All applicants are required to complete the Supplemental Questionnaire as part of the online application process. The questionnaire will be used to (1) assess each candidate's possession of the minimum qualifications and (2) determine each candidate's score on the Training and Experience Evaluation as described on the examination announcement.
Responses to supplemental questionnaire items must be supported by the information provided in the body of your application (i.e. Education and Training/Employment Record section). If you do not include the information you are about to describe in the body of your application, you will not receive credit for them. Resumes are NOT to be used or reviewed to determine whether you meet the minimum qualifications or to determine your score/rank. A resume should NOT be submitted to substitute for a complete application. All responses are final and cannot be altered after submission.
You may be asked to submit verification of education, experience or licenses at anytime during the recruitment and selection process. Falsifying one's education, training, or work experience or attempted deception on the application or evaluation may result in disqualification for this and future job opportunities with the City and County of San Francisco.
If you experience technical difficulties, make note of any error messages and contact the Analyst prior to the filing deadline.
PART ONE: LICENSES AND EXPERIENCE
This section of the Supplemental Questionnaire will be used to determine if you meet the minimum qualifications of a 2454 Clinical Pharmacist.
INSTRUCTIONS:For Questions 1-4, please answer by choosing the best response that matches your licenses.
1.
Do you possess a valid Registered Pharmacist license issued by the California State Board of Pharmacy?
*As a reminder, all licenses must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the license you are about to describe in the "Professional Licenses, Certification or Registrations" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your License section before submitting your application.
Yes
No
2.
What is the highest level of post-graduate training you have completed?
*As a reminder, all experience must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your Experience section before submitting your application.
I do not have any post-graduate training experience.
I have completed at least 6 months of a PGY1 training program.
I have completed a PGY1 training program.
I have completed at least 6 months of a PGY2 training program.
I have completed a PGY2 training program.
I have completed at least 6 months of a fellowship training program.
I have completed a fellowship training program.
3.
How many years of professional level experience do you have as a Clinical Pharmacist?
*As a reminder, all qualifying experience must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the work experience you are about to describe in the "Employment Record" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your Employment Record before submitting your application.
Less than one year (less than 2,000 hours)
At least one year (minimum 2,000 hours) but less than two years(4,000 hours)
At least two years (minimum 4,000 hours) but less than three years (6,000 hours)
At least three years (minimum 6,000 hours) but less than four years (8,000 hours)
At least four years (minimum 8,000 hours) but less than five years (10,000 hours)
Five years (minimum 10,000 hours) or more
I do not have any experience as a Clinical Pharmacist.
4.
Do you possess Board Certification in a pharmacy specialty area?
*As a reminder, all certifications must be listed in the application in order to be considered in review of Minimum Qualifications. If you do not include the certification you are about to describe in the "Professional Licenses, Certification or Registrations" section of your application, you will not receive credit for this experience. If you are copying an old application, please take the time to update your License section before submitting your application.
Yes
No
The question below will not be scored. It is for informational purposes only.
Please check the appropriate boxes to indicate your interest in working in the following settings:
Acute Care
Ambulatory Care
Behavioral Health
Skilled Nursing Facility
County Jail Facility
PART TWO: TRAINING AND EXPERIENCE EVALUATION
This section of the Supplemental Questionnaire will be used to determine your knowledge, skills and abilities in job-related areas that have been identified as critical for satisfactory performance for positions in Class 2454 Clinical Pharmacist.
Responses to supplemental questionnaire items must be supported by the information in the body of your application (i.e. included in the Education and Training and Employment Record sections) in order to receive appropriate credit, and are subject to verification. Verification of experience, licensure, and possession of valid certifications/certificates may be collected at any time during or after the selection process.
Your responses will be used to assist in determining your score and rank on the eligible list, and will be made available to departmental personnel and management staff to assist in their hiring decisions.
INSTRUCTIONS: For Questions 5-15, please indicate your self-assessment of training and/or work experience in the following areas:
5.
Recently (within the last 3 years) served on Pharmacy & Therapeutics (P&T) Committee or P&T Subcommittee
No
Yes
6.
Recently (within the last 3 years) provided direct patient/client care
No training and/or work experience
Up to one (1) year of training and/or work experience
More than one (1) year of training and/or work experience
7.
Recent (within the last 3 years) practiced under standardized procedures/protocol
No training and/or work experience
Up to one (1) year of training and/or work experience
More than one (1) year of training and/or work experience
8.
Highest level of residency training completed
None
PGY1
PGY2
9.
Completed a fellowship training program
No
Yes
10.
Have Specialty Certification
No
Yes
11.
Recent (within the last 3 years) experience completing DUE/Drug Monograph/Quality Improvement Project
No
Yes
12.
Recent (within last 3 years) experience giving formal presentations/inservices to medical, pharmacy or nursing personnel
No
Yes
13.
Experience with documentation in an Electronic Health Record
No
Yes
14.
Supervision (giving direction to) of subordinate staff: Pharmacy Technicians, etc.
No
Yes
15.
Experience providing services to indigent/homeless and/or mental health/substance abuse patients
No
Yes
CERTIFICATION:
I hereby certify that I am the author of this application and that all information presented is true and based on my background, skills and experiences. I understand that any false, incomplete, or incorrect statements may result in my disqualification of dismissal from employment with the City and County of San Francisco.
Department of Human Resources