Pharmacist careers have evolved far beyond the former roles of dispensing medications, and it is clear that perception has not kept pace with reality about modern pharmacy practice and roles. The role of the pharmacist may conjure what is now an outdated image of someone just putting pills in bottles.

With the growing number of career options, this may even imply different meanings depending on where the patient-pharmacist interaction occurs. Pharmacists are increasingly using their clinical knowledge in many different settings, including traditional community pharmacies and hospitals, as well as alternative settings, such as primary clinical practices that engage patients.

Furthermore, changes have occurred in the field of pharmacy, such as an expanded role of pharmacy technicians, increased use of automated dispensing systems, and more patients opting for mail order or online pharmacies, all of which has allowed pharmacists to consider alternate ways of providing health care in the community.

Among these, post-graduate/residency programs offer pharmacists a unique opportunity to both enhance their therapeutic expertise and to play a significant role in optimizing patient-centered care, together with other health care providers. We often come across pharmacists working in areas such as IT, pain management, cardiology, rehab, and public health.

There has also been a significant interest in the pursuit of post-graduate training programs. In light of the growing numbers of students opting for post-graduate trainings, colleges and schools of pharmacy may want to consider offering electives geared toward exposing students to post-graduate career possibilities and provide guidance toward success.

Even though many pharmacy schools and colleges now offer electives, incorporating them into a curriculum could spark students' interest early on and encourage them to pursue experiences that will not only make them qualified, but also make them competitive for residency programs. In addition to resources such as curriculum vitae, letters of intent, and recommendation letters, several organizations, such as the American College of Clinical Pharmacy and American Society of Health System Pharmacists provide guidance in these areas. By joining these types of organizations for a nominal membership fee, students can access their seminars/webinars or residency workshops.

Through one of the webinars, I learned that residency programs evaluate candidates using a metric system that incorporates individual skills, academic performance, publications, academic posters, leadership skills, professional experience, and APPE experiences. When applying to residency programs, future pharmacists should feel familiar with these evaluation metrics during their early career stages so that they can secure such experiences during school and gain a competitive edge during residency programs.

That being said, there may be students like me who feel they do not fully understand the whole process of residency applications, and on top of that, are not well acquainted with some of the evaluation parameters themselves, thus making this experience somewhat daunting for them.

While future pharmacists are aware of the myriad career options within the pharmacy profession, adapting this information into a curriculum that provides greater clarity and guidance about how to approach these diverse options may prove valuable.

Articles

In light of the growing numbers of students opting for post-graduate trainings, colleges and schools of pharmacy may want to consider offering electives geared toward exposing students to post-graduate career possibilities and provide guidance toward success.

The Benefit of Integrating Residency Workshops Into Pharmacy School Curriculum

® Pharmacy Face-Off Gameshow™, pharmacy students from the University of the Sciences Philadelphia College of Pharmacy and the Rutgers University Ernest Mario School of Pharmacy entered a lightning round with clinical questions.

, the teams were tied with 45 points each. In round 2, each student approached the podium to answer 3 clinical questions on topics such as sterile compounding, warfarin indications, and responsibilities of specialty pharmacists. At the end of round 2, Philadelphia was up with 145 points and Rutgers trailed with 115.

Students participating from the Ernest Mario School of Pharmacy included Emily Abdelmessih, Nandini Patel, Cara Trulli, and Kelly Reitmeyer. David Dill, Cynthia Ly, Alex Greene, and Karen Namubiru competed from the Philadelphia College of Pharmacy, and the gameshow was hosted by Maurice Shaw, PharmD, also known as the Sassy Pharmacist.

Tune in April 8 to see the exciting conclusion of the 

Click here to watch the final round of the Pharmacy Face-Off Gameshow™.

Videos

In part 2 of the Pharmacy Times® Pharmacy Face-Off Gameshow™, pharmacy students from the University of the Sciences Philadelphia College of Pharmacy and the Rutgers University Ernest Mario School of Pharmacy entered a lightning round with clinical questions.

Pharmacy Students Tackle Clinical Questions in Round 2 of Pharmacy Times® Pharmacy Face-Off Gameshow

 spoke with students at the Idaho State University College of Pharmacy and its partner program at the University of Alaska Anchorage College of Health.

