Pharmacy for the Curious

Qingyu Zhou, PharmD

Department of Pharmaceutical Science, College of Pharmacy

University of South Florida

Dr. Zhou’s major areas of interest and research expertise are in the
experimental therapeutics of metastatic tumors and acquired resistance to
molecularly targeted cancer therapies.One of Dr. Zhou’s current research
programs concerns the development of novel preclinical approaches to
guide the use of targeted therapeutic agents for the treatment of brain
metastases. The mission begins with the establishment of an in vivo brain
metastasis model that possesses the blood-brain barrier (BBB) and is able
to replicate the native environment of brain metastases; continues with
the characterization of the pharmacokinetic (PK) and pharmacodynamic
(PD) properties of a targeted therapeutic agent in the established in vivo
model; and is followed by quantitative evaluation of the relationship
between drug distribution in the target tissue and tumor response to the
treatment through the measurement of PD biomarkers representing the
specific signaling transduction networks in tumor cells and their
microenvironment – with each step working towards building a
framework to guide the rational design of drug dosing regimens that lead
to optimal tumor drug concentrations and maximal antineoplastic effects.
Dr. Zhou’s research also extends to the mechanistic study of acquired
resistance to targeted therapy in lung cancers using in vivo drug resistant
tumor models. The goal is to provide a means to understand the sequence
of biologically programmed events leading to the acquired resistance to
the targeted therapy in lung cancers and aid in the rational design of
combined targeted therapies with durable antitumor effects.

Kevin B. Sneed, PharmD

Professor, University of South Florida College of Pharmacy

University of South Florida

Dr. Kevin Sneed is the founding Dean of the University of South
Florida College of Pharmacy, and a tenured Professor in the USF
Department of Family Medicine. Dr. Sneed's research interests include the
pharmacological treatment of patients with Cardio-Metabolic Disorders,
and examining Health Care Disparities. Dr. Sneed is Chairman of the
Cultural Health Initiatives Committee for the American Heart
Association- Greater Southeast Affiliate- Board of Directors; Area Health
Education Center (AHEC)- University of South Florida, Board of
Directors; Area Health Education Center- USF (Gulfcoast North), Board
of Directors; USF Nanomedicine Research Center (UNRC) Board of
Directors; Humana Corporation, HumanaCARES Division National
Board of Advisors; and the Hillsborough County Sickle Cell
Association, Board of Directors. He participates in many community
endeavors on an annual basis, most notably the Florida Cancer Education
Network Men's Health Forum in Tampa, FL. Dr. Sneed is very active in
national and state organizations, among which include NPHA, ASHP,
AACP, FPA, FSHP, and Kappa Alpha Psi Fraternity, Inc.

Professor Shu-Feng Zhou, MD, PhD

Associate Vice President of Global Medical Development

Associate Dean for International Research

Department of Pharmaceutical Sciences,

University of South Florida

Professor Zhou is presently the Associate Vice President of Global Medical
Development & Associate Dean of International Research, College of
Pharmacy, University of South Florida, Tampa (USF), Florida, USA. USF
is one of only 25 public research universities nationwide with very high
research activity that is also designated as community engaged by the
Carnegie Foundation for the Advancement of Teaching. USF is a global
research university ranked 34th in federal research expenditures for
public universities and is one of the fastest growing in federal funding in
the US. Professor Zhou is one of the Highly Cited Researchers 2014
according to Thomson Reuter. He has published more than 350 peer-
reviewed papers in various pharmacology and medical journals including
New England Journal of Medicine, Cancer Research, Journal of Biological
Chemistry, Clinical Pharmacology and Therapeutics, and Clinical Cancer
Research. He has also published 18 books and book chapters and more
than 360 conference abstracts. His work has been cited more than 12,000
times by other colleagues with an H-index of 52. Dr Zhou has given more
than 120 invited seminars/keynote presentations to a variety of academic
institutes, government agencies, and high-profile international

conferences. He has received more than US$35.0 million in grants from
various funding bodies and industries. To date, he has trained 24 PhD
students, 12 MSc/Honors students, 14 postdoctoral staff and 45 visiting
doctors. Dr Zhou serves as an editor-in-chief or editor for 16 biomedical
journals including Drug Design, Development and Therapy, Drug,
Healthcare and Patient Safety, Clinical & Experimental Physiology &
Pharmacology, Clinical Pharmacology & Biopharmaceutics, Journal of
Pharmacogenomics and Pharmacoproteomics, Drug Metabolism Letters,
Journal of Pharmacy and Nutrition Sciences, Current Drug Metabolism,
etc. and is the editorial board member of 53 medical and pharmacological
journals.

Introduction: Being A Pharmacist As A Career In The US

Dr Paxton is a licensed pharmacist living in a small town in Wisconsin of
the United States (US) and owns an independent pharmacy. He has three
sons, and he sent them all to pharmacy schools hoping that at least one of
his sons would come back someday to take over his business. Many years
have gone by since Dr Paxton’s sons graduated from pharmacy schools.
Now, the oldest son is a senior director of licensing in a big pharmaceutical
company and the youngest son is a regional director of one of the nation's
largest retail pharmacy chains. The middle son decided to pursue his PhD
in pharmaceutical sciences upon completing his pharmacy degree, and is
now a full professor of pharmacogenetics at a prestigious medical school
holding multiple sustained competitive research grants from the National
Institute of Health, the US. Although all Dr Paxton’s sons have been trained
to be a pharmacist, they followed different career paths and each ended up
succeeding in their own career pursuits.

To date, more than 281,560 pharmacists in the US dispense medicines and
advice in numerous retail pharmacies and hospitals, as well as in clinical
and industrial settings. Pharmacists counsel patients by thoroughly
reviewing their medications and identifying the best way to use the drugs
when reducing drug-related costs. In addition, they provide advice on how

to lead a healthy lifestyle, conduct health and wellness screenings, offer
immunizations, and oversee the medications dispensed to patients.

With an aging population of baby boomers in the US, more Americans will
seek health services after the Affordable Care Act is implemented and there
is an increased demand for prescription medications. The Bureau of Labor
Statistics in the US has projected a 14.5 percent growth for pharmacist
employment by 2022, with the section adding 41,400 new jobs
(http://www.bls.gov/ooh/healthcare/pharmacists.htm). The median
annual wage for US pharmacists was $116,670 in May 2012. Solid
employment growth and a high median salary assist make pharmacist one
of the best healthcare jobs.

As healthcare continues to become more complex and as more people take
multiple medications, more pharmacists will be needed to dispense
medications and to counsel patients on how to use their medications safely
and effectively. Demand for pharmacists is also likely to increase in a
variety of healthcare settings, including clinics and hospitals when more
aged patients are admitted where pharmacists oversee the medications
given to patients and provide patient care.

Pharmacy Education In The US: To Become A Pharmacist

To become a qualified pharmacist in the US, a person must have a Doctor
of Pharmacy (PharmD) degree from an accredited pharmacy program. He
or she also must be licensed, which requires passing licensure and law
exams. Following graduation from a PharmD program, pharmacists
seeking an advanced position, such as a clinical pharmacy or research job,
may need to complete a 1- to 2-year residency. Pharmacists who choose to
complete the 2-year residency option receive additional training in a
specialty area such as oncology, ambulatory care, or geriatric care.

On June 14, 1997, the Accreditation Council for Pharmacy Education
(ACPE; also known as the American Council on Pharmaceutical Education

until 2003) adopted its Accreditation Standards and Guidelines for the
Professional Program in Pharmacy Leading to the Doctor of Pharmacy
Degree (Higby, 1997) (please see https://www.acpe-accredit.org/). Since
then, PharmD has been the sole professional degree to enter pharmacy
practice in the US.

On January 15, 2006, new PharmD standards and guidelines were adopted
by the ACPE, which focus on the development of students’ professional
knowledge, skills, attitudes, and values with a goal to ensure that students
acquire the ability to provide high-quality patient-centered care and
practice with competence and confidence in collaboration with other health
care professionals (Vlasses et al., 2008). A pharmacist’s education officially
begins with the PharmD program offered by ACPE-accredited pharmacy
school, which is typically four years in length (Janke et al., 2013).

According to American Association of Colleges of Pharmacy (AACP), as
of January 2014, there are 129 colleges and schools of pharmacy with
accredited (full or candidate status) professional degree programs and 2
schools with precandidate status in the US (see http://www.aacp.org/).
Sixty-seven colleges of pharmacy in the US are private institutes and 64 are
public universities/colleges. One hundred and thirty-one colleges will offer
the PharmD as a first professional degree and only 9 colleges will offer
PharmD as a post-BS degree in fall 2014. Among these colleges, 71 will offer
graduate programs in the pharmaceutical sciences at the MS and/or PhD
level in fall 2013. In fall 2013, there were 6,058 full-time and 362 part-time
pharmacy faculty members at 127 colleges/schools of pharmacy (see
http://www.aacp.org/).

