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MGH
PGY1 PHARMACY RESIDENCY
ROTATION
DESCRIPTIONS
updated 11/08
ACUTE
CARE
Residents will recommend patient-specific pharmacotherapeutic plans in
conjunction with the assigned medical/surgical team, provide appropriate
drug information, and communicate effectively.
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General
Medicine: Residents will understand
pathophysiology, clinical presentation and treatment of disease
states on the service, which may include: cardiovascular (arrhythmias,
ischemic heart disease, hyperlipidemia, hypertension), endocrine
(adrenal gland, diabetes, thyroid disorders), fluid/electrolyte
disorders, gastrointestinal (cholelithiasis, inflammatory bowel
disease, liver disease, pancreatitis, PUD), respiratory (asthma/COPD,
acid-base disorders), hematological (anemias, coagulation disorders)
and infectious diseases (abdominal infections, endocarditis, hepatitis,
HIV, respiratory tract infections, skins and bone, sepsis, UTI).
They will provide appropriate drug level monitoring.
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Preceptors:
Dorothy Albright, Pharm. D.
Pharmacist
Residency: University of Colorado Hospital
Interests: General Medicine
Anthony J. Fatalo, M.S., RPh, BCPS
Senior Attending Pharmacist
Interest: Cardiology, general medicine
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Cardiology/Cardiac
Care Unit:
Cardiac patients will present with angina, myocardial infarction, shock, hypertension, pulmonary hypertension, dysrythmias, cardiomyopathy, myocarditis/pericarditis and valvular heart disease. The goal of this rotation is to advance the knowledge, skills and abilities of the resident, with particular emphasis in cardiovascular drug therapy.
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Preceptors:
Paul Arpino, Pharm.D., BCPS
Senior Attending Pharmacist
Residency: St. Thomas Hospital, Nashville, TN
Interest: Cardiology, critical care
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Medical
Intensive Care Unit: Critically
ill patients with multi-system diseases will present with respiratory,
cardiovascular, renal and/or hepatic failure and sepsis requiring
intensive monitoring. Infectious disease and respiratory strategies,
including ventilatory support, will be used consistently, as well
as sedation and paralysis management. Residents will understand
guidelines for administration of frequently used intravenous medications,
including antihypertensives, vaopressors/inotropes, electrolytes,
and antibiotics. They will understand general dosing guidelines
and therapeutic strategies for patients with renal and hepatic failure
and make recommendations for dosage adjustments.
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Preceptors:
Krishna Shroff, Pharm. D.
Pharmacist
Residency: Cardiology, UMass Memorial Medical Center
Interest:
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Surgical
Intensive Care Unit:
Critically ill patients with multi-system diseases will present
with trauma and post-operative issues. Extensive use of vasopressors,
inotropes, electrolytes, antibiotics, sedatives, analgesics, neuromuscular
blocking agents, pain control, local anesthesia, post-operative
nausea/vomiting medications are employed. The resident will also
be exposed to mechanical ventilation, intravenous/intra-arterial
lines and other invasive monitoring devices.
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Preceptors:
Alan
DiBiasio, RPh
Senior Attending Pharmacist
Interest: Surgery, critical care
Kathryn Kalafatas, Pharm.D.
Senior Attending Pharmacist
Interest: Critical care, surgery, transplant |
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Pediatrics:
The patient population ranges in age from infancy to adolescence
with a variety of disease states pertinent to children, including:
seizure disorders (including ketogenic diet), infectious disease
(RSV, meningitis, HSV encephalitis), metabolic and congenital disorders,
respiratory (asthma, croup), failure to thrive/eating disorders,
GERD, cystic fibrosis, sickle cell anemia, Crohn's disease, and
nephrotic syndrome. Considerations include dosage forms/preparations
suitable for various age groups, differences in pharmacokinetic/-dynamic
properties in pediatrics, and drugs that are relatively contraindicated
in children.
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Preceptors:
B.
