Residency program celebrates 25 years of innovation, camaraderie and pioneering Minnesota ambulatory care

Photo: Dr. Morgan Hoeft pictured along with attendees at the 25 Year Postgraduate Pharmacy Residency Anniversary Celebration

As the College of Pharmacy celebrates the 25th anniversary of its Postgraduate (PGY1) Pharmacy Residency Program, the college community also celebrates a quarter-century of innovation, community and pioneering ambulatory care in Minnesota. When the program officially started in 1999, clinic-based PGY1 residency programs were almost unheard of. In the years leading up to that, faculty-built relationships with local health systems had led to informal and non-accredited “fellowships,” which became the precursors to the residency program. 

“I think that's an important part of our history, that we were not necessarily following the national norms here,” said Dr. Todd Sorensen, professor, senior executive associate dean for strategic initiatives and faculty affairs, and the program’s first director. “The purpose of the College of Pharmacy choosing to do this was to be part of facilitating the growth of this practice across the state.”

Residency programs became a catalyst for change in the acute care environment; as clinical practice in large hospitals grew significantly because of the programs, pushing staff to train and offer expanded services in order to host residents, the college’s goal was to similarly expand ambulatory care practice across the state. So it did. From its original three sites in 1999, the program blossomed into one of the largest multi-site PGY1 residency programs in the country. 

Reciprocal relationships emerged from the program, Sorensen said. Particularly for smaller, younger clinics only planning to have one resident at a time, the college’s program offered a convening point to relieve much of the administrative work— obtaining accreditation, recruiting, constructing the instructional program— without which smaller organizations may not be able to participate. The program’s affiliation with the University of Minnesota has also enabled them to recruit nationally, expanding their reach. 

“We've had people from various parts of the country come to the program and go to our rural sites because it gets on their radar,” Sorensen said. “There's a symbiotic nature between us, being the convening point. We brought the workforce to them and the residency program has caused them to grow their practices and expand them.”

Such is the case for Welia Health, a rural health system that has partnered with the college residency program. Dr. Kati Dvorak, a 2009 graduate of the program and Welia’s current site coordinator, said the college’s partnership is critical to their residency program. 

“I can for sure say we wouldn't have started a residency without having the [U of M] guide us. To go out and tell [the American Society of Health-System Pharmacists] you want to start a residency is very daunting and overwhelming,” Dvorak said. “It would take me a day a week to do all the administrative work that I know [the college’s residency program coordinator] Amy Pavelka is taking care of for me.”

As a rural site, there’s no corporate pharmacy with administrative staff to oversee Welia, so launching a residency program on their own would be piled on top of their usual workload. The site also offers residents a distinct edge. Pharmacists at Welia have to be a “sort of jack of all trades,” Dvorak said, operating as not only a clinic pharmacist, but an inpatient, emergency department, and oncology pharmacist as well. 

“Our APPE students coming from the U of M are surprised at what we do here. You get the idea that you need to go to the metro to get quality care and that pharmacists in the rural areas aren't really doing anything interesting, so I think it's super eye opening for them,” Dvorak said. “When I look at my own little group [of residents], they’ve gone on to practice in many different areas  and I'd like to think it's because we let them dabble in lots of different things and find their true passion.”

Vice versa, the vast array of sites the college works with, each structured differently and serving different communities, enriches the residents’ experiences. Not to mention they have an entire cohort of residents to turn to for support, networking, and to share what they’ve learned. Everyone benefits, especially Minnesota as a state. 

“Many people who come here and see how practice is in Minnesota— even though they weren't from here, many of them stay after residency and take positions,” Sorensen said. “[The program] brought pharmacists into this state who otherwise probably wouldn't be here now.”

On top of that, residents have branched off and started their own practices or created additional pharmacy services within their health systems, said Dr. Jean Moon, associate dean for student affairs, who served as the residency program’s director from 2016 through last January.  

“I believe Minnesota has a unique and collaborative culture where we are willing to share and learn from one another,” Moon said. “I think we were able to facilitate a model that really supported one another through the residency program so that sites and preceptors could learn from each other.”

When Moon first stepped into the position of director, she said the program was already quite large. During her time as director, she built upon the program’s innovation. For example, Moon and Dr. Sarah Schweiss, the program’s former associate director, implemented a peer review process for residents mirroring that of some clinicians’ practices, helping residents to “learn documentation styles and formats from other health systems and peer practitioners and prompt great discussion about inclusive language, liability and roles,” she said. Now that ambulatory care is well-established in the state, partly thanks to the residency program, Moon is curious what the next chapter is.

“I do think we continue to have huge opportunities with our rural sites and being able to support them in their residency training,” Moon said. “I think we need to continue to evolve as a college and meet the needs of our communities and where Minnesota practice needs us to be.”

Nearly anyone involved can speak to the unique sense of camaraderie within the residency program, which has now grown to include nearly 350 graduates. Dr. Allyson Schlichte, a program graduate from 2007 and the current residency site coordinator for M Health Fairview, heard about the program as a student in Iowa, but traveled here for the program and “fell in love with what the pharmacists in Minnesota were doing.” Schlichte believes Fairview’s growth would’ve been slower and more difficult without the partnership of the college’s residency program, allowing them to expand into affiliate sites. She says the program network is one she can always rely on for support, one of the reasons she’s happy to pay it forward as a current preceptor, along with the chance to watch former residents branch out to grow their own practices. 

“I just can't say enough good things about all of the connections that this program has created across the country. I think we all lean on each other and pull each other in for different projects that aren’t necessarily related to the U of M, but we know the skill set that people affiliated with the program have,” Schlichte said. 

Dr. Morgan Hoeft, director and lecturer at the college’s Pharmaceutical Care Learning Center, was a resident in the program in 2017 after graduating with her PharmD from the college. She was drawn to the college’s program by Minnesota’s reputation for ambulatory care and for the notably supportive program network (“we say Pharm-ily”), but ended up discovering far more: her passion for teaching. Hoeft completed her residency at the Community-University Health Care Center (CUHCC), where residents are permitted to assistant teach. Hoeft was a TA in the same lab that she works in today. She recalls chatting with pharmacists in other residency programs who endured two months of training, while in the college’s program she was visiting patients within her first week, which she says is a testament to the program’s structure. Her time in the program inspired her to reimagine her career pathway.   

“I wouldn't be here in my current job without my residency. If you told me I would end up a teacher, I probably would’ve thought that was crazy,” Hoeft said. “I really am eternally grateful for my experience within the program, because they helped me develop the skills I needed to be successful in this position and have become lifelong mentors and friends.”

For 25 years, the College of Pharmacy Residency Program has been defying norms, pushing progress in Minnesota, and building a famously supportive network of pharmacists deeply committed to patient care. Across the hundreds of graduates and their myriad of experiences, one thing is clear: the college’s residency program is something special. 

“Residency is a lot of what you make it. But I do think that there is something really special here, and it's kind of the reason I was drawn to the program to start with. The network of people here— I don't know if it's just Minnesota vibes or what— but we're all very friendly, very supportive, and have a really strong dedication to patients,” Hoeft said. “That's just a testament to the program, how it prepares you, and how it continues to shape you as a pharmacist going forward. There's just a special sauce.”