Each year pharmacy schools and colleges across the country receive
thousands of applications. Of those thousands of applicants, only a few
hundred are invited for an interview. From there, roughly one in every two
to three of those interviewed will be accepted. General decisions regarding
interviews are based upon careful evaluation of an applicant's completed
application, all supporting documentation, academic performance in

undergraduate and graduate studies, pharmacy college admission test
(PCAT) scores, and so on. In recent years, pharmacy schools strive to
recruit students who reflect the varied communities they will serve as a
more diverse pharmacist workforce will help broaden perspectives and
shape more culturally competent health care providers for the future
(Janke et al., 2013; Vlasses and Beardsley, 2013; Zellmer et al., 2013a).

For prospective students, entrance interviews offer them the opportunity to
demonstrate their sincere interest in pharmacy, academic preparation,
related experience, personal qualities, communication skills and the ability
to analyze information and solve problems. One of the typical questions
that prospective students are often being asked is why they want to go to a
pharmacy school or why they want to study pharmacy. A simple answer to
that question would be “I want to become a pharmacist”.

Being a pharmacist is one of the most exciting and challenging careers,
which requires extensive professional training. Pharmacy school curricula
emphasize professionalism and a commitment to lifelong learning. The key
objective is to provide students a thorough foundation in the biomedical,
pharmaceutical, social/behavioral/administrative, and clinical sciences and
to prepare students with the competencies needed to enter the pharmacy
field and to contribute to the profession of pharmacy throughout their
career (Berry et al., 2011; Thompson, 2012; Zellmer et al., 2013a; Zellmer et
al., 2013b).

During the 4 academic years of professional study, pharmacy students learn
both the science and the art of pharmacy. They study subjects such as
pharmacology, pharmaceutics, pharmacokinetics, and pharmacotherapy,
while also acquiring problem solving, teamwork, and communication skills.
Students enrolled in pharmacy schools and colleges are eligible to obtain an
intern licensure with the Board of Pharmacy at the beginning of their first
year so that they may perform any of the duties of a registered pharmacist
while working under the direct and personal supervision of a registered
pharmacist. Completion of the four-year professional curriculum along

with certain hours of clinical experience is usually required to earn the
Doctor of Pharmacy degree (Berry et al., 2011; Thompson, 2012; Zellmer et
al., 2013a; Zellmer et al., 2013b). After completing their education,
graduates must pass the North American Pharmacist Licensure
Examination (NAPLEX):
https://www.nabp.net/programs/examination/naplex/) in order to
practice Pharmacy in the US (Boyle and Myford, 2013; Madden et al., 2012;
McCall et al., 2007; Newton et al., 2008; Sturpe, 2010). In addition,
graduates must apply to the Board of Pharmacy in a particular state in
order to be licensed as a pharmacist in that state.

Inside The Classroom: Focus On Curriculum

In general, pharmacy curriculum in colleges and schools of pharmacy in the
US is structured to provide an education that integrates formal classroom
knowledge with clinical experience and thus prepares students for all career
options in pharmacy (Meszaros et al., 2013; Schlesselman and Coleman,
2013; Thompson, 2012). Students work autonomously and as part of a team
as they develop their patient-care skills and necessary knowledge that they
will need to practice pharmacy. Typically, the four-year pharmacy program
is divided into three years of didactic education on campus and one year of
experiential training with qualified preceptors at different practice sites
(Meszaros et al., 2013; Schlesselman and Coleman, 2013; Thompson,
2012).

Traditionally, the first two years of the PharmD curriculum are offered as a
“block” program of required courses. The first year curriculum has a focus
on the basic biological, physical, and chemical sciences that serve as an
imperative foundation of patient care, including anatomy/physiology,
medicinal chemistry, pharmaceutics and pharmacology. The second year
curriculum begins to transition into intensive therapeutic instruction.
Students learn about how common diseases such as diabetes, hypertension,
and asthma are best managed with the appropriate use of medications. In
the third professional year, students will complete courses in areas related

to drug information systems, pharmacy and health care management,
pharmacy law and ethics, communications, and the application of advanced
practice skills (Meszaros et al., 2013; Schlesselman and Coleman, 2013;
Thompson, 2012).

To ensure students develop the competencies essential to the pharmacist’s
expanding role as healthcare provider, more and more pharmacy schools in
the US begin to implement integrated curriculum in which basic and
clinical sciences and scholarly work are woven together throughout all four
years of pharmacy education (Boyle and Myford, 2013; Metzger et al., 2013;
Ofstad and Brunner, 2013; Wallman et al., 2013; Zorek and Raehl, 2013).

An integrated curriculum is developed to break down artificial barriers
between subject areas and reflect the way in which students will be
expected to demonstrate their scientific and professional knowledge on
medicines and their ability to use them effectively. For example, at the
University of South Florida College of Pharmacy (see
http://health.usf.edu/pharmacy/index.htm), the integrated
pharmacotherapy course features the merger of pharmacology, medicinal
chemistry, toxicology with pharmacotherapeutics. This approach, which is
currently the most common curricular model throughout the US, will
provide an opportunity for students to learn pharmacologic principles
relating to the activity of toxicity of each medication immediately before
learning how to apply that knowledge to direct patient care.

Outsider the classroom: Research and interprofessional experience
As we move into a new era in which genetics, technology and healthcare
reform exert strong influences on the health care landscape, there is a
burgeoning need for pharmacy education to reflect more scientific and
technological advances, increasing health expectations, and multi-
disciplinary primary healthcare (Boyle and Myford, 2013; Patwardhan et
al., 2012; Vanderwielen et al., 2014; Wu-Pong et al., 2013).

Like other healthcare professions, pharmacy practice is increasingly calling

for the integration of multiple disciplines to fully represent new ways of
thinking about medications in the emerging age of molecular and cellular
medicine. With a growing realization that scientific discovery can lead to
potential breakthroughs or paradigm-shifts in clinical practice, new faculty
and new research units have appeared in more and more pharmacy schools.

Besides inserting new content into the curriculum by carving out short
blocks of time in which the latest basic and/or clinical research findings can
be addressed, the development of a multidisciplinary culture among
researchers and health professionals is becoming a trend that changes the
face of pharmacy education, making new ways of interactive teaching and
learning possible (Vanderwielen et al., 2014; Zellmer et al., 2013a; Zorek
and Raehl, 2013).

In fact, gaining research experience while at pharmacy school is becoming
increasingly important. Involvement in research can not only help
pharmacy students with their professional development, but also make
them a better residency candidate as many competitive residency programs
now have the luxury of selecting from applicants who have all of the desired
elements, including good grades, strong reference letters, research
experience and even publications. Even if some students have no interest in
a pharmacy residency program, it is still a valuable experience.

Roadmap To Success For Pharmacists In The US

Although being a pharmacist is the original reason that students want to
study pharmacy, they will soon realize that pharmacy schools can offer
more than they have expected initially. The field of pharmacy is expanding
quickly, with a vast and rewarding array of opportunities, and it is likely
that a good "fit" can be found for everyone, depending on individuals’
interests and professional goals. Students can benefit from a well-rounded
PharmD program that incorporates problem-based learning, a vast range of
research and clinical opportunities and invaluable networking
opportunities to allow them to learn about alternative options and begin

exploring education and career paths tailored to their specific interests.
PharmD’s may choose to pursue careers other than retail and clinical
pharmacy, and they may do so at different times in their training or careers.

Alternative paths might occur directly out of pharmacy school once a
license is obtained, or after residency, or after years of practicing pharmacy.
At any of these stages a dual degree may be useful, such as MBA, MPH, MS,
PhD, JD, etc (Shannon et al., 2012). Even though most PharmD program
graduates are staying on the pharmacist career track, their potential
professional options is broad, ranging from basic science research to sole
clinical practice, from academia to private industry or consulting. While it
is without doubt that a PharmD degree makes one highly marketable, one’s
goals and ambitions will determine his/her career pathway.

References

Berry TM, Chichester CO, Lundquist LM, Sanoski CA, Woodward DA,
Worley MM and Early JL, 2nd (2011) Professional technical standards in
colleges and schools of pharmacy. Am J Pharm Educ 75:50.

Boyle M and Myford C (2013) Pharmacists' expectations for entry-level
practitioner competency. Am J Pharm Educ 77:5.

Higby GJ (1997) American pharmacy in the twentieth century. Am J Health
Syst Pharm 54:1805-1815.

Janke KK, Kelley KA, Kuba SE, Mason HL, Mueller BA, Plake KS, Seaba
HH, Soliman SR, Sweet BV and Yee GC (2013) Reenvisioning assessment
for the Academy and the Accreditation Council for Pharmacy Education's
standards revision process. Am J Pharm Educ 77:141.

Madden MM, Etzler FM, Schweiger T and Bell HS (2012) The impact of
pharmacy students' remediation status on NAPLEX first-time pass rates.

Am J Pharm Educ 76:191.

McCall KL, MacLaughlin EJ, Fike DS and Ruiz B (2007) Preadmission
predictors of PharmD graduates' performance on the NAPLEX. Am J
Pharm Educ 71:5.

