Pharmacy Residency Program at CUMC - Bergan Mercy

A tertiary care facility and teaching hospital located in Omaha, Nebraska, Creighton University Medical Center - Bergan Mercy is a level I trauma, academic medical center with a teaching and research affiliation with Creighton University. This will be the primary rotation site for the PGY1 Pharmacy Residency Program.

The hospital’s pharmacy department is structured as a team unit with clinical services provided via centralized, decentralized, team-based, and rounding pharmacists. Our pharmacists collaborate with various medical services to provide care for all patients and their clinical functions include, but are not limited to: pharmacokinetic and anticoagulation dosing/monitoring, multi-disciplinary care team rounding, antimicrobial stewardship, IV to PO conversions, drug information, and overall medication therapy management.

In addition, decentralized clinical pharmacy services are provided to all patient care areas, which includes 24-hours per day/7 days per week emergency medicine and critical care pharmacy clinical services.

Features include: 

• Academic Medical Center affiliated with Creighton University
• Level I Trauma Center
• 50-plus Adult ICU beds
• Emergency Medicine Clinical Pharmacy Services 24/7
• Level III Neonatal Intensive Care Unit
• Cardiothoracic, Vascular, and Neurosurgical Services

PGY1 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education and outcomes to contribute to the development of clinical pharmacists responsible for medication-related care of patients with a wide range of conditions, eligible for board certification, and eligible for postgraduate year two (PGY2) pharmacy residency training.

This program will center on developing a core skill set in medication therapy management, teaching, team functioning, communication, clinical research, literature evaluation, time management, presentation development and delivery, and direct patient interaction in an academic medical center setting.

PGY1 residents will receive a salary of $50,000/year with comprehensive medical, dental and vision care coverage. Life insurance, short and long term disability coverage is also available.

CHI Health Creighton University Medical Center-Bergan Mercy residency schedule consists of 12, one-month rotation blocks – which includes an Orientation month (July) and Research/Project month (December).

Required Rotations:

• Hospital Medicine
• Critical Care
• Infectious Disease/Antimicrobial Stewardship

Selective Required Rotations:*

• Ambulatory Care
• Cardiology
• Critical Care-Academic
• Emergency Medicine
• Family Medicine-Academic

* Residents will select a minimum of two selective required rotations. If the resident desires more than two rotations from this section, then those will be counted as elective rotation months.

Elective Rotations Offered:

• Antimicrobial Stewardship Elective*
• Drug Information*
• Neonatal Intensive Care
• Oncology/Hematology
• Pain Management/Opioid Stewardship
• Pharmacy Informatics*
• Pharmacy Management
• Psychiatry*
• Trauma-Critical Care

* Denotes off-site rotation

Required Longitudinal Rotations:

• Health System Management
• Inpatient Pharmacy Staffing

Jennifer Anthone, PharmD, BCIDP, BCPS

Rotation(s) Precepted: Infectious Disease/Antimicrobial Stewardship (required)

Pharmacy School: Creighton University School of Pharmacy and Health Professions

Postgraduate Training: PGY1 Pharmacy Residency at Creighton University Medical Center

Board Certifications: Board Certified Infectious Disease Pharmacist (BCIDP), Board Certified Pharmacotherapy Specialist (BCPS)

Practice Interest Areas: Antimicrobial Stewardship

Research Interests: quality improvement, antimicrobial stewardship initiatives

What I like most about precepting pharmacy residents: ID is a struggle for most, so I like to help residents learn this topic in a different format, bringing it down to the basics (bug-drug, therapeutic indications, and clinical practice treatment guidelines) so that it makes it easier for them to understand and retain. It’s great seeing the progress from start to finish on the rotation and helping them learn!

