Residency Objectives and Competencies

Objectives to set-up for success:

#1: Have effective study habits and have a system of organising my time and work so that I am able to efficiently and thoroughly carry out required tasks. I aim to finetune these skills to the requirements of my residency by the end of my first vacation/project week.

How to achieve:

  • Consistently organise any notes by topic on dropbox so that it is easily accessible
  • Actually use an agenda and calendar to map out a timeline for any required tasks (e.g. presentations) → check agenda daily and consider the feasibility of the timeline when circumstances change (e.g. how many hours do I need to complete it and how much time can I afford to dedicate to it each day?)
  • Start large tasks in small bits as early as possible!
  • Effectively prioritise tasks based on urgency, its demands and amount of time it will likely take to complete it
  • Use my ePortfolio as a tool to keep track of the resources I attain throughout the year
  • Whenever I notice my desk getting cluttered, take some time to re-organise my space to avoid clutter
  • Whenever a task seems overwhelming or the knowledge gap seems huge…take (lots of) deep breaths, and remind myself that fully understanding something takes time, tackling the task/topic in bits is better than trying to grasp the whole topic/task but only being able to touch the surface of it/doing a poor job, and don’t be afraid to ask questions or guidance.

#2: Maintain a positive mindset and consciously re-focus on the importance of residency in defining my practice.
(This might sound like a fairly obvious and perhaps easy thing to accomplish during residency, but I think a negative mindset can be something that I can easily and unconsciously fall into as the year becomes more challenging and stressful. Residency is an absolutely amazing opportunity to enhance my clinical skills, my thought process and ultimately, my care for my patients. Having the wrong mindset can make tasks seem tedious, residency daunting and distract me from my goals in residency.)

How to achieve:

  • See that each time I say “I don’t know”, I have actually identified a crucial knowledge gap that residency has given me the opportunity to fill
  • Know that it is okay and (although it really doesn’t seem like it, good) to be uncomfortable
    → ask for more opportunities in things that make me uncomfortable
  • Feel comfortable moving backwards during residency but not comfortable staying back
  • Avoid thinking of the prospect of failing this program and push yourself to continuously improve
  • Avoid using vague terms…like hopefully, I think, maybe, try
  • Avoid falling into “competitive busy-ness”. Working harder doesn’t mean that you are working efficiently.
  • Know that my preceptors are helping and supporting me and any constructive feedback is key to making me a better clinical pharmacist! 😊
  • Be open-minded yet critical
  • Know that it is okay to feel overwhelmed…to acknowledge my weaknesses…to cry. 😭

#3: Maintain a healthy lifestyle and work-life balance

How to achieve:

  • Sleep at least 6 hours a day and avoid relying on caffeine to stay awake
    – Drink at most 3 coffees per week
  • Exercise at least once a week
  • Take the stairs whenever possible 😅
  • Don’t skip meals
  • Spend Saturday morning doing something non-residency related

Objectives for residency:

#1: Have a systematic and efficient thought process (within 2 hours) so that I can effectively triage patients, assess for and prioritise drug-related problems, consider all possible treatment options, having a strong rationale for my recommendations and develop a comprehensive care plan and monitoring plan. Have the skills to tailor my thought process to any condition/patient.

How to achieve:

  • Develop my knowledge base
    → Read current guidelines and question/understand the rationale behind the recommendations
    → Keep up to date on current literature (e.g. through QxReads)
    → Consider pharmaco-kinetics and assess importance of knowing pharmacokinetics for certain drugs
    → Create cheat sheets on common therapeutic conditions (e.g. pathophysiology, treatment options, doses, monitoring parameters and tools)
    → Discuss with my co-residents on different topics
  • Ask each preceptor for their thought process and systematic approach to gathering information
  • Develop a systematic process for information gathering
  • Assess each condition individually and if the medications prescribed are the most appropriate choices and at its most appropriate dose for the individual (e.g. renal function, financial situation, previous experiences)
  • Learn to effectively interpret lab values
    → Discuss with preceptors
    → Look for connections between the changes in my patients and their lab values
    → Know what lab values to look for and what to expect, depending on the condition
    → Read interdisciplinary notes to understand other HCPs’ interpretation of them
  • Whenever possible, think my processes out loud to my preceptors and co-residents and ask for guidance
    → Ask for their feedback
  • Be able to apply current literature to my patient (e.g. consider if they fall into the patient population of the study, etc.)
  • Ask my resident advisors, preceptors and mentors if a mock oral exam is possible during my rotation
  • Time the amount of time it takes for me to complete a general patient workup as I progress through the rotation

#2: Be able to systematically search for relevant literature and critically appraise articles so that I can provide evidence-based recommendations.

  • Participate and attend journal club presentations
  • Become very familiar with the NERD-CAT tool
  • For appropriate clinical questions, search and critically appraise primary literature instead of solely relying on tertiary literature
  • Engage with other residents and my preceptors in discussions on relevant journal articles

#3: Be able to collaborate with other inter-disciplinary team members face-to-face, verbally by phone and through writing and help demonstrate the role of the pharmacists

  • Develop an understanding of each team member’s role in each field I practice in
  • Practise writing concise clinical pharmacy/SOAP/SBAR notes
    → Always consider what is pertinent to other health care professionals
    → Ask my preceptors for any feedback
    → Ask other health care professionals for any feedback
    → Read my preceptors’ notes and assess their style of writing and communicating
  • Take opportunities to discuss my thoughts and recommendations to other health care professionals
    → Ask for their interpretation and plan with the patient (e.g. understand what their priorities are)

#4: Be able to build rapport and effectively interview my patient, as well as, effectively communicate my care plans to preceptors and other health care professionals verbally and by paper

  • Observe the way my preceptors and other health care professionals communicate/collaborate with each other and patients
  • Take as many opportunities to develop my interview skills and build rapport with my patients
    → Think about what questions are the most important in developing my care plan
    → Ask my preceptors for feedback if they are observing my interviews
  • Take as many opportunities to do presentations, ask for feedback and be open to trying different styles of presentations

#5: Become an effective educator and future preceptor

  • Participate in the TMP-SMX Program and whenever possible, provide opportunities for my student to shadow me
  • Learn from the different ways my preceptors precept me and apply what works well when I teach
  • Be flexible! Understand that everybody is a different type of learner and for each teaching opportunity, ask for any feedback and constructive criticism

Competency Self-Assessment – Baseline: 
JIA (SHERMAINE) NGO Baseline Competency

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