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ERNEST MARIO SCHOOL OF PHARMACY VOL.3 ISSUE 3 DECEMBER 3, 2013

EMSOP

CHRONICLES x brought to you by the Pharmacy Governing Council

The International Challenge of Integrating Pharmacists Into Primary Healthcare Teams by Melanie Chen, PP2 Pharmacists have yet to become substantially involved in primary healthcare teams, despite their expertise in drug interactions and safe usage of medicines. Different interprofessional barriers between general practitioners (GPs), who prescribe medication, and pharmacists, who advise physicians and patients on drug effects, prevent pharmacists from being fully integrated into health systems. Previous studies illuminate a number of reasons behind these obstructions. The main barrier is the common perception of pharmacists as “shopkeepers,” or people whose sole job is to pick medicines off a shelf, count pills, and hand vials over

Table of Contents Rx Market Decline........................2 “Skittles Parties”.........................3 The Importance of Being Ernest..4 APhA-ASP MRM..........................5 A Guide to Fellowships................5

the counter to waiting patients. In his NewScientist article “In the pharmacist’s image,” Professor Ian MacKillop writes, “To most members of the general public, the pharmacist remains a glorified shopkeeper who enters their consciousness only when they need a prescription filling or the weekend is coming up.”1 A study conducted in 2003 by two members of the School of Pharmacy at Queen’s University in Northern Ireland confirms Dr. MacKillop’s opinion. Dr. Carmel M. Hughes and Dr. Siobhan McCann surveyed 22 GPs and 31 pharmacists to explore the rift between these two professions. The pharmacist’s “shopkeeper” image emerged as the study’s prominent theme and accounted for most of the concerns GPs had with extending prescribing rights to pharmacists. One of these concerns regards the business side of pharmacy, with one GP saying, “There is definitely a conflict between the NHS (National Health Service) primary healthcare team effort that we all feel we are involved in and with pharmacists and their role as the shopkeeper and their role in looking for profits for themselves.”2 The United Kingdom GPs, who are paid by capitation, mentioned this conflict of interest in the pharmacist’s dual role as both a healthcare professional serving the patient and as a self-serving businessperson in their responses as well. Many of the surveyed pharmacists felt indignant, citing that this kind of bias restrained their influence in healthcare.

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High Tech Adherance Gadgets by Saera Murtaza, P1 These days it seems there is an app or device to simplify your life for just about everything. Whether you need to be able to unlock your car door from the other side of the country, pinpoint the closest pharmacy to your location, or make sure you dispense tin foil with a precise cut, engineers and inventors are trying to make life as hasslefree as possible. Some would argue that technology complicates things, but others find it to be a resource that can be tapped into, and lately even more so when it comes to how it may be applied to healthcare. Despite the many advancements that have been made, the healthcare field is somewhat lagging when it comes to the full use and implementation of technology compared to other sectors. For instance, most hospitals have not switched over to bedside barcode medication scanning, and are still working out the process. A few companies would like to bolster the use of technology, especially in the outpatient care setting by providing ways for technology-adept baby boomers to easily track their own medication use or for people overseeing the care of their aging parents. Medication non-adherence is a big problem when it comes to medication therapy, and not taking drugs as prescribed can lead to more serious health problems later on and higher costs. Drug adherence is something that the U.S. government is particularly trying to encourage the U.S. health care system to try to achieve in order to minimize

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Prescription Drug Market Sees Decline in Growth by Smita Jaggernauth, P1

To the layperson, the pervasiveness of the pharmaceutical industry within society may make it seem as though the industry is growing at an exponential rate. However, recent reports have shown that the prescription drug market, while still growing, is gradually tapering off. The growth rate of prescription medications is at the lowest that it has been since the 1960’s, more than four decades ago.1 Projections from the data firm IMS Health showed that the global drug market would only grow at a rate of approximately 3% this year.2 This is a decline from previous years, in which the rate average around 5.4% with a high of 8% in 2006.1 Within the United States market, prescription drug sales is expected to only grow at a rate from 1-4%.

