Fellowship Program Aims to Connect Community Pharmacists, Explore Opportunities

Aislinn Antrim: Hi, I'm Aislinn Antrim with Pharmacy Times, and I'm here with Carlie Traylor, director of strategic initiatives and student affairs at the National Community Pharmacists Association, or NCPA, to discuss a new community pharmacy fellowship between NCPA and CPESN. And so, to kind of get started, what is the goal of this community pharmacy fellowship?

Carlie Traylor, PharmD: Yeah, that's a great question. So, number one, thank you so much for meeting with me today, I'm really excited to talk about the fellowship program. So, this really came about when I started working at NCPA in the summer of 2018. And so shortly after that, I was definitely a staff member that was like, but what about students? What about residents? How can we incorporate them in what we're doing with moving the profession of pharmacy forward? So, when it came up that a lot of our CPESN pharmacies—meaning Pharmacy Enhanced Services Network—were our best ones that had residency programs, you know, through like their partnerships or whatever. But we weren't seeing a sharp increase, we were seeing a stagnation/decline in the number of residency sites. So, it was kind of like, oh, no, these are our best pharmacies. How do we meet this need of creating change agents, because residencies are great for that.

I did my residency literally the first year of CPESN, so I can raise my hand and testify, I really benefited from that experience. So, this fellowship is about how can you bring a postgraduate education on a large scale to our community pharmacy profession. So, you get this opportunity to basically do almost like an executive MBA. You get to complete residency training, but at your pharmacy, so you get to grow where you're planted, which is absolutely revolutionary, because usually, you have to apply to programs and move to a different state. But this is basically like, do you have a pharmacy that's willing to let you experiment and use their pharmacy as a tool, as a laboratory? Then you can be a part of this program.

Aislinn Antrim: Yeah, that's really incredible. And from my understanding, the curriculum has kind of 3 main themes or components and I wanted to touch on each of them. So, the first one is practice transformation. What does that encompass? And why is that a key theme being explored in fellowship?

Carlie Traylor, PharmD: Absolutely. So, practice transformation is kind of the end all be all, right? That's why we're here, is we need to innovate, we need to move forward. We have to think beyond dispensing. I think I can boldly say that I don't think we'll ever let go of dispensing because I think that's a vital role that community pharmacists play, but we have to think beyond it. So, this is about helping the pharmacies to tap into that potential and actually implement these clinical services that they've heard at, like conventions and meetings, and they've seen their peers doing it. Like, that sounds great for them, but how do I do it for me?

We look at CPESN and Flip the Pharmacy for what are some of their core tenants. So, that's going to be medication synchronization, immunizations. It's going to be, you know, building in behavioral health services, opioid related services, medication billing, like all of these different kind of areas, pulling it together. And we do this with our CPEPSN luminaries. So, these are like hard hitting, you know, top 10 pharmacists in the country that basically give the fellows a backstage pass to their pharmacy and breaks down each service to say, “Hey, this is how you can do it at yours.” And then we have that, and it complements all of the curriculum that we go over, we have a capstone project. So, the fellows actually get to have essentially one on one time with these, you know, movers and shakers of pharmacy industry to say, “Hey, I'm trying to do this, like I'm coming up on this barrier, or I'm having this success,” and they're able to help navigate that as a group, which is awesome.

Aislinn Antrim: Absolutely. And managerial skills are another key component for the fellowship. What is the importance of effective management skills, even for students or pharmacists who might not be there yet, but they're kind of working towards that?

Carlie Traylor, PharmD: Absolutely. I think this is so key. Because if you're able to do a service, that's great as a pharmacist, but if you are the only one who's able to do that, that's a liability. And if you think at the pharmacy school, manager or management courses are a requirement. It's typically like one semester, right, like in the third year of pharmacy school, and a lot of pharmacists graduate not really seeing themselves as leaders or managers. But I challenge you to find a scenario where a pharmacist isn’t leading a team, especially in the community, because they are the captain of the ship, right? They're managing the cashiers, the technicians, the students, all the support staff within that particular shift, making sure that they have, you know, smooth sailing until the end. And so, what we talk about in these sessions is really about how to build up your team, how to break down a project. How do we do corporate feedback. What are some additional trainings that you can do? We have Tripp Logan join us about staff utilization. So, he talks about how community health workers are so vital and a perfect complement to a technician role in a pharmacy. So really getting to see those aspects of it is you can't skip that step, right. Like, we can talk all day about what a great enhanced service looks like, but it's a team sport. So, learning how to lead the team.

