Internal Medicine I and/or II Rotation

Preceptor - Roger Brumagin, PharmD

Rotation Description:

The Internal Medicine (IM) experience is a required rotation for the Pharmacy Practice Resident. This experience involves direct patient care through daily interaction with patients and all other stakeholders (family members, friends and various health-care personnel) in order to provide optimum pharmacotherapy and to prevent, identify, mitigate, minimize, and/or resolve any medication-related issues. For each of the two rotations, the resident will spend one calendar month (at a minimum of 40 hours per week) in a team-based environment that is centered around rounding with the IM team each morning. In addition to a good foundation in anatomy, physiology, pharmacology, pharmacokinetics and pharmacotherapy, excellent communication and interpersonal skills are vital in this setting.

It is expected that the resident will devise efficient strategies for accomplishing in a timely manner all required activities for this experience which may include, but are not limited to:

  • Comprehensive assessment of each drug therapy regimen on an ongoing basis and development of a drug therapy plan for      each patient while considering each patient's previous pharmacologic recommendations, current health care status (e.g.      organ function, medical history), personal health related goals and ideology (e.g. whether to opt for aggressive or strictly      palliative treatments), costs and treatment guidelines
  • Providing specific and accurate recommendations, both verbally and in writing, pertaining to drug therapy including, but not      limited to, dose adjustment, drug addition, drug deletion, and drug monitoring, while incorporating the principles of evidence      based medicine and established regulatory guidelines whenever possible
  • Effectively and professionally communicate with all health care professionals, patients and family members in regard to      medications, drug therapy regimen evaluations, formal recommendations, in-service topics, case presentations and other      required communications
  • Collaborating with other health care professionals in order to promote pharmaceutical care including, but not limited to,      attending physicians and/or pharmacists, medical and/or other pharmacy residents, medical and/or pharmacy interns, and      medical and/or pharmacy and/or nursing students, nursing personnel, nurses' aides, dietitians, social workers and ward      clerks
  • Performing the duties of a clinical pharmacist, including, but not limited to: renal and/or hepatic dosing, IV to oral      conversions, pharmacokinetic dosing, evaluating drug-patient interactions and/or drug-drug interactions drug-and/or      disease interactions and medication counseling
  • Assist in the creation of protocols and other improvement processes, such as modifying existing protocols, to maximize      patient outcomes
  • Appropriate documentation of all pertinent activities, in written form (typically in the patient's chart) and/or electronically      (typically via Meditech)
  • Providing timely, complete and accurate drug information to health-care professionals, patients and family members
  • As appropriate, assist in the education of students from the L|E|C|O|M School of Pharmacy who are on their Advanced      Pharmacy Practice Experiences (APPE) rotations
  • Strict adherence to all pertinent rules and regulations, which may include, but are not limited to, those of Millcreek      Community Hospital (MCH), the Lake Erie College of Osteopathic Medicine (L|E|C|O|M), the Erie County Board of Health, the      American Osteopathic Association (AOA), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the      State Board of Pharmacy of the Commonwealth of Pennsylvania, the Food and Drug Administration (FDA), the Drug      Enforcement Administration (DEA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

    • Rotation Topic Discussions / Readings

    Common disease states and/or topics with which the resident will be expected to gain facility through literature review, topic discussion and direct patient care experience may include, but are not limited to:

  • Asthma
  • Atrial Fibrillation
  • Cancer
  • Chronic Obstructive Pulmonary Disease
  • Coronary Artery Disease
  • Dementia
  • Diabetes (and all its sequelae)
  • Epilepsy
  • Heart Failure
  • Heparin-induced Thrombocytopenia
  • Hypercholesterolemia / Hyperlipidemia / Hypertriglyceridemia
  • Hypertension
  • Hypothyroidism
  • Infectious diseases, including, but not limited to:
  • Cellulitis
  • Diverticulitis
  • Endocarditis
  • Infective colitis
  • Osteomyelitis
  • Pneumonia
  • Urinary Tract Infections
  • Myocardial Infarction
  • Osteoporosis
  • Pain Management
  • Parenteral Nutrition
  • Parkinson's Disease
  • Stroke
  • Venous Thromboembolism

    The resident is expected to understand the pharmacotherapy related to these disease states as well as other disease states encountered in this setting. The preceptor or their designee will be available to the resident throughout the learning experience for consultation and topic discussions. Resident learning is predicated not only to the above responsibilities, but also on acceptance of personal responsibility and dedication to direct patient care and team service.

    ASHP Required Goals and Objectives to be taught and evaluated:

    Goal R1.4:

  • OBJ R1.4.1

    • Goal R2.1:
  • OBJ R2.1.1

    • Goal R2.2:
  • OBJ R2.2.1

    • Goal R2.3:
  • OBJ R2.3.1

    • Goal R2.4:
  • OBJ R2.4.1
  • OBJ R2.4.2
  • OBJ R2.4.3

    • Goal R2.6:
  • OBJ R2.6.1
  • OBJ R2.6.2

    • Goal R2.7:
  • OBJ R2.7.1

    • Goal R2.8:
  • OBJ R2.8.1
  • OBJ R2.9.2

    • Goal R2.10:
  • OBJ R2.10.1
  • OBJ R2.10.2

    • Goal R2.11:
  • OBJ R2.11.1
  • OBJ R2.11.2

    • Goal R2.12:
  • OBJ R2.12.1
  • OBJ R2.12.2
  • OBJ R2.12.3

    • Goal R3.1:
  • OBJ R3.1.2
  • OBJ R3.1.3

    • Goal R5.1
  • OBJ R5.1.1
  • OBJ R5.1.2
  • OBJ R5.1.3
  • OBJ R5.1.4
  • OBJ R5.1.5
  • OBJ R5.1.6

    • Goal R6.1:
  • OBJ R6.1.1
  • OBJ R6.1.2
  • OBJ R6.1.3

    •