UCSF Pharmacy Information Day - Part 4 - Pharmacist Panel Concluded

[The Questions from the Audience portion of the Pharmacist Panel.]

Q: Do you think that the UCSF PharmD program helped you pass the licensure exam? What was your class passing rate?

4 – UCSF makes sure you're very prepared, although my year didn't do so well. That was because we had an acute crisis care with a crash cart, and you have to do a separate class to get that experience, and the exam had a part that was all about that.

3 – It's all computerized now. I felt very comfortable. In your 4th year, you end earlier than other schools. You end in March. You'll have months to prepare for the exam. When you graduate, the class president/officers will organize reviews. I thought it was helpful.

If you'll look at the schedule, you'll see that  in your 4th yeyour 4th year ends early, and you have three months to prepare. I felt very comfortable taking it.

4 – You'll have a lot of resources.

1 – I was in the last class to take state board that was written. It was much harder.

3 – I don’t know passing rate.

Q: Can you talk about residencies in hospitals?

3 – There are different types. For the most part, when you graduate, you pretty much have to do a year of residency to work in a hospital in a metropolitan area. One or two students did it without it, but that's rare. It'll help you with your clinical skills. Just like in med school, they usually do another three years of residency, rotating through different services. You know the textbook stuff, but you have to put in your hours to be a seasoned clinician.

1 – Part of what happens is that there's a match. You'll interview and you'll be ranked. You need to have communication skills. And know what they focus on. Do your research into where you want to go. If you don't match with them, they won't pick you.

4 – I don't know about other schools, but at UCSF, most people do a residency. 60%. Right now they're working on a law to require that if you want to be [a clinical pharmacist?] you have to do a residency.

3 – At UCSF I feel like we tend to do residencies more than other schools. It’s just our culture, but a lot of us end up doing it. All sorts of residencies.  General residcies, pediatircs, infectious disease, or specialize.

Q: 1 – I have a question. what made you special? Why did UCSF choose you?

2 – Leadership is really important. How do you deal with difficult people? What would you do in a difficult situation? Volunteering and working.

1 – All I had was community pharmacy experience. I knew nothing else. But I was open to learn about it all. Life long learning. Knowing what was happening in the field was important. And communication.

3 – There's a lot of group work. I felt that people so friendly, and successful, but also down to earth.

3 – Try to be oyourself.

4 – I got waitlisted, so don’t ask me.  I agree with them, they’re looking for your personality.

Q: What was the most challenging question?

1 – It depends on who interviewd you.

Q: What is demand like for each of your fields?

1 – It depends on your location. In San Diego, it's hard. In San Francisco, it depends. It cycles. Every 7 years there's a shortage. We're trying, as a profession, to move away from counting, so who knows by the time you're done.

3 – SF General Hospital is trying to cut budget costs. There is a proposal to fire everyone and rehire everyone at 37.5 hours per week. Guess what job classes are exempt? There are two. Radio technologies, and the other was the pharmacist. Currently at my hospital, other departments are freezing, but I kinda don't want to announce this to the people I work with, but we're still hiring. Every year we hire 4 new pharmacists. Staffing pharmacists. If I may, in my own biased opinion, you will always have a job. If you're willing to do the work, you'll always have a job. If you don't have a job when you graduate, call me, I will find a job for you.

2 – It's not a matter of finding a job, it's a matter of finding a perfect job. You may have to make sacrifices based on location, but after that you can do what you want.

3 – If you want to do the worst shift ever, even being a clown for a circus, it's not always available. But with a PharmD, you can choose what you want to do. In bad economic times, you'll always have a job.

4 – In managed care, it's a little incestuous, there aren't a lot of people there. We call others and ask "Are you happy with your job?" That happened to me, and originally I was insulted, but eventually she broke me down. If someone applies we all call each other up. "Don't you dare take so and so." Even with the freeze for other jobs, pharmacists were still allowed to be hired.

Q: Knowing what you know now, what would have done differently with undergrad?

2 – I don’t think so. Once I got in, I still had to take two more classes before I could start. What I did was Foothill for chem lab, BART [subway] to Berkeley for physio, then work. You can do what you want with undergrad as long as you do the prererquisites. My friend was an English major.

4 – We had a music major, econ, engineering,... it doesn’t matter.

3 – If you work for a ballet company, the circus,... as an undergrad, you can’t ge ta lot of pharm experience. Maybe a clerk position. If you can, try to, but it’s not required. Do something to stick out.

1 – For me, I would have tried to… being well rounded is important… if all you take is science, how can you be well rounded? I would have taken more lit classes. Language classes.

