The Importance of NETWORKING

Posted by Alex at Friday, December 10, 2010

I just came back from ASHP's Midyear Clinical Meeting and consider it a success. My experience was very interesting and reflects how crucial networking is for any interview process. From the airport to the actual conference itself, you should always be in interview mode.

Many, many people attend Midyear and you will run into them at the airport, on the airplane ride, shuttle ride to your hotel...anywhere is fair game. Make sure you are always on good behavior!

So my adventure began on my flight heading over to the conference. I was sitting in my airplane seat decked out in my Michigan apparel, and this guy approaches me and says "Uh oh...an Ohio State fan sitting next to a Michigan fan." My response was, "Oh don't worry--I'll be nice!" From there we started talking and turns out he's a resident. He asked me what type of programs I'm looking into and I responded saying I'm interested in managed care. He responded, "Oh my buddy from pharmacy school is currently doing a managed care residency in Utah." And I responded, "I think I'm interviewing for that program at the conference!" Right then and there, he texted his buddy saying he's sitting next to a potential candidate.

Turns out that yes...his buddy was the person that actually interviewed me. Good thing I was able to carry on good conversations with the resident on my flight. I felt even more confident coming into the interview since I had his friend as a connection to break the ice.

During one of my interviews with another program, I discovered one of my interviewers worked with Dean Ascione in the past. I was pretty surprised. This same program also knew that I was presenting a poster during the student research poster presentation. To my surprise, they visited my poster and spent a good 15-20 minutes drilling me with questions. I was not expecting them to come! But then again, maybe I should have. However, overall I think I handled the heat pretty well.

On my flight leaving California, I discovered one of the residents from another program I'm applying to was on the same flight! I saw her in line waiting to board and said hi and small talked.

Overall message: networking is extremely important! It will give you the edge in any setting.

Cancer Sucks!!

Posted by Omo at Wednesday, December 01, 2010



My fourth rotation was at Karmanos Cancer Center in Detroit. I was working mainly with patients in the bone marrow transplant clinic and saw most of them as outpatients. This rotation was extremely fulfilling in so many ways. I got to see on average twenty patients daily. Some of my duties included:
1. Meet with and counsel patients on each visit ensuring that medications are taken appropriately and updating their medication list.
2. Look for any drug interactions especially when patients were started on a new medication.
3. Most patients were either an allogeneic-transplant or an autologous transplant so I had to make sure that their medications were well correlated to the type of transplant.
4. Some other patients were pre-transplant so I had to make sure that these patients were not on any meds that would interact with their chemotherapy.
5. I also had to update vaccinations on these patients because after transplant, they are required to have vaccinations done on a schedule.
6. I was also in charge of noting every intervention made by the pharmacy team in the pharmD clinical notes.

This experience allowed me to hone my patient counseling skills. I also had the opportunity to build a relationship with these patients because I got to see most of them at least once a week. I enjoyed learning about the experiences they shared with me. I was impressed that most patients were very knowledgeable on all their medications.

My mother died of cancer. I never fully understood what she went through while she was battling cancer because I was young. However, now that I have worked with these patients and witnessed what they go through, I can only imagine what my mother went through. I have great respect for her and all other cancer patients and survivors.

Cancer sucks but we as pharmacists can work to help alleviate the pain that patients go through!

Posted by Tiffany Pfundt at Monday, November 29, 2010

For my institutional rotation I chose a hospital close to home: Genesys Regional Medical Center in Grand Blanc. It wasn't the most exciting rotation I've had, but I think that can be said of most Institutional rotations. I managed to learn a lot, so I count it as a win!

Week One

I spent my first week shadowing various technicians around the hospital. Each day I worked with technicians in different areas of the pharmacy department. I learned how to receive and take care of drugs from the supplier, refill Pyxis machines, fill orders for medications not in the Pyxis, stock the clean room, prepare sterile products, and manage inventory. This week helped further my appreciation for technicians and the vital role they play in safe medication distribution.

Week Two

The second week I shadowed several pharmacists. The first two days I watched pharmacists enter orders into the computer. Genesys is currently developing Computerized Physician Order Entry (CPOE) software, but it won't be ready until next year. I also helped check IVs and unit dose medications after technicians prepared them. Then I went to one of the satellite pharmacies and worked with a pharmacist there. I finished up the week with the ICU pharmacist who does rounds twice a day with doctors in the ICU.

