William R. Pritchard Veterinary Medical Teaching Hospital

Pharmaceutical

Pharmaceutical Services - Residency Program

RESIDENCY PROGRAM IN VETERINARY CLINICAL PHARMACY

The Veterinary Medical Teaching Hospital at the School of Veterinary Medicine, University of California, Davis, is offering a residency program in Veterinary Pharmacy. Minimum qualifications include graduation from an accredited School of Pharmacy and a California Pharmacy License or ability to obtain a license within one year. The selection of residents is made on the basis of academic achievement, career objectives, letters of recommendation, and pertinent experience.

I. Objectives

To provide non-degree postdoctoral education in veterinary clinical pharmacy and therapeutics.
To prepare the resident for eligibility and certification by the Society of Veterinary Hospital Pharmacists (SVHP) as a diplomate.
To provide experience in designing a clinical pharmacology research project, undertaking the research, investigation, and publication of the findings.
To provide experience in the regulatory aspects of drug use in animals, including manufacturing (GMP practices, compounding), dispensation (extra-label use) and public health issues (food animal residues, feed additives).

II. Justification for Clinical Education

Veterinary Pharmacy is a practice that has slowly evolved from the role of a sole Veterinarian selecting, dispensing and sometimes manufacturing his/her own medications to a highly regulated, research-based pharmacy profession that requires a vast background of knowledge about pharmacology, therapeutics, law and compounding of drugs. The variety of species and scope of pharmaceutical information required to provide quality of care now necessitates a specialty residency to meet these demands. Academic veterinary centers, drug companies, manufacturing companies and regulatory agencies have all expressed interest in graduates from the program. Annual demand from the sources consulted with would approach one per year for academics (SVHP), 1-2 per year in regulatory departments (FDA), and 2-3 per year in commercial markets (Pfizer, Schering). We have had at least 10-20 applicants/year. This is the first established residency program in Veterinary Pharmacy for pharmacists.

The Veterinary Clinical Pharmacy Residency Program is designed to address these needs and provide non-degree postdoctoral education in veterinary pharmacy. The residency program will be a two-year program. Completion of the program will fulfill the experiential requirement to be eligible to take the exam and be certified by SVHP as Diplomat, International College of Veterinary Pharmacy (DICVP). Successful completion of the residency will result in a Residency Certificate.

The program utilizes the facilities and faculty of the Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis. A large clinical case load exists at the Veterinary Medical Teaching Hospital (VMTH) to support a multitude of pharmacy services, including inpatient, outpatient, nutrition, sterile infusion services, oncology, compounding, and emergency services. The VMTH and its national reputation for veterinary pharmacy services provide a core drug information and clinical consulting center for veterinary practitioners as well as pet owners.

III. Residency Program : Courses of activities

A. Duration
This will be a two year residency program for interested residents. A Certificate of Residency will be awarded to candidates successfully completing the program. Residents will be asked to work a minimum of 40 hours per week. Time off for sick leave and/or vacation will be according to established university policy (ie. 2 working days/month). Hours may be extended as required for travel to externship sites or rotations in the field.

B. General Scope and Nature of Training
In the first four months, residents will spend most of their time in the Veterinary Medical Teaching Hospital under the direct supervision of the Veterinary Clinical Pharmacist. Residents will attend clinical rounds in small, large and exotic animal clinics. Rotation through one or more of the subspecialty areas of cardiology, dermatology, neurology, oncology, and ophthalmology will be included. The resident will become familiar with the pharmacies computer system, formulary and dispensation protocols. Residents will take required Health and Safety coursework (Waste management, Hazardous drugs, Biologic Safety Hoods, etc.), prior to beginning their research project. They will obtain certification in both chemotherapy and nutrition preparation. The first four months will consist of approximately 50% clinical practice. The remaining time will involve work in drug information, design of clinical trials, and participate in Food Animal Residue Avoidance Databank (FARAD) training. There will be no designated class room work.

Starting in the fifth month, residents will select a specialty area of emphasis based on their own interests. A research topic will be selected and the following four months will be tailored to develop skills around that area. The research topic will be submitted for approval by the end of the fifth month. During the next four months, students will have the option to rotate through several specialty sites to develop and complete their research projects. Residents may rotate through the Drug Product Services Laboratory, Department of Clinical Pharmacy, at the University of California, San Francisco (UCSF), where they will obtain expertise in pharmaceutical compounding and manufacturing. The student may also rotate through Dr. Lisa Tell's Veterinary Drug Residue Laboratory at UCD where they will learn basic analytical techniques (HPLC) or in vitro assays to assess drug concentrations, metabolism and efficacy. The resident will continue to attend clinical rounds and participate in drug information and FARAD training .

In Spring, residents will be expected to present their project at the National SVHP meeting and /or the UCDavis Annual Residents Symposium. They should also participate in ongoing teaching course work for both veterinary and pharmacy students. They will continue to attend grand rounds and learn analytical skills pertinent to their research topic. Drug information and FARAD coverage will be required approximately every other week. Residents should select a Specialty service to shadow with a veterinarian.