 Yeah, pharmacy in rural areas, I think the barriers really come up like working in that setting. A huge thing that I work with is like the indigent population, within my clinic, I work in a family medicine clinic. And so, I do a lot of like patient assistance programs for people to get free medications from drug companies. And that's a huge thing that, you know, barrier we have to overcome is cost of medications. Again, just distance people come like, lots, you know, hundreds of miles sometimes even to come to clinics. So, just making sure that everything gets done within those visits. And, you know, it's not as easy as just saying, hey, you know, actually, I forgot, you need this one paper for this application. So can you come by the clinic and drop it off? That's just not possible for a lot of these people. And so, just being on top of those things, so yeah, hugely different. For me, just working, working in the rural setting.

 I think it's been very helpful to seeing what it really is, like I'm from Indianapolis, so there's not really like it's not the same thing. It's not where you can only get somewhere by boat or helicopter or anything like that. So I think it really has highlighted for me the struggles of getting proper medical care in a rural area, especially where if you're somewhere that's only accessible by certain routes, where you can just like drive, or even where a peer driving can be a lot, especially without snow and ice and it can still be really dangerous. Um, I think it's just really opened my eyes to like how badly those rural areas do need medical care and how difficult it can be and how important it is to have people who are trained in rural areas where they might not have accessibility to, you know, a level one trauma center or you know, other resources that may be nearby and places that are not rule.

Pharmacy Times spoke with students at the Idaho State University College of Pharmacy and its partner program at the University of Alaska Anchorage College of Health.

A Different Perspective of Rural Pharmacy Work for Pharmacy Students

In this month's episode, fourth-year student Ashley Lam discussed how pharmacists and pharmacy students can get involved in environmental issues. In addition to advocating for sustainable prescribing, Lam said students can get involved in organizations such as Rx for Climate and can encourage patients to make sustainable choices.

Podcasts

Fourth-year student Ashley Lam discussed how pharmacists and pharmacy students can get involved in environmental issues. 

Pharmacy Focus Podcast: Study Break - Episode 6

 So we're a smaller campus here, we have about 40 students. And that really has allowed us to develop relationships across the graduating classes, which I really appreciate because going into the program, it was such a new environment for me. And I really relied on the experiences of my upperclassmen to help me to help me navigate pharmacy school and getting my doctorate and so it's really nice to be able to pay that forward as a third year Pharmacy student. Also, there's strong connections between our campus the Alaska Pharmacists Association, and the profession of pharmacy at large. I feel like I've contributed to this as a student through my community outreach. But additionally, when traveling on my rotations, I've been extremely lucky and I'm so thankful of pharmacists in that area, who have offered me housing and shared their lifestyles of living and integrated me socially within the community. And this is really just one example of how my own lived experiences of how stakeholder support within Alaska is an integral role in our succession in our success as a profession.

 It's been really cool. Um, first of all, not people we're not a lot of people really know about the program up here. Pretty much everyone that program up here isn't born raised Alaskan, I'm one of the few who's not actually. So it's kind of cool, because people are always like, "Oh, my God, you're studying in Alaska." I think also kind of on the same thing as the roll thing. There's a lot of opportunities just because there's only so many of us students, it allows for a lot of opportunities for us to go out and do things that a lot of places elsewhere, cannot do like a lot of other schools, like even Idaho, like they have both their campuses there. And then they have like ITCOM and like medical schools and stuff. So they're like competing a little bit more for opportunities and spots and hospitals and outreach events. Whereas up here like it's pretty calm, we get all these opportunities. There's almost too many opportunities. Like, I want to do everything and I don't have the time to do everything.

Pharmacy Students and Their Experience In the First Pharmacy Program in Alaska

The COVID-19 pandemic caused massive disruptions in pharmacy schools, and even once some classes resumed in-person, students had a myriad of barriers and motivators to attend. To learn more about these impacts, we spoke with Cara Rutledge, a student at the University of Texas at Austin College of Pharmacy, who researched class attendance during the pandemic.

This episode also features Carolina Mussenden, a pharmacy student at the Nova Southeastern University College of Pharmacy who is simultaneously pursuing her MBA. Mussenden discussed the importance of leadership positions as well as finding balance between academics and extracurricular activities.



Are you interested in writing for Pharmacy Times? Reach out to AAntrim@pharmacytimes.com to learn about various opportunities to get involved!

