Not too long ago, I was in the last month and a half of my final year of pharmacy school. Only a handful of clinical experiences stood between me and walking across the stage to claim the sought-after PharmD. Around this time, I remember grabbing my phone and arbitrarily flipping through a stream of nondescript notifications until one — just one — caught my attention. It read, “PharmD Class of 2026 – P4s: 2026 RxPharmacist Summer Internship Part Time Program.” I simply couldn’t resist my curiosity.

All throughout pharmacy school, I’ve wanted to work and gain experience in niche pharmacy-related spaces. Opening that email and pursuing the opportunity turned out to be truly worthwhile.

I was tasked with two main assignments — first, updating the Tennessee MPJE study guide, and second, creating social media clips to further promote RxPharmacist. Both pushed me beyond my comfort zone, and both left me with transferable skills. The primary takeaway I’ve learned is that any project can be completed by breaking it down into smaller segments, and that anyone can learn almost anything, no matter their skill level, through small, consistent efforts.

I’m grateful for my time in this role as a graduate intern, and I encourage every student and pharmacist to maintain a state of learning while enjoying and trusting the process. I had excellent support throughout, along with the opportunity to further develop my time management and self-learning skills. Moving forward, I’ll carry these lessons with me as I begin an HSPAL PGY1 & 2 residency — a next step this internship helped prepare me for.

-Jessica W., RxPharmacist Graduate Intern

The modern pharmacist is expected to practice at the top of their license. They must make complex, evidence-based clinical decisions, be updated on rapidly evolving guidelines, counsel patients across a wide range of health conditions with limited time and often limited resources. Fortunately, the digital landscape has never offered more high-quality, free tools to support that kind of practice.

As the toolkit has grown, so has the conversation. The concern around a new addition to the clinical workflow: artificial intelligence (AI). Rapidly developing and highly invested in, AI is changing the healthcare landscape as AI-assisted tools are appearing in drug databases, literature search platforms, clinical decision support systems, and documentation software that outpaces most pharmacists’ training in how to use them critically. That conversation cannot be separated from the tools themselves. It is a pharmacist’s responsibility to differentiate what to use, but how also how to use it appropriately.

Whether you are a pharmacy student preparing for APPE rotations, a new practitioner building your daily workflow, or an experienced clinician looking to expand your resources, this post covers the free tools and apps that belong in every pharmacist’s digital toolkit.

Mobile Apps

Epocrates

Platform: iOS and Android | Cost: Free (Epocrates+ upgrade available) | Developer: Epocrates

Epocrates is a widely used clinical reference app among pharmacists and physicians. The free version includes:

• Drug information
• Interaction checker
• Pill ID
• Guidelines and decision tools
• Medical news
• Calculators and risk scores
• Reference tables
• “Bugs and Drugs” infectious disease reference

This provides a substantial amount of features at no cost. There is a paid Epocrates+ tier that unlocks disease information, herbs and supplements, ICD-10 codes, infectious disease treatment guidelines, and lab references. For pharmacists, the free tier covers core clinical functions. Students on APPE rotations and new practitioners could start with the free version and assess whether the additional content justifies the cost based on their practice setting. Some users report that ads remain present even in the paid version, which is worth knowing before upgrading.

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Pyrls

Platform: iOS and Android | Cost: Free (Pyrls Pro upgrade available) | Developer: Cosmas Health, Inc.

Pyrls is a free clinical reference app built by pharmacists, for pharmacists. The free version includes:

• Medication naming, indications, and pharmacology
• Counseling points and clinical pearls related to place in therapy, safety, and monitoring for each medication
• Reference tables, figures, and charts

The content is presented in a clean format designed for quick look up during a busy shift or rotation rather than extended reading. Pyrls emphasizes high-yield clinical pearls, especially the practical, nuanced details that experienced pharmacists know intuitively but can be difficult to find when digging through standard drug databases. User reviews highlight that the content is particularly useful for refreshing learned information on top medications and their counseling points. Also, users praise how the app continues to add guideline summaries and clinical charts over time. The free tier provides access to core drug content covering the medications pharmacists encounter most frequently and is sufficient for most daily clinical questions. Pyrls Pro expands access to a broader drug library and additional clinical content for practitioners whose practice demands it.

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CDC Vaccine Schedules App

Platform: iOS and Android | Cost: Free | Developer: CDC

The CDC Vaccine Schedules app is the official mobile version of the recommended immunization schedules published by the Advisory Committee on Immunization Practices (ACIP). It covers the childhood, adolescent, and adult immunization schedules in a clean, navigable format and is updated whenever ACIP releases schedule revisions. The app allows pharmacists to quickly look up the recommended schedule for a specific vaccine, review catch-up immunization guidance for patients who are behind, check contraindications and precautions for each vaccine, and walk through the full immunization schedule when conducting a vaccine review. Particularly for community pharmacists and ambulatory care practitioners, this app is essential. Vaccine administration and counseling is now a core pharmacist function and having ACIP recommendations at your fingertips ensures that what you are telling patients reflects the most current evidence and guidance.

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CDC STI Treatment Guidelines App

Platform: iOS and Android | Cost: Free | Developer: CDC

The CDC STI Treatment Guidelines app has the full CDC Sexually Transmitted Infections Treatment Guidelines directly on your phone in a searchable, user-friendly format. These guidelines are the authoritative clinical reference for the diagnosis, treatment, and management of sexually transmitted infections in the United States published by the CDC.

The app covers treatment regimens for gonorrhea, chlamydia, syphilis, genital herpes, HPV, trichomoniasis, pelvic inflammatory disease, and more. It provides first-line and alternative regimens, medication dosing, treatment duration, special population considerations (pregnancy, HIV-positive patients, pediatric patients), and counseling recommendations. It also includes guidance on partner notification and management, which is increasingly relevant given how often STI-related questions come up at the pharmacy counter, within the clinic, and in the emergency department. Pharmacists who can quickly pull up current CDC treatment guidance are better equipped to counsel patients, verify antibiotic regimens prescribed by other providers, and identify outdated or suboptimal therapy. This is particularly important as STI resistance patterns continue to evolve.

