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Implementing a Pharmacy Residency: Part Two

Written by Xin Wang Ruppel

How did you learn about this residency?
Knowing that I wanted to be in Wisconsin, I started my residency search by state on the ASHP web site where I found the listing for the Marshfield Clinic residency. I had heard of the Clinic's great reputation and decided to follow up with an information request to the program director.

What made you want to pursue this opportunity?
After learning more about the rotations and opportunities offered by the program, I felt that it matched many of my interests and would allow me to explore areas where I had little experience, such as ambulatory oncology. Given that the residency program was in its infancy, I felt that I would be able to contribute towards building a personalized and productive learning curriculum for myself and others, in addition to expanding my knowledge.

What activities did you participate in during the residency?
As a resident, I am exposed to multiple facets of pharmacy practice, from administration to outpatient practice, from investigational review boards to pharmacy benefit management. In addition to scheduled rotations, I have been involved with longitudinal management activities including the development of a quality assurance plan for pharmacy information services, evaluation of pharmacy performance, and more. I also participate on several committees including patient safety, medication therapy management, and drug evaluation, and have recently presented materials in each of the committees' meetings. Being the first resident of the program, I also have a unique insight into the process and requirements for ASHP residency accreditation.

What challenges have been faced, and how did you overcome them? Were there challenges that are associated with being the first resident to go through program at Marshfield Clinic?
The most significant challenge that I foresaw for myself was to successfully make the transition from student to practitioner. Although rotations during school taught me to apply academic knowledge to clinical situations, I had always been under the supervision of a preceptor or instructor and had never been fully responsible for my patient care activities. I knew that there were many challenges outside of an academic environment. As I transitioned into the residency program and accepted additional responsibilities as an independent practitioner, my apprehensions were put to rest as I found that I was able to utilize many of the skills that had led to my academic success, including a willingness to learn and the ability to prioritize tasks and manage time. The experiences and guidance from preceptors and colleagues were essential to my learning and has continued to help me build confidence and clinical skills throughout the residency year.

Some other challenges that I encountered as the first resident were minor and mostly involved rotation planning or scheduling. The issues were easily resolved after working with my program director and preceptors, who were all very flexible and accommodating.

How has this residency prepared you for your future as a pharmacist? What skills or knowledge have you gained that are valuable to you as a practitioner?
Residencies provide tremendous training for a new practitioner. The residency at Marshfield Clinic has enhanced both professional and personal aspects of my pharmacy practice. Professionally, I have gained valuable skills in research, particularly in my encounters with the investigational review board. My experiences from staffing the drug information services not only gave me opportunities to utilize a variety of information databases such as OVID and PubMed, but also allowed me to critically evaluate scientific publications, particularly through statistical analysis. Everyday interactions with colleagues and providers have increased my clinical knowledge and honed my skills, particularly in communication and presentation. From a personal aspect, I have had the opportunity to network with interdisciplinary providers including physicians, nurses, and administrators. I have also built a great pharmacy family through the close relationships with my coworkers and preceptors. Even though it is only the midpoint of the year, I feel that the residency has fulfilled many of my initial goals and has allowed me new experiences that will be valuable for future endeavors, both professionally and personally.

An entrepreneurial leader works to advance the profession of pharmacy by identifying and pursuing new opportunities to create value for patients and society. This means recognizing and fulfilling a professional obligation to promote change, to identify and pursue opportunities, and to improve patients' lives. How has this residency improved your entrepreneurial leadership skills?
Residencies in the ambulatory care setting are a developing field with continuously diverging pathways. The ability to explore opportunities in uncharted territory helped me build a strong sense of drive towards change and embracing innovation. From an entrepreneurial aspect, it has led me to identify gaps in the practice setting and focus on activities that produce results in progress. Also, the demands of residency training have challenged me to develop my self-management philosophy and establish values in patient care. For example, through my experiences, I have developed a stronger interest in drug information services, managed care, and education. I will utilize the residency training to develop and evolve my focus and to establish long-term goals that will accomplish the principles of entrepreneurship.

What advice do you have for students who would like to pursue residency opportunities?
Be open to different opportunities:

  • I had most of my clinical rotations during school in the inpatient care setting and had initially thought it to be the area that I would pursue for residencies. If I had eliminated all non- inpatient programs at the beginning, I wouldn't be a part of this exceptional program and writing this column.

Be flexible:

  • Be flexible with your requirements, especially when reviewing programs in the first few years of development and planning. Try to adapt to your learning environment and you will be surprised what you learn and what interests will develop.

Be selective:

  • Although you should be open and flexible to various experiences, keep in mind that there are an increasing number of residencies available with diverse career options, each one with their own unique opportunities and extraordinary mentors and preceptors. In your final selections, carefully evaluate your own goals and take time to select the program that best compliments your interest and learning needs.

Do you have any other comments regarding your unique and innovative residency experience?
Marshfield Clinic, despite being located in rural Wisconsin, is a leading health care system that shows great support for resident training. I would strongly encourage those who are interested in exploring new residency trainings to consider rural areas, to explore the challenges of providing care in such an area, and to assist in developing services for the underserved and the underprivileged population.