Even after some pharmacy school classes resumed in-person, students had myriad barriers and motivators to attending because of the COVID-19 pandemic.

Pharmacy Focus Podcast: Study Break - Episode 4

Handling finances can be especially overwhelming and stressful for pharmacy students, so we spoke with Tim Ulbrich, PharmD, co-founder and CEO of Your Financial Pharmacist. In this episode, Ulbrich discusses how to handle student loans, budgeting for the holidays, and what students should be prepared for in 2022.

If you're interested in writing for 

, reach out to AAntrim@pharmacytimes.com.

This episode was recorded prior to the Biden administration's extension of the student loan pause in repayments through to May 2022.

Handling finances can be especially overwhelming and stressful for pharmacy students, so we spoke with Tim Ulbrich, PharmD, co-founder and CEO of Your Financial Pharmacist. 

Pharmacy Focus Podcast: Study Break - Episode 3

In addition to the academic lessons necessary to become a pharmacist, hands-on research experience can help students learn practices and skills that are essential to being an effective, patient-centered health care professional.

My dream of becoming a pharmacist became a reality the moment I received my letter of acceptance from California Northstate University. After receiving this letter, I reached out to Ashim Malhotra, PhD, MS, PharmBS, FAPE, my faculty adviser and mentor for the 2021 Walmart Scholar Award, to explore the various experiences a first-year pharmacy student could be involved in, and he invited me to his research team that was focusing on targeting the mitochondria for novel drug discovery in pancreatic cancer.

Through this research experience, I learned how to conduct best pharmaceutical sanitation practices, how to connect disparate scientific concepts that serve as the underpinning of patient-centered care, how to write and communicate scientific literature, and how to manage my time while working in a high-stress environment.

Research is important for both the advancement of medicine and for patient-focused, efficient pharmacy practice. It is important that pharmacists pay attention to every detail when verifying prescriptions and ensuring good pharmacy practice includes providing patients with their medications at the highest quality standards of care possible.

Proper disinfecting and cleaning of the counter, pill counting trays, and devices, coupled with proper personal sanitizing techniques, provide patients with clean, uncontaminated medications, which became more important than ever after the emergence of COVID-19. During my time with the research team, I learned several of these sanitation skills, including the aseptic technique, continuous mammalian culture, experimental design, and quality assurance assays.

Performing the different assays helped me better understand the impact of pharmacological products on biological mechanisms. For example, the reactive oxygen species (ROS) assay is an experiment that determines the effect of oxidative stress on various intracellular pathways through the measuring of ROS, which are natural by-products that can affect cells in multiple ways. Since ROS can also trigger apoptosis, it is used as a target in treating patients with tumors and is a predictor for efficacy of anticancer medications.

Performing this assay helped me connect cellular biology concepts to pharmacotherapy treatment, which gave me a better understanding of why we learn these concepts in pharmacy school and why it is important to have a strong background in foundational science.

Aside from working with a research team, I had the chance to improve my scientific writing and communicating skills, both of which are essential in pharmacy. Scientific writing and communicating with other health care professionals can be daunting, but collaboration and coordination of novel ideas and treatments are necessary to contribute to the advancement of medicine.

Fortunately, the research team I was a part of actively exposed me to the world of scientific literature and how to appropriately communicate data through the creation of posters, book chapters, manuscripts, and presentations. By presenting at conferences, such as the American Society of Health-System Pharmacists Midyear Meeting and the American Society for Pharmacology and Experimental Therapeutics Annual Meeting, I learned to practice my presentation skills in front of other health care professionals, further fortifying my professional confidence and competence.

Lastly, time management is an important skill for any future pharmacist. Without it, I would not have been able to balance school, work, and research. On top of that, effective time management gave me more time to focus on my well-being during the school year and decreased my overall stress.

Although performing under stress is not a skill taught in school, it is a valuable skill to have for any professional pharmacy career. During lab meetings, we are put on
the spot and asked to explain our experiments and their significance. Being ready to answer unexpected questions is stressful, but it is similar to being on rotation and being asked questions by a preceptor.

Working with a deadline and being put on the spot in the lab also helped prepare me for my advanced pharmacy practice experience rotations and, subsequently, will continue to help me throughout my career. Acquiring the skills related to time and stress management coupled with the opportunity to integrate foundational sciences with experiential learning is challenging, but it is comforting to remember that these experiences are universal. Not only pharmacy students, but many students from other professional backgrounds are also experiencing similar challenges.

