A postgraduate year two (PGY2) pharmacy residency is designed to build upon those competencies developed by a postgraduate year one (PGY1) pharmacy residency pharmacy. All ASHP-accredited residencies are full-time commitments that require at least one year to complete. Because PGY2 residencies require that the applicant have completed a PGY1 pharmacy residency, one should plan for two years of training after receiving an academic degree. Some PGY2 pharmacy residencies may be offered in combination with other programs, such as a master's degree or a defellowship, which may require additional years to complete.

ASHP recognizes PGY2 pharmacy residencies in an ever expanding number of areas: ambulatory care, cardiology, critical care, drug information, emergency medicine, geriatrics, infectious diseases, informatics, internal medicine, managed care pharmacy systems, medication safety, nuclear pharmacy, nutrition support, oncology, pediatrics, pharmacotherapy, health-system pharmacy administration practice management, psychiatric pharmacy, and solid organ transplant. PGY2 pharmacy residencies participate in the ASHP Resident Matching Program.

Ambulatory Care Pharmacy

An ambulatory care pharmacy residency emphasizes communication and assessment skills, chronic disease management and preventative care, acute care and emergency-care triage, and therapy modifications for special patient groups. Other skills developed include drug literature analysis and the development of new clinical services in a variety of ambulatory care settings. Opportunities for further refinement in drug information, pharmacokinetic consults, and maintaining patient records and statistical data for continuity-of-care and research activities are available.

Cardiology Pharmacy

Accredited in accordance with the provisions of the ASHP Accredited Standard for Postgraduate Year Two (PGY2) Pharmacy Residency Programs, the design of this residency offers flexibility that allows residents to tailor the year to reflect personal interests. A typical program design might include six months of clinical services in the cardiovascular intensive care unit and telemetry units, with the remaining six months for research and clinical service electives of the resident’s choice. The resident is normally integrated into comprehensive clinical pharmacy services, and is involved in teaching and research activities.

Critical Care Pharmacy

A critical care pharmacy residency offers training in caring for the special pharmacy needs of critical patients of all ages. Much time is spent in the intensive care units, and experience is gained in areas such as hemodynamic monitoring, shock, burns, infectious disease, analgesia, and drug overdose management. Treatment of critical pathology associated with pulmonary, cardiac, renal, neurological, and hepatic organ systems is stressed. A residency in critical care pharmacy may also provide teaching and research experience.

Drug Information

This residency provides training in the skills necessary for managing complex drug information services. Residents learn how to effectively use medical information and databases, appropriate methods for monitoring accuracy in patient drug-use and safety, and pharmacoeconomic principles. Furthermore, residents acquire scientific writing skills, an understanding of drug policy development, and clinical and marketing research experience. The drug information resident is active in handling and responding to drug information requests; educating patients, health-care professionals and students about drug therapy and drug-delivery systems; assisting in the development of drug policies; and managing the formulary.

Emergency Medicine Pharmacy

This residency is a one-year program designed to develop a clinical practitioner with skills in emergency medicine, critical care, and toxicology. Experience may be gained from rotations in a level 1 trauma center, MICU, SICU, toxicology, burn intensive care, neurotrauma, cardiology, and the psychiatric crisis center. Residents complete a research project and participate in nursing and pharmacy student education.

Geriatric Pharmacy

A residency in geriatric pharmacy emphasizes the management of pharmacotherapy in elderly patients with acute and chronic health conditions. Training involves providing for the special needs of elderly patients through a knowledge of geriatric disease states, aging organ function and related drug response alterations, and pharmacokinetics and pharmacodynamic predictions. Other issues such as health maintenance, compliance, patient education, and social issues are also emphasized. Residents are often involved in clinical research activities and professional education.

Infectious Diseases Pharmacy

Training in infectious diseases pharmacy to assume the responsibility for drug therapy design and outcomes in these patients will involve a broad range of experiences in microbial virulence factors, host defense mechanisms, and epidemiology of infectious diseases, including medical microbiology research and management.

Informatics

A PGY2 pharmacy informatics residency inculcates pharmacists with the capacity to identify where technology and automation systems can work to improve the medication-use system. Graduates are prepared to be leaders who will take the initiative to advocate the pharmacy informatics perspective and command respect for their technical skills. Graduates exit with the capacity to contribute pharmacy leadership to the project life cycle of significant pharmacy information technology or automation initiatives. Such projects include the creation of clinical decision support programming; ensuring the accuracy of medication order intent; guiding clinicians to appropriate medication use; and selection, acquisition, implementation, and evaluation of technology and automation systems that support pharmacy operations.