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CDC Contraception App (Contraceptive Guidance for Health Care Providers)

Platform: iOS and Android | Cost: Free | Developer: CDC

The CDC Contraception app is the mobile version of the U.S. Medical Eligibility Criteria for Contraceptive Use (US MEC) and the U.S. Selected Practice Recommendations for Contraceptive Use (US SPR), which are the two CDC frameworks that form the clinical foundation for evidence-based contraceptive counseling in the United States. The app allows users to input a patient’s medical conditions and receive a structured summary on which contraceptive methods are safe, should be used with caution, or contraindicated based on the patient’s individual clinical profile. Categories range from MEC 1 (no restriction) to MEC 4 (absolute contraindication). The guidance is evidence-based, regularly updated, and specific enough to be directly applicable in clinical practice.

Pharmacists are increasingly involved in contraceptive counseling through medication therapy management visits, patient counseling at the point of dispensing, or collaborative practice agreements with OB/GYN providers. The CDC Contraception app transforms what could be a knowledge-intensive, potentially error-prone conversation into a structured, evidence-based consultation that serves patients and protects practitioners.

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About Herbs App

Platform: iOS and Android | Cost: Free | Developer: Memorial Sloan Kettering Cancer Center

The About Herbs app is a clinically rigorous, free resource available for dietary supplement and herbal medicine information. Developed and maintained by Memorial Sloan Kettering Cancer Center’s Integrative Medicine Service, About Herbs provides evidence-based monographs on hundreds of herbs, vitamins, minerals, botanical supplements, and other natural products.

Each monograph includes information on common uses, clinical evidence supporting or refuting those claims and specific considerations for cancer patients. It also contains basic pharmaceutical information such as known adverse effects, drug interactions, contraindications, The content is regularly reviewed by pharmacists, physicians, and researchers while the evidence is graded by quality. The quality grading distinguishes between findings from well-designed clinical trials and those based on preclinical data or anecdotes. Since patients routinely take dietary supplements alongside prescription medications, this app is most prudent for pharmacists as a tool to properly counsel. Many common herbs have clinically meaningful interactions with drugs pharmacists dispense every day. Some examples include St. John’s Wort and CYP3A4 substrates, fish oil and anticoagulants, echinacea and immunosuppressants, garlic and antiplatelet agents. For pharmacists with oncology patients, the cancer-specific data in About Herbs is particularly valuable, as this population often pursues integrative therapies alongside chemotherapy without always discussing it with their oncology team.

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MDCalc

Platform: iOS and Android | Cost: Free | Developer: MD Aware, LLC

MDCalc is a widely used free clinical calculator platform in pharmacy and medicine. It contains hundreds of validated clinical scoring tools and calculators. Each is accompanied by a description of the underlying study, the original derivation population, and notes on clinical interpretation. Pharmacists use MDCalc for tools like the Cockcroft-Gault equation for creatinine clearance, the CHA₂DS₂-VASc score for anticoagulation decisions in atrial fibrillation, the HAS-BLED score for bleeding risk, the Wells Criteria for DVT and PE, and many others. What makes MDCalc particularly valuable is that it links each calculator directly to the original validation study, giving pharmacists context about when the tool is and is not appropriate to apply. For instance, creatinine clearance estimate may need to be interpreted differently in a patient with very low muscle mass, very advanced age, or extreme body weight. MDCalc’s evidence summaries help pharmacists think through those nuances rather than applying a number mechanically.

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Drugs.com

Platform: iOS and Android | Cost: Free | Developer: Drugs.com

The Drugs.com interaction checker is one of the most accessible free tools for multi-drug interaction screening. It allows users to input an entire medication list and quickly survey interactions categorized by severity. While Drugs.com is not a substitute for clinical drug databases like Lexicomp or Micromedex (which are subscription-based), it is a practical and reasonably comprehensive free option for students on rotation and pharmacists in resource-limited settings. An important caveat for usage—interaction severity classifications vary across databases, and what one database flags as a major interaction may be categorized differently in another. The best practice is to use free tools as a starting point and verify clinically significant interactions against primary literature or an authoritative secondary database to further assess the clinical implications of the interaction.

Websites

DailyMed

Cost: Free | Developer: National Institutes of Health

The National Library of Medicine DailyMed platform provide free access to the complete, manufacturer-submitted prescribing information (package inserts) for every FDA-approved drug in the United States. DailyMed is particularly valuable because it is updated in real time when manufacturers revise labeling. This means it reflects the most current safety information, black box warnings, dosing guidance, and approved indications available. For any clinical question about what is officially approved, DailyMed is the authoritative primary source.

DailyMed is especially important when evaluating off-label use, verifying pregnancy and lactation categories, or checking specific pharmacokinetic parameters. Using it alongside a clinical drug database creates a more complete picture than either source alone.

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LiverTox

Cost: Free | Developer: National Institutes of Health

Drug-induced liver injury is a commonly known risk with acetaminophen usage, but the risk of hepatotoxicity with other drugs may not be as easy to ascertain. LiverTox serves as a resource to quickly find information related to liver injury that is associated with many drugs on the market. This includes background on how the drug causes liver injury, a “Likelihood Score” for the drug causing liver injury, and how to approach a patient that presents with drug-induced liver injury.

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LactMed

Cost: Free | Developer: National Institutes of Health

LactMed is a peer-reviewed database specifically focused on the safety of medications and chemicals during breastfeeding, including information on drug levels in breast milk, potential infant effects, and alternative options. This resource fills a gap that general drug databases frequently handle poorly. Questions about medication safety during pregnancy arise daily in practice, and pharmacists equipped with these specialized tools are better positioned to give accurate, individualized guidance.