3 – To make our job easier, think about how are you going to stick out. Someone brought their violin. That's not to say “Be kooky”, but you'll be in a class full of leaders. You have to bring something. People are always giving back to the school. That’s what the culture is. Don't just come here to UCSF if you want to grind out your classes and just work. If that’s you, this might not be school for you.

2 – Don’t come if you just want to count pills. It’s way too much work if you don’t want to be innovative. Come here if you want to put your name out there. Otherwise if you just want to count pills, it's way too hard.

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And that's it!!  Finally after three posts I got through the first segment of the UCSF Pharmacy Information Day. They were all awesome people, with a lot of energy. They certainly sell the school well. There was a lot of confidence in all of them, they all sounded happy, and you can tel they all love what they’re doing.

As a side note, it looked like the moderator gave all the speakers a gift of some Ghiradeli Chocolate.  Mmmmm...

Part 5 - UCSF PharmD Program Overview is next!

UCSF Pharmacy Information Day - Part 3 - Pharmacist Panel Continued

[The panel continues.]

Q: Now that you're currently practicing, looking back, how did pharm school prepare you?

4 – I was the last class before the pathways. I didn't get to be involved with that. It would have been nice to get the HPM (health policy and management) pathway before jumping into it. In pharm school you get skills to be able to compile large amounts of information. You don't get lost in the details. You can see in grey if that makes any sense. A lot of healthcare practitioners see in black and white. In my line of work, you can't just deny a request for non-FDA approved drugs. You have to look at the literature. We're not called the pharmacy department, we are clinical support. We have to keep up with the latest surgery procedures, and use skills in researching drugs. I have UCSF to thank for that.

3 – I took the HPM pathway, and now I'm doing something completely different. You can choose one pathway, but you don't have to stick with it. You still come out with a PharmD. UCSF really opens a lot of doors. We're forced to be so involved. You don't want to be the only one not in a club. All your classmates are all hardworking, energetic, and nice.

How many clubs are there now? There seems to be a new club every year. You get exposed to a lot of careers. UCSF has allowed that to happen for me. I knew I didn't want to do retail. It's good to know you can be in law, insurance, a physician group, research, or management. The pathways do help a lot. in HPM we studied out of Harvard Business School books. It helps you manage people. I remember we used something called word jujutsu. We role played how to deal with different people, how to negotiate a raise, and dealing with lobbyists. You deal with difficult people, and you have to use that, to calm things down rather than add to the fire. You don't want conversations to blow up. That's what UCSF has really taught me. People mostly are well spoken and get their point across [at work]. But you have to back up all your recommendations to the doctors on a daily basis. At UCSF you have to get up and talk. You do it at least once if not 10 times. You learn how to become a great speaker.

2 – UCSF prepares you for anything you want to do. With that said, you're never prepared for anything. For UCSF students, vs other schools, you have so many opportunities opened up for you. They make you think outside the box so you're not so rigid. you have experience in public speaking, presentations, interacting with colleagues. Those skills are just invaluable. Working on the east coast, comparing students here and Rutgers or USP, we're more prepared to deal with people and changes. Things that don't go your way. If you're in community pharmacy, you don't always get people who want to tell you about their winter vacation. You sometimes get yelled at about things beyond your control. The school teaches you how to deal with people like that. You don't just yell back or make the tech deal with that. That's what's great about a pharm degree. You spent 4 years in your undergrad, and 4 years in pharm school, and now you're the manager. That's your responsibility.

3 – You work a lot in groups at UCSF. You learn to be a team member. Now that I'm a working adult (I don't feel like an adult), you can tell sometimes, "You didn't play sports as a kid, did you?" You can tell. You have to work as a team.

4 – You learn about reflective listening. “I’m sorry you feel that way.”

1 – First thing is that when you're at a professional school, it takes about two quarters getting over the competitive feeling. UCSF does a good job about that. Gets those basics in you. Also you get to work with world class professors. I'm not sure about now, but I got to work with a nobel prize winner. You can't exchange that opportunity for anything. The connections, the dean, the awards, the opportunities, and the door that are available. That puts you in situations _____. They want to see you as a person. You can learn a completely different skill sets than just the science of it all. How to negotiate, those kinds of opportunities are valuable, how to read a patient's body language, how to approach them based off of that. Will they do what you want? Or will it be a negotiation? Or will you have to lay down the law.

3 – I still use those skills.

Q: Talk about how you see pharmacy practice changing in the future.

