PharmD to MD: How many more years of study?

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ThugMotivation

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Would Pharm.D's have to attend all four years of Med school (traditional way) if they switch to medicine or would they be able to do it in just 2-3 more years of study?

Does anyone know of someone who have decided to make such a switch and if its worth it?

Thanks!
 
You would still have to do the same four years.

Only possible exception (I would imagine) is if you go to a school where you take classes with med students. Some dental schools operate that way.

I have seen a lot of threads on sdn about pharm-to-med sooo if they don't come pouring in here, i would search and pm them

As for "worth it", I guess it depends on how much debt you have, your age, and if you have a family.

If you have a lot of debt, some would say work for a few years, pay back and then do it.

If you have a family, then how would they feel with you taking more time for school?

And age, are you 25... 35....45? If your young, probably good to go for it, if your older.. then probably not. Its about loss of possible income and delaying income...
 
I had heard that at one point there was a 3-year option through a school or two for PharmD to MD transfers, but no, it's 4 years of school plus 3-5 years residency (for most folks). I did a little financial cost/benefit analysis and figured that it would take me ~12 years of work post-residency to recoup the cost of school plus lost wages for 4 years school and 4 years of residency (wage differential) and interest. I should finish residency around 38, so my break even (financially) is at age 50. At that point I would have the same amount saved from either sticking with pharmacy or going to medicine (this was based on a $200,000/yr job versus a $100,000/yr pharmacy gig and a 15%/yr savigs rate). Obviously this can change drastically with different numbers plugged in.
 
Where do I sign up for this 15% savings rate?
 
id be interested to know what someone thinks of the curriculum between the programs after having done both and where they think individual boundaries lay
 
I'm in a four year MD program after finishing a 3 year PharmD. I work as a per diem pharmacist, and have plenty of outside time. The background in pharm. makes the program much easier in my opinion. I spend much less time in class and feel much less stressed in med school, however I feel that I am learning more and am much happier now.
 
Would Pharm.D's have to attend all four years of Med school (traditional way) if they switch to medicine or would they be able to do it in just 2-3 more years of study?

Does anyone know of someone who have decided to make such a switch and if its worth it?

Thanks!
Take this as you will, but there is absolutely no way I would want to pursue an MD after my PharmD. It's four years of pretty intense stress, and I imagine an MD would be similar in that regard, or perhaps more stressful.

Pick the path you want and go for it; duplicating your efforts when you plan to be an MD would not be worth it, in my opinion.
 
I'm in a four year MD program after finishing a 3 year PharmD. I work as a per diem pharmacist, and have plenty of outside time. The background in pharm. makes the program much easier in my opinion. I spend much less time in class and feel much less stressed in med school, however I feel that I am learning more and am much happier now.

what year are you? im wondering how much in the pharmD curriculum goes into physiology and diseases as compared to MD curriculum
 
what year are you? im wondering how much in the pharmD curriculum goes into physiology and diseases as compared to MD curriculum
I am obviously not in a medical program, and being a first year student I can't comment on instruction beyond the first year of pharmacy. However, I can hazard a guess that the physiology and diseases we cover in pharmacy programs are inferior in depth and breadth to their coverage in an MD curriculum.

That said, we get our fair share of common diseases and issues associated with medicines, not to mention a lot more training in medications than an MD program would have time to teach. 🙂
 
I am obviously not in a medical program, and being a first year student I can't comment on instruction beyond the first year of pharmacy. However, I can hazard a guess that the physiology and diseases we cover in pharmacy programs are inferior in depth and breadth to their coverage in an MD curriculum.

That said, we get our fair share of common diseases and issues associated with medicines, not to mention a lot more training in medications than an MD program would have time to teach. 🙂

I concur.
Of course, it depends on your pharm school and how detailed the classes were. Several of my pharm school classes were with DO students.
Gross Anatomy and Neuro were the hardest for me (since we didn't go into that much info in pharm school)
 
I am obviously not in a medical program, and being a first year student I can't comment on instruction beyond the first year of pharmacy. However, I can hazard a guess that the physiology and diseases we cover in pharmacy programs are inferior in depth and breadth to their coverage in an MD curriculum.