Robert Young, RPh
Senior
Attending Pharmacist
Interest:Pediatrics,
NICU, and pediatric critical care
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Pediatric
Intensive Care Unit: Patients range in age from newborns through nineteen years of age. Pediatric issues may include use of vasopressors/inotropes, electrolyte
abnormalities, infectious disease, trauma, including traumatic brain injury, neurology/neurosurgery, ECMO and cardiology and cardiac surgery, respiratory distress
and drug intoxication, management of pain and anxiety, iatrogenic
opioid and benzodiazepine dependence. |
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Preceptors:
Lois
F. Parker, RPh
Senior Attending Pharmacist
Interest: Pediatrics, Pediatric Critical Care, and Pain Management
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| Neonatal Intensive Care Unit: Patients are critically ill preterm and term newborns. Neonatal issues may include respiratory distress syndrome, infectious disease, electrolytes/nutrition, hyperbilirubinemia, congenital heart disease, metabolic disorders, seizures, use of ECMO and drug monitoring. |
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Preceptors:
B. Robert Young, RPh
Senior Attending Pharmacist
Interest: Pediatrics, NICU, and pediatric critical care |
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Emergency
Medicine: Patients will present
with a variety of disease states, which may include: stroke, diabetic
ketoacidosis, burns, trauma, poisonings/overdoses, and drug withdrawal.
Residents will understand concepts surrounding medications used
in a code situation, high-dose steroids, thrombolytics, and antibiotics.
They may deal with issues such as conscious sedation, motor vehicle
accidents, trauma codes, adherence in homeless patients, alcoholism,
drug addiction, post-exposure prophylaxis, and obtaining medication
histories.
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Preceptors:
Nancy
Balch, Pharm.D.
Senior Attending Pharmacist
Residency: Massachusetts General Hospital, Boston, MA
Interest: Emergency medicine, and influenza and pneumococcal vaccination
program
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Ambulatory
Oncology:
The practice of ambulatory oncology is representative of a spectrum
of healthcare issues. The rotation provides an opportunity to provide
care to adult outpatients who are receiving chemotherapy treatment.
The rotation will concentrate on one or two cancer types. Diagnosis
and staging, treatment design and monitoring, and supportive care
issues are the main focus. Methods of collaborative practice and
systems design are directed toward the overall goal of safety in
oncology practice. Significant opportunities exist for individual
patient counselling and patient education in general.
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Preceptors:
Regina
Holdstock, RPh, BCPS, BCOP
Supervisor, Oncology Pharmacy
Interest: Oncology, ambulatory care
Gayle Blouin, Pharm. D.
Senior attending Pharmacist
Residency: Dana-Farber Cancer Institute, Boston, MA
Interest: Pain and symptom management, end of life care
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| OR
Pharmacy/Anesthesia:
The resident will understand various types of surgery, including vascular,
cardiac, thoracic, neurology, pediatric, burns, as well as same-day
surgery, intubation and airway management and ECT. Medications the
resident will become familiar with include induction agents, muscle
relaxants, narcotics, antibiotics, and cardiovascular medications.
The resident may also become familiar with the OR pharmacy operations
- role of OR pharmacist/technician, control of controlled substances,
and drug distribution. |
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Preceptors:
Arvind
S. Shah, RPh
Senior Attending Pharmacist
Interest: Surgery, anesthesia, drug information and pain management
Michele
Winkler-Gettings, RPh
Attending Pharmacist
Interest: Intra-operative drug administration, surgery, investigational
drug studies, drug information
Audrey
Kennedy, RPh
Attending Pharmacist
Interest: Intra-operative drug administration, surgery, pain management,
drug information
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| Psychiatry:
Residents
will be exposed to the unique aspects of caring for the psychiatric
population, focusing on the pharmacological treatment of specific
diseases, including bipolar disorder, mania, schizophrenia, multiple
personalities, GAD, and MDD. The resident will develop skills necessary
to evaluate and treat the psychiatric patient, including patient interviewing,
assessing patients using psychiatric ratings scales and a more indepth
understanding of these disorders including the social and psychological
impact these disorders have on their daily lives. Interdisciplinary
patient care is highly evdent in this patient population, involving
psychiatrists, psychologists, social workers, OT, PT, pharmacists,
nurses and nutritionists. |
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Preceptors:
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| Inpatient
Oncology:
The oncology rotation is a supervised clinical experience in which
the resident develops the specialized knowledge base and practice
competencies necessary to provide pharmacy care to cancer patients.
