Tuesday, July 9, 2013

NC STATE UNIVERSITY RESIDENCY PROGRAM IN VETERINARY CLINICAL PHARMACY


NC STATE UNIVERSITY RESIDENCY PROGRAM IN VETERINARY CLINICAL  PHARMACY
The College of Veterinary Medicine, North Carolina State University, is offering a residency program in Veterinary Clinical
Pharmacy Practice.  Minimum qualifications include graduation from an accredited College of pharmacy and a current North Carolina
Pharmacy License in good standing.  The selection of residents is made on the basis of academic achievement, career objectives,
letters of recommendation, and pertinent experience.  This residency is a Post-Graduate Year One (PGY1) residency.

I. Objectives
A. To provide non-degree postdoctoral education in veterinary clinical pharmacy and therapeutics.
B. To prepare the resident for eligibility and certification by the Society of Veterinary Hospital Pharmacists (SVHP) as a
Diplomate of the International College of Veterinary Pharmacy.
C. To build a working knowledge and skill set in preparing high quality, safe, effective, and legally acceptable compounded
preparations for animal patients.
D. To provide experience in designing a clinical pharmacology research project; undertaking research, investigation, and
publication of the findings.
E. To build a working knowledge of the regulatory aspects of drug use in animals and instill a strong sense of  ethical
responsibility in decision making regarding veterinary drug use.
II. Justification for clinical education
A. A pharmacist’s responsibility for providing patients with high-quality pharmaceutical care extends beyond the human
species.  Although colleges  of pharmacy and licensing boards have focused almost exclusively on human
pharmacotherapy, society and regulatory agencies expect an equally competent quality of pharmaceutical care and
products to be provided for non-human family members and livestock.  Veterinarians are well-schooled in providing
quality care and products to animal patients, but few pharmacists are.  Any pharmacist encountering veterinary patients,
should be equipped with a working knowledge of veterinary pharmacotherapy and develop a clinically and legally sound
algorithm for processing veterinary prescriptions.  Because this curriculum is currently non-existent in the pharmacy
profession, a specialty-training residency is urgently needed to prepare pharmacists to participate in the veterinary care
team.  Academic veterinary centers, drug companies, compounding pharmacies, and regulatory agencies have all
expressed interest in hiring graduates from a veterinary clinical pharmacy residency program.  Annual demand in these
careers would approach 1-3 per year for academics (SVHP), 1-2 per year in veterinary specialty referral practices, 1-2
per year in colleges of pharmacy, 1-2 per year in captive animal non-profit organizations (zoos, aquariums, animal
shelters, wildlife sanctuaries) 1-2 per year in regulatory departments (FDA), and 2-3 per year in commercial markets
(veterinary pharmaceutical industry, compounding pharmacy industry), and 1-2 per year in professional organization
councils (Pharmacy Compounding Accreditation Board, American College of Veterinary Pharmacy, International
Academy of Compounding Pharmacists) .  Historically, this residency has attracted 20-25 qualified applicants per year.
This is the third established residency program in Veterinary Pharmacy for pharmacists and is currently in its third year
(2012).  The first veterinary pharmacy was established at Auburn University in 1989, which is not currently active, and
the second at the University of California Davis, now in the 8th year of the program (2012).The Veterinary Clinical Pharmacy Residency Program is designed to address these needs and provide non-degree
postdoctoral education in veterinary pharmacy.   Traditional PGY1 pharmacy residency programs are one year in
duration, therefore this residency program will be  a one-year program. Completion of the residency will fulfill the
experiential requirement to be eligible to take the exam and be certified by SVHP as Diplomate, International College of
Veterinary Pharmacy (DICVP).  Successful completion of the residency will result in a Residency Certificate.
The program utilizes the facilities and faculty of the Veterinary Health Complex, College of Veterinary Medicine, North
Carolina State University.  A large clinical case load exists at the  Veterinary Health Complex (VHC) to support a
multitude of pharmacy services, including inpatient chart review, outpatient dispensing, nutritional support, sterile and
non-sterile compounding, cytotoxic agent preparation, clinical drug study design and monitoring, drug information
research, pharmacy consult for the practicing referral community, and drug utilization review including adverse drug
event and medication error monitoring and reporting.  The NC State College of Veterinary Medicine is currently ranked
3
rd
in the nation (out of 28  schools), and the NC State VHC Pharmacy has established a national and local reputation for
providing outstanding veterinary pharmacy services and continuing education to veterinary practitioners, pharmacists,
and pet owners.  At least two Pharmacy  Compounding Accreditation Board (PCAB) accredited compounding
pharmacies are located in the Research Triangle Area, and these pharmacies would also  potentially  serve as
rotation/training sites for these residents.