As an academic goal, the desire for the betterment of human life (ie, drug discovery research) is a noble goal in and of itself. Yet, more specifically, the ultimate goal
of the pharmacy profession is to improve the quality of patients’ lives and decrease disease burden and related morbidity and mortality. Being a part of Malhotra’s lab helped me understand this specific goal with greater clarity, gain the skills I needed to perform at my highest level on rotations, and develop my professional persona as a future practicing pharmacist.

However, the lessons I’ve learned from my research experience go beyond the professional sphere, which is largely due to the efforts of my mentor over the past 3 years. For pharmacy students—both current and future—I would highly recommend finding a faculty member that conducts research that is of professional interest. In addition to practical experience, a mentor-mentee relationship in pharmacy school can provide guidance to help achieve personal, academic, and career goals. My experiences helped me contextualize the universality and significance of hypothesis-driven, evidence-based, scientific discovery and scholarship, as well as the need for practicing effective and audience-targeted communication as a pharmacist.

 s a PharmD candidate at California Northstate University College of Pharmacy.

Working on a Research Team Helps Develop Essential Practices, Skills

When one thinks of a pharmacist, most people’s first thought may be of the person standing behind the pharmacy counter at a local Walgreens or CVS, or a bustling hospital located in the centers of the biggest metropolitan cities in the world. However, in rural communities—particularly in Native American reservations—the pharmacy environment looks a bit different, and the role of the pharmacist in these communities is heightened in scope.

For Native American reservations, medical services are provided by the Indian Health Service (IHS), which is an operating division within the US Department of Health and Human Services (HHS) and US Public Health Service (USPHS). IHS provides direct medical and public health services to 2.6 million American Indians and Alaska Natives in 37 states.

Beyond providing care for indigenous populations in the United States, the USPHS also provides a pathway for students to work within these federal agencies through their Junior Commissioned Officer Student Training and Extern Program (JRCOSTEP).

For the summer of 2021, I had the opportunity to work as a Junior Commissioned Corps Officer at the Crow Service Unit in Crow Agency, Montana. JRCOSTEP students within IHS are those who pursue medical education and work as “seasonal” staff at the service unit. My main duties were to assist in the prescription flow in the outpatient pharmacy by filling, dispensing, restocking, and ordering medications, as well as working in the inpatient pharmacy by restocking the emergency room, inpatient clinics, and assembling crash carts.

As I look toward the start of my first professional pharmacy year, I’ve been thinking about the kind of pharmacist that I want to be in the future and whether I want to specialize in a specific area. Working in a clinical pharmacy has helped show me the varied roles a pharmacist can have, even within 1 hospital.

During my externship, I briefly shadowed Crow’s Pharmacy Informaticist, Kelsey Kroon, PharmD, to learn how drugs were entered into the system for use by providers and verification by other pharmacists. Kroon is responsible for updating the information on what drugs could and could not be accessed on Electronic Health Record (EHR) drug menus, following Pharmaceutical and Therapeutics Committee Meetings with other departments.

When supporting Kroon in this process, I was able to verify the EHR drug menu to see that the antibacterial options were up-to-date with advised first-, second-, and third-line of therapy, and so on. Furthermore, I double checked, revised, and formatted comments in the outpatient formulary excel spreadsheet.

One of the most interesting parts about the externship was working at the satellite clinics in Lodge Grass and Pryor, both located in Montana. Although both locations were hour-long drives from where I was living and located in the most rural parts of the reservation, these clinics are vital to the locals who cannot afford to make the lengthy trip to the Crow Service Unit. Without these satellite clinics, it would be difficult to ensure medication adherence and to monitor the effects and implementation of certain treatments. In emergencies, these clinics can immediately provide the stabilizing care that a patient may need until it is possible to transfer them to a larger service unit.

As part of pharmacy staff, I was able to engage in meaningful discussions with many of the pharmacists, physicians, nurses, dentists, and administration at the Crow Service Unit. Many of the health care workers at IHS are commissioned officers, which was extremely helpful in learning about what the process of working as an officer was like, why they decided to join, and what their experiences were like at other facilities. Dean Goroski, director of pharmacy at Crow Service Unit, has been with the USPHS as a commissioned officer for many years. This wealth of wisdom helped me develop a clearer picture of the types of careers available to pharmacists when working for the federal government.