Ashley Austin, PharmD, BCCCP

Rotation(s) Precepted: Emergency Medicine (selective required/elective)

Pharmacy School: University of Nebraska Medical Center College of Pharmacy

Postgraduate Training: PGY1 Pharmacy Residency and PGY2 Critical Care Residency at The University of Kansas Hospital

Board Certification: Board Certified Critical Care Pharmacist (BCCCP)

Practice Interest Areas: Emergency medicine, critical care

Research Interests: Emergency medicine

What I like most about precepting pharmacy residents: I love seeing residents grow throughout the year and during my rotation. It’s rewarding to see them gain confidence in their clinical capabilities. 

Annah Buss, PharmD, MBA

Rotation(s) Precepted: Orientation, Hospital Pharmacy Staffing (longitudinal)

Pharmacy School: Creighton University

Practice Interest Areas: Internal Medicine, Transitions of Care, Opioid Stewardship

What I like most about precepting pharmacy residents: I really enjoy seeing them grow in confidence and ability over the course of the year and find their strengths and interest areas.

Carla Christensen, PharmD

Rotation(s) Precepted: Neonatal Intensive Care (elective)

Pharmacy School: Creighton University School of Pharmacy and Health Professions

Postgraduate Training: Arkansas Children’s Hospital – Little Rock, AR

Practice Interest Areas: NICU, Pediatrics and Women’s Health

Research Interests: Neonatal Abstinence Syndrome (opioid and SSRIs), antimicrobial use in maternal and NICU patients, less invasive ventilation and the use of surfactants, antenatal steroid use in late preterm neonates, parenteral nutrition in the NICU, immunizations in the NICU, NICU nutrition, medications and lactation, and the student learner

What I like most about precepting pharmacy residents: Residents keep me on the breaking edge of practice.  In addition, I love to see the progression from July to June.  Your inquisitive minds and critical thinking, leads to excellent pharmacy practice and patient care.  

Keith Christensen, PharmD, BCPS

Rotation(s) Precepted: Acute Care

Pharmacy School: Creighton University School of Pharmacy and Health Professions

Postgraduate Training: PGY-1 Pharmacy Residency at UAMS Medical Center

Board Certifications: Board Certified Pharmacotherapy Specialist (BCPS)

Practice Interest Areas: Internal Medicine & Pulmonary

Research Interests: Inpatient drug use & Academics

What I like most about precepting pharmacy residents: Working with colleagues to jump start their clinical/precepting careers

Megan Dethlefsen, PharmD, BCPS

Rotation(s) Precepted: Monograph/Class Review, Medication Use Evaluation

Pharmacy School:  University of Nebraska Medical Center College of Pharmacy

Postgraduate Training:  PGY1 Pharmacy Residency at VA Nebraska-Western Iowa Healthcare System (Grand Island)

Practice Interest Areas: Critical Care, Medication Safety, Drug Information

Research Interests: Expansion of pharmacy services in the continuum of care, transitions of care

What I like most about precepting pharmacy residents: I cherish the “aha” moments, when you see the light bulb come on for the resident and know they now have a fuller understanding of patient care!

Stacey Dull, PharmD, BCPS

Rotation(s) Precepted: Trauma-Critical Care (elective)

Pharmacy School:  Creighton University School of Pharmacy and Health Professions

Postgraduate Training:  PGY1 Pharmacy Residency at University of Missouri Health Care

Board Certification: Board Certified Pharmacotherapy Specialist (BCPS)

Practice Interest Areas:  Critical Care, Trauma/Surgery

Research Interests: VTE prophylaxis and monitoring, augmented renal clearance, open fractures

What I like most about precepting pharmacy residents: I like to work collaboratively with pharmacy residents.  Pharmacy residents challenge me to stay updated in my practice area, and oftentimes, I can learn something from them!  