III. Residency Program: Courses of activities
A. Duration
This will be a one year residency program.  A Certificate of Residency will be awarded to candidates successfully
completing the program.  Residents will be asked to work a minimum of 40 hours per week. Time off for sick leave
and/or vacation will be according to established university policy (i.e. 2 working days/month). Hours may be extended as
required for travel to externship sites or rotations in the field.  Salary for this residency is consistent with other residency
stipends at the College of Veterinary Medicine and is $30,000 annually at the time of this printing. The benefits package
accompanying this stipend is valued at an additional $5,400.  Residents also receive 11 paid holidays in addition to the
24 days of annual and sick leave.
B. General Scope and Nature of Training
In the first four months, residents will spend most of their time in the  Veterinary Health Complex under the direct
supervision of the two Veterinary Clinical Pharmacists and incidental mentoring by faculty service clinicians. Residents
will spend approximately 50% of their time in clinical practice activities,  rotating on each of the clinical specialty
services,  participating and leading clinical rounds in small and large animal clinics, and performing drug utilization
review on hospitalized patients.  Residents will spend at least two full weeks in each of the subspecialty areas of soft
tissue and orthopedic surgery, internal medicine, behavior medicine, cardiology, dermatology, neurology, oncology, and
ophthalmology, equine medicine and surgery, and exotic animal medicine. The remaining 50% commitment will be in
the clinical pharmacy or clinical pharmacology laboratory precepting and rounding with pharmacy student externs and
veterinary students;  providing drug information; preparing sterile and non-sterile compounds and chemotherapeutic
agents; designing, implementing and monitoring clinical drug studies; and participating in clinical pharmacy activities.
Experiential rotations at other colleges of veterinary medicine (e.g. Exotic Animal Practice at the University of Florida College of Veterinary Medicine) are also available during this residency.  The resident will also spend time in the
Pharmacology Laboratory at NCSU CVM learning basic analytical techniques (HPLC) or in vitro assays to assess drug
potency and stability. An independent study consisting of a 4 module veterinary pharmacotherapy course covering drug
information resources, anatomy and physiology, regulatory issues, and food animal therapy will be completed by the
resident during the first month of the residency.  Optional activities also include rotations at veterinary private practices,
the United States Pharmacopeial Convention, the Food and Drug Administration, and other areas of interest to the
individual candidate.  Candidates are expected to produce a comprehensive portfolio describing the clinical activities and
insights gained in each of these rotation experiences.
Starting no later than the beginning of the third month, residents will select a specialty area of emphasis based on their
own interests and career goals.  A research topic will be selected and the following nine months will be tailored to
develop skills around that area. The research topic will be submitted to faculty mentors for approval by the end of the
third month.  Project proposal must be robust and of sufficient quality for acceptance by editorial boards of all major
peer-reviewed medical journals.   The resident must be first author on the final manuscript. Project results will also be
presented at the annual House Officer’s Seminar, and the annual meeting of the Society of Veterinary Hospital
Pharmacists, both in poster format as well as a formal presentation. Project will also be eligible for presentation in the
NC State Annual Research Forum.  During the next four months, the resident will spend time at NCSU CVM and other
approved sites to fulfill requirements necessary to complete this research project.
Throughout the residency, the candidate will accumulate a working knowledge of veterinary pharmacy legal and
regulatory processes.   While the majority of this leaning will occur incidentally during daily dispensing activities,
supplemental learning may be accomplished at any approved external sites such as veterinary pharmaceutical companies,
the North Carolina Board of Pharmacy and Veterinary Medical Boards, the Pharmacy Compounding Accreditation
Board, the United States Pharmacopeia, the Food and Drug Administration, the NC Department of Agriculture, and
Animal Plant Health Inspection Service.
From the  3
rd
month on, the resident will spend time developing special interests and skills. The resident will also be