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MotherToBaby

Cost: Free | Developer: The Organization of Teratology Information Specialists

MotherToBaby provides evidence-based fact sheets on medication safety during pregnancy and lactation, written for both clinicians and patients. This resource is extremely important because many mothers are aware that what they consume can be transferred to their baby, but they are unsure exactly what they should and should not do. Since MotherToBaby is a more patient-friendly website than other resources, the information can be directly shared with families.

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GlobalRPh

Cost: Free | Developer: David McAuley, PharmD

GlobalRPh is a free, pharmacist-developed web platform that hosts a wide range of pharmacy-specific calculators including renal and hepatic dose adjustment guidance, pharmacokinetics calculators (for vancomycin and aminoglycosides), IV compatibility tools, and nutrition-related calculators. Similarly to Drugs.com, GlobalRPh is not a substitute for clinical drug databases. A prudent pharmacist should use their clinical expertise when utilizing the information and verify with a second resource as appropriate.

AI Tools in Pharmacy Practice: Powerful, but Not What You Think

No conversation about clinical tools for pharmacists in 2026 is complete without addressing artificial intelligence. This section is not a list of AI apps to download. It is a framework for using AI tools that are already in your workflow with the clinical rigor and ethical awareness your patients deserve.

AI language models can process and synthesize large volumes of text almost instantaneously. They can draft patient education materials, assist with documentation, summarize broad topic areas, suggest differentials, and generate first-pass responses to drug information questions in seconds. AI tools can reduce cognitive load meaningfully in tasks demanding breadth and speed such as overview summaries, writing assistance, and initial literature orientation. However, for clinical utilization, that value is lost. Current AI language models hallucinate, meaning they generate confident, yet incorrect clinical information. They can cite studies that do not exist, misquote studies that do, report incorrect doses, invent contraindications, and describe drug interactions that have no basis in the literature. This is a known, documented, and persistent limitation of the technology. For example, a language learning model (LLM) could claim that atorvastatin is scientifically proven to be therapeutically superior to rosuvastatin, yet no clinical study actually exists to support this claim. Another example is if an LLM says the IDSA Guidelines for Acne recommend cephalexin as first-line management of acne vulgaris, when the IDSA does not even have published guidelines for acne treatment. If a pharmacist or any other health care provider acts on an AI-generated drug interaction, dose recommendation, or guideline summary without cross-checking against a verified source, patient safety could be risked.

Bias in AI

Clinical AI tools inherit the biases present in the data they were trained on. Medical literature has historically underrepresented women, elderly patients, patients with multiple comorbidities, and racial and ethnic minority populations in clinical trial designs. AI models trained on this literature will reflect and can amplify those gaps. A dose recommendation or risk stratification generated by an AI tool may not account for pharmacogenomic variation, population-specific pharmacokinetic differences, or clinical nuances that are relevant to underrepresented groups. For example, when prompted to make a dose conversion from tacrolimus immediate-release to tacrolimus extended-release, an LLM may suggest to decrease the total daily dose of tacrolimus IR by 20% and use that as the starting dose for tacrolimus ER based on the package insert. However, the patient’s African-American ethnicity was not added to the prompt, so the LLM did not account for the fact that African-American patients are typically started at a higher tacrolimus extended-release dose due to common variations in CYP3A5 metabolism amongst ethnic groups.

Pharmacists are trained to individualize therapy and think about renal function, hepatic status, body composition, drug interactions, genetic background, and social context for each patient. That training must be applied when evaluating AI-generated clinical output. Since the AI tool cannot support that level of individualization, the pharmacist’s clinical judgment must fill the gap.

An Ethical Framework for Using AI in Practice

As professional guidance from organizations including ASHP continues to develop, a practical ethical framework for pharmacists using AI tools includes four principles to keep in mind:

• Transparency: Be clear to colleagues, preceptors, patients, and institutions when AI tools have contributed to a clinical recommendation or documentation product, particularly in settings where that disclosure is relevant to accountability or patient trust.
• Verification: Treat AI-generated clinical content as a hypothesis to be confirmed rather than a conclusion to be acted upon. Every dose, interaction, guideline recommendation, or clinical fact generated by AI should be verified against an authoritative source before it influences a decision affecting patient care. A trustworthy source can include a validated drug database, primary literature source, or current clinical guideline
• Equity: Actively consider whether an AI-assisted recommendation is appropriate for the individual patient in front of you, especially when looking at patients from populations that may be poorly represented in the tool’s training data.
• Professional Accountability: Accept that no AI tool can bear responsibility for a clinical error. The pharmacist is ultimately held responsible for decisions that are made. The license belongs to you, not the algorithm.

The most important thing to understand about AI in pharmacy practice is that it amplifies the clinical foundation of the user. A pharmacist with strong evidence-based skills and a habit of verifying information can use AI tools safely and productively. A pharmacist who substitutes AI output for clinical reasoning is on the brink of a serious error. There is currently a lack of court cases and statutory guidance to determine how medical malpractice involving inappropriate AI use should be addressed from a legal standpoint. However, every attempt should be made to avoid harming a patient, whether that be due to not validating an AI response or other means.

The Big Picture

The best digital toolkit a pharmacist can build is one that prioritizes verified, evidence-based information above speed and convenience. Free tools make high-quality clinical references more accessible than ever, but access to information is not the same as the ability to critically evaluate it. That skill belongs to the pharmacist. As AI tools become more deeply integrated into pharmacy practice, the profession will need pharmacists who can use them efficiently without delegating clinical judgment to an algorithm. The pharmacists who do this best are the ones grounded in evidence-based practice, attuned to patient individuality, and committed to the ethical responsibilities that come with the license. Download the apps, bookmark the databases, and use the calculators, but always bring your clinical brain to what the tools produce.