That said, we get our fair share of common diseases and issues associated with medicines, not to mention a lot more training in medications than an MD program would have time to teach. 🙂

unfortunately, the curious and argumentative side of me doesn't have time to enroll in all of the various programs lol

I havent taken pharm yet while in med school, but I am aware that everyone hates it.
just looked up the final study guide from our inter-class share page... 102 pages, each page is a different classification of drug (beta-lactam ABX's, penicillins, carbapenems, for a few cell wall active drugs.... insulin analogs... glucosidase inhibitors.... clucocorticoids.... just a breif sampling of the page titles) each with 1-several drugs on it with mechanism of action, adverse reactions, common treatment protocols, contraindications, um.... no mention of price though (which covers a common pharmD complaint I hear about MD's prescribing the expensive stuff 😉)
I'm sure there are plenty of things about the curriculum that we do not cover, but physicians are, after all, the ones prescribing the drugs so I would hope we know as much about their use and action as a pharmacist would...
 
unfortunately, the curious and argumentative side of me doesn't have time to enroll in all of the various programs lol

I havent taken pharm yet while in med school, but I am aware that everyone hates it.
just looked up the final study guide from our inter-class share page... 102 pages, each page is a different classification of drug (beta-lactam ABX's, penicillins, carbapenems, for a few cell wall active drugs.... insulin analogs... glucosidase inhibitors.... clucocorticoids.... just a breif sampling of the page titles) each with 1-several drugs on it with mechanism of action, adverse reactions, common treatment protocols, contraindications, um.... no mention of price though (which covers a common pharmD complaint I hear about MD's prescribing the expensive stuff 😉)
I'm sure there are plenty of things about the curriculum that we do not cover, but physicians are, after all, the ones prescribing the drugs so I would hope we know as much about their use and action as a pharmacist would...

If this were the case, why do we have clinical pharmacists?
 
unfortunately, the curious and argumentative side of me doesn't have time to enroll in all of the various programs lol

I havent taken pharm yet while in med school, but I am aware that everyone hates it.
just looked up the final study guide from our inter-class share page... 102 pages, each page is a different classification of drug (beta-lactam ABX's, penicillins, carbapenems, for a few cell wall active drugs.... insulin analogs... glucosidase inhibitors.... clucocorticoids.... just a breif sampling of the page titles) each with 1-several drugs on it with mechanism of action, adverse reactions, common treatment protocols, contraindications, um.... no mention of price though (which covers a common pharmD complaint I hear about MD's prescribing the expensive stuff 😉)
I'm sure there are plenty of things about the curriculum that we do not cover, but physicians are, after all, the ones prescribing the drugs so I would hope we know as much about their use and action as a pharmacist would...
I am certain medical students take enough pharmacology for their academic needs.

I'm not one to argue, but I would expect that after four years, a pharmacy graduate would know more about drugs than a medical graduate. I would also expect a medical graduate to know more about physiology, illness and diagnosis than a pharmacy graduate.

We all have our place. Try to leave your preconceptions behind.
 
unfortunately, the curious and argumentative side of me doesn't have time to enroll in all of the various programs lol

I havent taken pharm yet while in med school, but I am aware that everyone hates it.
just looked up the final study guide from our inter-class share page... 102 pages, each page is a different classification of drug (beta-lactam ABX's, penicillins, carbapenems, for a few cell wall active drugs.... insulin analogs... glucosidase inhibitors.... clucocorticoids.... just a breif sampling of the page titles) each with 1-several drugs on it with mechanism of action, adverse reactions, common treatment protocols, contraindications, um.... no mention of price though (which covers a common pharmD complaint I hear about MD's prescribing the expensive stuff 😉)
I'm sure there are plenty of things about the curriculum that we do not cover, but physicians are, after all, the ones prescribing the drugs so I would hope we know as much about their use and action as a pharmacist would...

IMO, medical school doesn't have time to teach some of the intricacies of dosing in terms of PK/PD (i.e. warfarin, vanco/AMG, Phenytoin, TPNs etc.) We spent a fair amount of time with this in pharmacy school. Of course, certain specialities learn this really well, but others don't. This is quit evident by the knee-jerk reactions by many physicians in dosing complex and narrow therapeutic drugs. There simply isn't enough time to cover all of this in med school, and hopefully it is taught well in residency. I also see a lot of dosing errors with renal cleared meds, prime example is Pradaxa, which leads to more GI bleeds. This demonstrates the importance of team based medicine and I imagine we will be seeing a lot more of pharmacy to dose in the future.

