Download Supplemental Application

Supplemental Application Form – PGY1 Pharmacy Residency
Moses Cone Hospital – Cone Health
Name:
GPA
Current State License
Clinical areas of interest
(NC licensure required)
None
(select up to five)
Acute Cardiovascular
Disease
Hypertension
Anticoagulation
Internal Medicine
Ambulatory Care
Infectious Diseases
Diabetes
Oncology
Heart Failure
HIV
Asthma/COPD
Pain Management
Lipid Disorders
Trauma
Nephrology
Women’s Health
Stroke
Emergency Medicine
Research
Administration
Critical Care
Pediatrics
Neonatology
Medication Safety
Describe Your Experiences
Tell us something about yourself that we can’t get from reading your curriculum vitae.
Clinical Practice
Describe your patient care responsibilities on rotation and/or at your site of employment.
Describe a clinical intervention you have made on rotation.
Drug Information
What drug information resources do you use most often?
Pharmacokinetics / Dosing Consults
Describe a dosing intervention you made on rotation, such as a pharmacokinetic consult or adjusting
medications for organ function or drug interactions. If you have experience with formal pharmacy consults
(i.e. pharmacy-to-dose), please describe your experience with these consults.
Medication Use Processes
Describe your pharmacy distribution experience.
Pharmacy Computer Systems / Software / Handheld Tools
Please list any pharmacy computer systems, automated dispensing systems, software, or other electronic
tools with which you have experience.
Form to be uploaded with your Moses Cone application into PhORCAS
Supplemental Application Form – PGY1 Pharmacy Residency
Moses Cone Hospital – Cone Health
Research or Project Assignments
Describe a project and/or research that you completed, including any obstacles encountered.
Leadership
Describe your administrative, management, and/or supervisory experience.
Describe your personal leadership style.
Form to be uploaded with your Moses Cone application into PhORCAS