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As you have likely discovered throughout this section, a Postgraduate Year Two (PGY-2) residency is designed to build upon the skills achieved in the Postgraduate Year One (PGY-1) pharmacy residency program while focusing on a specific area of pharmacy practice.1 The resident will gain experience in medication therapy managment (MTM) and clinical leadership skills that are necessary when practicing in a particular subspecialty area. Some PGY-2 programs focus on the care of a specific patient population; therefore, these programs may have different goals and objectives that correspond to the population. This chapter will focus on PGY-2 residency programs in special patient populations.

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The PGY-2 pediatric residency is focused to transform a generalist who has completed a PGY-1 residency to become a specialist in the pediatric population.2 The six required and three elective outcomes set by American Society of Health-System Pharmacists (ASHP) are provided in Table 21-1.2

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Table 21-1 PGY-2 Pediatric Residency Outcomes
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A PGY-2 pediatric residency program must provide the resident with direct patient care opportunities in both the inpatient and outpatient setting. Pediatric pharmacy residents will be exposed to patients of all levels of acuity. This can range from a maintenance visit in an outpatient clinic, a patient in critical condition in an intensive care unit (ICU), or someone in respiratory arrest in the emergency department (ED). This allows the resident to develop into a well-rounded practitioner who has experience in providing various levels of patient care.

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Participating in the care of pediatric patients is a unique and challenging opportunity for pharmacists. Infants and young children are unable to verbalize their symptoms and feelings, thus there is a lack of direct subjective patient information available. Caregivers are relied upon to provide information to assist with developing the patient's differential diagnoses. Pediatric practice also teaches practitioners to include the patient's caregivers in the patient's care plan. Pediatric pharmacy practice differs significantly from that in adults due to weight-based dosing of medications, age-based laboratory parameters, differing pharmacokinetic and pharmacodynamic principles, and unique fluid and nutrition requirements. In addition, the limited data on safety and efficacy of medications in the pediatric population and the lack of pediatric-friendly dosage ...

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