Program Type: ASHP accredited PGY 1 Residency
ASHP Match Number: 176813
Purpose: The purpose of The Johns Hopkins Hospital Post-Graduate Year 1 (PGY1) Pharmacy Residency is to prepare pharmacists to practice as highly qualified independent practitioners able to provide patient care in a variety of environments, apply skill in medication related education, serve as leaders within the profession of pharmacy, and excel during further post-graduate training.
Program Overview: The Pharmacy Practice Residency is a 12-month postgraduate curriculum that offers training opportunities in acute care, ambulatory care, drug information and drug use policy development, clinical services and practice leadership. Our residents will have the opportunity to provide pharmaceutical care to patients in multiple settings, develop independent learning skills, maintain a professional ethic, provide effective drug education to others, understand research methods and opportunities, recognize the principles and application of drug use control, and assume personal responsibility for effecting change. A wide range of elective rotations are available, allowing residents to purse individual goals as well as complete core rotations. Upon completion of the ASHP accredited program, individuals are awarded a residency certificate.
- Internal Medicine (1 month)
This rotation is designed to provide residents with a broad training experience in managing acutely ill internal medicine patients admitted for diverse and complex medical management. The goal of this rotation is for residents to develop the skills and competencies in pharmaceutical care in the area of inpatient internal medicine, enabling them to effectively participate in therapeutic decision making, drug therapy selection, monitoring of acutely ill patients and discharge counseling. The active involvement of residents in screening patients' medication profiles for potential problems involving dosing, drug allergies, drug interactions, intravenous compatibilities and medication response, in addition to monitoring antibiotic therapy and any medication that requires additional laboratory monitoring, will help assure high quality patient care.
- Integrated Practice Rotation ( 3 months)
The Integrated Practice Rotation is a 3 month block experience within one of the pharmacy divisions - critical care, pediatric, oncology, or adult medicine pharmacy division. During this 3 month block, residents are expected to provide patient-care services within the division’s established team-based/integrated model of care. The resident will be exposed to and expected to perform a variety of roles and responsibilities of a pharmacist practicing in this model. This may include, but is not limited to: attending and actively participating in patient care rounds with the multi-professional team, performing order review and verification for assigned patients, participating in program-oriented services (such as: anticoagulation, therapeutic drug monitoring, readmission reduction and transition of care programs, or others), providing drug information and education, participating in patient safety initiatives, or performing any other functions expected of a pharmacist within the assigned division.
Leadership Collaborative Rotation (1 month)
The Leadership Collaborative Rotation (LCR) is a monthly collaborative experience required during the PGY1 residency that incorporates three areas of practice. Through this rotation residents gain experience regarding the medication-use process, medication safety, drug information and an understanding of administrative, management, and leadership principles within a large teaching and research-oriented hospital and health-system. The focus of this rotation includes such areas as practice leadership, drug policy, medication safety, operations, pharmaceutical outcomes, clinical and investigational drug services.
- One of the following Critical Care rotations ( 1 month)
- Cardiovascular Critical Care
This rotation is designed to allow residents to develop proficiency in the provision of pharmaceutical care to patients encountered in the specialized area of cardiovascular critical care medicine. The resident will be expected to build on the basic knowledge gained during other patient care rotations, while focusing intensively on the patients' cardiac and critical care issues. The resident will accomplish this by interacting with the interdisciplinary medical team during patient rounds and educational conferences, providing direct patient care through drug regimen reviews and by developing an understanding of the current application of drug therapy to various cardiovascular disease states encountered during rotation.
- Medical Intensive Care
The medical intensive care rotation offers residents an opportunity to develop comprehensive knowledge and skills necessary to meet the specific needs of the critically ill patient with multi-organ failure. The resident will be an integral member of the multidisciplinary critical care teams covering the units. The resident will develop competencies in the areas of critical care pharmacology, fluid and electrolyte balance, cardiovascular hemodynamics and ventilator support through direct patient care involvement and active participation in therapeutic decision making, drug therapy selection and appropriate dosing and monitoring using a multidisciplinary team approach to patient care.
