By: Sum Lam, PharmD, CGP, BCPS, FASCP
Sum Lam, Pharm.D., CGP, BCPS, FASCP is an Associate Clinical Professor in the Department of Clinical Pharmacy Practice at St. John’s University College of Pharmacy and Allied Health Professions. In conjunction with her full time appointment at St. John’s University, she is a clinical faculty at Geriatric Medicine Division, Winthrop University Hospital in Mineola. She is a preceptor for pharmacy students on their Inpatient and Geriatrics rotations.
A pharmacy residency is an organized, directed, postgraduate training program in a defined area of pharmacy practice. There are two types of residencies: Postgraduate Year One (PGY-1, general pharmacy practice) and PGY-2 (specialized pharmacy practice). Example areas of specialization for PGY-2 residencies and other useful information about pharmacy residencies are available at the American Society of Health-System Pharmacists (ASHP) website: http://www.ashp.org/menu/Residents/GeneralInfo.aspx.
After graduating from the University of Connecticut and completing a PGY-1 residency at Montefiore Medical Center in the Bronx, I eagerly relocated to Durham, North Carolina for a PGY-2 specialized residency in geriatric pharmacy practice. By then, I had developed a deep interest in optimizing drug therapy for older adults, who are more likely to have multiple disease states requiring complicated drug therapy. Often, the elderly are needy and disadvantaged financially, physically, and/or functionally. I felt that my knowledge and skills as a pharmacist could truly benefit and serve these patients. It was a big decision for me to leave New York for further pharmacy training, but I am so glad that I did.
My PGY-2 residency was a special collaboration among three institutions: Geriatric Research, Education & Clinical Center (GRECC) at Durham Veterans Affairs Medical Center, Duke University Center for the Study of Aging and Human Development, and the School of Pharmacy at the University of North Carolina. The training not only prepared me to be a more seasoned clinician, but also enhanced my ability to be an educator. Throughout the year, I worked directly with patients to optimize drug therapy outcomes. I witnessed the receptive and welcoming attitudes of the physicians to pharmacy recommendations that aimed at identifying, preventing, and resolving drug related problems. Pharmacists were valued members of the interdisciplinary team, and had the privilege of documenting Pharmacy care plan notes in patient charts. One of the most treasured experiences was to serve as a clinical instructor for pharmacy students at the University of North Carolina and a guest lecturer for medical/physician assistant students at Duke University. I was responsible for didactic lectures and a laboratory session for pharmacy students for one entire semester.
Each rotation gave me a memorable and unique experience. Running an outpatient pharmacy clinic and a PHARMAssist program (a clinic for indigent patients) opened my eyes on the diverse types of nontraditional remedies that local people used to treat daily aliments. For examples, BC powder for pain, Windex glass cleaner for bug bites, vinegar immersion for warts on the hands, and many others. Working with these patients allowed me to develop cultural sensitivity and respect for patients’ individuality. In the extended care and rehabilitation center, I performed monthly medication regimen reviews for about 20 long-term care residents throughout the year. Following these patients longitudinally allowed me to develop personal connections with these veterans.
My favorite rotation was home-based primary care, which incorporated telemedicine practice (a federally funded research project to reduce the hospitalization rate among frail elderly who reside at least 50 miles away from the medical center). Pharmacists traveled across towns, with a nurse practitioner and a clinical social worker, to visit patients in their homes. We performed assessments and counseled on medical issues, medication use, home safety, and benefit eligibility. Most patients were thrilled to meet us and to receive telemonitors (computers that allowed them to perform health monitoring and to gain access to healthcare professionals, including pharmacists, at the medical center at all times). This rotation also allowed me to learn about life through the experience of others. I will never forget the elderly man who showed me his purple heart and told me the heroic story behind it. In addition, this rotation gave me the unexpected opportunity to visit charming small rural towns in North Carolina.
I was most fond of the training on research and publication during the residencies. Thanks to the dedicated guidance of mentors, I completed and published two residency projects (during the PGY-1 and PGY-2) in a peer-reviewed, Medline-indexed pharmacy journal (AJHP). I presented both research projects at regional residency conferences and national ASHP clinical meetings. These were great rewards for the endless hours that I spent on protocols, data collection, poster preparation, and manuscript revisions during my residency years!
My pharmacy residency years were filled with hard work, yet they were fulfilling and rewarding. I have a few recommendations for pharmacy students who are interested in postgraduate training. First, learn about residencies from ASHP websites, colleagues, and faculty. Second, prepare early; attend residency showcases and resume/CV / interview workshops offered by our college. Third, explore your interest in pharmacy specialties during your year of rotations. Fourth, be mentored; Clinical Pharmacy Practice faculty members are ideal for providing advice on residencies. Finally, if possible, do not limit your residency search geographically. It is worthwhile to relocate for one or two years for excellent residencies. Personally, I would never regret leaving Connecticut to go to New York (and then moving to North Carolina) for residencies that prepared me to become a better teacher and clinician. Now, I am back in New York: a place I call home. Every good and perfect gift is from above.