I think it is really important for medicine to respect pharmacy and vice versa for the sake of patient safety (getting off my soap box now)
 
I had heard that at one point there was a 3-year option through a school or two for PharmD to MD transfers, but no, it's 4 years of school plus 3-5 years residency (for most folks). I did a little financial cost/benefit analysis and figured that it would take me ~12 years of work post-residency to recoup the cost of school plus lost wages for 4 years school and 4 years of residency (wage differential) and interest. I should finish residency around 38, so my break even (financially) is at age 50. At that point I would have the same amount saved from either sticking with pharmacy or going to medicine (this was based on a $200,000/yr job versus a $100,000/yr pharmacy gig and a 15%/yr savigs rate). Obviously this can change drastically with different numbers plugged in.

My own calculations for the break even point would be 55ish (slightly higher) assuming that pharmacist still make an adjusted 100 k ~ 40 hours every week. I did add in extra for hours additional over 40 for medical school and residency. When you adjust it for interests on earnings... it is possible I won't ever break even.

It should be noted that this is based strongly on a $200k yearly physician salary - specialty will obviously make the break even point a reality within my 40s.
 
I'm in a four year MD program after finishing a 3 year PharmD. I work as a per diem pharmacist, and have plenty of outside time. The background in pharm. makes the program much easier in my opinion. I spend much less time in class and feel much less stressed in med school, however I feel that I am learning more and am much happier now.

Just wondering how much you work outside of medical school? 8 hours a week?

I'm thinking about picking up a per diem job but with the way the market is going... that is seriously in doubt.
 
If this were the case, why do we have clinical pharmacists?
in my experience, to manage the high number of drugs for today's aging patient (unless there is a disproportionately large peds clinical pharmacists pool I am unaware of) and this is a very good thing to have. I don't have any delusions of always juggling everything that is going on with a patient at all times - if I did I'd say we didnt need any of the other providers and Id just play superdoc for a nominal fee.

but also in my experience, the clinical pharmacists run treatment alterations by the attending physician who still has veto power. this may just be out of respect, but I also suspect it is due to a pharmacists scope of knowledge being focused more on the medications themselves and less on the disease processes they interact with
I am certain medical students take enough pharmacology for their academic needs.

I'm not one to argue, but I would expect that after four years, a pharmacy graduate would know more about drugs than a medical graduate. I would also expect a medical graduate to know more about physiology, illness and diagnosis than a pharmacy graduate.

We all have our place. Try to leave your preconceptions behind.

the tone of this response makes the end a little ironic.

nobody has said we dont all have distinct and useful roles out in the world. if we wanted to split hairs we could talk about the fact that (ignoring the small anecdotal exposure in early semesters) med curriculum is pharmacological for 2.5 of the 4 years. we dont just hit it in basics and then ignore it while on rotations. we dont touch on formulation or business aspects, but i guess weve got our own professional development courses.

honestly im still responding an earlier comment about doctors who "make idiot scripts" and how pharmacists should handle that and I am curious how real of an issue this is. in my experience most "corrections" get ignored due to the pharmD not really being privy to the entire patient history. and the corrections that do have merit are quite often just drug interactions or allergy issues. a major concern, which is one reason why it is nice to have another check point before the pt starts downing pills 👍
 
IMO, medical school doesn't have time to teach some of the intricacies of dosing in terms of PK/PD (i.e. warfarin, vanco/AMG, Phenytoin, TPNs etc.) We spent a fair amount of time with this in pharmacy school. Of course, certain specialities learn this really well, but others don't. This is quit evident by the knee-jerk reactions by many physicians in dosing complex and narrow therapeutic drugs. There simply isn't enough time to cover all of this in med school, and hopefully it is taught well in residency. I also see a lot of dosing errors with renal cleared meds, prime example is Pradaxa, which leads to more GI bleeds. This demonstrates the importance of team based medicine and I imagine we will be seeing a lot more of pharmacy to dose in the future.