- Surgical Intensive Care
A rotation on this unit allows residents to work with the medical team to provide care for patients with multi-system organ failure. Patient populations include abdominal organ (renal, pancreas, liver) transplant, trauma, GI and vascular surgery. The resident will have the opportunity to round with the team and provide drug information and therapeutic drug monitoring education both in daily rounds and in-service formats. Residents are expected to be familiar with interpretation of common lab values, general pharmacokinetic principles and general information about specific disease states. Residents will be evaluated based on improvement and mutually agreed upon areas of concentration.
- Neurosciences Critical Care
The neurosciences critical care unit (NCCU) is a 24 bed intensive care unit consisting of approximately 70% neurosurgical and 30% neurological critical care patients. The rotation is designed to expand on basic knowledge and clinical abilities gained on previous rotations, and to enhance the residents critical thinking skills. The resident will join the interdisciplinary team on daily rounds and be intimately involved with the optimization of drug therapy in this specialized patient population. In addition, residents are expected to provide educational services to the team through a variety of forums. Patient care discussions are held daily, and numerous critical care topic discussions are performed throughout the rotation. Disease states commonly encountered in the NCCU include: hemorrhagic stroke, ischemic stroke, hydrocephalus, brain tumor, traumatic brain injury, spinal cord injury/disorders, status epilepticus, epilepsy, guillain barre, and myasthenia gravis. In addition to a specialized focus on the neurosciences, the resident will gain experience in more general critical care concepts such as: sedation, paralysis, fluids/electrolytes, nutrition support, pharmacokinetics, hemodynamics, invasive monitoring, multi-system organ failure, infectious diseases, and mechanical ventilation.
- Cardiac Surgical Intensive Care
The CSICU is an 18 bed unit that provides care for patients undergoing cardiac surgery. The unit census typically runs 10-15 patients. Patient care responsibilities are divided between two medical teams. Daily patient care activities include pre-rounding on all patients and then daily rounds with the interdisciplinary team. The resident will thoroughly evaluate medication related issues and present recommendations to the team, with follow-up for unresolved issues and review of patient transfer orders prior to discharge from the unit. After rounds, the resident will follow up on unresolved issues from rounds, review patient records and evaluate new admissions to the unit, review transfer orders, and meet with the preceptor for patient and literature review
- Ambulatory Care (6 months)
A unique feature of the program is the longitudinal nature of this rotation. This feature gives the resident the opportunity to develop continuity within a given site and to establish relationships with patients and medical providers.
The goal of the longitudinal ambulatory care rotation is for the resident to develop expertise in the medication therapy management of chronic disease states commonly encountered in the outpatient setting. The disease states include, but are not limited to; hypertension, hyperlipidemia, diabetes, asthma, heart failure, dementia, coagulopathy, obesity and nicotine addiction. Residents develop the necessary knowledge and skills to provide quality direct patient care in pharmacist lead drug therapy and disease management clinics facilitated through collaborative physician-pharmacist relationships. Clinical experiences include hematology, anticoagulation, general internal medicine and geriatric internal medicine. Residents also assess the need for patient education, lifestyle modification reinforcement, appropriate inhaler use and technique, insulin titration or instruction and adherence with drug therapy plans. They will gain experience as a resource to clinicians by providing drug information, monitoring drug therapy for efficacy, completing cost comparisons, and making recommendations for potential alternative regimens to achieve optimal patient outcomes.
Residents will choose two 3 month ambulatory care clinic experiences. The resident will participate in the clinics for half a day, every other week for each 3 month timeframe that they have chosen. The resident will work with the same preceptor, in the same clinic, on the same weekday during each 3 month clinic experience. There will be a midpoint evaluation at one and a half months and a summative evaluation at the end of each 3 month experience.