-APPE Student, Mollie Walters

References

1. Epocrates. Free Clinical Decision Support App. Accessed June 29, 2026. https://www.epocrates.com/discover
2. Cosmas Health Inc. Pyrls: Drug Information for Modern Clinical Practice. Accessed June 29, 2026. https://pyrls.com
3. Centers for Disease Control and Prevention. CDC Vaccine Schedules App. Accessed June 29, 2026. https://www.cdc.gov/vaccines/hcp/imz-schedules/app.html
4. Centers for Disease Control and Prevention. CDC STI Treatment Guidelines App. Accessed June 29, 2026. https://www.cdc.gov/std/treatment-guidelines/provider-resources.htm#MobileApp
5. Centers for Disease Control and Prevention. Contraceptive Guidance for Health Care Providers App (U.S. MEC/U.S. SPR). Accessed June 29, 2026. https://www.cdc.gov/contraception/hcp/contraceptive-guidance/app.html
6. Memorial Sloan Kettering Cancer Center. About Herbs, Botanicals & Other Products. Accessed June 29, 2026. https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search
7. National Library of Medicine. DailyMed: Current Prescribing Information. Accessed June 29, 2026. https://dailymed.nlm.nih.gov
8. National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Updated May 6, 2026. Accessed July 3, 2026. https://www.ncbi.nlm.nih.gov/books/NBK547852/
9. National Institute of Child Health and Human Development. Drugs and Lactation Database (LactMed®). National Library of Medicine. Accessed June 29, 2026. https://www.ncbi.nlm.nih.gov/books/NBK501922/
10. MotherToBaby. Evidence-Based Information for Pregnant and Breastfeeding Patients. Accessed June 29, 2026. https://mothertobaby.org/our-work/
11. MDCalc. About MDCalc. Accessed June 29, 2026. https://www.mdcalc.com/about-us
12. Schutz N, Kalichira AL, Worthy Woodbury CDRK, et al. ASHP statement on the use of artificial intelligence in pharmacy. Am J Health Syst Pharm. 2020;77(23):2015-2018. doi:10.1093/ajhp/zxaa249
13. Obermeyer Z, Powers B, Vogeli C, Mullainathan S. Dissecting racial bias in an algorithm used to manage the health of populations. Science. 2019;366(6464):447-453. doi:10.1126/science.aax2342
14. Veloxis Pharmaceuticals Inc. Envarsus XR (tacrolimus extended-release tablets) [package insert]. Revised December 2018. Accessed July 1, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/206406s007lbl.pdf

Advanced Pharmacy Practice Experience (APPE) rotations are a defining chapter of pharmacy school. After years of classroom lectures, pharmacokinetics equations, and drug interaction tables, APPE is where everything finally comes together in real time. Whether you are joining an inpatient pharmacy team, rounding in the ICU, or seeing patients in an ambulatory care clinic, the expectations are greatly increased in comparison to Introductory Pharmacy Practice Experience (IPPE) rotations. Preceptors are not looking for students who can recite a mechanism of action. They want students who can think, apply, and communicate like a pharmacist. APPEs serve as the bridge between a student that needs supervised and a pharmacist that performs the supervising. For this reason, preceptors want to ensure that their students are prepared for making real decisions in real scenarios.

The transition to an APPE rotation can feel overwhelming at first. Most students enter their first APPE rotation unsure of how to present a patient, what to look for on morning rounds, or how to structure a Subjective, Objective, Assessment, and Plan (SOAP) note that succinctly yet sufficiently provides information. The good news is that excelling throughout your APPEs is attainable, and this post will provide guidance on creating patient case workups, topic discussions, and SOAP notes that will impress your preceptor.

The Art of the Patient Case Work-Up

One of the most important experiences you will have on clinical rotations is discussing a patient case with your preceptor. Patient case presentation is a cornerstone of learning, especially during internal medicine and critical care APPEs. This is not simply reading the chart and summarizing what the nurse or provider documented. A pharmacy student workup is an active, clinical analysis of everything happening with a patient, filtered through the lens of pharmacotherapy.

• Where to Start: Begin with the admission diagnosis and the reason the patient is in the hospital. Then, review the medical history, surgical history, allergies, home medications, and any active problems. Pay particular attention to any comorbidities or lifestyle choices that could complicate treatment options. This background establishes the context necessary to understand where the patient came from before you can make meaningful recommendations. For example, if a patient with a complicated UTI has a documented sulfa allergy, it would not be wise to consider sulfamethoxazole-trimethoprim for this patient.

• Review the Medication List Critically: Instead of simply copying down the medication list, dissect it. For every drug, ask yourself:
  • What is the indication?
  • Is the dose appropriate for this patient’s renal and hepatic function?
  • Are there any drug interactions with other medications on the list?
  • Is the duration appropriate?
  • Does the route of administration make sense given the patient’s current clinical status?
  • Are there any medications from home that were inappropriately continued or held?

Since a prudent pharmacist would be looking at the medication list with this level of evaluation, preceptors are expecting their student to do the same. This gives students the opportunity to practice with their guidance before they are on their own after graduation.

• Labs, Vitals, and Trends: After the medication list has been evaluated, move to the labs and vitals of the current admission. Pay attention to trends, not just single values. A creatinine of 1.8 mg/dL looks different in a patient whose baseline is 0.9 mg/dL versus one whose baseline is 1.6 mg/dL. Look at inflammatory markers and white blood cell counts if infection is in the differential. Review cultures and sensitivities to assess whether empiric antibiotic therapy needs to be de-escalated and/or is appropriate. Evaluate glucose trends if the patient is on insulin or high-dose corticosteroids. Think about electrolytes in the context of the patient’s medications. For example, could the patient’s hypokalemia be due to furosemide use? Here is a list of reference ranges for common lab values that may be useful when reviewing a patient’s chart:

