CLERKSHIP: A WINDOW TO THE PHARMACY WORLD

IN THE EVER-GROWING HEALTH care industry, pharmacy remains a field in flux. The pharmacist is stepping out from behind the counter to play an integral role in the medical care of patients, and there is no better time than clerkship to experience the many faces of pharmacy. While pharmacy clerkship is an opportunity for students to apply knowledge in real-time, it is also an excellent time to consider a career path.

In addition to the many required clerkship rotations, students may choose from a few electives in order to broaden their pharmacy experience. In choosing elective rotations, students may stick with what they know, or they may step outside of their comfort zone and see a different side of pharmacy practice. Many forms of specialty pharmacy can offer new perspectives to students and help them to define pharmacy for themselves.

During my clerkship rotations, I experienced 2 forms of specialty pharmacy?home infusion pharmacy and managed care. Home infusion consists of various parenteral therapies delivered to patients for administration in their home. Services provided may include therapy such as intravenous (IV) antibiotics, chemotherapy regimens, and total parenteral nutrition. The role of the home infusion pharmacist is quite clinical in nature, as they monitor patients via lab values, follow-up phone calls, and communication with prescribers.

Many hospitals have an affiliated infusion pharmacy to serve patients ready to be discharged on home IV therapy, and, in such cases, the infusion pharmacist will meet the patient upon discharge to assess their condition and educate them on what to expect from their upcoming therapy. On a home infusion rotation, the clerkship student will take part in tasks such as evaluation of lab values, pharmacokinetic dosing, nutrition formula calculations, and patient education. In addition, I took part in many research projects, journal article evaluations, and quality assurance projects to meet standards of the Joint Commission on Accreditation of Healthcare Organizations. A home infusion rotation is well rounded, and it incorporates hands-on clinical knowledge in a specialized facet of pharmacy.

Managed care pharmacy is something that affects the majority of people in this country, namely anyone with a prescription insurance plan. While the managed care industry is not always strongly associated with pharmacists, they do serve a unique function within the organization. Clerkship students embarking on managed care rotations will take part in many projects ranging from formulary management to disease state management. The organization relies on the pharmacy department for information on current and upcoming drugs, pharmacoeconomic comparisons, and disease-specific treatment guidelines, all of which the student will participate in during the rotation. This type of specialty pharmacy gives students a different perspective on the often dreaded insurance company by providing an appreciation for the work that goes into formulary decision-making, as well as exposing the clinical side of managed care.

Home infusion and managed care pharmacy are just 2 of several types of specialty pharmacy, many of which can be experienced during clerkship. Other opportunities include prison pharmacy services, medical writing, compounding, and nuclear pharmacy. Clerkship is the final step in the arduous journey of pharmacy education, and few realize the invaluable opportunity that it brings. While many students view it simply as a requirement for graduation, those who take it as a chance to fit in as much interactive education as possible will benefit from the exposure they gain in this most important year. These opportunities are just a snapshot of what lies in the pharmacy field. Speak to your clerkship coordinator or advisor for the options that your school of pharmacy may offer.