IHS PGY-2 Pharmacy Residency Programs

Northern Navajo Medical Center

PO Box 160 (N Hwy 491) Shiprock, NM 87420

Phone: 505-368-7246
Fax: 505-368-7260

Director of Pharmacy
CDR Clint Krestel

Residency Program Director
CAPT Kevin McDermott, PharmD, BCPS, BCACP

Type of Training Site
Ambulatory Care

Positions :1; Early Commit is not available

Accreditation
ASHP Accredited

Facility Information
The Northern Navajo Medical Center serves as a referral center for reservation-based hospitals and clinics in New Mexico, Arizona, Colorado and Utah. Each year NNMC has roughly 133,000 outpatient clinic visits from 68,000 patients not including pharmacy visits.

Goal

Create a well-rounded, confident, and competent pharmacist practitioners capable of working in multiple clinic settings. PGY2 residents are expected to begin working towards the privileging requirements for the NNMC Pharmacist Practitioner during residency. This requires completion of physical assessment training course and obtaining 500 clinic hours in various settings.

Vision

National provider shortages are creating obstacles to patient care. It is the vision of NNMC to fill this gap with qualified Pharmacist Practitioners (PP). The PP assume the same level of diagnostic and therapeutic responsibilities as medical personnel, similar to nurse practitioners and physician assistants. PPs utilize comprehensive interviewing, physical assessment, and diagnostic skills to manage patients who present with common, high volume acute and chronic illnesses. Complex problems are referred to the physician.

The NNMC PGY2 program shall provide a training environment to meet this vision.

Rotational Experience Opportunities
Administration

Resident will learn administrative responsibilities, complete projects related to pharmacy administration, and develop an understanding of pharmacy leadership.

Physical Assessment Course

All residents shall be required to attend the NNMC Pharmacy Physical Assessment Course. This course provides training on performing general cardiology, pulmonology, abdominal, neurology, musculoskeletal, and HEENT examinations. Additionally, training on working up and evaluating common new complaints will be presented.

Chronic Disease Management Clinic

Manage any previously diagnosed disease states and related co-morbid conditions including but not limited to diabetes, hyperlipidemia, hypertension, asthma, COPD, heart failure, gout, hyper/hypothyroid, epilepsy, headaches, depression, GERD, sinusitis, anticoagulation, rheumatoid arthritis, and onychomycosis.

HIV/Hepatitis C

Specialized clinic involving care of these disease states and appropriation of funds to pay for required medications.

Epilepsy

Specialized clinic for the evaluation and treatment of seizure in adults.

Anticoagulation

General clinic for the monitoring and adjustment of warfarin, heparin products, and DOACs.

Family Medicine Clinics

In these clinics, residents will begin learning how to work up new complaints and hone diagnostic skills. Residents will perform appropriate physical examinations and order labs and tests as needed to treat and diagnose the patient. Focus is on common acute and chronic complaints with more complex complaints being referred to a higher level of care.

Outpatient

Resident shall screen medication orders, enter orders into the computer system, and counsel patients using I.H.S. techniques. Residents will be expected to review patient charts and perform necessary calculations to ensure safe medication administration.

Drug Information

Attend P&T and Medication Error meetings and write meeting minutes. Present case and journal article reviews to staff.

Student Program

Serve as primary preceptor to student(s) on rotation utilizing the ASHP preceptor roles and perform final student evaluations. Resident shall also assist Student Program Coordinator with all administrative duties.

Other Training

Residents shall attend Officer Basic Course (if Commissioned Corps), Indian Health Service Pharmacy Practice Training Program, and ASHP mid-year meeting.

Special Features
Surrounded by a land of immense natural beauty marked by towering mesas and bordered by scenic mountains, the community of Shiprock is situated on the banks of the San Juan River. Many world-class attractions are within 90 miles of Shiprock including the mountain bike meccas of Moab, Utah and Durango, Colorado. Winter sports destinations include the Rocky Mountain ski areas of Purgatory, Telluride, and Wolf Creek.

