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 Residency Curriculum Overview

The bulk of the Residency Program takes place in Victoria, at the Royal Jubilee and Victoria General Hospitals, alL Our residents do one rotation at the Nanaimo Regional General Hospital or the Cowichan District Hospital in Duncan. On occasion, Residents are required to travel to Vancouver to attend BC Wide events

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 | Overview of Residency Year | Rotation Descriptions |

The residency year consists of 52 weeks of rotations and begins in the second week of June. Residents complete 28 weeks of direct patient care rotations and 24 weeks of non-direct patient care rotations. Over the course of the residency year residents attend approximately 28 two hour academic half-days which take place on selected Wednesday afternoons. About Eighteen of these academic half days, also called “Therapeutic Sessions” are devoted to clinical topics and ten sessions focus on Leadership/Management topics. The one week toxicology rotation and the three day UBC summer didactics takes place in Vancouver, as does their BC wide case presentation to the other residents across the province. All our residents are given 7 weeks of scheduled time to complete a residency research project and our residents organize our annual Pharmacy Conference for their Management/Leadership project. See tables below:

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  Academic Detailing | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

Academic Detailing is an educational outreach program designed to meet the learning needs of family physicians. Clinical education sessions are provided in individual or small-group settings in primary care clinics. The primary ambition of the service is to translate evidence-informed medical information into clinically relevant knowledge that can be used to optimize prescribing patterns and, ultimately, patient outcomes. The service is currently based out of two communities on Vancouver Island (Comox Valley, Victoria) and provides service to family physicians throughout the entire Island Health region. This one-week experiential learning opportunity will involve independent travel to family physician clinics to observe education sessions and web-conferencing sessions regarding the critical appraisal of medical literature. It will also include the opportunity to participate in knowledge translation (searching for, critically appraising and synthesizing drug-therapy evidence) with the aim of producing an effective professional presentation for the team of academic detailing pharmacists. The clinical rotation in Academic Detailing will provide the Pharmacy Resident with training and experience in medication and practice-related clinical education. The rotation will have a specific focus on the topics being prepared and detailed at the time of the rotation.

 Adult ICU (Critical Care) | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The clinical rotation in adult intensive care provides the Pharmacy Resident with training and experience in the various aspects of critical care pharmacotherapy. The rotation is based in the intensive care units at the Royal Jubilee Hospital (RJH), Victoria General Hospital (VGH) and Nanaimo Regional General Hospital (NRGH). These tertiary care ICUs are similar in size, with approximately 10 beds per site. Patients present with various medical and surgical issues – RJH and NRGH provide greater representation of cardiac and chronic renal failure populations, whereas VGH provides greater representation of neurosurgery and trauma populations

 The ICU team typically consists of critical care physicians (rotating weekly), registered nurses, respiratory therapists, physiotherapists, dieticians, social workers, chaplains, and the clinical pharmacy specialist. Multidisciplinary students and residents are regular participants in all of the units, and members of the ICU team are eager to provide teaching in their respective areas of expertise. The majority of rotation time is spent on direct patient care activities, including but not limited to active participation in daily patient care rounds. The remainder of the time is comprised of working on assigned projects and/or presentations and participating in scheduled therapeutic discussions. The resident is provided with informal feedback on a daily basis and is formally assessed at the rotation midpoint and at the end of rotation. A final oral exam, in short-answer format, may be a component of the final evaluation.

 Ambulatory care (Geriatrics) | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The clinical rotation in ambulatory care – geriatrics is based at the Seniors Outpatient Clinic (SOPC) located at the Royal Jubilee Hospital – Memorial Pavilion. SOPC serves seniors who are living in the community who have cognitive or mobility issues or are medically complex. SOPC has an interdisciplinary approach. The team includes the following clinicians: geriatricians, geriatric psychiatrists, nurse practitioner, registered nurses, pharmacist, occupational therapists, physiotherapists, rehabilitation assistant and social workers. Each clinician is involved with clients in whom s/he has received a referral for. Clients are referred to the pharmacist for a comprehensive assessment and management of drug related issues. Interactions with clients are achieved through clinic visits, home visits and phone visits. Please note that access to a vehicle/transportation for home visits may be required during rotation.

