Pharmacy to medicine and Navy Pharmacy thread

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PharmD2MD

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I have been getting lots of PM's- pharmacists who are interested in med school, or pharmacy students interested in Navy pharmacy. My time is getting increasingly tight, so I am going to post the answers to questions I have been getting so I can quickly refer people to this thread. I don't mind answering questions at all, but I get the same questions a lot and seem to wasting a lot of time typing up individualized answers. If this thread doesn't help you, let me know I'll try to get back to you when I have a minute.

Important qualifier here- just my opinion and unique experiences. Caveat emptor.

I am not a recruiter, and I am no longer a Navy pharmacist. I switched gears in October of 2005. Don't just take my word for it- talk to recruiters about scholarship details, and try to get them to put you in touch with current active duty pharmacists to get the most current information.

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I'm actually going into pharm from medicine. Is there something about the job that is crummy I don't know about?
What things turn people off to pharm?
I perused some of your previous posts...looks like you are already in med school?

Anyway, pharmacy is in a tough spot right now. The push is for more highly trained clinical pharmacists, but there is very little going on terms of reimbursement for clinical services. Regardless of the reimbursement, most pharmacists have a pretty good salary but that's not my point. My point is that I don't think pharmacists are appreciated by other medical professionals or the public. That's why no one seems to be able to bill for clinical services effectively. Historically, pharmacists have provided these services for free- their salaries were paid by the hospitals so they didn't really care about pursuing reimbursement. Again, it's not about the $$, it's that you are treated like a glorified techician by the public and most physicians could care less about your input. Another example of this attitude is that more highly trained pharmacists are not compensated any more than pharmacists with no residency training. The public and the medical profession don't care about your input- they want their drugs and they want them quickly.

Another equally important issue is the nature of the patient care you'll be providing as a pharmacist. In a hospital you'll provide very little direct patient care. Retail pharmacy is not good for patient care either. The chains have fostered an environment that actually discourages patient counseling with drive thrus, coupons for switching pharmacies, and focusing on cranking out as many rx's as humanly possible.

Personally, I find what docs do much more interesting than my own job. I do like pharmacology and drugs, and I like seeing patients doing well and getting better when my recommendations are taken seriously. However, drugs are small piece of a much larger pie that is total patient care. I'll be happier and more fulfilled by knowing the whole process.

I would recommend that you shadow some pharmacists in a variety of settings before doing anything like quitting med school. I've known several pharmacists who became docs, but never the other way around. I also know a lot pharmacists who wish they would have went to med school instead. It's a tough, often thankless job. Not that I have any illusions about medicine being any easier, but I think it will be more rewarding and professionally satisfying. Hope this helps.
 
Hey,
thanks for the feedback. I am in the graduating class of ****...so i have quite a bit of time left to gain as much experience as i can to really evaluate my situation and future. I did the 2 year undergrad track so i'm only 20 right now and will be 24 when i graduate. im just trying to gather as much info as i can because i know that preparing to go to med school is a long process (Extra cir., volunteering, shadowing, MCAT, etc.) just curious, what was the reasons you opted for a career change? ( if you dont mind sharing your business)
thanks,
******

*****,

I would consider applying to med school ASAP, if I were you even if that means leaving the school of pharmacy. This depends on how much of sure bet you think med school will be. Pharmacy school is expensive- why spend the extra money on tuition and lose money in terms of 2 extra years of not making the big bucks?

I've always thought about med school, even in pharmacy school. It took me a while to make the leap- I wasn't 100% convinced at first, I had a committment to the US Navy, and I was tired of school when I graduated. I was attracted to medicine for a variety of reasons; direct hands on patient care, more challenging, and you get to call the shots. At the same time, I realized that clinical pharmacy is sort of a crock. We're not really recognized by other health care professionals or by the public as critical members of the team. I could elaborate on this...but I really recommend that you shadow some pharmacists and some physicians to make up your own mind. Also, keep in mind that true clinical pharmacy jobs are pretty difficult to find, especially if you specialize in something. It all comes down to $$- most clinical pharmacy services are not reimbursable via third party payers. Especially in hospitals.