One of the greatest contributors to the industry’s gradual decline is from patent expirations on popular brand names. In recent years, many blockbuster drugs faced patent expirations, such as Plavix in 20122 and Lipitor in 2011.1 Prior to patent expirations, pharmaceutical companies were able to dominate niche disease states. As generics were allowed to enter the market, these companies saw sharp declines in revenue. Sales in the generic market are expected to grow by more than 36 percent the next year, with generics making up 27 percent of the global drug market.2 The United States pharmaceutical market may be able to reverse its fate. If the Affordable Care Act succeeds in increasing enrollment to 30 million uninsured

Americans, total U.S. suspending on prescription drugs could increase from $420 to $460 billion.2 This increase in medication demand could help bolster the market. While the European and American markets may be suffering, other international markets are faring well. The Chinese market is expected to jump from making up 37% of the global share to 48% in 2017. References: 1. Musanthe K. Prescription drug sales rate hits 47-year low. CNN Money. March 13, 2008. http://money.cnn.com/2008/03/12/news/prescription_sales/. Accessed November 22, 2013. 2. Perrone M. Drug sales to hit lowest growth rate in decades. November 13, 2013. http://news.yahoo.com/drug-saleshit-lowest-growth-rate-decades-150659586--finance.html;_ ylt=A2KLOzIcE5BStAoAgnDQtDMD. Accessed November 22, 2013

Pharmacists in Primary Healthcare continued from front page

One pharmacist echoed the thoughts of his fellow pharmacists with his response, “…I think we have to be respected for what we do with medicines and I think at the minute GPs do not fully understand what we do. I think they think that we just put it into a bag and throw it out. I don’t think they see the role.”2 A common thread among pharmacists’ responses was that most GPs are unaware of the rigorous educational and clinical training all pharmacists go through, contributing to the divide. If these perceptions can be put aside, including pharmacists within a health system could have widespread positive results such as those documented at Fairview Health Services (FHS) at Minneapolis, St. Paul. At FHS, pharmacists are an essential part of a team. They provide consultions for patients on how to take their medication and also work with other medical professionals as part of a multidisciplinary team.3 A study conducted by the University of Minnesota College of Pharmacy looked at FHS’s embedded pharmacist model over a 15-month period and found that drug-related morbidity and mortality was significantly lower at FHS compared to other statewide clinics. 40% of diabetic patients within pharmacist-

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Photo credit: http://certification.acsm. org/files/image/shutterstock_138847340.jpg

integrated health systems at FHS reached all performance treatment goals in 2009, compared with the statewide average of 17.5%. In addition, over 4,000 drug therapy problems were reported to be resolved. The FHS study concluded that pharmacist-integrated healthcare teams helped to achieve quality performance through collaborative efforts between GPs and pharmacists.4 If interprofessional barriers between pharmacists and GPs arising from preconceptions and general unawareness can be mitigated, all members of the healthcare team – and especially the patient – can benefit. Acknowledging the contribution of every kind of healthcare

provider to the community is important to the future cohesiveness of our healthcare system.

References: 1 MacKillop, I. (1991, May 18). In the pharmacist’s image. Retrieved from http://www.newscientist.com/article/mg13017696.300--forum-inthe-pharmacists-image--ian-mackillop-dispenses-a-literary-touch-inthe-pharmacy--.html 2 Hughes, C. M., & McCann, S. (2003). Perceived interprofessional barriers between community pharmacists and general practitioners: a qualitative assessment. British Journal of General Practice,53(493), 600-606. doi: PMC1314673 3 Pharmacy careers. (2013). Retrieved from http://www.fairview.org/ careers/explorecareers/pharmacy/index.htm 4 Isetts, B. J., Brummel, A. R., de Oliveira, D. R., & Moen, D. W. (2012). Managing drug-related morbidity and mortality in the patientcentered medical home.Medical Care, 50(11), 997-1001. doi: 10.1097/ MLR.0b013e31826ecf9a