Meszaros K, Barnett MJ, Lenth RV and Knapp KK (2013) Pharmacy school
survey standards revisited. Am J Pharm Educ 77:3.

Metzger AH, Hardy YM, Jarvis C, Stoner SC, Pitlick M, Hilaire ML, Hanes
S, Burke J and Lodise NM (2013) Essential elements for a pharmacy
practice mentoring program. Am J Pharm Educ 77:23.

Newton DW, Boyle M and Catizone CA (2008) The NAPLEX: evolution,
purpose, scope, and educational implications. Am J Pharm Educ 72:33.

Ofstad W and Brunner LJ (2013) Team-based learning in pharmacy
education. Am J Pharm Educ 77:70.

Patwardhan A, Duncan I, Murphy P and Pegus C (2012) The value of
pharmacists in health care. Popul Health Manag 15:157-162.

Schlesselman L and Coleman CI (2013) College and school of pharmacy
characteristics associated with US News and World Report rankings. Am J
Pharm Educ 77:55.

Shannon SB, Bradley-Baker LR and Truong HA (2012) Pharmacy
residencies and dual degrees as complementary or competitive advanced
training opportunities. Am J Pharm Educ 76:145.

Sturpe DA (2010) Objective structured clinical examinations in doctor of
pharmacy programs in the United States. Am J Pharm Educ 74:148.

Thompson CA (2012) ACPE reviewing Pharm.D. program accreditation

standards. Am J Health Syst Pharm 69:2127-2128.

Vanderwielen LM, Vanderbilt AA, Dumke EK, Do EK, Isringhausen KT,
Wright MS, Enurah AS, Mayer SD and Bradner M (2014) Improving public
health through student-led interprofessional extracurricular education and
collaboration: a conceptual framework. J Multidiscip Healthc 7:105-110.

Vlasses PH and Beardsley RS (2013) What's next in the ACPE accreditation
standards revision process? Am J Pharm Educ 77:49.

Vlasses PH, Wadelin JW and Travlos DV (2008) Accreditation Council for
Pharmacy Education: annual report. Am J Pharm Educ 72:45.

Wallman A, Vaudan C and Sporrong SK (2013) Communications training in
pharmacy education, 1995-2010. Am J Pharm Educ 77:36.

Wu-Pong S, Gobburu J, O'Barr S, Shah K, Huber J, Weiner D and American
Association of Colleges of Pharmacy Graduate Education Special Interest G
(2013) The future of the pharmaceutical sciences and graduate education:
recommendations from the AACP Graduate Education Special Interest
Group. Am J Pharm Educ 77:S2.

Zellmer WA, Beardsley RS and Vlasses PH (2013a) Recommendations for
the next generation of accreditation standards for Doctor of Pharmacy
Education. Am J Pharm Educ 77:45.

Zellmer WA, Vlasses PH and Beardsley RS (2013b) Summary of the ACPE
Consensus Conference on Advancing Quality in Pharmacy Education. Am J
Pharm Educ 77:44.

Zorek J and Raehl C (2013) Interprofessional education accreditation
standards in the USA: a comparative analysis. J Interprof Care 27:123-130.

Chapter 5: Why Study Pharmacy? Professor
Brian Erstad, Pharm.D.

Brian L. Erstad, Pharm.D.
Professor and Head, Department of Pharmacy Practice & Science

University of Arizona College of Pharmacy

Brian L. Erstad, Pharm.D., FCCM, FCCM, FCCP, FASHP, BCPS is
currently a tenured Professor and Head of the Department of Pharmacy
Practice & Science at the University of Arizona College of Pharmacy. He is
also a Center Investigator for the Center for Health Outcomes and
Pharmacoeconomics Research and a co-director for the Arizona Clinical
and Translational Research Graduate Certificate Program. His clinical
responsibilities are performed at University of Arizona Medical Center
where he has been the residency program director for more than 20 PGY2
critical care pharmacy residents. Dr. Erstad’s research interests pertain
to critical care medicine with an emphasis on patient safety and related

outcomes’ research - he has authored more than 180 peer-reviewed
articles, monographs and book chapters. Dr. Erstad has served on the
Board of Directors of the American Society of Health-System Pharmacists
and on numerous committees and task forces for other organizations
including BPS, AHRQ, USP, Society of Critical Care Medicine (SCCM) and
the American College of Chest Physicians (ACCP). He is currently a
member of the FDA’s Drug Safety and Risk Management Advisory
Committee and a steering committee member of the United States Critical
Illness and Injury Trials (USCIIT) Group. Dr. Erstad was the first
pharmacist to receive the Society of Critical Care Medicine’s Shubin-Weil
Master Clinician/Teacher Excellence Award and one of only two
pharmacists first to be recognized as a Master of Critical Care Medicine
(MCCM).

Multiple Opportunities And Options For Pharmacists

When you graduate from a college of pharmacy today you have a wealth of
potential job opportunities that weren’t available a few decades ago. In the
past, you had two major practice options, working as a pharmacist in a
community pharmacy or working as a pharmacist in the centralized
pharmacy of a hospital.

Currently, the opportunities for pharmacists tend to reflect those for
physicians in terms of available practice settings. For example, there are job
options in ambulatory care clinics associated with physician groups or
health-systems such as VA medical centers or managed care organizations,
home health agencies that provide assistance for patients living at home,
skilled nursing or long-term care facilities, and medication management
centers. Further, there are opportunities in a wide variety of specialty
practice areas apart from ambulatory care including psychiatry, nuclear,
critical care, pediatrics, nutrition support, oncology, infectious diseases,
cardiology, emergency medicine, toxicology and geriatrics.

There are other reasons for choosing pharmacy as a career beyond the

satisfaction that comes from caring for patients as a health professional.
Pharmacy is commonly listed as a best job by groups that perform such
rankings and pharmacists consistently have been ranked first or second as
trusted professionals. There are options for part-time jobs and jobs with
differential shifts. While the pay range for pharmacists varies depending
on the nature of the position, the compensation associated with a full-time
position should be more than adequate for a family to live comfortably.

Pharmacy Has Undergone Substantial Changes

The curriculum of the University of Arizona College of Pharmacy has
undergone substantial changes since the college was founded in 1947.
These internal changes are reflective of many of the changes that have
occurred in the discipline of pharmacy as a whole ever since the inception
of pharmacy as a profession in the early 1800’s. In the United States, the
first college of pharmacy (Philadelphia College of Pharmacy) and first
pharmacy journal (American Journal of Pharmacy) were started in the
1820’s and the first pharmacy organization (American Pharmaceutical
Association) was formed in 1852.

In the late 1800’s and early 1900’s medications compounded by community
pharmacies accounted for most prescriptions. There were relatively few
pharmacists employed by hospitals in the early- to mid- 1900’s and those
that were employed had little direct patient care interactions. This started
to change in the 1960’s when a few pharmacists, under the auspices of
colleges of pharmacy, began to perform patient care activities on hospital
wards rather than in a centralized pharmacy. Several publications about
these “clinical” pharmacy or pharmacist experiences were published in
general hospital and pharmacy journals in the late 1960’s and early 1970’s.

Even today, when the word clinical when used in association with
pharmacy practice is often considered as being synonymous with
decentralized patient care services performed by pharmacists in hospitals.
However, this is really a misnomer since clinical pharmacy should be

defined more by direct patient care activities than by setting. For example,
a community pharmacist counseling a patient on medications is performing
a clinical function.

In other words, the focus is on the patient, not the technical aspects of drug
preparation or dispensing. The major pharmacy organizations in the
United States currently have definitions for a pharmacist or a clinical
pharmacist that reflect the responsibilities of this health care professional
for helping patients to optimize their use of medications. Unfortunately, if
one searches the internet for the definition of a pharmacist, a typical but
now outdated definition refers to a preparer and dispenser of drugs.

Acceptance Into An Accredited College Of Pharmacy

Acceptance into an accredited college of pharmacy in the United States
today usually requires at least 2 years of pre-pharmacy coursework
followed by 3 or 4 years in the professional curriculum depending on
whether coursework is offered year-round or for a portion of the year (e.g.,
spring and fall semesters).

As an example, it takes approximately 2 years of coursework to meet the
minimum pre-pharmacy requirements to apply for entrance into the
University of Arizona College of Pharmacy, but a substantial percentage of
our students have a 4-year degree prior to entering the college. There are
some schools of pharmacy that offer an alternative curriculum in which no
pre-pharmacy coursework is required, but rather students are admitted
into the pharmacy program directly from high school – all of the student’s
requirements for graduation are met by didactic and experiential learning
within the college.

While all colleges and schools of pharmacy require some degree of
foundation coursework in the basic sciences, the amount of this coursework
and how it is integrated into the curriculum varies. In general, most
curricula can be divided into didactic and experiential learning. Didactic

learning usually takes place in a classroom setting, although colleges and
schools of pharmacy in the United States are trying to promote the use of
more active learning strategies in the classroom in contrast to more a more
traditional lecture-based format.

