VA: Rewarding Opportunities and Room to Grow

Associate Editor

Recent graduates, as well as practicingpharmacists looking for a career move, will want to checkout the wide array of opportunities offered by the Departmentof Veterans Affairs (VA). Running a patient clinic,pursuing a specialty at one of its 157 medical centers, andengaging in research are among the many paths a VApharmacist can follow.

The VA employs more than 5000 licensed pharmaciststhroughout its network of medical centers, ambulatory andcommunity-based outpatient clinics, and nursing homes.Pharmacists get the chance to apply the full scope of theirskills and knowledge in their practice—working closely withphysicians, nurses, and other health care practitioners toensure that the nation's veterans receive the best care. The VAoffers plenty of room for advancement, as well as a chance towork with the largest residency program in the United States.

A FOCUS ON PATIENT CARE

The VA's pharmacy residency program offers more practicesettings and practice areas than any private sector system,with specialty opportunities for both postgraduate year 1(PGY-1) and postgraduate year 2 residents. These specialtiesinclude ambulatory care, geriatrics, infectious diseases,intensive care, internal medicine, oncology, primary care,and psychiatry.

Jane Pendergrass, RPh, is chief of pharmacy service at theDurham VA Medical Center (DVAMC) in North Carolina,where she has been on the staff since 1978. DVAMC's PGY-1 program is one of more than 80 VA pharmacy residencyprograms accredited by the American Society of Health-System Pharmacists.

Pendergrass has seen much growth in the profession overthe past 30 years. "We now have a large staff of clinical pharmacyspecialists, and many of them have limited prescriptiveauthority; in the late 1970s, that was unheard of," sheexplained. "Pharmacists have moved beyond the walls of thepharmacy to take active roles with the medical center."

Indeed, VA pharmacists round with the entire patient careteam, helping to guide the best course of drug therapies.They provide direct patient education, as well as conducttherapeutic and pharmacokinetic consulting services.

At DVAMC, pharmacy residents can choose from avariety of elective rotations, including clinics focusing onanticoagulation, hypertension, diabetes, and lipid and riskreduction. "We have a lot of opportunity to assist ourpatients by providing medication counseling and assuringeach patient understands his or her medications," notesPendergrass. Other rotations focus on infectious disease,formulary management, pharmacy administration, and theinvestigational drug service.

TRANSITIONING FROM THE RETAIL SECTOR

For those currently practicing in the retail setting, the VAoffers a high level of support to pharmacists who want tomake the switch. All newly appointed VA pharmacists completean extensive orientation program, and former retailpharmacists hired into VA outpatient settings can completespecial training and certification. The VA also offers tuitionreimbursement and scholarship programs for professionalcontinuing education.

Another advantage the VA offers is mobility. With facilitiesin all 50 states, the District of Columbia, and US territories,an employee may seek employment at any VA locationposting a vacancy and, if hired, transfer without loss ofbenefits. Only one active state license is necessary to practicein any VA facility.

VA salaries are competitive with the private sector. Startingsalaries are recommended by a Pharmacist ProfessionalStandards Board, based on professional education, training,and experience. VA pharmacists are compensated accordingto a Locality Pay System that ensures that they are paidcompetitive rates within each local labor market.

A PAPERLESS WORKPLACE

The VA has been on the leading edge of the electronic healthrecords movement. VA pharmacists work in a virtuallypaperless workplace that includes a computerized patientrecord system, a bar-code medication administration system,and fully automated robotic dispensing systems. Thus,VA pharmacists have more time to focus on patient care.

For more information on opportunities with the VA, go to www.VAcareers.va.gov, or call 800-949-0002.

"Electronic medical records allow pharmacists to seemedication orders in real time, which improves the timelinessof dosing. With built-in drug interaction programs andallergy alerts, it really has improved our ability to deliverhigh-quality patient care," notes Pendergrass.

"The VA is an excellent environment to practice pharmacy,"she concludes. "We have both inpatient and outpatientpharmacies which allow for a varied practice, and this helpsprevent burnout. Assisting in the care of military veterans isrewarding by itself. Every day, in some way, we have made adifference to our patients."