CoxHealth Pharmacy Residencies Manual

Table of Contents

• Standard 1: Recruitment and Selection of Residents                                                                                                     
• Standard 2: Program Requirements and Policies
• Standard 3: Structure, Design, and Conduct of Residency Program                                                                          
• Standard 4: Requirements of the Residency Program Director and Preceptors                                                      
• Standard 5: Pharmacy Services
• Chief Pharmacy Resident
• Appendix A – PGY1 Pharmacy Residency Springfield
• Appendix B – PGY1 Pharmacy Residency Branson
• Appendix C – PGY2 Ambulatory Care Pharmacy Residency

Standard 1: Recruitment and Selection of Residents

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Selection Introduction

Diversity, Equity, and Inclusion are priorities here at CoxHealth. The best way to serve our patients, employees, and communities is to ensure we can provide and maintain safe, welcoming environments for all as we serve, heal, educate, and innovate.

Programs select from eligible applicants by considering their readiness for post-graduate training and their potential to benefit from and meaningfully contribute to the program. Academic performance, cultural alignment in relation to our mission, vision, and values, letters of recommendation, letter of intent, scholarship, leadership, community service, professional experience, and ability to communicate are considered in the selection. In selecting from among qualified candidates, all CoxHealth programs participate in the PhORCAS electronic application process, participate in an organized file review and interview process, participate in the ASHP Resident Matching Program, and adhere to the Rules for the ASHP Pharmacy Resident Matching Program. 

Resident Qualifications (Standard 1.2)

• Graduate from Accreditation Council for Pharmacy Education (ACPE) accredited degree program or one in process of pursuing accreditation
• Ability to be fully licensed as a pharmacist in Missouri within 90 days of beginning residency
• For PGY2 ONLY: Complete an ASHP accredited or ASHP candidate status PGY1 pharmacy residency with submission of PGY1 certificate within 30 days of the PGY2 program start date.
  • Will consider candidate status PGY1 program completion with review of program

Recruitment (Standard 1.1)

Residency recruitment will be completed through various methods that may include open houses (virtual and/or in person), residency showcases (this may include ASHP, OSHP, etc), job fairs at pharmacy schools, and distributing informational recruitment resources to pharmacy schools.   
 

Residency Application Procedures (Standard 1.1)

          Early Commitment

          PGY1 Residents from any CoxHealth PGY1 program can apply for Early Commitment

          Application

• Due early November – Date will be determined and distributed by PGY2 RPD in early October
  • Application must include
    • Curriculum vitae
    • One-page letter of intent
    • One letter of recommendation
    • Development plan sent from PGY1 Director
• Interview will be scheduled for mid-November prior to Midyear and will follow Match Procedures

Scoring and Ranking procedures will be the same for all applicants

• If highest ranked candidate does not accept, it will be sent to next ranked applicant
• If position accepted by resident, they will be sent and need to complete the following requirements prior to ASHP Midyear Annual Meeting
  • Acceptance Letter
    • Preemployment requirements
    • National Matching Service (NMS) Early Commitment Letter of Agreement
• If not selected in early commitment, candidates are encouraged to apply during Match

Match Application Procedures (Standard 1.1)

Application Phase I and Phase II

• Application window closes January 5th (unless a weekend then it will be the following Monday), Phase II interview date selected by program RPD
• RPD plus at least one other preceptor or resident will review resident application using the provided rubric

  • Application review committee will review compiled rank lists after each has scored the applicants

    •  Any discrepancies in reviewers’ scoring will be reviewed and resolved by the residency executive committee
    • The resident candidates, based on final application score, will be invited to interview
    • If a candidate withdraws from selection process, the RPD reserves the right to either invite the next listed candidate or end their candidate search 
    • At the time of interview invitation, the RPD will provide 
    • Requirements of completion of the residency program 
    • Residency Manual with all policies and procedures

     

Interview Phase I and Phase II Procedures (Standard 1.1)

• Residents interview onsite or virtually, and will contain all or some of the following:
  • Leadership interview (director of pharmacy, operations director, clinical director, etc.) 
    • RPD interview (may be grouped with leadership)
    • Preceptor interview 1 (clinical preceptors) 
    • Preceptor interview 2 (longitudinal, clinical preceptor, and/or technician) 
    • Residency Executive Committee
    • Tour / lunch with current resident class - may be a separate time slot if virtual
    • Presentation: 5 minutes on candidate
    • PGY2s only – 15 minutes patient case presentation with Q/A with REC

Interview Scoring

• Panel Interviews are conducted
• Panels are defined by the program and will remain the same for all interviews in that phase
• Interview questions are scored 1-5
  • Qualities of ideal answer defined on each question 
    1. No qualities of ideal answer displayed
       1. ¼ qualities of ideal answer displayed
       2. ½ qualities of ideal answer displayed
       3. ¾ qualities of ideal answer displayed
       4. All qualities of ideal answer displayed
• Each interviewer has an overall score selection
  • Do Not Rank (comments required)
  • Recommend with reservations (comments required)
  • Recommend    
  • Highly Recommend
• Each panel score will be reviewed as a percentage of total points available and a ratio of highly recommended to number of overall score selections

Scores are weighted as defined by the program

Scramble Procedures (Standard 1.1)

• If no match in phase II, the residency program may participate in the Scramble Application Deadline May 1st (if on a weekend will be the following Monday)
  • RPD will ask for letter of intent, CV, and 3 letters of recommendation from candidates
  • 1-3 candidates per open position will be invited to interview 
    • Interview will consist of the same components as Phase I and Phase II
• After all interviews are complete, all preceptors available and current resident(s) meet to discuss and rank applicants to the program: Decisions will be made by May 15th or the following Monday if this falls on a weekend.
  • Scores from the interviews and the presentation will be included in the discussion
  • The preceptors and RPD may rank all candidates or may choose to rank only a partial list of applicants
  • The top candidate will be offered the residency program spot. If this is declined, the RPD will work through the list of candidates
• Once a candidate verbally accepts the position, RPD will provide the match agreement letter within the week

Review and Ranking (Standard 1.1)

• The ranking list is made in two ways, by percentage of interview points earned and by ranking category ratio selected
• Groups are compared and combined to create a final ranking list for Residency Interview Committee review
• If an interviewer marks “Recommend with reservations”, the candidate may be moved to a lower rank than those without reservations after discussion with selection committee
• If any interviewer marks “Do Not Rank”, the candidate will be moved down the ranking list after discussion of the selection committee 
  • If the “Do Not Rank” comments can be taught/caught up within our residency structure they may still be ranked
  • If the “Do Not Rank: comments cannot be taught/caught up, the candidate will move to the “Do Not Rank” list
• The Residency Program director has final authority on ranking submissions

Post-Match Pre-Employment Requirements (Standard 1.1)

