By Camille D. Ford | November 2025
Summary
At VA Tennessee Valley Healthcare System, Dr. Kristina Gill, Dr. Christina Creech, Dr. Rebecca Cripps, and Dr. Traci Dutton lead pharmacy residency programs that have graduated more than 150 residents since 1991. They train six to eight Postgraduate Year 1 (PGY1) and six to eight Postgraduate Year 2 (PGY2) residents each year. In 2020, their PGY1 program was recognized as Residency of the Year by the Tennessee Pharmacist Association. Their advice: “Be a sponge.” Their mission: train excellent clinical pharmacy practitioners to provide the best care possible to veterans.
The Hidden Profession
“We don’t have a lot of people who know that pharmacists have a residency program,” Dr. Gill says, “so we’re super excited to be able to brag on our program.”
When Dr. Creech tells people she’s a pharmacist, they immediately ask which pharmacy she works at. “I say, well, I don’t work at a pharmacy. I work at a VA clinic. And they say, ‘oh, well, is there a pharmacy in the clinic?’ and I’m like, ‘no, I’m clinical. I work directly with patients. I have the ability within VA to write prescriptions under a scope of practice. I have a DEA license, so I can write for controlled medications within VA,’ and they are just amazed that it is out there.”
Dr. Gill nods in agreement.
“Medical residencies are well-known. Everybody knows MDs will go through a residency, they’ll specialize in pediatrics, emergency medicine, but when you tell the general population you did a clinical pharmacy residency, they look at you like you have two heads. So, it’s really exciting to be able to speak about our program and continue to spread education about pharmacy residencies in general.”
Dr. Creech adds, “These residency programs have been around a very long time. I think they even go back to the mid-80s. So, it’s just getting the knowledge out there of what we do.”
Four Different Paths
As the four women settle into our interview, Dr. Rebecca Cripps laughs.
“I appreciate you interviewing us tonight and enjoying listening and learning stuff about each other we didn’t know already, and we’ve worked together for years, so this is great.”
Dr. Kristina Gill always knew she wanted health care, just not which path. During her undergrad years at Auburn University, her passion for pharmacy developed. “War Eagle, even though our football team may not be the best, we still love them, right Christina?” Dr. Gill chimes in during the interview.
She completed her PGY1 in Gainesville, Florida, and specialized in cardiology for her PGY2 in Massachusetts. “It was during those residencies that I really enjoyed being able to work the management and administration side of things to make a difference as much as possible.” Her current position as Associate Chief of Clinical Pharmacy and Education Services and PGY1 Program Director is one she’s wanted since the beginning.
Dr. Christina Creech’s journey took an unexpected turn. “I actually wanted to be a veterinarian,” she says, but after getting into vet school, realized she didn’t have the passion to continue. She even “ran away to Hawaii” where her brother was stationed in the Navy, then tried again to pursue veterinary medicine. “Every time I took the step toward vet school, things would go wrong.”
Her uncle, former Chief of Pharmacy at Gainesville VA, stepped in. “He’s like, ‘Look, come see me, let me show you what VA does with pharmacy, and see if maybe this is where you need to be.’ I realized that pharmacy is much more than what I thought, which I used to think was Walgreens. I didn’t want to be behind a counter just filling prescriptions. I wanted to be able to talk to people and get to know people.”
Everything fell into place. She completed both her PGY1 and PGY2 in pain management and palliative care at the Gainesville VA, the program her uncle had started. The timing was profound: she was there when her aunt needed hospice care. “I felt like I was where I needed to be.” She’s now Clinical Pharmacy Practitioner in Outpatient Pain Management at the Clarksville VA Clinic and PGY2 Pain and Palliative Care Pharmacy Residency Director.
Dr. Rebecca Cripps knew at 16 what she wanted thanks to her banker father who steered her away from accounting. “He was like, no, because he knew I like to talk to people a lot and I would not do well in accounting.” He connected her with a friend who owned an independent pharmacy. “I really fell in love with just that independent pharmacy practice and getting to know patients by their names.”
In her fourth year at Auburn, VA rotations in Murfreesboro changed everything.
