Community Pharmacy

Review of new and unique pharmacy careers

It is undeniable that the role of a pharmacist has advanced from the traditional “pill counter” to trusted health care professionals who contribute to patient outcomes through extensive management of drug therapy. According to a published study by the American Association of Colleges of Pharmacy (AACP), the primary practice that PharmD graduates wish to pursue upon graduation is community pharmacy. To outline why this is relevant, the Bureau of Labor Statistics (BLS) anticipates a decline in employment for pharmacists within a traditional retail environment, thus posing a threat to many who wish to follow this route (our full post entitled, “Pharmacist market saturation and career outlook“ can be found here). While all of this may be concerning, pharmacists are fortunately well-equipped with suitable skills that allow them to rise above orthodox practice and pursue nontraditional opportunities while maintaining impactful frontline care. Favorably, the American Society of Health-System Pharmacists (ASHP) has acknowledged this matter and launched its Practice Advancement Initiative (PAI), providing pharmacists with future practice models that may act as an option for those exploring alternative career paths. The campaign advocates for advancing the role of a pharmacist by establishing changes to current pharmacy resources, ultimately promoting career opportunities and patient care simultaneously.

While the number of PharmD graduates continue to increase and advancement of traditional pharmacy begins to slow, you may be asking yourself “what other roles can be filled by pharmacists?” This article will dive into more nontraditional and innovative roles that remain both unique and effective in our dynamic health care world today.

Non-traditional career opportunities:


TypeDescriptionWhere to find information
Nuclear Pharmacy  Nuclear pharmacists focus on the preparation, monitoring, drug information, storage, and handling of radioactive medications. In addition to this, pharmacists in this role provide quality control, patient safety, and counseling to those who require a more unique class of medications. The need for a pharmacist within a nuclear medicine team is impeccable as it allows for a boost in pharmaceutical care to patients.  National Association of Nuclear Pharmacies (NANP)
Specialty PharmacySpecialty medications are typically referred to as high cost medications that focus more on intricate disease states such as cancer, transplant, hepatitis, HIV, and multiple sclerosis. The prevalence of patients who require specialty medication is increasing, thus necessitating an increased demand for specialty pharmacists who can provide comprehensive care and close management.   Due to the increased complexity in the delivery of specialty pharmaceuticals, many health plans have established approaches to help with the obstacles associated with the distribution of these drugs to patients (classified as insourcing and outsourcing):

Insourcing: Staff are hired to manage the high demand and cost of these medications. These pharmacists are responsible for purchasing, handling, educating physicians and patients, and monitoring patient outcomes.

Outsourcing: Contracting with pharmacies that have established specialty pharmaceutical services to access its expertise, technologies, and resources.   Regardless of the approach a managed care organization wishes to pursue, both insourcing and outsourcing have identical requirements that include: Negotiating discounted pricesEmploying staff with specific expertise (with respect to administration, utilization, and monitoring of specialty medications)Accessing centralized distribution points for specialty pharmaceutical manufacturers  
Academy of Managed Care Pharmacy (AMCP)
Veterinary Pharmacy  While veterinary pharmacy is not a new area of pharmacy practice, it is expected to expand each year and become classified as a more unique career opportunity. Veterinary pharmacists may establish a career with veterinary schools, pharmaceutical companies, manufacturers, and a variety of regulatory agencies (including the FDA through the Center of Veterinary Medicine). An individual interested in working with animals may make this a suitable option; however, additional education and training through residency is required and opportunities are limited usually to academic institutions or professional organizations.  Veterinary Pharmacy Association
Compounding Pharmacy  What originally began as physicians taking on both the prescribing and compounding role of patient medication has now evolved to become the responsibility of a pharmacist since the late 19th century. At one point, during the early progression of the 20th century, the manufacturing of mass medications monopolized the service of compounding pharmacies. Today due to the increased need to formulate patient-specific drugs to tailor drug therapy, there appears to be a resurgence in the demand for compounding pharmacists. Compounding services allow pharmacists to prepare medications that target pain management, dermatology, pediatrics, geriatrics, and hormone replacement therapy.  Alliance for Compounding Pharmacy  