• All residents accepted will receive a letter from the Residency Program Director (RPD) outlining their acceptance to the program, along with pre-employment requirements; and requirements for residency completion, which must be accepted/signed by the resident and returned to the RPD within 30 days.
• Formally apply for the Pharmacy Resident I/II position through CoxHealth and receive an official offer from the Human Resources (HR) Pharmacy Recruiter
• Background check is required
• Onboarding appointment is scheduled by HR
  • In house – Visit with a Coordinator or Recruiter in person
    • Complete New Hire/Onboarding Paperwork – All paperwork sent and signed via DocuSign
      • Voluntary Disclosure/Equal Employment Opportunity (EEO) Voluntary Disclosure
      • Sign release for Fair Credit Reporting Act (FCRA) Background Check
      • Sign Conditional Offer of Employment
      • Badge Form
      • Parking Form
      • I-9 (provide employment verification documents)
      • New Hire Compliance Checklist
      • Provide copy of Education (diploma) –DocuSign available
      • Provide copy of Licensure (or application for licensure) –DocuSign available
      • Receive Job Description – sent via Workday 
      • Direct Deposit in Workday
      • W-4 (state & federal)
      • NH Information Form
      • Instructions for system wide orientation (SWO)
      • Attestation/Sign on Bonus/Relocation Bonus (if granted)
      • Badge picture taken
      • Drug Testing as well as blood draw is performed by employee health within 96 hours from Conditional Offer of Employment
      • Follow up appointment set with Employee Health to review blood draw results
  • Out of area – If new hire lives too far from a CoxHealth location to physically complete process on property
    • Same as above with the below exceptions
      • Drug Testing scheduled at a facility near new hires home or current employer – to be completed within 96 hours of scheduled date and time
      • Blood draw done by Employee Health at Orientation – Must be done ON-SITE 

Standard 2: Program Requirements and Policies

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Duration of Appointment (Standard 2.1)

Each resident must complete a minimum of 52 weeks and a full-time practice commitment or equivalent, with a minimum of 2/3 of the residency year completed as a pharmacist licensed to practice in the state of Missouri to receive a certificate of completion.

PGY1 Programs: 55-week appointment (second Monday in June to last Friday the following June)
PGY2 Programs: 52-week appointment 

Salary

PGY1 Residents (55-week appointment) - $50,128 annually (52 weeks)
PGY2 Residents (52-week appointment) - $55,848 annually

Orientation 

• Residents will participate in CoxHealth System Wide Orientation and are responsible for completing all assigned CoxHealth onboarding competencies.
• Residents will be oriented to their respective residency program, including, but not limited to:
  • Residency purpose, description, and practice environment
  • American Society of Health-System (ASHP) Accreditation Standards; ASHP Competency Areas, Goals, and Objectives
  • Residency program design, including all program requirements for successful completion
  • Description of required and, if applicable, elective learning experiences
  • Evaluation strategies
  • Residency policies, terms, and conditions
• Each program will develop an orientation calendar based upon the individual resident's needs and will distribute the calendar to the resident.     

Benefits, Leave and Travel (Standard 2.2)

Refer to the CoxHealth Benefits page for details of all provided employee benefits (https://www.coxhealth.com/employees/benefits/) 

This section does not define the amount of paid leave that may be provided as part of an organization’s benefits for employees; it defines eligibility to receive a certificate of completion related to the maximum time away from the program within a 52-week period which is 37 days, without requiring extension of the program.

• Examples of time away from the program include vacation time, sick time, holiday time, religious time, interview time, personal time, jury duty time, bereavement leave, military leave, parental leave, leave of absence, and extended leave.  
• 37 days is defined as 37 scheduled training days. Service commitment/staffing shifts are considered independent of training days and are included in the total service commitment/staffing shifts required to complete the residency program requirements. Compensatory days for staffing shifts, if given, are considered part of the service commitment, and are not counted as time away from the program. 
• If the resident exceeds 37 days away from the residency program, inclusive of PTO, and/or Extended Leave of Absence, the residency will be extended.  
  • The extension to make up any absence that exceeds the 37 days will be equivalent in competencies and time missed 
  • The resident will be paid at the stipend (resident) rate for the remainder of days worked  
  • Benefits will continue while in full time employment with CoxHealth 
  • Maximum extension will be 12 weeks

Paid Time Off (PTO) 

• Residents accrue PTO at a rate of 0.0654 hours per hour of paid time, which equates to 17 days of PTO annually.  
• PTO is used for vacation days, absences, sick days, non-worked holidays, and extended leaves of absence. 
• For sick days/unplanned absences, the resident must call the department manager/supervisor and notify the RPD each day of absence. Each sick day/day of unplanned absence will be removed from the resident’s PTO total.  
• All PTO requests must be approved by the RPD and preceptor prior to the period requested.  
• PTO not taken by the end of the residency year will not be paid out and will be forfeited, unless eligible for roll-over per CoxHealth Human Resources policy. 

Extended Leave of Absence 

• Pharmacy Residency Programs follow the CoxHealth System Policy in regard to Employee Leaves of Absence (including Family and Medical Leaves of Absence, Adoption Assistance, Personal Leave of Absence, and Military Leave of Absence) 
• Employees in a temporary status are not eligible for leave under the Medical Leave of Absence policy. Employees other than those in a temporary status may qualify for an unpaid Medical Leave of Absence after six (6) months of employment with the appropriate medical documentation. 
• If the employee is not eligible for a Family Medical Leave of Absence and the employee has been off work for more than seven (7) calendar days, the employee may apply for a Medical Leave of Absence with the start date of the leave being the eighth day off. The employee must request a Medical Leave of Absence through the Leave of Absence Administrator (Leave Administrator) to seek approval for a Medical Leave of Absence. 
• Approved leaves of absence will be documented in the Resident Development Plan (including duration of leave and extension date of residency).

Professional Meetings and Travel

CoxHealth supports resident participation in professional and educational meetings as an essential component of residency training, professional development, and dissemination of scholarly work. Funding provided by the program is intended to facilitate active engagement in meetings that advance the resident’s learning and contribution to the profession.

When financial support is provided, it will typically include registration, travel, and lodging expenses, in alignment with institutional policies and budgetary allowances.

Residents receiving financial support are expected to represent CoxHealth and the Pharmacy Residency Program(s) in a professional and meaningful manner (e.g., poster presentation, platform presentation, recruitment efforts, panel participation, or submission of an abstract).

Failure to meet the expectations outlined below or to appropriately represent the organization may result in denial of reimbursement or a requirement to repay associated expenses in accordance with institutional policy.

Expectations of the Resident

• Residents are expected to actively participate in scheduled meeting programming, averaging a minimum of 6 hours of educational or professional engagement per full (non-travel) day (e.g., keynote sessions, residency showcase, poster sessions, networking events, or sponsored programs).
  • Documentation of participation (e.g., CE records, attendance logs, or equivalent) must be submitted to the Chief Resident or RPD within 30 days of return.
  • Residents are expected to attend all required meetings, showcases, and assigned sessions as communicated prior to departure.
  • Within 30 days of return, residents are expected to share key learnings with the department (e.g., presentation, written summary, or educational session) to support dissemination of knowledge.
  • Residents must adhere to the CoxHealth Code of Business Conduct and Ethics and demonstrate professionalism consistent with the expectations of the residency program and the pharmacy profession.

Conference Attendance Expectations

• PGY1 Residents are expected to attend the ASHP Midyear Clinical Meeting.
  • PGY1 and PGY2 Residents are expected to attend the Midwest Pharmacy Residents Conference.
  • PGY2 Residents may attend an additional professional conference aligned with their specialty area, with approval from the RPD.