Jeremy
 
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Hello,
I'm a current first year studnet at ** college of Pharmacy. I did the 6 year route and got my AA at ** as well. Although I am trully interested in pharmacy knowledge I am realizing that I don't see myself practicing this profession. I picked this major when I was in highschool and it was what I wanted then, but as I'm getting older and having more exposure to it, it doesn't seem to provide the growth and patient interaction that I had expected. I suppose you could say that I'm having a career change, even though I haven't really entered the profession yet. I think I always wanted to be a doctor but wasn't ready to commit but as time goes on I realize what really is and isn't important to me along with the sacrifices I'm now ready to make. Pharmacy interests me, however I know that I want to practice medicine. The more volunteering and exposure I get to clinical settings only further reaffirms this desire. I spoke to an undergrad premed advisor and he basically told me that I would have many hurdles to overcome. His advice seems to go along with the intense questioning you faced from adcoms. I informed him that I wanted to apply my senior year of pharmacy school so that I could matriculate the fall right after graduation. He said that adcoms would look down on my application because they would see me as a pharmacy student that went to pharmacy school with no intention of practicing it. In addition, he said that I was contributing to the national shortage of pharmacists and that I had basically stolen a seat from another deserving student who had actual intentions of going into the field. That all the time adn resrouces the school had put into training me for a profession had been wasted. Nevertheless, I am realizing what I want and I don't want to waste any time so graduating and then immediately starting med school would be ideal.
Sorry for the length of this message. I just saw that you went somewhat of a similar route..minus the fact that you practiced pharmacy for a couple of years before applying. I didn't know how much of the advisors advice I should take to heart and figured someone that had been there and done that would be a more relevant source. Did the adcom seem to really look down on the pharm. D. degree? And if I told them that I realized while in pharmacy school I wanted to be a doctor and that I finished the degree because I figured the extra knowledge could only proove beneficial, would that be sufficient in convincing them that I'm not some confused student. Just was wondering if you could share some insight into some of the obstacles you were faced with and perhaps how you handled them.
THIS IS A LONNNNNNNNNGGGGGGGGGGG message I know...SORRY! any feedback would be greatly appreciated.
Sincerely,
****
****

I'm not familiar with how your program works. I did a 6 year Pharm.D, but my program was right out of high school. How many years do you have before you graduate? Your advisor has some valid points about the uphill road you have ahead of you in medicine. As I've mentioned, the adcoms won't give you much love for having a Pharm.D. However, I don't agree with your advisors guilt trip about taking away seats from other potential pharmacy students, or some sort of perceived obligation to the school for training you as a pharmacist. You need to do what makes you happy and professionally fulfilled- don't worry about the pharmacist shortage or any of that other crap the advisor said.

I would definitely advise you to apply to med school. You will probably regret it if you don't. I don't really have much other specific advice for you...it's difficult because there are so many factors, e.g. when you graduate, how competitive of an applicant you are, your personal life, etc.

In general, applying sooner is better than later. The April MCAT is better than August. Get as much volunteering/leadership/research related activities under your belt as you can. Look at schools that have a lot of older applicants- not because I'm making a judgement about your age, but because they tend to be more open minded about applicants from other professions. DO schools seem to be more open minded. I regret that I did not look into DO at all.

One more suggestion, then I'm back to studying: consider a pharmacy residency in the VA system. I have a couple of fraternity brothers who did this and they love their jobs, think pharmacy is great, seem to have lots of great patient contact, etc. I think the VA puts pharmacists in a better role...this might help you sort out whether or not you really want to give up pharmacy. If, after the residency, you decide to go back to school, then more power to you. It's only a year.

Good luck!

Jeremy
 
Hey,
I am a practicing pharmacist and i graduated in 2004. How and why did you go back to Med school? Was it difficult to do? Any input would be great! Thanks


How: through the Navy. I was an active duty pharmacist prior to starting at USUHS.

