As pharmacy practice rapidly changes, pharmacists are encountering greater opportunities to provide advanced patient care. With this rapid expansion of pharmacists’ roles, pharmacy students may often have difficulty learning about the plethora of career options available to them upon graduation.

Typical pharmacy student intern positions and traditional Introductory Pharmacy Practice Experiences (IPPEs) are often focused on medication distribution and do not expose students to the wide variety of direct patient care services that pharmacists can provide. Thus, Advanced Pharmacy Practice Experiences (APPEs) often serve as the first insight that many students have into a number of possible pharmacy careers. This can make it difficult for pharmacy students to make informed APPE choices and adequately prepare to be competitive residency candidates.

The University of Kentucky College of Pharmacy has recently redesigned its curriculum, attempting to remedy this situation by offering longitudinal IPPEs in direct patient care settings. While students in this program will continue to participate in traditional IPPEs following the summer of their first and second professional years, they will also undergo longitudinal IPPEs during the fall and spring semesters of their second (PY2) and third professional years (PY3). These new IPPEs will take place in clinical pharmacy settings and expose students to direct patient care activities.

This year, an elective course was offered to students willing to pilot the new longitudinal IPPE program. Forty PY2 and PY3 students were enrolled in this course and were assigned to a variety of direct patient care IPPE sites, including inpatient, community, and ambulatory care practices. The students received a list of all potential sites and preceptors and were instructed to select 5 sites that aligned with their interests and schedules. After receiving their preceptor assignments, the students spent 16 hours over the course of their fall semester participating in direct patient care activities and interacting with other health care providers, completing tasks such as medication reconciliations, patient education and counseling, and prerounding and rounding services.

I was assigned to an inpatient infectious disease pharmacist for this elective course, and although infectious disease was not my first choice during the selection process, I immediately realized it was a great fit for my professional interests. My initial on-site shift was also my first experience in rounding with an interprofessional health care team, and I realized that day that it was important for me to pursue a career that involves rounding. Three of my shifts were spent on the infectious disease consult team, where I participated in both pre-rounding discussions and rounds. I observed the pharmacist performing antimicrobial stewardship services during my final shift, which allowed me to see how specific antibiotics are regulated within the hospital and how a pharmacist is integrated into this process.

This experience greatly sparked my interest in pursuing a career in infectious disease pharmacy. Because it coincided with my infectious disease pharmacology course and reinforced many of the concepts I had learned in the classroom, I was able to apply those concepts and build on my knowledge with real-world applications. Based on this experience, I have already made efforts to pursue my newfound interest in infectious disease pharmacy, enrolling in an elective course for the following semester that focuses on infectious diseases and selecting an APPE in infectious disease pharmacy. This experience also allowed me to make professional contacts within this area of pharmacy that will be useful in the future.

Early exposure to direct patient care and advanced pharmacy practice is invaluable to helping guide student career development during pharmacy school. The sites included in this elective course provided students with exposure to advanced patient care that is difficult to gain through intern work and traditional IPPEs. I had never considered pursuing infectious disease pharmacy prior to this experience, but it has now become one my greatest professional interests. I believe that the addition of early direct patient care longitudinal IPPEs to pharmacy curricula will greatly benefit students and help them discover new areas of pharmacy and ignite their passion earlier in their education.
Joseph Plott is a 2019 PharmD candidate at the University of Kentucky College of Pharmacy in Lexington. Raised in Chattanooga, Tennessee, he received his bachelor of science in health science from Middle Tennessee State University in Murfreesboro.