Memberships

Pharmacy Residencies
Memorial Hermann Texas Medical Center

Residency Rotations and Experience Descriptions

Clinical Rotations

Anticoagulation Clinic: Shital Desai, Pharm.D., BCPS, Kenneth Chong, Pharm.D., Andrea Hall, Pharm.D., BCPS, Brian Gulbis, Pharm.D., BCPS
Cardiology: Andrea Hall, Pharm.D., BCPS, Brian Gulbis, Pharm.D., BCPS
Cardiovascular Surgery: Andrea Hall, Pharm.D., BCPS, Brian Gulbis, Pharm.D., BCPS
General Pediatrics: Chi Peyton, Pharm.D.
General Surgery: Brad Domonoske, Pharm.D., BCPS
Infectious Diseases: Edgar Rios, Pharm.D., BCPS
Internal Medicine: Latosha Mitchell, Pharm.D., BCPS
Liver Transplant: Latosha Mitchell, Pharm.D.
Medical Intensive Care: Christine Whong, Pharm.D.
Neonatal Intensive Care: Christine Domonoske, Pharm.D.
Neuro Trauma Intensive Care: Teresa Allison, Pharm.D., BCPS
Practice Management: Jim Maddock, RPh, MPA , Luisa Portugal RPh
Stroke Service: Teresa Allison, Pharm.D., BCPS
Surgical Critical Care: Brad Domonoske, Pharm.D., BCPS

Longitudinal Experiences

Transitional Care/ Subacute Care: Eileen Tharp, Pharm.D., BCPS, CGP
Burn Unit: Teresa Allison, Pharm.D., BCPS
Journal Club: Teresa Allison, Pharm.D., BCPS, Andrea Hall, Pharm.D., BCPS

Anticoagulation Clinic
Preceptors: Shital Desai, Pharm.D., BCPS, Kenneth Chong, Pharm.D., Andrea C. Hall, Pharm.D., BCPS and Brian Gulbis, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a diverse range of patient disease states and medication-related issues. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

Activities

• Design, evaluate, recommend, implement and monitor patients on anticoagulation therapy.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Evaluate patient's dietary history and habits for potential interactions with anticoagulant therapy.
• Provide timely drug information and medication-use education to the patients.
• Provide organized and concise input into the care of patients.
• Provide warfarin discharge medication teaching prior to the patient's discharge from the hospital.
• Document patient information in the medical record when appropriate and document all interventions in the patient's specific chart.
• Document patient related services in the clinical intervention database.
• Serve as a mentor for the Pharm.D. students as needed.

Burn Unit
Preceptor: Teresa Allison, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a diverse range of critical care disease states and medication-related issues involving the burn patient. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals. The resident will be evaluated on disease states and topics including: fluid resuscitation, physiologic complications experienced by the burn patient, pain management/sedation, impact of burns on drug pharmacokinetics and pharmacodynamics, and general ICU care.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s stay in the Burn Unit.
• Participate in weekly multidisciplinary rounds with the Burn Service.
• Provide organized and concise input into the care of patients on the service.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Provide nutrition support services to all patients on enteral feedings or TPN.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Document written recommendations in the medical record when appropriate.
• Document patient related services in the clinical intervention database.
• Prepare and present educational in-services for the nurses and medical team.
• Be familiar with Advanced Cardiac Life Support Protocols.
• Observe two procedures: skin graft in OR and dressing changes in unit

Cardiology:
Preceptors: Andrea C. Hall, Pharm.D., BCPS and Brian Gulbis, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a number of cardiology disease states and medication-related issues.  The resident is expected to provide detailed evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals. 

The resident will be evaluated on the following disease states: Congestive Heart Failure, CAD/Myocardial infarction, hyperlipidemia, interventional procedures, hypertension, and atrial fibrillation.

The resident will be exposed to essential aspects of cardiac anatomy, cardiac catheterization, echocardiography, and BLS / ACLS protocols.  Additional topics the resident will potentially be exposed to include diabetes mellitus, cardiogenic shock, syncope, intra-aortic balloon pumps, Swan-Ganz catheters, pacemakers, implantable defibrillators, methods of dialysis (including hemodialysis and CVVHDF), sudden cardiac death, hypothermia and general medical/ICU care.