Daniel Hannig, PharmD, BCPS

Rotation(s) Precepted: Orientation, Hospital Pharmacy Staffing (longitudinal)

Pharmacy School: University of Findlay

Postgraduate Training: PGY1 Pharmacy Residency at CHI Health CUMC-Bergan Mercy

Board Certification: Board Certified Pharmacotherapy Specialist (BCPS)

Practice Interest Areas: Critical Care

What I like most about precepting pharmacy residents: I love working with all the different residents, having to adjust to each one's learning style. It provides a better experience for the residents and allows me to improve on my education skills

Daniel Hilleman, PharmD, FACCP, FACCP

Rotation(s) Precepted: Cardiology (selective required/elective)

Pharmacy School:  Creighton University School of Pharmacy and Health Professions

Postgraduate Training: Pre-Doctoral Fellowship in Poison Control, Children’s Hospital, Omaha, NE

Fellow Status: Fellow, American College of Clinical Pharmacy (FACCP); Fellow, American College of Clinical Pharmacology (FCCP)

Practice Interest Areas:  Cardiology, Management of Substance Use Disorders (alcohol, tobacco, methamphetamine, cocaine, opioids)

Research Interests: Cardiovascular Pharmacotherapy; management strategies in methamphetamine-induced cardiomyopathy, role of anti-inflammatory therapy in ASCVD risk reduction, strategies to promote adherence in patients requiring poly-pharmacy

What I like most about precepting pharmacy residents: Helping residents apply evidenced-based pharmacotherapy to patient care; teaching residents principles of clinical research design and literature evaluation

Mark Malesker, PharmD, FCCP, FCCP, FCCM, FASHP, BCPS

Rotation(s) Precepted: Critical Care-Academic (selective required/elective)

Pharmacy School:  Creighton University School of Pharmacy and Health Professions

Postgraduate Training: Cardiovascular Research Fellowship at Creighton Cardiac Center

Board Certification, Fellow Status: Board Certified Pharmacotherapy Specialist (BCPS), Fellow-American College of Critical Care Medicine (FCCM), Fellow-American College of Chest Physicians (FCCP)

Fellow-American College of Clinical Pharmacy (FCCP), Fellow-American Society of Health-Systems Pharmacists (FASHP)

Practice Interest Areas:  Pulmonary and Critical Care

Research Interests: All things related to diseases of the chest (pulmonary, critical care, cardiac)

What I like most about precepting pharmacy residents: Keeps me updated with clinical knowledge, I can help contribute to the next generation of clinical pharmacy specialists

Gabriel Melgarejo, PharmD

Rotation(s) Precepted: Internal Medicine

Pharmacy School: University of Missouri - Kansas City

Postgraduate Training: University Health Truman Medical Center

Practice Interest Areas: Internal Medicine, Infectious Diseases, Cardiology

What I like most about precepting pharmacy residents: Witnessing and contributing to their growth, clinically and professionally, and being able to see them develop their own practice.

Kelly Nystrom, PharmD, BCOP

Rotation(s) Precepted: Oncology/Hematology (elective)

Pharmacy School:  University of Nebraska Medical Center College of Pharmacy

Postgraduate Training: Charleston Area Medical Center, Charleston WV

Board Certification: Board Certified Oncology Pharmacist (BCOP)

Practice Interest Areas:  Hematology/Oncology

What I like most about precepting pharmacy residents: I love precepting residents because I learn from them as much as they learn from me

Erin Santiago, PharmD

Rotation(s) Precepted: Pharmacy Management (required-longitudinal), Pharmacy Management (elective)

Pharmacy School:  Creighton University School of Pharmacy and Health Professions

Postgraduate Training: PGY1 Pharmacy Residency at Alegent Health Bergan Mercy Medical Center

Practice Interest Areas:  Pharmacy Management, Opioid Stewardship, Drug Diversion, Emergency preparedness

Research Interests: Same as above, process improvements, etc.

What I like most about precepting pharmacy residents: My pharmacy practice residency is what steered me toward my interest in management. It helped me see what goes on behind the scenes and the inner workings of the hospital. I like to work with the residents to hopefully pass that knowledge on to them and help them understand the role of a leader because they will be one as some point during their career whether they have an official title or not. The residents also bring new eyes to situations that I have encountered for years so I appreciate their perspective as new practitioners to bring new ideas to the team.