Skittles Parties: Not the sugary fun you had as a kid

by Saera Murtaza, P1

The term “Skittles Party” at first glance seems harmless and even something one might associate with a child’s birthday party, possibly with bright rainbow colored streamers and lots of candy. Unfortunately the name couldn’t be more deceiving and farther from the truth. It is a street term referring to what teenagers are doing all over the country, and has especially become quite the problem for law enforcement in Long Island, NY. Though these parties have been thought to have originated over a decade ago, recently it has become quite an epidemic for law enforcement officials on Long Island, with an alarming increase in recent reports. Studies conducted by law enforcement and drug awareness agencies have shown that a great majority of teenagers on Long Island have either participated in one of these parties or know someone else that did. The premise of a skittles party involves groups of teens getting together at a secret party, each guest bringing whatever they could find in their parent’s medicine cabinet, including opioid painkillers, antibiotics, antihistamines, and caffeine pills. The teenagers then play a game similar to Russian Roulette, but with the pharmaceuticals all mixed together in a bowl while simultaneously drinking alcohol in an attempt to get high in a social environment. This is extremely dangerous due to drug-drug interactions and drug-alcohol interactions, such as heightened nervous system depression with use of an opioid, that can lead to fatal consequences unbeknownst to these teenagers. Unfortunately, even if a party-goer were to call the rescue squad in the event of their peer’s overdose, what pills were ingested would be unknown, which means the health professionals will have a very difficult time. They will not be able to readily assess what substance the teenager is under the influence of, the dosage, or its toxicity level, rendering it harder to help them, especially if the toxicity is time sensitive. Officials are looking for ways to get the community involved in being proactive about this situation, especially by educating the parents who unfortunately are often unaware that their teenage children readily have access to their prescription pills and are using them for this purpose. The importance of parents safely securing their

Photo credit: http://blogs.villagevoice.com/dailymusto/Images/ pills%5B1%5D.jpg

prescription medications is something the authorities are trying to stress. Also, events have been held in various communities to safely dispose of unused medications. It is imperative that teenagers are also educated on the dangers of these parties and the harsh reality of how fatal the consequences can be in such a short amount of time. References: 1. “Skittles Parties” on Long Island raise concerns. Newsday. Deutsch, Kevin. http://www.newsday.com/long-island/skittles-parties-on-longisland-raise-concerns-1.6431204. November 13th 2013. Accessed November 25th 2013. 2. Skittles Parties- A Dangerous Trend. http://www.bacodablogs. com/2013/04/skittlesparties.html April 11th, 2013. Accessed November 25th 2013. 3. Expert: L.I. Teens Taking Handfuls of Drugs at Random at Parties. CBS News. November 14th, 2013. http://newyork.cbslocal. com/2013/11/14/expert-l-i-teens-taking-handfuls-of-drugs-at-randomat-parties/. Accessed November 25th 2013.

Gadgets

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and possibly eliminate billions of dollars of avoidable spending in health care. The engineers at a company called Adhere Tech have designed a bottle dedicated to increasing the medication adherence rate, promising to increase it from a dismal 60% to an ambitious 90%. The way that the Adhere Tech bottle works is that it sends an email or text message reminder to the patient to take their medication and also to a loved one that may live too far to be able to personally check up on them. The patented bottle tracks the amount of pills and sends this information wirelessly into a “cloud.” Breach of privacy is not to be a