1 – Back then it was just, how did it go? Count, pour, lick 'n' stick. That’s all we used to be. Pharmacists were only supposed to dispense meds and that’s it. Now we do medical collaborations. In stores, I rarely counted. I didn't care if I had to ring up patients, I wanted to be there to create a bond. I had patients from poison ivy to pancreatic cancer, and I wanted to be there to provide emotional support. It's shifting to being an information specialist [Note: I like that term. "Information specialist."] It's great to be able to think in grey. Not "this is what the book says".

2 – In terms of drug research, right now we're working on hepatitis c, the standard is a pill or shot once a week, with lots of side effects, and only 40% respond and get cured. Now we're developing new drugs, such as a protease inhibitor. Works similar to HIV drugs. We're moving away from a standard of care with lots of side effects and not that effective. Also, personalized healthcare. We're developing drugs that are easy to pick as low hanging fruit. Develping drugs for stuff that doesn't have a treatment, no more Cialysis. Going away from drugs approved for different disease states. Right now Lipitor is being approved for other stuff than just cholesterol. We're looking for drugs for treatments that otherwise wouldn't have it.

3 – It might be a little unethical to say, it's a huge cultural issue, that we shouldn't be prescribing if we're going to be dispensing. If the pharmacist prescribes and dispenses, you'll prescribe the most drugs to make the most money. But I hope in the future, it'll be more about prescribing medications. Because I'm in a hospital setting, I'm not selling the drug, so I can do this. I'm not making a profit out of that so it's ok.

Now, the doctor says this what I want, what do you think? We had a heart disease patient with renal failure. She was struck between two pathways. In that process, I was the one to decide. I wrote it and the doctor signed it. In outpatient, we can't do that. Hopefully there will be clinical pharmacists in inpatient as well as outpatient. Physicians do the diagnosis, they're good at diagnosis, then we prescribe.

4 – I agree. There are few states where pharmacists can prescribe. I did in Seatle, Washington, and I thought it was normal. And then in California you have to have a protocol to do that. I thought that was weird. Going forward, it may become easier to do. As physicians see that we're more specialized now. With healthcare reform, insurance carriers will be looking at more innovative payments. Instead of pay for service, it may be lump sum of money to manage my patients. They may say, here's how much you have to work with, now do what you can do. It will be more challenging. Cardiology, oncology... will be hard. It's very complex. They may give lump sums for different types of cancer. On the flip side, we have to include a clinical component. Intensive to withhold medication. People will get very innovative. Right now we can't sustain the rise in drug costs. We have a patient, her drugs cost $800k a year. It's for an enzyme replacement. It allows him to walk 20 more meters in 6 minutes. Is that efficient? Well, she has the disease, so she has the drugs. Going forward pharmacy will develop new payment methodologies.

[Now that's the end of the pre-set questions, next post will continue with the questions from the audience.]

UCSF Pharmacy Information Day - Part 2 - Pharmacist Panel

8:30 – 8:55 – REGISTRATION

It was quick and simple. Stand in line, say your last name, and then receive your packet. [More on the packet in a later post.]

9:00 – 9:15 – WELCOME

Also quick and simple. We just went over what was in the packet, and were given a reminder that there was a parking ticket voucher for anyone who parked in the garage.

9:15 – 10:15 - CAREER OPPORTUNITIES IN PHARMACY: A PHARMACIST PANEL

[Normal disclaimer: This is not word for word. I'm just doing the best I can to go off of my notes that I typed up while I was there. And I have to say that I loved hearing from these pharmacists, hearing about what it is that they do. I'm most familiar with what a community pharmacist does, and these people don't do that.]

Then we start off with the pharmacist panel! First here's our pharmacists:

1 - Shawn - District Pharmacy Supervisor of Walgreens
2 - Linda - Clinical Pharmacology Specialist Roche Palo Alto/Genetech
3 - Nam - Inpatient Clinical Pharmacist, Clinical Professor, UCSF School of Pharmacy
4 - Katherine - Manaer of Clinical Support Hills Physicians Medical Group

Q: Tell us about yourself. What goes on during a typical day?

4 - I work for the Hill Physicians Medical Group. I manage patients, and a network of physicians to service those patients. 8 pharmacists work in the medical group. If there was a typical day, I wouldn't be in manage care. Every day is different. It's about population based disease state management vs individual care. We view trends for about 300k patients. I look at diabetics to see if they're receiving certain drugs, what other drugs they can use to improve their health care quality, and work closely with physicians. Check on prescription patterns of physicians, and make sure they follow guidelines so it's all more consistent. Strive to improve quality. I work with a 50 million dollar drug budget. Develop guidelines, make sure drugs used appropriately, and work with the contract department for ancillary services.

