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Rachel Patel explains why the role of the conventional Pharmacist has now become complex and challenging.
23rd April 2018
Written by Rachel Patel
Background Into Pharmacy
The role of a Pharmacist has dramatically changed over the last decade, from the traditional role of your local friendly dispensing pharmacist at the front of a shop, to clinicians who are able to prescribe independently and manage patient outcomes within a team of professionals.
The pharmacy undergraduate course has also evolved in line with the growing clinical responsibilities made possible by professional reform driven by pressures on the current NHS system.
In the past, the undergraduate degree was concluded with students taking away a bachelor’s degree in pharmacy.
After 1997 however, the undergraduate degree was re-structured around more research and clinical development and graduates are now awarded a Master’s level degree.
This means the total time it takes an individual wishing to embark on a career as a qualified pharmacist is now 5 years. In contrast to a Medical or Dental degree, this is only one year less than becoming a Doctor or a Dentist.
Most students wishing to apply for a pharmacy degree will enter the course after achieving the minimum A-level points required straight after sixth-form. Science A-levels in Chemistry and/or Biology are essential, however students with literary or artistic A-levels can apply to higher institutions offering a ‘foundation year’ to help grasp the basic constructs of science subjects.
In this foundation year, students will be taught the basics of biology, chemistry and physics to underpin the knowledge required to understand how drugs affect the body, and vice versa.
Some Universities will also offer a 5-year sandwich course meaning students aspiring to enter the field of pharmacy have a variety of routes to consider before deciding on how to go about applying.
It is never too late to apply to study pharmacy, no matter how old you may feel you are. An increasing number of mature students enter this field after a solid career, having decided on a change in career direction.
The world of pharmacy has a plethora of opportunities and is not just confined to the ‘big 3’ sectors (Community, Hospital & Industry Pharmacy), which are generally laid out to students post-graduation.
As a product of both pharmacy school and working life, pharmacists are endowed with analytical, financial, teaching and practical experience, all of which can be transferred to working sectors such as Journalism, Finance, Academia, Regulatory affairs and Scientific/Medical writing.
Whatever the reason for choosing this career path, you are guaranteed to develop and nurture what you already knew during your undergraduate and post-graduate career. The variety of roles within pharmacy and beyond are endless, so whether it’s being a specialist clinical pharmacist in a hospital, a GP practice pharmacist conducting medicines reviews, or working in the field of regulatory affairs assessing the commercial release of medicinal products on to the global market, the choice is simply yours.
When Did You Decide On Becoming A Pharmacist?
Back in 1999 when I was at the stage of choosing where and what to study as 17-year-old, I looked at what subjects interested me, the city (obviously as a student, the nightlife was a quintessential requirement), and what opportunities were available to give back to society because of my education.
During my high school and sixth form days, Chemistry and Physics had always fascinated me and I decided to pick these subjects for my A-levels and supplemented my third and fourth with Biology and General Studies.
My heart was always with helping people so I chose to study pharmacy after attending a few career fairs and undertaking some work experience at a local
By investing my time in this way, I found a pharmacy degree suited my practical and scientific mind along with the chance to help and guide patients through optimising how they think and use their medication.
After deciding upon pharmacy, I applied to a few Universities before choosing to study at the University of Manchester embarking on a 4-year Master’s degree.
What Does A Pharmacy Degree Entail?
At the University of Manchester, the content of the learning was structured and geared towards drug delivery, development and clinical pharmacy practice.
The first few years as a pharmacy undergraduate are spent building and establishing knowledge in the following subjects:
• Pharmacy law & ethics
• Pharmacology & Pharmacokinetics
• Organic chemistry
• Social Pharmacy
• Business and finance management
• Physical pharmacy
Hard skills’ taught during undergraduate study include:
• Problem solving
• Analysis and interpretation of complex data
• High degree of attention and accuracy to detail
• Ability to organise oneself and prioritise tasks
• Critical appraisal of evidence and research
• Interpretation of medical data and statistics
• Commitment to ethics and continuing professional development
In the later years of the degree, subjects become less broad and more clinical; such as disease management of various conditions, biopharmaceutics and developing more hands on, practical ‘soft skills’ such as:
• Patience, compassion and empathy
• Active listening, clarifying and reflection
• Effective communication through verbal and non-verbal actions
Assessments were in the form of lab reports, exams, practical work and written assignments. The assessments throughout the degree developed my time management skills and improved my ability to cope under pressure; both important attributes in pharmacy practice.
During my time at University, I was lucky enough to be part of the first cohort of students attending hospital clinical visits to Manchester Royal infirmary for PBL (problem-based learning).
PBL was traditionally a form of learning used in medical and dental study and was adapted by various schools of pharmacy back in the early 2000’s. This form of learning is now the gold standard for UK undergraduate pharmacy students, as it provides an innovative learning environment facilitated by a teacher-practitioner.
During PBL sessions we were motivated and encouraged to set our own learning objectives and goals within a group of students studying a real-life patient case study.
Within our groups, the decision on who would be the ‘chair’ and ‘scribe’ was taken by the group.
This approach to learning helped us foster ‘active learning’ and develop both the hard and soft skills required to be a pharmacist.
