By Nimisha Sulejmani, Pharm.D., BCPS, residency program director, Henry Ford Health System, Detroit and Angela Michael, PharmD, BCOP, pharmacy specialist – hematology/oncology, Henry Ford Health System, Detroit
The easiest part of implementing a residency program is establishing the need for the training program and whether your institution provides a comprehensive experience to produce a successful resident. The challenge that follows is gaining adequate funding for the position. There are several avenues that can be explored for funding a residency program, such as a grant or outside funding sources, but the route you want to choose is the one that can be sustained over the long-term. This usually requires assessing the value a resident would add to the institution and how that would offset the cost associated with having a resident. Having a solid return on investment plan helps achieve the buy-in from the institutional budget oversight committee as well as maintaining the funds for the long-term.
Once the funding is secured, and the residency is at the phase of implementation, establishing the residency structure along with assigning goals and objectives for the program to the appropriate learning experiences can be challenging. It is critical for the success of a resident to find the right balance between structured rotational experiences and longitudinal experiences, including those that do not involve direct patient care, such as practice management or research development. Reviewing the required goals and objectives to be taught and evaluated during the residency can help overcome these challenges. Then, determine whether tangible evidence related to detailed activities performed to achieve the objectives can be produced to minimize redundancy and preceptor burden and maximize evaluation quality. Often times, these objectives do not fit into a clinical learning experience and may require a unique circumstance that would have to be evaluated outside the context of a structured rotation through the use of longitudinal experiences and on-demand evaluations.
One of the most important aspects of establishing a successful residency program is the preceptors. As a program director, it is important to ensure the preceptors have the appropriate qualifications for your residency, and if not, there is a plan in place for them to meet the qualifications in the future. Having qualified preceptors and an appropriate preceptor development plan helps ensure success of the resident as well as the residency program. Technology has played an important role in the success of pharmacy residency training programs and has improved significantly over time but still requires fine tuning. Setting up the programs (PharmAcademic™ and PhorCas™) appropriately for the residency training and recruitment can be challenging as the instructions on the functionality of the programs are not always user friendly and intuitive.
In regard to resident development throughout a new program, it is imperative to maintain an open line of communication with the residents in the program through the use of customized development plans, frequent bidirectional feedback and structured self-assessment. This will allow for identification of challenges within the resident’s progress early on to encourage individual program customization and assist with ongoing overall program improvement.
One of the most important facets to developing a new residency is creating contacts with other similar programs within your practice area. These programs become an indispensable resource while navigating the many challenges associated with creating, implementing and maintaining a successful residency. Establishing these mentorship relationships can significantly improve the process of navigating the complex system surrounding residency accreditation and will likely lead to a higher rate of success in implementation.