Program Design

The PGY2 Critical Care Residency at UNC Medical Center is a 12-month ASHP-accredited program designed to provide a robust and diverse experience in critical care pharmacy.  In addition to required components of a critical care training program set forth by ASHP, we strive to provide a wide variety of learning opportunities that can be tailored to help residents achieve their goals and prepare for future careers.

Rotation Experiences

The structure of the clinical training component of the residency year is centered around a set of required core rotations that lay the foundation for critical care pharmacy practice.  These rotations are chosen to provide fundamental and diverse exposure to the critical care setting, and to take advantage of the many experienced preceptors and challenging practice sites that UNC has to offer.  The core required rotations are supported by a wide variety of available elective rotations that residents may choose from to customize their learning experience based on interests, challenge themselves in areas of inexperience, and/or solidify knowledge in a specific area.

Rotations Structure

  • Orientation (1 month)
  • Medicine Intensive Care (2 months)
  • Surgery/Trauma Critical Care (2 months)
  • Neurocritical Care (2 months)
  • Burn Intensive Care (1 month)
  • Cardiothoracic Critical Care OR Cardiac Intensive Care (1 month)
  • Intensive Care Unit or Emergency Medicine Elective (1 month)
  • Additional Elective (1 month)
  • Research (1 month)

Available Elective Rotations

  • Emergency Medicine
  • Pediatric Intensive Care
  • Cardiothoracic Critical Care
  • Cardiac Intensive Care
  • Inpatient Bone Marrow Transplant and Cellular Therapy
  • Benign Hematology Consults
  • Infectious Disease Consults
  • Toxicology (off-site)
  • Nutrition (2 weeks - added to second month of Surgery/Trauma Critical Care)

Required Components

Research Project

Each resident will participate in a research project relevant to the practice of critical care medicine.  Over the course of the year this project will give residents experience with generating and vetting research questions/hypotheses, crafting IRB submissions, building research timelines and data collection forms, data collection and analysis, presenting research results at a national or regional critical care meeting, and writing up project results as a manuscript in a publishable format.  Successful completion of each of these components through participation in one or more research projects is required for completion of the residency.

Residents will have dedicated time to commit to completion of tasks associated with the research project. Residents will have the option during rotation planning of having this time scheduled as a block of days during December, formerly designated as “Research Month”, or to spread this time out over the course of the year as an equivalent number of administrative days to be taken at their discretion with approval of the program director and rotation preceptor.

Process Improvement Project / MUE

Each resident will take a leadership role in identifying and bringing to fruition potential improvements in the medication use process related to critical care pharmacy.  Examples of acceptable process improvement initiatives include but are not limited to: electronic medication use management (building / updating order sets or clinical pathways), updating or creating pharmacy guidelines relevant to critical care medicine, or implementing a new process in one or more ICUs (innovations to patient assessment, patient care rounds, etc.).  Appropriate activities in this category will be identified with the assistance of the RPD and program preceptors.

Resident Writing Project

Each resident must submit a manuscript suitable for publication for successful completion of the residency year. For many residents this will be their research project, but residents may opt to complete an alternative or additional writing project (i.e. case report, review article) with the assistance of one or more of the program preceptors. Though not a requirement of the residency program, each resident is encouraged to submit their manuscript for publication to a peer-reviewed journal.

Continuing Education Seminar

Each resident will complete and deliver a 30-60 minute ACPE-accredited continuing education presentation focused on a topic related to critical care pharmacy.  The seminar is open to all members of the pharmacy community, including a remote WebEx audience from across the state of North Carolina.

Professional Meetings

Each resident may choose to attend a national critical care conference (Society of Critical Care Medicine, American Thoracic Society) or a national pharmacy conference (ASHP Midyear, ACCP), and is strongly encouraged to attend a local chapter meeting of SCCM in the spring (CVCSCCM).  Participation in poster or platform presentations will be required at a minimum of one of these meetings.

