the surgery wards. This is a month-long experience in which the resident will participate in the provision of pharmaceutical care to acute care patients admitted to one of the surgery wards at the Little Rock campus. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. The resident will create therapeutic regimens for individual patients within the cost constraints of the institution and make appropriate adjustments in therapy as needed. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for day-to-day supervision of a senior pharmacy student in conjunction with the preceptor.

Internal Medicine
Rotation type: Required/ Acute Care
The Internal Medicine rotation is a required learning experience for the pharmacy practice resident. The experience involves the provision of direct patient care for patients on the Internal Medicine wards. This is a month-long experience in which the resident will participate in the provision of pharmaceutical care to acute care patients admitted to one of the internal medicine wards at the Little Rock campus. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. The resident will create therapeutic regimens for individual patients within the cost constraints of the institution and make appropriate adjustments in therapy as needed. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for day-to-day supervision of a senior pharmacy student in conjunction with the preceptor.

Geriatrics Clinic
Rotation type: Required/ Acute Care
The Geriatrics Clinic (GC) rotation is a required learning experience for the pharmacy practice resident. The experience involves the provision of direct patient care for patients in the GC program. This is a month-long experience in which the resident will participate in the provision of pharmaceutical care to ambulatory patients followed in the Geriatric Clinic at the North Little Rock campus. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for day-to-day supervision of a senior pharmacy student in conjunction with the preceptor.

Geriatric Psychiatry
Rotation type: Required/ Long-term Care
The Pharmacy Practice resident is required to complete the Geriatric Psychiatry (GeriPsych) to gain experience with the area of psychiatry. This month-long experience involves the provision of direct patient care to psychiatry patients followed in the inpatient (GeriPsych) clinical setting at the North Little Rock campus. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for day-to-day supervision of a senior pharmacy student in conjunction with the preceptor.

3C Geriatric Evaluation and Management Unit (GEM)
Rotation type: Required/ Long-term Care
The GEM rotation is a required learning experience for the pharmacy practice resident. This month-long experience involves the provision of direct patient care for patients admitted to the Geriatric Evaluation and Management Unit at the North Little Rock campus. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for day-to-day supervision of senior pharmacy students in conjunction with the preceptor.

Coumadin Clinic
Rotation type: Required/ Ambulatory Care/ Longitudinal
The CAVHS Coumadin Clinic is a pharmacist-run clinic created to closely monitor the therapy of anticoagulated patients. Residents are provided with experience and advanced training in the clinical care of warfarin and anticoagulation in general. It provides an opportunity to develop and improve patient education skills. Rotation activities include but are not limited to:

• Identifying those patients at greatest risk for medication therapy problems
Building a patient-specific data base via chart review, patient and caregiver interview and team input
• Evaluating drug therapy and documenting via progress notes
• Identifying treatment goals
Designing or modifying therapeutic regimens
• Designing and providing patient-specific and caregiver-specific medication education
• Following up on the effects of changes to the therapeutic regimen
Collecting outcomes information related to the care of the patient
• Contributing to departmental and health system analysis of medication misadventures
• Contributing to the learning and serving as a mentor to senior pharmacy students
Evaluating student performance while on this rotation and assigning a rotation grade in conjunction with preceptor

Diabetes/Endocrinology
Rotation type: Elective/ Ambulatory Care
The DM/Endo rotation is an elective learning experience for the pharmacy practice resident. The experience involves the provision of direct patient care for patients in the DM/Endo program. This is a month-long experience in which the resident will participate in the provision of pharmaceutical care to ambulatory patients followed in the DM/Endo Clinic at the Little Rock campus. The resident is responsible for identifying, preventing and resolving medication therapy issues for patients and serving as a drug information resource for the team. Good communication and interpersonal skills are necessary to promote efficient function of the team. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments. The resident may also be responsible for day-to-day supervision of a senior pharmacy student in conjunction with the preceptor.

Infectious Disease
Rotation type: Elective/ Acute care
The Infectious Disease rotation is an elective learning experience for the pharmacy practice resident. The experience involves the provision of direct patient care for patients on the infectious disease consult service. This is a month-long experience in which the resident will participate in the provision of pharmaceutical care to acute care patients referred to infectious disease service at the Little Rock campus. Under this preceptorship, the resident will be directly involved in the interpretation of patient specific laboratory data, the development of recommendations on antimicrobial drug treatment regimens for patients with complicated medical histories, the identification of drug interactions, pharmacokinetic or pharmacodynamic dosing, and the communication of the findings or recommendations to the appropriate clinician. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments.