- Cardiovascular Critical Care
- Adult Hematologic Malignancies
The hematologic malignancy service is responsible for providing care for those patients diagnosed with acute and chronic leukemia, myelodysplastic syndrome, Hodgkin's and Non Hodgkin's lymphoma, and myeloma. These services may include induction, consolidation, or salvage chemotherapy as well as supportive care. In addition to learning about hematologic malignancies, the resident will gain experience in immunocompromised infectious diseases and some critical care. The service is composed of an attending physician, one to two oncology fellows, one medical resident, one medical intern, a charge nurse, social worker, dietician, and a clinical pharmacy specialist. The resident will attend daily rounds and is responsible for assuring appropriateness of drug therapy for individual patients and making recommendations. Additionally the resident is expected to be a drug information resource for the team. The resident will review the patients with the preceptor daily. Additional rotation activities include topic discussions, participation in patient education of chemotherapy regimens, adverse drug effects, and discharge medications. Residents may have other activities including pharmacy and nursing in-services or small projects.
- Pharmacy Practice In A Community Hospital
The purpose of this rotation is to introduce and support the development of expert skills, practice philosophy and competency in pharmacy practice in a community hospital. The resident will participate fully as a member of the pharmacy department staff. Responsibilities may include drug distribution activities, providing drug information and monitoring patient pharmacotherapy regimens.
- Cancer Pain Service
The cancer pain service rotation experience will focus on providing pharmaceutical care and appropriate pain management to both inpatient and outpatient oncology patients. It is a multidisciplinary consult team that screens and assesses adult inpatients on a daily basis. The resident will have the opportunity to participate in the service's weekly multidisciplinary case conference. In addition to gaining skills in assessing pain, the resident will also develop expertise in designing individual pain regimens and performing opioid equianalgesic conversions.
- Infectious Disease
The Infectious Diseases rotation provides an opportunity for residents to gain insight in the management of infectious diseases and antimicrobial utilization. The resident will be working with the general infectious disease consult team and antimicrobial management program. They will be expected to attend daily rounds. The objective of this rotation is to develop problem-solving skills in infectious disease therapy and establishment of a firm knowledge base in infectious disease pharmacology and pharmacokinetics.
- Infectious Disease /Antibiotic Management Program
This rotation provides an opportunity for residents to gain insight in the management of infectious diseases and antimicrobial utilization. The resident will be working with the general Infectious Diseases (ID) consult team and Antimicrobial Management Program (AMP). They will also be expected to assess appropriates of antimicrobial therapy for assigned patients on daily basis, attend daily rounds with ID team and ID conferences. The objective of this rotation is to develop problem-solving skills in infectious disease therapy and establishment of a firm knowledge base in infectious disease pharmacology and pharmacokinetics.
- Neonatal Intensive Care
The Neonatal Intensive Care Unit (NICU) is a level-4 nursery with at 45-bed capacity. The majority of patients are premature infants, who may acquire a variety of unique disease states during their lives. The resident will be assigned to work closely with the medical team and attend daily work rounds. The goals of the rotation are to have the resident gain experience and proficiency for the pharmaceutical care of NICU patients. This will involve building the resident's knowledge on common NICU disorders and related therapies as well as related drug information resources. In addition, the resident will develop problem-solving skill in this patient population through a variety of patient care experiences.
The purpose of this rotation is to have residents gain experience and proficiency for the pharmaceutical care of general pediatric patients. This will involve building the resident's knowledge on general pediatric disorders and related therapies and drug information resources. In addition, residents will develop problem-solving skills in this patient population through a variety of patient care experiences. Residents will be working with the pediatric house staff team on a daily basis and attend work rounds each morning.
- Pediatric Infectious Disease
This rotation will provide an opportunity for the resident to develop a knowledgebase of infectious diseases unique to the pediatric/neonatal population. The resident will gain experience with antimicrobial dosing in this patient population, as well as experience with pharmacokinetics. The resident is responsible for assessing all aspects of antimicrobial therapy for patients followed by the pediatric ID consult service, rounding with the consult team on a daily basis, and attending standing ID meetings. The resident is also expected to serve as a resource for drug information questions. Residents will work on developing their critical thinking skills through daily patient care activities, and will also work on presentation skills through various inservices/presentations that will be provided to the medical/pharmacy staff.
