First-year residency in automation: Yes or no?

November 22, 2004

For Randy Carver, R.Ph., it was baptism by fire. Carver, the pharmacy automation coordinator at Phoebe Putney Memorial Hospital in Albany, Ga., learned his technology skills on the job, beginning back in 1995 when the hospital installed its first unit-based cabinet in the emergency department. "When I came on board, I didn't know anything about automation. I had no formal computer training, I had to learn everything," he said.

For Randy Carver, R.Ph., it was baptism by fire. Carver, the pharmacy automation coordinator at Phoebe Putney Memorial Hospital in Albany, Ga., learned his technology skills on the job, beginning back in 1995 when the hospital installed its first unit-based cabinet in the emergency department. "When I came on board, I didn't know anything about automation. I had no formal computer training, I had to learn everything," he said.

But nowadays, with multiple technologies-including bar- coding, computer- ized physician order entry, and robotics-having become such an integral part of the practice of health- system pharmacy, teaching pharmacists technology via the "school of hard knocks" seems a poor choice. That's why Carver, who oversees pharmacy automation-from evaluation and selection to design and workflow-is looking to hire a pharmacy technology/automation resident. "We have a need for this position and we think other hospitals have the same need," he said. The idea is not only to fill a need at Phoebe Putney Memorial but also to train pharmacists to fill the technology gap in other facilities.

Carver has circulated an advertisement to pharmacy schools and industry trade shows around the country touting the 12-month residency at a salary of $35,000. At its core the residency is designed to teach a pharmacist how technology integrates with pharmacy practice and how it affects patient care and safety. The resident, Carver noted, will learn the skills necessary to become a system administrator.

Janet Teeters, R.Ph., director of accreditation services at ASHP, said the current residency structure requires that pharmacists complete a basic pharmacy practice residency before moving on to a specialty residency. However, Teeters also acknowledged that setting it up as a specialty technology residency is controversial. "There are a lot of people who think you should know something about patient care before you move into that area, while others think that a pharmacist should just be able to come out of school and learn about technology," she said.

Carver takes the latter perspective on the issue. "Even though the technology residency would not be direct patient care, we are involved in patient care every day. We teach the big picture here."

In addition, he noted that he doesn't think he will attract many people if the residency is restricted to a second-year spot. "I think my residency lends itself more to a nontraditional student who's already out there and wants to pursue this as a career path but doesn't have the credentials to get a job in that area yet."

Both Carver and Teeters agree that the question over accreditation isn't a battle between ASHP and health-system pharmacists looking for the best way to implement a technology residency but is rather a difference of perspective on how best to determine the criteria for such a residency.

Teeters said ASHP has planned a session at its Midyear Clinical Meeting in December with the hopes of gathering experts in the field and establishing a dialogue on the subject. "We will discuss what is needed to train people in these areas and on what level should they be doing that."

The residency issue in general has been a sore spot in the health-system pharmacy community ever since the federal government cut funding for second-year residencies despite growth in the number of available residency slots.

Meanwhile, Carver said he has received clearance from his hospital for two residencies-one in internal medicine, the other in technology/automation. He's heard from a few interested parties but has no solid candidates. He noted that because technology has become such an integral part of health-system pharmacy, the need for a full-time resident is imperative.

"We're looking at a new pharmacy IS system, and that means new interfaces. Such a resident would have to become involved in a lot of different things that in the past would have never been considered a pharmacist's duty," said Carver.