Week Three

I spent the third week on the fourth floor working with clinical pharmacists. I helped dose and choose appropriate antibiotics, adjust medications based on patients' renal function, and dose Coumadin. Even though I was in the same place all week, I worked with a different pharmacist every day. I liked working with different pharmacists; it allowed me to see and compare the pharmacists' different styles in action.

Week Four

The last week I got to work with several clinical specialists. I worked with the infectious diseases pharmacist, operating room pharmacist, and ICU pharmacist again. While with the OR pharmacist I was able to sit in on an open heart surgery. I thought the first four hours were very cool, then my feet started to hurt and looking at a beating heart wasn't that exciting anymore. That is when I decided it is good I didn't become a surgeon. I never realized the heart torqued so much when it beat - very educational. To finish up the month, I gave an in-service to the department about Lantus and Levemir. The hospital had recently decided to only use Levemir as their basal insulin product. I enjoyed the project as it helped me brush up on my diabetes material.

For anyone who lives in this area, or who doesn't mind a quick trip up US 23, I recommend the rotation. As you can see, my four weeks included a good mix of observational and hands-on experiences.

Caring for the Critically Ill

Posted by BJ Opong at Monday, November 29, 2010

I spent the month of November at Sinai Grace Hospital a place that I am very familiar with. I also intern at Sinai so I was very familiar with the surroundings and the staff, which made the month all the more enjoyable. My time at Sinai would be spent in the ICU’s dealing with critically ill patients. From the beginning I was told that to work in the ICU you have to look at it a lot differently than the general hospital population.

First, I had to realize that these were the sickest of the sick within the hospital and some of my patients were not going to make it. Secondly, I learned the goal of the ICU, which is to get the patient out of the ICU as fast as possible, the longer a patient remains in the ICU mortality increases. This differs from general hospital practice because you are to treat the patient’s main complaint or admitting problem. In the ICU the common admitting cause was shock secondary to pulmonary edema from pneumonia. This would develop while in the hospital or sometimes present to the ED with. More than any other problem pneumonia was most commonly seen in ICU patients. Pneumonia is so common in the ICU that any patient who presents with a spike in temperature or WBC and shows some sign of infiltrates on the CXR are treated empirically until sputum cultures return.

The ICU pharmacist we worked with throughout the month was also on the CODE team. His responsibility was to be present when a code blue (adult emergency) is called, and administer medications from the crash cart. The pharmacist would deliver the recommended doses of Epinephrine or Atropine as needed. During our first week we were fortunate to be present for a code blue. The room was filled with over 12 people of various medical disciplines trying to resuscitate the patient. Over 40 minutes later the patient unfortunately expired. It was a very gripping first experience at a code that I learned a lot from and will never forget.

By and large this has been my most enjoyable rotation to date. I think I enjoyed the ICU because of the fast pace that the teams work, and in part to the style of critical thinking that goes into determining the treatment plan for some very dangerous and rare conditions. While I was in the ICU I was able to learn about a lot of different and new treatment modalities. I would recommend that anyone who enjoys the fast paced work environment spend time in the ICU.

Pharmacy Beyond "the Right Drug for the Right Patient at the Right Time"

Posted by Zhe Han at Sunday, November 21, 2010

This month, I traveled to the East coast and completed my fourth rotation at the US corporate headquarter of Sanofi- Aventis, located in Bridgewater, NJ. Although I have decided on a residency route during my first rotation, I was still very excited about this experience because the pharmaceutical industry is one aspect of pharmacy that I knew very little about so I really looked forward to gaining a good overview of the various roles pharmacists can have in this setting.

The department that I was in is called "Health Policy and Strategic Advocacy". If you aren't sure what this department does, you are not alone since I had no clue of what to expect when I began my rotation 4 weeks ago. So what is strategic advocacy? Here is an exact quote from my final presentation last Friday: "strategic advocacy is important because by cultivating impactful partnerships with influential players, the company can have a greater voice in changes that affect how well its products do on the market". In a nutshell, people in the advocacy department work closely with patient, provider, payer and quality groups to influence health policies that are beneficial to the company's products. For my final presentation, I focused on oncology and identified the top 10 groups which I think Sanofi- Aventis should work with (eg. ASCO, NCCN, National Business Group on Health, etc.). My project challenged me to think about pharmacy in relations to public policies.

During this rotation, I also had opportunities to meet one-on-one with fellows in other departments such as Medical Information, Health Outcome Research, Evidence Based Medicine, Marketing, Clinical Development, Translational Research, and Regulatory Affairs. These meetings gave me a very broad understanding of different roles pharmacists can have and how pharmacists' clinical training can still be valuable even in the industry. I certainly recommend this rotation to anyone who is curious to learn about the industry. An appreciation for how the industry conducts trials, markets its products, and communicates information to providers and consumers can be very helpful in other practice settings.