This rotation provides the pharmacy resident with training and experience in the various aspects of geriatric pharmacotherapy and chronic disease management. This may include, but is not limited to, management of polypharmacy, Parkinson’s disease, pain, behavioural and psychological symptoms of dementia and other chronic diseases. The majority of the rotation time is spent on direct patient care activities, which includes comprehensively assessing a client and identifying his/her medication issues, implementing, monitoring, adjusting, and educating of a client’s medication plan, full SOAP note documentation of all client interactions, liaising with appropriate team members in regards to care plan and participating in interdisciplinary rounds as appropriate. The remainder of the time is comprised of working on assigned projects and/or presentations and participating in scheduled therapeutic discussions.

The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation.

Cardiovascular Medicine | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome

The clinical rotation in cardiovascular medicine provides the pharmacy resident with training and experience in a regional cardiac referral centre. The rotation is based in the Coronary Care and Cardiovascular Units at the Royal Jubilee Hospital. The Royal Jubilee Hospital is one of 4 cardiac centers in British Columbia offering high intensity services such as heart catheterization, electrophysiology services, cardiothoracic surgery, vascular surgery and heart function clinic.
Each week of this four week rotation focuses on a sub-specialty of Cardiovascular Medicine where therapeutic discussions and observation of procedures will be targeted.

Week 1: Interventional Cardiology (Angioplasty, Stenting, Acute Coronary Syndrome, TAVI Valve Replacement)
Week 2: Electrophysiology (Atrial Fibrillation, ACLS, Pulmonary Vein Ablation, Device Implantation of Pacemakers and Defibrillators)
Week 3: Cardiac Surgery (Coronary Artery Bypass Surgery, Heart Valve Replacement)
Week 4: Cardiac Rehabilitation (Heart Function Clinic, Heart Failure Management)

The resident will get exposure to a wide range of specialty cardiac procedures such as coronary angioplasty and stenting, pulmonary vein ablation, coronary artery bypass surgery, heart valve replacement and repair. A majority of rotation time is spent on direct patient care activities, including but not limited to active participation in daily patient care rounds in the Coronary Care Unit . The resident will prepare an inservice presentation for nursing/medical staff on a contemporary cardiovascular topic which will be selected during the rotation. The remainder of the time is comprised of working on presentations and participating in scheduled therapeutic discussions, and completing drug information questions that may arise over the rotation. The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation.

Clinical Orientation | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | WELCOME

The Clinical Orientation rotation orients the pharmacy residents to clinical pharmacy practice in the institutional setting and also develops the resident’s basic foundational clinical skills that will be needed for subsequent direct patient care rotations. This rotation is based at both the Royal Jubilee Hospital (RJH) and Victoria General Hospital (VGH) and takes place within the general medicine patient population. This rotation is divided into three weeks of activities.

Week One (Clinical Orientation Workshop)

The first week includes both didactic and hands-on sessions that expose the residents to various skills necessary to provide pharmaceutical care, and prepares the residents for their direct patient care rotations.

During the first week they are introduced to finding information on Island Health’s intranet needed to provide direct patient care. The resident is introduced to resources which include drug and formulary information, policy and procedure information and intranet resources commonly utilized by ward based clinical pharmacists.

There is also an introduction to documentation, information gathering (powerchart and paperchart) and personal safety in the acute care environment (patient aggression, biohazard, isolation & contact precautions). Residents are also introduced to “working up and presenting a patient”. Residents spend two introductory days to ward-based clinical pharmacy practice during the first week.

One full day is spent participating in a physical assessment workshop. During the final day of week one residents are oriented to the allied health professionals they will work along with during their direct patient care rotations.