Mileage Reimbursement

Mileage and fuel incurred for travel between CoxHealth facilities or clinics is not eligible for reimbursement.

Duty Hours and Moonlighting (Standard 2.3)

All CoxHealth pharmacy residency programs comply with the ASHP Duty-Hour Requirements for Pharmacy Residencies Duty Hours | ASHP Duty Hours Policy Link  

Duty hours: Defined as all hours spent on scheduled clinical and academic activities, regardless of setting, related to the pharmacy residency program that are required to meet the educational goals and objectives of the program.

• Duty hours includes: inpatient and outpatient patient care (resident providing care within a facility, a patient’s home, or from the resident’s home when activities are assigned to be completed virtually); staffing/service commitment; in-house call; administrative duties; work from home activities (i.e., taking calls from home and utilizing electronic health record related to at-home call program); and scheduled and assigned activities, such as committee meetings, classroom time associated with a master’s degree for applicable programs or other required teaching activities and health and wellness events that are required to meet the goals and objectives of the residency program.
• Duty hours exclude reading, studying, and academic preparation time (e.g. presentations, journal clubs, closing knowledge gaps); travel time (e.g., to and from work); and hours that are not scheduled by the residency program director or a preceptor.
• Duty Hour Requirements
  • Duty hours limited to no more than 80 hours per week, averaged over a four-week period, inclusive of internal and external moonlighting. 
  • Residents will have a minimum of one day in seven days free of duty (when averaged over four weeks). 
  • Residents will have at a minimum of 8 hours between scheduled duty periods. 
  • Residents will not have continuous duty extending 16 hours.
  • Residency programs will not have “on call” services.
• Compliance and Violation of Duty Hours
  • Duty Hours will be reviewed monthly in PharmAcademic by RPD. 
  • If residents exceed duty hours RPD will assign comp day and adjust hours spent on rotation to not exceed duty hours with preceptor.  
  • If preceptor continues to require non-compliant hours a PIP will be initiated with RPD/Supervisor. 

Moonlighting is defined as any voluntary, compensated, work performed outside the organization (external), or within the organization where the resident is in training (internal). These are compensated hours beyond the resident’s salary and are not part of the scheduled duty periods of the residency program.

CoxHealth allows both internal and external moonlighting as long as hours remain within the acceptable duty hours limits and do not exceed 20 hours per 2 week pay period, and do not affect residents’ judgment while on scheduled duty periods or impact their ability to achieve the educational goals and objectives of their residency program and provide safe patient care. 

• Residents moonlighting internally shall be compensated at a pharmacist’s base hourly pay rate. 
  • All moonlighting hours must be approved at least one week in advance by RPD to ensure that Duty Hours remain within policy. 
  • All moonlighting hours will be logged in the development plan.  
  • If moonlighting hours place the resident above duty hours a verbal warning will be given. 
  • If moonlighting hours place resident above duty hours a second time or if moonlighting affects clinical decision making and judgement, the availability of moonlighting will be removed and assessed quarterly on the development plan for re-instatement.  

Requirements for Licensure (Standard 2.4)

All CoxHealth pharmacy residency programs require licensure within 90 days of documented residency start date. 

• Failure to obtain licensure will result in dismissal from the program.

  • Two failed attempts of the same examination will result in dismissal from the program.
  • Must obtain Medication Therapy Services Certification through the Missouri Board of Pharmacy within 90 days of the start date. 
  • Immunization certification is preferred but not required.
  • Must obtain Missouri Pharmacist, Missouri Intern or Missouri Technician license prior to day 1 of residency to be allowed on the premises. 
  • PGY2 Residents must have successful completion of an ASHP accredited PGY1 Pharmacy Residency, Candidate Status Residency, or Residency Exemption granted by ASHP prior to day 1 of PGY2 Residency start date. 

   

Requirements for Program Completion (Standard 2.5)

PGY1 Springfield – See Program Specific Appendix A
PGY1 Branson – See Program Specific Appendix B
PGY2 Ambulatory Care – See Program Specific Appendix C
PGY2 Critical Care - See Program Specific Appendix D

Residency Specific Remediation and Disciplinary Process (Standard 2.6,2.7)

The Residency Program Director (RPD), Residency Executive Committee (REC), and preceptors will follow a corrective action process based on verbal and written corrective action counseling when one or more serious deficiencies in a resident's performance is noted. The corrective action process will be used when addressing areas of resident performance and/or behavior requiring improvement or elimination. 

It is intended to initiate action that will assist the resident in correcting problems and improving performance and behavior. Failure to improve performance as addressed by the corrective action process within the specified time frame(s) will result in the resident not receiving a certificate of successful completion and may result in involuntary dismissal. However certain behaviors or actions will be considered immediate grounds for dismissal and the corrective action process will not apply. Corrective action process procedures and grounds for dismissal are outlined below.

Corrective action may be imposed if the resident fails to meet their obligations and responsibilities inherent to successful completion of the residency-training period. This includes, but is not limited to, progress toward achievement of learning experience objectives, completing assignments and meeting deadlines, progress towards completion of the residency project, completion of the program's requirements and deliverables as outlined in the completion requirements policy, and completion and submission of all program evaluation materials. Corrective action process may also be imposed if the resident acts in a manner contrary to the professional obligations (e.g., unprofessional behavior, plagiarism) and responsibilities of a pharmacist.

Procedure: The RPD will conduct a thorough investigation, including meeting with the resident to investigate the concern and offer the resident an opportunity to provide information relevant to the identified deficiencies. The following are examples of concerns, performance, or actions that may prompt an investigation to determine the need for corrective action (this list is not comprehensive):

1. Failure to make progress towards achievement of an educational objective in more than one learning experience. 
2. Failure to meet required deadlines.
3. Failure to complete assigned work.

Following an investigation, the RPD, in conjunction with the REC will review the results of the investigation to determine the need to impose corrective action. The RPD shall inform the Resident of the results of the review regardless of the final decision. In addition, the RPD will contact Human Resource (HR) personnel, as appropriate.

When the RPD, in conjunction with the REC, determines that corrective action is necessary, corrective action will begin with verbal counseling followed by, if necessary, a written corrective action plan.

1. Verbal Counseling will include a discussion of the issues identified. The Resident will also be provided with suggestions for improvement, progression expectations, and the expected timeline for meeting progression expectations or issue resolution that is no longer than four weeks. The Resident will also be notified that the Verbal Counseling discussion will be documented in the resident’s personnel file. The RPD and Resident’s preceptors will closely monitor the resident’s performance to determine if expectations for progression/issue resolution are being met.
2.  A Corrective Action Plan will be initiated if the RPD and Residency Advisory Committee determine the Resident has not met progression expectations or corrected identified issues by the end of the expected timeline. The purpose of the Corrective Action Plan is to document specific, measurable, achievable, repeatable and time bound (SMART) goals for a pharmacy resident who has failed to correct identified issues and/or displays behavior that is not conducive to achieving the predetermined objectives of the residency program. Corrective Action Plans will include the following components:
   1. Description of the issues that must be corrected.
   2. Timeline that does not exceed four weeks.
   3. Criteria for successful resolution of the corrective action plan.
   4. Date and signatures of the resident and RPD.
3. Within five working days of the agreed upon timeframe for evaluation, the RPD and REC will assess the performance of the resident relative to the plan and discuss the updated performance with the resident.
   1. If the resident was able to successfully complete the corrective action plan, no further action is necessary.
   2. If the resident is making progress but has not achieved all criteria for successful resolution: The RPD/RAC, may provisionally extend the Corrective Action Timeline, up to four weeks if, based on their assessment, the resident can successfully complete the plan in this time frame. Progression and duration of the extension will be documented in the Corrective Action Plan with a copy provided to the resident. At the end of any extension, the resident will be dismissed from the residency program and will not receive a certificate of completion if all criteria for resolution have not been met.
   3. If the resident was NOT able to successfully complete the corrective action plan, the resident will be dismissed from the residency program and employment terminated.

