PGY2 Ambulatory Care Pharmacy Residency Program

About The Program

This program is offered by Rhode Island Primary Care Physicians Corporation (RIPCPC) in conjunction with Integra. RIPCPC is a multi-specialty Independent Practice Association dedicated to improving patient outcomes through the Patient-Centered Medical Home model. It is part of the Integra network, an Accountable Care Association (ACO) that also includes Care New England (CNE) Health System and South County Health System. RIPCPC/Integra’s residency program provides organized and directed pharmacy training in an outpatient primary care physician office setting. The program centers on creating a caring and compassionate environment that promotes respect and dignity for every person. It allows the resident to develop knowledge and skills in various areas including medication therapy management, leadership, communication, practice management, critical thinking, time management, clinical research, and teaching. The program offers the resident the opportunity and stimulus to develop, to the highest degree obtainable, his/her professional expertise as a practitioner. A RIPCPC/Integra resident is a pharmacist, first and foremost, and is expected to contribute to the achievement of the Department of Pharmacy’s mission and vision statement, as well as the annual strategic plan. This will be achieved through participation in designated residency projects, activities, and successful completion of the program objectives. Efforts to provide optimal training and guidance for the resident will be extended whenever possible to the mutual satisfaction of the resident and the preceptor team. A demonstrable desire to learn, a sincere career interest in ambulatory care pharmacy practice, and a dedication to fully meeting all objectives and requirements of the residency program are expected of the resident.

Purpose

PGY2 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education and PGY1 pharmacy residency programs to contribute to the development of clinical pharmacists in specialized areas of practice. PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings. Residents who successfully complete an accredited PGY2 pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification, if available.

Structure

The program offers comprehensive experiences in ambulatory care pharmacy practice involving collaborative practice and medication therapy management in a variety of practice settings. These include adult primary care, pulmonary care, geriatric care, transitions of care, metabolic clinic. Additionally, residents will participate in a practice management learning experience that will provide opportunity to develop proficiency in innovative healthcare and pharmacy models.   Residents may elect to be involved in teaching activities at the University of Rhode Island College of Pharmacy.  A research project is required.

Program Requirements

Only residents that complete the minimum of twelve months of residency training equal to a full-time equivalent and fulfill the program requirements, including those specified in the Program Graduation Requirements/Residency Program Tracking Document, are granted a residency certificate and considered graduates of the program

Learning Experiences

All experiences are longitudinal with the exception of orientation.

Orientation

During the orientation period, the resident will complete any outstanding human resource requirements. Residents will receive access and training regarding electronic medical record. The resident will understand the program purpose and become familiar with the practice environment. Program design and requirements, including evaluations, will be reviewed. A description of required and elective learning experiences will be provided, and associated competencies, goals, and objectives reviewed. Residency policies, terms and conditions will also be reviewed. A completed Entering Interests Form and Entering Objective-Based Self-Evaluation Form will be a part of the initial assessment used to create a documented development plan for the residency year. A schedule for the residency year and resident development plan will be developed.

Primary Care I

The Primary Care I Learning Experience will allow the resident to become proficient in common disease states managed in a primary care setting. The structure of the learning experience will allow for the resident to meet goals and objectives assigned to this learning experience. The resident will work as part of an interdisciplinary health care team and engage in direct patient care activities while having the opportunity to precept pharmacy students. There are two sites as listed below with the preceptor and the resident will select one of the sites below in collaboration with the program director and preceptors: 

  1. South County Internal Medicine, 481 Kingstown Road, Wakefield, RI 02879
    Preceptor: Bethany Spadaro, BS Pharm, BCGP, CDCES

  2. CNEMG Family Care Center and Internal Medicine Group, 111 Brewster St, Pawtucket, RI 02860
    Preceptor: Ron Tutalo, PharmD, BCACP, CDCES

