General Medicine

Student pharmacists treat a mock patient

Patient Criteria

  • 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)

Preceptor Criteria

  • 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.

Site Criteria

  • 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:

  1. Participate in patient care or interprofessional care team rounds.
  2. Prepare one formal SOAP note/progress note each week.
  3. Present at least one formal patient case presentation, including analysis and interpretation of the primary medical literature as it applies to the patient case.
  4. 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
    • Diabetes
    • 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
  5. 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
  6. Present at least one journal club presentation, including analysis and interpretation of the primary medical literature.
  7. Complete at least two written drug information responses using appropriate institutional documentation or the Clinically Answerable Question Intake/Tracking Form.
  8. Present one in-service to pharmacy, nursing, or medical staff.