Women’s Health Center
Rotation type: Elective/ Ambulatory Care
The Women’s Health Center (WHC) elective rotation is designed to enhance the resident’s understanding of women’s health issues through practical experience in an ambulatory care setting. This is a month long experience. Objectives for WHC rotation include but are not limited to:

• Refine counseling skills by providing patients effective instructions and accurate information on drug therapy and disease state management
• Review medical literature focused on women’s health issues
• Demonstrate proficiency in locating information in a patient’s medical record in order to assist the patient or clinician with medical issues
• Utilize laboratory data in managing drug therapy
• Become an active member of the healthcare team by providing drug information and patient-specific recommendations to clinic staff

Practice Management
Rotation type: Required/ Ambulatory Care
This longitudinal experience will expose the resident to various pharmacy management philosophies and techniques. The resident will participate in topic discussions throughout the residency year with pharmacy managers and supervisors. Learning experiences include:

• Participating in periodic topic discussions of management issues
• Attending Pharmacy & Therapeutics Committee meeting
• Attending Research & Development Committee meeting
• Attending Medication Use Evaluation Subcommittee meeting
• Attending a national pharmacy conference or meeting (eg. ASHP MCM)
• Attending a local, state or regional pharmacy conference or meeting (eg. AAHP, Little Rock Pharmacy Directors meeting)
• Participating in a Smoking Cessation Class
• Designing and participating in Poison Prevention Week activities at area schools in March
• Participating in the annual review of CAVHS Pharmacy policies and procedures

Pharmacoeconomics
Rotation type: Elective/ Longitudinal
The Pharmacoeconomic longitudinal learning experience introduces the pharmacy practice resident to techniques used for decision-making and evaluation by utilizing pharmacoeconomics and outcomes research. During this experience, the resident will also participate in the pharmacy department's ongoing process for tracking medication expenditures and reporting results to the hospital’s pharmacy and therapeutics committee. This is a three-month experience in which the resident will prepare cost-benefit reports, analyze outcomes studies, analyze formulary requests, and participate in the pharmacy and therapeutics committee meeting. Good written communication and interpersonal skills are necessary to promote efficient function of the committee. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments.

Budget/Procurement Management
Rotation type: Elective/ Longitudinal
The Budget and Procurement longitudinal learning experience introduces the pharmacy practice resident to techniques used for decision making and evaluation by applying budgeting methods in a large health care institution. The resident may participate in budgetary planning and close out of the fiscal year. This is a three-month experience in which the resident will prepare cost-benefit reports, track medication expenditures, analyze formulary requests, and participate in the pharmacy and therapeutics committee meeting. Good written communication and interpersonal skills are necessary to promote efficient function of the committee. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments.

Quality Assurance
Rotation type: Elective/ Longitudinal
The QA longitudinal learning experience introduces the pharmacy practice resident to the principles of continuous quality improvement (CQI). Residents also become familiar with root cause (RCA) and failure mode effects analysis (FEMA) as well as accreditation, legal, regulatory and safety requirements that provide oversight of the CQI process. During this three-month experience, the resident will attend monthly committee meetings, become familiar with existing CQI processes and participate in a quality improvement analysis. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments.

Research and Development Committee
Rotation type: Elective/ Longitudinal
The R&D longitudinal learning experience introduces the pharmacy practice resident to the accreditation, legal, regulatory and safety requirements that provide oversight of human research. Residents also gain experience in the processes for managing investigational drugs. This is a three-month experience in which the resident will attend monthly committee meetings, analyze the costs associated with conducting clinical drug trials (Appendix E) and present the scientific merit of a clinical trial. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments.

Pharmacy and Therapeutics Committee
Rotation type: Elective/ Longitudinal
The P&T longitudinal learning experience introduces the pharmacy practice resident to the process of developing, implementing and maintaining a formulary system. During this experience, the resident will also participate in the pharmacy department's ongoing process for tracking and trending medication errors and adverse drug effects (ADE) (Appendix C). This is a three-month experience in which the resident will prepare the meeting agenda (Appendix D), investigate ADE reports, analyze formulary requests and participate in the committee meeting. Good written communication and interpersonal skills are necessary to promote efficient function of the committee. The resident must devise strategies for accomplishing the rotation activities in a timely fashion while still completing other residency assignments.

Consults:
Rotation type: Elective/ Longitudinal
The Consults longitudinal learning experience introduces the pharmacy resident to drug-specific consults and polypharmacy consult review. This is a three-month experience in which the resident will use formulary management/budgeting information to regulate cost impact here at the Central Arkansas Veterans Healthcare System. Residents will have the opportunity to review criteria for specific medications and to determine if the patient meets the selected criteria for the specific medication or if another alternative should be tried. Residents will also review requests by providers for medication therapy management. Here, residents will perform a comprehensive review of drug records looking for potential and existing drug problems, recognizing that “an ounce of prevention is worth a pound of cure.” In this rotation, it is important to have diplomacy skills in order to promote patient care.

ABOUT THE CITY OF LITTLE ROCK

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