OSHP PGY2 Resident Award

OSHP PGY2 Resident Award

To recognize a pharmacy resident who has demonstrated exceptional skills in the area of residency practice.
Please respond based on activities specifically completed as a resident (either PGY1 and/or PGY2) (information completed as a student is not applicable). State N/A in any field where the resident has not completed an activity. It is not required to have completed every activity to receive the award.
Nominee Information
Resident's Name

First NameLast Name
Resident Nominee Email Address
example@example.com
Resident Nominee Phone

Area CodePhone Number
Is the resident a current member of OSHP?
Does the resident attend the Division Day Meeting or LAC meetings?
If yes, what has the resident contributed to an OSHP Division or LAC?
List any board certifications
List any certifications or specific training programs completed
List awards or recognitions received by the resident during his/her/their PGY1 residency year. Include name, organization, and local/state/national classification. May also include any details to help us understand the award if needed.
List presentations within the health system completed by the resident. Consider in-services, CE, grand rounds, medical resident education sessions, etc. Include audience and type of presentation.
List presentations provided by the resident outside of the health system. Include audience, type of presentation, and local/state/national classification.
List peer-reviewed publications. Include citation and/or link to publication
List poster presentations. Include citation. Specify if peer reviewed or limited number of posters accepted.
Include community service with a brief description. Consider including number of hours or impact of community service
Describe any significant contributions this resident has made to your residency program, health system, or profession of pharmacy. Please include in “additional attachments” any documentation as warranted.
Nominee Significant Contributions to Residency Program
Additional Significant Information
Nominator Information
Nominator Name

First NameLast Name
Nominator Employer
Nominator Phone

Area CodePhone Number
Nominee Email Address
example@example.com
Nominator Email Address
example@example.com
I attest that as the Residency Program Director and/or Preceptor that I have completed this nomination to the best of knowledge and support this nomination.
Attachments
Nominee’s CV (required)

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Letter of Support From RPD (required)

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Additional Evidence #1

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