Stacy Semerad, PharmD

Rotation(s) Precepted: Internal Medicine

Pharmacy School: Creighton University School of Pharmacy

Postgraduate Training: PGY1 Pharmacy Residency at Mercy Hospital in Des Moines Iowa

Practice Interest Areas: Internal Medicine, Family Medicine, Diabetes, Anticoagulation

What I like most about precepting pharmacy residents: I like helping the residents and the Internal Medicine team learn more about drug therapy. I like to see the Pharmacy residents grow throughout the rotation and become independent with the team. It is great to see them interact with the patient care team and become the Pharmacist the team goes to when they have questions.

Dwight Shafer, PharmD, BCCCP

Rotation(s) Precepted: Critical Care (required)

Pharmacy School:  Creighton University School of Pharmacy and Health Professions

Postgraduate Training: PGY1 Pharmacy Residency at Creighton University Medical Center

Board Certification: Board Certified Critical Care Pharmacist (BCCCP)

Practice Interest Areas: Critical Care

What I like most about precepting pharmacy residents: The ability to mentor the next generation of pharmacists and to help them become more comfortable and confident in critical care settings.

All residents are expected to pursue licensure in Nebraska prior to beginning the residency training program. The process must be initiated with the National Association of Boards of Pharmacy and continued with the Profession and Occupational Licensure Division, Nebraska Department of Health.

It is expected that the resident will be licensed by August 1st so as to start the requirements for the longitudinal staffing component and be able to work on direct patient care activities independently while on rotations also. If the resident fails to obtain licensure prior to August 1st, the resident will be expected to obtain licensure as soon as capable and be required to make up their missed staffing hours after licensure is procured to keep the number of hours staffed consistent between all residents.

As a minimum requirement for employment the resident must obtain licensure as a pharmacist with the state of Nebraska within 90 days from the start of the residency. Failure to obtain licensure within 90 days from the start date will result in termination from the program.

The goal of the operational pharmacy practice experience is to ensure that each resident can function independently as a pharmacist.  Each resident will train with a preceptor(s) as assigned.  Basic training will take place during the first month of the residency.  Once the resident is deemed competent, he/she will be assigned to patient care units or central pharmacy for the remainder of the residency.  Residents will be evaluated on their staffing experiences on a quarterly basis. 

Required Staffing Commitment: Starting in August, each resident will be expected to staff in the pharmacy one evening shift per week (1630-2100) and every 4th weekend as a patient care pharmacist. Weekend staffing shifts will be scheduled for both Saturday and Sunday (1200-2030) and will provide a range of experience/opportunities for both central and clinical decentralized pharmacy staffing. 

Holidays: Residents are expected to work two holidays - one major (Thanksgiving or Christmas Day) and one minor (Labor Day, New Years Day, or Memorial Day) There must be at least one resident working on each minor holiday. Residents will not be assigned to work on Independence Day. Holiday assignments will be determined at the beginning of the residency year and decided upon by the residents themselves. It is the responsibility of the resident to arrange for a trade for a different holiday assignment if needed.

Each PGY1 resident will be provided up to approximately $1500 for professional development funds.  Residents are encouraged to use these funds to cover registration fee/airfare/hotel to attend the ASHP Midyear Clinical Meeting, registration fee for Midwest Pharmacy Residents Conference, and any other educational endeavors wanting to be pursued by the resident (i.e. ACLS, PALS, other professional meeting, professional reference book(s), lab coats, etc.). 

Paid Time Off

Each resident will have 14 days of paid vacation, sick, and/or interview leave available for the residency year. 

