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Pharmacy Careers in Pharmacy Careers in Academia & Ambulatory Academia & Ambulatory
CareCare
Andrew N. Schmelz, PharmDAndrew N. Schmelz, PharmDPost-Doctoral Teaching FellowPost-Doctoral Teaching Fellow
Dept of Pharmacy Practice, Purdue UniveristyDept of Pharmacy Practice, Purdue UniveristyMarch 30, 2009March 30, 2009
[email protected]@purdue.edu
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Finding the Right CareerFinding the Right Career
PharmD provides many options for PharmD provides many options for careerscareers
Can be tough to choose!Can be tough to choose!– Knowledge of career choices changesKnowledge of career choices changes– New opportunitiesNew opportunities
Need for pharmacy facultyNeed for pharmacy faculty– Change to PharmD as entry level degreeChange to PharmD as entry level degree– Aging population; need for more pharmacistsAging population; need for more pharmacists– New schools of pharmacy; larger, more New schools of pharmacy; larger, more
quality applicant pool of studentsquality applicant pool of students
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Traditional Pathways to Faculty Traditional Pathways to Faculty PositionsPositions
Clinical Track
Finish PharmD PGY1 Residency
PGY2 Residency
Faculty Position
Tenure Track
Finish PharmD Grad School (MS) Faculty Position
Grad School (PhD)
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Tenure Track FacultyTenure Track Faculty
DiscoveryDiscovery (high expectation for (high expectation for research)research)– 2 active grants2 active grants– 2 refereed publications each year (book 2 refereed publications each year (book
chapters, review articles, primary lit, etc)chapters, review articles, primary lit, etc) LearningLearning (teaching responsibilities) (teaching responsibilities)
– 12 rotation students / year12 rotation students / year– Assigned lectures & coursesAssigned lectures & courses
EngagementEngagement– Committee work, internal/external, volunteerCommittee work, internal/external, volunteer
““Time clock” for promotionTime clock” for promotion
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Clinical Track FacultyClinical Track Faculty
Discovery Discovery (lower expectation for (lower expectation for research)research)– 1 active grant / contract (co-funded 1 active grant / contract (co-funded
positions)positions)– 1 refereed publication / year1 refereed publication / year
LearningLearning (teaching responsibilities) (teaching responsibilities)– 16 rotation students / year16 rotation students / year– Assigned lectures & coursesAssigned lectures & courses
Engagement Engagement (clinical responsiblities)(clinical responsiblities)– Per agreement with clinical practice sitePer agreement with clinical practice site– Internal/external, volunteer, etcInternal/external, volunteer, etc
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Fellowship v. ResidencyFellowship v. Residency
RESIDENCYRESIDENCY– Usually Usually
accreditedaccredited programsprograms
– PGY1 / PGY2PGY1 / PGY2– Clinical Clinical in focusin focus– Can be Can be
individualizedindividualized– PGY2 – getting PGY2 – getting
extremely extremely specializedspecialized
FELLOWSHIPFELLOWSHIP– Usually Usually
unaccredited unaccredited programsprograms
– 2 years2 years– ResearchResearch in in
focusfocus– Highly Highly
individualizedindividualized
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My BackgroundMy Background
Graduated with PharmD in 2008Graduated with PharmD in 2008 Became interested in academia Became interested in academia
immediately before starting rotationsimmediately before starting rotations– PharmD project / Involvement with ELACPharmD project / Involvement with ELAC
Rotations influenced interest in amb Rotations influenced interest in amb carecare– Family Health Center of Floyd CountyFamily Health Center of Floyd County– Interest in pt careInterest in pt care– IndependenceIndependence
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My Background (cont.)My Background (cont.)
Decision to pursue academic careerDecision to pursue academic career– Require some form of post-graduate Require some form of post-graduate
trainingtraining– Initial goal to be Experiential Learning Initial goal to be Experiential Learning
DirectorDirector Interviewed with residency programs Interviewed with residency programs
in Spring 2008in Spring 2008– Geographic limitationsGeographic limitations– Results of the MatchResults of the Match
Received offer for Post-Doctoral Received offer for Post-Doctoral Teaching FellowshipTeaching Fellowship
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Post-Doctoral Teaching Post-Doctoral Teaching FellowshipFellowship
Started in May 2008Started in May 2008 IndependenceIndependence Responsibilities followed Responsibilities followed
closely with those of closely with those of traditional clinical-track traditional clinical-track facultyfaculty– Clinical practiceClinical practice– Teaching responsibilitiesTeaching responsibilities– Research responsibilitiesResearch responsibilities
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Clinical ResponsibilitiesClinical Responsibilities
Interest in ambulatory care drove Interest in ambulatory care drove clinical responsibilitiesclinical responsibilities
Diabetes Medication ManagementDiabetes Medication Management– 2 days/week; Dr. Jasmine Gonzalvo2 days/week; Dr. Jasmine Gonzalvo– North Arlington Clinic, Wishard CHCNorth Arlington Clinic, Wishard CHC– Amb Care for DM, HTN, and lipidsAmb Care for DM, HTN, and lipids
Center for Healthy AgingCenter for Healthy Aging– 0.5 days/week; Dr. Noll Campbell0.5 days/week; Dr. Noll Campbell– Specialty Care Center, WishardSpecialty Care Center, Wishard– Primary Care clinic for elderly patientsPrimary Care clinic for elderly patients
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Clinical Responsibilities Clinical Responsibilities (cont.)(cont.)
