Ambulatory Care Pharmacy

Residency Program Director: Emily Miretti, Pharm.D., BCPS, BCACP, CDCES

University of Michigan Health is recruiting applicants for a one-year PGY2 Ambulatory Care Pharmacy Residency. There are 2 positions available.   

General Description

The PGY2 Ambulatory Care Pharmacy Residency is designed to provide a strong clinical foundation and help the resident further develop research, teaching, leadership, and writing skills. Clinical rotations are longitudinal in nature and include core and elective experiences that focus on direct patient care in the Patient Centered Medical Home (PCMH) and specialty clinics. Each resident is offered the opportunity to customize their elective rotations to their clinical interest(s), selecting from opportunities in chronic kidney disease, cystic fibrosis, hematology/oncology, hypertension, infectious disease stewardship, oral chemotherapy, palliative care, pharmacogenetics, solid organ transplant, specialty pharmacy, transitions of care - geriatrics and transitions of care - heart failure/cardiology. A multitude of teaching opportunities are available to the resident, who will receive a faculty appointment as an Adjunct Clinical Instructor at the University of Michigan College of Pharmacy.

 

Recruitment Plan 

We are recruiting for two Ambulatory Care residents for the 2025-26 year.

Recruitment will occur in-person at ASHP Midyear in New Orleans, Louisiana through the PPS platform. We will also be represented at ASHP Midyear Showcase which will occur on Tuesday, December 10th from 1-4 PM (Booth 6004). Please stop by to connect with our residents and RPD!

We will also be at the following recruitment events:

  • ACCP x SNPhA Residency Showcase (VIRTUAL); November 13, 2024, 6:00-7:00 PM EST
  • University of Michigan Health Virtual Residency Showcase (VIRTUAL); November 21, 2024, 7:00-8:00 PM EST
    • Candidates must pre-register on or before November 20, 2024 

Unable to attend Midyear or interested in learning more before signing up for a PPS interview in December? Feel free to contact Emily Miretti ([email protected]) with questions or interest

 

Program Structure

Rotation Experiences are tailored according to resident interests in conjunction with the residency program director.

Required Rotations (Longitudinal rotations, 1/2 day per week unless otherwise noted)

  • Orientation (July) – month long block
  • Independent Patient Centered Medical Home (PCMH) Clinic – 11 months, ½ day per week
  • Primary PCMH Clinic – 10 months, ½ day per week
  • Secondary PCHM Clinic – 10 months, ½ day per week
  • Anticoagulation – 3-4 months; ½ day per week
  • Administration – 3-4 months; ½ day per week
  • Medication Optimization – 5.5-months; ½ day per week
  • Psychiatry – 3-4 months; ½ day per week
  • Transitions of Care – Ypsilanti Health Center – 5.5-months; ½ day per week
  • Transitions of Care – Central – 3-4 month block; ½ day per week

Elective Rotations (3-4 months; 1/2 day per week)

  • Chronic Kidney Disease
  • Cystic Fibrosis
  • Hematology/oncology
  • Hypertension
  • Infectious disease Stewardship
  • Oral chemotherapy
  • Palliative Care
  • Pharmacogenetics
  • Solid organ transplant
  • Specialty pharmacy
  • Transitions of Care – Geriatrics
  • Transitions of Care – Heart Failure/Cardiology

Additional Required Activities

  • Completion of at least 80% of ASHP objectives 
  • Completion of the areas/topics listed in the PGY2 Ambulatory Care CAGO appendix 
  • Completion of required and elective rotations
  • Teaching at the College of Pharmacy for 1 semester
  • Completion of a research project with the submission of a finalized manuscript suitable for publication
  • Completion of a writing project with the submission of a finalized manuscript suitable for publication
  • Completion of a 1 hour ACPE accredited CE presentation
  • Completion of final research presentation
  • Completion of all evaluations within PharmAcademic
  • Completion of the ASHP entering self-assessment interest form and participation in quarterly update meetings
  • Completion of staffing requirements
  • Completion of core Ambulatory Care topic discussions, journal clubs, journal watch
  • Participation on an institutional and/or professional committee
  • Participation on a U-M Health Residency committee
  • Completion of community service (at least 3 sessions at Student Run Free Clinic)
  • Serve as a mentor for at least 3 PGY1 residency case conference presentations 

Other Learning Opportunities

  • Teaching certificate program (optional)

Staffing

Residents will participate in outpatient pharmacy staffing approximately every 3rd weekend, including one minor holiday and one major holiday block. Residents will be on-call on Sundays (10am-4pm) 1-2 times per month. Residents receive all minor and major holiday blocks off that they are not scheduled to staff. Resident feedback forms are not required to evaluate staffing.

Research and Publication Opportunities

The resident will participate in the development and completion of a mentored longitudinal residency research project. Experience in protocol writing, IRB submission, data collection and analysis, manuscript preparation, and publication will be provided.

Opportunities for development of writing and presentation skills are also available through completion of a writing project suitable for publication, a major pharmacotherapy continuing education presentation on a topic of the resident’s choosing, and presentation opportunities at local, regional, and national meetings.

The resident has the potential to produce at least two manuscripts suitable for peer-reviewed publication by the completion of the residency. There may be additional opportunities depending on resident interest.

