Training Areas

You will work with various patient populations from the New York City metropolitan region, including but not limited to those

• Ages 18-65 and >65 years
• Speaking other languages, including Spanish, Bengali, Hindi, Chinese, Korean, Japanese, and French
• Uninsured or covered by Medicare, Medicaid, or commercial insurance
• With various socioeconomic statuses
• Who have varying degrees of health literacy
• With chronic conditions such as diabetes, hypertension, heart failure, COPD, asthma, inflammatory bowel disease, substance use disorders, hepatitis C infection, and polypharmacy

Required Learning Experiences

• Orientation (3 week block)
  • You will be oriented to the health system, our population health team, and the residency program

• Primary Care 1 (18 weeks longitudinal), Primary Care 2 (12 weeks longitudinal), Advanced Primary Care (6 months longitudinal)
  
  
• Primary Care 1 (5 weeks, block)
  • Telehealth, work from home
  • You will work with a team of clinical pharmacists who provide medication management support to patients at risk for progressive diabetic kidney disease, via telehealth.
  • The goal of primary care 1 is to allow you to hone your clinical skills in hypertension and diabetes management, as well as patient education skills.
  • This experience will provide adequate time to become comfortable with the electronic medical record and chart review.
    
    
• Primary Care 2 (12 weeks longitudinal)
  • In-person direct patient care
  • You will enhance your clinical knowledge as an embedded pharmacist within a clinic site optimizing disease state management in a variety of conditions such as diabetes, hypertension, COPD, and asthma.
  • You will also gain experience assessing for polypharmacy, completing medication reconciliation and providing adherence counseling.
  • While in clinic, you will gain valuable exposure providing care for patients utilizing billable pharmacist services including Medicare Annual Wellness Visits, Chronic Care Management, and Remote Patient Monitoring.
    
    
• Advanced Primary Care (6 months longitudinal)
  • In-person direct patient care
  • While continuing to be a key member of the interdisciplinary team optimizing care for patients, you will work collaboratively alongside physicians to establish or expand embedded primary care pharmacy services through the creation of new pharmacy services or by expanding previously existing services.
  • You will navigate various resources to improve health equity and provide culturally sensitive patient care.

• Transitions of Care (5 week block)
  • Direct patient care
  • You will work in ambulatory and inpatient teams to coordinate care across a continuum of health care settings. You will work with the health care team to resolve barriers to medication access and ensure safe discharge for patients at high risk of readmission (heart failure, diabetes, COPD, asthma, acute myocardial infarction

• Inflammatory Bowel Disease (13 weeks longitudinal; 0.5 day/week)
  
  • Direct patient care
  • You will train at Mount Sinai’s state-of-the art, comprehensive care center for patients of all ages living with inflammatory bowel disease (IBD), including Crohn's Disease and ulcerative colitis. You will provide medication therapy management, comprehensive medication counseling for biologics and other specialty drugs, therapeutic drug monitoring, medication reconciliation, medication/polypharmacy review, health maintenance, complementary and alternative medicine counseling, and smoking cessation support.
    
    
• REACH Program (13 weeks longitudinal; 0.5 day/week)
  • Direct patient care
  • You will train within the Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program to provide a patient-centered, harm reduction approach to primary care for persons who use alcohol and other drugs, and for individuals living with hepatitis C virus (HCV) infection. You will consider psychosocial factors and social determinants of health in the care of patients. REACH offers overdose prevention services, access to buprenorphine and other medicines to treat substance use disorders, as well as comprehensive primary care that integrates behavioral health (psychiatry, psychology, and social work). The REACH program further offers care coordination support from patient navigators and patient support groups.

• Management (11 months longitudinal)
  You will learn about the systematic approach to offering care to patients and the integrated healthcare delivery model. Working alongside our population health management team, you will learn how to incorporate your clinical skills into population health pharmacy management, and conversely, utilize your management skills to positively impact and expand your clinical work. You will be afforded the opportunity to emphasize key management skills that are necessary to direct operations of a population health ambulatory care pharmacy department while ensuring continued compliance with all legal mandates and patient quality/safety initiatives. You will become an integral part of service-level initiatives, working on various projects both clinically and/or operationally related to pharmacy.

