Program Overview
The PGY2 ambulatory care residency at Cleveland Clinic Hillcrest Hospital is designed to prepare pharmacists for impactful roles in primary care. By integrating advanced clinical practice, teaching, and research opportunities, residents develop the skills necessary to provide exceptional patient care and contribute to the advancement of pharmacy practice.
This program allows residents to pursue unique professional interests through working within a variety of primary care and cardiology clinics, working as an antimicrobial steward within the emergency department, providing transitions of care services, and providing education related to new oncology regimens. Graduates of the program are well-positioned for careers in ambulatory care.
Cleveland Clinic Hillcrest Hospital is a 500-bed community hospital.
Key Features of the Residency
- Longitudinal Rotations
- Primary care
- Cardiology
- Practice management
- Maternal fetal medicine
- Research
- Continuing education presentation
- 1-Month Rotations
- Transitions of care
- Emergency department
- Oncology
- Customized Learning Experience
Longitudinal projects allow residents to pursue their individual passions while also developing a business plan to help them learn how to establish new services. Residents can also design their own research projects coinciding with their personal interests.
- Clinical Skill Development
Primary care envelops many disease states. Pharmacy consults include those for patients with diabetes, type 1 diabetes on insulin pumps in pregnancy, heart failure, hypertension, asthma, COPD, and smoking cessation. We also treat patients within our anticoagulation clinic weekly.
Staffing and on-call service is not required.
Opportunities include precepting both pharmacy students and PGY1 pharmacy residents. In the second half of the year, the resident becomes responsible for most precepting responsibilities including topic discussions, patient discussions, and feedback.
Residents may design their own research project reflecting their personal area of interest that can be used to expand existing or develop new clinical services. Research projects will be presented at regional conferences. Resident projects need to be submitted for publication consideration, and these projects have historically been published[KS1] .
- Presentation Opportunities
- Continuing education presentation: Delivered to health care professionals within the enterprise
- Benefits within this experience include establishing a strong knowledge base within critical disease states and experience in delivering professional materials to a large audience.
- Quarterly in-service presentations: Delivered to primary care providers within Hillcrest primary care
- Benefits of this experience include establishing trust with providers, reviewing new literature, and getting practice with delivering important messages in a succinct manner.
- Monthly journal clubs: Delivered to ambulatory care pharmacists
- Benefits of this experience include evaluation of newly published literature, analysis of potential guideline changes, and development of research skills.
- Benefits of this experience include professional development early within the residency experience, board certification preparation, and critical analysis of guideline recommendations.
- Interdisciplinary Collaboration
The resident works with providers within the primary care office to provide medication reconciliation services once weekly. The resident makes recommendations on changes to medication therapy and obtains consultations for disease state management, if appropriate. The resident presents in-services quarterly to primary care providers focused on important guideline updates and new literature.
Current Resident Projects
Current projects:
- Shared medical appointments development
- Prediabetes and chronic disease management
Current research:
- Impact of pharmacist involvement in health literacy for patients with obesity
Recent resident publication:
- Tasseff N, Axtell S, Nixon B. Effect of extended pharmacist involvement in discharge transitions of care on hospital readmission rates: prospective, randomized, parallel arm design trial. J Am Coll Clin Pharm. 2024;7(1):8-14. https://doi.org/10.1002/jac5.1887
Reflections from Current Resident
Sophia Mancuso, Pharm.D.
Pharmacy School: Duquesne University School of Pharmacy
PGY1: Niagara Falls Memorial Medical Center
Clinical Interest Areas: Endocrinology, Transitions of Care
Cleveland Clinic Hillcrest is a welcoming environment that encourages residents to practice pharmacy with the latest guidelines and literature in mind. Throughout my interview process, I saw Hillcrest’s dedication to resident development and well-being. I have enjoyed longitudinal learning and developing relationships with preceptors and patients. Working in a variety of outpatient clinics has helped sharpen my clinical knowledge in a variety of settings. Preceptors and directors provide feedback and dedicate time to professional development. Throughout the year, residents develop their own practice style supported by the expertise of the preceptors.
What are your career aspirations after residency?
My goal is to help develop clinical services related to diabetes and patient education. I plan to become a board-certified ambulatory care pharmacist and certified diabetes educator.
Advice for Future Residents!
Look for a program where you can see yourself flourishing as a developing professional but also pushed to develop your best clinical and professional skills. Don’t be afraid to ask about endeavors related to your personal passions. These questions can lead to projects and service development that better yourself and the program. Strong emotional intelligence and drive can make you a more impactful resident. Both skills can help you leave a lasting impact despite the limited duration of the residency.
Contact Information
Program Director/Contact Name: Sandra Axtell, Pharm.D., BCPS, BCACP
Email: [email protected]
Website: http://www.clevelandclinic.org/hillcrestpharmacyresidency