Metabolic Clinic

The resident will work to manage a metabolic clinic with an emphasis on optimizing management of diabetes mellitus, hypertension, and hyperlipidemia.  Residents will manage patients in the office and will follow up with patients telephonically.  The structure will allow for the resident to meet the goals and objectives assigned to the learning experience.  There are two sites as listed below with the preceptor and the resident will select one of the sites below in collaboration with the program director and preceptors: 

  1. University Family Medicine 1351 South County Trail Suite 301, East Greenwich, RI 02818
    Preceptor: Diana Mercurio, BSPharm, CDCES, CDOE, CVDOE

  2. Fairlawn Primary Care, 966 Mineral Spring Avenue, North Providence, RI 02904
    Preceptor:  Jennifer Leavitt, PharmD, CDCES, CDOE, CVDOE

Staffing

The Staffing component at RIPCPC will involve ambulatory care related activities including but not limited to completion of:

  • Comprehensive Medication Reviews
  • Adherence outreaches
  • Recommending and implementing cost effective treatments for patients
  • Working to achieve contractual obligations for ACO: Adherence (RAS, Diabetes, Statin), Statin Use in Diabetes, Statin Use in Cardiovascular Disease, Polypharmacy, Direct/Indirect Cost Savings
  • Post-acute care follow-up calls
  • Drug information consultations
  • Patient and provider medication education
  • Detailed review of medication therapy management related to 4 specific disease states (subject to change): chronic kidney disease, neurology, rheumatology, gastrointestinal disease.

Research

The resident is required to demonstrate the ability to conduct a research project.  The resident will work with the guidance of the preceptor and research advisor to formulate a research question, conduct a literature search, determine how research will be conducted (study design, methods, data analysis), collect and interpret the data, and formally present project results.  The resident will work to develop their own project or choose a project based on suggestions from the residency program director, preceptors, and/or research project advisor.  If the resident develops their own project it must be feasible based on resources available, related to the practice area, and must be able to be completed within the residency year.  The resident will present the research project and impact of results to the pharmacy department, clinical staff, and others within the organization as appropriate.  Additionally, the resident will present at a local, regional, or national conference for Pharmacy Residents and Preceptors.

Transitions of Care

The Transitions of Care learning experience will allow the resident work collaboratively with the transition of care pharmacist at Kent County Hospital to ensure appropriate medication use for patients moving between healthcare settings and the home.  The resident will complete post discharge telephone follow-ups with home visits as deemed necessary and appropriate.  The structure will allow for the resident to meet the goals and objectives assigned to the learning experience. 

Kent County Hospital, 450 Tollgate Road, Warwick Rhode Island 02886

Pulmonology

The resident will work to provide medication management for patients with COPD, asthma, and those who desire to cease smoking.  Residents will collaborate with patient’s primary care and pulmonology healthcare teams.  Patients will be managed in the office and with telephonic follow up.  The structure will allow for the resident to meet the goals and objectives assigned to the learning experience.

Care New England Family and Internal Medicine Group Pawtucket, 111 Brewster St, Pawtucket, RI 02860

Geriatrics

The resident will provide medication management in collaboration with an engaged health care team at a practice site that focuses on the older adult.  The resident will gain experience assisting the older adult and their family as they navigate the healthcare system.  The structure will allow for the resident to meet the goals and objectives assigned to the learning experience. 

CNEMG Primary Care for Older Adults, 215 Toll Gate Road Suite 104, Warwick, RI 02886

Practice Management

The Practice Management learning experience offers the resident valuable experiences in healthcare practice models and policies.  Over the course of the year, the resident will meet monthly to learn strategies to develop and sustain an ambulatory care practice.  The resident will attend and present to RIPCPC/Integra providers at a POD or Pharmacy Committee meeting.

Elective experiences (24 weeks):

Academia

The elective longitudinal learning experience completed in coordination with University of Rhode College of Pharmacy is designed to provide the resident with experiences that contribute to his or her growth in teaching and precepting. The resident will have the opportunity to create or further develop a teaching philosophy and portfolio. 

