Q&A with a Geriatrics PGY-2 Pharmacy Resident

Kripali Patel, PharmD, is a post-graduate year 2 (PGY-2) pharmacy resident specializing in geriatrics at the Virginia Commonwealth University and Richmond Health & Wellness Program. Dr. Patel completed her doctorate of Pharmacy in May of 2016 at MCPHS University in Boston, Massachusetts. She completed her PGY-1 community pharmacy training at the University of North Carolina, Chapel Hill. She enjoys working in the community with a keen interest in chronic care management, medication adherence and transitions of care.

Q: Why did you decide to pursue a PGY-1 and PGY-2 pharmacy residency?

A: I chose to pursue a PGY-1 and PGY-2 residency to strengthen my clinical and interprofessional skills. During my last rotation in pharmacy school, I had the amazing opportunity to intern at the National Community Pharmacists Association (NCPA). At NCPA, I recognized the challenges facing community pharmacy and knew that I wanted to work in the community to help address these issues.

This led me to apply to the innovative new residency at the University of North Carolina—Eshelman School of Pharmacy, called the Independent Pharmacy Ownership Residency (IPOR). As the first IPOR resident, I gained a greater appreciation for clinical pharmacy services. This experience, coupled with my experiences growing up with grandparents affected by chronic conditions, led me to pursue a PGY-2 specializing in geriatric care.

Q: What is the structure of your residency program?

A: This residency program offers several longitudinal rotations, as well as elective clerkships. A majority of my time is spent at the Richmond Health and Wellness Program (RHWP), a unique interdisciplinary care coordination model that takes place in low income senior housing complexes around the urban Richmond, Virginia area. Another longitudinal rotation includes participating in the Virginia Geriatric Education Center’s Faculty Development Program. During the academic year, there is also an opportunity to practice precepting skills in the Foundations lab for P3s and a virtual geriatrics case that brings together the schools of Medicine, Nursing and Pharmacy.

I am also part of the Health and Wellness in Aging Populations core of the Institute for Inclusion, Inquiry and Innovation (iCubed) at VCU which provides training and development on conducting community engaged research, developing and sustaining community partnerships, and creating an inclusive environment for research, education and clinical service.

In addition, there are a variety of clinical rotations available to choose from. My first rotation took place at the VCU Medical Center with the hospital’s unique Geriatric Consult Service, which aids in the management of acute medical issues and co-management of chronic conditions for hospitalized older patients. For my second rotation, I am at the VCU Health System’s Center for Advanced Health Management, which deals with the care of patients with complex comorbidities, transitions of care and house calls.

Q: What are your day-to-day tasks?

A: My day-to-day tasks include attending clinic at the RHWP, three days out of the week. During clinic, I am responsible for overseeing interdisciplinary student teams composed of nursing, pharmacy, medicine, social work and undergraduate health science students. I am implementing programs to improve medication adherence and diabetes management for our RHWP patients, as well.

I spend some time, once a week, at the School of Pharmacy’s Foundations Lab, where I evaluate P3 students on clinical skills such as blood pressure measurement technique. When on specific clinical rotations, I also spend concentrated time in those sites developing my clinical and interprofessional skills.

Q: What are the benefits of completing a PGY-2 residency? What about the disadvantages?

A: A PGY2 allows you to really dive into an area of pharmacy that sparks your interest. During the residency, you are exposed to professionals who have years of experience and knowledge which is invaluable. In addition, there is an opportunity to understand and potentially address issues pertaining to your specialty. It is really an opportunity to become an expert in the field.

As far as disadvantages, I do not believe there are really any, aside from the fact that focusing in on one are of pharmacy may lend itself to losing sight of other areas of pharmacy practice.

Q: How did you decide your PGY-2 residency program was the right fit for you?

A: I decided that a PGY2 was right for me based on my previous experiences and an interview with my residency program director. During my time in pharmacy school, I worked at an independent long-term care pharmacy and, since then, the complexity of caring for older adults has always intrigued me.

After interviewing with my current residency director, I recognized an amazing opportunity to build on my clinical skills and address issues facing geriatric care such as chronic care management, and transitions of care.

Q: What opportunities does a PGY2 geriatrics resident have after completion of the residency?

A: As the baby boomer generation continues to age, there are growing opportunities in the care of older adults. There are a variety of settings that involve the care of geriatric patients, including inpatient, community pharmacy, long-term care, and the Department of Veteran Affairs. There are also a variety of areas to focus on, such as medication management, transitions of care, chronic care management, and so much more.

Q: What advice do you have for students looking to pursue a residency focused in geriatrics?

A: I would encourage students who are looking to specialize in geriatrics to get involved in organizations that provide an opportunity to work with older adults. Alternatively, a good start is talking to grandparents and learning what issues they have faced over the years with their care. Be sure that working with this population is something you are passionate about!