Residency in Critical Care Medicine
The Specialized Residency in Critical Care Medicine is a 12-month program with accreditation by the American Society of Health-System Pharmacists. The purpose of this program is to develop pharmacy practitioners who are able to assume the responsibility of providing pharmaceutical care in critically ill patients. Since nutrition support is an important therapy used in critically ill patients, the resident may choose to participate in a combined nutritional support/critical care program if it is mutually agreeable with the resident and preceptors.
Program Objectives
Upon completion of this residency program in critical care medicine, the resident shall be able to:
- Devise a plan for prioritizing the provision of pharmaceutical care when given limited time and multiple patients.
- Develop a healthy skepticism of published studies, as well as comments by other health professionals.
- Design a plan for evaluating medication levels in critically ill patients and subsequently make appropriate recommendations to health care providers and possibly the patient.
- Design a plan for initiating, monitoring/adjusting, and discontinuing antimicrobial agents in the critically ill patient.
- Generate a plan for administering medications when the GI tract is not functioning.
- Create a plan for deciding the type and rate of IV fluid that should be used in the critically ill patient.
- Design a regimen for initiating, monitoring, and discontinuing analgesic therapy in the critically ill patient.
- Create a cost-effective regimen for instituting, monitoring and discontinuing stress ulcer prophylaxis in critically ill patients.
- Design a plan for choosing ICU patients who should receive parental nutrition, as well as a plan initiating, monitoring and stopping parenteral nutrition.
- Describe common terminology associated with mechanical ventilation and list at least three examples of how ventilator settings may influence the choice of medications or nutrition.
- Discuss how common ICU devices and monitoring techniques are used in the care of the critically ill patient.
- Interact with and educate other health professionals in a professional and non-threatening manner.
Training Site
The resident's principal training will occur at University Medical Center, although limited arrangements may be worked out with other facilities, if necessary, to provide the resident with the best possible training.
The design of this program is intended to offer the resident as much flexibility as possible, while accomplishing the objectives of the program. Therefore, the program will be individualized to suit the needs of the particular resident. The resident is expected to participate in weekly clinical pharmacy conferences and the clinical pharmacy on-call schedule. The resident may be assigned activities in the inpatient pharmacy. It also is expected that any circumstances that inhibit the ability of the resident to meet the objectives of the residency will immediately be brought to the attention of the residency preceptor.
A complete list of activities will be discussed with the resident; such activities will include rounding with various multidisciplinary teams, meeting regularly with the resident's preceptor, attending and possibly presenting at pharmacy or other health professional meetings, assisting the preceptor with the training of PharmD students, participating in pharmacy activities that cross specialty practice, and providing written recommendations in the progress note section of patient's charts and providing formal consultations.
The resident will complete at least one project during his/her tenure at University Medical Center. This does not necessarily mean that the resident will be involved in all phases of the project, but rather the resident's responsibilities with regards to the project will be clearly delineated to the satisfaction of the resident and preceptor. The resident also may be asked to co-author case reports or review articles depending on other time constraints.
Preceptors
The preceptor for this program is Brian L. Erstad, PharmD, FASHP, who is a professor at The University of Arizona College of Pharmacy, with clinical responsibilities at University Medical Center, which includes being a member of the nutrition support team. Other individuals who will likely be involved in the resident's training include Carol J. Rollins, MD, RD, PharmD, who coordinates the nutritional support team, and Brian Kopp, PharmD, and Yvonne Huckleberry, PharmD, who provide clinical staff pharmacy services in the ICU setting.
Fringe Benefits
Group health and life insurance, vacation and sick leave, and financial support to selected professional meetings
Number of Positions: One
Applicant Qualifications
The applicant for the residency in critical care medicine should have graduated from an accredited Doctor of Pharmacy (PharmD) program and completed a clinically oriented residency before beginning his/her critical care residency. Suspension of these criteria may be allowed for exceptional candidates as determined by the residency preceptor.
Inquiries and applications should be directed to:
Brian L. Erstad, PharmD, FASHP
Professor
Department of Pharmacy Practice and Science
College of Pharmacy
The University of Arizona
Tucson, AZ 85721
(520) 694-5600
email: erstad@pharmacy.arizona.edu