Rotation Descriptions

PGY1 Applicants Please Note:  Prisma Health – Upstate will participate in PhORCAS (Pharmacy Online Residency Centralized Application Service).  No additional application materials are required outside of PhORCAS.

Adult Internal Medicine

The Medical Teaching Service (MTS) experience creates a foundation for pharmacy residents on an inpatient general medicine service. The resident will be assigned to an MTS team consisting of an attending physician, medical residents, interns and students. The resident will:

  • Attend patient care rounds and teaching rounds on a daily basis.
  • Present developed therapeutic plans for each of their patients to the preceptor on a daily basis.
  • Provide patient counseling on medications and disease-states.
  • Obtain medication histories.
  • Write pharmacokinetic and therapeutic consult notes as necessary.
  • Participate in journal club.
  • Give two formal presentations to the preceptor.

In addition, the resident will have the opportunity to conduct informal and/or formal educational services to physicians, nurses and pharmacists. Topics commonly encountered and/or discussed throughout the rotation include pneumonia, urinary tract infections, bacteremia/sepsis, chronic obstructive pulmonary disease, heart failure, venous thromboembolism, angina/myocardial infarction, stroke, seizure disorders, acute and chronic renal failure, peptic ulcer disease, gastroesophageal reflux disease, pancreatitis, hepatitis/cirrhosis, diabetes, anemia, fluid-electrolyte disorders, acid-base disorders, human immunodeficiency virus, dementia and liver disease.

Adult Internal Medicine: Family Medicine

The Family Medicine experience creates a foundation for pharmacy residents on an inpatient general medicine service. The Family Medicine Teaching Service (FTMS) consists of an attending physician, clinical pharmacist, medical residents, interns and students and serves the acute medical needs of patients during hospitalization. The resident will:

  • Attend morning report and teaching rounds on a daily basis.
  • Present developed therapeutic plans for each of their patients to the preceptor.
  • Write pharmacokinetic and therapeutic consult notes as necessary.
  • Provide drug information services for the healthcare team.
  • Participate in topic discussions/journal clubs.
  • Be actively involved with ongoing projects.
  • Provide two formal presentations to the clinical service

Topics commonly encountered and/or discussed throughout the rotation will include both internal medicine and ambulatory care based topics. This rotation can be tailored to resident-specific interests/needs. In addition, the resident will have the opportunity to conduct informal and/or formal educational services to physicians, nurses and pharmacists.

Adult Internal Medicine: Hospitalists Service

The Hospitalists Service experience is an elective rotation for pharmacy residents on an inpatient general medicine service. The resident will be assigned to a portion of the Hospitalists Service (based on interest). The Hospitalists Service is comprised of seven day-shift physicians rounding on patients throughout the hospital, three pharmacists and students. As a member of the patient care team, each resident will work closely with the preceptor to provide pharmaceutical care. The resident will:

  • Attend Grand Rounds each Friday morning.
  • Present developed therapeutic plans for each of their patients to the preceptor on a daily basis.
  • Independently round on patients daily.
  • Provide patient counseling on medications and disease-states.
  • Obtain medication histories.
  • Write therapeutic consult notes as necessary.
  • Participate in journal club.
  • Give formal presentations to the preceptor.
  • Conduct informal and/or formal educational services to physicians, nurses and pharmacists.

Topics commonly encountered and/or discussed throughout the rotation include internal medicine-based topics.

Adult Oncology

The Hematologic Malignancies/Adult Oncology rotation is an elective option for PGY-1 residents. This rotation involves the provision of direct pharmaceutical care to patients with a variety of hematologic malignancies including, but not limited to, leukemia, lymphoma and multiple myeloma. Based on patient census and the interest of the resident, bone marrow transplant and/or solid tumor pharmacotherapy may be included. The resident will obtain knowledge and experience as it relates to the general principles of oncology pharmacy practice, including oncologic supportive care issues.

Ambulatory Care

The Ambulatory Care experience is a month long clinical experience, offered year round by the Prisma Health Department of Pharmacy Services. The purpose of this experience is to allow the PGY-1 resident to develop skills in optimizing patients’ medication therapy in a fast-paced ambulatory care setting. The resident will work in collaboration with other healthcare professionals to optimize patient care.

Residents will spend most of their time at the Anticoagulation Clinics across the Prisma Health campuses. The Anticoagulation Clinics are managed by clinical pharmacists and accept referrals from various practices throughout Greenville and the surrounding areas. Anticoagulants managed include warfarin, bridging anticoagulants (enoxaparin and fondaparinux), and the direct oral anticoagulants (apixaban, dabigatran, edoxaban, and rivaroxaban).

The resident may also have the opportunity to shadow pharmacists at the Transitional Care Program (TCP) and Center for Family Medicine (CFM).  TCP visits focus on patients who have recently been discharged from the hospital. These patients are followed closely by the TCP team (physician, pharmacist, nurse, and care manager) through weekly visits for approximately 4 weeks to prevent further hospitalizations and ER visits. At CFM, the pharmacist sees complex patients with medical residents at a family medicine practice and is available for consult while the resident reviews patient cases with the attending physician.  At both sites, pharmacists are an integral part of the care team and may contribute by completing medication reconciliations and assessing risk factors, lab values, drug interactions, and adherence or cost issues. Pharmacist recommendations are discussed with the physician provider(s), and the pharmacist will either directly educate the patients on those changes or teach medical residents how to do so when applicable.

