PGY-2 Pain and Palliative Care Residency
Mark Holtsman, Pharm.D.
Nathan Bryant, Pharm.D.
The University of California, Davis Health System, Department of Pharmacy offers a one-year PGY-2 in Pain and Palliative Care.
Pain Management and Palliative Care is a strong, well-established and progressive center of excellence at the University of California, Davis Medical Center (UCDMC). The UC Davis Center for Pain Medicine was named a Clinical Center of Excellence by the American Pain Society. Clinical Pharmacy Pain Management Services at UCDMC are provided in the following areas: Acute Pain Service, Inpatient Pharmacist Pain Management Service, Palliative Care, and Home Hospice. The Pain and Palliative Care specialty residency will provide residents with a comprehensive training and educational experience as a Pain Management Pharmacist.
To train Pain and Palliative Care Pharmacists to provide high quality, cost-effective, specialty pharmaceutical care to patients with pain and distressing symptoms in a positive learning environment that promotes independent, critical thinking, creativity and a culture of mutual respect. To prepare the graduating resident for clinical practice in the specialized field of Pain and Palliative Care pharmacy. A graduate of the program should be competent to become a clinical specialist at a large health care institution, as well as adjunct or clinical faculty for a school of pharmacy. The program should also lay the groundwork for a future position as a Pain and Palliative Care pharmacy residency program director.
The major area of focus is adult Pain Management, with an emphasis on analgesic pharmacology, pain assessment, symptom management, neuraxial analgesia and anesthesia, investigational analgesic therapies, prevention and management of drug toxicities and medication safety in pain and palliative pharmacy practice. Pain Management and Palliative patient care is provided in multidisciplinary settings, and Pain Management and Palliative care pharmacy residents will interact with clinical pharmacists, pharmacy technicians, physicians, nurses, social workers, physical therapists, patients, and caregivers to provide comprehensive care to patients with pain and distressing symptoms. Daily activities will include providing pain management consultations, participating in palliative care and hospice rounds, providing drug information to physicians, nurses and patients, medication reconciliation and coordination of home and discharge medications including preparation of opioid tapering instructions when needed.
The UCDMC PGY2 Pain and Palliative Care Residency is designed to meet the educational goals and objectives, as outlined by the ASHP PGY2 Pain Management and Palliative Care Residency Accreditation Standard.
4 weeks each, unless otherwise noted
- Inpatient pain management service (minimum of 3 rotations)
- Inpatient palliative care service
- Home hospice
- Acute pain service (Epidural/Regional)
- Pain procedures
- Pediatric pain management
- Ambulatory HIV/AIDS clinic
- Pain management clinic
- Medication safety (2-4 weeks)
- Longitudinal cancer pain clinic (2 months)
- Longitudinal pediatric pain clinic (2 months)
2-4 weeks each
- Investigational drugs service
- Gynecological surgery
- Psychosomatic medicine service
- Critical care
- Orthopedic surgery
- Repeat/extension of any of the required learning experiences
UCDMC offers many opportunities for both clinical and didactic teaching. The resident will be responsible for assisting preceptors with clerkship teaching for University of California, San Francisco pharmacy students and UCDMC PGY1 pharmacy residents. The resident will assume the primary preceptor role for UCSF pharmacy students during their last inpatient pain management learning experience.
The resident will be required to prepare an ACPE accredited pharmacy grand rounds presentation on a Pain and Palliative Care topic, based on the resident’s interests and a department needs assessment. The PGY2 Pain Management and Palliative Care Resident will also have the opportunity to participate in the annual, 8-week pharmacology lecture series that is administered as part of the oncology medical fellows training, as well as weekly Pain Management Journal Club and daily Pain Management Conferences in Anesthesiology and Pain Medicine. In addition, the resident may choose to participate in academic teaching, as requested by regional schools of pharmacy, with the approval of the program director.
All UCDMC PGY2 residents are required to complete a research project during their residency and present their research at the Western States Residency Showcase. In preparation for conducting their research project, the resident will be complete UCDMC IRB-required training and certification. The resident will prepare a project proposal, which will be reviewed and approved by the UCDMC Pharmacy Residency Project Advisory Committee. The resident will also submit their project to the Pharmacy and Therapeutics Committee and the IRB for approval, before embarking on their research. Upon completion of the project, the resident will be required to summarize their research project in a manuscript.
Pharmacy and Therapeutics Committee Activity
The resident will be required to complete a medication use evaluation or a drug formulary review, as assigned by the UCDMC P&T Committee coordinator. The P&T Committee activity will be related to a Pain Management or Symptom Management product or topic. The program director will work with the P&T Committee coordinator and the resident to determine the assignment, based on the resident’s interests and the needs of the department.
The resident will participate in various committee activities, as assigned by the program director. Assignments will be determined based on current department initiatives. The purpose of the resident’s committee involvement is to ensure the resident gains exposure to the Pain Management pharmacist’s role in activities related to quality-improvement, medication safety, guideline development and assessment/implementation of technology and automation within the institution and pharmacy department. Committees in which Pain Management and Palliative Care pharmacists play a key role at UCDMC include: Pain and Sedation Sub-Committee of the P&T Committee, Palliative Care Committee and UCDMC PCA/Epidural Pump Workgroup.
Pain Management and Palliative Care Service Project
The resident will participate in a project designed to provide education and information to Pain Management and Palliative Care providers and/or patients on a topic related to pain management, symptom management and/or prevention of complications related to pain management.
The resident is encouraged to maintain an active role in Pharmacy and Pain Management professional organizations. The resident is strongly encouraged to become a member of the American Academy of Pain Medicine and attend their annual meeting in the early Spring. The resident will be provided with some financial support from the institution and professional leave time to facilitate participation in professional development activities.
Pharmacy Department Service
The PGY2 Pain Management and Palliative Care resident will be expected to provide ~300 hours of pharmacy department service. This expectation will be met primarily by providing pain management pharmacist coverage one weekend per month plus one major holiday (Thanksgiving, Christmas Eve, Christmas Day or New Year’s Day). A back-up pain management pharmacist will always be available on site or on-call, to advise and support the PGY2 Pain Management and Palliative Care resident as needed.