Week Two and Three (Clinical Orientation Ward)

The skills learned in week one will then be applied in weeks two and three, when the resident will spend their time performing direct patient care activities. Pharmacy residents will complete full patient assessments and work as part of an interdisciplinary team. The pharmacy residents will follow patients from their admission on the ward to the time of discharge. They will perform full initial medication assessments, admission medication reconciliation, documentation of recommendations, discharge medication reconciliation and medication counseling, and will collaborate with the interdisciplinary team at rounds.

The residents will be asked to present their patients using a systematic head to toe approach. At the end of week three, the residents will undergo a mock exam situation where time limits will be placed on their patient work up and presentation. The overall goal of this rotation is to develop the residents’ process for patient assessments, thereby preparing them for their clinical rotations.

Drug Distribution & Sterile Products | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The Drug Distribution and Sterile Products (DD/SP) rotation takes place primarily at two pharmacy sites in South Island (inpatient pharmacies at the Royal Jubilee Hospital and Victoria General Hospital), and is comprised of a series of meetings with the Pharmacy Manager, Geo 3 & 4, and three weeks of dedicated rotation time at an assigned rotation site. Residents are given broad exposure to various aspects of the drug distribution system, such as solving drug related problems, reviewing distribution policies, reporting medication errors and other activities to facilitate the development of a “working knowledge of medication use systems”. Rotation activities include both observation and active participation with a variety of the pharmacy assistants/technicians (e.g. order entry, maintenance of night cupboard, wardstock/narcotic supplies and the use of dispensing cabinets). The resident will also conduct pharmacist-related activities such as medication reconciliation, order verification and adhering to all policies and procedures to ensure medication safety.

The rotation includes a distinct component focused on sterile product compounding and distribution. Residents are provided with an introduction to sterile preparation. Various examples include medications for injection, topical or injectable ophthalmic
preparations, bladder instillations, medications for intrapleural administration and medications intended for the epidural or intrathecal route. The resident will be introduced to parenteral nutrition, oncology protocol orders, the use of aseptic technique for the preparation of IV admixtures (including hazardous medications), and the processing of other patient specific medication orders that require sterile preparation. In addition, key resources and guidelines explicit to sterile product compounding will be explored. During the rotation the resident will be expected to work and communicate with pharmacy technicians/assistants, dietitians, physicians and other pharmacists to process orders for sterile products and resolve drug related issues as they arise.

By the end of the rotation, residents are expected to understand and be able to effectively explain all aspects of the drug distribution and medication use systems in order to be able to optimize patient safety and patient care. Accordingly, residents will apply their knowledge of medication management tools (such as formularies, automatic substitution policies, medical directives, etc) and therapeutic strategies (such as therapeutic drug monitoring, drug utilization review, etc) to ensure safe and effective use of medications within the health care organization. Residents will also utilize reporting systems (such as adverse drug reports or medication incident reporting) as vehicles to improve the quality of medication use within the health care organization or system.
The resident will work with a variety of different pharmacists throughout the distribution rotation who will be responsible to oversee that the specific components of the distribution rotation are achieved.

  emergency medicine | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The clinical rotation in emergency medicine provides the Pharmacy Resident with pharmacotherapy training and experience in a variety of patient populations (medical, ambulatory, critical care). The rotation is provided at the Royal Jubilee Hospital (RJH), a 500-bed tertiary care hospital which provides specialized care to cardiac, nephrology, critically-ill and surgical patients. The RJH Emergency Department (ED) has 2 trauma beds, 24 acute care beds, 8 minor treatment beds, a busy ambulatory patient care area and up to 14 hallway beds which all serve to accommodate over 57,000 patients per year (~155 / day).

The ED is a dynamic, unpredictable environment that will allow the Pharmacy Resident to be exposed to a variety of activities throughout this rotation including opportunities to observe various procedures that take place for patients admitted to the ED. During this 4-week rotation, the Pharmacy Resident will work with the multidisciplinary team to provide clinical pharmacy services to a wide variety of acute illness cases including resuscitations, acute cardiac and respiratory presentations, infectious diseases, pain-related presentations, and overdoses. Identification and management of medication-related adverse events which result in ED visits are emphasized throughout the rotation.