Additionally and more recently, much more emphasis has been placed on
the use of various technologies (e.g., pre-recorded presentations as part of
flipped classrooms, web-based instruction) to facilitate learning. A
common theme to all colleges and schools of pharmacy is the increasing
emphasis on early and continuous on-the-job practice experiences in real-
world pharmacy practice settings.

In the United States, experiential training that takes place early in the
curriculum is known as an Introductory Pharmacy Practice Experience
(IPPE) and more advanced experiential training that occurs later in the
curriculum is referred to as an Advanced Pharmacy Practice Experience
(APPE). Such experiential training for larger numbers of students
necessitates the participation of far more pharmacist preceptors than most
colleges or schools have as practice faculty. So, these colleges and schools
often rely heavily on the preceptorship of non-faculty pharmacists who
have some type of adjunct appointment.

A Graduate/Research Degree In Pharmacy and
Scholarships

While most students graduating from colleges or schools of pharmacy in
the United States pursue careers with direct patient care responsibilities,
prospective students also may elect to undertake a research degree in
pharmacy through sequential or combined MS or PhD degrees. At the
University of Arizona College of Pharmacy we offer the option of a
combined PharmD/PhD degree that allows a student to graduate earlier
than if these degrees were obtained in sequential order.

We offer graduate training in a variety of areas including

pharmacology/toxicology, drug discovery and development, pharmaceutics
and pharmacokinetics, and pharmaceutical economics, policy and
outcomes. The typical postgraduate job associated with one of the latter
degrees would be in the pharmaceutical or biotechnology industry. More
information on these programs, scholarships and other aspects of the
University of Arizona College of pharmacy can be found on its website
(http://www.pharmacy.arizona.edu/).

As one of the top ten colleges of pharmacy in the United States, the
University of Arizona College of Pharmacy believes that all of our students
should graduate with at least a basic understanding of research
methodology. In addition to didactic instruction related to research, we are
one of the few colleges or schools of pharmacy that requires our students to
perform a so-called “senior’ research project that involves some form of
scholarship.

Interdisciplinary Care Teams for Clinical Research and
Senior Projects

Our students have the opportunity to perform projects in the areas of basic
science or clinical research, or they may elect to perform quality
improvement-type projects that often have local implications for improving
patient care. There are a number of laboratories in which our students can
perform basic science research and a number of local hospitals in addition
to our own academic medical center that offer opportunities for performing
clinical research projects.

Our hope is that the senior project will help our students to better
understand research methodology and allow them to constructively critique
and apply medical literature to the patients they serve at their practice sites.
We have seen some more tangible benefits of the required senior project in
terms of subsequent presentations and publications. The success of our
senior project requirement is evidenced by the numerous competitive
research awards received by our students from professional pharmacy

organizations and associations. This helps to contribute to our success as a
top ranked college of pharmacy.

The United States has a unique system of healthcare delivery that is in a
constant state of flux with marked disparities in care. Colleges and schools
of pharmacy must graduate caring students who are comfortable and
competent to practice in this environment; further, the colleges and schools
must graduate students that reflect the diversity of the patients we serve.
Our graduating students must be willing to be the medication-use experts
on interdisciplinary care teams that take the responsibility for providing
care that will improve patient outcomes.

At the University of Arizona College of Pharmacy we strive to have the best
students who are taught by the best faculty who are supported by the best
staff in an environment that is conducive to learning.

Chapter 6: Pharmacy for the Curious: Why
Study Pharmacy? - Professor Clive Roberts,
Ph.D.

Clive Roberts, PhD
Professor and Head of School, School of Pharmacy

University of Nottingham

Professor Clive Roberts originally trained as a Physicist, receiving his PhD
in 1991 from Imperial College, London on the construction of novel
Scanning Tunnelling Microscopes and their application in
nanolithography. Professor Roberts subsequently took up a postdoctoral
position in the Laboratory of Biophysics and Surface Analysis (LBSA), a
Research Division of the School of Pharmacy,
(www.nottingham.ac.uk/pharmacy/lbsa), The University of Nottingham
under the direction of Martyn Davies, Saul Tendler and David Jackson. In
1994 he took up an academic position in the School of Pharmacy as a
Lecturer in Biophysics, and in 2001 as Reader in Biomedical
Nanotechnology. In January 2005 he was promoted to the post of Chair of
Pharmaceutical Nanotechnology. Professor Roberts is now Head of the
School of Pharmacy (2013). His current research is focused on the
application of novel analytical and formulation strategies to develop new
medicines and biomedical devices. Recently this has included a significant
amount of work in the area of 3D printing of solid dosage forms, and in
particular with AstraZeenca and GSK. Some of the tablets produced can
be viewed during 2013-15 at the London Science Museum and Manchester
Industrial Science Museum in their exhibitions, '3D printing the future'.
Professor Roberts’ research interests are concentrated on the application
of novel analytical and formulation strategies to develop new medicines

and biomedical devices

Many Students Do Not Have A Clear View Of Their Future

When I came to choose what subject I wanted to study at University back in
the early 80’s I was lucky, I felt I knew absolutely what I wanted to do and
even where I wanted to do it. I was desperate to live and study in London
and I loved Physics. So that’s what I did as an 18 year old. So why am I
writing an article about ‘Why study Pharmacy’, apart from the obvious that
I now teach and do my research in a School of Pharmacy, and in fact have
done so since 1990?

Well I know many people considering higher education do not have such a
clear view of their future as I felt I had, and so I hope this article can help in
your decision making. Of course as it turns out I did not have that clear a
view of where I was going as I now work in Pharmacy! So that’s lesson one,
your career is not necessarily mapped out by your degree, and I believe as a
basis of preparing for a potentially changeable future Pharmacy offers a
tremendous start.

I have found Pharmacy to be a wonderful home for the curious and
adventurous, a subject not bound by tight discipline boundaries, open to
new ideas and populated by gifted people from a wide range of disciplines
and backgrounds. These backgrounds range from the clinical and social
sciences, through fundamental molecular biology and chemistry to my
original love, the physical sciences and on to industrial pharmacy.

Current Trends in Pharmacy Education and Practice

The feeling of being part of a wider team - no matter what role you play
within it - whose goal it is to improve the lives and health of people makes
Pharmacy, I believe a stimulating and rewarding career. I have especially

enjoyed the satisfaction of teaching and training the next generation of
Pharmacists and also the ease with which one can blend fundamental
curiosity driven research with direct applications that make a difference to
society.

When I look at a modern Pharmacy undergraduate course, it is amazing to
see the range and depth of areas that are brought together. Pharmacy
provides a scientific core of understanding of how drugs are discovered,
how we they interact with our bodies and how we make medicines,
embedded within training that produces students with a strong sense of
social responsibility and the professional training to go on to become
practicing Pharmacists.

In the UK and around the world we are seeing big changes in Pharmacy
education, with changes in the UK in our governance and accreditation
body and new guidance on curriculum content, with a greater emphasis on
practical hands-on clinical training and a need for students to demonstrate
by action (not theory) that they are capable of being a practicing
Pharmacist. In Nottingham, for example, a new 5-year course has been
launched which integrates the traditional post-degree Pre-Registration (on
the job) training that follows the normal 4-year course as part of the degree.
This is a dramatic shift in educational strategy; seeing Universities taking
responsibility for the delivery and assessment of this critical practical phase
of training. I believe this trend will continue, and that we will also see
increasing efforts to share and integrate best practice between Schools of
Pharmacy from around the world.

How Portable Are The Skills Of A Pharmacist?

You may well be familiar with your local Pharmacist in the community and
perhaps even in hospitals. In these roles the Pharmacist is primarily the
expert on medicines and their dispensing to the public, but they are also
able to provide a wide range of advice on healthy lifestyle choices and also
some diagnostic services. These are roles that require excellent people and

communication skills. In addition to these traditional career routes for
Pharmacists, many other roles within national healthcare systems can be
found, such as in primary care or indeed in specialist areas such as
veterinary pharmacy and regulatory affairs.

How portable are the skills of a Pharmacist? Although individual countries
typically regulate Pharmacy as a profession and hence mobility of
employment as a practicing Pharmacist is not always straightforward (it
depends upon the agreements in place between countries), it is still an area
that has a lot to offer in terms of international training and mobility.

I come from a School with a strong international aspect with students
drawn from all around the world. We also have a sister School in Malaysia
where we have our own campus, which takes in almost 100 students a year.
These students join us in the UK for the final part of their course, enriching
both their experience and also of our UK-based students. Such
opportunities are a key part of a modern globally aware education. This, for
example, is a fact not lost on the Pharmaceutical industry, itself a globally
integrated enterprise. There are significant prospects for people with
Pharmacy training in a wide range of industrial areas including drug
discovery, clinical trials, medicines manufacture and marketing.

A Pharmacy degree also provides excellent skills if you wish to stay in
research, another area where there are opportunities all around the world.
An open mind, able to move into and effectively combine new areas along
with strong organizational skills provides a basis for becoming a leading
researcher, and if you enjoy teaching also a University academic.

