ACCP has long supported the need for residency training in the preparation of clinical pharmacists who are able to effectively participate in team-based patient care.¹ Many ACCP programs and publications have been created that enrich residency training and provide professional development for residency preceptors. While the American Society of Health-System Pharmacists (ASHP) has taken on a primary role in residency program accreditation, the ASHP Commission on Credentialing (COC), the group responsible for maintaining residency standards through accreditation, represents an intraprofessional collaboration. The COC focuses on improving and ensuring the quality of more than 2500 pharmacy residency training programs. COC’s work includes developing training program standards, performing on-site and electronic surveys to assess performance against the standards, and recommending a length of accreditation for each program evaluated to the ASHP Board of Directors (BOD). The Centers for Medicare & Medicaid Services recognizes ASHP-accredited residency programs, allowing these programs to obtain graduate medical education pass-through funding.

The COC consists of 20 members who serve a 3-year term.² Eleven of the voting members are preceptors or program directors of PGY1 or PGY2 residency programs who apply for the opportunity to serve on the COC. A vice chair is selected from the group each year, who subsequently serves 1-year terms as chair and past chair. An additional position is reserved for a current resident. Appointments are made by the incoming ASHP president, with subsequent approval of the ASHP BOD. Another four voting members represent the pharmacy organizations that have partnered with ASHP. In addition to providing financial support, each organization submits a name or names to be considered for appointment to the commission. Partner organizations include ACCP, the Academy of Managed Care Pharmacy, the American Association of Colleges of Pharmacy, and the American Pharmacists Association. There are also two voting public (non-pharmacist) members, often selected from other health care professions, to provide additional insight into advances in residency training. In addition to the voting members, there are two non-voting members: the ASHP BOD liaison, typically the immediate past president, and Janet Silvester, vice president, ASHP Accreditation Services. COC members must submit any potential conflicts of interest before voting and agree to maintain confidentiality regarding all work of the commission. In addition to the COC members, other attendees at these meetings include accreditation services staff, contract surveyors, and invited staff from the partner organizations. These individuals can participate in open discussions, but do not review programs or vote. Lead surveyors, both ASHP staff and contract surveyors, are often present to provide information about the programs they have reviewed.

The current ACCP appointee to the COC is Dr. Terry Seaton, professor of pharmacy practice in the Division of Specialty Care Pharmacy at the St. Louis College of Pharmacy and a board-certified pharmacotherapy specialist. Seaton is a Fellow of ACCP who served as ACCP president in 2016–2017. Past ACCP appointees to the COC, in order of their service, are:

• Jerry Bauman, Pharm.D., FCCP, FACC: 2006–2008
• Stuart Haines, Pharm.D., FCCP, BCPS, BCACP: 2009–2011
• John Murphy, Pharm.D., FCCP, FASHP: 2012–2014
• Joseph Saseen, Pharm.D., FCCP, FASHP, BCPS, BCACP: 2015–2018
• Marcia Buck, Pharm.D., FCCP, FPPA, BCPPS: 2019

The COC meets twice yearly in March and August to review survey results for programs undergoing initial accreditation or reaccreditation, evaluate requests for new residencies, and conduct the work of its committees.² Members are assigned to either the Quality Committee or the Standards committee. The Quality Committee is tasked with ensuring the COC’s ability to determine the quality of a program through the currently available tools for assessment. This committee reviews the questions included in the annual program survey of residency program directors that replaced the mid-cycle report when the transition to an 8-year accreditation cycle was implemented. The Quality Committee also participated in developing the annual surveys distributed to samples of residents and preceptors that were initiated in 2019. The Standards Committee is gearing up for revisions to the competency areas, goals, and objectives (CAGOs) for all PGY1 and PGY2 programs using feedback from several stakeholders, including residency program directors and member organizations as well as a period for public comment. The committee will focus on harmonizing the three PGY1 residency standards (PGY1, PGY1 community based, and PGY1 managed care) as well as transitioning to revising the PGY2 standards concurrently to allow for greater consistency.

In addition to the standing committees, the COC has several ad hoc subcommittees to address new issues. Current areas of focus are addressing the unique needs of multisite residency programs, diversity and inclusion in the profession, and well-being and resilience for both residents and preceptors. The well-being and resilience for residents and preceptors is of significant importance to all health care professions, including pharmacy, and has become a priority for ASHP.^2,3 The COC included a question regarding the presence of established policies and programs related to resident and staff well-being and resilience on the 2019 annual survey.⁴ Only 27% of respondents had implemented a program, with another 53% relaying that a policy or program was under discussion but had not yet been implemented. Only 20% of respondents had not yet initiated discussions on methods to improve well-being or resilience. These data will be used to inform future decisions regarding education, intervention, and management programs. This is just one example of the COC’s dedication to continuous improvement in residency training and its commitment to incorporating a wide range of input from trainees, preceptors, program directors, partner organizations, and representatives from outside the pharmacy profession. ACCP’s appointees to the COC serve as valuable participants in this work, giving the College’s members a voice in the future of residency training.

References

1. American College of Clinical Pharmacy Board of Regents. Board of Regents Commentary. Qualifications of pharmacists who provide direct patient care: perspectives on the need for residency training and board certification. Pharmacotherapy 2013;33:888-91.
2. Kalus J, Silvester J. Update from the ASHP Commission on Credentialing. MCM19 Presentation Update. December 2019. Available at www.ashp.org/Professional-Development/Residency-Information/Other-Information/Commission-on-Credentialing/. Accessed February 1, 2020.
3. Flannery AH, Jones GM. Providing for wellness in residency program directors. Am J Health Syst Pharm 2020;77:162-3.
4. Silvester JA. Resilience in residency program directors. Am J Health Syst Pharm 2020;77:163-4.