During summer of the first year, residents will participate in a minimum of two weeks at a Veterinary Clinic externship site. At the same time, they will write their project up for publication to a peer reviewed journal. They will undertake a brief overview of Veterinary Pharmacy Regulatory processes. Depending on the resident's area of interest, that may be accomplished at any of the following external sites. This may include a regulatory agency such as 1) a Drug Company, 2) CVM or AVMA, or 3) FARAD. These rotations should provide residents with a good appreciation of food animal residue issues, Good Laboratory Practices (GLP) and Good Manufacturing Practices ( GMP).

Residents in the second year will spend most of their time developing special interests and gaining regulatory experience. They will be encouraged to write grant applications, animal protocols and articles that will be submitted to peer review Journals for publication. Approximately 10-20% time will involve teaching of Pharmacy and Veterinary students and participating in Clinical rounds and Journal Club. The remaining time will be spent doing a second research project and gaining an understanding of Good Laboratory Practices (GLP) and Good Manufacturing Practices ( GMP). The resident may also choose to continue or expand on their research project from the first year. If available, the resident may have the opportunity to do an externship at the FDA or at CVM. The resident will further their regulatory background by learning Quality Assurance and designing of target studies. They will be trained in data extraction and pharmacokinetic modeling. They will have the opportunity to learn non-linear pharmacokinetic modeling programs (PC Win-NonLin). Students will further their research methodology, critical assessment of the literature, research design, writing and presentation skills.

C. Time Line
Residents in their first three months will start in the Inpatient/Outpatient Pharmacy at the VMTH, School of Veterinary Medicine, UC Davis, learning pharmacy operations, veterinary compounding, drug information and FARAD training. Students will learn the veterinary formulary and attend weekly rounds given by the Veterinary Medical Teaching Hospital., in both small and large animal services as well as several elective rounds in a subspecialty of their choice (ophthalmology, cardiology, oncology, etc.). Students will additionally select a drug information topic and learn how to critically evaluate the literature. The topic will then be either presented orally at pharmacy rounds or written up and submitted for publication to a peer reviewed journal. Students will identify an area of research interest by the end of the 5 th month. Topics will be highly flexible and based on the specific interests of the individual resident. Starting in the 5 th month of the residency program the student will learn the basic research techniques necessary to complete their research project. This will be done either in Dr. Tell's Laboratory or Dr. Scott Stanley's Pharmacology/Pharmacokinetics Laboratory at UCDavis. Here students can learn a variety of analytical techniques (HPLC) to assess drug and metabolite concentrations or several in vitro cell culture models to assess drug efficacy. Alternatively, if their area of interest is involving drug manufacturing or compounding of formulations they will have the opportunity to develop these skills in the Pharmaceutical Compounding Laboratory at UCSF. In the following 4-5 months, the resident will design, perform and do data analysis on their research topic. They will work with Drs. Wiebe and Tell to write up results in abstract form for submission to the UCD, VMTH Annual House Officers Seminar Day. Research projects will also be written up for submission to and potential publication by a peer reviewed journal. The last two months of the first year, Resident's will spend time on an Externship, learning regulatory issues with one of the following: 1) a Drug Company, 2) FDA or CVM or 3) FARAD. Here the students will learn the basic processes of GLP, GMP and other drug approval processes.

D. Knowledge and Skills
The Pharm. D. level candidate will be provided with information and experience to apply their considerable skills in medical treatment of disease conditions, therapeutic regimen design, clinical trials, drug distribution and regulation, pharmaceutics, pharmacology, kinetics, drug information sources and services, etc. in the provision of pharmaceutical services for animal patients.

Graduates of this program will have a unique combination of skills. Their knowledge of drug marketing, quality assurance, and clinical trial design, tempered with their veterinary experience will make them valuable assets to the veterinary pharmaceutical industry, regulatory agencies, colleges of pharmacy, and colleges of veterinary medicine.

IV. Structure and Organization

Residents will be supervised directly by Dr. Valerie Wiebe, Pharm..D. (Director of Clinical Pharmacy). Approximately 40% of her time will be involved in directly overseeing the resident in a clinical capacity. Others who will participate significantly in the resident's instruction will include Dr. Lisa Tell, DVM who oversees residents in the FARAD externship program as well as other faculty members depending on their area of interest. Dr. Kyvan Nguyen, Pharm. D will oversee residents spending time at The University of California, San Francisco, Pharmaceutical Compounding Laboratory. He will spend approximately 10% effort overseeing the residency. Dr. Wiebe will work to assist the resident in the selection, clinical design and methodology of the research project.

The resident will have desk space and computer access at the VMTH main pharmacy and with Dr. Tell's laboratory. Analytical equipment, chemicals and other required instrumentation to complete their research project will be available in both the Equine Analytical Laboratory and Dr. Tell's Veterinary Drug Residue Laboratory.