I think it is really important for medicine to respect pharmacy and vice versa for the sake of patient safety (getting off my soap box now)

👍 thanks. I always appreciate a specific example from someone whose been there over comparative speculation.
many people (myself included) are guilty of only knowing what we know, so the "well what the hell else COULD there be?" thoughts start to come up. but that is a good point.

when you see dosing issues what do you typically do? and how is it received?
 
the clinical pharmacists run treatment alterations by the attending physician who still has veto power. this may just be out of respect, but I also suspect it is due to a pharmacists scope of knowledge being focused more on the medications themselves and less on the disease processes they interact with

nobody has said we dont all have distinct and useful roles out in the world. if we wanted to split hairs we could talk about the fact that (ignoring the small anecdotal exposure in early semesters) med curriculum is pharmacological for 2.5 of the 4 years. we dont just hit it in basics and then ignore it while on rotations. we dont touch on formulation or business aspects, but i guess weve got our own professional development courses.

honestly im still responding an earlier comment about doctors who "make idiot scripts" and how pharmacists should handle that and I am curious how real of an issue this is. in my experience most "corrections" get ignored due to the pharmD not really being privy to the entire patient history.

Agree.

Agree... they really need to fix this especially in the first year of professional educational. There is a lot of BS.

This last point is much more complicated. I don't think one can really make generalizations because there is always a counter argument. I can tell you that there is usually something wrong with most patients drug regimen that I have come across but most not life threatening. What a good pharmacist does is knowing which fights to pick.

***Getting side track with my thoughts but as to the last point... oftentimes pharmacists don't have the complete history especially in the community setting and even sometimes in the hospital. I can tell you that no one is infallible. There are plenty of therapeutic errors while not life threatening are certainly present.
 
Agree.

Agree... they really need to fix this especially in the first year of professional educational. There is a lot of BS.

This last point is much more complicated. I don't think one can really make generalizations because there is always a counter argument. I can tell you that there is usually something wrong with most patients drug regimen that I have come across but most not life threatening. What a good pharmacist does is knowing which fights to pick.

***Getting side track with my thoughts but as to the last point... oftentimes pharmacists don't have the complete history especially in the community setting and even sometimes in the hospital. I can tell you that no one is infallible. There are plenty of therapeutic errors while not life threatening are certainly present.

in an ideal world there wouldnt be fights lol. but at the higher professional levels there are plenty of inflated egos to deal with :laugh:
ive worked on plenty of teams and will usually be the first to say that I am not perfect - so an open environment and lack of fear to ask questions (i.e. why did you go this route instead of....?) goes a long way. The times ive been a team leader I also have a very short fuse for people who take questions personally and people who don't ask questions and act like the other person is just an idiot for not doing something the way they would have. IMO this is a good parallel to the Dr/physician interaction. Half the time a mistake could have just been avoided if a pharmacist had felt comfortable to ask "hey why are we doing this instead of....?" to which any non-childish doctor should be comfortable slapping his own forehead and thanking the other for catching it, and half of the "stupid scripts" would likely look that way from someone on the outside looking in and in an open dialogue it would be easy to fill in those gaps in information/knowledge
 
Just wondering how much you work outside of medical school? 8 hours a week?

I'm thinking about picking up a per diem job but with the way the market is going... that is seriously in doubt.

It really depends. I've worked from 8 hours to 32 hours/week. It depends on how much they need me and how busy my school schedule is.
You would be surprised how easy it is to find per diem work. I just applied for an additional per diem job to supplement this one. I should be able to make enough money for tuition plus living expenses next year.
But it's not just about the money. I really enjoy working, gaining more experience and keeping my pharmacy perspective. I have learned a lot recently and I believe it will make me a better physician. Luckily, I don't need a lot of sleep and learn quickly (plus I am in a P/F curriculum)

👍 thanks. I always appreciate a specific example from someone whose been there over comparative speculation.
many people (myself included) are guilty of only knowing what we know, so the "well what the hell else COULD there be?" thoughts start to come up. but that is a good point.

when you see dosing issues what do you typically do? and how is it received?

I pick and choose my "battles", mostly because if I bring up every little detail, eventually I will irritate the physicians (I always try and put myself in their shoes). I also acknowledge that I may not know the details of the patient (this is an annoying part of pharmacy). Commonly, I will ask the nurse for more information first (the good ones usually know what is going on and are invaluable).

If I need to, I contact the physician. I try to be very non-confrontational, something like, "I'm just curious why you choose this dose for patient Smith given that his CrCl is 20. The PI recommends x dose in this case. Is there a specific reason you are using Y dose?"

I always have a recommendation ready, I never just say, you can't use this drug because it is contraindicated. Their first response will be, what do you recommend? If you don't have an answer you look like a tool.

