What I Wish I Knew - Starting a New PGY-2 Program

Stephanie Coveart, PharmD, BCPS, BCPP
Clinical Pharmacist Practitioner – Mental Health
Lt. Col. Luke Weathers, Jr. VA Medical Center
Memphis, Tennessee

Dr. Coveart is a Clinical Pharmacist Practitioner (CPP) in Mental Health at the Lt. Col. Luke Weathers, Jr. VA Medical Center in Memphis, TN. She is the Residency Program Director (RPD) for the newly established PGY-2 Psychiatric Pharmacy residency program at her facility. Dr. Coveart received her Doctor of Pharmacy degree from the University of Tennessee College of Pharmacy and completed both her PGY-1 Pharmacy residency and PGY-2 Psychiatric Pharmacy residency at VA Tennessee Valley Healthcare System in Nashville, Tennessee.

Have you considered starting a new PGY-2 Psychiatric Pharmacy residency program at your facility but have no idea where to begin? I was in your shoes not very long ago. Here are some considerations and starting points to help the process feel less overwhelming.

Does my facility have the resources to start a residency program?

This question is arguably the most important question you must ask yourself prior to starting a residency program. The best place to start is the American Society of Health-System Pharmacists (ASHP) “How to Start a Residency Program” document.1 This guide walks you through step-by-step to help you determine if you and your site are ready to start a residency, from initial assessment to recruiting. A few key initial steps in determining site readiness are to evaluate whether you have a pharmacist who will meet the ASHP requirements to be the RPD for the program, leadership support to start and maintain the program, a core group of preceptors with a variety of learning experiences, and interdisciplinary support, especially with the Mental Health service. Additional considerations include adequate trainee space and equipment, affiliation agreements with colleges of pharmacy for teaching and learning opportunities, and the presence of other healthcare training programs at your facility to facilitate layered learning and interdisciplinary collaboration.

Two other very important documents to review are the ASHP Accreditation Standard for Postgraduate Residency Programs and Required Competency Areas, Goals and Objectives for Postgraduate Year Two (PGY2) Psychiatric Pharmacy Residencies.2,3 These documents will help you prepare for accreditation and develop meaningful learning experiences so you can meet the goals and objectives of the program, paving the way for an optimal program design that drives the successful completion of the program. Additionally, it is important to note per ASHP, you are required to include an adult inpatient psychiatry experience (acute or “step-down unit”) and an outpatient clinic, “partial hospitalization”, or day treatment center experience. If necessary, you have the option to coordinate with other training sites to meet these requirements.

How do I fund the position?

Once you determine you have the support to start a new PGY-2 program, you must secure funding. If direct facility funding is not available, you could explore partnering with a local college of pharmacy or determining if any grants may be available. You could further discuss with your facility’s education department and leadership to see what other funding opportunities are available. Specifically within the VA, the Office of Academic Affiliations (OAA) may have funding opportunities for creation of new residency programs or expansion of existing programs via a Request for Proposals (RFP).

While garnering support for funding, it is important to highlight the potential benefits of investing in a psychiatric pharmacy trainee. Some benefits include increasing access to care, expanding research opportunities, and providing additional opportunities for teaching throughout the facility. Establishing a PGY-2 Psychiatric Pharmacy residency is also a great avenue for promoting expansion of mental health services and CPP positions at your facility.

Where can I look when I have no idea what to do?

I highly recommend reaching out to other facilities who have a successful PGY-2 Psychiatric Pharmacy residency program for mentorship. If your facility already has other pharmacy residency programs, they can provide valuable guidance on essential steps such as establishing policies, procedures, and developing your curriculum. I found both sources of support incredibly beneficial. Additionally, the American Association of Psychiatric Pharmacists (AAPP) offers the RPD Community which is available at https://aapp.org/community. I know firsthand the process of starting a new residency program can be very overwhelming. However, I am confident these tools will help you get started.