Of course, as my career path demonstrates you do not necessarily have to
have a Pharmacy degree to do research in Pharmacy and to make a direct
difference to the quality of life of people. Skills across the physical, life and
social sciences are valued and have a significant role to play in the
development and delivery of new medicines and therapies.

Pharmacy Provides The Maximum Flexibility In Career
Path

In my own research I have been lucky enough to collaborate with engineers,
chemists, physicists, pharmacologists, mathematicians, food scientists,
biologists, social scientists, clinicians as well as many industrial colleagues
from around the world. This has allowed me to work with colleagues on a
range of medicines and medical devices that are now available on the
market; I can feel that in a small but significant way I have made a
difference.

As part of this work, I have also had the opportunity to be involved in the
direct commercialization of some of my work through the creation of
companies and license deals, a process that really brings home the direct
impact research can have, in creating high quality jobs, improving business
performance and of course, helping healthcare products to reach market.
Pharmacy has given me these opportunities. This does not mean that other
subjects cannot provide some or all of these openings, clearly they can, but
I would suggest that Pharmacy provides the greatest breadth of possibilities
and the maximum flexibility in career path.

So to finish what do I think are the defining characteristics of a Pharmacy
undergraduate and researcher? I would say a scientist at heart but one that
wants to make a direct and personal contribution to human health and
wellbeing, if that is you, perhaps you should study Pharmacy and make a
difference.

Chapter 7: Alternative Degrees In Schools Of
Pharmacy – Professor Steven M. Firestine,
PhD

Steven M. Firestine, PhD
Department of Pharmaceutical Sciences

Wayne State University

Dr Steven M. Firestine is an Associate Professor of Medicinal Chemistry at
the Eugene Applebaum College of Pharmacy and Health Sciences at
Wayne State University. He received a B.S. with honors in chemistry from
the University of Michigan and a PhD in Medicinal Chemistry from
Purdue University. Dr. Firestine conducted postdoctoral research in the
laboratory of Dr. Stephen J. Benkovic before joining the medicinal
chemistry faculty at Duquesne University. In 2005 he moved to Wayne
State University. Dr. Firestine maintains an active, NIH-funded research
program focused in the area of antiinfective drug design. To date, he has
authored more than 40 articles in peer-reviewed research journals and
presented more than 75 research abstracts and seminars. Dr. Firestine is
an active reviewer for the NIH. He serves on the editorial board of ACS

Combinatorial Sciences and is a reviewer for numerous scientific journals.

Introduction

Schools of pharmacy are often more dynamic places than most students
realize. In many ways, schools of pharmacy are mini-universities with
faculty in areas such as economics, chemistry, biochemistry, pharmacology,
business, clinical training and outcomes, epidemiology and community
practice. A range of options can also be seen in degree programs as well.
While the majority of students know that a pharmacy school confers the
professional PharmD degree, many fail to appreciate that schools of
pharmacy, particularly at research intensive schools, also offer graduate
Masters of Science (MS) and Doctoral (PhD) degrees1. The purpose of these
degree programs is fundamentally different from that of the PharmD
degree in that these degrees are not designed to train students to become
practicing pharmacists.

Rather, the goal of these graduate programs is to train students to conduct
research in disciplines related, sometimes very broadly, to the profession of
pharmacy. Thus, students generally interested in pharmacy but not the
practice pharmacy may find that graduate degrees in a school of pharmacy
offer them the training that they seek. In this chapter, we will provide an
overview of the graduate MS and PhD degrees in the United States, how to
apply for these programs, examine the training that students receive during
these degrees and what students can do with the degree once they graduate.
The overview provided in this chapter is strongly based upon the
pharmaceutical sciences graduate program at Wayne State University;
however, our graduate program is similar to those commonly found in U.S.
pharmacy schools. It should be noted though that some schools have
unique programs or execute the graduate degrees differently than what is
described here. Students interested in a MS or PhD program at a specific
school are urged to seek out the specifics of that program [1].

Overview Of The MS And PhD Degrees

The MS and PhD degrees are advanced graduate degree programs that are
typically associated with the basic science departments of a pharmacy
school, although many departments of social and administrative sciences
also award these degrees. Occasionally, these degrees can be found in
clinically-oriented departments.

For the MS degree, there are typically two varieties. A non-thesis MS degree
requires graduate-level coursework but does not require the completion of
a research-intensive project or the writing of a thesis. A thesis MS degree,
which is more common, requires advanced coursework as well as a research
project and a thesis. In almost all instances, a PhD degree is intensely
focused on research and requires students to dedicate themselves to the
completion of a substantial body of research. At the end of the degree, PhD
students are required to write a dissertation (usually several hundred pages
in length) documenting the research conducted by the student during their
degree.

Typically, MS degree programs require 2-3 years to complete while PhD
programs require 4-6 years for completion. As you may notice, the time to
degree is variable. For non-thesis MS degrees, two years are commonly
required for completion of the required coursework. For research-intensive
MS and PhD degrees, the time to degree is highly dependent upon
successful completion of the research project. The nature of research is
such that it is impossible to predict how research will progress or what
problems will be encountered and thus, the time it takes to complete a
project is also uncertain. The determination of when a project has been
completed is made by the student’s research advisor (see below) as well as a
committee comprised of faculty members from both within and outside of
the Department that houses the degree. This committee meets regularly
(usually yearly) with the student to evaluate progress and advise the
student on problems encountered with their work. Research-intensive MS

students as well as PhD students must defend their research to this
committee and it is ultimately the decision of the committee to determine
whether the student has satisfactorily completed their research project and
thus whether a degree should be awarded.

Applying for a MS or PhD Degree Program

The first thing that a prospective student must consider before applying for
admission to a graduate program in a school of pharmacy is what discipline
the student wishes to study. In most schools of pharmacy, there exists
either a single department of pharmaceutical sciences or individual
departments focused on specific disciplines. The most common science-
based disciplines found in pharmacy schools are medicinal chemistry,
pharmaceutics, pharmacognosy (the study of medicines from plants),
industrial and physical pharmacy and pharmacology (although sometimes
pharmacology departments are housed in a school of medicine).

The most common non-science discipline which confers MS or PhD degrees
is social and administrative sciences which typically focus on
pharmacoeconomics, business, epidemiology, and related areas. The course
of study, along with the types of research that the student must conduct
while obtaining the degree is highly dependent upon not only the
department but also the discipline that the student selects. Thus, students
should spend significant time analyzing their interests before applying.

To apply to a graduate MS or PhD program, students are generally required
to take a placement test called the Graduate Record Exam (GRE). Some
schools also require specialized versions of the GRE exam as well. Students
applying for MS or PhD degrees must have a bachelors degree in a
discipline related to the graduate program. The most common
undergraduate BS degrees typically seen for applicants are chemistry,
biology and pharmacy (for foreign institutions). Foreign students who have
a BS in pharmacy do not necessarily have an advantage in gaining
acceptance to a graduate program in a school of pharmacy. For applicants

who are non-native English speakers, a test of English language proficiency
is also commonly required. Finally, most schools require letters of
recommendation and it is advantageous for the student to obtain letters of
recommendation from Faculty rather than teaching assistants, managers,
or other supervisors.

One frequently required document for the application to graduate school is
a statement of purpose. Students interested in advanced degree programs
should spend time on this document. Most admissions committee members
will read this statement to determine the student’s interest and to discover
the motivation of the student in undertaking an advanced degree. Students
should highlight these issues in their statement of purpose. In addition,
students should indicate Faculty members in the Department that they are
interested in working for as doing so helps the committee but also indicates
that the student has spent time researching the program.

Pharmacy schools sometimes conduct recruiting trips to targeted
institutions and these represent a good opportunity for the student to learn
about a program and meet with Faculty. Recruiting trips to foreign
countries are also becoming more commonplace. In addition to
recruitment, many schools hold open house events in which potential
students have the opportunity to visit the school and the department.
Again, students should take the opportunity to attend these open houses if
at all possible because it provides the student with a chance to see the
department, meet faculty and other graduate students and to learn about
program.

Many schools conduct interviews of applicants. These interviews can be in-
person where the school invites the applicant to the department for
meetings with key faculty members as well as students already in the
program. For foreign students, interviews are generally done via telephone
or Skype conversations. As was mentioned above for the discussion of the
statement of purpose, applicants who have been contacted for interviews
should prepare themselves by examining the Departmental website, looking

at Faculty in the discipline of interest and reading about the school and
university in general. It is always a good idea to prepare questions to ask
the interviewer.

What Happens During The MS And PhD Degree?

In some aspects, the work necessary to obtain a MS or PhD degree is
similar to what is needed to obtain a BS degree. Students in a graduate
program typically spend the first two years taking didactic coursework. This
coursework is a combination of general courses that all students in the
program must take as well as specialized courses that reflect the discipline
of the student. In most cases, courses outside of the department are also
required. Students are usually required to give seminars on both their
research project as well as on a topic unrelated to their thesis or
dissertation work. These seminars are meant to enhance the ability of the
student to research a topic and effectively communicate the topic to an
audience.