Whiteriver Indian Health Service Hospital

PO Box 860 Whiteriver, AZ 85941

Phone: 928-338-3502
Fax: 928-338-3510

Director of Pharmacy
CDR Greg Sarchet, PharmD, BCPS

Residency Program Director
LCDR L. Michelle Vaughn, PharmD, BCACP, BC-ADM, CDE

Assistant Residency Director
LT Marilee Chapman, PharmD, BCACP

Type of Training Site
Ambulatory Care

Positions 1

Accreditation
ASHP accredited residency program

Facility Information
Whiteriver Indian Health Hospital provides services to over 20,000 Native Americans primarily of the White Mountain Apache Tribe throughout the beautiful White Mountains of Arizona. The Fort Apache Indian Reservation spans an area the size of Delaware, and is located in the high desert of Northeast Arizona. The facility receives over 120,000 ambulatory visits and 2,000 admissions annually. Local services/departments include: Outpatient, Inpatient, Emergency Room, Dental, Eye, Physical Therapy, Occupational Therapy, Dietary, Diabetes, and a full suite of Pharmacy services.

Goal

To prepare PGY-1 trained pharmacists to become exceptional ambulatory care practitioners. Our philosophy aligns with the Indian Health Service Mission: to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest possible level. All activities undertaken by the resident will support the IHS mission.

Rotational Experience Opportunities
The Whiteriver Service Unit (WRSU) PGY2 Ambulatory Care pharmacy residency program builds on Doctor of Pharmacy (PharmD) education and residents’ prior PGY1 pharmacy residency experience to contribute to the development of exceptional clinical pharmacists in Ambulatory Care practice. The program provides PGY2 residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care. WRSU pharmacists are fully integrated into in several areas of Ambulatory Care practice, including: Family Medicine, Internal Medicine, Urgent Care, Dialysis, Skilled Nursing, Home Visits, and provision of vaccines for adults and children in the community. The resident will be embedded in the Patient Centered Medical Home (PCMH) and care for patients under a broad collaborative practice agreement (CPA). The Chronic Disease Therapy Management (CDTM) CPA allows pharmacists to manage diabetes, hyperlipidemia, hypertension, heart failure, chronic pain, rheumatology, hepatology, nephrology, anticoagulation, hypothyroidism, tobacco cessation, immunizations, and other chronic conditions, as well as some acute issues. PGY2 residents complete a required Pharmacy Administration and Leadership learning experience with exposure to both pharmacy and hospital administration and leaders. The resident will have the opportunity to pursue an elective rotation (Pediatrics) in addition to block rotations in PCMH, Community Outreach and ER/Outpatient Staffing, as well as experience in dialysis. PGY2 residents will precept pharmacy students. Participation in a Teaching and Learning Certificate Program is encouraged and supported. The resident will initiate and implement a residency project as a longitudinal experience including a written manuscript.

Other Training

Residents shall be sent to Officer Basic Course (if Commissioned Corps), Indian Health Service Applied Clinical Training Program, New Mexico Physical Assessment Course, Indian Health Service Southwest Regional Pharmacy Continuing Education Meeting (QUAD), Southwest States Residency Conference, and ASHP Midyear meetings.

Special Features
As the first fully accredited PGY2 residency in the Indian Health Service, we pride ourselves on pharmacy innovation. WRSU has a long history of progressive pharmacy practice and is nationally known for innovative programs. We are located in the northern area of Arizona surrounded by lakes and the largest ponderosa pine forest in the nation. During the summer months, many people come for the cool weather to fish, hike, camp and bike; and during the winter, people come for the wonderful skiing/snowboarding opportunities at the Sunrise Ski Resort. Whiteriver is an excellent home base to explore the southwest. Flagstaff, Phoenix, Tucson, and the Grand Canyon are all less than 4 hours away.