The course was intense and challenging due to the long hours in lectures every week, coupled with trips to the library for the requisite reading list. But for those who had a thirst for knowledge like myself, it was a great time for like-minded students to come together to learn the field.
Once I’d completed my Master’s degree in 2005, I started my pre-registration year at North Staffordshire Hospital.
The pre-registration year is the time taken to convert all your undergraduate experience into practice, and it assesses your competence in pharmacy practice before sitting the final exams to qualify as a registered professional.
I thoroughly enjoyed my time as a pre-reg pharmacist because the structured competency programme acted as a bridge between being an undergraduate and transitioning into a fully-fledged pharmacist.
After qualifying as a pharmacist, I decided I wanted to stay in hospital pharmacy and started my career as a Cancer Services Pharmacist in 2008 at the Queen Elizabeth Hospital in Edgbaston, Birmingham.
It was here I developed an interest in providing pharmaceutical services to cancer patients after completing a post-graduate diploma in clinical pharmacy.
In the UK, the risk of developing cancer is 1 in 2 if you were born after the 1960’s. This represents 50% of all UK residents aged 57 years or under.
Invariably, patients with a cancer diagnosis will have some degree of contact with the pharmacy team.
My experience of working in cancer services is immensely rewarding. I do everything with the intention of providing hope in the treatments we supply to patients.
Often, we prepare patient’s intravenous chemotherapy, ensure safety checks of prescriptions, and check supportive medications are given for each cycle of treatment.
The pharmacy is the ‘go-to’ hub for patient counselling, and information about any chemotherapy query.
The pharmacy is in the background of hospitals, churning out treatments made within highly aseptic facilities. The team consists of pharmacy assistants, technicians and pharmacists. The service is placed to provide bespoke and timely treatments to patients on the wards, or as day case treatments.
When patients start chemotherapy, they are understandably apprehensive about what it is going to do to them. To prepare the patients for treatment, in-depth counselling is given prior to the first cycle of chemotherapy.
After treatments, we supply and advise patients how and when to use or take supportive medicines such as mouthwashes, emollient creams, anti-sickness and antibiotics. Depending on the individual, pharmaceutical consultations are tailored to meet the patient needs, as all chemotherapies and supportive medicines differ with the type of cancer they have.
Usually, a friendly chat is all that is required to make the patient comfortable and susceptible to take in all instructions on how and when to take their medicines.
Chemotherapy nurses are well trained in being compassionate to their patients and will communicate to us in pharmacy if a patient is particularly nervous. Some patients are naturally more anxious than others, and this is ok.
We tend to find patients become more relaxed for subsequent cycles of treatment as they form trustworthy and friendly relationships with staff from the nurses, volunteers and the pharmacy. This allows us to follow up on their treatment, as well as review supportive medication.
Also, over time, we all become friendly faces to the patient with whom they can share their grief and happiness in life.
As pharmacists, we are the last port of call for patients, and our main objective is to deliver treatments without delay to the patient. From a patient’s perspective, this is understandable as they need their own surroundings and support network to deal with and manage the aftermath of chemotherapy side effects.
Working in this area has very harrowing and sad moments. Treatments don’t always result in happy endings, and that’s tough to watch because you feel powerless to help them after all the time they’ve spent with you.
It’s important to show your emotions where appropriate, because at the end of the day we are all human and in some way or another we are all affected by each patient’s pain and disappointment surrounding the outcome of their therapy.
Equally, there are times of happiness and joy when a patient has conquered their cancer and it can be seen in terms of how they are both physically and mentally after their treatments.
It is very humbling to help a patient out of a very dark time, when all good things seemed so far away, but when they’re on the other side of their journey they can take the next steps into looking forward to the future.
My Career Route And Qualifications
Whatever route you decide to take, the opportunities with a pharmacy degree are endless and it is up to you where you want to take your career.
My route was:
To specialise in Cancer Services, you will need to have worked in a Hospital Pharmacy as a rotational pharmacist for at least 2 years and have gained a Post-Graduate Diploma in Hospital Clinical Pharmacy.
It is recommended to have sufficient knowledge of general pharmacy practice before deciding to specialise in any area of interest.
As well as this, and most importantly, individuals must develop empathy towards their patients.
Individuals wishing to work in Cancer Services must also be aware of the emotional trauma experienced by patients, and should try to develop personal resilience in the face of it.
It is also important to keep yourself physically fit and active because you will be required to see various patients, cover many aseptic releasing slots and attend meetings, sometimes back to back. But if you enjoy the fast-paced environment, then this may be the path for you.
Personally, I motivate myself by developing compassion for my patients and knowing that I am doing my best for them in the form of service to improve their quality of life.
I find joy in helping others less fortunate than myself, and this helps me to stay grounded in my job.
The role of the cancer pharmacy service is to provide chemotherapy. Therefore, opportunities can be found in working as an Aseptic/Technical Pharmacist or Clinical Pharmacist, or both if you prefer to be ‘hands on’ with both aspects of the role.
Career progression is also available in the hospital setting, as once you have gained experience in a specialist role, you may go on to manage the service as the lead pharmacist. Here, you will oversee managing staff, handling budgets, supporting clinicians, chief pharmacists, finance managers, service leads with service improvement plans, and making important decisions on how to maintain and improve the service.
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