Summer Internship Experience

e c n e r i e p x E t n e u d t S

SUMMER PLACEMENT C O M M U N I T Y P H A R M A C Y

W O R D S B Y T E O H W H E M A Y

I haven’t had much hope to hear from the community pharmacies I’ ve sent out emails to since the covid-19 pandemic swept across the whole of Malaysia and completely threw everyone off-guard. Needless to say, I was pleasantly surprised to know that I’ ve managed to snag a chance to partake in a community pharmacy placement. I wanted more exposure in the field of pharmacy to be more prepared for the role of working as a pharmacist, so this opportunity couldn’t have been more perfect for me.

I was recruited by a large chain pharmacy that had over 40 branches spread throughout Malaysia and I spent a month working at the branch near my home as a trainee. The pharmacy was considerably big and they had a huge variety of items stocked up. There were shelves for every category — shelves at the self-care section were lined with a variety of shampoos, creams and lotions, and even an array of toothpaste that were specially formulated to suit different needs. The pharmacy also offered a collection of health supplements of various brands for children, adults and the elderly.

Herbal ingredients and organic snacks were available in a different section, where an assortment of milk powders was displayed for sale. Multiple shelves were dedicated especially for Over-The-Counter (OTC) medicines that included common analgesics such as Panadol, non-medicated eye drops and antacids in both tablet and liquid forms.

Over-The-Counter

We would start the day off by sanitising the pharmacy and setting up the cash registers, of which two were located at the pharmacy counter at the back of the shop. To comply with the SOP set by the government following the outbreak of covid-19, I would routinely check and record the body temperatures of every staff member to ensure the crew ’s safety as well as customers’ . The staff members were friendly and attentive — they made sure that I was wellinformed of the essential jobs around the pharmacy and walked me through them, providing guidance whenever I got caught up in a difficult situation. The pharmacists demonstrated how to keep a check on Pharmacy (P) and Prescription-only medications (POM) medicines which were arranged on the display shelves underneath and behind the counter respectively as to determine if new stocks are required to be ordered from the headquarters.

The dispensing of medicines that contain ephedrine and pseudoephedrine are specially monitored and recordings must be done with every purchase. I was assigned to keep the records up to date and ensure that the number of leftover medicines tallies with the recorded quantity.

The pharmacy was more often busy than not as customers would enter the moment the shutters rolled up right away in the morning! Some customers enjoy taking a casual stroll around the pharmacy, while some prefer to be in and out under five minutes. It is important to be courteous when speaking to customers while maintaining a professional yet welcoming tone. In the beginning, I struggled to interact with customers. I often stumbled over my words, unable to calm my nerves with the fear of making mistakes. After all, I was only a first-year student and my knowledge in the field of pharmacy was still limited, hence I had problems identifying most of the medicines requested by the customers. The pharmacists were practically my lifesavers — they would swoop right in and direct me to the appropriate shelves to pick up the medication, but I thought it would be best if I was able to handle the situation on my own.

The pharmacists urged me to familiarise myself with the way the medicines were lined up in the pharmacy (along with the overall structure of the pharmacy so I could assist the customers with locating products). P medicines (more commonly known as Group C Poisons in Malaysia) and POM medicines (Group B Poisons), as well as OTC medicines, were organised according to their indications. It was interesting to see how there were plenty of medicines available for the same indication — which was why I found it difficult to match the type of medication to their brand names, particularly Group B Poisons, often to which customers would refer to. I would come across a couple of common ones every day, such as Glucophage, an oral diabetes medicine containing the active ingredient metformin, and I eventually managed to remember their names off the top of my head after a few days working in the pharmacy. With this knowledge, I was able to quickly locate certain medicines and it helped me tremendously when serving customers. Despite that, I made sure not to be hasty in the process and would always double-check the name and strength of the medicines before dispensing them, under the supervision of the pharmacists. Prior to the dispensary, the pharmacists would first review the prescriptions brought in by the patients to ensure that the medicines are used for the correct indications and are of the appropriate dose and strength. Once the pharmacists are satisfied with the choice of medicines, they will proceed to put down their signatures along with the date of the dispensary, as well as a reference number before keeping the prescriptions in a binder file in chronological order to allow future referrals.

Every Wednesday and Saturday, a new shipment of poisons would arrive at the pharmacy. The medicines were packed neatly into large plastic crates upon delivery, with the same type of medicines bundled together. I was tasked to review the new stocks and ensure that the types and quantities of medicines received were as stated on the order invoice. It was a long and tedious process because there were just so many items to review and I would often feel burned out afterwards. The pharmacists also explained that the expiry dates of each and every packaging of the medicines must be checked as they would influence the system of which the medicines are arranged. The medicines with quicker expiry dates would be brought to the front, where they are most likely to be sold sooner to reduce the chances of medicines spoiling due to excessively long storage time.

I’ ve always known that running a pharmacy requires more than just textbook knowledge, but I did not truly grasp just how important experience comes into action. Experience plays a vital role as it involves applying ethical and professional judgement on everyday decision-making in the pharmacy. There were a couple of times where sales representatives of pharmaceutical companies came in to promote their products and requested us to advertise them in the pharmacy. The pharmacist-in-charge would analyse the data produced from clinical studies by the companies, along with the promotional leaflets whilst probing the sales representatives for further details. A decision is then made based on several factors, such as the quality and effectiveness of said product compared to the ones that are currently being sold in the pharmacy — it would not be ethical to sell customers fruitless products for profit, and it would be unprofessional for a pharmacist to neglect care for people who are in need of their services.

Of course, there were several other instances where we had to practice ethical and professional judgement in the pharmacy, but this one stuck with me the most, and it gave me a better understanding towards the significance of Pharmacists’ Duty of Care that we learnt in class.

The placement experience left me with more than what I could’ ve hoped to gain in such a short amount of time. Although it may sound redundant and exhausting, I highly recommend pharmacy students to take some time out during the summer break for placements and internships. The experience would most definitely broaden your knowledge of pharmacy jobs and give you plenty of opportunities for hands-on learning. Being a pharmacist demands more than just book knowledge and theories, and it’s never too early to strive beyond that!