VA Greater Los Angeles Healthcare System

We offer the following:

• PGY1 Pharmacy Residency (10 positions)
  • Optional Area of Focus in:
    • Acute Care
    • Ambulatory Care
    • Geriatrics
    • Neurology
• PGY2 Ambulatory Care Pharmacy Residency (2 positions)
• PGY2 Neurology Pharmacy Residency (2 positions)

Program Booklets and Information:

• tinyurl.com/VAGLA-PharmacyResidency

Program Description:

This specialty residency provides a comprehensive experience in contemporary neurology pharmacy practice, particularly in the areas of stroke, epilepsy, headache, and neurosurgery.  Clinical experiences in movement disorders, dementia/neurobehavior, general neurologic disorders, and neurosurgery are offered as well.  The resident will practice clinical pharmacy in an acute setting, as well as in an ambulatory setting primarily at the West Los Angles (WLA) Medical Center location.  An elective in psychiatry rotation at USC is available for residents interested in the experience. Neurology preceptors include skilled physician providers, neurology pharmacists, and research faculty members with extensive experience in this specialty, as well as in research and academia.

Residents will be involved in teaching, with possible appointment as Adjunct Clinical Instructor of Pharmacy Practice at the USC School of Pharmacy.  Teaching opportunities include didactic and small group facilitations, as well as precepting pharmacy students and PGY1 pharmacy practice residents.

                Clinical and laboratory-based research opportunities are available.  Residents are required to complete a neurology-oriented research project suitable for presentation and publication. Residents will be required to attempt the BCPS certification by the end of their PGY2 residency year.

Practice Experience

Inpatient Experiences

• Acute Care Neurology: The resident will be responsible for reviewing and monitoring drug therapy regimen, which includes completing antimicrobial, heparin, and anti-seizure medication pharmacokinetic dosing consults.  Residents will serve as the drug therapy specialist, as well as a pharmacy educator on the team.

• Inpatient Neurology Service: In addition to the above, residents will provide thorough education to patients on management of risk factors for secondary stroke prevention.  They will actively participate in interdisciplinary team meetings and medical rounds.  The medical team consists of Board-Certified Neurologist attendings, UCLA Neurology fellows, UCLA Neurology residents, UCLA Psychiatry and Internal Medicine interns, and a clinical pharmacist.
• Epilepsy Monitoring Unit:  This is a specialized unit that was developed as part of the Epilepsy Center of Excellence (ECoE), designed to diagnose epilepsy, determine seizure localization, and identify subsequent surgical candidates.  The resident will work closely with an Epilepsy fellow and be responsible for obtaining a detailed admission history and medication history in preparation for long term video EEG monitoring. Residents will actively participate in assessing/planning safe drug titration on and off anti-seizure medications and devising safe and effective medication regimen.
• Acute Care Neurosurgery:  The resident will be responsible for reviewing and monitoring drug therapy regimen, which includes antimicrobial and anti-seizure medication pharmacokinetic dosing consults. Resident will actively participate in interdisciplinary team meetings and neurosurgical rounds.  The medical team consists of UCLA Neurosurgery attendings, UCLA Neurosurgery residents and Surgery interns, nurse practitioners and a clinical pharmacist.
• Advanced Acute Care Neurology: Residents will build upon their experience from Acute Care Neurology and provide patient care with an emphasis on increased independence while assessing medication appropriateness and devising medication plans. They may have the opportunity to precept pharmacy students and PGY1 pharmacy residents under the supervision of their pharmacy preceptors.

Ambulatory Care Experiences

• Ambulatory Care Neurology: During this learning experience, residents will be participating in various clinics listed below. They will have the opportunity to assess current neurology disease specific medication regimen to initiate and adjust medications under the supervision of clinical pharmacists and attending physicians. Their responsibilities will also include interviewing patients prior to seeing their provider, reviewing medication profiles for drug interactions, appropriate dosing, therapy duplication, and possible medication-induced side effects, assessing adherence, and identifying barriers to adherence. Residents will be an integral part of a multidisciplinary team to optimize medication therapy regimen.