- Pediatric Intensive Care
The Pediatric Intensive Care Unit (PICU) is a 26-bed tertiary care unit that serves as the regional trauma unit for children in the Baltimore area. The age range of patients includes newborns up to older adolescents. Common diagnoses include trauma, postoperative, medical, and critically ill oncologic patients. The major goals of this rotation are to have the resident gain experience and proficiency in the pharmaceutical care of PICU patients. This will involve building the resident's knowledge on common PICU disorders and related therapies, as well as related drug information resources. In addition, the resident will develop problem-solving skills in this patient population through a variety of direct care experiences.
- Pediatric Nutrition Support
The goal of this rotation is for the resident to experience the pharmacists role on the team and to develop an appreciation for the multidisciplinary approach to patient care with respect to metabolic support. In turn, the rotation provides the resident perspective in viewing the full scope of pharmacy services relating to a pediatric patient's nutritional support in addition to the compounding and dispensing functions. The rotation also allows the resident to experience a variety of clinical therapies from a multidisciplinary point of view. Emphasis will be placed on developing the resident's communication skills in the field of nutrition support while tailoring the experience to the resident.
By the end of the rotation, the resident should be able to assess and evaluate a pediatric patient's nutritional status, participate in therapeutic decision-making, and monitor the patient's nutritional support. This rotation is intended to provide the resident with the basic tools needed to understand, rationally discuss, and continue self-study in pediatric nutritional support.
- Pediatric Oncology
The pediatric oncology service is responsible for providing care to pediatric patients (newborn 21 years old) with solid tumors, hematologic malignancies and those patients receiving a hematopoietic stem cell transplant. This rotation will allow the resident to gain experience and knowledge in pediatric malignancies, immunocompromised infectious diseases and supportive care. The resident will also gain a better understanding of the basic fundamentals of pharmacotherapy in the pediatric patient. The resident will work closely with the multidisciplinary team in patient care decision making and will serve as the drug information resource for the team.
- Pediatric Emergency Medicine
The service is responsible for the care of acutely ill pediatric patients within the department. During the rotation, residents will gain knowledge and experience in the management of acutely ill pediatric patients. This involves developing a systematic approach to obtain pertinent patient information, building the resident’s knowledge of common pediatric disease states and Peds ED disorders, and drug information references. The resident will be responsible for obtaining relevant patient information and developing evidence-based therapeutic plans for patients. In collaboration with the care team, the resident will work to provide care and will serve as the drug information resource. Lastly, the residents will be actively involved in critical care and trauma situations by providing assistance with medication selection, preparation, and dosing.
- Adult Emergency Medicine
The Emergency Medicine service is responsible for providing care for those patients in the Adult Emergency Department, Urgent Care, and Emergency Acute Care Unit. During this rotation, pharmacy residents are expected to gain and apply knowledge of the empiric treatment of emergency medicine disease states and monitor therapeutic regimens for effectiveness and adverse effects. Residents are expected to perform chart reviews and patient interviews/assessment in order to effectively evaluate medication management. The pharmacy resident will also be exposed to and actively involved in all code situations, including all patients seen in critical care and trauma scenarios. Residents will have the opportunity to build knowledge base in both medication preparation and dosing recommendations in critical situations. This rotation provides a blend of critical care medicine responsibilities and review of internal medicine disease states and their pharmaceutical needs.
- Pharmacy Informatics
This rotation includes the care and feeding of Pharmacy information technology systems in an academic medical center. The resident gains experience with implementing healthcare computer projects, drug-use policy, investigational services, pharmacy operations, clinical and decentralized pharmacy services, human resources, finance, and budget activities through the use of appropriate technologies. Previous residents completing this rotation have implemented a hand held documentation system for clinical practice, worked on the Pharmacy web site, and served on the Project team for the successful implementation of the current Provider Order Entry system.
