Milwaukee Veteran's Affairs Medical Center Post Graduate Year Two (PGY2) Infectious Diseases 

Location: Clement J Zablocki VAMC in Milwaukee, WI

Contact: Grace Mortrude, PharmD, BCIDP grace.mortrude@va.gov

Details/Description: The Clement J. Zablocki VA Medical Center offers a one year PGY2 residency in Infectious Diseases Pharmacy Practice for pharmacists desiring advanced clinical training in infectious diseases pharmacotherapy. The program is accredited by the American Society of Health-Systems Pharmacists (ASHP). The Milwaukee VA PGY2 ID pharmacy practice residency builds on experiences gained through a PGY1 program and is designed to offer both didactic and clinical experiences leading to the development of a practitioner with expert knowledge and skills in the area of infectious diseases pharmacotherapy.

The goals of the PGY2 ID residency are to:

• Develop expertise in clinical infectious diseases pharmacotherapeutics and antimicrobial stewardship
• Optimize understanding of anti-infective pharmacology, pharmacotherapy and pharmacokinetics/pharmacodynamics of antimicrobials
• Enhance teaching skills by precepting students on ID clinical rotations
• Contribute to an interdisciplinary healthcare team
• Contribute to a pharmacist-run antimicrobial stewardship program by offering patient specific recommendations to optimize treatment of infectious diseases
• Strengthen communication skills by presenting formal and informal lectures and in-services as well as interacting with other healthcare providers
• Enhance clinical research and/or quality improvement skills by completing a major project
• Develop skills to become an independent ID clinical pharmacy specialist

CLINICAL TRAINING

Required Rotations:

• Orientation: (~ 4 weeks; customized based on the resident's knowledge, skills, and abilities)
• Antimicrobial Stewardship Program (4-8 weeks)
• Antimicrobial Stewardship Program (ASP)/ID Consults Combined – Part 1 (3-4 months)
• Antimicrobial Stewardship Program (ASP)/ID Consults Combined – Part 2 (3-4 months)
• ID Consult Service (4-8 weeks)
• Infectious Diseases Administration (longitudinal)
• • Antimicrobial drug information, antimicrobial stewardship intervention and antimicrobial use reporting (Annual Antimicrobial Stewardship Report), antimicrobial drug use policy, formulary management, and order set development (longitudinal)
• Microbiology lab (semi-longitudinal 1-3 months)
• • 1-2 sessions/week for a total of ~15 sessions over 1-3 months; depending on microbiology supervisor’s schedule
• Outpatient ID Clinic/OPAT Clinic (longitudinal)
• Outpatient Infectious Diseases – BLOCK Rotation (4-8 weeks)
• includes Hepatitis C clinic, OPAT program management, and HIV/ID clinics
• PGY2 Research Project (longitudinal)
• Other longitudinal responsibilities built into core rotations: Biannual OPAT and ASP reports, microbiology projects, educational in-services, fecal microbiota transplant monitoring, quality improvement projects/initiatives, and multidisciplinary meetings

Elective Rotations:

• Antimicrobial stewardship with a COVID-19 Focus (4-8 weeks depending on patient load)
• Critical care (4-8 weeks)
• Emergency Department/Outpatient Antimicrobial Stewardship (block) (4-8 weeks)
• Hematology/oncology (4-8 weeks)
• Internal medicine (4-8 weeks)

Longitudinal Rotations/Activities:

The ID resident has several longitudinal responsibilities throughout the year.

OPAT Program:Patients discharged home on long-term home IV antibiotics are followed by the clinical ID pharmacist via the Outpatient Parenteral Antibiotic Therapy (OPAT) program. Patient’s laboratory parameters and clinical progress are monitored weekly. Patients are then followed-up in the outpatient ID clinic by the ID team. The ID resident will support this program by arranging home IV antibiotics in the outpatient setting, performing and evaluating the weekly lab assessments, and provide patient follow up as needed.

Infectious diseases/HIV clinic:The Zablocki VA Medical Center has several ID clinics in which patients with either HIV/AIDs and/or chronic infections are seen by the ID team. The ID resident will participate in these clinics by providing medication counseling, laboratory monitoring, and assisting with antimicrobial management.

Hepatitis C clinic:The ID resident will provide direct patient care in the pharmacy-run Hepatitis C clinic throughout the year. Patient’s laboratory parameters and clinical progress are monitored throughout treatment.

Infectious Diseases/Antimicrobial Stewardship In-services: The ID resident will provide in-services to providers and/or pharmacy trainees/staff throughout the year.

ID Pharmacy administration: The ID resident will be assigned various administrative assignments throughout the year, which may include policy writing, stewardship initiatives, and clinical decisions support design.

HOSPITAL COMMITTEE INVOLVEMENT

The ID resident will be involved in the Pharmacy, Nutrition, and Therapeutics Council, Infection Control Council, and the Antimicrobial Subcommittee.

TEACHING RESPONSIBILITIES

The PGY2 ID resident will have extensive involvement with pharmacy students on the infectious diseases clinical clerkship rotation. Responsibilities include providing one-on-one mentoring, presenting seminars and in-services, and assisting with the evaluation process. The resident will also provide formal lectures to pharmacy students at Concordia University and/or other pharmacy schools as opportunities arise.

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