Pharmacy Careers in Academia & Ambulatory Care

1. Pharmacy Careers in Academia & Ambulatory Care Andrew N. Schmelz, PharmD Post-Doctoral Teaching Fellow Dept of Pharmacy Practice, Purdue Univeristy March 30, 2009 anschmel@purdue.edu

2. Finding the Right Career • PharmD provides many options for careers • Can be tough to choose! • Knowledge of career choices changes • New opportunities • Need for pharmacy faculty • Change to PharmD as entry level degree • Aging population; need for more pharmacists • New schools of pharmacy; larger, more quality applicant pool of students

3. Traditional Pathways to Faculty Positions Clinical Track Finish PharmD PGY1 Residency Faculty Position PGY2 Residency Tenure Track Finish PharmD Grad School (MS) Faculty Position Grad School (PhD)

4. Tenure Track Faculty • Discovery (high expectation for research) • 2 active grants • 2 refereed publications each year (book chapters, review articles, primary lit, etc) • Learning (teaching responsibilities) • 12 rotation students / year • Assigned lectures & courses • Engagement • Committee work, internal/external, volunteer • “Time clock” for promotion

5. Clinical Track Faculty • Discovery (lower expectation for research) • 1 active grant / contract (co-funded positions) • 1 refereed publication / year • Learning (teaching responsibilities) • 16 rotation students / year • Assigned lectures & courses • Engagement (clinical responsiblities) • Per agreement with clinical practice site • Internal/external, volunteer, etc

6. RESIDENCY Usually accredited programs PGY1 / PGY2 Clinical in focus Can be individualized PGY2 – getting extremely specialized FELLOWSHIP Usually unaccredited programs 2 years Research in focus Highly individualized Fellowship v. Residency

7. My Background • Graduated with PharmD in 2008 • Became interested in academia immediately before starting rotations • PharmD project / Involvement with ELAC • Rotations influenced interest in amb care • Family Health Center of Floyd County • Interest in pt care • Independence

8. My Background (cont.) • Decision to pursue academic career • Require some form of post-graduate training • Initial goal to be Experiential Learning Director • Interviewed with residency programs in Spring 2008 • Geographic limitations • Results of the Match • Received offer for Post-Doctoral Teaching Fellowship

9. Post-Doctoral Teaching Fellowship • Started in May 2008 • Independence • Responsibilities followed closely with those of traditional clinical-track faculty • Clinical practice • Teaching responsibilities • Research responsibilities

10. Clinical Responsibilities • Interest in ambulatory care drove clinical responsibilities • Diabetes Medication Management • 2 days/week; Dr. Jasmine Gonzalvo • North Arlington Clinic, Wishard CHC • Amb Care for DM, HTN, and lipids • Center for Healthy Aging • 0.5 days/week; Dr. Noll Campbell • Specialty Care Center, Wishard • Primary Care clinic for elderly patients

11. Clinical Responsibilities (cont.) • VA Rotation • 1 month/year; Dr. Susan Bex • Rotated through several clinics • Primary Care • Anticoagulation • Cardiology clinic • Lipid clinic • Attended topic discussions with students • Presented to clinical pharmacists

12. Teaching Responsibilities • Course Coordination • CLPH 49000-007 Clerkship Bootcamp • CLPH 49000-00X Diabetes Elective • Didactic Lectures • PHPR 20200 (Nursing Pharmacology) • P 570 (Pharmacology for PT) – IUPUI • Adult Med Rotation • Roundtables

13. Teaching Responsibilities (cont.) • Integrated Lab • Evaluate oral presentations • Facilitate small group activities • Diabetes lab - facilitated 1 station for week • Other Teaching Experience • Invited presentations • Co-precepting students; leading topic discussions • Development of “In Their Shoes” experience

14. Research Responsibilities • Submission of THREE primary literature articles for publication during fellowship • IPPE Programs survey (published!) • Roundtable evaluations (submitted abstract for poster at AACP) • Spanish-Speaking Pharmacists needs assessment (in data collection)

15. What is Amb Care? • Ambulatory care: • Provision of care for outpatients • Primary care: • See patients for chronic/acute conditions • Serve as “gatekeepers” for access to healthcare • Family Practice: • Working with physician with board certification • Usually private practice model in nature

16. Pharmacists’ Roles in Amb Care • Working with physicians • Obtain medication histories • Identify any medication-related problems • Provide recommendations to physicians • Provide patient education on medications • Working “independently” • SEE patients independently of physicians • Manage specific disease states • Under “scope of practice”

17. Amb Care Pharmacist Skills • Patient history / interviewing • Thorough history of diseases and medications • Ability to efficiently gather patient information • Physical assessment • BP, Pulse • Breath sounds • Diabetic foot exam • Pharmacotherapy knowledge • Clinical decision-making & critical thinking

18. Benefits of Amb Care Career • Patient interaction • Specific hours • Potential for impact • “Cutting edge” of practice

19. My Advice to You • Find mentors! • Guide you to that perfect position • Networking • Potential for research experience • Start preparing now for your future career • Involvement in extracurricular activities • Discover your passion (practice area!) • Carefully evaluate residency options if desired

20. Advice (cont.) • Be willing to step outside of your box • Geographically • Emotionally • “Only those who dare to fail greatly can ever achieve greatly.” - JFK