Activities

• The resident will follow assigned patients in the CCU and 3-Cullen from admission until discharge. The resident will present patients to the preceptor on a daily basis.
• Attend daily patient-care rounds with the cardiology team. 
• Provide discharge medication counseling for all patients going home on new anticoagulation therapy.
• Provide timely, accurate and concise drug therapy recommendations, drug information, and medication-use education to physicians, patients, and others members of the healthcare team.
• Monitor appropriate vital signs, laboratory values, test results and cultures.
• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the entire patient’s hospital stay.
• Monitor patients for drug-induced disease states and evaluate each patient for drug interactions
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Utilize appropriate primary, secondary, and tertiary drug information resources to answer all drug information-related questions. The use of Internet search resources (i.e., Google) is not acceptable.
• Lead topic discussions or patient case presentations with the preceptor and any pharmacy students on the previously mentioned disease states.
• Prepare and present at least one additional educational inservice appropriate for the medical staff and/or nursing staff related to a cardiology topic.
• Discuss at least two recent articles from current cardiology literature related to one of the required topics listed above.
• Appropriately document activities in the medical record and MedKeeper database
• Serve as a mentor for pharmacy students as needed.

Cardiovascular Surgery
Preceptors: Andrea C. Hall, Pharm.D., BCPS and Brian Gulbis, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a number of cardiovascular disease states, surgery-related issues, and medication-related issues. The resident is expected to provide detailed evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

The resident will be evaluated on the following primary disease states and surgical interventions: coronary artery disease, CABG surgery, cardiogenic shock, septic shock, valvular heart disease, endocarditis, aortic aneurysms, aortic dissections, carotid artery repair, and heparin-induced thrombocytopenia, as well as general ICU care.

The resident will be exposed to essential aspects of cardiac catheterization, echocardiography, intra-aortic balloon pumps, Swan-Ganz catheters, pacemakers, implantable defibrillators, ventricular assist devices, methods of dialysis (including hemodialysis and CVVHDF), and BLS / ACLS protocols.

Activities

• The resident will follow assigned patients in the CVICU and 4-Cullen from admission until discharge. The resident will present patients to the preceptor on a daily basis.
• Attend daily multidisciplinary patient-care rounds with the CV surgery intensivist team.
• Provide discharge medication counseling for all patients going home on new anticoagulation therapy.
• Provide timely, accurate and concise drug therapy recommendations, drug information, and medication-use education to physicians, patients, and others members of the health care team.
• Monitor appropriate vital signs, laboratory values, test results and cultures.
• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the entire patient’s hospital stay.
• Monitor patients for drug-induced disease states, document adverse drug reactions per hospital standards and evaluate each patient for drug interactions
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Utilize appropriate primary, secondary, and tertiary drug information resources to answer all drug information-related questions. The use of Internet search resources (i.e., Google) is not acceptable.
• Lead topic discussions or patient case presentations with the preceptor and any pharmacy students on the previously mentioned disease states.
• Prepare and present at least one educational in-service appropriate for the medical staff and/or nursing staff related to a cardiovascular surgery topic.
• Present at least two journal club reviews of current CV surgery literature.
• Appropriately document activities in the medical record and MedKeeper database
• Serve as a mentor for pharmacy students as needed.

General Pediatrics
Preceptor: Chi Peyton, Pharm.D.

Rotation Objectives
The resident will be exposed to a diverse range of pediatric patient disease states and medication-related issues. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s hospital stay.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service
• Lead patient case presentations and topic discussions with the preceptor and other pharmacy students.
• Provide discharge medication counseling for the patients/parents on the service.
• Present an in-service to the staff pharmacists and/or nursing staff.
• Document patient related services in the clinical intervention database.
• Serve as a mentor for the Pharm.D. students as needed.

General Surgery
Preceptor: Brad Domonoske, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a diverse range of patient disease states and medication-related issues related specifically to the patient in a surgical ICU. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through daily interactions with physicians and members of a multidisciplinary team, consisting of an attending, fellow, residents, interns and students. Other members of the healthcare team include a respiratory therapist, dietitian, nurses, and social worker.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s hospital stay.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service.
• Provide discharge medication counseling for the patients on the service.
• Document written recommendations in the medical record when appropriate.
• Document patient related services in the clinical intervention database.
• Prepare and present an educational in-service for the nurses, medical team and/or pharmacy staff.
• Serve as a mentor for the Pharm.D. students as needed.

Infectious Diseases
Preceptor: Edgar Rios, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a diverse range of infectious disease-related issues. The resident is expected to provide individualized evaluation of infectious disease (ID) related drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

Activities

• Contribute to the design, evaluation, implementation and monitoring of pharmacotherapy related to infectious disease problems consistently throughout the patient’s hospital stay.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form or the ADR hot line.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service.
• Document patient related services in the clinical intervention database.
• Attend weekly University of Texas ID conference.
• Attend weekly city wide infectious diseases conference.
• Attend daily microbiology rounds with the infectious diseases service.
• Provide in-services as needed to the infectious diseases physicians, fellows, residents and clinical pharmacists.
• Serve as a mentor for the Pharm.D. students as needed.

