Congratulations you made it to summer! The sun is shining for longer hours in the day and so are you! We will miss the P3s as they start the next chapter of their life. Wishing incoming P2s and P3s good luck in IPPEs and APPEs!

As always, our team is excited to bring you OCPD resources, residency, and fellowship information, and insights into traditional and non-traditional pharmaceutical careers throughout the year.

Ask a Senior Professional!

Do you have tricky career or professional development questions that you would like to ask anonymously to pharmacy professionals?

Our team will get in touch with SOP faculty, residents, and/or alumni AND GET YOU EXPERT ANSWERS! We will feature 2-3 answers on our monthly newsletter, so ask away :)

You asked, and we got you answers!

We received many excellent questions about careers from last month's "Ask a Senior Professional" survey. Since many P1 students expressed interest in clinical residency programs, we got in touch with Dr. Paul Takamoto. Dr. Takamoto hold various appointments as an Emergency Medicine (EM) Clinical Pharmacist, the PGY-2 EM Program Coordinator, and an Assistant Clinical Professor at UCSF School of Pharmacy. He was also recently a therapeutics lecturer for the first-year class!

Interview questions and answers:

(1) What are your primary responsibilities as an ED clinical pharmacist?

I work in a clinical setting with many healthcare practitioners - staff, physicians, nurses, respiratory therapists, and technicians - resulting in numerous day-to-day interactions compared to other clinical settings. The dynamic in the ED is unique because our scope of practice involves acute care conditions such as strokes, MI, seizures, and sometimes traumas. The cases we deal with can range from life-threatening situations to refilling a medication or dealing with a dog bite, so our practice can be broad.

In terms of skill sets, we are versed in a lot of different areas. Sometimes, the clinical manifestations we encounter are more complex than expected, requiring our active involvement. As a result, our responsibilities are diverse in nature. We can play a role in expediting the decision-making process for selecting medications such as antibiotics or anti-anginal drugs, finding alternatives for patients with allergies, screening for significant drug-drug interactions, and rectifying order issues. Technically, everything is considered STAT in the ED, so there is a sense of urgency with orders. Medications must be promptly approved and administered to address acute emergencies.

(2) What tools or strategies do you use to verify these medication orders?

There are incidents such as dosing errors that could potentially harm patients, but thankfully there are various safeguards in place to minimize these mistakes. In hospital settings, we use electronic health records and order entry verification systems. These interfaces require prescribers to select medications within specific dosing, frequency, and route parameters, reducing the likelihood of errors.

Along with these system level restrictions, there are other safeguards in place. Before nurses administer drugs they scan patients to ensure the right person is receiving the right medications. These procedures span various domains of nursing, medicine, and pharmacy, which is crucial due to the high patient turnover rate in the ED.

(3) What role do you play as an educator and what is your precepting philosophy?

My involvement with precepting is important to me. Residents spend about six weeks with us throughout the year. During our time together, I lead our simulation labs, which focus on learning through mannequin-based scenarios. The idea is that we are creating scenarios such as codes or high risk situations where you want to have prior experience before treating patients. These models are advanced and can simulate actions like crying or vomiting which is useful for clinical applications. As our residents get practice with taking vitals or administering medications or any other clinical skills, they absorb everything from the learning case and prepare to treat patients. In the case that we uncover clinical challenges, we try to have proactive discussions to address those issues in a systemic manner. Ultimately we get a chance to teach various topics such as strokes, STEMI, seizures, sepsis, intubation, anaphylaxis, and aortic dissections.

In terms of my precepting philosophy, it's all about finding the right balance of imposter syndrome and overconfidence. As learners, we often struggle with where we stand in terms of clinical knowledge and confidence while navigating our training. When we interact with healthcare professionals, it's important to recognize that we are surrounded by learners of all disciplines. Challenging yourself to learn from others and to teach individuals with less experience both have benefits in the broader sense of building individual confidence and maintaining an open mind.

(4) Medication shortages can occur at any time from fluctuations in demand, manufacturing issues, etc. How do you handle medication shortages or emergencies when specific medications are not readily available in the ED?

It's tough. In the last several years, most medication shortages were actually critical medications that did not have good alternatives and were necessary in the ED. At one point, we had a shortage of dextrose which was devastating. Individually, there's not much you can do except to find evidence-based alternatives. Fortunately these shortages wax and wane, but sometimes there are permanent discontinuations or recall issues that you have to deal with. Our pharmacy purchasing group deals with these situations and they try to foresee expected shortages to minimize effects at the hospital level. If we can see issues on the horizon, we make suggestions to prescribers and create alerts about medications within our ordering system, but this is a challenging issues across the board.

(5) How did you arrive at your decision to go directly into PGY-1 residency?

My initial motivation for pursuing pharmacy was actually derived from an interest in oncology, so I completely changed tracks! Although I was unfamiliar with the role of ED pharmacists, my experience at Stanford exposed me to the field. Observing the impact of my clinical decisions on patients' outcomes in the ED provided a level of satisfaction and fulfillment that resonated with me. This ability to make a noticeable difference in a short period of time resonated with me, ultimately influencing my decision to pursue a career in the ED. Another major pull factor was my preceptor who reaffirmed my interest in the field. That's another reason why precepting is important in terms of potentially influencing people's career choices.

(6) P1 students have expressed concern with acquiring internships. What advice do you have for P1 students that are searching for internship opportunities?

I feel like being a student gets progressively harder as the years go by. Opportunities are increasingly competitive, so it's important to stay attentive and proactive. As students, we often develop ideas about the best way to become marketable in the fields we wish to pursue. But rather than being goal-oriented, it's better to have a curiosity mindset. It's important to think of "how can this opportunity help develop my skills this way or experience in another area?" When you open yourself to new ideas, you meet new people, and along the way you will find someone that will support your endeavors.

For more information visit the Assembly Bill 1286 Implementation.

(California Board of Pharmacy, 2024).

Pharmacoeconomics (PE) is the discipline that applies various economic analyses to assess the value of different pharmaceuticals, biologics, and health technologies. The overarching goal is to achieve the best return on investment for each healthcare dollar spent. So, all healthcare environments can benefit from incorporating PE.

PE specialists evaluate the design, validity, and reliability of health economic studies which can inform downstream decision-making strategies. Their work streamlines the assessment of healthcare-related products within formularies and analyzes expected clinical and financial outcomes. Lastly, their working knowledge about medical information systems enables the development and integration of evidence-based and indication-specific guidelines into clinical practice.

The California Society of Health-System Pharmacists. Pharmacy practice perspectives written for pharmacy students, residents, and new practitioners. 2004.

What if you could find a career counseling appointment anytime you were looking for one?

Help manifest this future by taking our 3-minute anonymous appointment preferences booking survey!

As part of your OCPD's commitment, to be responsive to your needs, we are continually assessing our appointment booking offerings, so that we can update our appointment availability for when you need it most. Every month we'll offer students the chance to take this survey so that you can share your monthly and quarterly scheduling preferences, because we know that your schedules change frequently. 



Students who take the survey have the option to win a $25 Amazon gift card by entering our monthly gift card raffle, (winners are announced every month!).  

Did you know?

We have an incredible team at the Office of Career and Professional Development (OCPD) that can help you with your professional needs.

Our most popular services include career counseling services with career counselors, application material review sessions (CV, resumes, LOI) with career peers, mock interviews, and networking appointments. Book an appointment!