Why: this is sort of complex and probably varies from person to person. Basically, I wanted more direct patient care, more autonomy, and less of the hassle of clinical pharmacy. Unfortunately, clinical pharmacy is still in it's infancy and won't progress until insurance companies are routinely paying for our services. We are offering a service for free, and constantly trying to justify our existence through BS funny numbers derived from potential savings or whatever. Bottom line is the rest of the world has yet to see the value of the clinical pharmacist.

The application process is a hassle. You'll get tons of questions about why you want to make the switch from interviewers. They seem to be suspicious of pharmacists. Having a Pharm.D is not an advantage in the application process. USUHS worked out for me because people switch careers all the time within the military and no one thinks twice.

Don't be discouraged- if this is what you want to do, jump on it before it's too late. It's definitely doable- just be aware of the obstacles.

Jeremy
 
Hi there,
I have learned from some of your posts on this site that you've worked as an active duty PharmD in the military. I don't mean to bother you, but I would appreciate any advice you could offer.
I graduated w/ a PharmD in 2004. I am working in retail but am dying to get out and pursue a residency. The incentives/residency training offered by the military are enticing.
In your experience, how likely was it for one to actually get a residency? As a PharmD, were you stuck in pharmacy operations, or did you have clinical duties as well?
Thank you for your time and I hope to hear back from you soon!


I don't know how likely it is that you would get a residency. Honestly, the Navy has what seems to be a backwards informal method for selecting would be pharmacy residents. They don't participate in the ASHP match. I just kept bugging the pharmacy specialty leader about it and I got it. They may have formalized this by now- this was in 2002. ASHP griped about our process (or lack thereof) when they accredited the residency. From what I've seen in the military, if someone is really interested in doing something (and it will benefit the military), then they generally allow the person to do the training. Sometimes it's not right away- you may end up doing a tour somewhere and then getting a residency.

After my residency I did a variety of jobs in the hospital, depending on what was needed ranging from ICU clinical pharmacist (where I spent most of my time), neonatal ICU backup guy (when the regular NICU pharmacist wasn't around), regular inpatient staffing, inpatient division officer (a managment job), training residents, students, new grads, etc. I honestly liked my job there. However, then I got transferred to Guantanamo. Not much clinical pharmacy there simply because the sick people generally get evac'ed off the island. It wasn't bad though- I took care of other things that needed to be done- JCAHO, updating policies and procedures, remodeling the pharmacy, and some other items. I had a whopping 4 coumadin people that I kept track off for the internist.

Now, I've told you a little about what I've done. It's just my experience. The military isn't a good way to go if you really have your heart set on doing a very specific job- for example, if you really want to be an ICU clinical pharmacist, you might get to do that at some point, but then you'll get moved and you will have to adjust to other duties. I liked the variety. But that's just me.

Hope this helps.

Jeremy
 
Hey, could you please elaborate on the quality of life as an officer in the navy (how different is it from being enlisted) and also some general info about navy pharmacy, such as a typical day as a pharmacist.
Thanks

The military is a caste system of sorts. I can't really get into all of the differences between officers and enlisted right now, but I'll give you a few things to think about. Know that the differences are more drastic in line units (i.e. ships, Marines, etc.) than in medical settings. Nonetheless, in addition to significant pay differences, you'll generally be treated with more respect, people will take you at your word (unless you give them reason not to), and you'll have many more opportunities for big leadership positions. The officers basically are the middle management and higher ups in the military. Senior enlisted are an important and invaluable part of the middle management also- but they will have worked 15-20 years to have as much responsibility as you might have a year out of school.

No typical days really- some days are like working at any other pharmacy, sometimes it's not. It really depends where you are. Most of my time prior to going to GTMO consisted of normal pharmacy type of days.
 
Hello,

I've been doing some research into the HSCP program lately, and would love to ask some questions.

Deployments: what sort of deployments could a navy pharmacist expect?
At the moment, there aren't a lot of pharmacist deployments. The Navy doesn't seem to regularly use pharmacists in fleet hospitals, although it can can happen and I do know pharmacists who have been deployed with fleet hospitals. Getting deployed on the Mercy or Comfort would be cool since they do a lot of humanitarian work, but that's fairly rare also since they don't go out too often and there are only 1-2 pharmacists on board. Bottom line is, as a pharmacist, you might get deployed, but you probably will not. Fleet hospitals or hospital ships would be the most common deployed setting.


