Dismiss Modal

Elective Rotations


Advanced Hematology/Oncology

Hematology-oncology (heme-onc) is an elective two to six week learning experience at Children’s of Alabama for residents who have completed the core heme-onc rotation but desire more time in this practice area. There are 24 hematology-oncology beds in the hospital housed on 8 Quarterback, although the service frequently overfills to other hospital units. The hematology-oncology service has 2 teams, the chemotherapy service and the hematology/oncology medical service. 

The chemotherapy service includes an attending physician and a nurse practitioner.  Typically, the chemotherapy service team will be responsible for the care of approximately 4 to 10 patients.  

The hematology/oncology medical service includes an attending physician, a fellow physician, medical residents, oncology nurse practitioners, hematology nurse coordinator, a clinical pharmacy specialist, social workers, and pastoral care.   Pharmacy residents and other health professionals in training also participate when assigned to the hematology-oncology service.  Typically, the medical team will be responsible for the care of approximately 15 to 30 patients.

The resident will have the opportunity to expand knowledge on oncologic emergencies, complications of cancer treatment, sickle cell anemia and learn to develop and document monitoring plans for related medication management for less commonly seen disease states. Other major elements of this rotation component include processing oncology orders, fielding drug information questions, new diagnosis discharge troubleshooting and teaching, and preparing either a journal club presentation or a written drug information response.

 

Advanced Infectious Disease and Antimicrobial Stewardship

Infectious disease (ID) is an elective two to six week learning experience at Children’s of Alabama for residents who have completed the core ID rotation but desire more time in this practice area.  The ID team provides consult services to patients on various primary services at COA and the University of Alabama at Birmingham (UAB), so patients can be located anywhere at COA and occasionally at UAB.   The ID outpatient service conducts clinic in clinic 7 in the McWane Building.  The ID consult service includes an attending physician, an ID fellow-in-training physician, a PGY2 or PGY3 medical resident, and a clinical pharmacy specialist. Pharmacy residents, pharmacy students, and other health professionals in training also participate when assigned to the ID consult service.  The ID outpatient service consists of the same practitioners that are on the consult team but also includes an outpatient nurse clinician.  Typically, the ID consult service census will range from 6-15 patients per day.

In addition to providing patient care services as in the core rotation, the ID elective will focus on protocol/policy development, medical staff education (fellows and nursing), as well as antimicrobial stewardship involvement and/or development of new clinical services within the ID division. ID fellow education is a critical component of the advanced ID elective.  The resident will be expected to present one formal lecture on infectious disease pharmacotherapy.  Topic will be determined either by the resident, preceptor, or fellowship program director. During the ID II rotation, the resident may have the opportunity to work with advance practice experience Pharm.D. students to develop precepting skills.  Due to the advanced nature of this rotation, the resident shall take more of the teacher role in this relationship.

Advanced Neonatal Intensive Care Unit

Neonatal Intensive Care (NICU II) is an elective two to six week learning experience at Children’s of Alabama for residents who have completed the core NICU rotation but desire more time in this practice area. There are 48 NICU beds in the hospital housed on the 6th floor of the Benjamin Russell Hospital for Children.  The NICU is considered a level 4 NICU, which has the ability to perform ECMO, dialysis, all forms of advanced life support, all forms of advanced respiratory support, and houses all neonatal surgical sub-specialties. There are 2 teams (Harbert and Quarterback) comprised of: an attending physician, fellows, neonatal nurse practitioners, social workers, discharge planners, neonatal nutritionist, and clinical pharmacist. On occasion there will be a 4th year pharmacy student(s) from either Samford University or Auburn University, the primary nurse, and respiratory therapy. Typically, the NICU teams will each be responsible for the care of approximately 24 patients.

In comparison to the core rotation, for the advanced rotation, the resident should:

  • Provide an in-service to nursing or physicians
  • Spend more time verifying orders for medications and facilitating drug delivery to ensure overall pharmaceutical care
  • Lead the “resident physician”/trauma as well as perform the necessary post-event duties (charge for the medications, re-stock the code/trauma bag, etc.)