- Medication Quality and Outcomes
The rotation is designed to give the resident a basic understanding of pharmacoeconomics and health services research as they relate to medication use policy. The rotation will have a strong didactic component which will require the resident to complete several readings and discussions on research methods, statistics, cost-benefit analysis, health economic analysis and current health policy issues. Practice experience is gained through participation in projects designed to optimize policy decisions for the organization.
- Investigational Drug Service (IDS)
The goal of this rotation is to understand the role and contributions of the Investigational Drug Service (IDS) in the context of the Department of Pharmacy, The Johns Hopkins Hospital and the Johns Hopkins University School of Medicine and Bloomberg School of Public Health. IDS directly dispenses for many drug studies, sets up studies in pharmacy satellites, and audits drug storage, labeling, and record keeping for studies where the investigator holds the drug. The AIDS Clinical Trials Group (ACTG) pharmacist is part of IDS. The resident will gain an understanding of the new drug development process, learn about regulations concerning the dispensing of investigational drugs, the pharmacist's role on the IRB, and become familiar with the daily operations of a pharmacy-based investigational drug service.
- Abdominal Organ Transplant
The transplant rotation will expose residents to kidney, liver and pancreas transplantation. They are expected to become familiar with immunosuppressant pharmacotherapy as well as medical and surgical issues that surround a transplant patient. The resident will attend daily morning rounds with the multidisciplinary transplant team. There will be daily discussions with the preceptor regarding the patients.
- Blood and Marrow Transplant
The adult blood and marrow transplant (BMT) service is responsible for providing care to patients undergoing BMT for hematologic malignancies. In addition, the service also includes management of patients undergoing routine therapy or supportive care for acute and chronic leukemia, Hodgkins and Non-Hodgkins lymphoma, myelodysplastic syndromes, and multiple myeloma. The resident will gain experience managing infectious disease in immunocompromised patients, and some critical care. The resident will be responsible for attending daily rounds, monitoring drug therapy, and providing drug information to the medical team. The resident will meet with the preceptor daily to discuss patients, and will cover topic discussions routinely. Additional rotation activities will include patient education and discharge coordination, and a nursing in-service during the month.
- Link to the application information:
Cathy L. Walker, B.S. Pharm
Title: Assistant Director, Education and Training
Education: B.S. Pharmacy, Philadelphia
College of Pharmacy and Science, 1985
Training: Pharmacy Practice Residency,
Children’s Hospital National Medical Center,
Washington D.C., 1986.
Cathy Walker is the Assistant Director, Education and Training, for the Department of Pharmacy at the Johns Hopkins Hospital. She is the Residency Program Director for the PGY1 Pharmacy residency, and serves as the Residency Program Coordinator for all of the Hopkins residency programs. Ms. Walker received her pharmacy degree from the Philadelphia College of Pharmacy and completed her Pharmacy Practice residency at the Children’s National Medical Center, Washington, DC.
Ms. Walker is active in the Eastern States Conference for Pharmacy Residents and Preceptors, serving on the Advisory Board and as the Conference Chair in 2008. She is committed to pharmacy education and is a member of the Notre Dame University of Maryland Experiential Education Advisory Board. She is a past member of the Preceptor Development Section Advisory Group of the American Society of Health System Pharmacists and the UHC Research and Education Committee. The Department of Pharmacy is an accredited ACPE provider, for which Ms. Walker is the Continuing Education Administrator.
Ms. Walker has been the recipient of the Maryland Society of Health-System Pharmacists’ Pharmacist of the Year award. Prior to moving into pharmacy administration, Ms. Walker practiced as a pediatric pharmacist and nutrition support pharmacist, where she served as preceptor for numerous pharmacy students and residents.
Cathy L. Walker, B.S. Pharm
Assistant Director, Education and Training
Department of Pharmacy
The Johns Hopkins Hospital
600 North Wolfe Street / Carnegie 180
Baltimore, Maryland 21287-6180
Phone: (410) 614-4377