APhA   National Community Pharmacists Association
Toxicology  Pharmacists in this role can serve as toxicology specialists within poison control centers. In these centers, they facilitate patients who have ingested or otherwise have been exposed to medications or household chemicals. Pharmacists will direct patients to the proper course of action and will subsequently follow-up with them depending on the severity of the situation.  American Association of Poison Control Centers
   TelepharmacyTelepharmacy aims to meet the needs of today’s healthcare consumers through the use of telecommunication. The application of this tool covers a wide and diverse scope, including drug review and monitoring, dispensing, sterile and non-sterile compounding verification, medication therapy management, patient assessment, patient counseling, clinical consultation, outcomes assessment, decision support, effective drug information, and electronic prescription filling. Telepharmacy technology allows pharmacists to provide communication and remote care delivery. It significantly improves quality of patient care and medication process and safety by increasing accessibility and efficiency through reducing the need to travel. Especially during the ongoing pandemic, telepharmacy has established itself as an attractive tool to positively impact patient outcomes. Individuals who have been tested for COVID-19 could have a consultation with the pharmacist on the phone or video conferencing platforms such as Skype or zoom for follow-up care. Telepharmacy aims to improve U.S. economy and healthcare efficiency.  ASHP’s Statement on Telepharmacy  
2019 NIH Study on Telepharmacy
Regulatory Sciences  Pharmacists also play a huge role in regulatory drug and biologic development at the Food and Drug Administration (FDA). Many pharmacists work at the FDA and if you are lucky, you may score a rotation site at the FDA to learn more what they do from drug labels, to drug reviews and ensuring regulations are met.  FDA Regulatory Fellowships  

Regulatory Affairs Professionals Society (RAPS)  

While additional opportunities may require fellowship training, pharmacists can also be involved within the pharmaceutical industry and strive in research and development, quality assurance, marketing, and regulatory affairs. There are still many other pockets of careers we did not dive into such as medication therapy management (MTM), pharmaceutical industry, consulting, and data analytics, the PharmD degree is versatile and allows the flexibility of pharmacists to create their own unique careers outside the ‘box’ of retail and hospital pharmacy. As health care transforms, pharmacy roles will also grow, allowing pharmacists to take on new and unique roles.

Best of luck in your career searches!

Sam Tamjidi

RxPharmacist Team

References:

  1. 6 Things to Know About Telepharmacy During COVID-19. (n.d.). Retrieved September 26 2020, from https://blog.cureatr.com/6-things-to-know-about-telepharmacy-during-covid-19
  2. ASHP Statement on Telepharmacy. (n.d.). Retrieved September 26 2020, from https://www.ashp.org/-/media/assets/pharmacy-informaticist/docs/sopit-bp-telepharmacy-statement.ashx
  3. Bai, S., Hertig, J. B., & Weber, R. J. (2016). Nontraditional Career Opportunities for Pharmacists. Hospital pharmacy, 51(11), 944–949. https://doi.org/10.1310/hpj5111-944
  4. Kramer, M.H. (2019, January 14). Retrieved September 22, 2020, from https://www.thebalancecareers.com/veterinary-pharmacist-125836
  5. Specialty Pharmaceuticals. (July 18, 2019). Retrieved September 27 2020, from https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/specialty-pharmaceuticals
  6. What is compounding? (n.d.). Retrieved September 22, 2020, from https://www.medisca.com/compounding/what-is-compounding

Career advancement opportunities – Residency or fellowship?

Over the last decade, the profession of pharmacy and the capabilities of a pharmacist has advanced immensely with respect to broader clinical responsibilities and logistical needs in the Pharma industry. We previously lived in a time where a bachelor’s degree in pharmacy sufficed for a career in pharmacy practice. Since 2003; however, the Doctor of Pharmacy (PharmD) degree has superseded previous qualifications to become a licensed pharmacist and has provided pharmacists more holistic roles as a healthcare provider. To dive deeper, the role of a pharmacist now extends from the initial introduction of a chemical molecule for drug therapy all the way to managing a patient’s regimen post dispensing. Based on the competitiveness and saturation of the workforce, in addition to employment projections showing decreased future demand for retail pharmacists (as previously mentioned in our Pharmacist market saturation and career outlook blog here), it is presumed by many that a PharmD will simply be a stepping stone within the realm of pharmacy practice. Therefore, the well-rounded ability needed for our future pharmacists will strongly build through residencies and fellowship.

