Pharmacy students: Our greatest asset or most squandered opportunity?

November 12, 2007

Pharmacy students should be given good training when they are doing their internships and externships, not used as a replacement for vacationing staff.

Ihave been in pharmacy for 35 years. Over that time, my interests and areas ofspecialty have changed again and again. One thing, however, has remained constant:my interest in education, specifically in the experience of students.

Studentshave to fulfill a specific number of intern hours and rotations in order to graduate.These requirements can present a great educational opportunity for students ifthey offer meaningful activities, or they can be a waste of time if nothing usefulis provided. Here's an account of my experience.

Onestudent's perspective
When I began pharmacy school, I visitedlocal hospitals and soon found myself in the office of a director of pharmacy.My interview was filled with promises of endless educational opportunities withmotivated pharmacists. My experience was quite different. The pharmacists hadno intention of taking time with students. Even when I brought questions, theworkload was such that there was little time for such activity. The pharmacy cultureI was exposed to was in no way structured for education.

Dissatisfied andwanting more, I switched to another hospital. Here again, the director of pharmacypainted a similar picture of the priority of education in his department and theinstitution at large. This environment proved to be worse than that of my initialexperience. The pharmacist would retire to the back of the pharmacy and read thenewspaper, while the pharmacy students performed all the duties and responsibilitiesof the pharmacist.

On many occasions I asked pharmacists about their experiences.Over and over again I received the same answer, "They did it to me, too."Each time I received this response, I became more resolved to be the person whowould break this chain when I began my own practice.

Myexternship experience
My final year of pharmacy school wasfilled primarily with extern experiential rotations. My hospital rotation wasperformed at a 150-bed facility. There was no instruction, no guidance, no curriculum,no plan, no accountability, and most of all no interest in students. My next rotationwas in a retail setting. This pharmacy's unabashed plan was to use me as a freeemployee. I worked on the line as a pharmacist the entire time, while the regularemployee was on vacation. There was no instruction on any subject at any time.Fortunately, my final month consisted of an excellent internal medicine rotationat a VA hospital. It was truly the best month of my entire pharmacy education.

Duringmy final year of school, I began a conversation with the state board of pharmacyabout these matters. As our interaction progressed, it became clear that for thesake of my fellow students, it would be better if I didn't "rock the boat."So I opted to maintain my silence. I finished school disillusioned about my internshipand rotation experience and determined to be an agent for change.

Fromstudent to educator
After a few years in practice, I foundmyself at another small rural hospital. This hospital took student externs ona regular basis. As I began to settle in, the student coordinator was in the processof transitioning to other areas of responsibility. I was approached about takingthis role, and I agreed. I asked the departing pharmacist for his curriculum andmaterials. In return I received a blank stare. There was none. The students simplycame, observed, and were handed to technicians as free help. I was outraged. Inthis setting, the director of pharmacy wanted two things: the prestige of "educatingstudents" and the opportunity to have free employees.

Like it or not,pharmacists send clear messages to our students. Pharmacies that offer solid trainingfor students will find their reputations spreading quickly. Students will flockto these programs, which will have a continuous supply of potential premium employeesto choose from. On the other hand, pharmacies that use students only for Rx fulfillmentwill end up with a tarnished image.
Training students takes time, effort, andcommitment. But the rewards are profound. For students to become their best, weneed to give them our best.

THE AUTHOR is a clinical pharmacistat Salem Hospital Regional Medical Center in Salem, Ore. He is currently in hisfinal year of the nontraditional Pharm.D. program at University of Florida. Heis also in preparation for the BCPS examination this fall.

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