Internal Medicine Pharmacy

A residency in internal medicine pharmacy is designed to develop broad acute and ambulatory experience in such areas as critical care, cardiology, endocrinology, infectious disease, pulmonary and renal care, and oncology. This type of residency requires a strong foundation of pharmacy practice skills, and emphasizes consultation, clinical and didactic teaching, and quality assurance of care.

Managed Care Pharmacy Systems

A residency in managed care pharmacy practice prepares the resident to manage populations, outcomes, and systems. The resident will build the knowledge, skills, and abilities needed to assume administrative or managerial roles and responsibilities in any managed care setting, including pharmacy benefit management companies (PBMs) and health maintenance organizations (HMOs).

Medication-Use Safety

PGY2 residencies in medication-use safety are designed to transition PGY1 residency graduates from generalist practice to a specialized role as an organizational leader in the achievement of medication-use safety. Graduates of the program are enabled to lead multidisciplinary teams whose function is to vision a safe medication-use system for the organization, identify needed improvements in the present system, plan for and implement needed changes, and assess the change achieved. Residents also exit with content matter knowledge of decision-support, human factors engineering, medication-use safety nomenclature, and the culture of safety. Trained to be highly effective communicators and project managers, they are able to employ this background to effectively represent the medication safety perspective when the organization considers the design of its technology and automation systems.

Nuclear Pharmacy

The diverse and unique practice of nuclear pharmacy encompasses product formulation, the radiopharmaceutical distribution system, and the clinical, developmental, and support services offered to nuclear medicine and radiology. Current approaches to nuclear pharmacy management, radiation protection and technology, and quality assurance activities are emphasized.

Nutrition Support Pharmacy

Residents may participate in managing the nutrition support service through assessing and diagnosing nutritional status, and designing and monitoring nutritional and electrolyte treatment plans. Experience is gained working with a broad spectrum of patients, including trauma and surgical patients, patients having endocrine abnormalities, and renal- and hepatic-compromised patients. The resident also learns about various infusion techniques and systems for administering nutritional agents.

Oncology Pharmacy

In an oncology pharmacy residency, the resident will plan appropriate therapy, oversee anti-cancer drug preparation, and expertly manage the therapy and associated adverse effects in patients receiving anti-cancer and supportive-care therapies. Management of cancer-related problems such as pain, nutrition disorders, nausea and vomiting, and infectious disease is also emphasized. Although the focus of the residency is on clinical practice and patient care, opportunities for teaching and clinical research — including new and investigational drug research — are typically available in these programs.

Pediatric Pharmacy

Residents gain experience caring for pediatric patients with acute and chronic conditions in such areas as infectious disease, cardiology, pulmonology, and rheumatology. Training involves knowledge of pediatric conditions, developmental organ function and related dose-response alterations, and pharmacokinetics and pharmacodynamic predictions.

Pharmacotherapy

Developed in partnership with the American College of Clinical Pharmacy, a residency in pharmacotherapy prepares the resident to ensure safe, appropriate, and economical use of drugs in patients. Among the specialized functions of this residency are to collect and interpret data to design, recommend, implement, monitor, and modify patient-specific pharmacotherapy; interpret, generate, and disseminate drug therapy knowledge; and design, recommend, implement, monitor, and modify system-specific policies and procedures in collaboration with other professionals to optimize health care.

Health-System Pharmacy Administration

In a pharmacy administration residency, concentration is on operational, fiscal, and health-care related issues which influence pharmaceutical care. Leadership skills such as effective communication, negotiation, and departmental management are emphasized. Moreover, appropriate skills necessary to conceptualize, implement, and evaluate innovative pharmacy services are essential elements for developing competent managers.

Psychiatric Pharmacy

The resident gains experience in treating diverse psychiatric and behavioral problems, including schizophrenia, depression, mania, bipolar disease, phobic states, substance abuse, personality disorders and related behavioral problems, and neurological disorders in adolescents and adults. Patient communication and assessment skills are emphasized, along with research activities, drug information and education.

Solid Organ Transplant Pharmacy

Graduates of solid organ transplant pharmacy residencies are equipped to participate as essential members of interdisciplinary teams caring for transplant patients, assuming responsibility for the transplant-related medication aspects of care. Residents will become proficient in the care of patients as they prepare to receive a transplant, during the acute care phase of transplantation, and in the ongoing primary care role as the pharmacist works with the patient to sustain the life of the transplanted organ, deal with diseases that occur or reoccur post transplant, and enhance the patient’s general health and wellness. In addition to patient care responsibilities, graduates can be relied upon to lead the development and implementation of medication-related guidelines and protocols for transplant patient care, meet the health system’s transplant-related drug information needs, and provide the transplant perspective when the organization is making technology and automation decisions. Graduates are also highly skilled in the design and delivery of transplant pharmacy education and training for patients and/or caregivers, health care professionals, and health care professionals in training.