Advanced Pediatric Hospital Medicine

Pediatric Hospital Medicine is an elective two to six week learning experience at Children’s of Alabama for residents who have completed the core PHM rotation but desire more time in this practice area. Throughout the year, there are five interdisciplinary PHM teams that care for a variety of patients admitted throughout the hospital, but generally to the Dearth Tower, the Special Care Unit, and 10 Harbert (Neuro/Rehab/Ortho unit). Each of the teams include an attending physician, PGY2 or PGY3 medical resident(s), PGY1 medical intern(s), and medical students (MSIII or MSIV). Other disciplines on the team include a clinical pharmacist, pharmacy students, a nurse case manager, a social worker, a clinical nutritionist, and the primary nurse. Pharmacy residents and other health professionals in training also participate when assigned to the PHM service.  Each PHM team has the capacity to care for up to 16 patients (80 patients for the service as a whole), and usual census is 10-12 patients/team.

During the PHM II rotation, the resident may have the opportunity to work with advance practice experience Pharm.D. students to develop precepting skills.  Due to the advanced nature of this rotation, the resident shall take more of the teacher role in this relationship.

Advanced Pediatric Intensive Care Unit

Pediatric Intensive Care (PICU II) is an elective two to six week learning experience at Children’s of Alabama for residents who have completed the core PICU rotation but desire more time in this practice area. There are 24 PICU beds in the hospital housed on 7 Quarterback.  The PICU medical team consists of an attending physician, critical care fellows, two nurse practitioners, four PGY2/PGY3 medical residents, and sometimes a medical student (MSIV). Other members of the PICU multidisciplinary team include a clinical pharmacist, clinical nutritionist, respiratory therapist, primary nurse, social worker, and sometimes other medical professional students.  Pharmacy residents and other health professionals in training also participate when assigned to the nephrology service.  Typically, the PICU team will be responsible for the care of approximately 24 patients.

In addition to daily PICU responsibilities, the resident will be required to provide an in-service to nursing or physicians on a pharmacy related PICU topic, as well as attend all medical emergencies while onsite (“resident physicians” and traumas). During the PICU II rotation, the resident may have the opportunity to work with advance practice experience Pharm.D. students to develop precepting skills.  Due to the advanced nature of this rotation, the resident shall take more of the teacher role in this relationship.

Advanced Pulmonary

Pulmonary is an elective two to six week learning experience at Children’s of Alabama for residents who have completed the core pulmonary rotation but desire more time in this practice area. There are 24 pulmonary beds in the hospital housed on 10 Quarterback.  The pulmonary service has two teams. The nurse practitioner team includes an attending physician, nurse practitioner, and nurse practitioner students. The medical resident service includes an attending physician, a pulmonary fellow, a PGY2 or PGY3 medical resident, a PGY1 medical intern, a nurse practitioner, a 4th year medical student and a clinical pharmacy specialist. Pharmacy residents and other health professionals in training also participate when assigned to the pulmonary service. Typically, each pulmonary team will be responsible for the care of approximately 30 patients.

During the Pulmonary II rotation, the resident may have the opportunity to work with advance practice experience Pharm.D. students to develop precepting skills.  Due to the advanced nature of this rotation, the resident shall take more of the teacher role in this relationship.

Alabama Poison Information Center (APIC)

Alabama Poison Information Center (APIC) is an elective, two to four week learning experience at Children’s of Alabama.  The APIC has been a long-term commitment of COA to the citizenry of Alabama since 1958. The APIC was the 14th center established in the United States, during a time when serious morbidity and mortality was attributed to poison ingestion in children and adults. Since its inception, the Center engaged in providing the most accurate and rapid poison information to only physicians in the early years and then to both the professional and general public. The APIC has provided 24/7, toll free access of life saving information since 1978. The APIC is a fully certified poison center by the American Association of Poison Control Centers. Throughout the years of dedicating substantial resources to developing a quality professional staff, quality assurance programs, data surveillance and research, 800 number access and state of the art informational resources, the APIC serves the entire State of Alabama as the only certified statewide center by the Alabama Department of Public Health.