Dismissal:  Grounds for immediate dismissal from the residency program include but are not limited to:

1. Failure to obtain pharmacist licensure within 90 days of the residency start date.
2. For PGY2 residents, failure to provide their PGY1 certificate of completion within 30 days from the residency start date.
3. Knowingly or negligently placing a patient, employee or any other person in danger.
4. Falsifying information on a document.
5. Committing plagiarism as determined by the REC after review of the materials suspected of plagiarism.

CoxHealth Pharmacy Residency Programs abide by the CoxHealth Corporate Policy for Counseling and Disciplinary Practices 

https://coxhealth.policymedical.net/policymed/anonymous/docViewer?stoken=1dce6a6a-08c6-49c2-86e2-6495a891fb24&dtoken=43863582-e273-4f57-b4bb-77bc4e436547  

CoxHealth Employee Expectations 

It is the responsibility of all employees to conform to CoxHealth’s policies and standards of conduct, performance, and attendance and to meet all duties as defined below: 

Duty to Follow a Procedural Rule: The duty of the employee to perform their assigned job in a responsible manner avoiding at-risk behavior. At-risk behavior is a behavioral choice that increases risk where risk is not recognized or is mistakenly believed to be justified; and to comply with CoxHealth standards, such as, but not limited to, the Code of Conduct, Dress Code, Time and Attendance.

Duty to Avoid Causing Unjustifiable Risk or Harm: The duty of the employee to avoid causing risk or harm to himself, to fellow employees, customers, visitors and to the organization by demonstrating reckless behavior. Reckless behavior is a conscious disregard or substantial and unjustifiable risk. 

If an employee’s misconduct or reckless behavior may be a violation of criminal law, the Human Resources Department will seek an opinion from in-house legal counsel about reporting the violation to law enforcement officials and act accordingly. 

CoxHealth Conditions for Dismissal 

• Failure to attain licensure as outlined in the Eligibility Requirements 
• Failure to uphold the expectations as outlined in the Pharmacy Resident I and/or Pharmacy Resident II Job Descriptions 
• An employee has incurred at least eight periods of absence and has been counseled through all steps of the progressive disciplinary process within the preceding twelve months, according to the Absence/Tardiness Policy (F4) (Discipline during the preceding 24 months may also be considered where the employee has a chronic absence pattern resulting in repetitive discipline short of discharge) 
• An employee has incurred at least seven periods of tardiness and has been counseled through all steps of the progressive disciplinary process within the preceding three months, according to the Absence/Tardiness Policy 
• An employee commits an offense that is so serious that progression through the formal levels of progressive discipline is not warranted. 
• Failure to self-report any arrests and/or convictions of any of the crimes
• Theft including diversion of drugs from the hospital or patients 
• Fighting or threatening physical assault on hospital property 
• Willful destruction of hospital property or property of others 
• Careless job performance 
• Insubordination (refusal to carry out reasonable instructions) 
• Clocking-in or out another employee 
• Falsification of reason for absence 
• Falsification of business records. Falsification of time records, which includes the excessive use of internet and or email privileges for personal use 
• Conviction of a felony or receiving a court sentence in lieu of trial as a result of a nolo contendere (no contest) or Alford plea 
• Harassment of other individuals 
• Violation of the Drug and Alcohol in the Workplace Policy (F2). Violation of moral conduct or ethics 
• Reckless behavior or disregard for the safety of self, others, or property in the course of employment 
• Carrying concealed weapons 
• Leaving prescribed work area without permission 
• Sleeping on the job 
• A shift of unreported absence (No Call – No Show) 
• Conduct detrimental to hospital image, including but not limited to conduct in violation of CoxHealth values while serving as a volunteer or representing CoxHealth at health system or community events 
• Discourtesy to patients or others 
• Disruptive behavior 
• Submits or causes to be submitted a false worker’s compensation claim or otherwise fails to abide by CoxHealth’s Worker’s Compensation standard 
• Submits or causes to be submitted a false harassment claim 
• Submits or causes to be submitted a false claim under any other CoxHealth policy 
• Previous steps in the disciplinary process have not corrected the inappropriate behaviors or conduct 
• Violation of CoxHealth Information Management policies 
• Unauthorized release of documents, whether electronic or written, restricted by CoxHealth for internal use only to unaffiliated outside organizations or individuals. 
• Becoming excluded from participation in government programs 
• Use of social or electronic media, regardless of where messages are sent or received, that results in false, malicious, or disparaging comments regarding persons associated with CoxHealth 
• Misuse of CoxHealth property, including hardware, software, photos/images or representing CoxHealth in any manner if not authorized to do so 
• Use of health system equipment, supplies, facilities, or paid time to provide or receive care outside the normal care delivery system and business operations of CoxHealth 

Standard 3: Structure, Design, and Conduct of the Residency Program

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Required, Longitudinal and Elective Experiences (Standard 3.1)

PGY1 Springfield – See Program Specific Appendix A
PGY1 Branson – See Program Specific Appendix B
PGY2 Ambulatory Care - See Program Specific Appendix C

Staffing Component (Standard 3.1)

Weekend and Holiday Staffing 

PGY1 Springfield – See Program Specific Appendix A
PGY1 Branson – See Program Specific Appendix B
PGY2 Ambulatory Care - See Program Specific Appendix C

Staffing Outside of Program Requirements / Pulling Residents Off Scheduled Learning Experiences 

• The CoxHealth Pharmacy Leadership Team is committed to honoring the ASHP Standard 3: Design and Conduct of the Residency Program, noting the importance that residents’ training enables them to achieve the purpose, goals, and objectives of their residency programs. However, during the residency year, there may be times in which the CoxHealth Pharmacy Leadership Team asks to remove a resident from a learning experience for an enhanced educational opportunity (i.e., participation in a DNV survey, pharmacy inventory, ASHP Visiting Leader, etc.), or to assist in times of crisis/disaster. 
• To honor this commitment to ASHP Standard 3, the CoxHealth Pharmacy Leadership Team will not remove a resident from a learning experience without prior discussion with and approval from the RPD.  

Competency Areas, Educational Goals, and Objectives (CAGO) (Standard 3.1)

CoxHealth residency program goals and objectives align with the residency purpose and meet the Competency Areas, Goals, and Objectives (CAGO) required by the American Society of Health-System Pharmacists Accreditation Standards.