• Professional leave: In addition to the 14 days of general PTO, the residents will be allowed professional leave for attendance at professional meetings.  This includes a maximum of four work days for ASHP Midyear and two work days for Midwest Pharmacy Residents Conference (MPRC). 
• Educational Leave: Residents are allowed and encouraged to partake in educational opportunities throughout the residency year.  If the educational opportunity requires time off from the residency rotation, unless a preceptor requires attendance as part of their current rotation – the resident will be required to use PTO/vacation time to attend as this will fall outside of the days already provided for professional leave.
• Interview days: The resident can use any of their 14 PTO days for pursuing future employment opportunities in the spring of the residency year.  If more than 5 days will be missed during a single rotation month due to interviews, the resident is required to meet with the rotation preceptor and Residency Director to coordinate a plan for making up the missed rotation time. 

The primary emphasis of the residency program is to develop the resident’s practitioner expertise.  An integral part in the development of the resident is an appreciation of research methodology.  Provisions will be made for the resident’s participation in a clinical research project activity or a self-directed investigation in an appropriate pharmacotherapeutic area.  The project undertaken, by mutual agreement of the resident, primary preceptor, Residency Director, and participating co-investigators, will be of suitable quality for publication in a peer-reviewed journal and presentation at a major scientific meeting and the Midwest Pharmacy Resident Conference.  All projects must be mentored by a Creighton University Medical Center-Bergan Mercy core preceptor. View a list of former PGY1 Pharmacy Resident Research Projects.

The residency research project should provide an experience and/or appreciation of clinically oriented research.  This will include the following:

• IRB training
• Study design and protocol development
• IRB submission of protocol
• Data collection and organization
• Statistical analysis
• Summary of results
• Conclusions
• Project written in manuscript format
• Formal presentation of work

Residents of CHI Health Creighton University Medical Center-Bergan Mercy will participate in educational activities of the Creighton University School of Pharmacy Department of Pharmacy Practice. The purpose of such activities is to foster development and refinement of the resident’s communication skills and effectiveness as a teacher and to provide the students with a resident role model.

Residents will assist with Pharmacotherapeutics Case Studies discussions in the fall and/or spring semester.  Case studies take place weekly on one day (to be determined prior to each semester) with an approximate 1 hour time commitment per session.  Each resident will be assigned one session each week for the case studies session.  The resident will help facilitate the case studies, discussions, and work with the Instructors of Record to evaluate student performance. 

In addition to facilitating and grading case studies weekly, each resident will be required to prepare one comprehensive case with a faculty preceptor/mentor in the fall.  The resident will then be the primary educator to the pharmacy students for cases on the day that their comprehensive case is presented.

All residents will be required to help facilitate and teach in the Creighton University Diabetes Elective course offered to pharmacy students in January of each year.  This will include an introduction/review session with the primary instructor of record to determine expectations and requirements of the resident as preceptors prior to the start of the course.  The resident will be allowed time away from their rotation to participate in this teaching activity.

Rotation teaching responsibilities will be at the discretion of individual preceptors and based on whether students have been assigned during the resident’s rotation month.  Primarily, these responsibilities will include patient care discussions, evaluation of patient case presentations, and examining drug information reviews.  These responsibilities may also include acting as instructor in the preceptor’s absence.  The resident will always be under close supervision by their preceptor. Residents will be asked to participate in the evaluation of P4 students on rotation during patient case presentations.

Educational activities during rotations may include the presentation of drug therapy talks and provision of drug information resources to the medical teams on a formal or informal basis.

Each PGY1 resident at CUMC-Bergan will be responsible for preparing and delivering two CE quality grand rounds presentations that can be in the categories of case report, literature review/current controversy topic, or therapeutic update. Each presentation will be 45-50 minutes in length with 10-15 minutes allowed for questions after the presentation.  Each resident will be assigned a pharmacist preceptor for each of the presentations. Grand rounds will be held on Thursdays at 12 PM.

Topic Selection: Topics will be chosen and agreed upon mutually by the resident and their preceptor.  Grand Rounds presentations should be in one of the following category types: clinical controversies, case report, new treatments, or therapeutic update with new literature.  A list of previous topics will be provided to ensure the resident avoids a recently presented topic.  

