American Pharmacists Month – The Career of the PharmD: Growth and Expertise Creates New Paths of Opportunity
Today’s student earning a Doctor of Pharmacy degree (PharmD) has a multitude of career paths before them. While it is easy to see a pharmacist at a community pharmacy in their white coat helping patients – a vital role in health care – today’s PharmD is trained to perform many roles and to succeed in multiple and diverse settings. Roseman University started the first and second school of Pharmacy in Nevada and Utah respectively —to respond to a demand for more pharmacists. Roseman has trained thousands of healthcare professionals as nurses, healthcare MBAs, dentists, and orthodontists and has cumulatively graduated over 3,500 pharmacists since its inception in 1999.
Roseman’s accelerated PharmD program compresses a four-year doctoral program into three years. Within the curriculum is ample clinical exposure to a variety of settings. Student pharmacists are exposed to various practice settings within months of starting the program and will accumulate over 1,700 hours of clinical practice across a plethora of pharmacy settings.
Roseman’s educational model also prepares PharmD graduates to be competitive for nation-wide residencies. While it is optional for graduates to pursue this type of training, today’s pharmacist has far more opportunity to develop specialized skills for unique work environments. The paths to pursue range from Academia, Ambulatory Care, Nuclear, Oncology, Pediatric, or Long-term Care Pharmacists, industry positions such as Drug Discovery, Drug Development and Regulatory Affairs, Owner, or Telepharmacist. Choosing a path does not mean that it is the only path in a career. Many PharmDs are continually learning and as such, desire to work in different settings to continue to round out their experience.
According to Dr. Mark Decerbo, a high degree of specialization and training will continue to be the norm as the complexity of disease states, medications, and patient populations shift and grow. With that, there will be less opportunity to move into new areas without needing additional training. Some of the most common paths for PharmD graduates will be reviewed.
The Retail Pharmacist
A community-based retail pharmacist transitions from their program of choice directly into the pharmacy upon successfully passing their national and state board examinations. According to Dr. Leaina Oswald, the retail pharmacy environment is one of the best ways to connect with patients on a routine basis.
A community pharmacist thrives in fast-paced environments, enjoys teamwork, and takes pride in helping others. As the pharmacist on shift that day, you will lead your team of technicians and pharmacy interns to ensure safe medication delivery to your patients. Daily activities include checking every prescription for indication, effectiveness, safety and likelihood of the patient to be compliant, processing refills, overseeing inventory, providing immunizations, completing daily reports, and counseling patients so that they are educated to understand how and why to take their medications. You are the go-to healthcare provider late at night and on weekends when patients cannot reach their physicians. You are the person the public turns to figure out if an ache or pain is something that they can use an OTC product for or if it warrants going to the doctor, or what to do if child spikes a fever and the pediatrician’s office is closed. The public trust community pharmacists and the close relationships developed with patients often motivate pharmacists to the best they can each day.
Salaries for community pharmacists range from $90,000 – $140,000 a year and shifts vary between companies from 8 to 12 hours per day. Some community pharmacists chose to work part-time allowing for ample amounts of personal or family time. Many stores have 2 to 3 pharmacists who will work together to arrange schedules, swapping shifts to allow someone to have extra days off if needed.
According to Dr. Oswald, as provider status evolves for the pharmacy profession and the role of the retail community-based pharmacist grows, pharmacists will likely become even more focused on patient care. Some retail companies are leveraging pharmacists to perform health screenings for common conditions like influenza, strep throat, or pink eye. In these environments, pharmacists work collaboratively with physicians to prescribe treatments if deemed medically necessary. It is an exciting time to serve the public in community pharmacy settings.
The Specialty Pharmacist
Specialization has driven the pharmacist into a variety of settings within various areas of the hospital or clinic. Graduates wishing to pursue this path will advance to a one to two-year residency, depending upon their area of expertise. Areas of specialty include Nuclear Pharmacy, Oncology, Pediatrics, and Infectious Diseases among many others. Despite this advanced training, in comparison, hospital pharmacists typically earn less than retail pharmacists.
Record numbers of graduates now seeks postgraduate residency training, and the number of residency positions is growing, but only six or seven of every 10 applicants is successful in securing a spot. In Nevada, Roseman graduates often need to go out of state to secure a residency position, which can create challenges. While the number of pharmacists has grown significantly since the 1990s due to the number of pharmacy programs, the challenge is preparing students to be preferentially sought in a high supply environment.
This is a notable trend however, and one that may come to impact licensure in the future. “The importance of residency training as a mechanism for further skills development will continue, perhaps even becoming a requirement for practice in the future,” says Dr. Decerbo, who also notes that pharmacists with MBAs offer a powerful skill set, allowing them into the C-Suite and upper level management positions, critical in today’s climate of corporate mergers.
The pharmacist’s workday can vary but will generally begin by updates on patient medications and clinical condition overnight. Patient profiles will be reviewed for drug interactions, lab results analyzed, and other tests reviewed before joining the medical team for rounds. On rounds, the pharmacist serves as the drug therapy expert to the physicians with whom they work, making recommendations, providing teaching, and answering drug information questions in real time. In the afternoon, the pharmacist ensures medication orders are carried out, engages in clinical teaching of pharmacy residents, and works on other projects and protocols.