Lab Value	Standard Range	Lab Value	Standard Range
Sodium	136-142 mEq/L	AST	10-30 U/L
Potassium	3.5-5.0 mEq/L	ALT	10-40 U/L
Calcium (total)	8.2-10.2 mg/dL	Hemoglobin	12-18 g/dL
Magnesium	1.3-2.1 mEq/L	Platelet count	150-350*103 cells/mm3
Glucose (fasting)	70-110 mg/dL	WBC	4.5-11.0*103 cells/mm3
Serum creatinine	0.6-1.2 mg/dL	BUN	8-23 mg/dL

• Building Your Assessment: Once you have gathered the data, synthesize it. What is the patient’s active problem list from a pharmaceutical standpoint? What is optimized, what needs to change, and what needs monitoring? Be prepared to provide at least one concrete recommendation for each active problem. This could include adding a specific drug (with dose, route, and frequency) to the current or home medication list. It could also include changing a current drug to an alternative agent or discontinuing a current drug altogether. If an active problem does not require any medication changes, provide a lab value that should be monitored in relation to the active problem. Your preceptor does not expect you to know everything, but they do expect you to show that you thought critically about the patient in multiple capacities.

Mastering the Topic Discussion

Topic discussions (sometimes called pharmacotherapy discussions, drug information sessions, or topic presentations) are a standard expectation on nearly every APPE rotation. These are structured, educational conversations where the student is given a relevant topic, researches it thoroughly, and presents the information to the preceptor or team.

• Choosing a Topic: The best topic discussions arise naturally from a patient encounter. If you admitted a patient with community-acquired pneumonia (CAP) and had a question about the role of respiratory fluoroquinolones versus beta-lactam/macrolide combination therapy, that would be a suitable topic. If a recent patient in the anticoagulation clinic asks about the differences between rivaroxaban and apixaban for atrial fibrillation, That may be considered as a topic. Tying the discussion to a real patient not only makes the content more relevant, but it demonstrates clinical curiosity.

• Structuring Your Preparation and Research: A strong topic discussion is not merely a web-browser summary. Topic discussion should be based on primary literature and current clinical guidelines. Start with the most recent guidelines from relevant professional organization (ACC/AHA for cardiology topics, IDSA for infectious disease, ADA for diabetes, etc.). Understand the guideline recommendations and the evidence provided that led to the recommendations. Then, look into one or two key clinical trials that relates to the topic and be able to discuss the study population, primary outcome, results, and clinical implications.

• Format and Delivery: Topic discussions do not need to be formal slideshow presentations unless your preceptor requires it. In many cases, a concise verbal summary with supporting notes or a one-page reference is appropriate. Aim for clarity over comprehensiveness. A 10-minute discussion that covers the key points clearly and invites dialogue is more impressive than a 30-minute monologue that feels like the student is reading off a script.

• Responding to Questions: Be prepared to answer follow-up questions. Preceptors will probe your understanding by asking about subpopulations, contraindications, cost considerations, medication adverse effects, or patient counseling points. If you cannot answer something, it is completely acceptable to say: “I am not sure, but I will look that up and follow up with you.” Intellectual honesty is respected far more than simply guessing.

Writing a Pharmacy SOAP Note

A well-crafted SOAP note is a clinical communication tool that showcases your reasoning when providing recommendations. Learning to write one well is a skill that will carry you through APPEs, residency, and beyond. Here is how to approach each section:

• Subjective (S)
  • The subjective section captures information from the patient’s perspective such as what they report, how they feel, and what brought them to seek care. This includes the chief complaint, history of present illness (HPI), relevant social and family history, and current medications. It may also include relevant patient-reported symptoms such as pain level, nausea, shortness of breath, or adherence concerns. A common mistake pharmacy students make in the subjective section is providing too much or too little information. You do not need to recite the patient’s entire history, only what is relevant to the problems you are addressing. If you are writing a SOAP note for a patient presenting with uncontrolled hypertension, the relevant subjective data includes their blood pressure readings at home, their adherence to current antihypertensives, their diet and sodium intake, and their current symptoms (if any). Their history of an appendectomy in 1999 would not be appropriate to include in this SOAP note.

• Objective (O)
  • The objective section contains measurable, verifiable clinical data. This includes the patient’s past medical and surgical history, current home medications, vital signs, laboratory values, relevant diagnostic findings (ECG, imaging results, culture data), current inpatient medication doses and routes, and physical exam findings relevant to the problem being addressed. For pharmacy-specific SOAP notes, the objective section often becomes particularly rich because medication-related data is central to the assessment. Renal function values (SCr, CrCl, eGFR), hepatic function markers (AST/ALT), drug levels if applicable (vancomycin troughs, digoxin levels, lithium concentrations), and key lab parameters that monitor efficacy or toxicity should also be included. Keep the objective section factual and organized. This is not the place for interpretations, just providing information.

• Assessment (A)
  • This is the most intellectually demanding section of the SOAP note, and it is the one that most reveals your level of clinical thinking. The assessment is where you interpret the data and identify the drug therapy problems (DTPs) present for the patient. Organize your assessment by problem. For each active problem, state whether the condition is controlled or uncontrolled, staging of the condition (if applicable), identify any medication-related issues (subtherapeutic dosing, adverse effects, drug interactions, inappropriate therapy, unnecessary medications, need for additional therapy), and connect the objective data to support your conclusion. Proper citations should be included throughout the assessment to provide evidence-based clinical reasoning that explains how you analyzed the patient and came to your conclusions. For example, if a patient with diagnosed HFrEF is not currently receiving an SGLT2 inhibitor, you could state, “The 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure recommends patients with stage C HFrEF receive an SGLT2i to reduce heart failure-related hospitalizations” to provide concrete reasoning into why you recommended the patient be prescribed empagliflozin. The provider or preceptor appreciate and expect your recommendations to have primary sources present.

