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“There are two types of pharmacists: those that directly care for patients and those that support those that directly care for patients.”

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Gae Ryan – PharmD

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The majority of Postgraduate Year Two (PGY-2) residency programs aim at producing pharmacists with specialized knowledge, skills, and abilities, with the intent of caring for a targeted group of patients such as those critically ill, having an infectious disease, or with age-based needs (pediatric and geriatric populations). Then there are PGY-2 residency programs that could be categorized by some as being focused on “non-patient care” or follow a “management track” within the specialties of health-system administration, drug information, medication-use safety, and informatics. For you, this grouping of specialized residencies may conjure up feelings of aversion as your explicit goal for becoming a pharmacist was likely to one day be able to help and care for patients (note: you may have actually written this in your application for pharmacy school or responded as such during interviews). If this is the case, for the next few minutes, please suspend any apprehension you may have with regard to pursuing these types of PGY-2 programs and reflect on the following scenario:

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  • Imagine that you are currently on an Internal Medicine rotation in your last year of pharmacy school. You just completed the second week of your rotation at Boxer Medical Center, and you are currently following three patients assigned by your preceptor. Your team has had many interesting patients, but by far, the majority of your time has been either working up patients with pneumonia, heart failure, or “mental status changes”— all three of which have provided you numerous opportunities to recommend interventions surrounding medication therapy. Your preceptor has noted that you have been managing your workload well and has challenged you to take on additional responsibilities. She suggests increasing your workload by having you choose one of the following items:
    1. double your patient load to six patients total;

    2. develop a drug monograph for a new antibiotic;

    3. draft a protocol or an order set for community acquired pneumonia;

    4. conduct a chart review of patients with “mental status changes” to evaluate for possible drug-related causes; or

    5. assist the Heart Failure Nurse Practitioner in developing patient education materials (including information about medications) to provide at discharge.

  • Which one would you choose and why?
  • If you chose (a), to increase your patient load, it is likely that you genuinely find the most reward in making individual patient interventions since you probably enjoy working closely with patients and other care providers to optimize the health of individuals. If you chose any of the other options, your reasoning could be that your efforts today would likely impact many patients over time, even though you may never actually interact one-on-one with the patients that would benefit from your work. So rather than helping patients individually, you help support the system that cares for your patients.
  • The PGY-2 residency programs ...

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