Three major oral presentations:

  • 1 hour ACPE-accredited CE presentation 
  • Research project results at Great Lakes Pharmacy Resident Conference (GLPRC)
  • Research project results to pharmacy department

Teaching Opportunities

A multitude of teaching opportunities are available to the resident, who will receive a faculty appointment as an Adjunct Clinical Instructor at the University of Michigan College of Pharmacy. Resident teaching opportunities include, but are not limited to, the following:

  • Teaching in our Pharmacy Practice Skills III Course, which focuses on management of chronic disease states in the ambulatory setting
  • Co-precepting second year Introductory Pharmacy Practice Experience (IPPE) students and fourth-year Advanced Pharmacy Practice (APPE) students on clinical rotations
  • Facilitating small group discussions (topic discussions, journal clubs, and case presentations) for APPE students
  • Didactic and Team-Based Learning teaching paradigms
  • Participating in a teaching series and teaching certificate program
  • Providing interdisciplinary presentations and in-services
  • Teaching in courses for other health sciences disciplines (Medicine, Nursing, etc.)
  • Precepting extracurricular activities in the community for our College of Pharmacy students

Resident Publications

Roa PA, Bostwick JR, Patel PD et al. An interdisciplinary intervention for detection of sexual dysfunction associated with antidepressants: A pilot study. Ment Health Clin 2024;14(4): 236-241. 

Xu J, Ashjian EJ. Treatment of hypertriglyceridemia: A review of therapies in the pipeline. J Pharm Pract 2023;36(3):650-661.

Xu-Stettner J, Thompson AN, Fitzgerald LJ, et al. Comparison of transplant pharmacist treatment decisions between telehealth and clinic visits. Prog Transplant 2023;33(2):156-161.

Elder MJ, Ashjian EJ. Pharmacotherapy for Type 2 Diabetes Mellitus: What’s up and coming in the Glucagon-Like Peptide-1 (GLP-1) pipeline? J Pharm Pract 2023;36(2):418-428.

Dualeh SHA, McMurry K, Herman AE, Maryan S, Pacurar LA, Waits SA, Tishcer S. Evaluation of an opioid restrictive pain management initiative in adult kidney transplant recipients. Clin Transplant 2021;35(7):e14313.

Johengen EK, Ward KM, Coe AB, Pasternak AL. Assessing the knowledge, perceptions, and practices of primary care clinicians toward pharmacogenetics. J Am Coll Clin Pharm. 2020 [epub ahead of print].

Cho KH, Ashjian EJ, Smith MA, Pai AB. Approaches to medication management in patients with kidney failure opting for conservative management. Nephrol Nurs J. 2020;47(4):319-71.

Aldrich SA, Ashjian EJ. Use of GLP-1 receptor agonists in patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease. Nurse Pract 2019;44(3):20-28.

Farhat NM, Vordenberg SE, Marshall VD, Suh TT, Remington TL. Evaluation of interdisciplinary geriatric transitions of care on readmission rates. Am J Manag Care. 2019;25(7):e219-e223.

Farhat NM, Farris KB, Patel MR, Cornish L, Choe HM. Comprehensive medication reviews: Optimal delivery setting and recommendations for quality assessment. J Am Pharm Assoc 2019;59(5):642-645.

Fennelly JE, Coe AB, Kippes KA, Remington TL, Choe HM. Evaluation of clinical pharmacist services in a transitions of care program provided to patients at highest risk for readmission. J Pharm Pract. 2020;33(3):314-320.

Lindell, VA, Stencel DL, Ives RC, Ward KM, Fluent T, Choe HM, Bostwick JR. A pilot evaluating clinical pharmacy services in an ambulatory psychiatry setting. Psychopharmacol Bull. 2018;48(2):18-28.

Ashjian EJ, Kurtz B, Renner E, Yeshe R, Barnes GD. Evaluation of a Pharmacist-Led Direct Oral Anticoagulant Service. Am J Health-Syst Pharm 2017;74(7):483-89.

Ashjian EJ, Tingen JM. SGLT2 inhibitors: Expanding oral treatment options for type 2 diabetes mellitus. Nurse Pract 2017;42(4): 8-15.

Funk KA, Hudson S, TIngen JM. Use of clinical pharmacists to perform depression screening. Qual Prim Care. 2014;22(5):249-50.

Stranges PM, Marshall VD, Walker PC, Hall KE, Griffith DK, Remington T. A multidisciplinary intervention for reducing readmissions among older adults in a patient-centered medical home. Am J Manag Care. 2015;21(2):106-13.

Stranges PM, Tingen JM. End of the road: Diabetes care when insulin may not be an option. Clin Diabetes. 2014;32(2):87-9.

Preceptors

  • Emily Miretti, PharmD, BCPS, BCACP, CDCES
  • Jennifer Baldridge, PharmD, BCACP
  • Nick Dillman, PharmD
  • Heidi Diez, PharmD, BCACP
  • Jessica Fennelly, PharmD, BCACP, BC-ADM
  • Lianne Granata, PharmD
  • Nghi Ha, PharmD, MPH, BCPS, CACP
  • Jennifer Hagopian, PharmD, BCPS, BCTXP
  • Marcy Holler, PharmD
  • Madison Irwin, PharmD, BCPS
  • Kellie Kippes, PharmD, BCPS, BCACP
  • Kristin Klein, PharmD, BCPPS
  • Lan Le, PharmD, BCACP
  • Valerie Lindell, PharmD, BCACP
  • Amy Pasternak, PharmD, BCPS
  • Elizabeth Renner, PharmD, BCPS, BCACP, CACP
  • Hiral Satishchandran, PharmD
  • Denise Sutter-Long, PharmD, BCPS
  • Amy Thompson, PharmD, BCACP
  • Kristen Ward, PharmD, BCPP
  • Trisha Wells, PharmD

Residency Program Director Information

Emily Miretti, PharmD, BCPS, BCACP, CDCES
Program Director & Ambulatory Care Clinical Pharmacist Specialist
Michigan Medicine
Clinical Associate Professor
University of Michigan College of Pharmacy
428 Church Street
Ann Arbor, MI
Email: [email protected]