Contact:
Kelly Echevarria, Pharm.D., BCPS
South Texas Veterans Health Care System
Audie Murphy Division (119)
7400 Merton Minter Blvd.
San Antonio, TX 78229
kelly.echevarria@va.gov

James Lewis, Pharm.D.
University Health System
Inpatient Pharmacy
4502 Medical Drive
San Antonio, TX78229
James.Lewis@uhs-sa.com
(210) 358-0421

LOCATION:
San Antonio, Texas

LENGTH OF RESIDENCY:
1 year

START DATE:
July 1

REQUIREMENTS:
Pharm.D. degree from ACPE-accredited institution.
Eligible for licensure in Texas.
An accredited Pharmacy Practice Residency

STIPEND:
Competitive salary plus generous vacation (13 days) and sick leave (13 days). Health insurance is available.

This Specialty Practice Residency in Infectious Disease is designed to provide a challenging training opportunity for individuals desiring to develop clinical competency in the specialized area of infectious disease pharmacotherapeutics. The 12-month training period incorporates both outpatient and inpatient rotations devoted to the development of skills essential for the delivery of pharmaceutical care with a primary focus on infectious diseases.

The resident spends a minimum of four months as an active member of the Adult Infectious Disease Consult Service, providing services in both the STVHCSand the affiliated county teaching hospital, University Health System's Hospital. Together, these facilities represent approximately 600 adult inpatient beds. The ID Consult Service sees approximately 2 to 4 new consults daily, and maintains an active patient load of around 12 to 16 patients. As a member of the ID Consult Service, the ID pharmacy resident is responsible for participating in the design and implementation of appropriate therapeutic regimens, monitoring the outcome of therapy, assisting in the application of pharmacokinetic principles to individualize therapy as needed, and in the provision of patient, disease and drug specific information to other members of the consultation service. A significant number of patients seen by the ID Consult Service are either cases of acute or chronic fungal infections, cases of infective endocarditis or tuberculosis, and serious infections in post-trauma/surgery patients.

The resident spends a minimum of one month rotating through the microbiology, fungal and viral laboratories. This experience is important for the resident to appreciate the sophisticated techniques employed in these areas and to establish limited skills in basic techniques.

An additional two months assigned to the Inpatient AIDS Service are also required, where the resident will be actively involved in the acute care of ill HIV-infected patients, with a variety of associated opportunistic infections.

One month of Antibiotic Management / Stewardship is also required.  This rotation involves reviewing daily cultures and antibiotics throughout the hospital and enforcing formulary use of antimicrobials, as well as attending sit-down rounds with the ID consult service.

In addition to the monthly rotations, the resident is assigned to the Immunosuppression Clinic (HIV Clinic) for one half-day a week for approximately 9 months. Here the resident learns how to care for HIV-infected patients in an ambulatory care setting, observing the natural history of the disease and its therapy. The resident is responsible for participating in the design and implementation of the appropriate therapeutic regimens, monitoring the outcome of therapy, and intensive patient counseling.

Elective rotations are offered to individuals based on the particular strengths and weaknesses of the trainee. Areas where elective rotations are provided include: drug information center, pediatric ID, MICU, general adult inpatient medicine, bone marrow transplant, and the research laboratory. Such flexibility makes the residency able to provide important experience and training in selected areas that will enable the resident to be broadly functional and competitive for future career options.

The resident will be responsible for an independent research project. In addition, the resident is expected to participate in ongoing collaborative research projects. The primary nature of these protocols center on antibacterial antiviral, and antifungal drug development and therapeutics. Both preclinical animal studies and clinical trials are generally in place, and the resident is encouraged to participate actively in any study of interest.

During the residency, the resident is expected to significantly contribute to a manuscript to be submitted for publication in a professional journal. This can be a book chapter, case report with literature review, review article, or original research article.

The resident is jointly appointed as a Clinical Instructor in the Department of Pharmacology, The University of Texas Health Science Center at San Antonio and the College of Pharmacy, The University of Texas at Austin. In this capacity, the resident participates in the supervision of Doctor of Pharmacy students assigned to the ID elective rotation, the HIV selective rotation, and in didactic lectures in infectious disease therapeutics to pharmacy students. In addition, the resident participates in pharmacy staff development programs as assigned.

To ensure that the goals and objectives established for each resident are being met, the resident meets regularly with the primary preceptors to discuss patients, assigned topics for discussion, or other issues as necessary. During the course of the year, readings in the major topics in ID will be assigned and discussed with the resident. The resident also participates in the weekly ID Journal Club and weekly case conference discussions, and attends a number of other available conferences, such as Medicine Grand Rounds.

The residency will follow the ID specific Specialty Residency Standards and Objectives established jointly by ASHP and SIDP.