For PhD students, an advanced test is required after the completion of the
coursework. This qualifying exam is typically composed of two parts. The
first part is a written examination that is based upon material learned in the
courses. The exam is frequently broken up into general knowledge sections
as well as specialized sections which are related to the students discipline.
In the second part, students are required to defend a research proposal to a
committee of faculty members. The research proposal is typically written in
the style of a grant and may or may not be related to the student’s research
project depending upon the rules of that particular program. Upon
successful completion of both of these parts, the student becomes a PhD
candidate.

One of the most important parts of obtaining a graduate degree is the
selection of an advisor2. As mentioned previously, most MS and PhD
degrees are research intensive and thus require a research project, which is
given and overseen by a faculty research advisor. In many ways, graduate

education is similar to an apprenticeship where the primary mechanism of
instruction is on-the-job-training with direct contact with a skilled person
in the trade3. Research is typically carried out in a laboratory or other
setting managed by the faculty advisor and the faculty member is not only
responsible for providing the training but also the necessary supplies and
support to successfully complete the project. The faculty research advisor is
the single most important person to the success of the student and thus,
students should be careful in the selection of an advisor. Faculty research
advisors have tremendous authority to direct students and in many cases,
the faculty research advisor can remove a student from the program based
upon their assessment of the student’s performance.

Given the importance of selecting an advisor, most programs conduct
rotations in which students work with multiple faculty advisors before they
select their final mentor. The purpose of the rotation is two-fold.

First, it allows the student to investigate the research, meet with other
students working for an advisor and also assess the advisor to determine
whether there is compatibility between the advisor and the student.

Secondly, the rotation gives the advisor a chance to assess the student and
to determine, which, if any, students the advisor is willing to mentor. The
final matching of student with a faculty advisor is usually done by a
committee with input from both the student and the advisor.

Generally, the advisor’s choice of students is usually granted. Since the
completion of most research-intensive programs is contingent upon a
research project that is dependent upon an advisor, students that fail to
find a faculty mentor are usually asked to leave the program.

One of the most important questions students have regarding an advanced
degree is how to finance the degree. For most PhD degrees, certainly in the
science disciplines, students receive free tuition, fringe benefits and a
stipend for their work on the research project. Thus, students selected into

a PhD degree are paid to get their degree! Funds for the stipend and tuition
usually come from either the faculty advisor’s grants or from the university.

In general, students paid for by the advisor are generally classified as
graduate research assistants (GRAs) and are required to spend full time on
research. Students paid for by the University are generally graduate
teaching assistants (GTAs) and have teaching responsibilities in addition to
their research. Students classified at GTAs are still expected to conduct
research, but because of the additional workload, generally do not do as
much research as GRAs.

Thus, most programs strive to limit the amount of time students spend as
GTAs. For MS students, nearly all programs require students to support
themselves and to pay tuition. Occasionally, MS students are supported by
advisors or by other funds; however, MS students are almost never given
teaching assistantships because of the limited time MS students have to
complete the degree.

The primary effort behind a MS and PhD graduate degree is research, with
the key difference between the MS and PhD degrees being the amount of
time spent conducting research. Research projects are almost always
related to the discipline of the advisor as well as ongoing studies being
conducted by the faculty mentor. After joining a research group, students
will usually spend the first one to two years becoming familiar with the
basic skills related to the discipline as well as learning how to “think” about
research [3].

One of the most challenging aspects new students face when conducting
research is the uncertainty; it is very likely that students will spend
considerable time working on a project only to have it fail or for the results
to be unimportant. For example, in the field of medicinal chemistry, it is
quite common to synthesize a series of compounds only to find that they
have no biological activity. Such a result usually does not result in
publication and thus, students will have received no external benefit for

their hard work. Give this challenge, it is frequent for students to spend
over 40 hours per week working on their research and most students will
end up having multiple projects to ensure that they have a solid thesis or
dissertation. The uncertainty of research coupled with the fact that students
will experience many failures can pose a significant mental challenge for
students. However, students should take hope in that it is surprisingly
frequent that thesis or dissertation projects come together late in the degree
and is usually the result of increased confidence, hard work and knowledge
by the student.

As was mentioned above, the faculty advisor has the primary role of
overseeing the research and aiding the student with problems, educating
them on conducting the research, as well as helping them with writing. The
research committee, selected by the student and the advisor, aids the
faculty mentor in this role and helps to advise the student. Once the student
has completed their research, most programs require that the student meet
with the committee to evaluate their work before a final defense is set. The
purpose of this meeting is to provide an overview of the proposed thesis or
dissertation project and to allow the committee to voice any concerns
regarding additional data that may be required before the student can
graduate.

Once the committee agrees with the content of the thesis or dissertation,
the student can begin writing their final document. Upon completion, this
document is given to the committee and the final phase of the degree can
begin. In this phase, the student must present their research in an open
seminar and at the completion, the public is asked to leave and the formal
committee evaluation of the research begins. The committee members ask
the student questions regarding any aspect, no matter how small, of their
research project. The student must answer the questions and defend their
project. This portion of the procedure can last for as long as the committee
wishes. Upon completion, the committee makes a decision regarding
whether to award the degree to the student. If the committee agrees, the
student is awarded the degree. If the committee disagrees, then either the

student is dismissed from the program or is allowed to return again to the
committee to address any deficiencies noted by the committee.

What Do I Do With My Degree?

A common question students ask is what can someone do with a MS or PhD
degree? The answer to this question is complex and unfortunately changes
over time depending upon the economic circumstances at the time of
graduation4,5. Many MS and PhD graduate work in the pharmaceutical or
biotechnology industry with the exact job depending upon the discipline of
the graduate. For example, medicinal chemistry graduates typically obtain
jobs in drug discovery or organic synthesis, while those graduating with
degrees in pharmaceutics usually working in jobs related to drug delivery or
formulation. Students with degrees in social and administrative sciences
who obtain jobs in the pharmaceutical industry normally work in sales,
marketing or managing insurance-related areas.

Unfortunately, the pharmaceutical industry in the USA has been steadily
shrinking over the last 10 years and thus jobs in this sector can be
challenging to obtain6. Outside of the US, the pharmaceutical industry in
China and India has grown considerably and many foreign students from
these countries have returned to take advantage of these openings. Careers
for MS trained scientists in the US is one area of growth and anecdotal
evidence suggests that getting a job at the MS degree is easier than with a
PhD degree7. However, graduates should be aware that the chance for
advancement starting with a MS-level position is substantially different
than for PhD level jobs in most companies.

PhD degree holders have the ability to work in academia as faculty
members either in schools of pharmacy or in other programs4. Usually, the
position will be in a department related to the discipline of the degree.
Obtaining an academic appointment can provide a rewarding career;
however, academic jobs can be challenging to obtain4-6. In addition,
depending upon the nature of the school, PhD-level faculty members will

have an expectation of establishing a vigorous research program of their
own in which they must compete for grant funding and will be expected to
educate graduate students as well as professional pharmacy students. Grant
funding both within the US and in Europe can be very difficult to obtain
and this provides an additional challenge for becoming a faculty member in
a research-intensive school.

Lastly, MS and PhD degree holders can expand to other fields not directly
related to pharmacy5,6,8. For example, degree holders are needed in patent
law offices, regulatory organizations such as the FDA and publications
related to the profession of pharmacy. These so-called alternative career
options can provide students with the chance to use the knowledge that
they obtained during their degree to areas outside of research. Obtaining
jobs in these areas can be challenging, but also provide students with an
additional career avenue which they would not have had with a BS degree.

References

1. For information on Graduate Programs in the United States, please see
the American Association of Colleges of Pharmacy website:

http://www.aacp.org/resources/student/graduateresearchstudents/Pages/
default.aspx

2. Zhao, CM; Golde, CM; and McCormick, AC. More than a signature: how
advisor choice and advisor behavior affect doctoral student satisfaction. J.
Further High. Ed., 31, pg. 263-281, 2007.

3. Parker, R. Skill development in graduate education. Mol Cell. 46, pg 377-
81, 2012.

4. Wu-Pong S; Gobburu J; O'Barr S; Shah K; Huber J; and Weiner D. The
future of the pharmaceutical sciences and graduate education:
recommendations from the AACP Graduate Education Special Interest

Group. Am. J Pharm. Educ., 77, pg S2, 2013.

5. Schillebeeckx M; Maricque B; and Lewis C. The missing piece to
changing the university culture. Nat Biotechnol., 31, pg 938-941, 2013.

6. National Institutes of Health. Biomedical Research Workforce Working
Group Report. National Institutes of Health,
http://acd.od.nih.gov/biomedical_research_wgreport.pdf; 2012.

7. Colwell RR. Graduate education. Professional science master's programs
merit wider support. Science. 323, pg 1676-1677, 2009.

8. Fuhrmann CN; Halme DG; O'Sullivan PS; and Lindstaedt B. Improving
graduate education to support a branching career pipeline:
recommendations based on a survey of doctoral students in the basic
biomedical sciences. CBE Life Sci Educ., 10, pg 239-249. 2011.