Aislinn Antrim: Wonderful. And patient care is kind of the third piece of this. How have expectations for patient care changed, and how is that being taught in the fellowship?

Carlie Traylor, PharmD: So, I think that if you heard the term, I remember going through residency interviews, and being like, I want to be a clinical pharmacist, but I recognize that that's an oxymoron. You’re saying the same thing twice, right, like, a pharmacist is a clinical pharmacist. But I do think that whenever when you're talking to community pharmacists who have been in practice for 10, 15, 20 years, they hear that and go, “Oh, I can never do that.” Right? Like, that's too high level for me. And what we try to do with the patient care dyads, right, is we're not trying to give them a pharmacotherapy lecture, right? These patient care dyads, they are going to be on diabetes, cholesterol, blood pressure, they're going to be on depression, anxiety, opioid use disorder. So, it's going to be kind of these like, commonly seen chronic illnesses within the community setting. And we talk about, hey, here's what the science says, now these are the resources that you can tap. But this is how you can create a structure where you stay up to date consistently, and immediately apply this knowledge to your patients. So definitely, when we were crafting these learning videos, we were saying, “Okay, here's the structure. And this is the mechanism of action.” It's how do you use this knowledge, stay up to date, and apply it to your patients? That's really the method.

Aislinn Antrim: And just speaking very broadly, what is the value of fellowship opportunities like this one for pharmacy students?

Carlie Traylor, PharmD: Yeah, so that’s something we haven't talked about yet. So, it's 100% virtual and the value in this is there's no travel requirement. So, you can really, like, grow where you're planted, in a particular pharmacy, and it's fantastic because we do something called a flipped classroom. Most recently graduated pharmacists have at least had one course that was a flipped classroom. So that's where you watch a recorded lecture and then participate in a live discussion and we even have a short homework assignment for them to complete. So really cutting to the chase and having a 90-minute discussion on, you know, staff utilization, like I mentioned, with Tripp Logan. They're going okay, you looked over the homework assignment, you read this article, you watched this video. What made sense for your practice, what questions do you have? And it's such an enriching conversation, because the fellows are learning from the faculty members, right, straight from the horse's mouth, but they're also learning from one another.

So, an example would be we had our immunization live discussion back in October. And we had such a broad range of experience and state privilege, like we have some states that have the ability for technicians to immunize, and they had trained their technicians to do that. And then we have some pharmacies that, no, the pharmacist is the only person from A to Z that handles that process. So, from a fellow, you get this massive brain trust. And it's all on your timetable, right? We encourage the fellow and the pharmacy to protect a certain amount of time a week for that pharmacist, but we do limit it. Like, when we have live discussions, we typically do it twice a month and it's for a maximum of 90 minutes. So, they know they can plan their day around it. So, I love that it, we're fulfilling the mission. We're empowering change agents in community pharmacy.

Aislinn Antrim: So what should pharmacists know if they're interested or if they just want to learn more information?

Carlie Traylor, PharmD: Absolutely. So, I mentioned this earlier, but this is open to any pharmacists practicing at a community pharmacy. So, what I love about this is when I did my residency training, like I'm still in relationship with my co-residents and my preceptors and this has been almost 10 years ago. What you do in the fellowship is you're getting to build relationships with pharmacists across the entire country, and with varying degrees of experience. So, you could be a fellow if you just graduated from pharmacy school. You could be someone who's practicing in another part of the industry and is coming back to community pharmacy, an existing staff member, someone who's specifically hired to fill the role of a fellow. This is perfect for a pharmacy that's wanting to kind of test out what a clinical director will look like and give, you know, the pharmacist and the pharmacy a year to test it out. And they get access to all these new services. So really, if you're interested, if this sounds like something that you want to try, the first step is reaching out to us via email at fellowship@ncpa.org. And then from there, I can walk you through the enrollment process. So, it's a simple enrollment form where the fellow does a self-assessment and the pharmacy kind of provides additional information, we'll sign a contract with the pharmacy. There's a tuition of $7,500 for the year. And then as soon as you get signed up in there, do all the paperwork, and you get access to the website for that calendar year. And it's fantastic. So, I really have been really proud of this and excited about the results that we've seen over the last two years. So going into our third year, I think it's going to be even better.

Aislinn Antrim: Absolutely. Thank you for telling me about it.