Competency Areas represent categories of resident capabilities and include

Required (R1–R4) must achieve 100% of R1 goal and 90% average of all objectives
R1: Patient Care
R2: Advancing Practice and Improving Patient Care
R3: Leadership and Management
R4: Teaching, Education, and Dissemination of Knowledge

Educational Goals describe broad abilities

Educational Objectives are measurable outcomes of participation.
Criteria provide examples to assess performance and identify areas for improvement.

Program-specific CAGOs

• PGY1: ASHP Required Competency Areas
• PGY2 Ambulatory Care: ASHP Ambulatory Care CAGO

• PGY2 Critical Care: ASHP Critical Care CAGO

   

Resident Development Plan, Completion Checklist, and Deliverables (Standard 3.3)

Purpose
The Quarterly Resident Development Plan (RDP) is designed to support your growth throughout the residency year. It brings together feedback, self-reflection, and program expectations to help you recognize your strengths, identify opportunities for development, and create meaningful goals. The RDP serves as a guide to keep you on track, support your success, and ensure you are progressing toward completion of all residency requirements.

Resident Responsibilities
Residents are encouraged to actively engage in the RDP process by:

• Completing a thoughtful self-assessment, reflecting on strengths, areas for growth, and progress toward goals and objectives.
• Reviewing prior evaluations and considering trends in feedback. 
• Collaborating with the RPD and preceptors to develop and refine individualized goals and action plans. 
• Following through on agreed-upon action items and timelines. 
• Monitoring progress and communicating any barriers or support needs in a timely manner. 
• Keeping residency deliverables and completion checklists up to date on a quarterly basis. 
• Ensuring all RDP updates and required components are completed accurately and on time. 
• Using the RDP as a living document to guide your ongoing professional and personal development.

Evaluations and Scoring (Standard 3.4)

Evaluation Procedures

Resident progress toward required goals and objectives is assessed and documented in PharmAcademic.

Initial Assessment

• Residents complete the ASHP Entering Interests Form prior to meeting with the RPD.
• The RPD assesses baseline knowledge and skills.
• Results are documented in the Resident Development Plan by the end of orientation and used to guide learning experiences and program planning.

Formative Assessment

• Preceptors provide ongoing, timely, specific, and constructive feedback.
• Learning activities are adjusted based on continuous observation and assessment.

Summative Evaluation

• At the end of each learning experience, residents receive verbal and written evaluations. 
• For experiences ≥12 weeks, evaluations occur at least every 3 months.
• All preceptors contribute when multiple are assigned.
• Residents evaluate both preceptors and learning experiences.

Evaluation Scale and Expectations

• Evaluation sessions should include the resident, current preceptor, and (when applicable) the next preceptor to promote continuity. 
• All evaluations are accessible in PharmAcademic, and preceptors are expected to review prior evaluations.

Scoring Guidance

• Needs Improvement (NI): Requires frequent guidance for basic and complex tasks.
• Satisfactory Progress (SP): Independent with routine tasks; limited guidance for complex tasks.
• Achieved (ACH): Independent and efficient with both routine and most complex tasks.
• Achieved for Residency (ACHR): Sustained independent performance across settings and patient populations.

ACHR Determination

Assigned by the RPD when:

• Objective is marked ACH, or
• Resident has ≥2 SP evaluations with no unresolved NI, positive feedback, and no actionable concerns.

Assessment of Progress

• Progress is reviewed quarterly by the RPD, Residency Advisory Committee (RAC), and preceptors.
• Feedback includes specific examples and actionable steps to ensure completion of all program requirements.

Evaluation Timeliness

• Evaluations should be completed within 7 days of the due date.
• The RPD/designee monitors completion monthly.
• Repeated delays may result in disciplinary action per CoxHealth policy.

Professionalism Expectations 

• Code of Conduct: Residents are expected to always uphold the CoxHealth Compliance Code of Business Conduct and Ethics (i.e., “Code of Conduct”). 
• Dress Code: All residents are expected to dress in appropriate professional attire as outlined in the CoxHealth Dress Code policy, or as mandated by learning experience preceptor. 
• Name Badges: All personnel must wear their badge while on campus. If misplaced, a temporary badge may be obtained at the Security Office. Badges may be replaced at a fee. 
• Cell Phones: While it is recognized that smart phones may be used for clinical information purposes (i.e., Lexicomp, UpToDate, email), residents should refrain from using cell phones in patient care areas per department policy. Excessive use of cell phones, especially for non-work-related activities, will result in disciplinary action. Extenuating circumstances should be discussed with the learning experience preceptor. 

Standard 4: Requirements of the Residency Program Director and Preceptors

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Residency Program Director Definitions (Standard 4.1)

Each Residency has a single residency program director (RPD) who serves as the organizationally authorized leader of the residency program. 

The RPD may delegate, with oversight, administrative duties for the conduct of the residency program to one or more individuals. 

Residency Program Director Eligibility (Standard 4.2)

PGY1 RPDs are licensed pharmacists from the practice site who:

• Completed an ASHP-accredited PGY1 residency and a minimum of three years of relevant pharmacy practice experience;

         or 

• Completed ASHP-accredited PGY1 and PGY2 residencies and a minimum of one year of relevant pharmacy practice experience;

         or 

• Has a minimum of five years of relevant pharmacy practice experience if they have not completed an ASHP-accredited residency.

PGY2 RPDs are licensed pharmacists from the practice site who: 

• Completed an ASHP-accredited PGY2 residency in the advanced practice area, and a minimum of three years of additional practice experience in the PGY2 advanced practice area; 

  or 

• Has a minimum of five years of experience in the advanced practice area if they have not completed an ASHP-accredited PGY2 residency in the advanced practice area. 

   

Residency Program Director Practice and Professionalism (Standard 4.3)

RPDs serve as role models for pharmacy practice and professionalism as 

evidenced by:

• Models and creates an environment that promotes outstanding professionalism. 
• Maintaining BPS certification in the specialty area when certification is offered in that specific advanced area of practice (PGY2 RPDs only).
• Contribution to pharmacy practice. For PGY2 RPD’s, this must be demonstrated relative to the RPD’s PGY2 practice area.
• Ongoing participation in drug policy or other committees/workgroups of the organization or enterprise.
• Maintaining regular responsibilities in the advanced practice area in which they serve as RPDs (PGY2 RPDs only). 
•  

Residency Program Leadership and Oversight (Standard 4.4)

The RPD must establish and chair a residency advisory committee (RAC) specific to that program and represent them on the Residency Executive Committee (REC). 

Oversight of the residency program is accomplished by a combination of committees including a REC and RAC 

• Residency Advisory Committee (RAC)
  • Committee membership includes RPD(s), preceptors, and pharmacy leaders. 
    • Ongoing program assessment will include: 
      • Discussion of program improvement opportunities.
      • Discussion of applicant selection process outcomes.
      • Review of learning experiences.
      • Review of residents’ evaluations of preceptors and learning experiences.
  • Residency Executive Committee (REC)
    • Committee membership includes residency program directors for all CoxHealth residency programs, residency coordinators, and a member of the steering committee.
    • Ongoing assessment includes:
      • Recruitment and selection of residents.
      • Update and maintain all residency-related documents across the system 
      • Identify program improvement opportunities for all programs across the system. 
      • Review, appoint, and reappoint preceptors across all programs. 
      • Provide preceptor development opportunities and resources. 

