- Variety of adult patients (>18 years)
- Diseases/disorders which involve the internal organs.
- Cardiovascular disorders (chest pain, chronic stable angina, acute coronary syndrome, supraventricular arrhythmias, ventricular arrhythmias, heart failure, valvular heart disease, dyslipidemia, hypertension)
- Endocrinologic disorders (Diabetes mellitus, diabetic ketoacidosis, thyroid disorders, osteoporosis, adrenal disorders)
- Gastoenterologic and Hepatologic disorders (diarrhea, constipation, pancreatitis, GERD, peptic ulcer disease, gastrointestinal bleeding, viral hepatitis, cirrhosis, inflammatory bowel disease, nausea/vomiting)
- Pulmonary medicine disorders (asthma, COPD, pleural effusion, pulmonary embolism, acute respiratory distress syndrome [ARDS])
- Hematologic disorders (anemia, sickle cell anemia, thrombocytopenia, venous thromboembolism, coagulation disorders, coagulopathy)
- Infectious diseases (bacteremia, lower respiratory infections, urinary tract infections, tuberculosis, infective endocarditis, osteomyelitis, skin and soft tissue infections, HIV/AIDS [including opportunistic infections], STDs, septic arthritis, CNS infections, fungal infections, tick-borne illnesses)
- Nephrologic disorders (acute renal failure, chronic renal failure, fluid and electrolytes, acid- base disorders, calcium and phosphorus metabolism)
- Rheumatologic disease (rheumatoid arthritis, osteoarthritis, polymyositis, SLE, vasculitis, multiple sclerosis)
- Neurologic disorders (altered mental status, dementia, stroke, transient ischemic attack, peripheral neuropathy, epilepsy, Parkinson’s disease, headache)
- Oncologic disease (breast cancer, colon cancer, lung cancer, prostate cancer, cervical cancer, skin cancer, pain management, leukemia/lymphoma, multiple myeloma, chemotherapy- induced nausea/vomiting, febrile neutropenia)
- Nutrition (parenteral and enteral nutrition, nutrition in organ failure, obesity)
- Psychiatric disorders (major depressive disorder, substance abuse, bipolar disorder, schizophrenia, sleep disorders, anxiety disorders)
- Pregnancy and lactation (appropriate drug therapy in pregnancy and lactation, preeclampsia/eclampsia, gestational diabetes, hyperemesis gravidarum)
- Pharmacist with credentials which provide evidence of expertise in internal medicine (e.g., Board certification, residency) or equivalent practice experience, with at least 2 years’ experience as a practicing pharmacist.
- Provides patient-centered care/pharmacotherapy management.
- Actively participates as a member of the patient-care team.
- An internal medicine/general medicine unit where patients present with the disorders/diseases listed in the patient criteria section. (At least 50% of the disorders are likely to be encountered in the unit).
- The unit uses a team-based approach or other inter-professional (or interdisciplinary) approach to patient care.
- The unit has a sufficient number of patients such that the student can manage 3-10 patients at any given time.
Required Course Activities
To achieve the learning objectives, students completing the General Medicine Advanced Pharmacy Practice Experience should complete the following activities/assignments:
- Participate in patient care or interprofessional care team rounds.
- Prepare one formal SOAP note/progress note each week.
- Present at least one formal patient case presentation, including analysis and interpretation of the primary medical literature as it applies to the patient case.
- Discuss with the preceptor the treatment, monitoring, and outcomes of the majority of the following common general medicine conditions, with discussions based on actual or simulated patient cases and/or drug therapy problems:
- Anticoagulation and venous thromboembolism
- Chronic obstructive pulmonary disease/asthma
- Community-acquired and healthcare-associated pneumonia
- Congestive heart failure
- Coronary artery disease
- Hepatic Disorders
- HIV/Opportunistic Infections
- Hypertension, including hypertensive emergency/urgency
- Myocardial infarction
- Renal Failure/End Stage Renal Disease
- Skin and Soft Tissue Infections
- Stroke/transient ischemic attack
- Participate in therapeutic drug monitoring activities, including:
- Application of pharmacokinetic dosing principles to drugs in the following classes, as applicable to the institution: antibiotics, anticonvulsants, and/or immunosuppressants for organ transplant rejection; and
- Recommendation of dosing adjustments for renal and hepatic impairment
- Present at least one journal club presentation, including analysis and interpretation of the primary medical literature.
- Complete at least two written drug information responses using appropriate institutional documentation or the Clinically Answerable Question Intake/Tracking Form.
- Present one in-service to pharmacy, nursing, or medical staff.