You said you went to GTMO, what is that and I have a family and 2 children, how often are deployments w/o your family? How long do these last?
GTMO= Guantanamo Bay, Cuba. You probably wouldn't be deployed very often. Can't say for sure, but if you were deployed 2-3 times over an entire 20 year career that would sound about right. Pharmacists just don't get deployed very much. A standard deployment in the Navy is 6 months. However, you may get stationed overseas somewhere which is different from being deployed. Usually you can take your fam with you overseas.


Are deployments a guarantee? I've heard that pharmacists don't get deployed on ships but what about the hospital ships mercy and comfort?
No guarantees that you will or will not deploy. You are correct, the only ships with pharmacists are the Mercy and the Comfort. They are in port most of the time and deploy rarely. When they are in port (which is most of the time), all of the medical staff attached to the ship work at the local military hospitals and clinics.

Stations: Do you ever get moved more frequently than 3 years? What is life like on base? How are the facilities? I'm assuming there are things that would help a family adjust?

Yes. Once you've been on station for 24 months, you are eligible to receive orders to move again. It happens, but realize that it's expensive for the Navy to move you and your family so they aren't going to frivolously uproot you unless you are really needed somewhere. You generally will live off base. On base, there are gyms, grocery stores, department stores, banks, post offices, etc. Stuff is generally cheaper on base, sometimes drastically in expensive areas like San Diego or DC. There are family oriented programs on base, but I can't really speak to that because I am single.

Is it feasible to be able to work in the large naval medical centers? What advice would you give to help with this?

Yes, in fact it is quite probable. Again, no guarantee, but from what I have seen the Navy likes to stick new grads at the big hospitals so they can learn as much as they can before sending them out to little hospitals or clinics. I think if simply make it well known that's where you prefer to work, the pharmacy specialty leader in conjunction with the detailer will try to accomodate you. You won't alway get your own way though- "needs of the Navy" come first.


Work: I've read that pharmacists generally do more administrative work and the techs do all the dispensing? Does that mean I can be expected to work more with patients and docs, etc? Can you please give me a day in the life of a navy pharmacist?

Military hospital pharmacy is very similar to civilian hospitals. The techs are good, but JCAHO still requires a pharmacist to do everything that they would in a civilian hospital. I think the level of patient interaction is about the same as in civilian pharmacy settings.

Education: Can you explain the residency possibilities? How many? How hard is it to get in? What about advanced degrees? While in school for these, does that count towards your time in?

The Navy has two pharmacy residencies- one in San Diego, and one in Bethesda, MD. Competitiveness depends on how many people are interested which varies widely from year to year. If you didn't get it for your first tour out of school, it's likely you would get it next time you are up for orders. The Navy didn't participate in ASHP's match program when I went through it. I don't know if they do now or not. At the time, it seemed like pharmacy specialty leader just sort of picked an applicant, not sure what exactly the criteria is.

Advanced degrees: sort of like the residency deal- it's a crap shoot. If you bug them enough, they'll probably let you do it eventually. The Navy has a program called DUINS (duty under instruction) that allows you to get a variety of degrees from universities of your choosing. You go to school full time and still keep all of your active duty pay and benefits. It's fairly competitive because it's a really good deal. MBA's, MPH, various administration degrees, fellowships, and even some PhD's.

The time in residency or DUINS counts toward pay and retirement. Residency doesn't count usually toward your service commitment, not sure about DUINS.

Would it be feasible after pharmacy school and commission immediately apply for one of these advanced degrees or would one have to work a while?
Probably not. DUINs orders are highly coveted and they only have a couple of slots for people to be in school at any given time.
 
Is there a significant lifestyle difference between enlisted and officers?
Yes. The pay is higher for officers and you get treated differently (which is sad in some ways- you have to watch out for your enlisted guys). The lifestyle difference is sort of like comparing pharmacists to techs, or mid-management to the worker bees. I'm not trying to sound elitist- it's just the way it is. Enlisted folks deserve an awful lot of credit- they are truly the backbone of the military and they do their jobs without a lot of the bennies that officers get.