involved in mentoring rotating pharmacy students and conducting clinical pharmacy rounds and leading a monthly
Journal Club.
C. Time Line
Applications for the residency program are open in October of the year prior to the residency year and positions awarded
by April 15 of the residency year. The residency training period begins on or about July 15 each year and ends on or
about July 14 the following year. Residents in their first four months will start in the Inpatient/Outpatient pharmacy at
the VHC, College of Veterinary Medicine, North Carolina State University, learning pharmacy operations, veterinary
specific sterile and non-sterile compounding, cytotoxic drug preparation, and drug information.  Students will learn the
veterinary formulary and attend weekly rounds given by the Veterinary Health Complex., in both small and large animal
services as well as several elective rounds in a subspecialty of their choice (ophthalmology, cardiology, oncology, etc.).
Students will additionally select a drug information topic and learn how to critically evaluate peer-reviewed evidence.
The topic will then be either presented orally at pharmacy rounds or Internal Medicine rounds or written up and
submitted for publication to a peer reviewed journal.  Students will identify an area of research interest by the end of the
3
rd
month.  Topics will be highly flexible and based on the specific interests of the individual resident.  Starting in the 5
thmonth of the residency program the student will learn the basic research techniques necessary to complete their research
project.  This will be done at the pharmacology/pharmacokinetics laboratory at NCSU CVM.  Here students can learn a
variety of analytical techniques (HPLC) to assess drug and metabolite concentrations or several in vitro cell culture
models to assess drug efficacy. Alternatively, if their area of interest is involving drug manufacturing or compounding of
formulations they will have the opportunity to develop these skills in the pharmaceutical laboratory at one of the North
Carolina Schools of Pharmacy (The University of North Carolina at Chapel Hill, Campbell University or Wingate
University). In the following 7-9 months the resident will design, perform and do data analysis on their research topic.
They will write up results in abstract form for submission to the Annual Research Forum at NCSU, and will also present
these findings in the form of a House Officer’s seminar as do all NCSU CVM house officers, as well as at the annual
meeting of the Society of Veterinary Hospital Pharmacists.  Projects are also eligible for presentation at the annual NC
State Research Forum.  Research projects will also be written up for submission to and potential publication by a peer
reviewed journal.
D. Knowledge and skills
The Pharm. D. level candidate will be provided with information and experience to apply their considerable skills in
medical treatment of disease conditions, therapeutic  regimen design, clinical trials, drug distribution and regulation,
pharmaceutics, pharmacology, kinetics, drug information sources and services, etc. in the provision of pharmaceutical
services for animal patients.
Graduates of this program will have a unique combination of skills.  Their knowledge of drug marketing, quality
assurance, and clinical trial design, tempered with their veterinary experience will make them valuable assets to the
veterinary pharmaceutical industry, regulatory agencies, colleges of pharmacy, and colleges of veterinary medicine.
IV. Structure and Organization
Residents will be supervised directly by Gigi Davidson, BSPh, DICVP, Director of Clinical Pharmacy at the NCSU
CVM VHC Pharmacy and the senior faculty clinician during specialty service rotations.  Others who will participate
significantly in the resident’s instruction will include Daniel Aber,  BSPh,  veterinary clinical pharmacist, who will
oversee skills development in inpatient and outpatient veterinary pharmaceutical and compounded preparation dispensing
to residents.  Dr. Mark Papich, Professor of Pharmacology at NCSU CVM will oversee the clinical pharmacological and
clinical drug research skills development for the resident.  At the time of writing, the residency advisory committee
consists of Steve Marks, DVM, DACVIM (Small Animal Internal Medicine), Teresa DeFrancesco, DVM, DACVIM
(Cardiology and Critical Care), and Jennifer Davis, DVM, PhD, DACVIM, DACVCP (Equine Internal Medicine,
Veterinary Clinical Pharmacology).
Graduate students in the Clinical Pharmacology service will oversee research design, methodology, statistical analysis
and analytical chemistry techniques of residents.
The resident will have desk space and computer access at the VHC main pharmacy.  Analytical equipment, chemicals