• Care Management (8 months longitudinal)
  The Mount Sinai Health Partners (MSHP) Care Management department serves as a centralized care management resource to our population health team. The MSHP Care Management team is comprised of Registered Nurses in the role of Nurse Clinical Coordinators, Social workers, and Care Coordinators, who are assigned to support employed and voluntary primary care and specialty practices. As a pharmacy resident, you will be uniquely positioned to address an array of medication-related issues for patients who are at high risk of readmission by counseling patients on their medications and identifying medication-related barriers, collaborating with physicians and other members of the healthcare team, and optimizing medication regimens.

• Medication Access Program (8 week block)
  • Direct Patient Care
  • You will be responsible for providing medication and disease state education for high cost injectable and oral medications for various different specialties (including rheumatology, dermatology, cardiology, endocrinology etc). You will become familiar with the Medicare structure and resources to aid in medication access, such as NYS Epic and patient assistance programs (PAP). The goal of the MSHS MAP is to improve adherence with medications and ultimately health outcomes by providing a virtual platform for education, support, and 340B pharmacy access for patients prescribed a new medication or struggling with access or cost. 

• Population Health (11 months longitudinal)
  Throughout this experience, you will utilize population health data to identify patients who may be non-adherent to prescribed medications and provide care across various practice settings. You will collaborate with physicians and other members of the healthcare team to prescribe guideline-recommended therapies, optimize medication regimens, and identify cost-reduction opportunities with payers.

• Research (11 months longitudinal, with a 5 week concentration in December)
  • Indirect patient care
  • You will be involved with a research project, to hone your skills in evaluating scientific literature and using the scientific method. You will adjust the research process to address health inequities.  We anticipate that you will initiate and complete a research project during the course of this program. This research experience should result in a publication. 

• Educational Conference (11 months longtitudinal)
  Throughout the year, you will design and present journal clubs, patient highlights, population health sessions, pharmacy ground rounds/seminars, and case conferences.

• Staffing (12 months longitudinal; every other Saturday)
  • Direct patient care
  • Unlike traditional staffing roles, you will not be verifying orders or dispensing medications. You will be responsible for population health ambulatory care pharmacy initiatives such as patient outreach to improve clinical quality measures and providing medication education/reconciliation at our student-run free medical clinic (EHHOP). EHHOP improves access to health care services and creates a health outreach partnership with the East Harlem community by providing quality health care, regardless of ability to pay.

Elective Learning Experiences (Current and Future)

• Current
  • Cardiology
  • Endocrinology
  • Weight Management
  • Pharmacogenomics
  • Remote Patient Monitoring: Clinical Program Management
• Future
  • Specialty Pharmacy/340B
  • Diabetic Kidney Disease

Remote Patient Monitoring Program

PGY2 residents will have the opportunity to train in digital medicine within our Condition Management program. In this pharmacist-led Remote Patient Monitoring (RPM) program, patients are provided connected devices that transmit their physiological data directly into our electronic health record. Residents will work directly with supervising physicians in managing a panel of patients with uncontrolled hypertension and diabetes to help them achieve blood pressure and glycemic goals. Residents will partner with Registered Dieticians and RPM Care Coordinators to help support additional nutritional and lifestyle coaching. Residents also have the option of selecting an elective learning the foundational components of operating an RPM program. Working closely with the Program Director and Program Manager, residents will be involved in developing and refining program workflows, selecting RPM vendors, and understanding program finances. 

Program Milestones Supported by PGY2 Residents

2020 

• Spring: Amidst the COVID-19 pandemic, first residency class researched RPM program creation
• Summer: Enrolled first patient with uncontrolled hypertension

2021 

• Through the KidneyIntelX program, expanded RPM to patients with diabetic kidney disease
• Enrolled 500 patients

2022 

• Expanded RPM to high risk maternity population  
• Enrolled 1,000 patients