University of Rhode Island College of Pharmacy, 7 Greenhouse Road, Kingstown, RI 02881                                  

Primary Preceptor: Anne Hume, PharmD, FCCP, BCPS

Primary Care II

This is an elective learning experience conducted at the same site where the resident is completing his or her Primary Care learning experience.  The Primary Care II experience will emphasize practice management principles necessary to become a successful ambulatory care pharmacist. The experience will allow the resident to become proficient independently managing his or her own patient panel. In addition, the resident will be involved with identifying opportunities for performance improvement at the primary care site. The resident will strategically plan to identify opportunities for marketing, service expansion, or improvements to service efficiency.

 

Required Duration Preceptor(s)
Orientation Weeks 1-3 Jennifer Leavitt, PharmD, CDCES, CDOE, CVDOE Diana Mercurio, BSPharm, CDCES, CDOE, CVDOE Ronald Tutalo, PharmD, BCACP, CDCES
Primary Care I Weeks 4-51 Bethany Spadaro, BSPharm, BCGP, CDCES Ron Tutalo, PharmD, BCACP, CDCES
Metabolic Clinic Weeks 4-51 Jennifer Leavitt, Pharm D, CDCES, CDOE, CVDOE Diana Mercurio, BSPharm, CDCES, CDOE, CVDOE
Transitions of Care Weeks 4-27 or 28-51 Shannon Levesque, PharmD
Staffing Weeks 4-51 Jennifer Leavitt, PharmD, CDCES, CDOE, CVDOE Diana Mercurio, BSPharm, CDCES, CDOE, CVDOE
Geriatrics Weeks 4-27 or 28-51 Stacey Ranucci, BSPharm, BCGP, CDCES
Pulmonology Weeks 4-27 or 28-51 Ron Tutalo, PharmD, BCACP, CDCES
Practice Management* Weeks 4-51 Stacey Ranucci, BSPharm, BCGP, CDCES
Research Project Weeks 4-51 Ron Tutalo, PharmD, BCACP, CDCES



Elective Duration Preceptor(s)
Academia** Weeks 4-27 or 28-51 Anne Hume, PharmD, FCCP, BCPS
Primary Care II** Weeks 4-27 or 28-51 Bethany Spadaro, BSPharm, BCGP, CDCES, Ron Tutalo, PharmD, BCACP, CDCES

 

* Practice management discussions will be scheduled in advance based on mutually agreed upon availability of preceptor and resident. Residents will be invited to selected meetings to enhance their practice management experience.

** Each resident must select one elective learning experience

Week 52 will be unscheduled to allow for smooth transition and completion of requirements.

 

Sample Schedule

Resident 1

Week # Monday Tuesday Wednesday Thursday Friday
1-3 Orientation Orientation Orientation Orientation Orientation
4-27 Metabolic Clinic Pulmonology Primary Care I Administrative Time/Staffing Academia or Primary Care II
28-51 Metabolic Clinic Geriatrics Primary Care I Administrative Time/Staffing Transitions of Care



Resident 2

Week # Monday Tuesday Wednesday Thursday Friday
1-3 Orientation Orientation Orientation Orientation Orientation
4-27 Metabolic Clinic Geriatrics Primary Care I Administrative Time/Staffing Transitions of Care
28-51 Metabolic Clinic Pulmonology Primary Care I Administrative Time/Staffing Academia or Primary Care II

 

Meet the Preceptors

The RIPCPC/Integra pharmacy team is embedded in primary care practices throughout the state providing pharmacy services to approximately 150,000 patient lives.  They strive to improve health and wellness of their patients by practicing patient-centered, team-based, and evidence-based medicine.  They are all passionate about furthering the growth of the pharmacy profession and addition to the PGY-2 Residency Program, precept University of Rhode Island APPE students.

