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Implementing a Residency Program: Part One

Written by Sara Griesbach

What inspired Marshfield Clinic to consider and develop the residency program?
The development of a pharmacy residency program at Marshfield Clinic has been a natural evolution of the organizational desire and commitment to contribute to the development of future pharmacy leaders. Marshfield Clinic is one of the largest non-profit multi-specialty clinics in the United States and education is a cornerstone of the Mission of the organization. The broad based Pharmacy Services at Marshfield Clinic offer many unique experiential learning opportunities in Clinical Pharmacy Services, HMO Managed Care pharmacy practice, Outpatient Pharmacies, Sterile Products pharmacies, 340b pharmacy, and Investigational Drug Program. The Marshfield Clinic Research Foundation provides opportunity for experience in clinical research including pharmacogenomics and bioinformatics. We believe that a pharmacy residency at Marshfield Clinic offers a unique and broad based experience for postgraduate training.

Describe the implementation process (include details such as funding, staffing, development of curriculum, and any other steps involved in establishing the residency).
The implementation process began over 1 year prior to our first resident starting. The key faculty members were identified and learning opportunities established including 4-6 week rotations and longitudinal experiences. Each preceptor developed a learning description for their rotation as well as the key learning objectives that would be taught and assessed during the rotation. A residency website was developed and our program was advertised on numerous state and national pharmacy organization websites. Key staff members participated in pharmacy career fairs across the Midwest, as well as the residency showcase at the ASHP Clinical Midyear meeting. As Program Director, I attended the ASHP National Preceptor meeting in Washington D.C. with a fellow preceptor to learn more about the residency learning system (RLS) and ASHP accreditation requirements. Reviewing materials available from the ASHP website was very helpful in the development process. Development of key policies was also important (e.g., when licensure is required by). The key faculty continues to meet on a monthly basis, continually developing and improving our program. The Marshfield Clinic Pharmacy Residency program is fully integrated within our Division of Education. As Pharmacy Residency Program Director, I am included in monthly meetings with the Program Directors of Marshfield Clinic’s Medical Residencies and all are actively involved in identification and implementation of ideas to improve the residency programs at the Clinic, and to increase collaboration between programs across the system.

What challenges, both initial and continuing, were faced while developing this opportunity?
The main challenges faced while developing this opportunity for residents were in identifying the structure of the program, and determining what the required staffing component would be. Like most programs, we have identified ongoing challenges and opportunities in initiating preceptor development tools and documentation of their effectiveness.

What does Marshfield Clinic hope to gain from implementing this program?
Education is a key component of Marshfield Clinic’s corporate mission statement. Through our Pharmacy Residency Program, Marshfield Clinic hopes to positively impact our key mission of education, and aid in the development of future pharmacy leaders while continuing to create a unique and rewarding professional pharmacy practice.

What were the main objectives for the residency?
The main objective of the residency at Marshfield Clinic is to prepare the resident for a clinical pharmacist/leadership role in an integrated healthcare delivery system, adjunct faculty position, or PGY-2 training in an area of choice.

Entrepreneurship requires the ability to recognize and fulfill a professional obligation to promote change, to identify and pursue opportunities for the purpose of improving patients’ quality of life. How does the implementation of this program embody the spirit of entrepreneurship?
This program is playing a key role in the development of Medication Therapy Management services across the Marshfield Clinic System. One portion of the staffing component includes Medication Therapy Management (MTM). Formalized Medication Therapy Management Services are currently being developed at Marshfield Clinic and the resident has ongoing involvement in identification of patient populations to target for MTM services, development of intervention and documentation templates used in MTM, planning MTM availability at different practice sites, and providing MTM services to Marshfield Clinic patients.

Because this residency is neither hospital nor community based, it offers the resident a unique and innovative educational experience.

What advice do you have for students who wish to participate in this type of residency program?
Advice for potential residents in this or any other program is to maintain flexibility and develop confidence in expressing opinions and giving feedback. Attend career fairs with an open mind and learn more about programs that may be of interest to you.

What advice do you have for pharmacists who are interested in initiating a new educational program at their site?
A key starting point is attending the National ASHP Residency Preceptor Conference in Washington D.C. This program outlines all of the key components of starting a residency program. We would also recommend starting the formalized planning for a residency well in advance of recruiting the first resident

For more information on the Marshfield Clinic Pharmacy Residency, our program web site is available at: ts/pages/default.aspx? page=postgradpharmacy