Resident responsibilities

Resident will fill out the “Grand Rounds Timeline Due Dates – Resident and Preceptor Agreement” form by required date with their preceptor and submit to RPD well in advance of the presentation. Failure to comply with this required expectation will result in disciplinary action.

1. Discuss topic ideas/selection with preceptor – select topic 8 weeks prior to presentation date
   
2. Perform literature review to assess and ensure topic is a viable presentation option
   
3. Complete Grand Rounds CE Grid and Formal Literature Search Spreadsheet – submit to preceptor 6 weeks prior to presentation for review/feedback
   
4. Submit CE Grid/Needs Assessment to Creighton CE Office – 4 weeks prior to presentation
   
5. Submit a COMPLETE first draft of presentation slides to the RPD and grand rounds preceptor 3 weeks prior to presentation
   - COMPLETE first draft must include: all slides completed (no placeholders/plans for what will be finished later, all citations/audience questions included)
6. First Practice Presentation with preceptor – 2 weeks prior to presentation date
   
7. Other Practice Presentations TBD based on need
   
8. Submit final presentation slides to Creighton CE Office 2 days prior to presentation (NO EDITS)
   

Mentor responsibilities

The pharmacist preceptor role for grand rounds will be to assist the resident in appropriate choice of topic and preparation of the presentation. The preceptor will ensure that the presentation meets the requirements for continuing education credit and will guide the resident in content and delivery of the material. The preceptor will schedule a minimum of one rehearsal session that should occur 2 weeks prior to the scheduled presentation date. Additional rehearsal sessions may be scheduled if needed. If the preceptor feels that the resident is not prepared for the presentation, the resident will be responsible for updating and correcting the presentation to meet the mentor’s expectations outside of residency rotation activities. If the presentation is still not meeting the requirements of a quality grand rounds presentation, the preceptor may need to postpone the presentation if necessary.

In order to successfully complete the residency program and receive a certificate of completion, the resident must complete the following requirements:

• The resident must obtain their Nebraska Pharmacist Licensure by no later than 90 days after their start date – expectations are outlined below. Failure to become licensed within 90 days will result in dismissal from the PGY1 pharmacy residency program.
  
• The resident must successfully complete all required learning experiences with no Needs Improvement evaluations remaining at the completion of the residency.
  
• The resident must have 80% of the required competency areas, goals and objectives for the residency program evaluated to be “Achieved for the Residency” by the end of the residency year as determined by the Residency Advisory Committee.
  
• The resident must have completed all components of their longitudinal research project, as determined by the primary preceptor and the residency director. Failure to complete components of this project as outlined below will result in disciplinary action (unless special exemption is given for outstanding circumstances beyond the resident control).

1. IRB protocol submission by November 1st of the residency year (at the latest) – this includes a completed copy of the data collection spreadsheet
2. Data collection completed by March 1st of the residency year (at the latest)
3. Formal written research report in accepted manuscript style and approved by the primary preceptor prior to the end of the residency year, unless specific exemption is granted by the primary preceptor for circumstances that would warrant delay of report preparation (i.e. project will continue past the end of the current residency year)

• The resident must present their research project at the Midwest Pharmacy Residents Conference.
• The resident must present two Grand Rounds presentations. Required timeline and expectations for each grand rounds presentation will be agreed upon by the resident and preceptor in advance of the presentation (see “Grand Rounds Timeline Due Dates – Resident and Preceptor Agreement” form for details). Failure to comply with this required expectation will result in disciplinary action.
• The resident must complete a drug monograph and/or class review and Medication Use Evaluation (MUE) as assigned by the primary preceptor within the timeline given. Failure to adhere to project deadlines can result in disciplinary action.
• The resident must be present at all Grand Rounds sessions unless the absence is excused by the Residency Program Director.
• The resident must complete all didactic teaching requirements, as described in the manual.
• The resident must complete all clinical service/staffing hours and duties, as described in the manual.
• The resident must complete one written Clinical Pearl for the CHI Health Pharmacy/Provider Newsletter when assigned.