It encompasses general principles of cancer treatment and chemotherapy,
pharmacotherapy of common oncology/hematology disease states, pain
management and supportive care. |
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Preceptors:
Sami Ahmed , Pharm.D., BCPS
Senior Attending Pharmacist
Residency: Massachusetts General Hospital, Boston, MA
Interest: Pediatrics, oncology, BMT, leukemia, sarcomas
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| Transplant
ID:
Residents will understand pathophysiology, clinical presentation and
treatment of disease states on the service, which include: kidney,
liver, lung and pancreas islet cell transplants. The resident will
recommend and implement patient-specific pharmacotherapy in conjunction
with the patient care team including antifungals, antivirals and antibiotics. |
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Preceptors:
Firdosh
Pathan, MS, RPh
Senior
Attending Pharmacist
Interest: Transplant, infectious disease, endocrine, medicine
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| Neurology/Neuro ICU :
MGH offers a residency rotation on the neurosciences ICU, exclusive
for neurosurgery and neuromedicine patients. Diagnosis may include
aneurysms, stroke, status epilepticus, Guillain-Barre' syndrome, intracranial
hypertension, cerebral vasospasm, and many other conditions warranting
ICU admission. |
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Preceptors:
Michael
Bodock, RPh
Senior Attending Pharmacist
Interest: Neurology, emergency medicine, general medicine
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| Pain
Management:
This rotation will provide the resident with an opportunity to interact
with patients suffering from various pain syndromes, including cancer
pain, neuropathic pain and acute pain. The resident will appreciate
the complex psychosocial issues associated with these patients. |
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Preceptors:
Lois
F. Parker, RPh
Senior Attending Pharmacist
Interest: Pediatrics, Pediatric Critical Care, and Pain Management
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Infectious Disease: The resident provides technical and clinical information and communicates results of monitoring activities to nurses and physicians as required regarding the therapeutic actions, possible adverse reactions or interactions of antimicrobial agents. He/she develops, proposes and implements guidelines and programs for the improvement of antimicrobial utilization and participates with nurses and physicians in all clinical activities as required. The resident performs daily patient rounds (M-F) to review new and changed anti-infective orders.
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Preceptor:
Petra Khoury Bassil, Pharm. D.
Attending Pharmacist
Residency: Massachusetts General Hospital
Interest: Infectious Disease
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New rotations may be created.
NON-ACUTE
CARE ROTATIONS
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Pharmacoeconomics/pharmacoepidemiology:
The resident will understand terminology, MGH databases, and work
with a project that determines effectiveness vs. efficacy of therapeutic
intervention.
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Preceptors:
Ronald
R. Gaudette, M.B.A., RPh
Senior Attending Pharmacist
Interest: Surgery, pharmacoepidemiology
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Informatics:
The resident will understand the role of automation at MGH, Omnicell
automated drug dispensing, database development, use of the Web
for information dissemination, computer-based training, and the
on-line formulary. |
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Preceptors:
Ron
Imperiali, RPh
Pharmacy Specialist, Informatics
Interest: Computer-based training, database management, web publishing
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| Pharmacy Administration:
Upon completion, the resident will increase understanding
of the management of a pharmacy department, multidisciplinary committees,
teamwork and communication, legal issues, leadership development,
activities of the pharmacy director, the hospital and pharmacy vision
from the Partners Healthcare perspective, Joint Commission, ASHP, the value of
empowerment, budget planning, performance improvement, and human resources. |
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Preceptors:
Margaret
Clapp, M.S., RPh
Pharmacy Director
Residency: Massachusetts General Hospital, Boston, MA
Interest: Management, teaching and systems improvement
Theresa Visconti, RPh
Pharmacy Specialist, Human Resources and Staff Development
Residency: Lenox Hill Hospital, New York, NY
Interest: Staff development |
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Medication
Education Safety and Approval Committee:
The
resident will understand the process for the acceptance of drug
therapies into the acute care formulary and participate in formal
clinical and pharmacoeconomic evaluation of new drug therapies including
financial impact on the institution. The provision and documentation
of drug information will be a responsibility of the resident throughout
the year.