Also, maybe someone with experience could list some disadvantages to the military and military pharmacy specifically.
Deployments, unexpected orders to crappy duty stations (like GTMO in my case), moves every three years, bureaucracy, getting stuck with a crappy boss and not being able to quit or transfer. I had a few beefs with Navy pharmacy which I'll share with you. I thought they were overly outpatient focused and they let their inpatient programs slide. I was also frustrated by the q3 yr turnover, which was pretty disruptive if you were trying to get a clinical program up and running. I didn't like seeing what I felt to be a double standard- basically, the Navy has technician manned pharmacies (no pharmacist on site) in some locations that only serve active duty personnel. It's a double standard, b/c they made sure pharmacists were present whenever dependents/retirees were involved since these parties can sue the government.



I know the contract is 8 years but is the remaining time required to be active reserves with drill every month or is there another option?
The contract is 3 years active duty and then you may opt to go active reserves as you mentioned, or you may go inactive reserve (IRR) for 5 years at which time you may resign your commission if you desire. IRR basically means that you don't do anything other than keep your address updated with the military. There is a chance of being recalled, albeit a small one for pharmacists.


Is pharmacy practice in the military very clinical or is it just verifying scripts?
Thanks again guys
For the most part, it's not very clinical. The outpatient operation dominates the picture by it's sheer volume and the money involved. Somehow I sort of lucked out in this department and ended up getting a residency followed some inpatient/ICU experience. However, if you get stuck in a little place like GTMO where you are the lone pharmacist, it can be as clinical as you want it to be. You will know all the docs which really helps, get some sort of program up an running, then you'll get orders to your next duty station...

A lot of it is what you make of it. I expressed a lot of interest and aptitude in doing inpatient clinical stuff, so that's what they did with me until the GTMO hammer fell. GTMO wasn't all bad- just boring mostly.
 
I have been getting lots of PM's- pharmacists who are interested in med school, or pharmacy students interested in Navy pharmacy. My time is getting increasingly tight, so I am going to post the answers to questions I have been getting so I can quickly refer people to this thread. I don't mind answering questions at all, but I get the same questions a lot and seem to wasting a lot of time typing up individualized answers. If this thread doesn't help you, let me know I'll try to get back to you when I have a minute.

Important qualifier here- just my opinion and unique experiences. Caveat emptor.

I am not a recruiter, and I am no longer a Navy pharmacist. I switched gears in October of 2005. Don't just take my word for it- talk to recruiters about scholarship details, and try to get them to put you in touch with current active duty pharmacists to get the most current information.

6.5 year bump!

Questions relating to PharmD -> MD switch:
  1. PharmD2MD are you still around?
  2. How is everything going with medicine in Navy? Happy you made the switch?
  3. Could you tell us a little about your experience thus far? How does it compare to your pharmacy experience with Navy? (hours, workload, admin, patient care)
  4. What are you doing now (residency, past residency, GMO/UMO/FS)?
  5. Figure this is a yes due to USUHS and prior time, but going career?
  6. Was the Navy very willing to give you a letter of approval to attend USUHS, or was this a difficult process to obtain?
Questions relating to PharmD in Navy:
  1. How long were you a pharmacist for Navy before USUHS?
  2. Had you done HSCP or direct accession?
  3. Did you receive special pay right away or not until after your education commitments (if did USUHS)
  4. What is your opinion on San Diego vs. Bethesda vs. JAX? (these are our three preference locations, or will be once we are emailed with availability, come on April!)
LOTS of questions... hoping you're still around to answer even a few of them. Thank you for any and all answers!
 
I'll try my hand at #4 section 2
Bethesda is now a joint effort with army and navy. It it still working at overcoming the cultural differences between the two services. A very busy place and some politics to go along with it.

San Diego is also one of the big three medical centers for the Navy with NMCP being the third. you will learn a lot here and you will likely work some long shifts. The advantage of going here is that you will be well prepared for your next duty station vs going to a smaller MTF/clinic or mid sized Mtf like jax and then going to a large medical center

/r
RogerWilco
 
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