Stacey Ranucci, BSPharm, BCGP, CDCES

Stacey joined the team as a clinical pharmacist in 2016 and currently serves as The Director of Pharmacy for the RIPCPC/Integra network.  She received her pharmacy degree from the University of Rhode Island, has 20 plus years of experience in geriatrics and continues to consult for Triad Health Care in Rhode Island.  She is board certified in geriatric pharmacy and Diabetes Education.  She is an Adjunct Clinical Assistant Professor, University of Rhode Island, College of Pharmacy and is the current chairperson of the Rhode Island Department of Health’s Board of Pharmacy.  Stacey is a fellow with the Rhode Island Geriatric Education Center for certification in Interdisciplinary Practice in Geriatrics, a preceptor for URI APPE students and PGY1 residents affiliated with Kent Hospital in Warwick, Rhode Island. She is a current member of the Rhode Island Department of Health Antibiotic Stewardship & Environmental Cleaning Task Force and is the immediate past-chair of the Education Advisory Committee & the Antibiotic Stewardship Taskforce with the American Society of Consultant Pharmacists.  

Ron Tutalo, PharmD, BCACP, CDCES

Ron serves as director of the Residency Program. He has seven years of clinical ambulatory care experience and has been with RIPCPC/Integra for almost 5 years.  His prior work experiences are in pharmacy benefit management, hospital pharmacy, and retail pharmacy. He has earned national certifications in ambulatory care pharmacy, diabetes care and education, and has a teaching certificate. He has earned local certifications within the state of Rhode Island that include diabetes and cardiovascular disease outpatient education. He also serves as Clinical Assistant Professor at the University of Massachusetts Graduate School of Nursing and as Adjunct Clinical Assistant Professor at the University of Rhode Island College of Pharmacy.

Anne Hume, PharmD, FCCP, BCPS

Anne supervises the elective academia learning experience.  Her teaching and scholarship includes primary care, integrative medicine, geriatrics, and interprofessional education/practice. She works with family medicine residents on the geriatrics rotation and precepts PharmD students on an ambulatory care APPE. She received the URI College of Pharmacy Teacher of the Year award in 2010 and 2014 and has published extensively and is a reviewer for many primary care, nursing, and pharmacy journals. She is an Associate Editor of the APhA Handbook of Nonprescription Drug Therapy and writes a monthly column on Integrative Medicine for Pharmacy Today.  She is currently developing a new book on the clinical use of botanicals, along with a co-editor.  Anne is active in the American College of Clinical Pharmacy (ACCP) and in other professional organizations.  She is a past Chair of Ambulatory Care Practice and Research Network of ACCP.

Jennifer Leavitt, PharmD, CDCES, CVDOE

Jennifer is one of the clinical pharmacists and serves as co-coordinator of the PGY-2 residency program.  She has been part of the RIPCPC/Integra team for almost 5 years.  Jennifer graduated from the University of Rhode Island College of Pharmacy where she earned her Doctor of Pharmacy degree.  Her prior work experience includes community pharmacy, specialty pharmacy, and pharmacy benefit management.  She holds certificates in cardiovascular disease and heart failure and has earned both state and national certifications in diabetes education.

Shannon Levesque, Pharm D

Shannon received her Doctor of Pharmacy degree from the University of Rhode Island in 1998. Since graduation, Shannon has maintained a clinical pharmacy practice in a variety of settings including ambulatory care pharmacist positions based in hospitals and primary care provider network/ACO settings and as a pharmacist pain management consultant. Shannon joined the Kent Hospital team in 2018 to develop a new ‘Transitions of Care Pharmacist Consult Service’ targeting patient at high risk for readmissions associated with financial penalties to the institution. Shannon is an active member of the Kent Transitions and Readmission Prevention Committee, Congestive Heart Failure Steering Committee and Readmission Huddle Team. 