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Preceptors:
Dena
Alioto, RPh
Senior Attending Pharmacist
Interest: formulary management, diabetes,
cardiology, and critical care
Paul Arpino, Pharm.D., BCPS
Senior Attending Pharmacist
Residency: St. Thomas Hospital, Nashville, TN
Interest: Cardiology, critical care
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Clinical Trials
Pharmacy: The
resident will gain an understanding of drug research at the MGH,
including the role of the Human Research Committee at MGH, the role
of the primary investigator, research associates, study monitors
and the role of the Research Pharmacy. The resident will review
protocols for the Clinical Trials Pharmacy Committee.
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Preceptors:
John
Vetrano, Pharm.D.
Senior Attending Pharmacist
Interest: Research
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| Teaching Pharmacy Students: The resident will develop practice competencies in educating advanced pharmacy practice students at the MGH. Opportunities to teach at the local colleges of pharmacy are also available. |
Trisha LaPointe, Pharm.D., BCPS
Assistant Professor of Pharmacy Practice
Massachusetts College of Pharmacy-Boston
Residency: Massachusetts General Hospital, Boston, MA |
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STAFFING
| Staffing
is an important part of the residency year. The pharmacy resident
will be able to review and enter orders, answer/document
medication information requests, process research medication orders
and non-formulary orders, and dispense narcotics from the Omnicell automated
drug dispensing machine. The resident will understand central pharmacy order
flow, pneumatic tube system, and functions of personnel working in
the production areas of the department. |
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Preceptors:
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PROJECT
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resident project, an investigation of a particular element of pharmacy
practice, will be developed taking into consideration the resident's
interests, department needs, and approval of pharmacy and residency
directors. This project will usually take a number of months to complete.
There will be several opportunities to present this work, at national,
regional, and local meetings. |
RESIDENCY ADVISORS/RESOURCES
Robert
K. Hallisey, Jr, M.S., RPh
Pharmacy Specialist, Clinical Services
Specialty Training: Institute for Health Care Improvement, Managing Excellence
and Quality Improvement
Interest: Cardiology, critical care, emergency medicine, and general medicine
Barbara
T. Irby, M.S., RPh
Pharmacy Specialist, Experiential Education/Residency Director
Residency: Johns Hopkins Hospital, Baltimore, MD
Interest: Training and education of staff, residents and students
Erasmo
(Ray) Mitrano, M.S., RPh
Pharmacy Specialist, Operations
Interest: Management, automation, performance improvement
Joseph
P. Santoro, RPh
Pharmacy Specialist, Operations
Interest: Nutritional support, chemotherapy, sterile products, and management
Theresa
Visconti, RPh
Pharmacy Specialist, Human Resources and Staff Development
Residency: Lenox Hill Hospital, New York, NY
Interest: Staff development
Dorothea Rudorf, PharmD, M.S.
Associate Professor of Pharmacy Practice, Massachusetts College of Pharmacy-Boston
Interest: Infectious Disease, general medicine, training and education of students and residents
Trisha LaPointe, Pharm.D., BCPS
Assistant Professor of Pharmacy Practice
Massachusetts College of Pharmacy-Boston
Residency: Massachusetts General Hospital, Boston, MA
Tanya John, Pharm.D.
Senior Attending Pharmacist
Interest: Pediatrics, medication safety, oncology
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