The relationship between the federal government and Indian tribes was established in 1787, based on Article I, Section 8 of the Constitution of the United States.

 As the primary federal health care provider for natives, IHS continues to work to raise their health status to the highest level.

The IHS focuses on specific areas, such as encouraging natives to get the COVID-19 vaccine to help decrease overall deaths from COVID-19, as well as helping with the management of diet, nutrition, and exercise to reduce rates of obesity, heart disease, and diabetes on the reservation. The IHS also delivers sex education courses to support a reduction in teenage pregnancies and the spread of sexually transmitted diseases.

The focus on education and support can be seen throughout the clinic on posters and desktop screensavers that display facts about the importance of receiving vaccinations and getting tested for COVID-19, in addition to information on diet and safe food storage.

These educational efforts seem particularly effective as 71% of the IHS employees are Native Americans.

 Amber Walks Over Ice, PharmD, deputy chief pharmacist of the outpatient pharmacy at the Crow Service Unit, is originally from the native community in Flathead County, Montana. Most of the pharmacy technicians are native Crows, but some, like Jennifer Lawton, CPhT, are Navajo. As the vaccination rates slowly increase within the Crow reservation, the efforts of the IHS team at the Crow Service Unit become more visible.

Every summer, Crow Agency hosts Native Days, a series of events and festivities where members of the tribe can exhibit their physical and mental skills through competition. The main events include the rodeo, relays, arrow tournaments, and the Ultimate Warrior races, which involve a mile-long canoe race, a 6-mile foot race, and a 6-mile horse relay. There are also prayers, parades, and a powwow.

During my time at the Crow Service Unit, I was fortunate enough to watch the women’s Ultimate Warrior race alongside one of the native pharmacy technicians, Randa Black Eagle, CPhT. As part of the crowd, I could see how Native Days brought everyone together.

The time I’ve spent in Montana as a JRCOSTEP student has been invaluable. Beyond gaining experience in a clinical pharmacy, I have been able to interact with the Crow tribe—whose autonym is Apsáalooke, or Absaroka—both personally and professionally, which is something not many Americans have done. Since the Native American reservations are sovereign states and do not often house outsiders beyond IHS staff, most people have no concept of what it means to be Native American in the 21st century.

Natives’ most frequent media representation features a bow and arrow and a feather, and they’re often depicted as wild or savage—even today, in some Scholastic textbooks. However, the Native American population is not something of the past, and they are not relics of a time long forgotten. They are alive and have survived years of genocide. Today, they are continuing to revive their culture and heritage through language, Native Days, social events, like Crow Fair, and the employment of natives within IHS.

It may sound counterintuitive, but what makes a pharmacist great at their job is not just their understanding of pharmaceuticals, but their ability to show empathy for a patient. For this reason, my time at the Crow Service Unit taught me that truly great pharmacists strive to understand their patients’ way of life, their struggles, and their victories.

The road to becoming the greatest health care provider I can be is not just through school, but through genuine interactions with the humans I serve as well. This is why serving as a JRCOSTEP student at the Crow Service Unit remains instrumental in my understanding of who I want to be in my role as a pharmacist in any community I may work in, in the future.

Had it not been for my participation in the JRCOSTEP program, I would never have encountered the strength and resilience of the Crow tribe. The time I have spent with the USPHS will stick with me for the rest of my career. Despite working in the Crow Service Unit for only 3 months, the time I spent there made me excited for the rest of my journey as a student. One day, as a licensed pharmacist, I will have the opportunity to help make my community healthier, which is a goal I know I can be proud of.

Indian Health Service. July 20, 2021. Accessed August 17, 2021. https://www.ihs.gov/aboutihs/

Indian Health Service Fact Sheets. US Department of Health and Human Services-Indian Health Service. March 6, 2008. Accessed August 17, 2021. https://web.archive.org/web/20080423193111/http://info.ihs.gov/Profile08.as

Learning the Value of Community With the Indian Health Service

In this finals week special episode, Jessica Louie, host of The Burnout Doctor Podcast, discussed burnout among pharmacy students and how to have a long-term perspective on mental health.

Jessica Louie, host of The Burnout Doctor Podcast, discussed burnout among pharmacy students and how to have a long-term perspective on mental health. 

Student Voices