and other required instrumentation to complete their research project will be available in either the Pharmacy or the
Pharmacology laboratory at NCSU CVM.V. Faculty participating in the proposed program
In addition to the faculty mentioned above, residents will be mentored at times by all clinical faculty at the NCSU CVM
VHC as well as faculty from the surrounding colleges of pharmacy.  
VI. Process of evaluation
Residents will be evaluated based on several criteria.  Requirements that must be met before a resident can receive a
Certificate of Residency for the program include: 1) Satisfactory completion of all rotations, 2) Satisfactory completion
of the research project, 3) Satisfactory completion of the externships, 4) Determination that all requirements have been
met by the Director of Clinical Pharmacy Services. Attendance is mandatory for the entire program.  Poor attendance
will be grounds for dismissal.  Residents must complete all requirements in order to obtain a Certificate.  VHC policy
will be followed in cases where dismissal is required for any resident.
VII. Certification
The specific academic requirements and conditions needed to complete the residency and obtain a certificate include:
1) Demonstration of competent knowledge and skills in:
-dispensing veterinary pharmaceuticals to a variety of species
-preparation of sterile dosage forms including IV fluids,  TPN, chemotherapy, unit doses
-compounding of sterile and non-sterile pharmaceutical preparations for use in veterinary medicine
-performing drug utilization review for veterinary patients
2) Demonstration of competence in:
-Location/evaluation/critical assessment of drug information in the veterinary literature
-extrapolation of available drug information to the veterinary patient where appropriate
-clinical consulting
3)  Satisfactory completion of clinical rotations and completion of portfolio documenting therapeutic plans for a minimum
of 5 disease states in each of the following specialties:
-Small Animal Internal Medicine
-Neurology
-Dermatology
-Cardiology
-Ophthalmology
-Oncology
-Small Animal Orthopedic surgery
-Small Animal Soft Tissue Surgery
-Large Animal Internal Medicine
-Large Animal Orthopedic Surgery
-Large Animal Soft Tissue Surgery
-Exotic Animal Practice
Other specialty rounds (e.g. Behavior medicine, Wellness, Food Animal Medicine and Surgery)
4) Preparation, completion and submission of a research project showing proficiency in:-strength of  hypothesis
-research design
-methodology
-statistical analysis
-scientific writing
5) Demonstration of competence in legal, regulatory and ethical issues including:
-drug use in food animal species
-preparation and disposition of compounded preparations in animal species
-pharmaceutical waste and disposal
-monitoring and disposition of controlled substances
-drug prohibitions in performance animals
6) Demonstration of competence and effectiveness in teaching skills including:
        -leading rounds and journal club with pharmacy student externs
        -leading rounds and journal club with veterinary students and house officers
        -presenting continuing education and scientific seminars to all faculty, staff and students of the VHC and other
veterinary health care sectors.
Budget:
First Year Resident Salary 30,000
Plus Benefits 5,400
One Year Total 35,400
Contact Persons:
Gigi Davidson, BSPh, DICVP
Director of Clinical Pharmacy Services
North Carolina State University College of Veterinary Medicine
4700 Hillsborough Street
Raleigh, NC 27606
Gigi_Davidson@ncsu.edu
919-513-6575
FAX: 919-513-6571
Application Process:
Beginning in October of the year preceding, applicants can follow this link to the application process:
http://www.fis.ncsu.edu/hr/job_applicants/
Application materials include:
Application
Curriculum vitae
3 letters of recommendation
Transcripts (accredited schools of pharmacy)
Letter of interestVETERINARY PHARMACY RESIDENCY PROGRAM
July 15 through July 14
Month General Duties Monthly Rotations Projects
1  Pharmacy Inpatient/Outpatient Operational proficiency
Completion of 4-Module Independent Study
Journal Club and Rounds with pharmacy students
2 Pharmacy Various Services Portfolio
(Compounding) Explore research topic
3 Pharmacy Various Services Portfolio
(Sterile) Finalize research topic
       4 Services Various Portfolio
Research project
      5 Services Various Portfolio
Research project
      6 Services Various Portfolio
Research project
   
7 Research Research Research
   
8 Research  Research Research
      9 Data analysis Statistician/Librarian Write-up results
     10 Externship Externship Outside agency
     11 SVHP Meeting SVHP presentation Poster, PowerPoint, Presentations
     12 Pharmacy Wrap up/Competency assessment Residency Completion

No comments:

Post a Comment