3 - I work in the SF General Trauma Level 1, in-patient clinical pharmacy side. I work in a hospital. There are two main services: inpatient family medication and an acute care elders unit. I start at 7:30, and sit at a table with physicians, and we talk about our patients. They'll talk about what kind of medications they want to try, and sometimes I'll interject when it comes to dosing, when they may want to switch anti-biotics, or suggest other pain medications that may be more appropriate to an elderly person. I also make sure there are good drugs on the formulary list. We admit about 7 patients a day every day. After we talk about them, we go and meet the patients. That's important. We can see their weight, ethnicity, or if they're confused. In the afternoon, if I have students, I talk with them.

2 - I work for Roche/Genetech, a pharmaceutical company. Not many PharmD's do what I do. Although there are three in my department from UCSF, it's not something a lot of people [who go to pharmacy school] do. There are a lot of PhD's and MD's. I go to a lot of meetings about developing drugs, and don't see patients. Contract out studies. When we get drugs, they've usually gone through animals or lab tests, and the first thing we do is design a study for a single test in humans. Then based off that, other studies get done, and by the end it's a 10 year process. A lot of the time, you don't make it to the end. It will get canceled, or you get moved off the project. I want to make it from end to end. When you study PK [pharmacokinetics0 and PD [pharmacodynamics], you are very valuable.

1 - I supervise 35 community pharmacies, 200 pharmacists. My day is never the same. With 35 different pharmacies, instead of having patients, I have pharmacists. I help solve issues when they have ethical issues or problems. I deal with new negotiations. The Health Policy Management pathway helped with that. I help facilitate patient care programs, make sure people are trained appropriately, marketed, and set up guidelines. MTM programs. Help patients get more formulary drugs. My day is spent visiting all of my pharmacies. 25% is management and personnel issues.

Q: How did you decide to become a pharmacist?

1 – I originally wanted to be a vet, but eventually I became allergic to cats, so that didn't work out. It didn't happen 'til late in college. But I'd been working as a cashier for a pharmacist since I was 16. The pharmacist said I had common sense, I was great with patients, etc, and I should consider being a pharmacist. So I took a year off from college and thought about it. At this point I only had community pharmacy experience. No managed care or ____. I looked into it all, and I liked dealing with patients that you see on a regular basis, so I went into community pharmacy.

2 – I was an undergrad at UCLA, my major was chemistry. [Something about engineering...] ... worked for a semi-conductor company. What got me to apply to pharmacy school... well... I took some courses at a community college for some credits, and then when I talked to a counselor, he said I was wasting my time [because I already had a degree]. I told him I always wanted to go to UCSF, and it turned out pharmacy was the right one for me. I knew the pharmaceutical sciences pathway was the right path, and that community pharmacy was not the right one for me. I did sometimes like working in a pharmacy, but not 40 hours a week. Sometimes I float in the pharmacy just to see some patients.

3 – I have a lot of admiration for people who work and then go back to school. It's not easy. As an undergrad, I was interested in genetics. I love the theory of genetics. I worked in the genetics lab as an undergrad, did a lot of work, published a lot of studies, and did public health at UC Berkeley. I loved the science of drugs. The story of drugs, how drugs bind to enzymes, etc. I came back to be a TA for an undergrad program. I loved it. I come from a long line of pharmacists, and I've been working there since I was 17. I do not like retail, and I didn't think I could do that for the rest of my life. And I didn't want to be blinded and go there for the rest of my life just 'cause my family did. So that's why I explored genetics. But if I went down that way, it would be studying one protein for the rest of my life, and you may or may not discover something.

I do so many things in a given day. You are such a busy bee. I write a box for every task I do, and by the end of the day I'm like, "Wow, I did a lot today." I still go back to my drawings when I teach other students. You can do so many different things, and don't have to just do everything people typically think [a pharmacist] does. I'm the worst counter.

4 – I'm the first of 6 kids to graduate from high school. I also wanted to be a vet. Davis didn't want me. At UCSD I voluteered in a program at a pharmaceutical company. Pfizer owns it now. I enjoyed it. I got to work with animals, and I had a relationship with a high performance lipid chromatographer. I thought about getting a PhD. I looked into the PharmD program, and I liked that it was flexible. I didn't want to be stuck doing the same thing my whole life. If I got bored, I could switch after 10 years and still be working in the same field [Note: This is one of the very appealing aspects of pharmacy for me as well.] I called up and asked if there were pharm programs in California. There were only three at the time. UCSF was the only one that gave me an interview.

