Pharmacy students are often told that there are many avenues to their pharmacy careers. This is especially true with the changing landscape of the profession. Many pharmacists specialize in specific therapeutic areas upon completion of specialized training, and they do this through residency training, certificate programs, and fellowships. 

In community pharmacy, opportunities are emerging, and depending on state legislation, pharmacists can participate in patient services such as prescribing contraceptives and other medications, point-of-care testing for flu and streptococcus, administration of long-acting injectable medications, and pharmacogenetic testing. Pharmacists in many practice settings also are stepping into roles to meet national needs that include chronic disease state management, antimicrobial stewardship, and opioid stewardship. Some pharmacists have embarked on unique entrepreneurial career paths in order to reach their professional goals.

According to the US Bureau of Labor Statistics, in 2018, approximately 57% of pharmacists worked in the community setting.1 Over the next 10 years, however, the number of community pharmacist positions will likely decrease, as rising mail order sales and online pharmacies increasingly take the place of traditional retail pharmacies. It is also estimated that 26% of pharmacists practice in hospital, clinical, and home health settings. This number is expected to increase as a pharmacist’s roles expand, the geriatric population grows because of a longer life expectancy, and an increased need for medications to treat chronic conditions.

With the rise in pharmacy graduates, and pharmacy schools across the nation, pharmacists often need to create distinctive positions in the workforce. Constructing a nontraditional pharmacy role involves creativity, networking, and involvement with pharmacy organizations to pave the way.

UNIQUE PRACTICE AREAS FOR THE PHARMACIST
Tina Bayuse was the first pharmacist to work for the National Aeronautics and Space Administration (NASA).2 As a child, she was interested in space travel, and during pharmacy school she attended a presentation on how medications affect people differently in space. She pursued a rotation with the Johnson Space Center pharmacology lab.

These experiences helped her create her role as a NASA pharmacist. Her duties include preparing medication kits for launches, collaborating with scientists and engineers to learn how medications work in space, and providing medication recommendations for astronauts. Medications for the kits include those used for emergencies, such as antibiotics and cardiac life support, and for convenience, including typical medications that would be used during travel.

Space travel presents interesting considerations for pharmacists, such as ensuring that the volume and mass of medications are within the appropriate limitations of the space station, that their packaging is safe and appropriate, and that they remain stable. They must also determine optimal ways of administering the medication while traveling in space.

The FDA, nuclear pharmacy, and poison control are other practice areas in which pharmacists can contribute their medication knowledge and skills. Pharmacists practicing within the FDA have roles that include the evaluation of drug proposals, the surveillance of currently marketed drugs for safety and efficacy, the compounding, formulation and dispensing of medications, research, advising, and project management.

Nuclear pharmacy was the first specialty recognized by the Board of Pharmacy Specialties in 1978. Nuclear pharmacists focus on safe and effective use of radioactive medications and are involved with storage, handling, compounding, dispensing, monitoring, and drug information related to these medications.

Pharmacists can serve in the poison control sector as toxicology specialists. In this role, they assist patients who have been exposed to harmful medications and household or environmental substances, and they provide drug information to law enforcement, schools, and other health care providers.

The pharmaceutical industry offers numerous additional opportunities for pharmacists, and they often involve specialized training through industry fellowships. Pharmacists can serve in research and drug development, drug information, quality assurance, regulatory affairs, and marketing. In addition, many pharmacists serve as medical science liaisons and can build relationships with health care providers, as well as serve as experts on sales teams.

INNOVATIVE BUSINESS MODELS
Pharmacists have pursued entrepreneurial endeavors for many reasons, but they usually start by working on a passion project that grows into a revenue stream and solving a problem they have identified in their field. The recent article, “Trends in the Pharmacist Workforce and Pharmacy Education” stated, “Associations and employers should investigate innovative business models with sponsors and angel investors who recognize the value of social entrepreneurship, to demonstrate proof of concept for new revenue streams.” 3

The pharmacy degree serves as a foundation for many selfemployment paths, including—but not limited to— consulting, wellness coaching, medication therapy management (MTM) services, medical writer, speaker, and career coach. Pharmacists have leveraged their community pharmacy experience to create prior authorization services and administer injections.

Pharmacy consultants draw upon their expertise to advise organizations on various initiatives, such as facilitating and grading at a pharmacy school, speaking at national meetings, and utilizing their drug expertise in senior care or long-term care facilities. Because pharmacists have experience with helping patients reach lifestyle goals, wellness coaching has evolved as a career path. Telehealth opportunities also exist for pharmacists who are interested in providing MTM services over the phone, such as working for health insurance companies or innovative platforms. Pharmacists with strong writing skills may find employment opportunities with continuing education firms or as a freelance writer. Accountable care organizations are hiring pharmacists for chronic disease state management and adherence interventions.4

Some consulting avenues require many more years of experience than others, so talk to pharmacists in your desired space and ask about their career journeys.

CONCLUSION
As health care transforms into value-based care, opportunities for nondispensing pharmacy roles will continue to grow. PharmD degrees prepare us for practice-ready service in a variety of settings. Talk to your mentors about what additional skills you may need to meet the needs of this changing landscape.

REFERENCES
  1. Bureau of Labor Statistics, US Department of Labor. Occupational Outlook Handbook, Pharmacists. Washington, DC: BLS; 2019. www.bls.gov/ooh/healthcare/pharmacists.htm. Updated September 4, 2019. Accessed September 4, 2019.
  2. Page E. How Tina Bayuse became the first pharmacist at NASA. The Pharmaceutical Journal. February 5, 2016. pharmaceutical-journal.com/careersand-jobs/careers-and-jobs/career-profile/how-tina-bayuse-became-the-first-pharmacist-at-nasa/20200530.article. Accessed September 11, 2019.
  3. Heath S. How ACOs can use pharmacists for wellness coaching, engagement. PatientEngagementHIT website. patientengagementhit.com/news/how-acos-canuse-pharmacists-for-wellness-coaching-engagement. Published April 30, 2019. Accessed August 29, 2019.
  4. Lebovitz L, Eddington ND. Trends in the pharmacist workforce and pharmacy education. Am J Pharm Educ. 2019;83(1):7051. doi: 10.5688/ajpe7051.