What are some opportunities to differentiate yourself as a newly graduate? Let’s take a look at the following main categories of post-graduate training programs:

Residencies:

  • Focus primarily on direct patient care
  • Within a clinical, hospital, or community setting
  • Collaborate with pharmacists, nurses, and other healthcare professionals
  • Duration: 1 year each – Postgraduate Year One and Two (PGY1 and PGY2)
    • PGY1 – General medicine
    • PGY2 – Specialized therapeutics
      • Specific areas of focus include: Ambulatory care, cardiology, critical care, geriatric, pediatric, oncology, pain management, and more. For a more complete list of options, be sure to check out American Society of Health-System Pharmacists’ (ASHP) website.
    • Interestingly enough, the perception of a PGY3 residency has been viewed negatively by many pharmacists. Based on a distributed survey, residents, preceptors, coordinators, and other pharmacists believe that PGY3 training offers limited benefits in professional development.
  • Career after completion: Hospital or clinical pharmacist

While clinical and hospital settings are more predominate, many also choose to pursue community-based residency programs. This path allows residents to remain within the community setting while taking on critical education and training to provide increased care and improve patient outcomes.

Another popular residency of interest is managed care. Managed care residencies heavily focus on evidence-based clinical decision-making and comparative research, medication therapy management, clinical drug evaluation, formulary management, quality assurance, and drug utilization review. A pharmacist within these roles is responsible for performing any analysis, for example, drug utilization data to identify trends and then implement new strategies to improve patient outcomes. Additionally these roles may also require on-going knowledge of all heath plan pharmacy benefits. Beyond the logistical aspects of analyses, clinical knowledge is key for a successful career in managed care. Managed care pharmacists are also part of multidisciplinary teams during rounds in which they serve as the primary drug information resource, provide pharmaceutical interventions, facilitate prior authorizations, and develop educational materials for patients and providers.

What’s the likelihood of matching?

Below is a graphical representation of the match statistics between 2013-2020. Figure 1 illustrates the amount of applicants participating in the match, positions offered, matches/positions filled, unmatched applicants, and unfilled positions. Based on the trend, it’s easy to interpret that residency is playing an expanding role as more programs are being introduced each year. While this appears to be beneficial, it’s also important to address the increasing applicant pool, making it a challenging to gain acceptance in the program of your choice.

A close up of a map

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Figure 1. Complete match statistics between 2013-2020.

Fellowships:

  • More research and data-based
  • Within the pharmaceutical industry, academia, nontraditional pharmacy or healthcare setting
  • Collaborate with professionals, both in and out of healthcare
  • Duration: Ranges between 1-3 years depending on the program
  • Career after completion: Pharmaceutical industry or academia

It is very clear that these two main options provide two distinct pathways. The direction you wish to pursue will strictly depend on your interests. If you thoroughly enjoyed classes that focused on therapeutics, pharmacology, and kinetics throughout pharmacy school then a residency may be the best option for you. Conversely, if you were more engaged on the economics, research, and administrative science side of pharmacy, then a fellowship would be better suited for you. Whether you wish to enhance your clinical knowledge or look for professional advancement, a residency or fellowship will provide a firm foundation and present you with many unique career opportunities down the road.

What can you do now and what are some additional resources to find out more?

  • Take a moment to fill out the APhA Career Pathway Evaluation Program for Pharmacy Professionals survey. This quiz will aim to assess your goals, values, strengths, likes, and dislikes.
  • Maximize your potential and showcase your academic achievements while demonstrating your leadership qualities outside of the classroom.
  • Check out the ASHP and ACCP directories to get a better idea of the many residency and fellowship opportunities out there and which institute may best suit you.

Whatever you wish to do is ultimately your decision. All we recommend from our end is to be the best version of yourself and manifest all your skills in an effort provide to the pharmacy profession.

Good luck!

Sam Tamjidi

RxPharmacist Team

References:

  1. Dang, Y. H., To-Lui, K. P. (2020). Pharmacist perceptions of and views on postgraduate year 3 training. American Journal of Health-System Pharmacy, 77(18), 1488-1496. doi:10.1093/ajhp/zxaa198
  2. Doctor of Pharmacy. (n.d.). Retrieved September 19, 2020, from https://en.wikipedia.org/wiki/Doctor_of_Pharmacy
  3. Goode, J. R., Owen, J. A., Bennett, M. S., & Burns, A. L. (2019). A marathon, not a sprint: Growth and evolution of community-based pharmacy residency education and training. Journal of the American College of Clinical Pharmacy, 2(4), 402-413. doi:10.1002/jac5.1140
  4. Postgraduate Education Frequently Asked Questions: Residencies and Research Fellowships. (n.d.). Retrieved September 17, 2020, from https://www.pharmacist.com/sites/default/files/files/10-417postgraduate.pdf
  5. Tips on Applying for a Residency or Fellowship. Academy of Managed Care Pharmacy. (n.d.). Retrieved September 19, 2020, from https://www.amcp.org/resource-center/group-resources/residents-fellows/tips-on-applying-residency-fellowship
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