PGY2- Psychiatric Pharmacy Practice Clinical Rotation Descriptions

CORE EXPERIENCES: (Required)

Adult Inpatient Psychiatry (6 weeks) at LAC+USC Psychiatry at Augustus F. Hawkins/MLK Medical Center
Preceptor: Julie A. Dopheide, PharmD, BCPP, FASHP
The goal of this core experience is to allow the resident to intensively manage more challenging patients while integrating
into the psychiatric treatment team. Dr. Dopheide will be the primary preceptor but the resident will lead medication
education group, and assist in supervising students. He or she will provide evidence based recommendations on
optimizing drug therapy while further developing interview skills, clinical assessment skills and patient and staff education
skills. The resident will co-lead conferences with Dr. Dopheide and document clinical activities in the chart. Adverse
drug reactions, medication errors and all clinical interventions will be recorded in the pharmacy computerized databases
including the patient safety network (PSN) and Quantifi (pharmacy intervention tracking system). The resident will
expand and solidify their knowledge base in psychopharmacology.

Supervisory Role – Adult Inpatient Psychiatry (6 weeks) at LAC+USC

Preceptor: Julie A. Dopheide, PharmD, BCPP, FASHP
This 6 week experience will involve semi-independent precepting of P4 PharmD students. The students will directly
monitor all of the patients and the resident will meet with them daily for supervision and guidance. The resident will be the
role model, lead case presentations, all conferences and will conduct mid-term and final examinations with students (with
input and assistance from Dr. Dopheide). The goals are twofold: 1) Provide the resident with the experience of leading an
acute care clinical pharmacy service on a general inpatient unit while teaching and supervising PharmD students.

Center for Community Health (CCH) Safety Net Clinic

Preceptor: Julie Dopheide, PharmD, FASHP and Paul Gregerson, MD.
Provide primary care for outpatients with psychiatric illness while collaborating with their primary care providers to
optimize each patient’s overall mental and physical health. The approved protocol developed in 2008 calls for all referred
patients to have a psychiatric diagnosis, however, the resident will work with the consultant psychiatrist and primary care
physician to clarify the psychiatric diagnosis when necessary. The resident gains experience in addressing each patient’s
individual needs and coordinating overall care which often includes making referrals for housing, psychotherapy and
substance abuse recovery.

SELECTIVE OPTIONS (Must select 3, can fit up to 6 experiences if abbreviated)

LAC+USC Child/Adolescent Psychiatry (Clinic) (6-8 weeks), can be combined with Juvenile justice or other experiences
Preceptor: Chris Snowdy MD and Julie Dopheide, PharmD, BCPP
The resident will work with attending staff and child fellows at the LAC+USC child/adolescent clinic and participate in
patient assessment, family counseling, and behavioral modification. The resident will present didactic lecture(s) on topics
in psychopharmacology with preceptor supervision. The resident will attend didactic instruction on Thursdays with the
child fellows. The resident will participate actively in the Pediatric Psychotropic Guidelines committee meetings at the
Department of Mental Health.

Consultation and Liaison Psychiatry (4-6 weeks) at LAC+USC Medical Center

Preceptor: Susie Park, PharmD, BCPP, CSHP
The psychiatric pharmacy resident will see patients with the psychiatry resident and assess and manage psychiatric illness
in individuals with acute medical conditions (eg. heart failure, cancer, trauma, burn victims, acute infections, HIV,
autoimmune diseases, renal failure, etc.) while they are receiving treatment for these conditions in the hospital. The
resident will gain experience as a psychiatric consultant in an acute care hospital and will serve as a drug information
resource in the hospital. The resident gains first hand experience on psychotropic dosage adjustment in organ failure, the
clinical significance of drug interactions in the medically ill patient and the unique side effects experienced by medically ill
patients.
Geriatric Behavioral Health – Caremore, Irvine, LAC+USC
Preceptors: Jim Rose PharmD and Joseph Pratty, MD (Caremore), Helena Chui, MD and Freddie Segal (LAC+USC and
Rancho Los Amigo Rehabilitation Center), Brad Williams, PharmD, (UC Irvine)
The resident has the opportunity to participate in patient assessment with a world-renowned expert in vascular dementia,
(Helena Chui) at LAC+USC and Rancho Los Amigos. Evaluation for traumatic brain injury and other some other
neurologic disorders is also a part of the LAC+USC component of this rotation. At UC Irvine, the resident works with a
multidisciplinary team to evaluate a patient with suspected dementia. Psychological and psychosocial evaluations are a
unique feature of this experience as the team of experts spends the entire day assessing one patient. The resident provides
education to the patient and family. At Caremore, the resident has the opportunity to assess medication regimens and make
recommendations for optimization to both MD’s and nurse practitioners.

Emergency Psychiatry at LAC+USC Medical Center

Preceptor: Julie Dopheide, PharmD and Psychiatric Emergency Services Medical Staff
The pharmacy resident will work with the psychiatry resident to assess and manage acute psychiatric illness.
The resident will gain experience seeing severe symptomatology and recommending optimal treatment based on symptoms
and individual patient parameters. The resident will take medication histories and be able to differentiate drug-induced
psychosis from schizophrenia, bipolar mania, and acute depression.

Substance Abuse/Addiction Medicine – Veteran’s Healthcare System, Downtown Los Angeles.

