PGY1 Pharmacy Residency Program: Acute Care Setting

The first 5 weeks of the PGY1 residency program are dedicated to the Orientation rotation. Orientation focuses on educating residents on policies, procedures, expectations, schedules, and project requirements; developing goals for residency; and familiarizing residents with Billings Clinic and the Pharmacy Department. Residents also learn how to use PharmAcademic™ (electronic evaluation system) during Orientation.

The Pharmacy Practice rotation starts in week 3 of Orientation and lasts 6 weeks. It helps residents become confident in the use of pharmacy information systems, evaluation of prescriber orders, and the utilization of the integrated dispensing system, and general pharmacy workflow. Billings Clinic residents are trained on all pertinent technology and information systems relevant to their practice area, (e.g., Oracle/Cerner, Omnicell, DoseEdge, Liberty, and much more).

Residents spend the remainder of their PGY1 residency program participating in various clinical rotations. Residents are exposed to all aspects of patient care using an integrated approach. Residents work in a dynamic, educationally-stimulating residency environment as they mentor student pharmacists from several colleges of pharmacy during both their introductory and advanced pharmacy practice experience rotations at Billings Clinic. Residents interact regularly with intern, resident, and attending physicians from the Billings Clinic Internal Medicine Residency Program. They may also interact with psychiatry residents, nursing residents, and periodically with the providers from the Montana Family Medicine Residency Program.

• Cardiology: 5 weeks
• Critical Care: 5 weeks
• Infectious Diseases: 5 weeks
• Internal Medicine: 5 weeks
• Orientation: 5 weeks
• Pharmacy Practice: 6 weeks

Residents rank the rotations in order of preference. Whenever possible, residents are scheduled for their top choices of elective rotations at the start of the year. They also have a third elective rotation, which they can choose as the year progresses.

• Ambulatory Care – Primary Care: 5 – 6 weeks
• Emergency Medicine: 5 – 6 weeks
• Neonatology: 5 – 6 weeks
• Oncology: 5 – 6 weeks
• Psychiatry: 5 – 6 weeks

• Medical Emergencies
• Pharmacy Academia
• Pharmacy Administration/Medication Safety
• Practice Advancement Projects
• Staffing

Flexible Time
Residents are also allotted 2 weeks of "flexible" time in their year, which can be used for vacations, project time, and/or extending a rotation. These flexible weeks are scheduled around the Christmas and New Year’s holidays.

Project Time
Once residents start clinical rotations, they are allotted approximately one project day per rotation, which may be used for projects, meetings, or other residency assignments. Additionally, residents have 2 – 3 dedicated weeks for project time in the second half of the year.

Residents are required to staff on a rotating basis approximately every 2 – 4 weekends throughout the year. Staffing includes weekend shifts in the Main Inpatient Pharmacy and shifts on the inpatient surgical unit in the hospital. Additionally, residents are each required to staff 1 holiday (usually New Year’s Day or Memorial Day).

Throughout the year, residents take turns being the pharmacy resident on-call and responding to medical emergencies, including cardiopulmonary resuscitation (CPR) events, strokes, and traumas (level 1). The goal of the on-call time is for residents to gain the necessary skills and confidence to serve in the primary pharmacist’s role at medical emergencies. On-call hours are from 0630 – 1700, and residents are required to be on-site when they are on-call. Residents are on-call for approximately 10 weeks of the residency year, but this may be adjusted based upon frequency of events and each resident’s exposure to medical emergencies.