Longitudinal Experiences

Pharmacy Practice Responsibilities

Critical Care Pharmacy residents will receive training specific to staffing in all of the ICU settings and any shift that covers an ICU (evening/weekend), as well as the emergency department.  Residents who are new to the program and institution may also receive limited training in operational areas in order to better understand workflow associated with medication delivery. Over the course of the year, pharmacy practice responsibilities will consist of:

  • Three (3) one-week evening staffing blocks (Mon-Fri)
  • 1/3 of weekends (Sat-Sun) clinical staffing

Pharmacy practice responsibilities will include but are not limited to: verification of medication orders, clinical management of medication issues, follow-up of therapeutic drug monitoring, patient profile review, answering complex drug information questions, admission and discharge medication reconciliation, and participation in medical emergencies.

In addition to clinical staffing responsibilities, residents will also participate in the Code Blue response program. The Code Blue response program allows every resident the opportunity to be the primary responder at medical emergencies at the Medical Center for a portion of the year.

Teaching Requirements

Critical Care residents will serve as teaching assistants in the spring semester of the academic year in the Critical Care Elective.  In this role residents will assist in developing structured classroom time, coordinate with lecturers, prepare quizzes and exams, and field questions from students.  Each resident will also deliver one lecture during this elective, comprising 1.5-3 hours of classroom time. 

Residents will coordinate and serve as instructors in the critical care group teaching that occurs every month among the learners on the various critical care rotations.  Each resident will have one 60-minute block per month to teach a small group about different critical care topics using active learning techniques. 

Practice-based teaching will occur in the form of direct precepting. Residents will frequently serve as co-preceptors or primary preceptors for pharmacy students and/or PGY1 residents when on the same rotation.  This may include leading topic discussions and patient discussions, supervising the students on rounds, giving feedback to students on their performance, etc. 

Residents will also participate in the Combined Critical Care Conference curriculum.  Over the course of the year this will involve presentation of at least four formal journal club presentations on landmark or relevant new literature, as well as at least four case conference presentations where their preceptor/content expert will select a current patient for the learner to present and direct them to the specific topic/disease state that will be the cornerstone of the presentation.  

Leadership / Committee Involvement

In addition to residency leadership and committee requirements, each resident will participate as a member of an interdisciplinary committee at the Medical Center.  Available committees include the ICU Advisory Committee, Adult Sedation Committee, and Resuscitation Committee. Regular attendance at committee meetings is required.

Requirements for Program Completion

In order to receive a certificate of Residency completion, residents must complete all requirements specified in the appointment agreement:

  • Complete all scheduled learning experiences
  • Receive an evaluation score of “Achieved for the Residency” (ACHR) for at least 85% of PharmAcademic objectives required by the program
  • Complete a one year research project or a pre-specified part of a multi-year research project, including all of the following: data retrieval, data analysis, formal presentation (poster OR platform) at a local/regional/national forum, creation of a draft manuscript in publishable quality, project proposal submission, creation of a data collection tool, and IRB submission (if appropriate).
  • Prepare and submit a minimum of one manuscript suitable for publication based on work conducted during the residency year
  • Contribute approximately 400 hours of staffing support to the department through weekday, weekend, day/evening and holiday clinical and/or operational staffing requirements based on departmental need
  • Attend at least 8 hours of resident CE programming
  • Complete all evaluations in PharmAcademic, ASHP's approved tool
  • Provide a 30-60 minute (RPD determined) ACPE accredited CE program for pharmacists and/or pharmacy technicians within and outside the Department of Pharmacy
  • Participate in required departmental “on-call” services as necessary to support departmental functions
  • Serve as a support resource/teaching assistant at the UNC Eshelman School of Pharmacy during at least one semester of the academic year
  • Serve on a designated hospital or health system committee as assigned by the program
  • Complete a medication use evaluation or quality improvement project
  • Document completion of the PGY2 Critical Care program appendix as required by ASHP
  • Participate in the review and follow up of one ICU medication safety event
  • Deliver one 1.5-3 hour lecture in the critical care elective course at the UNC Eshelman School of Pharmacy
  • Upload files to document completion of all required residency components into Pharmacademic (CE, MUE, research project, data collection tool, manuscript, IRB, research proposal, appendix completion, etc.)

For more information, contact:

Brian McKinzie, PharmD, BCCCP

Residency Program Director, PGY2 Critical Care Specialty Residency
Clinical Specialist, North Carolina Jaycee Burn Center