As a pharmacy educator and adviser to budding pharmacists, I am often asked about the different facets of a pharmacy career—what are all the options and which one is right for a particular individual?

The good news is that the profession has gained a lot of variety in the past 50 years. The challenge lies in understanding the very wide standard deviation of opportunities and how to properly match up an opportunity to an ideal candidate via strengths and values.

Some pharmacists have the luck of finding their ideal jobs right out of residencies, fellowships, or pharmacy school. Many of us do not. In other cases, our work environment, needs, goals, and values change over time. Career variety can be a wonderful way to learn even more about pharmacy, make a pharmacist invaluable to employers, and change the game of the profession itself, as professionals shape the profession over time and bring different skill sets to the table to make pharmacy more empirical and holistic.

In this article, we look at 3 professionals who made choices that were game changers in their careers. Each dared to try different areas of pharmacy and health care practice. We’ll also show that change can happen at any time within one’s pharmacy career journey—early, middle, and even late career. We discuss the career paths of a pharmacist early in her career (<5 years in practice), a mid-career pharmacist (>20 years in practice), and a pharmacist/physician who has failed at retirement twice and is still working full time (>40 years).

Risk: Changing the Game Early in Your Career
Blair Thielemier, PharmD, attended the University of Arkansas for Medical Sciences in Little Rock, Arkansas, and earned her doctorate of pharmacy in May 2011. Although she has been in practice only 4 years, her career in pharmacy is already full of variety.

“I have gone from full-time independent retail to full-time clinical hospital pharmacy, and now to relief services and medication therapy management (MTM) consulting,” Dr. Thielemier said.

Currently, she is a clinical pharmacist at BT Consulting in northeast Arkansas and southeast Missouri. She first started out, however, with a job at an independent retail community pharmacy after completing an internship there.

“I was comfortable and had a strong background in retail, so I knew I could provide excellent service to our patients,” she said. “I stayed on there for about a year before leaving to pursue an opportunity in a local hospital as a clinical pharmacist.”

Dr. Thielemier loved serving patients, but she wanted to challenge herself. She also felt the pull of possible burnout, stress-filled days, and physical pain in working long hours in community practice. With an interest in entrepreneurship and in possibly owning her own community pharmacy one day, however, it was not an easy decision to leave.

Her next career move in pharmacy stemmed from her advanced pharmacy practice experience rotation. The director of pharmacy for a small, rural hospital called Dr. Thielemier and said he received the budget to hire another full-time pharmacist.

“I was hesitant because I had little background in hospital and [was] not confident in my clinical skills, but I knew he would help me make the transition to clinical hospital pharmacist,” Dr. Thielemier said.

She took on the challenge and became a full-time clinical hospital pharmacist for 2 years, until budget cuts forced her to take on pro re nata status. Although the cutbacks were due to budget tightening, Dr. Thielemier loved the experience.

“We set up protocols for dosing warfarin, renal antibiotics, formulary management during drug shortages, titrations of IV medications for ICU patients, and helped with post-op orthopedic surgery patients,” she said.

Since mid-2014, Dr. Thielemier has set up shop independently as an entrepreneur. On top of relief work for a few pharmacies in her local area, she has also started a small business helping local pharmacies build clinical services for their patients.

“I am consulting for community pharmacies to help them implement MTM and immunization clinics,” she said. “Through MTM consulting and coaching, I can provide a cost-effective solution to delivering clinical and MTM services in busy community pharmacies. In turn, the pharmacies will see improved Medicare star ratings, greater patient satisfaction, less adverse drug events, and increased medication adherence (via higher refill rates). This increases revenue.”

Dr. Thielemier said the board game her career most resembles is Risk.

“I’m rolling the dice, not knowing what the future will hold, but aiming for world domination,” she said.

Although Dr. Thielemier does take risks, each risk is educated. Taking risks can broaden skill sets and learning on the job, which will enable careers to take off even faster.
 
Cranium: Changing the Game in Mid-Career

Christopher Hamilton, RPh, is a second-generation pharmacist and graduate of Butler University College of Pharmacy and Health Sciences. During his 20-plus-year tenure in pharmacy practice, he has enjoyed a variety of positions in community practice pharmacy, home infusion pharmacy, the pharmaceutical industry, community mental health care pharmacy, and long-term care pharmacy, among other areas.