Chapter 8: Why Study Pharmacy? An
Academic Pharmacist’s Viewpoint -
Professor Elizabeth Williamson, PhD

Elizabeth M Williamson BSc (Pharm), PhD

Professor of Pharmacy at the School of Pharmacy
University of Reading

Professor Liz Williamson is the former Director of Pharmacy Practice at
the School of Pharmacy, University of Reading. She is a member of
various UK Department of Health regulatory committees, including the
British Pharmacopoeia Commission, and is Chair of the British
Pharmacopoeia expert advisory group (EAG) on herbal and
Complementary Medicines, the Panel for Veterinary Medicines and vice-
chair of the EAG for medicinal chemicals. Liz is Editor of the journal
Phytotherapy Research and a member of the editorial board of
Phytomedicine and the Chinese Journal of Integrative Medicine (Beijing).
She is also a member of the Society for Medicinal Plant and Natural
Product Research (GA), the Phytochemical Society of Europe and the
Singapore International Expert Panel for Herbal Medicines. Her research
interests centre mainly on evaluating the quality of herbal medicines and
their pharmacological effects, and in particular synergistic effects with
other herbal medicines and the potential for interactions with
conventional medicines. She is currently investigating the type and safety
of herbal and nutritional supplements taken by cancer patients in the UK
and also in Thailand. Liz has published extensively in the area of herbal
and natural products and spoken at many international conferences
including the International Federation of Pharmaceutical Sciences, The
China Academy of Chinese Medical Sciences and the British Association
for the Advancement of Science.

More Career Opportunities Than I Can Imagine

Pharmacy has given me more career opportunities than I can imagine
gaining from any other degree programme. Although I have worked in both
the community and hospital sectors, and enjoyed both, my heart has always
been in academic pharmacy and specifically pharmacognosy, the study of
medicinal plants and natural medicines. In some cases I have managed to
combine both, working part-time in academia whilst doing a regular locum
to keep my professional skills up to date.

One of the best things about the pharmacy programme, wherever in the
world you study, is the breadth of knowledge you gain in so many areas,
some of which you don’t know about before you enrol, and some of which
haven’t even been discovered at the time. When I graduated, we didn’t
know how aspirin worked, and one of the great pleasures of a pharmacy
education is learning all this new and exciting stuff, and being able to
understand it, throughout your life.

Pharmacognosy - The Study Of Medicinal Plants And
Natural Medicines

I did not know that pharmacognosy as a discipline existed until I started to
study pharmacy, which in the UK in those days was a Bachelors’ degree. I
chose pharmacy because loved the medical sciences, and liked the idea of
helping patients, but I didn’t want the hands-on (literally) approach of the
physician or nurse. When I found that my love of plants and the chemical
and biological sciences could be combined, I knew I had found what I
wanted to do. The mythology, magic and other Harry Potter-ish aspects of
medicinal and poisonous plants always appealed to me (even before the
stories were written and I read them to my children) as well as the more
conventional scientific side of looking to the natural world for new drugs.

So I specialised in pharmacognosy, despite warnings from my tutors that it
was pointless to study such an old-fashioned subject (who needs plant
drugs? Only 60% of modern anticancer drugs are of natural origin after
all!), and then I did a PhD in the subject at the School of Pharmacy,
University of London (now University College London). There I met my
mentor and good friend, the late Prof Fred Evans, and embarked upon a
post-doc looking at tumour promoters from plants and their mechanism of
action. If I learned anything from all of this, apart from a lot of
phytochemistry and pharmacology, it is to trust your own instincts and
ignore those who want to push you into their idea of what you should do,
and that research is so exciting and interesting it is a miracle that you can
actually be paid to do it.

Pharmacy Research Encompasses Many Aspects Of
Medical Research

Academia is not an easy option. Most university members of staff receive
emails from students over the summer months, asking about some study
issue and apologising for ‘disturbing your vacation’ and that makes us
smile. The students’ long break is when we do our research, write the grant
applications to fund it, analyse our data, write the papers and textbooks and
go to the conferences that make our work known. Not only do students like
to be taught by lecturers who produce the information they learn - and they
love it when we’re on the TV or in the national press – but our reputation as
scientists adds credibility to our teaching. Most of us enjoy interacting with
students, and sharing our enthusiasm for our subject areas is a pleasure, for
us if not always for them!

Pharmacy research encompasses so many aspects of general medical
research – almost all of them, in fact, from clinical studies to computer
modelling simulations of drug action – that there is bound to be something
that grabs your interest. There are the experimental laboratory sciences, the
chemistry and formulation of drugs, their pharmacology and their
interactions with other medicines, but there is also a huge area of

psychological research looking at why people do not always take their
medicines in the way they were prescribed, why they sometimes refuse to
take medicines at all, and why they sometimes insist on them when they
aren’t necessary. Human behaviour is fascinating and never more so than
in the field of medicine.

Chinese Medicine And Ayurveda

My own interest in natural products encompasses all of these, and includes
ancient systems such as traditional Chinese medicine and Ayurveda, as well
as the use of modern herbal and nutritional supplements. Herbal medicines
can be studied as a source of potential new drugs and it is also important to
know how they can be used safely alongside modern conventional
medicine. I have needed all my pharmacy background subjects to do my
research: ethnobotany (the science of how different ethnic groups use plant
medicines) points the way to drug discovery, and then we need chemistry to
isolate and identify the active substances, and pharmacology to see how
they work.

Often, there are several active compounds and then we also need to know
how they act together (in synergy or antagonistically). Formulation science
(pharmaceutics) is necessary to make these complex extracts into
medicines, and finally, we need to conduct clinical studies to know if they
actually work.

How Do You Go About Being An Academic Pharmacist?

You don’t have to be an academic to do research, although you do need to
acquire the relevant research skills (see Smith 2010), and many
pharmacists now carry out research whilst practising professionally. This
helps to improve our knowledge of how and why people take medicines,
and how to optimise their use both economically and therapeutically, and
also provides an interesting path to career progression, which in the UK
means that as a clinical pharmacist you can reach consultant status. There

is nothing quite like seeing your name on the top of a research publication
for the first time - and after nearly four decades I have to confess that the
thrill still remains.

A research background in pharmacy can lead to a job in academia, mixing
teaching and research; in a government department, working on legislation
and public health (see Krska 2010); in industry working on drug
development, clinical trials and regulation; in publishing and medical
journalism, and many other areas. In clinical practice, research skills are
very useful and can add to your job satisfaction enormously, not to mention
your career prospects!

So how do you go about being an academic pharmacist? Well you first need
to get good grades in your degree programme: finding and funding a PhD is
competitive. Did enjoy your research project? That is the first big test, when
we find that students get drawn in to research and finally understand what
the excitement is about. You need to be tenacious (or as your family and
friends will call it, stubborn) as research is not easy and rarely goes
according to plan - if it were predicable, it would not be worthy of the name
research.

My Best Practice Advice

Choose the more challenging aspects of your degree and do those courses
well. Don’t just do the minimum you can get away with, well, not in your
chosen subjects at least! Do the statistics modules whether you want to or
not; believe me, you’ll need them, even though you can get a nice computer
programme to work out your actual numbers.

Make friends with computer geeks if you aren’t one, you’ll need them to tell
you which of those programmes you need to use. In fact, make friends with
all kinds of researchers as science is more collaborative now than it has ever
been and multidisciplinary projects seem to be the way forward. When you
choose your area for research, remember that grants are only there for

certain subjects deemed important by government, industry and other
funding organisations, unless you are personally very rich…. Pick
something you’re interested in but keep an eye on trends in research, and
don’t jump on a bandwagon that has already departed.

Don’t imagine you can compete with a world-class lab full of Nobel prize-
winners on your own, but do see if you can get some experience working
there. Search the databases for PhD opportunities (see
www.findaphd.com/) or write a research plan (see Weber and Cobaugh
2008), get in touch with your prospective supervisor and convince him or
her that you’re the right person for this project.

Prepare properly for an interview if you get one! When you get a place, do
be realistic but keep your standards high, always. Never publish data you
don’t know to be valid and don’t plagiarise, ever. Give credit to your co-
workers and they will do the same for you. Dishonesty is the greatest sin of
all in science, pharmacy is about helping people to improve their health,
and patients deserve the best you can do. During your research, you will
experience terrific highs when your results are good, and lows when your
experiments don’t work (and they won’t all), but remember that unexpected
results can lead to new discoveries! The life of an academic life is varied,
interesting and challenging but it is either right for you or not.

However, with pharmacy, you are also a member of a profession you can
return to which is always rewarding and often surprising, whichever branch
you choose, and what could be a more promising start to a career?!

Find a PhD: http://www.findaphd.com/

Krska J. Pharmacy in Public Health. First edition Pharmaceutical Press,
UK, 2010.

Smith F. Conducting Your Pharmacy Practice Research Project. A step-by-
step guide. Second edition. Pharmaceutical Press, UK, 2010.