“The preceptors both really poured into me and saw something in me I didn’t see in myself. They showed me clinical pharmacy and what it looked like in VA, which was different than I’d seen anywhere else.” She completed her PGY1 at VA Tennessee Valley Healthcare System 16 years ago and has been there ever since as Clinical Pharmacy Practitioner in Home Based Primary Care and PGY2 Ambulatory Care Residency Program Director.
Dr. Traci Dutton found pharmacy while working in her hometown hospital.
“When I interacted with the staff in the pharmacy, I thought, ‘This is pretty neat. This might be something that I could do.'” After pharmacy school in Massachusetts, she did her residency at the Tuscaloosa VA Medical Center.
Her first rotation was unforgettable. “I can remember being on my very first rotation as a first-year pharmacy resident, as green as anything, and sitting in that room with those providers and those patients and thinking, ‘These are my people. I feel like I am at home, working with these veterans.’ I have been in VA for 15 years. I still feel that way.” She’s now Clinical Pharmacy Practitioner in Mental Health and PGY2 Psychiatric Pharmacy Residency Program Director.
The Mentorship Philosophy
Dr. Gill had amazing preceptors and an amazing residency program director during her residency years. “She challenged me, but she also supported my learning and growth in the clinical pharmacy realm. I knew early on into those residency years that eventually I would love to be an RPD [residency program director] and give back to residents the way my previous RPD and preceptors did for me.”
Her philosophy is clear. “We’re going to challenge our residents. We’re going to make them the best of the best. When they’re done with our residency program, whether it’s a PGY1 year or they specialize in a PGY2 year, they’re going to be the most competitive candidate applying for jobs not just within VA, but outside of VA as well. All of our residents that have completed our programs have gotten a job after residency.”
Dr. Creech brings her veterinary background to mentorship. “I come from a different background of the veterinary realm where you can’t necessarily talk to the patient itself. I did a lot of training of other technicians to do different procedures, whether it be drawing blood from the neck of a parakeet to working with animals in certain ways. I come from that ‘see one, do one, teach one’ mentality. You see someone do it, you try it, and then you teach the next person. That’s what I bring to mentorship as well.”
She emphasizes the value of real experience. “I really enjoy sharing the life experiences and those clinical pearls. We can all pull things from books, but sometimes hearing the experiences, hearing the stories, hearing how and when we do certain things really pulls that information together and helps solidify that information so they can take it on and move forward.”
Dr. Cripps’s approach stems directly from her own experience.
“My first experience would be the way that I was mentored by others. When I think about how much they poured into me professionally but also on a personal level and what that meant to me and for my career and for my life, to be honest, I want to do that for others. I want any resident who trains with me, whether it be an ambulatory care resident or PGY1 resident or a student or any trainee who trains with me, to feel challenged but also to feel supported. I want it to be a rich learning environment, to push them and challenge them and make them better for their future patients that they serve, and then also just in life in their own personal careers.”
Dr. Dutton echoes this sentiment. “I was very fortunate throughout my career to have worked with some amazing individuals that have mentored me, helped teach me, helped shape me. I knew that was something I always wanted to give back because VA Tennessee Valley is the third VA that I’ve worked in, and one of the things when I first came to VA Tennessee Valley is that everybody here is very focused on a commitment to excellence and providing excellent care. We all support each other as well as support the learning programs of our residencies. We want to be better ourselves, and we also want to make the trainees that we are fortunate to mentor excellent as well.”
What Makes Tennessee Valley Stand Out
“It’s the people,” Dr. Dutton says. “The colleagues that we all get to work with every day and the veterans that we get to work with. We just have a great health care system that has a commitment toward not only our own professional enrichment but then pouring into the professional enrichment of our residents.”
The numbers tell part of the story. VA Tennessee Valley Healthcare System is a level 1A facility with a PGY1 program established since 1991. More than 150 residents have completed the program. The system offers rotations in women’s health, substance use disorders, cardiology, oncology, critical care, fully intact and in-house stem cell transplant (the only VA with this capability), mental health residential rehabilitation, and emergency medicine.
“We are a growing facility that is expanding and offering new services and have great affiliations with Vanderbilt and Meharry,” Dr. Cripps notes. “The quantity and the quality of clinical rotations and preceptors is unmatched across VA programs.”
Dr. Creech highlights what often goes unmentioned: “Many of our preceptors have served as national subject matter experts across VA. These are usually committee positions that individuals have to be chosen for, and there are many of us here at VA Tennessee Valley who have served in those positions and have helped other facilities start new programs. That adds into what makes us stand out.”