Currently a pharmacist at a large chain community practice pharmacy, Hamilton said he has enjoyed variety in his career.

“[T]his variety has given me a good opportunity to leverage different career experiences, broaden my skill set as a pharmacist, and help other pharmacists realize that there are other areas of practice out there, just waiting to be explored,” he said. “It has also led to a very strong, varied professional network.” Hamilton lists the work, benefits, and challenges associated with each of his positions in Table 1.

When Hamilton mentors young pharmacy interns, he often asks them why they think they want a certain career path in pharmacy, then asks them if they know their strengths and what other opportunities they think are out there.

“Of all the jobs I’ve had, my [greatest] growth was with the large pharmaceutical company,” he said. “They had a lot of strengths training within pharma, and my manager in big pharma encouraged me to take strengths training and personality tests, like Myers-Briggs, so I could figure out what motivates me.”

Mr. Hamilton described his career like the game Cranium, saying his different jobs have allowed him to use and enhance a variety of skills and activities. 

“When I grew up, my dad had 3 choices: retail, hospital, and independent pharmacy,” he said. “Now, there are a countless number of options. I never would have guessed when I launched from pharmacy school that I’d do anything beyond retail, but I’ve been lucky to have such a rich portfolio of experiences. It makes me a better pharmacist.”

Table 1: Challenges and Opportunities in Different Pharmacy Roles
Title Type of Organization Challenges and Opportunities
Staff pharmacist/ pharmacist in charge Community pharmacy, large chain Challenges: There were limitations on building the business and challenges associated with corporate policy adherence, building the patient base, and marketing.
Opportunities: I worked for a pharmacy that has pharmacy as the central focus of business. I can also be intrapreneurial.
Director of pharmacy Home infusion pharmacy Challenges: I managed a broad group of people with varying education. I was also on call 24/7/365 and managed warehouse and pharmacy duties, plus the coordination of drug delivery all in one position when on call.
Opportunities: This was a different setting from community practice; I worked with IV meds and critically ill patients and managed a team.
Women’s health associate Large pharmaceutical company Challenges: It was difficult to form long-term relationships just by speaking to patients and health care professionals via phone. I only discussed on-label indications and data.
Opportunities: I learned and really dug into women’s health drugs, and I solved problems for patients and health care providers.
Women’s health professional team leader Large pharmaceutical company Challenges: I managed nearly 20 health care professionals, and finding each person’s motivation to work at a high level and methods for gaining individual success was a challenge.
Opportunities: I managed health care professionals and led the team well because I had experience performing the same job functions.
Neuroscience pharmaceutical sales representative Large pharmaceutical company Challenges: I had to develop a thick skin, as some health care providers did not find value in working with me, and I obviously could not talk off-label. Also, I only focused on neuroscience drugs and felt like I was losing knowledge in other therapeutic areas.
Opportunities: I loved the autonomy of being self-directed in this role and enjoyed developing long-term relationships with health care professionals who saw my value and respected me. I think I had more respect because I was a pharmacist, too.
Pharmacist in charge Community mental health facility pharmacy Challenges: I liked community practice, but it was different because I was working with social workers, physicians, nurses, and the medical teams. It was a “twist” on retail pharmacy. Pharmacy was tiny, and there was little opportunity for growth within the position.
Opportunities: I got my groove back as a pharmacist, because I already was strong in neuroscience, but I also regained knowledge in general medicine. It was also an 8 to 5 job with no weekends or holidays.
Oncology specialist pharmacy Managed care pharmacy, call center Challenges: The work wasn’t as stimulating, because it was a call center. There were similar challenges to the women’s health call center work: lack of contact with patients and health care providers. There was not much growth within the position.
Opportunities: I learned a lot about oncology and helped a lot of patients.
Clinical account program manager Pharmacy benefit manager Challenges: I never felt fully prepared, but I always learned on the job. There was high pressure from stakeholders, and all had strong opinions about therapies for patients. I had little to no work/life balance, and therefore I had to leave to enjoy family time again.
Opportunities: Learning was constant on the job. I developed my skill sets in formulary management, adjudication, and professional presentations.
Pharmacist Long-term care pharmacy Challenges: I worked PRN [pro ne rata] in long-term care, just to keep a hand in it.
Opportunities: With PRN work, you work when you want to work.
 
