Q: Tell me more about the kind of pharmacy you practice, clinical pharmacy.
A: Clinical pharmacists actually see patients in a clinic and talk to them either about how they're using their drugs or make sure they understand what they're using. There's a lot of research these days that says you ought to be working on a goal. We don't diagnose, but we do order lab tests. Usually what happens is we get sent the more difficult patients, the ones that aren't really responding to therapy or the ones not motivated to take their medications.
Q: What gets you excited about your job?
A: The neat thing about my job is it's not the same thing day in and day out. There's always little things where a drug is supposed to be used in a certain way and you find out it can be used in a different way or you find out your patient can't take it the way it's designed and you have to come up with creative ways to get the drug to the patient. It can be very exciting in that way.
Q: What advice would give students who are going into clinical pharmacy?
A: If you want to do clinical pharmacy, it's highly recommended, although not required, that you do a residency program. There are one year residency programs called PGY1 (post graduate year one). In that residency program you learn everything about a pharmacy. Students learn how to be an administrator, how to pick and choose what drugs you carry at your pharmacy, how to treat patients in the clinic. Then there are PGY2 residency programs where you can really specialize.
Q: What's the value of post-graduate residencies?
A: After that one year, people claim that its equivalent to three years of experience and you are more qualified to get advanced level jobs as opposed to someone who comes out with just a Pharm.D degree.
Q: What looks good on a resume?
A: I would recommend everybody do a residency. One more year of training but it gives you a lot good experience that you wouldn't get otherwise. The problem with the residency program is you make about half what a pharmacist makes. Since it's not mandatory, that's why a lot of people don't go that route.
Q: Is it important to specialize within pharmacy?
A: Pharmacy is so big these days, you cannot know it all. The only way you can really offer good advice to somebody who wants to use a drug is to know it really well. What I recommend to pharmacists that I supervise is that it's really important to specialize. My very first boss when I graduated from pharmacy school said if you ever really want to be an expert and be somebody that people come to when they want a definitive answer on something, you had to specialize.
Q: How competitive are pharmacy jobs?
A: There is actually a shortage of pharmacists. However, clinical positions are premium jobs. When we have clinical positions available at our five clinics at the VA, these jobs have what every pharmacist wants , so the competition for them is really high. If you have a position in an inpatient pharmacy or a refill job, where you're filling 100 or 200 prescriptions a day, it isn't as appealing as that clinical job. You might get one applicant for that inpatient job, and you're going to hire them because there is a shortage of pharmacists.
Q: Tell me more about the pharmacist shortage.
A: There is a shortage of nurses, but if you look at it percentage-wise, there is a way bigger shortage of pharmacists than nurses. One of the reasons there is such a shortage is that retail pharmacies have expanded so fast all over the country. There just aren't enough pharmacists to fill those drugstore positions. In the inpatient hospital setting there is a shortage because hospital pharmacists historically haven't made as much money as retail pharmacists. If you're faced with what it costs to go to pharmacy school and all that pharmacy debt, you'd likely choose the higher paying position.
Q: Anything else you want to add?
A: I would recommend if someone was going to do a residency that they do it at a VA. We're 100 percent computerized. Everything is in the computer: lab work, physicians' notes, prescriptions. There is a lot of autonomy between physicians and pharmacists here. Physicians respect us, they want us to be involved in the management of their patients. They are actively looking to have more pharmacists in the hospitals. We're really cutting edge in terms of technology. We have this practice for about 10 years now called barcode medication administration, where they scan the drug, scan your bracelet and they know this drug is ordered for this patient. The VA is a very popular place these days to work.