Core Rotations

The orientation rotation is a one month experience that will cover the dispensing and clinical operations in the pharmacy department of Mercy Hospital of Buffalo as well as the expectations of the PGY2 residency program. Within this rotation the resident will be oriented to the physical layout of the department and hospital, read and understand Catholic Health, Mercy Hospital policies and procedures, and pharmacy department specific policies and procedures, as well as software programs pertinent to the pharmacy department. The resident will complete clinical competencies as required by the department during this period.

The MHB I Emergency Department rotation is a required one month learning experience at Mercy Hospital of Buffalo. In this rotation, the resident will learn the skills necessary to become a competent clinical pharmacist that can work independently and provide direct patient care to patients in the emergency department (ED). This is an extension of the orientation period to prepare the resident to independently staff in the ED on weekends. The ED at Mercy Hospital is a 32-bed unit, with 2 resuscitation rooms, and is one of the largest EDs in the area. Clinical pharmacy services are provided in the Mercy Hospital ED, at minimum, from 0800-2100 Monday through Friday, overnight from 2100-0700, and 1300-2100 on weekends

The MHB II Emergency Department rotation is a required one month learning experience at Mercy Hospital of Buffalo. In this rotation, the resident will practice the skills necessary to perform as competent clinical pharmacist that can work independently and provide direct patient care to patients in the emergency department (ED). This rotation is an extension of the MHB ED I rotation and resident will be expected to perform at the level of a clinical pharmacy specialist.

In this one month rotation, the resident will be practicing as the clinical pharmacist in the emergency department at Mercy Hospital of Buffalo. The focus of this rotation is on pharmacy precepting and the teaching, education and dissemination of knowledge. In addition to providing emergency department clinical pharmacy services, the resident will be expected to formally take on the role of precepting a PGY1 pharmacy resident and/or APPE/IPPE student. This will include orientating the learner to the learning experience, providing formative and summative feedback, and effectively employing preceptor roles (instructing, modeling, coaching, or facilitating).

Emergency Medicine at Kenmore Mercy Hospital is a required, one month learning experience for the PGY2 EM program. The ER is a 25-bed unit that cares for a mix of ambulatory, medical, surgical, and neurocritical care patients. Attending physicians and advance practice providers (APPs) are responsible for caring for our emergency room patients. The ER pharmacist works closely with nurses, providers, respiratory therapists, and consultants to provide comprehensive medication management services to our patients.

The SOC Emergency Department rotation is a required one month learning experience at Sisters Hospital. The ED at Sisters Hospital is a 29-bed unit equipped with two code rooms and a 5-bed fast track. Clinical pharmacy services are provided in the ED, at minimum, from 0900-2200 Monday through Friday. Pharmacist responsibilities in the ED include responding to cardiac arrests and stroke emergencies, answering drug information questions from ED and Sister Hospital caregivers, patients, and families, antibiotic stewardship (including the daily outpatient microbiology report), collaborating with the centralized pharmacists to assure timely medication availability, and medication reconciliation. In addition, the ED pharmacist will serve as a drug information resource during the evening hours and be responsible for determining appropriateness of medication therapy and completing pharmacy consults for the hospital during this time.

The resident will be expected to complete two month long rotations in a critical care unit. The choice of which of two of the following units will be at the discretion of the resident:

• Medical Intensive Care Unit (MICU)
• Mercy Hospital of Buffalo
• Kenmore Mercy Hospital
• Cardiac Intensive Care Unit (CVICU)
• Neurocritical Care Unit (NICU)

This a one month required virtual direct patient care rotation. The resident will work with the clinical toxicologists, fellows, and residents at the Upstate New York Poison Control Center. The purpose of this learning experience is to expose the resident to different cases of toxin exposures and how to manage such patients. The resident will develop a comprehensive approach to the poisoned patient as defined by: the ability to manage exposures when the specific toxin cannot be identified or when inadequate information is known regarding a specific toxin, and the ability to appropriately evaluate and initiate therapy for a number of commonly presenting toxins. This experience will include both acute care patients and outpatients. The center has an annual call volume of 70,000 from a 54-county service area. The poison control center is affiliated with the Department of Emergency Medicine at Upstate Medical University. Additionally there will be requirements for participating in the poison control center’s simulations, Toxicology Case Conferences, topic discussions, and journal club.

The Clinical Overnight rotation is a required 2 week long learning experience at Mercy Hospital of Buffalo (MHB). This rotation is similar to the EDI and EDII rotations, but gives the resident experience during the overnight hours (2100 – 0700) which can be unpredictable. Responsibilities on this rotation will expand to provide clinical coverage for the entire hospital during the overnight hours. This will include attendance of all rapid responses, cardiac arrests, strokes, reviewing critical care patients, and answering drug information questions from any hospital provider. During this rotation, the pharmacy resident will work collaboratively with several disciplines including the ED physicians, ED mid-level providers, hospitalists, intensivists, critical care mid-level providers, medical residents and ED nurses to optimize pharmaceutical care for the ED patients. The resident will use evidence-based medicine to provide pharmaceutical care to a range of hospitalized patients, from the ambulatory to the critically ill.

The resident will be required to participate in research throughout the year. The research project may be of a clinical, economic, research, administrative, or quality/process improvement design. The resident will work with their assigned preceptor(s) to create a new study design proposal, conduct a literature search and submit for IRB approval. The resident will then collect and analyze data, while preparing a final poster and manuscript by the end of June.

This 12 month longitudinal rotation will cover the dispensing and clinical operations in the pharmacy department of Mercy Hospital of Buffalo, with a focus on the emergency department. Staffing requirements include every third weekend in the emergency department and coverage of two holidays (one major and one minor) as needed by the department. It is expected the resident will be able to independently staff as a clinical pharmacist in the emergency department once they are licensed as a pharmacist in New York State and have successfully completed both the orientation and MHB I ED rotations.

This 12 month experience is designed to give residents a chance to develop their professionalism and to learn about and participate in important pharmacy-related functions of the health system that are not necessarily associated with direct patient care. The resident will demonstrate knowledge and application skills in the pharmacy services that are critical to safe, effective, and cost-conscious medication use in a hospital and pharmacy departments, including (1) practice management; (2) medication-use policy development; (3) optimizing medication therapy; (4) drug product procurement and inventory management; (5) monitoring medication use; (6) education of healthcare professionals; and (7) evaluating the effectiveness of the medication-use system.

Elective rotations are an area that allows for customization of our program to fit the interests of the residents. Some examples of electives include:

• Cardiovascular Intensive Care Unit (CVICU)
• Neurocritical Care (NICU)
• Medical Intensive Care Unit (MICU)
• Infectious Diseases/Antimicrobial Stewardship- Kenmore Mercy Hospital
• Neonatal ICU – Sister’s Hospital of Charity
• Advanced Academic Teaching Certificate (longitudinal)
• Erie County Medical Reserve Corp (MRC)/Specialized Medical Assistance Response Team (SMART) (longitudinal)