V. Faculty participating in the proposed program

Dr. Valerie Wiebe, Pharm. D. will be primarily responsible for the direct supervision and evaluation of residents. She will spend 40% time directly overseeing the resident. She will assure that the resident achieves the stated objectives of the program. Dr. Lisa Tell, DVM will oversee the regulatory aspects of the program, including FARAD training and analytical methods training.

VI. Process of evaluation

Residents will be evaluated based on several criteria. Requirements that must be met before a resident can receive a Certificate of Residency for the program include: 1) Satisfactory completion of all rotations, 2) Satisfactory completion of the research project, 3) Satisfactory completion of the externships, 4) Determination that all requirements have been met by the Chief Clinical Pharmacy Coordinator. Attendance is mandatory for the entire program. Voles evaluations will be performed to provide feedback to Residents. Poor attendance will be grounds for dismissal. Residents must complete all requirements in order to obtain a Certificate. VMTH policy will be followed in cases where dismissal is required for any resident.

VII. Certification

The specific academic requirements and conditions needed to complete the residency and obtain a certificate include:

Demonstration of satisfactory knowledge and skills in:
-dispensing veterinary pharmaceuticals to a variety of species
-preparation of sterile products, TPN, chemotherapy, unit doses
-efficacious compounding of pharmaceuticals for use in veterinary medicine

Demonstration of skills and abilities in:
-Location/evaluation/critical assessment of drug information in the Veterinary literature
-extrapolation of available drug information to the veterinary patient
-clinical consulting

Completion of clinical rotations in:
-general medicine of small animals, horses, food animals and exotics
-specialty rounds

Preparation, completion and submission of a research project showing proficiency in:
-research design
-methodology
-data analysis
-scientific writing

Demonstration of knowledge in:
-food animal regulations
-regulatory procedures for drug manufacturing and laboratory analysis of pharmaceuticals.

Budget:

First Year Resident Salary	$37,308
Plus Benefits	3,472

One Year Total	(Subject to change)..........$40,780

Contact Persons
Dr. Valerie J. Wiebe, Pharm. D.
VMTH Chief Clinical Coordinator
Department of Pharmacy, RM 1150-UC Davis
1 Shields Ave.
Davis. CA. 95616-8747
vjwiebe@ucdavis.edu
Phone: (530) 752-0178
Fax: (530) 754-2230

Dr. David Wilson, BVSc, MS
VMTH Director and
Associate Dean for Clinical Programs
UC Davis
One Shields Avenue
Davis, CA 95616-8747

VETERINARY PHARMACY RESIDENCY PROGRAM (First Year)
Month	General Duties	Monthly Rotations	Projects
1	Pharmacy (General dispensing)	Inpatient-Small animal	Drug information FARAD training
2	Pharmacy (HS classes) (Chemo/TPN certification	ICU-Small animal	Drug information FARAD training
3	Pharmacy (Compounding)	Inpatient Equine	Drug information FARAD training Analytical skills
4	Pharmacy (Compounding)	Outpatient Equine	Drug information FARAD training Analytical Skills Grant writing
5	Research (GLP/GMP)	Exotics/Anesthesia	Select Research Project (Literature review)
6	Research (FARAD coverage)	Research (Perform study)	Research
7	Research (FARAD coverage)	Research (Continue study)	Research
8	Research (FARAD coverage)	Research	Research (Begin write-up of study)
9	Data Analysis	Statistics	FARAD (Symposium talk)
10	Teaching (DVM/Pharm D)	Shadowing	FARAD
11	Externship	Externship	FARAD
12	Externship	Externship	FARAD

VETERINARY PHARMACY RESIDENCY PROGRAM (Second Year)
Month	General Duties	Monthly Rotations	Projects
1	Externship (FDA/CVM)	Small Animal Ruminants	Drug information FARAD Write animal protocol
2	Externship (FDA/Audits)	Poultry	Drug information FARAD (Quality Assurance)
3	Externship (FDA/CVM)	Tulare/Dairy	Drug information FARAD
4	Externship (Drug Company)	Inpatient/Outpatient Food Animal	Drug information FARAD
5	Pharmacokinetics (Non-linear programs)	Marine Animals/Aquatics	Select Research Project FARAD/DI
6	Pharmacokinetics	Shelter Medicine	FARAD/DI
7	Research (Analytical)	Avian Medicine	FARAD/DI
8	Research (Analytical)	Research	FARAD/DI
9	Data Analysis (Analytical)	Statistics	FARAD (Write up Study)
10	Data Analysis (Analytical)	Project Write-ups	FARAD/DI
11	Project Write-ups	Open	FARAD/DI
12	Project Write-up	Open	FARAD/DI

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Past Veterinary Pharmacy Residents

UC Davis School of Veterinary Medicine