What Residents Learn
PGY1: Building the Foundation
Dr. Gill explains the core mission: “to provide our residents with baseline skills, knowledge, and confidence to excel in the clinical pharmacy realm. We offer research, publications, teaching certificates, and leadership rotations to help prepare our residents to enter into a competitive job market and be a standout candidate.”
PGY2 Psychiatric Pharmacy: The Full Continuum
Dr. Dutton’s residents train across the entire mental health spectrum. “We have pharmacists who work in substance use disorders, in inpatient psychiatric units, in outpatient clinics, in our residential rehabilitation treatment program. Our residents really get to spend time with each of those people so they learn not only about what happens in the specific area, but also across the continuum of care-how to see our veterans as complex humans with their own issues and challenges, and to be able to work with people all throughout the whole continuum of care to make sure they get the care that they need.”
PGY2 Pain Management: The Whole Health Model
“Pain is subjective,” Dr. Creech begins. “Since pain is unseen, it encompasses not only the physical feeling but also perceived injuries, which can be things along the lines of mental health concerns. By looking at the person as a whole person and leaning into what we tend to call the biopsychosocial aspects of pain, our residents learn how to educate veterans, support them through things like opioid changes, and get them to the right treatment or therapy for them.”
PGY2 Ambulatory Care: Building Clinics from Scratch
Dr. Cripps’s residents spend three days a week rotating through specialties like outpatient mental health, pain, anticoagulation, women’s health, home-based primary care, and emergency medicine. One day a week, they work in a longitudinal primary care clinic seeing the same patients every two to three months.
But the most unique aspect? The other day is spent building a new clinic from the ground up.
“Our residency requires our residents to develop a new clinic based on the needs of our facility and the interest of the resident,” Dr. Cripps explains. This year, one resident is tackling fatty liver disease. The other is ensuring post-cardiac catheterization patients get appropriate medication management within two weeks of their procedure.
“They train other PGY1 residents. They train students. They train us through journal club presentations and Fun Fact Friday emails. They integrate patient education every single day,” Dr. Cripps says.
Building Clinics That Last
Dr. Cripps explains how today’s resident projects become tomorrow’s essential services. “A lot of our current clinical pharmacy services were initially started by PGY2 ambulatory care residents getting into that area. That was a longitudinal project. Now, we have seven pain pharmacists at VA Tennessee Valley from that PGY2 resident 15 years ago getting involved in the pain clinic. When they see what we’re able to provide and the services we’re able to provide, they really want more of us.”
The pattern repeats across specialties. “We expanded into women’s health through that same avenue. We expanded into emergency medicine. One of our clinical pharmacy practitioners works in emergency medicine and started out doing that as a PGY2 resident. Obesity and the MOVE! clinic, which is obesity weight management, that was initially started from a PGY2 resident getting involved in that and then seeing that pharmacists could fill that role and work in that area. A lot of our areas have really shown the expansion of what we’re able to provide and hire for as far as positions and the number and thousands of veterans we serve in those clinics because a PGY2 resident was able to first establish the need for that service.”
Dr. Creech shares the lasting impact on veterans: “I have many veterans who still ask about whatever happened to that resident I talked to last year, did they get a job, how are they doing? They developed those relationships.”
How Residents Collaborate
“Each year we have between six to eight PGY1 and six to eight PGY2 residents, so upwards to a max of 16 residents each year,” Dr. Gill explains. “Having a large class like this allows for the most optimal collaboration, not just amongst the PGY1s and PGY2s respectively, but amongst the entire class.”
The program uses a layered learning model. “Our PGY2s can precept our PGY1s if they’re on the same rotation. Our PGY1s have the opportunity to precept pharmacy students on the same rotations. We also, for our PGY1s, assign them a PGY2 buddy at the beginning of the year. This PGY2 essentially acts as a mentor for their residency year and guides them. What worked well for them their PGY1 year? What didn’t work well? Tips and tricks navigating our electronic health record system? Advice on do I do a PGY2, or do I go for a job? We constantly encourage communication and collaboration between them throughout the year and especially focusing on time management. Their PGY2 buddies can help them with tips that worked for them and also helping ensure they have an appropriate work-life balance.”