• Secondary Stroke Prevention Clinic (two half-days per week):  This clinic focuses primarily on the prevention of secondary stroke. Residents will also have the opportunity to provide education related to stroke such as medication teaching, recognition of stroke symptoms, and utilization of non-pharmacological treatments.
• Refractory Seizure Clinic (one half-day per week): In addition to the responsibilities listed above, residents will also obtain a comprehensive anti-seizure medication history and monitor seizure response.
• Headache Clinic (one half-day per week): In addition to the responsibilities listed above, residents will be involved in selection of abortive medications and evaluate usage to prevent medication overuse headaches. They will evaluate the need for prophylactic treatment and participate in initiating and monitoring appropriate prophylactic therapy. They will also educate patients to recognize signs and symptoms of headache and to identify headache triggers.   
• Movement Disorder Clinic (one half-day per week):   In this clinic, residents will have the opportunity to provide care for patients with movement disorders such as idiopathic Parkinson’s disease (PD), essential tremor, Huntington’s disease, tardive dyskinesia, etc. Residents will also assess and evaluate treatments related to non-motor symptoms of PD such as psychosis, depression, dementia, autonomic dysfunction, and insomnia.

• Advanced Ambulatory Care Neurology: In addition to the clinics and responsibilities listed in the Ambulatory Care Neurology learning experience, residents will have the option of adding one of the following clinics:

• General Neurology Clinic (one half-day per week): In addition to above responsibilities, residents will have the opportunity to provide detailed counseling on medications to patients diagnosed with general neurologic disorders, particularly neuropathy and myasthenia gravis.
• Neurobehavior Clinic (one half-day per week): Residents will have the opportunity to conduct an in-depth review of medication profiles, evaluating all medications and their potential to contribute to memory disorders. Residents will also be involved in telephone titration of dementia medications.
• Multiple Sclerosis Clinic (one half-day per week): In this clinic, residents will evaluate medication therapy regimen as related to multiple sclerosis (MS) and MS flare. They will be assisting in selection of disease modifying agents with considerations of efficacy, safety, and formulary status.

Program Structure

ROTATIONS

Staffing Requirements

Residents are required to function as a pharmacist in the inpatient setting for average 1 day every weekend for 1 rotation of the year. Inpatient staffing covers ICU, ward, and ED patients, in addition to patients on PK and heparin per pharmacy medications.

Longitudinal Experiences

VAGLAHS PGY2 Pharmacy Residents are required to successfully complete 2 longitudinal experiences (12-months long) located at the Primary Practice Site. Residents also have the option to take elective longitudinal experiences located at USC.

REQUIRED

1. QI/Research Project

VAGLAHS utilizes the Flipped or Inverted Research Model (IRM) for residency projects. Residents work on 2 projects throughout the year: 1) Project #1 – Complete a pre-existing project started by a previous resident; 2) Project #2 (Flipped Model) – Initiate a new project to be completed by a following resident. Minimum resident requirements for Project #1: Abstract, PowerPoint, Manuscript, Poster, presented at regional conference, electronic Research Binder (for IRB projects only), and physical Research Binder (for IRB projects that require it only). Minimum resident requirements for Project #2: Project Description or Protocol, Abstract, IRB paperwork and submitted application (if applicable), Hand-Off Summary, and electronic Research Binder (for IRB projects only). Dedicated administrative time occurs ½ day every week which can be used for anything residency related including QI/Research projects.

2. Education/Preceptoring

Residents will have the opportunity to precept PGY1 residents, APPE pharmacy students (Level IV), IPPE pharmacy students (Level I/II/III), and possibly pharmacy interns and pre-pharmacy students.