Preceptor: Daily supervision by Ed Moore MD and weekly and as needed discussions with Julie Dopheide, PharmD. The
resident will become part of the substance abuse recovery team and manage the health of patients taking naltrexone,
methadone, acamprosate and other psychotropics designed to decrease craving and facilitate recovery. The resident will
participate in any ongoing research that the team is working on. The resident will conduct psychoeducation grouops for
patients.

Edelman Children’s Court

Precptor: Jane Tran-Tesoro, PharmD, BCPP
The resident will work with the court system in assessing the appropriateness of psychotropic medication for youth who are
in detention or who are under the care of the state. The resident will provide psychoeducation on the appropriate use of
medications in children and adolescents. The resident will attend pediatric psychotropic guidelines meetings at the
department of mental health.

Juvenile Justice at Eastlake Juvenile Detention Center

Preceptor: Julie Dopheide, PharmD, and Soe Moe Kyaw MD.
The resident will work with probation and clinical staff to optimize psychotropic drug therapy for youth in juvenile
detention. The resident will oversee appropriate drug therapy monitoring for youth with a wide range of neuropsychiatric
diagnosis. The resident will attend meetings to assist with guideline development on psychiatric pharmacotherapy for
youth.

Child/Adolescent Psychiatry – LAC+USC

Preceptor: Julie Dopheide, PharmD, BCPP and Maria Goldstein, MD.
The resident will be a part of the multidisciplinary inpatient team caring for children and adolescents with a
wide array of psychiatric illnesses including schizophrenia, bipolar disorder, depression, substance abuse,
attention-deficit hyperactivity disorder, conduct disorder and eating disorders.

Eating Disorders- BHC Alhambra or Bella Vita Center

Preceptor: Julie Dopheide, PharmD, BCPP with input from Patricia Pitts PhD and supervising MD.
The resident will participate in the evaluation and treatment of patients with eating disorders including
anorexia nervosa, bulimia nervosa, binge eating disorder and mixed eating disorders. The resident will gain
an appreciation for the importance of non-pharmacological interventions to treat these disorders (dialectical
behavioral therapy) The resident will provide psychoeducation to patients, their families and medical staff.

Neurology Clinics
Preceptors: Mark Lew MD, Laura Kalayjian MD, Soma Sahai MD; weekly discussions with Julie Dopheide, PharmD
The resident will see patients with refractory epilepsy, movement disorders and a wide array of other neurological
conditions including migraine, stroke, Huntington’s chorea, and Parkinson’s disease. The resident will learn how to
differentiate drug-induced movement disorders from idiopathic conditions. The resident will gain experience in the dosing
and monitoring of anticonvulsants used for multiple seizure types.

Kaiser Permanente – Behavioral Health – Pasadena

Preceptors: Kathrine Roe, PharmD, BCPP, Janet Aiso, PharmD, MBA The resident will work alongside Dr.
Roe providing MTM/CMM services patients with anxiety, depression, and insomnia. The resident will
participate in face-to-face interviews and telehealth clinical services. There may be an opportunity to visit
the partial hospitalization program in addition to Kaiser’s inpatient service in China town as well.

Keck Medical Center of USC – Consultation and Liaison Service

Preceptor: Erin Knox, PharmD.
The resident will work with the psychiatry residents and attending under the supervision of the preceptor to
provide psychiatric drug therapy consultation to patients with acute care medical conditions. The resident
will participate in weekly treatment planning, conduct medication groups as needed and supervise students
on rotation.

Participate in Psychiatric Pharmacy Business Meeting

A residency retreat is conducted in June to discuss individualizing the residency according to the resident’s
career goals and the clinical and teaching needs of LAC+USC. This 8 hour planning meeting is typically
off-site to allow for minimal interruptions. Quarterly business meetings are also held in order to provide
the resident with feedback on presentations, teaching and to discuss topics in neuropsychiatric pharmacy.
The CNS module course coordinator attends these meetings to review the resident’s lecture prior to
presentation in the PharmD Curriculum as well. Each resident

Didactic Coursework
The PGY-2 Psychiatric Pharmacy resident will attend didactic lectures/case presentations and seminars with the LAC+USC
psychiatry residents and attendings throughout the year at the LAC+USC practice site. Topics include the clinical
psychiatric interview, mental status examination, diagnostic formulation of all major DSM-5 psychiatric disorders,
pharmacokinetics and pharmacodynamics of the psychotropics, cultural issues in psychiatry, psychopharmacology of
pregnancy, medical/legal issues in psychiatry, assessing and preventing suicide, psychological assessment, and substance
use disorders.If the resident has not previously attended the research and teaching skills courses offered by USC, these
courses are required.

Research Project
The resident will collaborate with faculty to develop a clinical research project. The resident will discuss project ideas with
psychiatric pharmacy faculty and preceptors to identify a worthwhile project that has scientific and clinical merit.
Psychiatric Pharmacy faculty and Dr. William Gong work with the resident to develop a project and present it to peers and
faculty for feedback. PGY2 psychiatric pharmacy residents are required to present a poster at the College of Psychiatric
and Neurologic Pharmacists Annual meeting. Presentation at the Western State’s Conference for Pharmacy Residents and
Lecturers is optional. The project must be submitted for publication prior to residency completion.