Dr. Cripps describes the daily reality.
“They’re in the same office a lot of times, sometimes they aren’t, depends on the rotation and where they are. There’s so much daily collaboration, whether it be just asking a general question. It’s on a professional level, it’s on a personal level, getting opinions, or developing that relationship. They collaborate on a regular basis.”
She adds with a smile, “There’s nothing that helps a PGY1 realize where they are like when they’re having to train the next generation. They definitely can see how far they’ve come when they’re training someone and they’re like, ‘Oh my gosh, I can’t believe the student doesn’t know this.’ It also challenges them because they may have a really good student or a really good PGY1 resident that really challenges that resident to make sure they’re working at the top of their game.”
Dr. Dutton notes the cross-pollination of ideas. “They work together on projects. Maybe a second-year resident will have an idea for a project, and a first-year resident will say, ‘Oh, that’s really interesting. I might like to expand it this way.’ They all influence each other all the time.”
Dr. Creech sees the teaching go both ways.
“My resident will learn from Dr. Dutton’s residents when she’s on mental health rotation because she’s not the expert in that, but then when the mental health residents are on a pain rotation, she may take more of the teaching role at that point because she will then be more of the expert. So, they teach each other back and forth that way.”
Direct Impact on Veteran Care
“Our residents are providing direct patient care to veterans in whatever rotation or whatever clinical setting they’re on,” Dr. Cripps emphasizes. “They have the support of their preceptors and their programs, but they are the ones providing the clinical care. They are having direct veteran care experiences. Their impact is to really improve and expand the quality of that care. Whether that’s them teaching us and training us or talking about some new evidence that just got released, the residency program as a whole is impacting the quality of the veterans’ health care that they’re getting every single day.”
Dr. Creech adds, “During the longitudinal experiences, they are seeing patients, the same patient over and over again throughout that time. They’re developing those relationships, and it’s really value-added to the veterans.”
What They Hope Graduates Carry Forward
Dr. Creech hopes for more than clinical skills.
“Not only the passion for what we do, but the compassion of what we do. I also hope that they take forward an idea of self-care. Those of us who work in pain management, especially hospice and palliative care, it’s not for everyone. We try to foster within our residents having that self-care, that personal grace of dealing with emotions, and I do hope that they carry that forward as well.”
Dr. Dutton hopes they carry a love of lifelong learning and that they see the joy of learning something new and how it benefits those around them.
For Dr. Gill, it comes back to the core mission: “We’re teaching and helping shape the next generation of excellent clinical pharmacy practitioners to provide the best care possible to our veterans.”
The Future
“Over the next few years, we expect to see even more rotations offered at VA Tennessee Valley specifically within the pharmacy residency program because we are continuing to expand care to our veterans,” Dr. Gill says. “For example, just in the past few years, we’ve expanded our pharmacist footprint into preventive medicine or the MOVE! obesity clinic. We also have a pharmacist in pharmacogenomics and a pharmacist in neurology. Those are funded positions. We applied for them, we showed a need for them, we showed how beneficial having a clinical pharmacist practitioner in these specific areas would benefit not only Tennessee Valley but our veterans, and we were awarded grants for those.”
The program is also evolving with technology.
“We will continue to prioritize telehealth platforms into our residency experiences like video visits and telephone care. This helps and continues to enable our residents to provide personalized and accessible care to veterans across Middle Tennessee and even to our rural areas.”
Advice to Applicants
Dr. Dutton’s advice is simple but profound: “Be open to all things every day. There are learning opportunities out there for every one of us to improve care, to learn things, to better ourselves, and to provide excellent care for our veterans.”
Dr. Gill shares what has become the program’s signature advice: “Our favorite thing that we give to students, at least from a PGY1 perspective, is to be a sponge. Soak in all the information that you’re going to get your PGY1 year.”
It’s advice born from experience. “That knowledge will stay with you for the rest of your career. Be a sponge is probably my favorite saying because you are going to learn a lot, and it’s going to be a very good year for you just to start your career.”
What It Means to Them
For Dr. Gill, the residency training at VA Tennessee Valley Healthcare System means excellence.