      • Ensure all ASHP Standards are met.

         

Residency Program Preceptor Appointment and Reappointment (Standard 4.4)

Appointment and Reappointment

The Residency Executive Committee will review all submitted ASHP Academic and Professional Records (APR) Bi-annually, and grant preceptor or development plan status based on ASHP eligibility criteria and expectations, as outlined below. Preceptors and/or preceptors on development plans appointed or reappointed will be documented in the REC meeting minutes. For all preceptors not meeting ASHP eligibility criteria and expectations, a Preceptor Development Plan (PDP) will be created and submitted. 

 Initial Preceptor Assessment

Initial assessment for potential preceptors shall include an interview with the Residency Program Director (RPD) to discuss preceptor eligibility criteria and expectations as outlined by the American Society of Health-System Pharmacists (ASHP) Standards.

• Preceptor candidates must review the following:
  • ASHP Standards for the residency program in which the preceptor will be precepting.
    • ASHP competency areas, goals, and objectives of the residency program in which the preceptor will be precepting.
  • Preceptor candidates must submit the following to the RPD for review and to the Residency Executive Committee (REC) for a vote:
    • ASHP preceptor Academic and Professional Record (APR).

Ongoing Preceptor Assessment

• Preceptors will complete and submit an updated APR every two years to the program RPD and/or designee split between two groups.
• The RPD and/or designee will review submitted preceptor APR, resident-submitted ASHP Preceptor Evaluations, ASHP Learning Experience Evaluations, verbal feedback, and a resident-submitted CoxHealth Program Evaluation annually in the spring, which will be used to provide preceptors with ongoing assessment of performance.
• Preceptor self-assessment.
• At the end of each learning experience, the preceptor is encouraged to self-assess precepting and the learning experience, using questions similar to the ASHP Preceptor Evaluation, to prompt self-reflection.

  • Preceptors will complete a self-evaluation of preceptor performance and their learning experience, as part of the annual CoxHealth Preceptor Needs Assessment.

     

Preceptor Development (Standard 4.4)

It is an expectation that all preceptors are actively engaged in meeting and maintaining ASHP Preceptor Qualifications.

A preceptor development plan (PDP) will be created among the preceptor, RPD and/or designee/Pharmacy Administration, for the following: 

• Preceptors who do not meet the minimum ASHP preceptor qualifications and/or completion of ongoing preceptor development criteria. 
  • Preceptors can refer to Preceptor Development Resources documents for contribution/experience ideas to meet minimum criteria.
• Preceptors who receive a score of NEVER or FALSE from a resident on an ASHP Preceptor and/or Learning Experience Evaluation Form.

PDPs must include met vs unmet preceptor qualifications, preceptor barriers, action items, and follow-up timeline; and will be reviewed/updated annually by the preceptor, RPD, and/or designee. 

If it is felt the preceptor has not made sufficient effort toward meeting ASHP Preceptor Qualifications by the RPD and/or designee, the issue will be brought before the REC. Preceptor status may be suspended with majority vote by the REC.

• Suspended preceptors may resubmit preceptor status after one year and evidence of improvement/meeting ASHP Preceptor Qualifications.
• The decision to reinstate a suspended preceptor must be passed by both the RPD and majority vote by the REC.

Residency preceptors are expected to actively participate in the residency program to support resident development and program engagement. Preceptors must participate in at least four (4) of the following activities during each residency year:

• Didactic sessions
• Fire Drill Journal Clubs
• Formal presentations (e.g., journal clubs, patient case presentations, or grand rounds) with completed evaluations
• Candidate interviews (may only be counted once per residency year)
• First Friday Topic Discussions
• Monday Morning Leadership sessions
• End of Year Residency Banquet
• Resident social events organized by the RPD, RPC, or residents

Participation will be tracked through a yearly attestation, which preceptors must complete to confirm fulfillment of this requirement.

Residency Program Preceptor Eligibility (Standard 4.5)

PGY1 Preceptors must be licensed pharmacists who

• Have completed an ASHP-accredited PGY1 residency program followed by a minimum of one year of pharmacy practice experience in the area precepted;

  or

• Have completed an ASHP-accredited PGY1 residency program followed by an ASHP accredited PGY2 residency and a minimum of six months of pharmacy practice experience in the area precepted;

  or 

• Have three or more years of pharmacy practice experience in the area precepted if they have not completed an ASHP-accredited residency program.

PGY2 Preceptors must be licensed pharmacists who 

• Have completed an ASHP-accredited PGY2 residency program followed by a minimum one-year of pharmacy practice experience in the area precepted;

  or

• Have three or more years of pharmacy practice experience in the area precepted if they have not completed an ASHP-accredited PGY2 residency program.

Residency Program Preceptor Qualifications (Standard 4.6,4.7)

Preceptors’ Qualifications: Preceptors must demonstrate the ability to precept residents’ learning experiences as evidenced by 

• Content knowledge/expertise in the area(s) of pharmacy practice precepted.
• Contribution to pharmacy practice in the area precepted.
• Preceptors actively participate in and guide learning when precepting residents.
• Preceptors who do not meet these criteria have a documented individualized preceptor development plan to achieve qualifications within two years.

Residency Program Preceptor Qualifications (Standard 4.8)

The residency program may incorporate non-pharmacist preceptors to provide expertise in specialized areas; however, all such learning experiences will maintain oversight by a qualified pharmacist preceptor who is responsible for ensuring alignment with ASHP PGY1 standards, residency goals and objectives, and the integrity of resident training and evaluation. Non-pharmacist preceptors contribute discipline-specific knowledge and interdisciplinary perspective, while the pharmacist preceptor retains accountability for assessing resident performance. Residents are expected to demonstrate progression toward readiness for independent pharmacy practice, as reflected in the PGY1 Competency Areas, Goals, and Objectives (CAGOs), including:

• R1.1 (Patient Care): Applying clinical judgment to assess patients and develop, implement, and monitor patient-centered care plans. 
• R1.2 (Interprofessional Team): Integrating interdisciplinary input and communicating effectively with the healthcare team. 
• R1.3 (Medication-Use Systems): Assuming accountability for safe and effective medication-use processes. 

Progression is evaluated longitudinally through achievement of these objectives, with final determination of readiness for independent practice made by the pharmacist preceptor.

Standard 5: Pharmacy Services

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Pharmacy Services (Standard 5.0)

CoxHealth is committed to aligning pharmacy services with the expectations outlined in ASHP PGY1 Standard 5 by ensuring that medication-use systems, clinical services, and operational practices are designed, implemented, and continuously improved to support safe, effective, and patient-centered care. Pharmacy services are led by the System Director of Pharmacy and supported by pharmacy leadership, including the Residency Program Director (RPD), Residency Executive Committee, and interdisciplinary stakeholders, to ensure alignment with organizational priorities, regulatory requirements, and evidence-based practice. Through structured policies, standardized workflows, and ongoing evaluation of key performance indicators, CoxHealth ensures that pharmacy services remain responsive to patient care needs while supporting resident learning within a high-functioning practice environment. Continuous feedback, quality improvement initiatives, and collaboration across the health system drive optimization of pharmacy services, ensuring consistency with ASHP standards and readiness for independent pharmacy practice.