The Teaching Faculty Pharmacist
A teaching faculty pharmacist’s workday mirrors that of students in the University setting. Days run on average from 8-5 with evening grading, communication and committee work several nights per week for several hours. “In a typical day, I will meet with 2-6 students, speak with 1-3 preceptors, prepare lectures, work on research and grants in-progress, attend college, university or national-level committee meetings, and work collegially with my peers, “ says Dr. Oswald.
According to Dr. David Rawlins, ample preparation is necessary to successfully walk into the classroom. While the faculty day is long and requires constant interaction with students, as well as physical endurance from standing and moving throughout the room, this can be the most rewarding time for faculty. “It is a wonderful feeling to be working with a student and see their eyes light up as they get a concept,” says Dr. Rawlins.
Teaching faculty earn less than retail pharmacists, but the job is more flexible and requires less physical fortitude than the retail setting. Dr. Oswald agrees with Dr. Rawlins about the impact felt with working with students every day. “Working one-to-one with students to help them achieve their dreams…is something very rewarding to me,” notes Dr. Oswald.
Even within this role, faculty may pursue different paths. Some may be drawn to administrative functions like Directors, Assistant Deans, Deans, or even Presidents of their academic institutions. Additionally, gaps in teaching time offer faculty the opportunity to do research or clinical work. Research involves the opportunity to work on your own ideas in educational techniques, laboratory or community research and to ultimately involve students in research if they desire. Because of the teaching aspect, the approach to research in this setting is markedly different from that in a pharmaceutical company, says Dr. Rawlins.
Employees working for a pharmaceutical company might work in drug discovery or in clinical development performing tasks such as basic research, designing new clinical trials, analyzing the data of a past trial, or recruiting physicians to participate in trials. In drug discovery, the employee will spend much of their time in the research lab trying to find new agents that might be a pharmaceutical. When not in the lab, they attend team meetings where they present their results and discuss with the team other ways of approaching problems. They will also attend seminars and company meetings. Salaries in the Pharmaceutical industry are generally higher than those either in academia, the hospital, clinic or pharmacy—sometimes twice as high—but that comes at a cost.
Compared to academia, there is not as much freedom, and projects, which may have required a great deal of time and investment, may be eliminated at any time with sometimes very little explanation. Dr. Rawlins says, “You work on projects that are important to the company, and ultimately to the shareholders.”
As a veteran pharmaceutical employee who has moved into academia, Dr. Rawlins explains that, “In academia, you are more in control of what you are working on, which requires you being more self-motivated, however the resources for accomplishing research are more abundant in the industrial setting.” According to Dr. Rawlins, those pursuing leadership positions within the industry might go on to earn a PhD.
Most important is the ability to work in a team setting. “The ability to work for the good of the team is critical, and the ability to take criticism is valuable. In the industry, being flexible is important as you may be switched from project to project,” says Dr. Rawlins. And given the stress, it isn’t uncommon for someone in the industry to switch paths mid-career; this is a normal part of the journey of the PharmD.
Additional Training Opportunities
Postgraduate fellowship training is yet another path for the PharmD, and that can be achieved in either a traditional academic fellowship or an industry fellowship. An academic fellowship provided by a University are training programs focused in a specific clinical area such as Oncology or Infectious Diseases. Typically, two years in duration, this prepares the PharmD for independent research or as a clinical research scientist for Faculty positions in academic settings or research in the private sector. The industry fellowship allows the fellow to gain experience in various departments within a pharmaceutical company in areas such as regulatory compliance, medical information, pharmacoeconomics, and pharmacovigilance.
More Alike Than Different
While the various training opportunities and career paths diverge, most agree that there are commonalities that exist among this profession. According to Dr. Decerbo, the importance and commitment to lifelong learning is a given. The pursuit of knowledge does not end the day a diploma is awarded. Reading and ongoing dedication to professional practice is part of a continuum of learning. Communication skills are paramount to success, as one needs to work alongside physicians, nurses and other health care professionals, work with patients, and communicate clearly, concisely, and compassionately.
Understanding and knowledge of the other professions with which one is interacting allows for greater understanding and collegiality. Empathy and the ability to listen to the patient is crucial and having the ability to deliver information in a way that empowers is important. Accuracy and attention to detail is paramount in the drive to reduce potential medical errors. Finally, being a natural advocate for patients is a must for any PharmD.
The profession of pharmacy is widely diverse and rich with opportunity and change. The changes seen in the last 10 years of the profession will undoubtedly be eclipsed by new changes in the future. While there are many paths to pursue now–far more than most people understand–technology, advances in education, specialization and future healthcare shifts will undoubtedly lead to new career paths and environments suited to the PharmD.
By Vanessa Maniago, Special Advisor to the President, Roseman University of Health Sciences, contributing authors Mark Decerbo, PharmD, Associate Professor of Pharmacy Practice, Roseman College of Pharmacy, David Rawlins, PhD, Assistant Professor of Pharmaceutical Sciences, Roseman College of Pharmacy, Catherine Leiana Oswald, PharmD, Assistant Professor and Introductory Experience Coordinator, Roseman College of Pharmacy