“We’ve been established as a program since 1991, and we’ve been nationally recognized many times as a residency program throughout the years. In 2020, our PGY1 program was recognized as the Residency of the Year by the Tennessee Pharmacist Association. We also received the Undersecretary of Health Award for Excellence in Pharmacy Practice in 2018. All that to say, the residency training at VA Tennessee Valley to me means that we’re teaching and helping shape the next generation of excellent clinical pharmacy practitioners to provide the best care possible to our veterans.”
Dr. Creech gets emotional thinking about it. “For me, being able to work with residents, it’s all about being able to share that knowledge, being able to teach. It’s going to sound kind of strange, but for me, it’s also in a way a way to mother. I’ve never had children. I am a four-legged mama. When it comes to my residents, I’m a mama bear. I want the best for them. I just absolutely love seeing and hearing what they’re doing and where life’s taking them. Part of what this residency training program is for me, it’s just that personal fulfillment and that kind of family that just gets extended.”
Dr. Cripps is the only one of the group who actually did her residency training at VA Tennessee Valley Healthcare System.
“I would have to say life-changing for me. My residency training shaped me not just professionally but also personally. Some of my most favorite people on earth – not just at work or professionally, but that I’ve ever met – have been my coworkers and people that I’ve worked with during and since residency training, and also the ones that I got to train. Getting to see that legacy and getting to see my little professional children go off and do big things in the world of pharmacy, whether that be in VA or out of VA, it really brings a lot of joy.”
Dr. Dutton adds, ” I have colleagues that I had as students or residents, so just being able to go forward and to work with them and to continue to learn with them and from them every day is really amazing.”
What Veterans Day Means
For Dr. Dutton, Veterans Day carries deep meaning.
“Veterans Day to me is a day to honor all of the veterans that have sacrificed so much for us and for our country. It is certainly an honor to be able to provide care for those veterans and to train the future generation to provide care for those veterans. We want to provide the best care possible and to assist in the training of those future VA pharmacy practitioners across the whole mental health care spectrum.”
She explains the importance of Primary Care Mental Health Integration.
“It is oftentimes the entry point into mental health care for many of our veterans who may not be sure how to enter mental health care or what mental health care is. Our residents get to experience that to help bring the veterans into our system and to get the care that they need.”
Dr. Creech’s connection to Veterans Day runs through her family.
“I have a strong family history of service. I am a granddaughter, a daughter, a niece, a cousin, a sister to veterans. My mother worked at Fort Campbell, Kentucky, for over 30 years. I’ve had aunts who’ve worked as nurses in VA hospitals and uncles who have worked at VAs and cousins who work at VAs. We come from a family of service, and it has always been instilled in us what our veterans have done for us. So, it’s a big family tradition for us to really honor our forefathers and the veterans within our family.”
Her work is an extension of that tradition. “When I went into pharmacy, going from veterinary medicine into pharmacy, I stepped into pharmacy school the very first day saying I wanted to do a residency, and I only wanted to work within VA. If I was going to be a pharmacist, I was going to be a VA pharmacist because it is so important to me to be able to give back, because I honestly was not able to serve. I’ve had back issues and things that made it concerning that I could have been seriously injured. So, I never did that service route. This is my service.”
Within her pain management role, she helps connect veterans to the mental health support they need. “We do talk a lot about mental health and how mental health affects pain and pain affects mental health.”
Dr. Gill sees Veterans Day as a daily reminder.
“Veterans Day is a day that we honor the sacrifice, courage, and resilience of the men and women who served. But specifically, as pharmacists at VA Tennessee Valley, it holds an even greater reminder of the responsibility that we have to care for our veterans beyond just their time in uniform. It’s a reminder to all of us within Tennessee Valley that we will continue to serve those who served. For me, it also reinforces my commitment to our VA mission and the ICARE values of Integrity, Commitment, Advocacy, Respect, and Excellence to continue to improve trust, hope, and helping veterans achieve the best quality of life that we possibly can.”
Dr. Cripps isn’t from a military family, but that makes her appreciation no less profound.
“Veterans Day is a day to really think about the ones who served and were willing to make that choice to serve. They didn’t have to, and they chose to. Just to think about the sacrifices that they made and not to forget that. We get to encounter them every day in our job and just to be grateful for their willingness to do that for us. I’m not a veteran. I’m not really from a family of veterans. My grandfather was a veteran but didn’t talk about his service at all. When I think back on that time and the sacrifices that they made, and then now that we get to serve them, and just to see so many of them as still humble servants in so many ways. I’m thankful for them.”