concern, as all the data that gets sent to the cloud is encrypted and HIPAA compliant. Another company called Proteus has come up with the Helius system for medication management. This system is straight out of the future, and is not only fool proof but also most likely to improve adherence. It utilizes an Android tablet that has the Helius program installed on it. A few trial pills are ingested by the patient for the purpose of monitoring function and how it will sync with the tablet. The pills have a smart chip in them which syncs with a patch worn externally by the patient that detects movement for tracking exercise and if the patient has not gotten enough rest. All of the data is sent as alerts to the tablet, as well as to a connected authorized family member’s phone via text message updates. It can even “nudge” a patient (comparable to a Facebook “poke”) if they have forgotten to take their drugs. Once the trial is successful, the patient will be mailed their real medication with a Helius chip linked into it for monitoring and checking the biological effect on the patient. This information gets sent as a report to the medical practitioner who will either approve the medication use or see if they need to tweak it based on the output in the report. These two innovative technologies, though not yet on the market, will be sure to create a buzz when they do. As other companies catch on there may be increased options for patients and families who wish to integrate technology into their medication regimen for the purpose of accuracy and for improved quality of life. As with all new technology there are always glitches in the beginning, as well as high cost, but since the pharmaceutical industry is used by such a large population it may only be a short time before the changes trickle down the market chain and into the hands of the average consumer. References: 1. Technology Reminds People To Take Prescriptions, Sends Info To Doctor. CBS New York. http://newyork.cbslocal.com/2013/11/01/ seen-at-11-high-tech-health-advances/ November 1, 2013. Accessed November 22, 2013. 2. Adhere Tech. http://www.adheretech.com/ Accessed November 22, 2013 3. Introducing Helius. Proteus. http://www.proteus.com/. 2013. Accessed November 22, 2013 4. A Cell Phone In A Pill Bottle, To Text You To Remember Your Meds. http://www.fastcoexist.com/1681935/a-cell-phone-in-a-pill-bottle-totext-you-to-remember-your-meds. May 6, 2013. Accessed November 22, 2013

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The Importance of Being Ernest Exploring the EMSOP Network: Where can a Pharm.D. from EMSOP lead you?

Mayez Enver, PharmD, EMSOP Class of 2012 by Jennifer Kim, P3

This is Part II of a two-part interview with Dr. Mayez Enver about his school career and current career. I would like to thank Dr. Enver for conducting this interview with me. Mayez Enver, former chapter President of American Pharmacists Association Academy of Student Pharmacists (APhAASP) and graduate of Ernest Mario School of Pharmacy (Class of 2012), is a passionate and positive individual who always has the mindset that you should take any opportunity that is given to you and to have a positive attitude about your work. He is currently a Pharmacy Manager at Target in Watchung, New Jersey. Read on to see how he launched his career. After his fifth year at EMSOP, Dr. Enver began his Advanced Pharmacy Practice Experience (APPE) rotations. He participated in the main requirements for rotations: community, ambulatory care, hospital, clinicals, pharmacy industry, and managed care. Dr. Enver thoroughly enjoyed his rotations, though he was not without some bumps in a few. Overall, his experience was positive, but it was his industry rotation that left the greatest impression. While at his industry rotation at a well-known drug company, Dr. Enver became extremely involved with the dynamics of the office. He even presented for international officials of the drug company at their headquarters. According to Dr. Enver, it was one of his best experiences because of how involved he got with the office and its work. The greatest piece of advice he could offer for students going into rotations is to treat each one as a four-week interview. His methodology was to behave like a full-time employee at each facility and try to leave a mark. His work at each site ultimately impacted his preceptor and everyone else who worked there. Dr. Enver believes that APPE rotations are great and rare opportunities to familiarize oneself with the facility and its staff. However, Dr. Enver also recommends that for rotations that do not live up to one’s expectations,

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the best thing to do is the make the most of the experience. In his opinion, if the attitude towards the rotation is negative, then the entire experience will be negative. His advice for students who are having a difficult time with a rotation is to just enjoy what they can, and to test themselves in different ways.

that recently, pharmacies barely recruit graduates straight out of school. A piece of advice from the recruiter was that flexibility is key when trying to get hired. After hearing all this at that time, Dr. Enver realized that his offer from Target was invaluable and a great opportunity, and that is when he decided to accept the offer.