• Plan (P)
  • The plan translates your assessment into specific, actionable recommendations. Every drug therapy problem identified in the assessment should have a corresponding plan. A well-written plan includes the specific intervention (with drug name, dose, route, frequency, and duration), monitoring parameters (symptoms to watch for, lab values to look at, what target you are aiming for, and how often to re-check), and patient counseling points. Using the HFrEF example above, the plan might read: “Recommend initiating empagliflozin 10 mg by mouth once daily. Monitor renal function (SCr, BUN) and electrolytes (Na, K, Cl, Mg) every 3 months, signs of euglycemic DKA, and counsel patient on signs of UTI (dysuria, hematuria, polyuria, urinary urgency).” This level of specificity is necessary to practice because it reflects how real clinical pharmacists think and document in their daily practice.

Habits of Successful APPE Students

Beyond the three core projects described above, students who truly stand out on APPEs share a few habits that are worth highlighting.

• Be proactive, not reactive: Do not wait for your preceptor to ask you to look something up. Come to each interaction with questions already formulated and answers already researched. Find the drug-related problems before they are pointed out to you.

• Own your mistakes and learn from feedback: You will make errors in judgment during your APPEs, but this is expected and part of learning. What matters is how you respond. Preceptors notice students who internalize feedback, adjust, and improve. The ability to accept constructive criticism and grow from it is a transferable skill that can be beneficial in your future career.

• Communicate with confidence, not arrogance. When presenting a patient or making a recommendation, be clear and direct. State what you found, what you think it means, and what you recommend. You are not expected to know the correct recommendation for every situation but avoid presenting all your points with hesitation.

• Build relationships with the team. Pharmacy students who take time to understand the workflow of the nurses, physicians, and other health professionals they work alongside are consistently rated higher by preceptors. Interprofessional collaboration is not a buzzword. It is daily clinical practice that is utilized in nearly every pharmacist’s career.

The Big Picture

Every patient case you work up, every topic discussion you prepare, and every SOAP note you write is building the clinical foundation that will define your practice as a pharmacist. If you ever feel stuck, be bold enough to ask questions. Every pharmacist knows what it’s like to be a student. This is your opportunity to demonstrate and observe the implementation of what you have learned from pharmacy in clinical practice. Put your best foot forward in your rotation to not only impress your preceptor, but to take advantage of your opportunity to learn and grow. The students who come out of APPEs ready for residency, fellowship, or entry-level practice are the ones who approached each rotation as an active learner rather than a passive observer. The skills covered in this post are the same skills that preceptors evaluate, residency programs reward, and employers expect. Start building these skills now, refine them on every rotation, and utilize them when you become a full-fledged pharmacist.

-APPE Student, Mollie Walters

References

1. American Society of Health-System Pharmacists. Emergency medicine APPE student rotation. Accessed June 29, 2026. https://www.ashp.org/-/media/assets/pharmacy-practice/resource-centers/preceptor-toolkit/sicp-emergency-appe-student-rotation-updated.pdf
2. Podder V, Lew V, Ghassemzadeh S. SOAP Notes. In: StatPearls. StatPearls Publishing; updated August 28, 2023. Accessed June 29, 2026. https://www.ncbi.nlm.nih.gov/books/NBK482263/
3. Stamm PL, Haines ST, Edwards KL, et al. Educational outcomes necessary to enter pharmacy residency training: 2023 update. J Am Coll Clin Pharm. 2024;7(9):952-956. doi:10.1002/jac5.1994
4. Stowers L. Early APPE advice. Transitions. American Pharmacists Association. Published September 18, 2018. Accessed June 29, 2026. https://www.pharmacist.com/Publications/Transitions/early-appe-advice
5. American Society of Health-System Pharmacists. Tips and tricks for APPEs and internships – A perspective of our own. ASHP Podcasts: Student Perspectives. Published May 16, 2025. Accessed June 29, 2026. https://www.ashp.org/professional-development/ashp-podcasts/student-perspectives/2025/tips-and-tricks-for-appes-and-internships-a-perspective-of-our-own
6. American College of Clinical Pharmacy. Reference values for common laboratory tests. Pharmacotherapy Self-Assessment Program (PSAP). Published May 2026. Accessed July 1, 2026. https://www.accp.com/docs/sap/Lab_Values_Table_PSAP.pdf

Ask a pharmacy student what they plan to do after graduation and you will likely hear one of these answers: retail or residency. While there is absolutely nothing wrong with either of those paths, the reality is that a PharmD degree opens far more doors than most pharmacy programs ever stop to discuss. The job market has evolved significantly over the past decade, and pharmacists are now practicing in settings that did not exist when today’s professors were in school themselves. This is not a post about settling for something unconventional because traditional jobs are hard to find. This is about recognizing the full value of a PharmD and the remarkable range of opportunities that are actively looking for pharmacists with clinical knowledge, regulatory expertise, and communication skills. Whether you are a PY1 just beginning to think about the future or a PY4 weighing your options with graduation around the corner, this overview is designed to give you a more complete picture of what is available and how to position yourself to get there.

Traditional Career Paths

Before diving into non-traditional roles, it is worth revisiting the familiar paths because it is important to appreciate the depth of specialization and career growth available within them.