????!!!

Posted by Salem at Saturday, November 20, 2010

I have spent the first half of November on rotation in the Drug Information Center at Ann Arbor’s Veterans Affairs hospital.

When VA staff members have medication questions they call the Drug Information Center. It is my job to provide answers to their questions. In a time when everyone on the medical team carries a handheld PDA full of downloaded drug information resources, the questions that make it all the way to me are the obscurest of the obscure. Questions like:

??!How do you prevent bortezomib-induced hypotension in a patient receiving hemodialysis??!

and

??!Is there any evidence for using minocycline to treat panitumumab-induced dermatologic toxicity??!

The great thing about the drug information center is that so many excellent drug information resources are readily available. They have some of my personal favorites; Lexi-comp, Micromedex, Facts & Comparisons, PubMed with full text access, Trissel’s and plenty of conversion and compatibility charts. So when I get puzzling questions like these I am able to find the answers if they are out there.

Most of the questions people ask do not require immediate responses, so I am usually given plenty of time to come up with thorough answers. It’s a great way to help out in caring for patients, in a mellow environment. I can see how drug information would be an attractive field for the pharmacist who is interested in research and caring for hospitalized patients, but wants to avoid the hustle and bustle of the floor.

Ghana International Rotation

Posted by BJ Opong at Saturday, November 13, 2010

I have traveled to Ghana several times in the past with my family, and this experience was vastly different from the others. The first and most notable difference was that this was not a vacation and that I would be working at Komfo Anokye Teaching Hospital (KATH). Although I had traveled to Ghana several times prior, I had my first ride on a Trotro. This was by far the new experience outside of KATH that I will remember the most. I had always wondered how the Trotro system works and how you would know where each Trotro was headed, now I know. It was a bit of an adventure the first time I had to wait at Tech Junction with close to 50 other people waiting to head into town. The moment the Trotro pulled up and the doors opened there was a mad dash to the doors to be one of the 12 fortunate people who had a seat, and avoid having to wait another 20-30 minutes for the next one. Although we ended up taking a droppin the rest of our time in Ghana, the Trotro experience is one that I will always remember due to its authenticity to Ghana.

My experience at KATH was just as memorable. KATH on appearance seemed very different from the hospitals I had experienced in the past. As the saying goes “appearances are only skin deep”. As we began to round with the pharmacists and the clinicians, I realized that a lot of the same types of patient and administration issues were present. KATH services a lot of patients in a very resource-constrained facility. Although the budgets may be different hospitals everywhere are faced with the burden of trying to deliver the patient the best care possible, while keeping their costs down. The issue of medications that are too expensive for the patient to afford arise often in the US and similar to here it is up to the pharmacist to determine an alternative medication that has similar efficacy that the patient can afford. Some similar patient issues that I encountered were patients who were non-compliant when it comes to regularly taking their insulin or other medications. It was up to the pharmacist and other health personnel to try to convince the patient of the importance of compliance and how properly taking the medication would lead to less hospital visits.

Another similarity that I was surprised to find is that both Hypertension and Diabetes are very common disease states. I believe that the diet plays a large part in the prevalence of diabetes in Ghana. The diet is filled with dishes heavy on carbohydrates and low on green leafy vegetables. These posse a large problem when attempting to counsel patients on their diabetes and lifestyle changes that needed to be made to improve or slow the progression of the disease. Patients with Hypertension often came to the hospital with very high initial blood pressures. The pharmacists attributed this to patients’ unwillingness to receive frequent check ups. By the time the patients come to the hospital the condition had worsened and would take longer to stabilize. Both of these conditions and issues often occur in the US as well.

Some of the differences that I noticed immediately while on the wards were the prevalence of different infectious diseases. Disease states such as malaria, enteric fever, tuberculosis and schistosomiasis are things we read about but only if we are lucky would we ever encounter it in the hospital. Another disease state that I had never even heard about but is endemic to the area was Buruli Ulcers. I was very surprised to learn of how common it was, so much that the World Health Organization sends a lot of resources and support to help prevent the spread.

I have truly enjoyed this trip to Ghana and getting to experience the country from a new perspective. Being a Ghanaian-American this trip has opened my eyes to some of the woes of the health care system and limited access to resources, be it health based literature or actual medications.