Program Design

The PGY2 Emergency Medicine Residency at UNC Medical Center is a 12-month program designed to provide a robust and diverse experience in emergency medicine pharmacy.  In addition to required components of an emergency medicine 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 emergency medicine pharmacy practice.  These rotations are chosen to provide fundamental and diverse exposure to the emergency medicine/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 (0.5-1 month)
• Emergency Medicine (6 months)
• Medicine ICU (1 month)
• Surgical ICU (1 month)
• Research (1 month)
• Any Elective (2 months)

Available Elective Rotations

• Neuroscience ICU
• Burn ICU
• Pediatric ICU
• Toxicology
• Additional experiences available

Required Components

Research Project

Each resident will participate in a research project relevant to the practice of emergency 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 meeting, and writing up project results as a manuscript. Completion of each of these components through participation in one or more research projects is required for completion of the residency.

Quality Improvement Project

Each resident will take a leadership role in identifying and bringing to fruition potential improvements in the medication use process related to emergency medicine 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 emergency medicine, or implementing a new process in the emergency department. Appropriate activities in this category will be identified with the assistance of the RPD and program preceptors.

Resident Writing Project (optional)

Each resident has the option to submit a manuscript for publication. 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.

Continuing Education Seminar

Each resident will complete and deliver a 30-60-minute ACPE-accredited continuing education presentation focused on a topic related to emergency medicine 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 or emergency medicine conference (American College of Emergency Physicians, Society of Academic Emergency Medicine, Society of Critical Care Medicine) or a national pharmacy conference (ASHP Midyear, ACCP). Participation in poster or platform presentations will be required at a minimum of one of these meetings.

Longitudinal Experiences

Pharmacy Practice Responsibilities

Residents will receive training and orientation to the department's services during their first few weeks of the program. Over the course of the residency year, residents must complete an average of 400 hours of staffing. Emergency Medicine Pharmacy residents will receive training specific to staffing in all of the Emergency Department responsibilities.  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) or as determined by the needs of the department
• Every third weekend (Sat-Sun) clinical staffing, combination of ED and floor patients

Additionally, residents are also responsible for staffing during one of three major holiday blocks (Thanksgiving, Christmas, or New Year’s) and one of three minor holidays (Labor Day, Martin Luther King, Jr Day or Memorial Day). These requirements may be changed annually based on the needs of the department.

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. Additionally, ED staffing will require trauma, STEMI, stroke and code response, as well as any other needs of the department.

Teaching Requirements

Emergency Medicine pharmacy residents will serve as teaching assistants for one semester. Residents primarily serve as evaluators of different clinical scenarios, giving pharmacy students feedback on performance. Optional educational activities are available in the critical care and toxicology electives.

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.

One unique component of the UNC program is the involvement of the Emergency Medicine pharmacy team in the didactic component of the EM physician resident training program. Residents will be required to complete at least one presentation for the Emergency Medicine residents/physicians during the year.

Leadership / Committee Involvement

Each resident will participate as a member of an emergency medicine interdisciplinary committee and/or have committee involvement requirements in the pharmacy department. Involvement will be based on scheduling and the needs of the department.

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)
• 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 Emergency Medicine program appendix as required by ASHP
• Attend all PGY2 EM specific POD topic discussions (unless excused by program RPD)
• Deliver at least one 30-60 minute didactic education lecture to emergency medicine providers and residents during Emergency Medicine Conference
• 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.)