Following graduation from EMSOP, Dr. Enver became a Target Pharmacist. His path to becoming a community pharmacist at Target was unexpected and fortuitous. His friends invited him to a general career fair while he was a PP2 student, and Dr. Enver decided to take a chance and attend it. He brought his curriculum vitae, and he networked with every single table to find an opportunity. Unfortunately, because he was a pharmacy student, most of the companies were not interested due to how occupied a pharmacy student is. Dr. Enver faced many rejections before going to the last table in the fair; he almost left at this point, but he told himself, “one more table.” That table ended up being a showing from Target. Had Dr. Enver left the multi-purpose room at the Busch Campus Center where the fair was held, then he would have never gotten to his current position.

Dr. Enver recounted the reason he accepted the position of Pharmacy Manager (RXM) offered to him so soon in his career. To him, it was not the increase in salary that compelled him, but that it was just another challenge for him to overcome and succeed. According to him, Dr. Enver is the type that never says “no” to opportunities, and he loves to challenge himself. As a RXM, he works 60 hours per week so his position is very time consuming. However, Dr. Enver says, “At the end of the day, because I am manager, the pharmacy is my pharmacy, and I am making decisions that impact many people. Becoming Pharmacy Manager is a rare opportunity, especially because fewer Targets are being opened in New Jersey, so I am happy to have taken the opportunity even if it is difficult. It really was the chance to grow and further develop myself.”

Initially Dr. Enver was offered a Target Pharmacy summer internship, and through that internship, he was offered a job as a Pharmacy Technician, which he worked as for five years. After graduation he was offered a position of Floater Pharmacist for Target, and while it was not his first choice, ultimately Dr. Enver was glad he took the position and where he is now. He floated around pharmacies for about three months, but after a performance evaluation at the end of the third month, Dr. Enver got assigned a “home store.” Then a few weeks later, he became Pharmacy Manager of that store.

He has flourished at his job, but it was not the road that he thought he would walk. Dr. Enver originally did not see himself doing community pharmacy, but in the end, he is happy with his choice. As a community pharmacist, he gets the chance to get to know his patients and their medication profiles and to foster personal and professional relationships with them. Dr. Enver says his pharmacy is less volume intense than other pharmacies, but this is conducive to creating and maintaining the close relationships he has with his patients. Dr. Enver gets to educate them on weight management, stress reduction, and a variety of other health topics as a pharmacist.

Dr. Enver explained that he chose to get into community pharmacy and take the offer from Target Pharmacy after a conversation with a recruiter from a chain pharmacy. This recruiter told Dr. Enver that New Jersey is fairly saturated in terms of job availability for pharmacists, and

However, Dr. Enver does not see being a pharmacist as an end all. His ultimate career goal is to educate and present to people – not just about pharmacy topics,

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The Student Voice Opinions and Commentary

Fellowships: Breaking Into Industry Pharmacy by Kevin Lai, P1; Susie Lee, P1; and Hanson Yu, P1

As many have probably learned both inside and out of the classroom, the field of pharmacy is becoming much more competitive and now offers more career options than ever before. When starting to apply for jobs, whether at a hospital, community pharmacy or pharmaceutical company, it is crucial to find a way to stand out. For those who may be interested in a career in industry, one extremely important way to distinguish oneself is by completing a fellowship. But what exactly is a fellowship? How does it differ from residencies and internships? Let’s discuss the nuances of obtaining a fellowship and the opportunities it can provide. In a nutshell, fellowships are highly individualized and usually research-based opportunities that provide specialized training for a career in the pharmaceutical industry. They are not long term and only last between 12-24 months. Generally, fellowships provide a salary that is slightly above average living expenses, about $35,000 to $40,000 a year. They are typically offered by colleges of

pharmacy with a direct affiliation with a pharmaceutical company.1 For example, the fellowship program at Rutgers has affiliations with companies such as BristolMyers Squibb, Johnson & Johnson, Merck, and Pfizer, among many others.2 Although fellowships are often talked about in the same way as residencies or internships, there are important distinctions that must be made. Residencies are offered in a clinical setting to learn a specific clinical subset, such as emergency medicine, oncology, or pediatrics. Residencies are highly organized and the application process is similar to fellowships. However, residents have a defined curriculum whereas fellows have a more individualized process.3 Internships, on the other hand, are usually offered to undergraduates and are even more short-term than either residencies or fellowships. Fellowships are certainly a great way to start one’s pharmaceutical industry career, but obtaining a fellowship takes a great deal of preparation so it is best to start early if possible. First of all, there are certain general requirements in obtaining a fellowship. Typically, no matter where

