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Required
Medication Management
Residents manage care of their patients by ordering and interpreting labs, and prescribing and adjusting medications. They are responsible for the education and follow-up of their patients and staff care plans with attending physicians or clinical pharmacists. Patients seen in this clinic are referred by their primary provider for co-management of chronic conditions including hypertension, hyperlipidemia, diabetes, and BPH.
Hypertension
Patients with more complicated or more difficult to control hypertension are referred to this clinic for evaluation and treatment including patients on 3 or more medications and those with secondary hypertension due to renal artery stenosis, hyperaldosteronism or other factors. Residents manage all aspects of the patients care in conjunction with an MD attending and Pharmacist preceptor.
Rheumatology
Patients with a wide variety of rheumatologic disorders are cared for in this clinic. Residents provide direct patient care including physical assessment, and development of therapeutic and monitoring plans. These patients are co-managed with Pharmacist preceptor and Rheumatologist attending physicians.
Diabetes
Patients with more complicated and difficult to control diabetes are referred to this clinic. The clinic uses a multidisciplinary approach to the management of Type 1 and Type 2 Diabetes. Residents see patients in both a Pharmacist-managed clinic as well as a clinic which has both Pharmacist and Endocrinologist attendings. The resident is responsible for all aspects of the patient’s diabetes-related care. The program is structured to provide the resident the opportunity to monitor the safety and efficacy of drug therapy in ambulatory care settings, including medical record review, patient interview, and targeted physical assessment, interpretation of laboratory data, consultation with staff and patient education to achieve optimal patient outcomes. In addition to clinic, patient home glucose monitoring done between clinic visits is assessed and patients are managed by telephone.
Smoking Cessation
This service is provided in group cessation together with a Social Worker whose specialty is addiction therapy. Residents provide the medication management support for this service including nicotine replacement and bupropion. Group sessions are held weekly and are done in face to face meeting, by teleconference and video conferencing.
Osteoporosis
Patients with osteoporosis or history of non-traumatic fractures are evaluated for secondary causes of osteoporosis and for management of their reduced bone density. Residents assess patients, order bone density studies and other tests needed to look for risk factors and provide bisphosphonates and other treatments to improve the problem.
Anticoagulation
The clinic manages most patients receiving warfarin from our hospital and cares for over 700 patients. Residents see patients in clinic as well as in telephone follow-up to assure safe and effective anti-thrombosis. They also initiate therapy and transition patients from inpatient to outpatient care. The clinic manages both long-term patients as well as those on short-term post-operative prophylaxis. They also coordinate warfarin interruptions for procedures using low molecular weight heparin if warranted. The clinic is Pharmacist managed. Madison is one of 7 sites chosen nationally for the ASHP Antithrombotic Pharmacotherapy Trainee program.
Epilepsy Clinic
Residents independently evaluate patients with a wide range of seizure disorders. Residents will also gain experience evaluating patients with various psychiatric comorbid disorders including major depression, bipolar disorder and anxiety. The resident is responsible for obtaining a medical history, symptom and disease history, performing a short neurological exam, and monitor AED therapy for these patients. The resident works closely with Barry E Gidal, Pharm.D., a nationally recognized epilepsy clinical specialist, as well as the epilepsy nurse case manager and an attending neurologist to provide optimal patient care. Residents may also be asked to provide telephone follow-up to selected patients when antiepileptic drug therapy has been recently initiated or modified. The resident is also responsible for assisting in precepting fourth year pharmacy students who rotate through this clinic.
Allergy and Asthma
Residents are responsible for independently interviewing and monitoring patients who with allergic rhinitis, sinusitis, and asthma. The resident will obtain a medical history, symptom and disease history, perform a brief physical exam including ears, nose, throat and lung assessments, and monitor medication efficacy, safety, and adherence. The resident will learn to effectively evaluate spirometry and symptoms to determine medication appropriateness and efficacy. An Allergist oversees the clinic and staffs with the resident to provide optimal patient care.
