Fellowships 101: Q&A with the ACCP/ASHP/VCU Congressional Health Care Policy Fellow Program Director

This series reviewing opportunities for students after pharmacy school continues with a focus on the broader lens of health care policy.

One program specific to pharmacists interested in health care policy is the American College of Clinical Pharmacy (ACCP), the American Society of Health-System Pharmacists (ASHP), and Virginia Commonwealth University’s (VCU) Congressional Health Care Policy Fellow Program. The director of the program, Gary Matzke, PharmD, FCP, FCCP, FASH, FNAP, FAAAS, and 2 former fellows share about this one-of-a-kind policy fellow program for pharmacists.

GM: First off, we were very intentional with the name of this program. It is a health care policy fellow program, not a fellowship. Fellowships focus on research training and development, and this experience is not research-focused. This is a post doctoral or postgraduate program for pharmacists who want to learn about and develop skills in policy, specifically health care policy. This program focuses on developing policy or regulations and implementing policy. It is not solely focused on pharmacy, either—it looks at the broader picture of health care overall.

We have been hosting this fellow program since 2006. It is a collaboration between the School of Pharmacy at the Medical College of Virginia/VCU, ACCP, and ASHP, and it is a 1-year and 1-fellow experience per year. It is the only program that I am aware of specifically for pharmacists to get involved in health care policy.

Q: Why was this program started?

GM: The genesis of this program grew out of an experience I had as a health policy fellow myself in a program sponsored by the American Association of Colleges of Pharmacy and the American Association for the Advancement of Science. I spent 18 months as a health policy fellow for the Senate committee on Health, Education, Labor, and Pensions. It was a challenge to get away from academia midcareer that long to complete a fellow program, but it got me on Capitol Hill. After my own experience, I realized there was a need for younger individuals to have that sort of an experience and opportunity as well. So, I sparked a conversation with ACCP, ASHP, and VCU to create this opportunity for new pharmacists. Thus, we focus our in-person recruiting to the ASHP midyear and ACCP annual meetings for this opportunity.

Q: Why is this experience important to pharmacy practice and health care?

GM: It is important to pharmacy that we have individuals who understand the processes of analyzing and making good, sound policies. Policy happens everywhere—at local institutions, and regional, state, and federal levels. How do you find the data, work with the data, work where there is not much data, and put it in perspective to create sound policy? There has not been a preponderance of pharmacists who have been involved in legislative or regulatory policy; nurses and physicians in Congress outnumber us. In fact, the 114th Congress will have a pharmacist in the House for the first time in decades.

Q: What prerequisites, if any, are required?

GM: The main requirements are that the pharmacist has graduated from an accredited school of pharmacy, is a United States citizen, and has completed a postgraduate year 1 (PGY-1) residency and/or equivalent experience. Many have also earned additional degrees, such as a master of public health or a juris doctor, or completed a PGY-2 residency prior to applying to this fellow program.

Q: As you mentioned, fellowships are typically focused on research. Does this fellow program require research, and why was it named as a fellow program rather than a residency? How is it structured?

GM: We really wanted to ensure that people would understand that this opportunity is to look at health care issues from a professional organizational perspective—not to perform “traditional” research. The fellow starts September 1 and spends 1 month with ASHP government affairs and 1 month with ACCP policy staff. Then, the 2 associations and VCU work with the fellow to identify an office of an individual representative or a committee to work with in Congress. The fellow then spends the remaining 10 months working as a policy fellow in the office of that senator or representative or on committee staff.

Q: What projects do fellows work on during this yearlong experience?

GM: Fellows develop a lot of skills during this experience that they may not have been taught in pharmacy school. They learn how to evaluate and analyze policies, write briefs on health care issues, respond to government regulating agencies (like the FDA or the Department of Health and Human Services [DHHS]), and contribute to the drafting of legislation for the office or the committee they are working for during the year. They work as staff in the congressional offices on a variety of issues and writing projects. We have had fellows who were asked to put together a hearing; they have had to identify experts on the pros and cons of an issue. They prepare for the hearings and write the questions for the senators or representatives to ask of the experts.

Q: What types of skill sets would be enhanced during this fellow program?

GM: Fellows learn how to write in a nonpharmacy or publication language. In policy writing, you have to write succinctly. Communication within the policy arena is a challenge for most people; if you can’t get to the main point in 1 page, your point may be lost. A 10- to 12-page paper isn’t going to be an efficient or effective policy brief.

The fellows also mature quickly as they are working in their congressional office. Their reporting structure is as a free agent. They do not report to the school or the 2 professional organizations. They are working for that senator, congressperson, or committee. They work with people who are neither pharmacists, nor health care professionals. We have the expectation of

practice before the fellows come in. Having practical clinical experience is critical for them to have a real-world practice frame of reference.

Q: What career paths have fellows from this program gone on to pursue?

GM: The fellows have gone on to a wide variety of experiences, such as government agencies, like the Centers for Medicare & Medicaid Services or the FDA. They have also gone on to teaching/academia, think tanks, consulting firms (pharmacist-attorneys), and policy positions at state associations and agencies. It is important to note that the fellows all take away a valuable experience in looking at population and public health through this opportunity, as well.

George Neyarapally, PharmD, MPH, the very first ACCP/ASHP/VCU policy fellow, shares what he gained from his experience as a fellow below:

GN: When I graduated from Johns Hopkins with an MPH in health policy, I wanted to apply the health policy and public health theories I studied at Hopkins to real practice by contributing to the development of national public policy solutions. I did a Google search and found information about a new fellowship program created to support pharmacists’ contributions to national health policy—making. I could have never imagined how invaluable and fulfilling my experiences working in the Office of the Secretary of the DHHS and in the Senate working on national health and legislative policy issues would be. It was an honor to work with staffers and leaders in the executive and legislative branches of the government on these issues.

My fellowship experiences in national health policy and legislative policy have substantially contributed to my career in multiple health agencies in the federal government, which I recently left to take a state health agency position. Some of these specific skills include legislative policy analysis, health policy implementation and evaluation, legislative research, and the ability to learn and integrate different points of views and expertise when developing policy solutions.

Derek Griffing, PharmD, MPH, was the 2012-2013 ACCP/ASHP/VCU policy fellow. He shares his experiences from the program:

DG: I completed the fellow program because of a longstanding passion for public policy, particularly with regard to health care and the political process. In fact, I pursued an MPH with a health policy concentration prior to the fellow program because I already knew that I would, at some point, transition into the policy world. People who seek policy careers are generally interested in the big picture and addressing the most pressing problems. When it comes to health care, the problems policymakers deal with are among the most critical facing the nation, whether they be the tens of millions of uninsured or the fact that health care spending is so high in the United States that it threatens the economic well-being of the country.

On a broader level, working on the Hill greatly improved my understanding of how policy is developed and negotiated among the political parties and diverse stakeholder groups. I learned to look at the bigger picture and to not get lost in the weeds. I learned about key stakeholder groups and their thinking on a range of topics. I also learned the importance of asking the right questions to experts in order to develop the most evidence-based policies, although, of course, such policies are not always implemented.

Writing is a critical skill in the policy world, and I was fortunate to strengthen my own skills on the Hill. From a technical perspective, I learned to write sharp, concise documents, which is imperative when working with senior-level officials with incredibly busy schedules. Further, I learned to prioritize, organize, and present information in a logical manner.

Erin Albert, PharmD, JD, MBA, is an associate professor/director at Butler University College of Pharmacy and Health Sciences, as well as a writer and entrepreneur. For more on her work, log on to erinalbert.com.