The APIC is located in the McWane building.  Center staff includes nurse and pharmacist specialists in poison information (certified by national examination and sponsored by the American Association of Poison Control Centers). The management team includes a doctoral credentialed environmental toxicologist director, a medical toxicology boarded medical director, and an emergency medicine boarded pediatrician assistant medical director. Advanced level consultation is available from this team beyond the initial level of contact to our center staff and is provided on a 24/7 basis.

Staff at the APIC center will handle over 100,000 poison calls per year (resulting in ~34,000 human exposures with over 60,000 follow-up calls). A vital component of this quality professional service is a statewide educational program designed to heighten public and professional awareness of the center, to inform parents and caregivers of the best preventive actions, and to provide continuing education for healthcare professionals on the assessment, triage, and management of poisoned patients. Advanced Hazmat Life Support courses, grand rounds on topics in clinical toxicology, medical toxicology consultations and other educational/clinical services are provided. Special emphasis is placed upon providing such education and service to rural, traditionally underserved areas of the state. In fact, over the last 10 years, the APIC has teamed with Healthy Child Care Alabama, a statewide network of public health nurses who are assigned counties in the state to provide preventive health education. The collaboration has resulted in significant increases in the awareness of rural area citizens. The work in primary prevention continues to be an integral component of our center and augments the effectiveness of the informational services provided.

Blood and Marrow Transplant (BMT)

Blood and bone marrow transplant (BMT) is an elective, two to six week learning experience at Children’s of Alabama. There are 8 inpatient and 4 outpatient BMT beds in the hospital housed on 8 Harbert.   The patients include mostly hematology/oncology patients and patients with various immunodeficiencies. The BMT medical service includes an attending physician, BMT nurse practitioners, a clinical pharmacy specialist, social workers, and pastoral care.   Typically, the medical team will be responsible for the care of approximately 5-10 inpatients and the outpatient clinic.

Cardiology (CCU) and Heart Transplant

Cardiovascular Care Unit (CCU) is an elective, two to six week learning experience at Children’s of Alabama. There are 15 CCU beds in the hospital housed on 8 Harbert.  The CCU medical team consists of an attending physician, cardiovascular fellows, and nurse practitioners. Other members of the CCU multidisciplinary team include a clinical pharmacist, clinical nutritionist, respiratory therapist, primary nurse, social worker, speech pathologist, PT and OT. Typically, the CCU team will be responsible for the care of approximately 8-12 patients.

Cardiovascular Intensive Care (CVICU) 

Cardiovascular Intensive Care (CVICU) is an elective learning experience at Children’s of Alabama. The rotation will be a minimum of ten days but may be longer depending on resident interest and/or preceptor availability. The 20 beds in the CVICU housed on 4 Quarterback. The CVICU has 2 rounding day teams and 1 rounding evening team. Each rounding team consists of an attending physician and nurse practitioner. Other members of the CVICU multidisciplinary team include a clinical pharmacist, respiratory therapists, clinical dentition, and the primary nurse. Pharmacy residents and other health professionals in training also participate when assigned to the CVICU service. Typically, the CVICU team will be responsible for the care of approximately 14-20 patients. In addition to daily responsibilities, the resident will lead topic discussions and attend all medical emergencies int the unit while onsite.

Emergency Department

Pediatric Emergency Department (ED) is an elective, two to four week learning experience at Children’s of Alabama.  The Pediatric Emergency Medicine Department provides a statewide and regional referral site for complex emergency problems and acute tertiary care for the state's major pediatric trauma and medical center at the Children's of Alabama Emergency Department. The division’s faculty members are specialized in pre-and in-hospital emergency care and resuscitation and trauma services. The Children’s of Alabama ED has more than 70,000 visits yearly and provides 24-hour care for children presenting with illness or injury. It is recognized as the major provider in the state of Alabama for specialized care of life-threatening traumatically injured and burned children. The Emergency Department participates in a community-based emergency plan established by the Birmingham Regional Emergency Medical Services System. The ED also works in conjunction with the Regional Poison Control Center housed within Children’s of Alabama.