Getting the Knowledge Out
Dr. Creech has seen the public’s reaction when she explains what she does. “I can’t tell you how many people out in the public go, ‘You know, I wish I had something like that. I would love to have a pharmacist I can work with.’ And I’ve even had some people say, ‘Hey, my granddaughter was thinking about going into a science field. Can I have them talk to you, and can you tell them what you do?’ It’s getting the knowledge out that we are more than standing in a pharmacy, the traditional type of pharmacy world, which is definitely needed and value-added and stressful beyond measure, but we do work in a different manner.”
The Metric of Success
Reflecting on the success and impact of the PGY1 and PGY2 programs at VA Tennessee Valley Healthcare System, Dr. Cripps puts it simply: “Seeing them continue to grow and blossom as clinical pharmacy practitioners after residency, that’s our metric of success and seeing all the things that they accomplish wherever they end up. A lot of our residents have become residency program directors at their own facilities and created their own programs. You get to see them off training and leading the next generation. I’m just so proud of them.”
She smiles, remembering the messages she receives. “They’ll message and say, ‘I’m so grateful for my training. I’m with someone from another residency training program, and I feel so much more prepared for my job.’ I get that every single year, and I’m so grateful for it always, that we really do have a great program.”
Resources for Veterans and Healthcare Professionals
VA Healthcare Services
- VA Health Care Enrollment: va.gov/health-care/how-to-apply
- My HealtheVet: myhealth.va.gov
- Veterans Crisis Line: Dial 988, then press 1 | Text 838255 | veteranscrisisline.net
VA Pharmacy and Medication Information
- VA Pharmacy Benefits: va.gov/health-care/about-va-health-benefits/pharmacy-benefits
- Medication Management: va.gov/health-care/refill-track-prescriptions
Mental Health and Pain Management Support
- VA Mental Health Services: mentalhealth.va.gov
- Pain Management: va.gov/painmanagement
- Substance Use Disorder Treatment: va.gov/health-care/health-needs-conditions/substance-use-problems
Tennessee Valley Healthcare System
- TVHS Main Site: VA Tennessee Valley Health Care | Veterans Affairs
- Nashville VA Medical Center: 1310 24th Avenue South, Nashville, TN 37212
Pharmacy Career Information
- American Society of Health-System Pharmacists (ASHP): ashp.org
- VA Pharmacy Careers: va.gov/health/pharmacy.asp
- Pharmacy Residency Information: ashp.org/professional-development/residency-information
- Tennessee Pharmacist Association: tnpharm.org
Recognition and Awards
- Pharmacy Residency Program | VA Tennessee Valley Health Care | Veterans Affairs
- 2018 Undersecretary of Health Award: Excellence in Pharmacy Practice
About the Program Directors
Dr. Kristina Gill, PharmD is Associate Chief of Clinical Pharmacy and Education Services and PGY1 Residency Program Director at VA Tennessee Valley Healthcare System. An Auburn University graduate, she completed her PGY1 in Gainesville, Florida, and specialized in cardiology during her PGY2 at UMass Memorial Medical Center in Massachusetts.
Dr. Christina Creech, PharmD is PGY2 Pain and Palliative Care Residency Program Director and Clinical Pharmacy Practitioner at the Clarksville VA Clinic. After leaving veterinary school, she found her calling in VA pharmacy through her uncle, a former Chief of Pharmacy at Gainesville VA, where she completed both residencies.
Dr. Rebecca Cripps, PharmD is PGY2 Ambulatory Care Residency Program Director and Clinical Pharmacy Practitioner in Home Based Primary Care at VA Tennessee Valley Healthcare System. She completed her PGY1 residency at Tennessee Valley 16 years ago, making her the only program director who trained at the system where she now teaches.
Dr. Traci Dutton, PharmD is PGY2 Psychiatric Pharmacy Residency Program Director and Clinical Pharmacy Practitioner in Mental Health at VA Tennessee Valley Healthcare System. After completing her residency at the Tuscaloosa VA Medical Center, she has spent 15 years at VA Tennessee Valley working across the mental health continuum.
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