Family Practice Clinic
Residents spend one afternoon a week during one rotation at the Wingra Family Practice Clinic. This clinic serves a diverse population, with many patients being uninsured or having limited access to healthcare. Residents spend time doing a variety of activities including anticoagulation, diabetes management, prescription preparation through the patient assistance program, shadowing and help staff medical residents.
Pharmacotherapy Lab
This rotation is designed to introduce the resident to academia. Residents will be co-teaching at the UW-Madison School of Pharmacy in the Pharmacotherapy laboratory. The Pharmacotherapy lab is set up as an experiential learning setting. Residents will have hands on teaching experience in both small and large groups. Teaching modules relate directly to the resident's clinical experience in areas including hypertension, epilepsy, smoking cessation, anticoagulation and hyperlipidemia. Residents are also given the opportunity to present a didactic lecture to the second year doctor of pharmacy students.
Geriatrics
Residents manage the care of the predominately elderly population by ordering and interpreting labs, and prescribing and adjusting medications. They are responsible for the education and follow-up of their patients and staff care plans with attending physicians or clinical pharmacists. Patients seen in this clinic are referred by their primary provider for co-management of chronic conditions including hypertension, hyperlipidemia, diabetes, and BPH.
Ruby Team Medication Management
Residents on the Ruby Team will manage the care of their clinical patients, by ordering and interpreting labs, and prescribing and adjusting medications. They are responsible for the education and follow-up of their patients and staff care plans with attending physicians or clinical pharmacists. Patients seen in this clinic are referred by their primary provider for co-management of chronic conditions including hypertension, hyperlipidemia, diabetes, and BPH.
Silver Team Medication Management
Residents on the Silver Team will manage the care of their clinical patients, by ordering and interpreting labs, and prescribing and adjusting medications. They are responsible for the education and follow-up of their patients and staff care plans with attending physicians or clinical pharmacists. Patients seen in this clinic are referred by their primary provider for co-management of chronic conditions including hypertension, hyperlipidemia, diabetes, and BPH.
Gold Team Medication Management
Residents on the Gold Team will manage the care of their clinical patients, by ordering and interpreting labs, and prescribing and adjusting medications. They are responsible for the education and follow-up of their patients and staff care plans with attending physicians or clinical pharmacists. Patients seen in this clinic are referred by their primary provider for co-management of chronic conditions including hypertension, hyperlipidemia, diabetes, and BPH.
Teaching Certificate Program
The teaching certificate is a separate program that complements the experiences obtained in the laboratory. Residents are taught strategies to teach the adult learner, facilitate discussions and design a lecture. A certificate, signed by the Dean of the School of Pharmacy, will be presented to the resident after successful completion of this program.
Electives
Women's Health
Participation in this elective rotation is an opportunity for the resident to refresh knowledge and skills related to the female patient. Residents spend time observing and consulting with clinic providers.
Psychiatry
Psychiatry is an elective rotation which provides residents a broad interdisciplinary experience. Residents experience medication management in a pharmacist run clinic, including participation in our centralized intake system. Objectives include experiential learning of different DSM-IV axial diagnosis, clinical interview skills, psychopharmacology initiation, monitoring and evaluation as well as participation in Mental Health service journal club meetings.
Dermatology
Residents work with attending Dermatologists in addition to Dermatology fellows and medical residents. Emphasis is placed on recognizing common dermatologic problems and their management.
Hepatitis C
The pharmacist co-manages patients with the Gastroenterology team to evaluate and treat patients with the hepatitis C virus. Patient education, lab ordering, monitoring, dose adjustments and side effect management are needed monthly through out drug treatment and are largely the responsibility of the pharmacist.
Infectious Disease
The ID clinic serves as the primary care clinic for all HIV+ patients at the Madison VA. It is also a consult clinic for patients with severe or chronic infectious diseases. All patients on home IV antibiotics are followed in the ID clinic. Experience during the rotation would likely include HIV, home infusion, diabetic or ischemic ulcers, treatment of osteomyelitis, endocarditis, etc. Plus you get to see some pretty great wounds!