APhA MRM Experience

by Brian Thomas, P3

The car pulls up to the valet booth and we all stumble out, our legs cramped from a four hour stasis during the drive to our nation’s capital. Suddenly, the excitement of the scene around us starts to envelope me and excite me. The energy emanating from the cavernous chandelier-clad lobby is contagious as we receive our room keys. We cut through the bustle of the lobby with its tourists and fellow attendees, and make our way up to our rooms where we prepare for dinner and the opening event. After a quick bite at Chipotle, we find ourselves again shrunken, this time by the enormity of the convention center ceiling. An energetic young woman begins speaking to the crowd with poise and confidence, reminding us that we are here for the advancement of our profession and that the advancement that we speak of is directly secondary to our collaboration and efforts at this

meeting. This was how the APhA-ASP National President, Brandi Hamilton, welcomed the student pharmacists of Region 1 and 2 to the 2013 Midyear Regional Meeting (MRM). The weekend kept pace with the fervor of the first evening as committees met, national and regional members gave presentations, and policy resolutions were fine-tuned. The APhA-ASP Midyear Regional Meeting, held this year in Washington, D.C., has many goals and purposes—some of which are to bring student pharmacists together, improve pharmacy advocacy, and vote upon draft resolutions to be put

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you go, a postgraduate degree is required, and the Rutgers Pharmaceutical Industry Fellowship particularly requires applicants to have obtained a PharmD by the time you are ready to start your fellowship. Other advanced degrees are not accepted at the Rutgers program.2 One great way to get yourself recognized while applying for fellowships is to attend the Annual Midyear Clinical Meeting, usually held in the first week of December. Over 2,000 pharmacy experts from dozens of countries attend this meeting. It is essential to attend this convention in order to be competitive in the fellowship application process. Midyear is a great opportunity for networking, meeting face-to-face with company members, and generally making a good impression. Typically, during this convention one would be interviewed multiple times by various affiliated companies. After Midyear, you would then send out applications to fellowships that interest you, and if there is a positive response to your application, you will be invited to go on-site for an interview.4 The pharmaceutical industry is extremely rewarding, but breaking in to the industry requires dedication and hard work. For those with a serious interest in the field, it would be advantageous to look into applying to fellowships in order to become more competitive when applying for a long-term position. However, because fellowships are extremely competitive, this should not discourage anyone from trying to get a job in industry, as it is still possible without a fellowship. To find out more information about fellowships, visit the following websites: http://www. fiercepharma.com to stay updated on news in the pharmaceutical industry and http:// connect.ashp.org/MCM13/Home/ for information on the Midyear Convention. References: 1. PharmD Pharmacy Fellowships. http://www.pharmacyfellowships. com. Published September 2013. Accessed November 19, 2013. 2. Why Should I Do A Residency? American Society of Health-System Pharmacists Web site. http://www.ashp.org/s_ashp/docs/files/RTP_ ASHPResidencyBrochure.pdf. Accessed November 20, 2013. 3. Rutgers Pharmaceutical Industry Program. http://pharmafellows.rutgers.edu. Accessed November 18, 2013. 4. The Midyear 2013. American Society of Health-System Pharmacists Web site. http://connect.ashp.org/MCM13/Home/. Accessed November 20, 2013.