VA RotationVA Rotation– 1 month/year; Dr. Susan Bex1 month/year; Dr. Susan Bex– Rotated through several clinicsRotated through several clinics
Primary CarePrimary Care AnticoagulationAnticoagulation Cardiology clinicCardiology clinic Lipid clinicLipid clinic
– Attended topic discussions with studentsAttended topic discussions with students– Presented to clinical pharmacistsPresented to clinical pharmacists
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Teaching ResponsibilitiesTeaching Responsibilities
Course CoordinationCourse Coordination– CLPH 49000-007 Clerkship BootcampCLPH 49000-007 Clerkship Bootcamp– CLPH 49000-00X Diabetes ElectiveCLPH 49000-00X Diabetes Elective
Didactic LecturesDidactic Lectures– PHPR 20200 (Nursing Pharmacology)PHPR 20200 (Nursing Pharmacology)– P 570 (Pharmacology for PT) – IUPUIP 570 (Pharmacology for PT) – IUPUI– Adult Med RotationAdult Med Rotation– RoundtablesRoundtables
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Teaching Responsibilities Teaching Responsibilities (cont.)(cont.)
Integrated LabIntegrated Lab– Evaluate oral presentationsEvaluate oral presentations– Facilitate small group activitiesFacilitate small group activities– Diabetes lab - facilitated 1 station for weekDiabetes lab - facilitated 1 station for week
Other Teaching ExperienceOther Teaching Experience– Invited presentationsInvited presentations– Co-precepting students; leading topic Co-precepting students; leading topic
discussionsdiscussions– Development of “In Their Shoes” Development of “In Their Shoes”
experienceexperience
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Research ResponsibilitiesResearch Responsibilities
Submission of Submission of THREETHREE primary primary literature articles for publication literature articles for publication during fellowshipduring fellowship– IPPE Programs survey (published!)IPPE Programs survey (published!)– Roundtable evaluations (submitted Roundtable evaluations (submitted
abstract for poster at AACP)abstract for poster at AACP)– Spanish-Speaking Pharmacists needs Spanish-Speaking Pharmacists needs
assessment (in data collection)assessment (in data collection)
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What is Amb Care?What is Amb Care?
Ambulatory care:Ambulatory care:– Provision of care for outpatientsProvision of care for outpatients
Primary care:Primary care:– See patients for chronic/acute conditionsSee patients for chronic/acute conditions– Serve as “gatekeepers” for access to Serve as “gatekeepers” for access to
healthcarehealthcare Family Practice:Family Practice:
– Working with physician with board Working with physician with board certificationcertification
– Usually private practice model in natureUsually private practice model in nature
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Pharmacists’ Roles in Amb Pharmacists’ Roles in Amb CareCare
Working with physiciansWorking with physicians– Obtain medication historiesObtain medication histories– Identify any medication-related problemsIdentify any medication-related problems– Provide recommendations to physiciansProvide recommendations to physicians– Provide patient education on medicationsProvide patient education on medications
Working “independently”Working “independently”– SEE patients independently of physiciansSEE patients independently of physicians– Manage specific disease statesManage specific disease states– Under “scope of practice”Under “scope of practice”
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Amb Care Pharmacist SkillsAmb Care Pharmacist Skills
Patient history / interviewingPatient history / interviewing– Thorough history of diseases and medicationsThorough history of diseases and medications– Ability to efficiently gather patient informationAbility to efficiently gather patient information
Physical assessmentPhysical assessment– BP, PulseBP, Pulse– Breath soundsBreath sounds– Diabetic foot examDiabetic foot exam
Pharmacotherapy knowledgePharmacotherapy knowledge Clinical decision-making & critical thinkingClinical decision-making & critical thinking
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Benefits of Amb Care CareerBenefits of Amb Care Career
Patient interactionPatient interaction Specific hoursSpecific hours Potential for impactPotential for impact ““Cutting edge” of practiceCutting edge” of practice
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My Advice to YouMy Advice to You
Find mentors!Find mentors!– Guide you to that perfect positionGuide you to that perfect position– NetworkingNetworking– Potential for research experiencePotential for research experience
Start preparing now for your future Start preparing now for your future careercareer– Involvement in extracurricular activitiesInvolvement in extracurricular activities– Discover your passion (practice area!)Discover your passion (practice area!)
Carefully evaluate residency options if Carefully evaluate residency options if desireddesired
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Advice (cont.)Advice (cont.)
Be willing to step outside of your boxBe willing to step outside of your box– GeographicallyGeographically– EmotionallyEmotionally
““Only those who dare to fail greatly Only those who dare to fail greatly can ever achieve greatly.” - JFKcan ever achieve greatly.” - JFK