A majority of rotation time is spent on direct patient care activities. The remainder of the time is comprised of working on assigned projects and/or presentations and participating in scheduled therapeutic discussions. The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation.

  internal Medicine CTU | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The Clinical Teaching Unit (CTU) is an internal medicine-teaching program for medical students and residents that is based on 5N in the Patient Care Centre at the Royal Jubilee Hospital. There are three CTU teams which are led by various attending Internal Medicine physicians who oversee the medical teaching and rotate on a biweekly basis. Each team has a 2nd or 3rd year internal medicine (senior) resident who manages each CTU team. In addition, two to three junior medical residents and two to three medical students make up the rest of the team and carry a patient load. The program strives to have bedside clinical teaching rounds which the pharmacy resident is encouraged to take part in. The unit is structured around teaching and as a result there are many educational opportunities available, including daily morning report, Medicine Grand Rounds, and Interesting Cases Rounds, which the pharmacy resident is expected to attend. The pharmacist participates fully in direct patient care rounds with medical staff, medical residents, nurses and other support staff and provides teaching and education as required.

 Internal Medicine | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The clinical rotation in internal medicine provides the Pharmacy Resident with training and experience in a variety of medical conditions, including but not limited to: pain managements, diabetes, anemia, common infections, cardiovascular diseases, geriatric medicine, gastroenterology, and respiratory pharmacotherapy. The rotation is available at Nanaimo Regional General Hospital, the Royal Jubilee Hospital and the Victoria General Hospital.

The general medicine team consists of house physicians (rotating weekly), specialist physicians, nurse practitioners, registered nurses, licensed practical nurses (LPN), registered care aides, physiotherapists, social workers, dieticians, occupational therapists, nurse liaisons, and clinical pharmacists. Multidisciplinary students and residents are regular participants in both of the units. A majority of rotation time is spent on direct patient care activities, including but not limited to:

active participation in daily patient care rounds
developing and implementing care and monitoring plans
interviewing and counselling patients
assist with medication reconciliation
obtaining patient’s own medications
proposing interventions and discussing care plans with physicians and team members
documenting interventions and recommendations in the patient’s chart
documenting resolved drug therapy problems in rDTP tracker (CARI)
assisting in acquiring special authority
creating discharge prescriptions
creating medication calendars for patient teaching.

The remainder of the time is comprised of working on assigned projects and presentations for the care team or pharmacy department and participating in therapeutic discussions on relevant medical conditions. The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation by their preceptor(s).

  Infectious Disease & antimicrobial stewardship | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

This rotation is available at the Cowichan District Hospital (CDH), the Nanaimo Regional General Hospital (NRGH) and the Royal Jubilee Hospital (RJH).

Royal Jubilee Hospital
At RJH this rotation involves two distinct services – the Antimicrobial Stewardship Program (AMS) as well as Infectious Diseases (ID) consult service. This rotation is based in Victoria at the Royal Jubilee Hospital (RJH). Each day, the resident will take on the care of one new patient, either from the ID consult service list, Outpatient Parenteral Therapy Service (OPAT) or a selected patient requiring an AS consult. It is therefore expected that the resident follows 20 patients during their 4 weeks. Each day, a new therapeutic topic will be covered that is relevant to the patient case that day. The ID portion of this rotation will provide the resident an opportunity to learn about the role of the infectious disease consultation team as well as the pharmacist’s role within such team. For select patients where ID is consulted, the resident will have the opportunity to make initial assessments and recommendations and then provide follow-up and monitoring for commonly seen infectious diseases. The level of involvement may range depending on patient factors, however, most patients referred to the consultation team have complex disease processes, whereas AS patients will usually involve be simpler cases. One week rotation at outpatient IV antibiotic clinic (OPAT) will also be included.