Internal Medicine
Preceptors: Latosha Mitchell, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a diverse range of patient disease states and medication-related issues. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s hospital stay.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service
• Lead patient case presentations and topic discussions with the preceptor and other pharmacy students.
• Provide discharge medication counseling for the patients on the service.
• Present an in-service to the medical and pharmacy staff and other members of the health care team.
• Document patient related services in the clinical intervention database.
• Document patient information in the medical record when appropriate.
• Serve as a mentor for the Pharm.D. students as needed.

Liver Transplant
Preceptor: Latosha Mitchell, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to immunology/transplantation with a focus on the liver transplant population. The resident will become familiar with disease states that affect the liver, peri-operative care of the liver transplant recipient, complications of transplantation, infectious diseases, and managing immunosuppressive therapy. The resident is expected to provide individualized evaluation of drug therapy, patient education, and participate in patient’s care through interactions with physicians and other health care providers.

Activities

• Design, evaluate, recommend, implement and monitor patient –specific pharmacotherapy consistently throughout the patient’s hospital stay.
• Provide pharmacokinetic consultations on all drugs monitored by serum level.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance forms
• Provide timely drug information and medication-use education to patients, parents, physicians and other members of the health care team
• Provide organized and concise input into the care of patients on the service
• Lead patient case presentations and topic discussions with the preceptor and other pharmacy students
• Assist with discharge planning (i.e. medication counseling, therapeutic substitutions for outpatient prescriptions)
• Present an in-service to the medical staff and other members of the health care team
• Document patient related services in the clinical intervention database
• Document patient information in the medical record when appropriate
• Serve as a mentor for Pharm.D. students as needed
• Participate in the out-patient clinic follow-up of new transplant recipients
• Ensure adherence to transplant protocols

Medical Intensive Care
Preceptor: Christine Whong, Pharm.D.

Rotation Objectives
The resident will be exposed to a diverse range of patient disease states and medication-related issues involving critically ill medicine patients. The resident is expected to provide individualized evaluation of drug therapy and participate in patient care through interaction with physicians and other healthcare professionals.

Core content that will be covered via patient experiences, discussions of reading materials, and/or case presentations includes a review of the following topics:  venous thrombosis prophylaxis, gastrointestinal stress ulcer prophylaxis, sedation, analgesia, and neuromuscular blockade, systemic inflammatory response syndrome (SIRS), sepsis/septic shock, acute alcohol withdrawal, diabetic ketoacidosis (DKA), acute gastrointestinal bleeding, acute drug overdoses, and acute renal failure.

Activities                                        

• Design, evaluate, recommend, implement, and monitor patient-specific pharmacotherapy consistently throughout the patient’s ICU stay.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Conduct a formal in-service on a critical care related topic for the MICU team.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the physicians and other members of the healthcare team.
• Document pharmacist interventions and activities in the clinical intervention database.
• Lead patient care presentations and topic discussions with the preceptor and pharmacy students.
• Serve as a mentor for Pharm.D. students as needed.

Neonatal Intensive Care
Preceptor: Christine Domonoske, Pharm.D.

Rotation Objectives
The resident will be exposed to a diverse range of neonatal patient disease states and medication-related issues. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s hospital stay.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Provide nutrition support services in conjunction with the dietician to all patients on enteral feedings or TPN
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the nurses, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service
• Lead patient case presentations and topic discussions with the preceptor and other pharmacy students.
• Document patient related services in the clinical intervention database.
• Serve as a mentor for the Pharm.D. students as needed.

Neuro Trauma Intensive Care Unit
Preceptor: Teresa Allison, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a range of patient disease states and medication-related issues related to neurosciences. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals. The resident will be evaluated on the disease states and topics including: traumatic brain injury, SAH, stroke patients, spinal cord injuries, and general ICU care.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s ICU stay.
• Ensure consistent patient care on transfer out of NTICU by continuing involvement in patient care and/or follow-up with appropriate medical staff and residents and clinical pharmacists.
• Continue to provide patient care as needed on the floors/IMU after discharge from the ICU.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Provide nutrition support services to all patients receiving enteral feedings or TPN.
• Provide fluid and electrolyte management for individualized patient disease states.
• Monitor appropriate laboratory values and cultures.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service.
• Document written recommendations in the medical record when appropriate.
• Document patient related services in the clinical intervention database.
• Prepare and present an educational in-service for the nurses, medical team and/or pharmacy staff.
• Be able to understand and perform a neurological examination.
• Be familiar with Advanced Cardiac Life Support Protocols.
• Serve as a mentor for the Pharm.D. students as needed.