Weber RJ, Cobaugh DJ. Developing and executing an effective research
plan. Am J Health-Syst Pharm—Vol 65 pp 2008 2058-2065

Chapter 9: Why Study Pharmacy – A Public
Health Viewpoint – Professor Ross Tsuyuki
PharmD

Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, FCSHP, FACC
Professor of Medicine (Cardiology)

Director, EPICORE Centre/COMPRIS
Faculty of Medicine and Dentistry
University of Alberta

Dr. Ross Tsuyuki was born and raised in Vancouver, BC. His training
includes a B.Sc.(Pharm.) from the University of British Columbia
(Vancouver, British Columbia, Canada) and a hospital pharmacy
residency from St. Paul’s Hospital (Vancouver). He has also completed a

Doctor of Pharmacy (PharmD) from the State University of New York at
Buffalo, a postdoctoral fellowship in clinical trials in the Division of
Cardiology at McMaster University, Hamilton, Ontario, Canada and an
MSc in Health Research Methods from McMaster University. Currently,
Dr. Tsuyuki is currently a Professor of Medicine (Cardiology) and the
director of a health research coordinating centre called EPICORE Centre
(www.epicore.ualberta.ca) and the Centre for Community Practice
Research and Interdisciplinary Strategies (COMPRIS). Dr. Tsuyuki has
received several awards for teaching, as well as appointment as a Fellow
of the Canadian Society of Hospital Pharmacists and the American
College of Cardiology. In 2005, he was recognized as the Canadian
Pharmacist of the Year by the Canadian Pharmacists Association. His
research interests include improving the care of patients with heart
failure and hypertension, prevention of cardiovascular disease, pharmacy
practice research, provision of support for other researchers and training
the next generation of health researchers.

Pharmacy in Canada and Alberta

By way of introduction, let me say a few words about pharmacy in Canada.
Our pharmacy education is a 5 year baccalaureate degree, although a
number of schools are switching to a 6 year doctor of pharmacy (PharmD)
program. After that, one can get licensed and practice, or get further
training. Further training can be in the form of a residency (usually 1-2
years of hospital or community training) and/or a postgraduate PharmD
program (2 years).

Healthcare in Canada is funded by the federal government, but is
administered by the provinces and territories. This means that health
systems differ between provinces and that affects how pharmacists practice.

There are about 37,000 pharmacists in Canada. The profession of
pharmacy is represented by the Canadian Pharmacists Association
(www.pharmacists.ca) and the Canadian Society of Hospital Pharmacists

(www.cshp.ca). The national pharmacy professional journals are the
Canadian Pharmacists Journal (www.cpjournal.ca) and the Canadian
Journal of Hospital Pharmacists (http://www.cjhp-online.ca/). Pharmacy
practice in Canada is changing from a product-oriented profession
(dispensing drugs) to a patient-centred model of care (providing direct
patient care). The Blueprint for Pharmacy (www.blueprintforpharmacy.ca)
has set the vision for pharmacy in Canada: “Optimal drug therapy outcomes
for Canadians through patient-centred care”, and all pharmacy
organizations have signed on to meet this vision.

Career Pathways

OK, I have to admit, I went into pharmacy because I thought it would be a
surefire way to get into Dentistry or Medicine. Then I realized that as a
pharmacist you could have incredible influence on healthcare and society.
Then it hit me – what I valued was to be able to “do the most good for the
most people”. Kind of a “public health” point of view. Let’s examine how
you can accomplish this as a pharmacist.

Clinical Opportunities

Depending upon where you work, the patient care opportunities are
numerous. They range from a community pharmacy, to hospital pharmacy
(where pharmacists work in teams with other healthcare professionals to
see hospitalized patients), to outpatient clinics and community-based
primary care teams. The common theme is that no matter where you work,
pharmacists take care of patients.

Worldwide, the “scope of practice” of pharmacists (i.e., the legislation that
governs the things that pharmacists can do) has been expanding and that
further expands the number of things pharmacists can do for patients. The
reason for these changes is that as our population ages, the demand for
healthcare is increasing and pharmacists are the most accessible healthcare
provider.

In Canada, the scope of practice for pharmacists has been changing
particularly rapidly, and we enjoy some of the broadest scopes of practice
anywhere in the world. In my home province of Alberta, for example,
pharmacists can alter prescriptions (change the dose, formation, or
substitute another drug), independently prescribe drugs (i.e., based upon
the pharmacist’s assessment of a patient’s needs), conduct physical
examinations, give injections (like vaccines) and order laboratory tests.
Many of these things are similar to what a physician does. In addition, as a
community pharmacist, you can bill the provincial health plan for these
services. To learn more about pharmacy in Alberta, you can visit these
websites: www.pharmacists.ab.ca and www.rxa.ca.

I work in an outpatient clinic at the Mazankowski Alberta Heart Institute,
where patients with heart failure (weakness of the heart muscle after a
heart attack, or other damage to the heart) come for their care. Heart
failure is a complex disease – one of the most common reasons for
hospitalization, patients are very limited in their activities, and the
prognosis is very poor. I work with a team that includes physicians, nurses,
and dieticians. We each have our own expertise and work together to take
care of our patients. When I am in clinic, I see patients on my own
(interviewing the patient to see how they are doing, reviewing their
medications, checking for side effects, and performing physical assessment
and checking their laboratory tests). I then get together with the physician,
nurse and/or dietician to review the patients’ progress and then together
we formulate a plan for the patient. Then I talk to the patient and family to
make sure they understand and agree with the plan, and write prescriptions
and/or follow-up lab tests. It’s enormously satisfying to be able to help such
sick patients.

Research Opportunities

People see their pharmacist more frequently than they see their physician.
Face it, it’s much easier to get in to see a pharmacist compared to a

physician. No appointment is necessary and pharmacies are almost
everywhere. Accessibility of healthcare is a big issue these days, and
pharmacists are well positioned for primary (point of first contact)
healthcare.

Primary healthcare is relatively new to pharmacy and the study of it is
called pharmacy practice research. This kind of research deals with how
pharmacists can improve health of individual patients and whole
communities – this is the public health approach that I mentioned earlier.

Let’s look at an example: Hypertension (or high blood pressure) is a
common condition (affecting 20-40% of all people) and is considered the
number 1 preventable cause of death worldwide (affecting more people
than HIV, smoking, pollution, etc). Having hypertension increases your risk
of heart disease and stroke markedly. The problem with hypertension is
that it doesn’t cause any symptoms and many people have it and don’t
know it. Of everyone with hypertension, between one third and two thirds
of people don’t have their blood pressure under control. So, hypertension is
an important public health problem.

We, and others, have started to encourage people to get their blood
pressure checked in pharmacies. You might have seen the self-serve kiosks
that measure blood pressure in your local pharmacy. To take it a step
further, we have conducted research to see the impact of having a
pharmacist to take care of patients’ blood pressure. Indeed, numerous
studies (about 40) have shown that pharmacists care of patients with
hypertension results in a reduction in blood pressure of about 8/4 mmHg,
which translates into a reduction in the risk of stroke by over 40% and of
heart attacks by about 30%! There are now Canadian guidelines for the
management of high blood pressure by pharmacists (see
http://cph.sagepub.com/content/146/3/146.full).

Similarly, researchers are studying the impact of pharmacists in a number
of other important disease areas like diabetes, high cholesterol, asthma,

osteoporosis, smoking cessation, mental health, etc. To learn more about
pharmacy practice research in Canada, please see www.core.ubc.ca,
www.epicore.ualberta.ca/compris, and http://www.open-pharmacy-
research.ca/.

Conclusion

One of the key differences between a physician’s practice and a
pharmacist’s practice is how you see patients. As a physician, you only see
your own patients. As a pharmacist, you see the patients of many different
physicians. As such, you are able to “spread your influence” to improve
patient care to whole populations of people – hence the public health angle
that I mentioned. Now that is important!

Taking care of patients is an incredible honour and privilege. In pharmacy,
we need people that are outgoing, meticulous, good communicators who
want to take responsibility to care for patients. The opportunities are as
exciting as they are limitless.

Chapter 10: What Makes A Great
Pharmacist? – Professor Derek Jorgenson,
PharmD

Derek Jorgenson, BSP, PharmD, FCSHP
Associate Professor of Pharmacy
College of Pharmacy and Nutrition
University of Saskatchewan

Dr. Derek Jorgenson is an Associate Professor of Pharmacy in the College
of Pharmacy and Nutrition and the College of Medicine at the University
of Saskatchewan (Canada). He is also an adjunct professor at the
University of Ottawa School of Nursing. Dr. Jorgenson teaches both
undergraduate and graduate students in pharmacy, medicine,
physiotherapy and nursing. He also maintains an active health service
utilization research program that focuses on the role of pharmacists in the
primary health care system. Dr. Jorgenson has a clinical background as a
community pharmacist but now maintains a clinical practice as a
consulting pharmacist in an interprofessional primary health care team.
He also runs the Medication Assessment Centre within the College of
Pharmacy and Nutrition, which is a student run clinic, supervised by
faculty at staff at the College.

The Secret To Becoming A Great Pharmacist

Students have asked me many times over my career as a pharmacy