PGY2 Neurology residents have the option to be primary preceptor for IPPE students. If opting in on this experience, resident would offer availability as primary preceptor for at least 1 IPPE students. When assigned as primary preceptor of IPPE student, resident is responsible to conduct and organize the student rotation and complete student evaluations in a timely manner. 

ELECTIVE

• USC Teaching Certificate Program

Residents have the option of a joint academic appointment with the USC School of Pharmacy which offers opportunities to teach and lecture to Level I, II and III Pharm.D. students, and undergraduate pre-pharmacy students. Residents are provided the opportunity to participate in various scheduled coursework and seminars developed to enhance the residency experience. Those residents participating in this affiliation will receive faculty appointment and earn a teaching certificate from the university. This is a 10-month long longitudinal experience that occurs ½ day every Thursday.

General Program Information:

Application Process

Applications must be complete and meet yearly established deadlines to be considered. Only applications and materials submitted via PhORCAS™ will be accepted. Incomplete or late applications will not be considered.

VAGLAHS Pharmacy Residency Programs participate in the ASHP Residency Matching Program and follow ASHP Match Rules. This residency agrees that no person at this residency will solicit, accept, or use any ranking-related information from any residency applicant.  Download the Application Agreement from www.natmatch.com/ashprmp.

Download Program Information

The most updated versions of the VAGLAHS Pharmacy Residency PGY1 and PGY2 Program Booklets, and Residency Showcases and Open House Information are available for download at the following link:

https://tinyurl.com/VAGLA-PharmacyResidency

About VA Greater Los Angeles Healthcare System

The VA Greater Los Angeles Healthcare System (VAGLAHS) is one of the largest health care facilities within the Department of Veterans Affairs. It is one component of the VA Desert Pacific Healthcare Network (VISN22) offering services to Veterans residing in Southern California and Southern Nevada. VAGLAHS consists of two ambulatory care centers, a tertiary care facility and 8 community based outpatient clinics. VAGLAHS serves Veterans residing throughout five counties: Los Angeles, Ventura, Kern, Santa Barbara, and San Luis Obispo. There are 1.4 million Veterans in the VAGLAHS service area. VAGLAHS is affiliated with both UCLA School of Medicine and USC School of Medicine, as well as more than 45 colleges, universities and vocational schools in 17 different medical, nursing, paramedical and administrative programs. The West Los Angeles Healthcare Center (WLA) is a tertiary care teaching facility dedicated to providing a wide array of acute and ambulatory patient care services to our nation’s veterans. The comprehensive diagnostic and treatment services provided include a broad range of medical, surgical, and psychiatric care. Internal medicine subspecialties include cardiology, ...infectious diseases, gastroenterology, allergy, pulmonology, nephrology, endocrinology, rheumatology, and hematology/oncology. Major surgical subspecialties include orthopedics, urology, neurosurgery, ophthalmology, plastics, ENT, podiatry, and cardiothoracic surgery. In addition to the main acute care hospital, there is a 180-bed nursing home, a hospice unit, and Home-Based Primary Care. The Sepulveda Ambulatory Care Center (SACC) offers a state-of-the-art ambulatory care facility. The center has specialty outpatient programs in spinal cord injury, stroke rehabilitation, women's health, preventative medicine, dentistry, and mental health, and chemical dependency. Extended care activities include a 120-bed Academic Nursing Home and a Home-Based Primary Care Program. The facility hosts extensive clinical and basic science research, including Geriatric Research Education and Clinical Center (GRECC) and Field Program for Health Science Research and Development (HSR&D). The HSR&D program evaluates provider practice and patient outcome studies in the delivery of ambulatory health care. The Los Angeles Ambulatory Care Center (LAACC) is located in the heart of Downtown Los Angeles. It serves as a centrally located facility for the diverse veteran population of the city of Los Angeles, focusing on primary care and mental health services. The clinic provides special services in post-traumatic stress disorder, day treatment, medical service, and mental health services.

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