Cowichan District Hospital & Nanaimo Regional General Hospital
At CDH and NRGH each day, the resident will take on the care of one at least one new patient as identified by: having a positive blood culture, positive c difficile infection, antibiotic resistant organism, an OPAT patient, a request for consult from a pharmacist or physician, or a selected patient that would benefit from an AMS consult. It is therefore expected that the resident follows a minimum of 20 patients during their 4 weeks. Each day, a new therapeutic topic will be covered that is relevant to the patient case that day.

All Sites
The AMS portion of this rotation will provide the resident with the opportunity to learn about the appropriate use of antimicrobials on various wards. With the goal of stewardship in mind, the resident will provided clinical patient care to selected patients who have a drug therapy problem related to optimization of antimicrobial therapy. The resident will work to identify and resolve the patient’s DTPs, make suggestions to the team, monitor therapy and provide education regarding the optimal use of antimicrobials. The resident will also spend time learning about the different modalities of providing AS services (audit and feedback, protocol development, education etc.) and about the different moving parts of the program (medical microbiology, laboratory medicine, infection prevention and control, ID, research etc.).

  Leadership-Management | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The Leadership/Management Rotation provides the resident with instruction on and the opportunity to apply leadership and management principles and skills. Each month, usually beginning in September, the residents meet with the preceptor for a two-hour workshop on a topic related to leadership and/or management. These sessions may require work to be completed in advance. Formal presentations, written reflections/assignments and project work are used to demonstrate achievement of learning objectives. The residents are also required to undertake a major project intended to provide an opportunity to apply various leadership and management skills.

Medication Use Management | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The Medication Use Management (MUM) rotation is a one-week rotation that provides the Pharmacy Resident with training and experience in provincial hospital formulary management. The rotation is based at the Royal Jubilee Hospital (RJH). Rotation time will be divided between didactic teaching, observation and participation in formulary-related meetings, and work on individual or group assignments. Assignment work will involve an opportunity to practice scholarly writing, which will be formally evaluated. The resident will have an opportunity to meet with the preceptor daily. The resident will be provided with informal feedback during the rotation and a formal rotation evaluation will be completed at the end of the week.

 Nephrology | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The Royal Jubilee Hospital Renal Program (within the VIHA renal program) consists of both inpatients and ambulatory patients. There are approximately 1625 renal patients throughout the Vancouver Island Health Authority. This number includes 150 in-centre hemodialysis, 175 community dialysis unit and 100 home based dialysis patients as well as 1200 chronic kidney disease patients. Possible educational opportunities within this rotation include the Chronic Kidney Disease (CKD) Program, community dialysis centers, home-based dialysis therapies and in-centre hemodialysis units. There are currently seven Nephrologists, many specially trained RNs, Dieticians, Social Workers and one Clinical Pharmacy Specialist. There are regular weekly inpatient nephrology rounds on Fridays at the Royal Jubilee Hospital Renal Conference Room for the purpose of handing care to the weekend nephrologist.

A majority of rotation time is spent on direct patient care activities, including but not limited to active participation in daily patient care discussion with the preceptor. The remainder of the time is comprised of working on assigned projects and/or presentations and participating in scheduled therapeutic discussions. The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation.

Orthopedic Surgery | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

This rotation will involve the direct care of patients admitted to an Orthopedics unit for management of both surgical and non-surgical orthopedic diagnoses. This rotation is based in Victoria at the Royal Jubilee Hospital (RJH). This rotation will allow the resident to expand their knowledge in many areas of orthopedics, including, but not limited to, post-operative pain management, the management of chronic pain in non-surgical patients, VTE prophylaxis in a variety of surgical and non-surgical situations, treatment of related infections (osteomyelitis, septic arthritis, infective osteonecrosis, etc.), and the treatment and prevention of osteoporosis. If time and resources allow, the resident will also be given the opportunity to directly observe an orthopedic surgery.