[The rest of the pharmacist panel to be continued next post.]

UCSF Pharmacy Information Day - Part 1 - Overview

Alright. Just got back from the UCSF Pharmacy Information Day (rather than going to my graduation ceremony at SFSU). It was worth it.

Coming out of it, I feel better about applying there. And I already knew that I was going to do that.

So here's the schedule:

- 08:30-08:55 am - Registration

- 09:00-09:15 am - Welcome

- 09:15-10:15 am - Career Opportunities in Pharmacy: A Pharmacist Panel

- 10:15-10:30 am - Break

- 10:30-11:15 am - UCSF School of Pharmacy Pharm.D. Program: An Overview

- 11:15-12:15 pm - Pharmacy Student Panel

- 12:15-01:30 pm - Lunch with Pharmacy Students and Campus Tours

- 01:30-02:00 pm - Funding Your Pharmacy Education

- 02:00-03:00 pm - UCSF School of Pharmacy Admissions/Preparing a Competitive Application

- 03:00 pm - Closing/Evaluation

This was the full-day version of the Preview Day that I attended back in October. While four of the six parts to the event were covered last time, they were condensed a bit, and there was still something to learn during each of the major sections.

They started off with a bang, with an excellent Pharmacist Panel that was 100% new information for me. Yet I still learned some good insights into what's it's like being a student, a useful Letter of Recommendation tip, a starting point for researching out of state schools, some useful Financial Aid info, and revised the way I need to look a my pursuit of pharm tech experience.

Everyone talked sooo fast. The day was throwing all kinds of info at me. But as usual, I had my trusty netbook with me, and so I'll be breaking it all down and sharing it all on here over the next few days.

Next Up: Registration, Welcome, and Pharmacist Panel!

Undergraduate work complete! and Now what?

Alright, I took my Psy Research Final today. Piece o'cake! We got our paper back as well, and the way I figure the resubmitted homeworks are going to turn out, as well as other miscellaneous points, I figure that I could have gotten a 42/75 on the final and still passed. And I'm confident of about 70 of those 75 questions. That means I didn't even need the extra credit to get an A in the class. Pretty cool.

And that's it. That's the end of my undergraduate responsibilities, besides submitting my grade from the 1 unit class I took at my community college. (Minor, but important. No degree without submitting that to SFSU. It was part of my graduation plan that I had signed off on to get the semester started.) It's not a great accomplishment. In fact it's a bit of an embarrassment, but it's done. A part of the shame I carry with me can be put aside now.

Resuming study for the PCAT is part of the So now what? I haven't done any studying. I checked the exam dates Friday night, and there are four dates to take it before next round of applications:

June 19, 2010 (Register by May 7th)

August 21, 2010 (Register by July 9th)

October 16, 2010 (Register by Sept. 3rd)

January 22, 2011 (Register by Dec. 10th)

June 19th is definitely too soon, and I'd rather have January 22nd as an option if I don't like my results. If possible, I'd like to take the exam at the August 21st date. That'll be during the first week of the Fall semester, so there won't be any other exams that I'll have to be considering.

I've already begun studying since yesterday. I'll just have to evaluate my progress as the July 9th registration date approaches. Just as important, I need to seriously research out of state schools, because I'll need to be able to say which schools I want my results sent to when I register, I believe.

More info can be found directly at the official PCAT website, including a .pdf of the PCAT Candidate Information Booklet.

Saturday, May 22nd is the graduation ceremony for SFSU. Will I be going? Nope! I'll be going to the UCSF Pharmacy Information Day instead. I went to the Preview Day back in October, and now will be the full day experience. Here's the agenda straight from the confirmation email:

Program Agenda:

- Welcome

- Career Opportunities in Pharmacy (Pharmacist Panel)

- School of Pharmacy Pharm.D. Curriculum

- Why Pharmacy? (Pharmacy Student Panel)

- Lunch with Current Pharmacy Students

- Financial Aid & Campus Tours

- UCSF School of Pharmacy Admissions Process

- Preparing a Competitive Application

- Evaluation and Questions

It cost $25 to register, and that comes with food and parking. Awesome. Parking tickets have not been my friend in the past.

I like that this event happens so soon after finals. It's easier working with momentum. That's one of the reasons why I began studying again for the PCAT yesterday (and am continuing today) before finals was even over. I'll be sure to read over my posts from the Preview Day, and see what I can take away from their day long presentation.