Ambulatory Care – Diabetes

The resident will spend time both inpatient at Greenville Memorial and outpatient at various locations of the Diabetes Self-Management Program.  The resident will work with inpatient internal medicine patients with uncontrolled diabetes to identify barriers to successful glycemic management and collaborate with healthcare providers to identify solutions.  The resident will provide individual and group diabetes education to adults and children with Type 1, Type 2, and gestational diabetes.  Rotation goals include application of evidenced based medicine of diabetes pharmacotherapy, patient and family education, improving transitions of care, and integrating diabetes technology when applicable.

Antimicrobial Stewardship

The Prisma Health Antimicrobial Stewardship Program (ASP) is a coordinated system level program that promotes appropriate use of antimicrobial therapy, reduces microbial resistance, decreases the spread of infections caused by multidrug-resistant organisms, and improves patient outcomes.  The program is led by an ID trained pharmacist and an ID physician.

Residents on this rotation will complete active stewardship review and make patient specific recommendations to the primary teams, provide education to various services regarding antimicrobial stewardship topics, and complete antimicrobial stewardship related quality improvement projects for the system.

Topics focused on during this rotation include:

  • Antimicrobial stewardship principles
  • Diagnostic testing performed in the microbiology laboratory
  • Urinary tract infections/asymptomatic bacteriuria
  • Bloodstream infections
  • Antimicrobial resistance
  • Respiratory infections

Cardiology

The Cardiology Teaching Service (CTS) experience is an elective rotation. CTS directly admits patients and accepts consults from various services at the Greenville Memorial Hospital campus to manage a broad scope of cardiovascular conditions. This rotation is designed to provide a basic overview of the acute and chronic management of commonly encountered adult cardiovascular diseases. CTS provides medical; as well as, interventional management as treatment approaches.

The resident will be assigned to a team consisting of an attending physician, medical resident(s), intern(s) and student(s). Disease states encompass STEMI, NSTEMI/US, CHF exacerbations, arrhythmias, anticoagulation, hypertensive crises, interventional cardiology and others.

Cardiovascular Intensive Care

The Cardiovascular Service is a non-teaching service consisting of a pulmonary/critical care board certified attending physician, physician assistants, a clinical pharmacy specialist and a respiratory therapist. The team provides critical care consultative service to cardiothoracic surgery patients. The average daily census for the service ranges from 10-20 patients depending on consultations, with most patients requiring mechanical ventilation. Disease states managed include post-operative care of coronary artery bypass grafts and valve repair/replacement, sepsis resulting from a multitude of causes, pain management as well as many other disease states.

Drug Information

The Prisma Health Drug Information Service responds to clinical queries from Pharmacy, Medicine and Nursing Staff. The scope of drug information consults is quite diverse and may include patient-related therapy decisions, protocol/order set development, clinical research and/or investigational drug inquiries and adverse drug reaction monitoring in any given month.

Infectious Diseases Consult Service

The Infectious Diseases Consult Service is utilized by all of the various services in Greenville Memorial Medical Campus to participate in the care of patients with difficult to manage infectious diseases. The service is a multi-disciplinary team consisting of an infectious disease attending physician, internal medicine residents, medical students and a pharmacist. Disease states commonly encountered include pneumonia (community and hospital acquired), urinary tract infections, bacteremia/sepsis, hepatitis/cirrhosis, human immunodeficiency virus, osteomyelitis, endocarditis, sexually transmitted diseases, opportunistic infections, meningitis and various fungal infections.

Longitudinal On-Call/Clinical Pharmacokinetics Consult Service

The clinical on-call/pharmacokinetics longitudinal experience provides on-call and pharmacokinetics consult service at Prisma Health – Upstate. The on-call/pharmacokinetics consult service is designed to provide consistent clinical resources to GMMC healthcare providers in a timely manner. The resident will design, monitor and evaluate evidence-based patient-specific therapies involving clinical pharmacokinetics, drug information questions, investigational drug services, therapeutic outcomes program, clinical services cross-coverage and additional pharmacotherapy consults.

Medication Use/Medication Safety

Provides support for the Prisma Health Pharmacy and Therapeutics Committee by reviewing and preparing drug formulary reviews, medication usage evaluations, meeting agenda/minutes and other relevant meeting materials as appropriate. During the rotation, the resident will gain an understanding of the organizations’ medication-use systems by applying medication safety principles and best practices.  This rotation will help equip residents to understand the complexity of medication safety and the need to identify and manage system failures to improve patient safety.

Residents will have the opportunity to learn about different types of medication errors, factors that contribute to medication errors, the severity of those errors, and the steps that go into their prevention.  Residents will also gain experience in collecting data on medication errors, analyzing the findings, communicating with other healthcare professionals and administrators through a reporting mechanism, and tracking and trending an area of failure and success.  Residents will share the information obtained through various means such as a hospital-wide performance improvement initiative.  Residents may also have the opportunity to attend pharmacy and therapeutics committee meetings, interdepartmental performance improvement meetings, and monthly hospital-wide medication error rate reporting discussions.

The resident will have the opportunity to explore a variety of areas within the medication-use system: computerized prescriber order entry (CPOE) systems, electronic health records (EHR), clinical decision support tools, automated dispensing machines, ‘smart’ infusion pumps, and bar code medication administration and medication error surveillance.

Medicine/Pulmonary Intensive Care