The resident will be provided with the opportunity to learn about the role of the pharmacist within the patient care team, which serves a variety of orthopedic patients. They will also have the opportunity to make initial assessments and recommendations and then provide follow-up and monitoring for commonly encountered orthopedic conditions. The resident will work to identify and resolve each of their patient’s drug therapy problems (DTPs), make suggestions to the interdisciplinary team, monitor therapy, and provide education and feedback regarding evidence-based approaches to treatment. The level of involvement may differ for each patient depending on patient-specific factors; however, every effort will be made to identify and assign patients to the resident for whom complex disease processes, complex medication regimens, or the presence of multiple actual or potential DTPs provide an opportunity for the most beneficial pharmacist involvement as well as an optimal experience for learning and skills development.

Each day, the resident will take on the care of at least one patient admitted to the unit. It is therefore expected that the resident will comprehensively work up and follow a minimum of 20 patients during their four week rotation. The number of patients a resident will be responsible for at one time will vary depending on the acuity and intensity of the patients admitted to the unit. Generally, this will be limited to 10-15 patients at one time. It is the responsibility of the resident to discuss workload with the preceptor if it becomes overwhelming. The preceptor will make every effort to ensure that workload is appropriate and applicable to the goals of the residency.

As new therapeutic topics arise that are relevant to each patient case, they will be covered daily via a combination of self-directed and preceptor-assisted learning. Scheduled therapeutic discussions on select topics will be confirmed at the start of the rotation, and other items may be discussed informally according to the resident’s area(s) of interest/need for learning, as well as the types of patients encountered during the rotation. These topics will generally be preceded by assigned readings.

 Pediatrics | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The clinical rotation in pediatrics provides the Pharmacy Resident with training and experience in various aspects of pediatric pharmacotherapy. The rotation is based on three different wards at Victoria General Hospital – 4C, 4D and PICU. The focus is on the diagnosis and treatment of acutely sick children. Each ward patient has his or her own staff pediatrician, child psychiatrist or surgeon who serves as their most responsible physician. Pediatric Royal College residents (R1-R4), first year Family and Royal College medical residents (R1) and third year UBC medical students are also involved in patient care. A pediatric intensivist is responsible for PICU patients. There is also a full multidisciplinary team consisting of a pharmacist, dietician, respiratory therapist, physiotherapist, occupational therapist, social worker, child life specialist, social worker as well as registered nurses. A majority of rotation time is spent on direct patient care activities, including but not limited to active participation in daily patient care rounds. The remainder of the time is comprised of working on assigned projects and/or presentations and participating in scheduled therapeutic discussions. The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation.

  Perinatology | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The clinical rotation in perinatal care provides the Pharmacy Resident with training and experience in the various aspects of neonatal and maternal pharmacotherapy. The rotation is based in the neonatal intensive care unit (NICU), the high-risk antepartum (AP) unit, the labour and delivery unit (LDR) and the post-partum unit (Mom and Babe). The NICU has 22 beds, the high-risk antepartum unit has 8 beds, LDR has 2 operational rooms, 8 delivery rooms and 2 post anaesthetic recovery rooms and Mom and Babe has 28 beds. The rotation time will be divided among these units in a flexible manner based on the resident’s interest.

The inter-professional perinatal team includes: neonatologists, paediatricians, obstetricians, anaesthetists, family doctors, midwives, registered nurses, clinical nurse educators, clinical nurse leaders, respiratory therapists, physiotherapists, occupational therapies, dieticians, diabetic educators, social workers, aboriginal liaison, public health nurses, the program manager and the clinical pharmacy specialist. Multidisciplinary students and residents are regular participants in the perinatal units, and members of the perinatal team are eager to provide teaching in their respective areas of expertise.

The majority of rotation time is spent on direct patient care activities, including but not limited to active participation in patient care rounds. The remainder of the time is comprised of working on assigned projects and/or presentations and participating in scheduled therapeutic discussions. The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation.