Diana Mercurio, BSPharm, CDCES, CVDOE

Diana joined the team in December of 2016 and serves as the residency program co-coordinator.  Prior to her role at RIPCPC/Integra, she was employed by Prospect/Charter Care, initially in the pharmacy department and then as a member of the Performance Improvement/Quality team as the stroke coordinator and diabetes clinical manager.  She holds certificates in anticoagulation, pain management, cardiovascular disease, stroke management, and heart failure.  She is a nationally and locally certified diabetes educator.  Diana is a fellow with the Rhode Island Geriatric Education Center for certification in Interdisciplinary Practice in Geriatrics.  She is an Adjunct Clinical Assistant Professor, University of Rhode Island, College of Pharmacy and was recently appointed to the American Health Council’s Industry Board.

Bethany Spadaro, BSPharm, BCGP, CDCES

Bethany is one of the clinical pharmacists with six years of experience on the Integra care team and 23 years of experience as a licensed pharmacist.  She graduated from the University of Rhode Island College of Pharmacy.  She has extensive geriatric experience in the long-term care setting.  In addition to her pharmacist license she has two national board certifications; Board Certified Geriatric Pharmacist, BCGP and Board Certified Diabetes Care and Education Specialist, CDCES.  She works predominantly in the southern part of the state where she is embedded in busy multi-provider practices.

Preceptors in Training

Brianna Kimball, PharmD

Brianna joined the team as a clinical pharmacist in July of 2020 after completing her PGY-2 Ambulatory Care Residency with RIPCPC/Integra. She earned her Doctor of Pharmacy degree from The University of Rhode Island College and completed a PGY-1 Pharmacy Residency with the VA Maine Healthcare System.   She earned her Teaching Certificate through the University of New England College of Pharmacy. During her residency experience with RIPCPC, she had an integral role in developing and implementing a pharmacist-led chronic obstructive pulmonary disease management program at one of our outpatient primary care clinics, which we have since expanded.  She is currently a preceptor-in-training for our current PGY-2 Ambulatory Care Pharmacy Residents.

Amy Schauster, PharmD, BCGP, AE-C, CDOE, CVDOE

Amy joined the team in November 2019.  She graduated from the University of Rhode Island in 1999 and has been working in the profession for over 20 years with a background as a Community Pharmacist, a clinical pharmacist in a Managed Care setting, and in Pharmacy Benefits Management.  Amy has a Board Certification in Geriatric Pharmacy, is an asthma educator, and is a Certified Diabetes and Cardiovascular Outpatient Educator.  She is currently a preceptor-in-training for our current PGY-2 Ambulatory Care Pharmacy Residents.

Salary & Benefits:

  • Stipend: $45,000 per 12 months
  • Health, dental and vision insurance
  • Holiday, paid time off
  • Company issued laptop computer and cell phone
  • Travel, continuing education allowance

How to Apply

Submit your application materials via Pharmacy Online Residency Centralized Application Service (PhORCAS) by application deadline to be considered for the RIPCPC/Integra PGY-2 Ambulatory Care Residency Program. Please refer to application deadline in PhORCAS. 

Candidate Requirements

Applicants must meet the following qualifications to be considered for the program:

  • Graduate of an ACPE-accredited School of Pharmacy.
  • Applicants must be participating in or have completed an ASHP-accredited or candidate for accreditation PGY1 Pharmacy Residency Program
  • Eligible for pharmacist licensure in Rhode Island.
  • Flexibility to start on a pre-determined date. Ask the program director for the exact date. Adjustments to the start date are not allowed.

The Pharmacy Residency programs participate in the Residency Matching Program (“The Match”). After “The Match”, employment as a pharmacy resident is still contingent upon the applicant satisfying RIPCPC’s employment eligibility requirements.

Application Process

Please apply through the Pharmacy Online Residency Centralized Application Service (PhORCAS).

Your application must include:

  • Letter of interest, specifying:
    • Your personal career goals
    • Why you’re interested in residency training, what you’re looking for in a residency program and why you’re interested in our program
  • Curriculum vitae (CV)
  • Three references (separate letter not required)
  • Pharmacy school transcripts

Onsite Interview

All Pharmacy Residency Candidates must complete an on-site interview. If any circumstances preclude an onsite interview, the interview may be held virtually. A request to reschedule an interview date will only be granted in extenuating circumstances.