The emergency department is located on the 1st floor of the Benjamin Russell Hospital for Children and is composed of 53 beds (47 patient rooms, 4 resuscitation/trauma rooms, one minor procedure room and a pelvic examination room). The ED medical team consists of attending physicians, fellows, medical residents, and nurse practitioners. Other members of the multidisciplinary team include respiratory therapists, nurses, clinical assistants, and child life specialists. 

The pharmacy resident is responsible for identifying and resolving medication therapy issues through review of new medication orders.  In addition, the resident will act as a drug information resource for other health care providers in the ED and provide code/trauma response during the time that they are based on the unit.  The resident will serve as liaison between the ED and central pharmacy, as well as between the ED and the floor should patients be admitted, to assist in the medication reconciliation process.

Since no pharmacist works daily in this area, to participate in this elective the resident must be at a point in their training where they are capable of independent practice, as determined by the Residency Program Director (RPD) in coordination with the Residency Advisory Committee (RAC). The resident also must have completed code/trauma response training and be capable of independent code/trauma response (with technician support), as determined by the pharmacy educator.

Investigational Drug Studies

The investigational drug study rotation is an elective, two to six week learning experience at Children’s of Alabama.  The investigational study pharmacy works with multiple disciplines to provide evidence-based, patient-centered investigational medication therapy management.  The investigational study pharmacy provides hands-on dispensing of study medications.  Patients may be located on any inpatient unit or outpatient clinic.  Patients range in age from newborns to adults.

The investigational study pharmacist is responsible for ensuring proper medication storage, documentation, preparation and dispensation for all medications administered to patients enrolled in an Institutional Review Board approved medication study. The pharmacist will also provide drug information and education to healthcare professionals as well as patients and caregivers about investigational medications.

Teaching and Learning Certificate

The Teaching and Learning Certificate (TLC) program is an elective longitudinal rotation available to Children’s of Alabama pharmacy residents through Samford University McWhorter School of Pharmacy (MSOP).  The purpose of the TLC program is: “To obtain fundamental knowledge required to effectively educate others and to gain confidence in their abilities to provide education and function in an academic environment.” 

Goals of participation in the TLC at Children’s of Alabama include:

  1. Gain skills in becoming an effective teacher by developing critical thinking abilities in learners.
  2. Build ability in adjusting teaching activities to level of knowledge of audience.
  3. Gain experience with active learning strategies.
  4. Develop effective precepting skills.
  5. Build ability in providing effective feedback to learners.
  6. Increase comfort in public speaking.

Minimum requirements of the TLC program include:

  1. Attend and participate in teaching-related educational seminars - Teaching and learning seminar topics fall into different topical areas covering the role of a teacher, classroom management, interprofessional education, lesson/lecture plans, curricular design, evaluation/assessment and precepting. Residents will complete the program through face-to-face sessions and online assignments.
  2. Develop and deliver at least 30 minutes of “formal lecture” - The resident in concert with his/her teaching mentor or TLC coordinator will identify a learning session the resident will provide.
  3. Small group discussion - Residents will also be required to be involved in facilitation of small group (>5 learners) learning experiences.
  4. Laboratory Instruction - Residents will get experience in developing a laboratory/simulation type activity for learners, preferably with school of pharmacy students.
  5. Serve as a co/preceptor for at least one Pharmacy Practice Experience (APPE or IPPE) - The resident’s residency program director will work with the resident to determine the most appropriate time for experiential teaching to occur. Because pharmacy practice experiences are scheduled in advance, the resident may not be the preceptor of record, but still assumes substantial teaching responsibilities. These activities may include, but are not limited to, working with the primary preceptor on activities and assessments, developing experience goals and activities, assisting with learning activities, and evaluating student assignments.
  6. Document teaching activities and experiences in Pharm Academic including self-reflection on accomplishments and opportunities for improvement.
  7. Participate in a “learning community” Residents will be assigned a MSOP faculty mentor and grouped into learning communities based upon who their assigned teaching MSOP faculty mentor.

Attendance at 75% of sessions and completion of all online modules are required for successful completion of the TLC program.