 
Chutes and Ladders: The Professional Who Can’t Quit

Tim Franson, MD, who has more than 40 years of work experience, was first a pharmacist. He graduated from Drake University College of Pharmacy in 1974 but originally became interested in pharmacy working as a high school student stocking shelves in a pharmacy. Medical school was not really part of the plan for Dr. Franson, either, but he worked as a community pharmacist while attending medical school in Illinois.

Dr. Franson found his passion for infectious diseases (ID) during his medical training in Rockford, Illinois. He was mentored by an ID physician, and the physician was both passionate and intense.

“There were a lot of antibiotics being developed, and I had the opportunity of getting involved in clinical trials with my mentor in Rockford,” he said. “That’s where I got bit by the bug of clinical trials.”

After completing residency and fellowships in medicine, Dr. Franson transitioned into academia and teaching for a few years.

“I was always interested in pharmacology from my pharmacy roots, and I really thought I was going to stay in academia forever,” he said. “I became the hospital epidemiologist during the AIDS outbreak; the work was fascinating. But I had National Institutes of Health-funded research in IV drugs, catheters, and their use in the elderly, and our research in this arena introduced me to the world of big pharma for a career path I never even considered.”

Eli Lilly and Company invited Dr. Franson to speak about his research at the company, where he met one of the most influential mentors of his career.

“He was the ultimate mentor to me, as one of the brightest people I’ve ever met,” he said. “He could generate 50 new ideas for something in an hour.”

Between his new mentor and fascination with the work Lilly was doing, Dr. Franson started at the lowest rung on the ladder at Lilly as a clinical research physician in 1986. During his 22-year career there, he held several positions and worked in many different areas of the company. At one point, he had 1000 employees reporting to him in his division. He retired in 2008 (for the first time) as global vice president for regulatory and drug safety, which he led for the last 5 years of his career there.

It was during a reorganization of the company in 2008 that Dr. Franson had to share how much longer he wanted to sign up for, and he decided to retire and take some time off—4 months. During his time off, however, a former coworker from Lilly asked him for some consulting help, which led to more engagements, then an invitation to work for a large law firm and consulting company in Washington, DC. He commuted for 5 years from Indiana to Washington, DC. During his consulting tenure, he worked on several regulatory projects for all types and sizes of drug companies, as well as for patient advocacy groups and universities.

In 2015, Dr. Franson is now at YourEncore, a pharmaceutical consulting firm that allows professionals from the pharmaceutical sector who are retired to contract on a part-time or ad hoc basis.

“If, for example, a small pharma company needs pharmacovigilance experts for a short-term project, we can cull MDs, PhDs, and PharmDs from our pool of contractors to help them,” Dr. Franson explained.

Dr. Franson chose Chutes and Ladders as the board game most appropriate for his career.

“There are a lot of ups and places with your career that shoot you to other places you never even considered,” he said. Mentors are also clearly important to his career success during his decades in practice.

“Even my colleagues who I went to pharmacy school with were co-mentors, as we all pushed each other in our careers,” he said. “Equally important is to serve as a mentor for others throughout one’s career.”

Franson never believes he will retire, either.

“I’ve tried twice now, and I just love to work,” he said.
 
Candy Land

A map of my own career story can be found in my first book, The Medical Science Liaison: An A to Z Guide. If I had to describe my career path thus far using a board game simile, though, I would have to choose Candy Land.

Not only has my career path been full of interesting options, but it has also had many, many twists and turns, just like the game. There have been interesting stops along the way, and even though I am still in the middle of my own career board, I am appreciative of these 3 pharmacists sharing their stories, because they give us all more ideas of how to enhance the variety of our own profession and career lives. More variety in a profession allows for better patient care and a far more interesting profession overall, too.

So, if you are a pharmacist and feel stuck, get out there and change the game! You now have several ideas on how to make that happen. Our 3 pharmacists did, I did, and so can you. 


Erin L. Albert, MBA, PharmD, JD, is an associate professor of pharmacy practice and the director of continuing education at Butler University College of Pharmacy and Health Sciences. She is also a health outcomes pharmacist with Myers and Stauffer LC. Her books and blog are available at www.erinalbert.com.