Chief Pharmacy Resident

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Chief Pharmacy Resident (Misc.)

The Chief Pharmacy Resident is a PGY2 resident who manages and coordinates activities of all concurrent pharmacy residents, and delegates tasks to other residents as appropriate. The Chief Pharmacy Resident acts as intermediary between the Residency Advisory Committees (RAC), the Residency Executive Committee, and residents; and provides leadership in all areas pertaining to pharmacy residency programs, monitoring the professional and personal well-being of each resident.

• Knowledge, Skills, and Abilities Required
  • Ability to communicate effectively, both orally and in writing.
  • Skill in organizing participation in meetings and visits with other programs.
  • Skill in examining and implementing new strategies and procedures.
  • Ability to exercise leadership skills within the pharmacy department and among peers.
• Application Process
  • A written letter of application (1 page or less) should be addressed and provided to the members of the Residency Executive Committee via the Springfield PGY1 RPD by July 30th of the residency year. This letter should highlight the applicant’s qualifications and cite specific examples of previous leadership. 
  • The Residency Executive Committee will select and appoint one Chief Pharmacy Resident after the interview process is complete.
• Responsibilities
  • Serving as a liaison for residents during RAC meetings (both Springfield and Branson PGY1 RAC, and the Residency Executive Committee).
    • Chief to attend all RAC and Residency Executive Committee meetings, and communicate applicable information to appropriate RPD/committee as necessary.
    • Chief to schedule monthly touchpoint with Springfield PGY1 RPD.
  • Disseminating information of interest to all residents. 
  • Representing residents at departmental and system functions.
  • Providing leadership and motivation to all residents. 
  • Chief to schedule monthly touchpoints with residents 
  • Advising/coaching residents on feedback received as appropriate.
  • Overseeing PGY1-PGY2 mentor/liaison relationships.
  • Organizing and managing all resident travel throughout the year (ensuring hotels, flights and meeting registrations are completed in a timely fashion).
    • Process for registration, flights, and hotel reservations will typically start 2-3 months prior to meeting date(s).
    • Ensure all meeting attendees have shared contact information and a list of expectations (i.e., agenda, required meetings) prior to arrival.
  • Coordinating resident participation in events.
    • Convert all candidate information collected at recruitment events to an Excel that can be shared with all RPDs.
    • Coordinate with RPDs/preceptors/residents a schedule for who needs to be present in the booth at what time (i.e., resident booth rotation).
    • Ensure all posters and recruitment materials make it to scheduled events and back.
  • Assisting RPDs with interview date planning/set-up.
  • Chairing the Preceptor of the Year Award Committee.
  • Coordinating end of the year events with Springfield PGY1 RPD in April.
  • Assisting with any other residency related tasks as delegated by the RPD(s).
• Succession
  • If the Chief Pharmacy Resident is deemed unable to complete their responsibilities, the Residency Executive Committee will appoint an alternative Chief Pharmacy Resident.
• Relationships
  • Directly Reports to: PGY1 Pharmacy RPDs (Springfield and Branson).
  • Indirectly Reports to: PGY2 Pharmacy RPDs, Program Preceptors.
  • Supervises: PGY1 and PGY2 Pharmacy Residents.

Appendix A: PGY1 Pharmacy Residency - Springfield

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ASHP-Accredited since 1995
ASHP Program Code: 64015
National Matching Service Code: 171913

Scope

CoxHealth is the region’s only locally owned, not-for-profit health system, serving a population of over 1 million.  Our 6-hospital organization has facilities in Springfield, Branson, Monett, and Lamar, and more than 80 physician clinics in the region.

The CoxHealth PGY1 Pharmacy Residency – Springfield Campus learning experiences are primarily located at Cox Medical Center South, which is a 706-bed Level 1 Trauma, Level 1 Stroke Center, and Level 1 STEMI, Level III NICU center in Springfield, Missouri.  Additional learning experiences are available at Cox North, Meyer Orthopedic and Rehabilitation Hospital, University of Missouri-Kansas City at Missouri State University, and within our various primary care clinics in Springfield.

Please refer to the CoxHealth ‘About Us’ page - https://www.coxhealth.com/about-us/ for additional information and specific facts regarding our facilities.

Residency Overview

Please refer to the CoxHealth Pharmacy Residencies Manual

 Program Description

PGY1 residency programs build upon Doctor of Pharmacy (PharmD) education and outcomes to develop pharmacist practitioners with knowledge, skills, and abilities as defined in the educational competency areas, goals, and objectives. Residents who successfully complete PGY1 residency programs will be skilled in diverse patient care, practice management, leadership, and education, and be prepared to provide patient care, seek board certification in pharmacotherapy (i.e., BCPS), and pursue advanced education and training opportunities including postgraduate year two (PGY2) residencies.

In addition to the ASHP PGY1 Program Purpose, further emphasis is placed on preceptor development; interdepartmental collaboration; enhancement of leadership and project management skills; and the provision of medication education.

Number of Residency Positions Available: 4

Duration of Appointment: 55-week appointment (second Monday in June to last Friday the following June)

Salary: - $50,128 annually (52 weeks)

 Staffing Requirements

• Residents will staff 2 x 10 hour shifts every 4th weekend in Internal Medicine, and 1 x 4 hr evening shift in Central Pharmacy weekly with rotating responsibilities.  Residents will be allowed one compensatory (comp) day off around weekends worked. Compensatory time off shall be used the Friday before or the Monday after the worked weekend. 
• Code Blue coverage day of evening shift from arrival to end of evening shift.
• No required holidays. However, if a required weekend or evening shift falls on a holiday, the resident is responsible for covering that shift and will be paid holiday pay at pharmacist rates.  Must take PTO for any non-worked holidays.

Program Structure

Note:  All learning experience durations may be modified at the discretion of the Residency Program Director to best meet the needs of the individual resident.  Any changes from the typical duration will be documented in the quarterly Resident Development Plan. 

Certificate Program 
A teaching certificate program through the University of Missouri-Kansas City is available and encouraged for all residents, but is not a requirement of the residency. A certification will be required for completion, the resident may choose a certificate in lieu of the teaching certificate (e.g. medication safety, pharmacokinetics, Investigation drug services, non-malignant hematology, research, diversity equity and inclusion etc.).  The first $250 of cost will be covered by the residency program (full cost for teaching certification).

Residency Program Director
Brooke Bitner, PharmD, BCPS, BCEMP
Cox Medical Center South
3801 S. National Ave
Springfield, MO 65807
Brooke.Bitner@coxhealth.com
620-249-8383

Appendix B: PGY1 Pharmacy Residency - Branson

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ASHP-Accredited since 2018 
ASHP Program Code:  64039
National Matching Service Code: 256813

Scope

CoxHealth is the region’s only locally owned, not-for-profit health system, serving a population of over 1 million.  Our 6-hospital organization has facilities in Springfield, Branson, Monett, and Lamar, and more than 80 physician clinics in the region.

The PGY1 Pharmacy Residency – Cox Medical Center Branson learning experiences are primarily located at Cox Medical Center Branson, a full-service hospital caring for residents and visitors to Stone and Taney Counties; and Cox Monett Hospital, a full-service Level 4 stroke and STEMI center.