• Community and Retail Pharmacy: Community pharmacy remains the most visible entry point into the profession. Pharmacists in this setting interact with more patients on a daily basis than almost any other healthcare provider. However, the retail landscape is shifting from simply dispensing prescriptions. Independent pharmacies and regional chains are increasingly offering clinical services such as medication therapy management (MTM), point-of-care testing, immunizations, and collaborative practice agreements with prescribers. Pharmacists who utilize their position as clinical community practitioners are creating meaningful, patient-centered interactions that look very different from the drive-through image that is often associated with the profession. If community pharmacy is your path, think about what certifications (diabetes educator, immunizer, MTM specialist) and clinical services you can build into your practice over time.
• Health System and Hospital Pharmacy: Hospital pharmacy encompasses a spectrum of roles from general staff pharmacists to highly specialized clinical pharmacists in areas such as critical care, infectious disease, oncology, cardiology, and transplant. Many health system positions now require or strongly prefer post-graduate training, especially residency. However, entry-level positions in health systems remain available and are an excellent launching point for pharmacists who want clinical depth and interprofessional collaboration built into their daily work. Pharmacists practicing in hospital settings can perform a variety of tasks such as verify orders, round with care teams, counsel patients at discharge, and serve on pharmacy and therapeutics (P&T) committees. For students drawn to patient care in an acute setting, this is a traditional path worth pursuing. Nowadays, it often requires a residency.
• Ambulatory Care Pharmacy: Ambulatory care sits at the intersection of community and clinical pharmacy. It is one of the fastest-growing practice areas in the profession as the expanded scope of practice allows pharmacists to serve more patients in a clinical setting. Pharmacists in ambulatory care clinics manage chronic disease states (diabetes, hypertension, hyperlipidemia, anticoagulation, heart failure) often under collaborative practice agreements that give them prescribing authority within defined protocols. Ambulatory care pharmacist positions are found in physician offices, federally qualified health centers (FQHCs), health system outpatient clinics, and patient-centered medical homes (PCMHs). A residency is recommended, if not required, to pursue this route.

Non-Traditional Career Paths

Maybe the traditional options described above do not seem to align perfectly with your interests. Maybe you are already working in a traditional setting and are ready for a change. Maybe you are tired of hearing about the same opportunities and want to know what else is available. Whatever the reason, rest assured that there are plenty of career paths opportunities for pharmacists.

• Pharmaceutical Industry (Medical Affairs, Clinical Development, and Drug Safety): The pharmaceutical industry employs pharmacists across a wide range of functions, and it is a world that many pharmacy students may not even be aware of as options. Many pharmacist roles in industry are deeply clinical, but they focus on drug development and evidence generation rather than individual patients.
  • Medical Affairs: Pharmacists serve as scientific liaisons between a pharmaceutical company and the healthcare community. They educate physicians, nurses, and other health care providers on the clinical evidence behind a company’s medications. Medical Science Liaisons (MSLs) provide transparent, scientific information throughout the entire life cycle of a drug. This can involve assisting investigator-initiated trials or helping implement a drug in a newly approved population. This role requires strong communication skills, strong understanding with primary literature, and the ability to translate complex science for a variety of audiences.
  • Clinical Development: Pharmacists work on clinical trial teams, helping design protocols, assess drug safety, interpret clinical data, and support regulatory submissions. A background in pharmacokinetics, pharmacodynamics, and evidence-based medicine makes pharmacists particularly well-suited for this work.
  • Drug Safety and Pharmacovigilance: This is an area where pharmacists identify, analyze, and report adverse drug events from post-market surveillance. It is detailed, systematic work that directly impacts public health, and pharmacist knowledge of drug mechanisms and adverse effect profiles is a significant asset in this setting.
• Regulatory Affairs: Pharmacists who enjoy policy, precision, and the intersection of science and law may find regulatory affairs to be an ideal fit. Pharmacists in regulatory affairs work for pharmaceutical companies, contract research organizations (CROs), or the FDA itself. They ensure that drug products meet the safety, efficacy, and quality standards required for approval and continued market authorization. The FDA employs pharmacists as reviewers, inspectors, and policy advisors across multiple centers including the Center for Drug Evaluation and Research (CDER) and the Center for Biologics Evaluation and Research (CBER). These positions offer the opportunity to shape drug approval decisions that affect millions of patients.
• Managed Care and Health Insurance: Managed care pharmacy is a field that has profound influence over which medications patients can access and at what cost. Pharmacists in managed care work for health insurance plans, pharmacy benefit managers (PBMs), and integrated health systems in roles focused on formulary development, utilization management, outcomes research, and drug policy. In these positions, pharmacists analyze clinical evidence, evaluate cost-effectiveness, write clinical criteria for prior authorizations, and influence coverage decisions for entire patient populations. For students interested in healthcare economics, drug policy, and systems-level thinking, managed care is a practice area that offers both intellectual depth and real-world impact.
• Informatics and Digital Health: Health informatics is an emerging and rapidly expanding area for pharmacists, particularly as electronic health records (EHRs), clinical decision support systems, and data analytics become central to healthcare delivery. Pharmacy informatics specialists design and optimize medication-related components of EHRs, develop clinical decision support alerts, evaluate drug database systems, and analyze medication utilization data. Beyond traditional informatics roles, pharmacists are now entering digital health companies developing medication adherence platforms, telehealth services, remote patient monitoring programs, and AI-driven clinical tools. A pharmacist who combines clinical knowledge with comfort in data systems and technology is exceptionally well-positioned in this space.
• Poison Control: Poison control centers are staffed largely by pharmacists, and it is a field that is highly dependent on drug and toxicology expertise. Poison Information Specialists answer calls from the public and healthcare providers about toxic exposures to medications, household chemicals, plants, and environmental agents, providing evidence-based guidance in real time. Many poison control positions offer competitive salaries, defined schedules, and the intellectual challenge of toxicology-focused clinical decision-making. For pharmacists who love the urgency and variability of clinical problem-solving without a traditional hospital setting, poison control is worth exploring.
• Academia and Pharmacy Education: Pharmacists who are passionate about teaching, research, and mentorship may be drawn toward pharmacy academia. Faculty positions exist across the full spectrum of pharmacy programs from large research universities to smaller teaching-focused institutions. Many faculty positions blend responsibilities in teaching, scholarly activity, and clinical practice. These various tasks allow pharmacists to maintain a patient care component while contributing to the education of the next generation. Academic pharmacists also pursue research in areas ranging from pharmacoepidemiology and health outcomes to clinical pharmacology and pharmacy education science. A notable adjacent path is pharmacy education companies and content development organizations This includes test prep, continuing education, and professional development platforms. Pharmacists who enjoy writing, curriculum design, and communicating clinical knowledge at scale are building careers in this growing space. A great example is the many students and faculty who have contributed their expertise to platforms like RxPharmacist (the platform you’re on right now!).
• Consulting: Pharmacist consultants work independently or within healthcare consulting firms to advise long-term care facilities, health systems, insurance companies, and government agencies on medication management strategies, regulatory compliance, formulary design, and clinical program development. Long-term care consultant pharmacy is a well-established niche, requiring pharmacists to conduct monthly medication regimen reviews for nursing home residents and make recommendations to prescribers. Independent pharmacy consultants also advise legal teams as expert witnesses in malpractice cases, work with startups navigating drug-related regulatory questions, and support healthcare organizations implementing quality improvement initiatives.
• Military and Public Health Service: The U.S. military and the U.S. Public Health Service (USPHS) both commission pharmacists as officers, offering career paths that combine pharmacy practice with public service. Military pharmacists practice in a wide range of settings from stateside military treatment facilities to deployments supporting service members overseas. USPHS pharmacists serve in federal agencies including the FDA, Indian Health Service (IHS), Bureau of Prisons, and the CDC. These paths offer loan repayment benefits, structured career advancement, and the opportunity to serve populations that often have limited access to care. For students motivated by service and drawn to federal practice settings, military and USPHS pharmacy is a path worth considering.