Practice Management
Preceptors: Jim Maddock, RPH, MPA , Luisa Portugal RPH

Rotation Objectives
The resident will be exposed to a broad range of management topics. The resident is expected to participate in management meetings and complete management assignments at a local and system - wide level. Topics include finance, budgeting, human resources, policies and procedures, regulatory affairs, formulary management, performance improvement, benchmarking and leadership. The resident will interact with staff across the System.

Activities

• Attend Pharmacy & Therapeutics Committee meeting
• Attend Pharmacy Coordinating Council meeting
• Attend Pharmacy Management Team meeting
• Member of department safety committee
• Prepare drug monograph
• Assess department compliance with JCAHO standards
• Assess department compliance with policies and procedures
• Conduct performance improvement assignment
• Conduct medication utilization evaluation
• Conduct benchmarking assignment
• Prepare department safety newsletter

Stroke Service
Preceptor: Teresa Allison, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a diverse range of patient disease states and medication-related issues surrounding patients with strokes or stroke-related events. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals. The resident will be evaluated on disease states and topics including: hypertension, anticoagulation/antiplatelet therapy, hypercholesterolemia, and antithrombolytics.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s stay.
• Ensure consistent patient care throughout their stay by continuing involvement in patient care and/or follow-up with appropriate medical staff and residents and clinical pharmacists.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Provide nutrition support services to all patients receiving enteral feedings or TPN.
• Provide fluid and electrolyte management for individualized patient disease states.
• Monitor appropriate laboratory values and cultures.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service.
• Document written recommendations in the medical record when appropriate.
• Document patient related services in the clinical intervention database.
• Prepare and present an educational in-service for the nurses, medical team and/or pharmacy staff.
• Observe one procedure of IV and IA thrombolytic administration.
• Provide discharge medication counseling for the patients on the service when appropriate.
• Be able to understand and perform a neurological examination.
• Serve as a mentor for the Pharm.D. students as needed.

Surgical Critical Care
Preceptor: Brad Domonoske, Pharm.D., BCPS

Rotation Objectives
The resident will be exposed to a diverse range of patient disease states and medication-related issues related specifically to the critically ill patient in a surgical ICU. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through daily interactions with physicians and members of a multidisciplinary team, consisting of an attending, fellow, residents, interns and students. Other members of the healthcare team include a respiratory therapist, dietitian, nurses, and social worker.

The resident will be exposed to a diverse range of patient disease states and medication-related issues. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s STICU.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance form.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service.
• Provide discharge follow-up to clinical pharmacist who will be covering patient on the floor
• Document written recommendations in the medical record when appropriate.
• Document patient related services in the clinical intervention database.
• Prepare and present an educational in-service for the nurses and medical team.
• Serve as a mentor for the Pharm.D. students as needed.

Transitional Care Facility/ Subacute Care
Preceptor: Eileen Tharp, Pharm.D., BCPS, CGP

The Transitional Care Facility (TCF) is a nine bed skilled nursing unit. The Subacute Care Unit (SACU) is a thirteen bed step-down unit. The multidisciplinary team consists of members of the following disciplines: medicine, nursing, physical therapy, occupational therapy, case management, social work, dietary, pharmacy and others.

Rotation Objectives
The resident will be exposed to a diverse range of patient disease states and medication-related issues. The resident is expected to provide individualized evaluation of drug therapy and participate in patient’s care through interaction with physicians and other health professionals.

Activities

• Design, evaluate, recommend, implement and monitor patient-specific pharmacotherapy consistently throughout the patient’s hospital stay.
• Document pharmacotherapy reviews within 72 hours of patient admission to the unit and follow-up evaluations as needed and at least every 30 days.
• Provide pharmacokinetic drug monitoring support when appropriate in all patients.
• Monitor patients for drug-induced disease states, documenting adverse drug reactions using the hospital’s variance reporting system.
• Provide timely drug information and medication-use education to the patients, parents, physicians and other members of the health care team.
• Provide organized and concise input into the care of patients on the service.
• Provide discharge medication counseling for the patients on the service.
• Document written recommendations in the medical record when appropriate.
• Attend weekly multidisciplinary meetings in order to understand the patient’s care fully and communicate drug-related issues that may impact the overall care of the patient.
• Complete the medication section of the MDS for Medicare patients.