   Psychiatry | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The clinical rotation in adult inpatient psychiatry provides the Pharmacy Resident with training and experience in the various aspects of psychiatric pharmacotherapy. The rotation is based primarily in the psychiatric units at the Royal Jubilee Hospital (RJH) Patient Care Centre (PCC). Each ward is divided mostly by age, specialty and/or acuity (6 wards total). Most of these have capacity for 15-16 patients per ward. There is also Psychiatric Emergency Services (PES) located in the Archie Courtnall Centre within the Emergency Department at the Royal Jubilee Hospital. It is a specialized emergency area that provides intensive assessment and crisis intervention for patients arriving in emergency with psychiatric disorders. The inpatient units are primarily involved in achieving stabilization of patients’ psychiatric conditions. The majority of patients suffer from schizophrenia, mood disorders, and drug-induced psychosis. Stabilization is achieved through a multi-disciplinary team approach, which involves psychiatrists, nurses, psychologists, social workers, occupational/recreational therapists, dieticians and the clinical pharmacist. The clinical pharmacist for psychiatry also provides some ambulatory services out of Victoria Mental Health Centre and the Mental Wellness Day Program (both located in Eric Martin Pavilion (EMP) on the RJH campus). Additionally, psychiatric-related consultations from Island Health colleagues and other clinicians (independent of geographic location) are a regular component of the practice.

Therefore, while some rotation time will be spent on attending patient care rounds/huddles and doing initial overviews of new admissions, the nature of this pharmacy service is primarily consultative. Completing requested consults and drug information queries will comprise a bulk of the rotation. The remainder of the time is dedicated to completing assigned projects and/or presentations and participating in therapeutic discussions and/or groups. In order to provide a comprehensive experience, rotation time will also include exposure to non-pharmacological treatment modalities, primarily occurring at the Mental Wellness Day Program. The resident is provided with informal feedback on a daily basis and is formally evaluated at the rotation midpoint and at the end of rotation.

 Precepting | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

The precepting skills rotation is a mandatory four-week rotation in the Island Health Pharmacy Practice Residency Program. During the rotation, the resident will be responsible for precepting a University of British Columbia Entry-to-Practice (E2P) PharmD student, in addition to providing clinical pharmacy services within a designated patient care area under the supervision of the primary preceptor. The E2P student is a fourth year pharmacy student who will be completing their eight-week hospital rotation ( PHRM 472 or PHRM 473). The resident is required to precept the first four weeks of this rotation.

This rotation will follow the tiered model of precepting. This means that the resident will act as the primary preceptor for the E2P student during their rotation. The resident will, in turn, be precepted by a designated Clinical Pharmacist, who will act as a resource for the resident during this rotation. During this rotation, the resident will have the opportunity to develop skills in the four roles of practice-based teaching (direct instruction, modeling, coaching, and facilitation), while at the same time continuing to build on existing skills in the provision of direct patient care.

toxicology | RETURN TO TOP OF PAGE | ROTATION DESCRIPTIONS | welcome |

Location
BC Drug and Poison Information Center (DPIC)
St. Paul’s Hospital – Vancouver, BC

DPIC provides telephone poison information and toxicology consultation service to health care professionals and the general public 24 hours a day, 365 days a year. The Poison Center is staffed by pharmacists, nurses and consulting physicians.

Goal
The goal of the 1 week rotation is for the resident to become familiar with the role of a poison control center and develop a basic understanding of the general management of the poisoned patient.

Objectives
Upon completion of the 1 week toxicology rotation, the resident should be able to:
1. Demonstrate knowledge of and ability to use reference resources available to retrieve toxicological information.
2. Demonstrate the ability to discuss the toxicology, pathophysiology and therapy of common toxins.
3. Demonstrate the ability to obtain a pertinent history regarding a poisoning exposure.
4. Demonstrate skills necessary to evaluate the potential severity of a toxic exposure.