Post-Graduate Training: Investing in Your Future

Regardless of the career path you are considering, post-graduate training can open doors, accelerate your timeline, and deepen your clinical or scientific foundation in ways that direct entry into the workforce may not. With that said, post-graduate training is not a requirement for every path in pharmacy, so the decision whether to pursue one of these options should be influenced by your ultimate career goals.

• PGY-1 Pharmacy Residency: A PGY-1 (Post-Graduate Year 1) residency is a one-year, ASHP-accredited training program that provides intensive, supervised clinical experience across a variety of patient care settings. PGY-1 programs exist in hospitals, community pharmacy, managed care, and ambulatory care settings. Completing a PGY-1 develops advanced clinical skills, establishes professional networks, and is widely considered the minimum training requirement for competitive clinical pharmacy positions and most PGY-2 programs. The residency match process (conducted annually through the National Matching Services system) is competitive, and students who perform well on APPE rotations, build strong letters of recommendation, and articulate a clear professional vision tend to stand-out when Residency Program Directors are reviewing the large amounts of applicants.
• PGY-2 Pharmacy Residency: A PGY-2 residency is a one-year specialty training program completed after the PGY-1. Specialty areas include critical care, infectious disease, oncology, cardiology, ambulatory care, psychiatry, pediatrics, solid organ transplant, emergency medicine, and many others. PGY-2 training is designed to prepare pharmacists for advanced specialist positions, leadership roles in clinical practice, or faculty positions with a clinical practice component.
• Pharmacy Fellowship: Fellowships are research-intensive training programs that prepare pharmacists for careers in drug development, clinical research, medical affairs, regulatory science, or health outcomes research. These programs are most often conducted in the pharmaceutical industry or academia. Unlike residencies, fellowships are not standardized through ASHP accreditation. Therefore, program structure and duration vary, typically ranging from one to two years. Fellowships are the most direct post-graduate pathway into the pharmaceutical industry for new graduates. They generally attract students who are motivated by research, drug development, and population-level impact rather than direct patient care.
• Graduate Degrees (MS, MBA, and PhD): Some pharmacists pursue graduate education alongside or after their PharmD to build expertise in a specific domain. An MS in Health Outcomes or Pharmacoepidemiology supports careers in outcomes research and managed care. An MBA opens doors into pharmaceutical industry leadership and healthcare administration. A PhD in Pharmaceutical Sciences, Clinical Pharmacy, or a related field is an option for pharmacists pursuing independent research careers and faculty positions at research-intensive institutions. Dual degree programs (PharmD/MBA, PharmD/PhD) are available at several schools and allow students to build these credentials in parallel with their pharmacy education.

Key Takeaway

Whether your path leads to a community pharmacy, a pharmaceutical company, a federal agency, a clinical informatics team, or a classroom, the clinical foundation built in pharmacy school is the common thread. The setting may change, but understanding drugs, patients, and evidence remains constant. Know that foundation well, and you will find a place to use it that genuinely fits who you are. Remember that even if you choose one path at the beginning of your journey, there is an entire world of possibilities. You may find your match on the first try, or you may need to endure some trial and error. Regardless, the key to success in your career is discovering what utilizes your strengths while also giving you a great sense of joy.

-APPE Student, Mollie Walters

References

1. American Society of Health-System Pharmacists. Residency Program Directory and Accreditation Standards. Accessed June 29, 2026. https://www.ashp.org/professional-development/residency-information
2. American College of Clinical Pharmacy. Residencies and Fellowships. Accessed June 29, 2026. https://www.accp.com/stunet/resfel.aspx
3. U.S. Food and Drug Administration. FDA Pharmacy Student Experiential Program. Accessed June 29, 2026. https://www.fda.gov/about-fda/center-drug-evaluation-and-research-cder/fda-pharmacy-student-experiential-program
4. U.S. Public Health Service Commissioned Corps. Pharmacist. U.S. Department of Health and Human Services. Accessed June 29, 2026. https://www.usphs.gov/professions/pharmacist/
5. American Society of Consultant Pharmacists. What Is a Consultant Pharmacist? Accessed June 29, 2026. https://www.ascp.com/page/whatisacp
6. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Pharmacists. U.S. Department of Labor. Accessed June 29, 2026. https://www.bls.gov/ooh/healthcare/pharmacists.htm
7. Centers for Disease Control and Prevention. Translational Tools for Pharmacists. Published April 2024. Accessed June 29, 2026. https://www.cdc.gov/high-blood-pressure/media/pdfs/2024/04/Translational_Tools_Pharmacists.pdf
8. Florida Poison Control Centers. Employment. Accessed June 29, 2026. https://floridapoisoncontrol.org/contact/employment/