Please refer to the CoxHealth ‘About Us’ page - https://www.coxhealth.com/about-us/ for additional information and specific facts regarding our facilities.

Residency Overview

Please refer to the CoxHealth Pharmacy Residencies Manual

Program Description

PGY1 residency programs build upon Doctor of Pharmacy (PharmD) education and outcomes to develop pharmacist practitioners with knowledge, skills, and abilities as defined in the educational competency areas, goals, and objectives. Residents  who successfully complete PGY1 residency programs will be skilled in diverse patient care,  practice management, leadership, and education, and be prepared to provide patient care, seek board certification in pharmacotherapy (i.e., BCPS), and pursue advanced  education and training opportunities including postgraduate year two (PGY2) residencies.

In addition to the ASHP PGY1 Program Purpose, this program provides residents the opportunity to advance the practice of rural pharmacy and become proficient in rapid response situations.

Number of Residency Positions Available: 2
Duration of Appointment: 55-week appointment (second Monday in June to last Friday the following June)
Salary: $50,128 annually

 Staffing Requirements 

• Residents will staff 2 x 8 hour shifts every third weekend.      Shifts will primarily occur in central pharmacy. 
• Residents will staff 1 x 4 hour evening shift one day a week.      Shifts will primarily occur in central pharmacy. 
• Residents will not be required to work any holiday shifts. 

Training Experiences

Resident Emergency Response

Residents will attend codes, level I strokes, and rapid responses throughout the hospital while on duty. The residents must obtain BLS, ACLS, and attend “Code Blue for Pharmacists” prior to attending codes. For level one stroke response, residents should complete the credentialing process for pharmacists and demonstrate knowledge of the thrombolytic procedures and the anticoagulation reversal protocol. 

Code Blue/Rapid Response

Residents will attend all codes and rapid responses for patients that are on their service during normal rotation hours. At least one resident should respond for patients who are not on either resident’s service. The resident will initially serve as a back-up pharmacist, then assume lead-pharmacist responsibilities once competencies are met*. A preceptor will serve as a back-up pharmacist on codes until the resident has shown complete independence in managing codes. During emergency medicine learning experiences, the resident will respond with the Emergency Medicine Pharmacist to all rapid responses and code blues throughout the house from 3:30 to 9:30 PM Monday through Friday. 

Code Stroke

Residents will respond to all level 1 strokes between the hours of 8:00 AM and 1:00 PM Monday through Friday that the resident is on rotation. The resident will be responsible for assessing the patients for inclusion/exclusion criteria, going with the patient to CT, assessing the home medication list, and dosing/mixing thrombolytics in coordination with the medical team. If a bleed is identified on CT, the resident should coordinate with the physicians and central pharmacy for urgent reversal if indicated. The resident should remain with the patient until a decision is made about whether or not to treat. 

Weekend response*

On weekends, the resident staffing will be responsible for attending all codes, rapid responses, and level 1 strokes throughout the hospital for the 8 hours the resident is staffing. In addition, the resident should report to the emergency department upon request to assist with critical patients.

Debriefing

Residents should participate in team debriefing sessions following each code, if one is offered, in order to improve team performance. In addition, the resident should review each patient case with the attending pharmacist for the current rotation if applicable, or the Critical Care or Emergency Medicine Pharmacist. Residents should be prepared to discuss what went well during the code and areas for improvement.

*Residents must demonstrate competence prior to any independent response. This may include discussions with the Emergency Medicine Pharmacist, Critical Care Pharmacist, the Clinical Coordinator, and completion of the Emergency Medicine I and/or Critical Care I learning experience. Final determination of competence will be made by the Critical Care or Emergency Medicine Pharmacist. 

Program Structure

Note: All learning experience durations may be modified at the discretion of the Residency Program Director to best meet the needs of the individual resident.  Any changes from the typical duration will be documented in the quarterly Resident Development Plan.  No more than 1/3rd of the residency direct patient care learning experiences can occur in a specific disease state or patient population.

Teaching Certificate Program 

A teaching certificate program through the University of Missouri-Kansas City is available and encouraged for all residents, but is not a requirement of the residency.  Cost will be covered by the residency program should a resident choose to enroll.    

Residency Program Director
Evan Roberts, PharmD
Cox Medical Center Branson
525 Branson Landing Blvd.
Branson, MO 65616
Evan.Roberts@coxhealth.com
417-335-7290

Appendix C: PGY2 Ambulatory Care Pharmacy Residency

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Accredited since 2012
ASHP Program Code: 64015
National Matching Service Code: 665065

Scope

CoxHealth is the region’s only locally owned, not-for-profit health system, serving a population of over 1 million. Our 6-hospital organization has facilities in Springfield, Branson, Monett, and Lamar, and more than 80 physician clinics in the region.

The CoxHealth PGY2 Ambulatory Care Pharmacy Residency learning experiences are primarily located in Cox Medical Group clinics in Springfield, Missouri. There are additional learning experiences which take place at the University of Missouri-Kansas City (UMKC) School of Pharmacy at Missouri State University in Springfield, Missouri.

Please refer to the CoxHealth ‘About Us’ page - https://www.coxhealth.com/about-us/ for additional information and specific facts regarding our facilities.

Additional details regarding the residency program can be found at: https://www.coxhealth.com/education/pharmacy-residency/.

Residency Overview

Please refer to the CoxHealth Pharmacy Residencies Manual

Program Description

The mission of the CoxHealth PGY2 Ambulatory Care Residency Program is to cultivate advanced clinical practice skills that develop the resident into a confident and adaptable ambulatory care practitioner. The program provides robust opportunities in leadership, clinical practice site development, and a personalized residency experience tailored to the resident’s professional goals.

Residents will participate in longitudinal primary care experiences across multiple practice sites, each building upon the other to enhance clinical decision-making, patient care ownership, and population health management. These sites offer diverse care environments and patient needs, allowing exposure to a broad spectrum of populations, including family medicine, internal medicine, and settings that serve medically underserved and complex patient populations. Select sites may also provide focused learning opportunities in areas such as geriatrics.

In addition, residents will rotate through specialty clinics and elective experiences to further strengthen management of complex disease states and explore areas of clinical interest, which may include endocrinology, cardiology, transitions of care, and academia.

Number of Residency Positions Available: 1
Duration of Appointment: 52-week appointment 
Salary: $55,848 for a 52-week appointment

Staffing Requirements:

No required holidays, but must take PTO or work on projects for any non-worked holidays (will not get holiday pay for time spent on projects)

Teaching Certificate Program

A teaching certificate program through the University of Missouri-Kansas City is encouraged for all residents who did not receive one during their PGY1 but is not a requirement of the residency. Cost will be covered by the residency program should a resident choose to enroll.

Program Structure:

Note: All learning experience durations and clinic sites may be modified at the discretion of the Residency Program Director to best meet the needs of the individual resident. Any changes from the typical duration or clinic site will be documented in the quarterly Resident Development Plan. The program covers expenses for two meetings per year. One which is required (Midwest Pharmacy Residents Conference) and one of the resident’s choice. 

Residency Program Director
Brian Grace, PharmD, BCACP
CoxHealth at Home – Springfield
2240 W Sunset St
Springfield, MO 65807
Brian.Grace@CoxHealth.com