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Dr. Enver Continued from page 4

but also about anything that anyone wants to be taught. To reach his goal, he has started a small business, Evergreen Educational Group, LLC, that is catered to helping people learn. Currently, Dr. Enver is a freelancer and also does some work pro bono based on his time schedule. The purpose of his endeavor is to develop himself professionally, and at end stage, to make the finished product of what he can offer valuable enough to make the business a full-time job. Thus far, Dr. Enver has done presentations on time management and team development and pharmacy related topics such as preventive care and health nutrition. While he refines his product through practice and preparation, Dr. Enver gets to better himself and become a better pharmacist through education. Now that Dr. Enver has been in the “real world” for a few years now, he enjoys reaching out to EMSOP and its students to be of any help. To all current students at the EMSOP, Dr. Enver recommends they get work experience and make the most of it. All students have unique skill sets to develop through working professionally, and through this process, resumes can be built and bolstered. Dr. Enver strongly believes that having work experience is a strong predictor of whether a student will be employed in the future. Being involved at EMSOP is another key piece of advice. Dr. Enver says that students should take advantage of the number of organizations that are available, their conventions, and the networking opportunities. In addition, he believes that it is truly important to better interview skills and master special abilities – an interview is only about fifteen minutes, and a first impression is the last impression. Lastly, Dr. Envers’ most important piece of advice is: “your mindset has to be that getting a degree is not your last goal, but that receiving a PharmD should lead you to thinking that being a pharmacist is a profession [in which] you constantly need to improve. Once you have this initiative and passion, you will find ways to accomplish your goals, and you will change others’ lives.”

MRM Continued from page 5

forth nationally. APhA later adopts select resolutions that make it through to the national level for which the organization advocates and lobbies on Capitol Hill. As the Rutgers House Delegate to the Regional House of Representatives, the latter was the focus of my weekend. This year, Rutgers put forth a resolution that echoes and reemphasizes an adopted resolution from 1997, advising that Center for Medicare and Medicaid Services ICD-9 (diagnosis) codes or indications be required on valid prescriptions. Fortunately, we were able to secure enough votes to have our resolution be one of the handful that were passed for this year’s meeting. The weekend did not only consist of this exercise in law and public policy, but also featured a showcase with various pharmacy organizations and retailers present. Other activities that our members attended include the various talks and panel discussions about residencies, fellowships, interview techniques, and much, much more. These interesting events, sprinkled with the exciting night life of D.C. truly created an amazing weekend for all the members who attended. Many times throughout the weekend, often during intriguing conversations with students or listening to panel discussions, I found myself coming to profound conclusions. Two of these conclusions are intriguing, as they seem dissonant with one another. The first is that the world of pharmacy is very small, while the second conclusion is that the world of pharmacy is large and it is expanding. I understand

that this seems illogical at first, but let me explain. First, Ernest Mario School of Pharmacy may be one of a handful of pharmacy schools in the area, but it is one of more than 120 pharmacy schools in the country, so there are a lot of student pharmacists out there. The students that attend these schools often have prior degrees, life experiences, and networks that are more expansive than us 0-6’ers, but that being said, the students who are enrolled in 0-6 programs, like ourselves, tend to be the more enterprising of the bunch. The good news is that despite the rate of growth in pharmacy programs across the country, pharmacy does remain a very small world. What I mean by that is that those students who will attempt to make strides in their field, no matter the subspecialty, will all know each other, or at the very least, have heard of each other. This means that if you do something noteworthy—good or bad—you will be noticed in the pharmacy universe, and people will know who you are. The APhA-ASP Midyear Regional Meeting give student pharmacists a true taste of what the outside pharmacy world is really like, in condensed form. Much like many other national pharmacy conventions do, this conventions made me realize that despite the growth that we see presently in pharmacy, the profession remains intimate and, in ways “small,” as we have been told countless times. It became clear during this weekend that we, as individual pharmacists, are in control of the size of our world, just as we, as a community, are in control of the future of pharmacy practice.

Editor-in-Chief: Christina Zikos Associate Editors: Jennifer Kim, Jazmin Turner, Yingzhi Zhang Layout Editor: Maryann Torres Contributing Editors: Melanie Chen, Smita Jaggernauth Disclaimer: The opinions expressed in EMSOP CHRONICLES do not reflect the views of the Pharmacy Governing Council (PGC) or Ernest Mario School of Pharmacy (EMSOP). For questions, comments, and information on how to get involved, e-mail emsopchronicles@gmail.com

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