Some docs are awesome about it, and will take all your recommendations, once they know you, others are total tools all the time (so is life). On the flip side, I know several pharmacists that have a goal of catching physicians in a mistake in order to massage their own egos, so it goes both ways.

Personally, I don't see the point, I just try to be treated like I like to be treated- I learned that it kindergarten 🙂

I have caught some big errors and I am sure that some pharmacist will save my butt in the future too... thankfully.
 
in an ideal world there wouldnt be fights lol. but at the higher professional levels there are plenty of inflated egos to deal with :laugh:
ive worked on plenty of teams and will usually be the first to say that I am not perfect - so an open environment and lack of fear to ask questions (i.e. why did you go this route instead of....?) goes a long way. The times ive been a team leader I also have a very short fuse for people who take questions personally and people who don't ask questions and act like the other person is just an idiot for not doing something the way they would have. IMO this is a good parallel to the Dr/physician interaction. Half the time a mistake could have just been avoided if a pharmacist had felt comfortable to ask "hey why are we doing this instead of....?" to which any non-childish doctor should be comfortable slapping his own forehead and thanking the other for catching it, and half of the "stupid scripts" would likely look that way from someone on the outside looking in and in an open dialogue it would be easy to fill in those gaps in information/knowledge

Truth
 
It really depends. I've worked from 8 hours to 32 hours/week. It depends on how much they need me and how busy my school schedule is.
You would be surprised how easy it is to find per diem work. I just applied for an additional per diem job to supplement this one. I should be able to make enough money for tuition plus living expenses next year.

Community or Hospital? I'm thinking of staffing per diem or maybe doing chart review on the weekends for a long-term care facility.
 
the tone of this response makes the end a little ironic.

nobody has said we dont all have distinct and useful roles out in the world. if we wanted to split hairs we could talk about the fact that (ignoring the small anecdotal exposure in early semesters) med curriculum is pharmacological for 2.5 of the 4 years. we dont just hit it in basics and then ignore it while on rotations. we dont touch on formulation or business aspects, but i guess weve got our own professional development courses.

honestly im still responding an earlier comment about doctors who "make idiot scripts" and how pharmacists should handle that and I am curious how real of an issue this is. in my experience most "corrections" get ignored due to the pharmD not really being privy to the entire patient history. and the corrections that do have merit are quite often just drug interactions or allergy issues. a major concern, which is one reason why it is nice to have another check point before the pt starts downing pills 👍
I apologize if my tone struck you as off; I felt rather put off by your tone as well (in addition to some you've posted in the past slandering pharmacy). I would not want to disrespect anyone working to provide patient care. We do all share common goals and want the best outcomes possible for patients.

Inpatient pharmacy corrections will vary in usefulness depending on whether the institution shares medical information with pharmacists...better information sharing helps everybody make better decisions and recommendations, to my knowledge. Outpatient corrections will also vary, depending on the level of information sharing made available to the pharmacist. The pharmacist can't dispense something if there is a question of its safety for the patient, no matter how petty or small the correction might seem.

I'm not going to comment on the rest of your post as I believe you have a fish to fry with a different poster. Nobody should be calling anybody an idiot; that's just unprofessional. 🙂 Peace?
 
I apologize if my tone struck you as off; I felt rather put off by your tone as well (in addition to some you've posted in the past slandering pharmacy). I would not want to disrespect anyone working to provide patient care. We do all share common goals and want the best outcomes possible for patients.

Inpatient pharmacy corrections will vary in usefulness depending on whether the institution shares medical information with pharmacists...better information sharing helps everybody make better decisions and recommendations, to my knowledge. Outpatient corrections will also vary, depending on the level of information sharing made available to the pharmacist. The pharmacist can't dispense something if there is a question of its safety for the patient, no matter how petty or small the correction might seem.

I'm not going to comment on the rest of your post as I believe you have a fish to fry with a different poster. Nobody should be calling anybody an idiot; that's just unprofessional. 🙂 Peace?
👍 that is not uncommon
 
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I'm appreciating the mostly open discussion here!

One thing that I'd like to point out is that a lot of our job descriptions are not solely based on what you know. If you've been around medicine, then you know that physicians, nurses and pharmacists are all trained with different mindsets and that is for a reason! If a pharmacist questions the direction a physician may be taking with a patient's ordered therapy, it is often just making sure that the physician has thought about it from the angle that the pharmacist has been trained to think. I think that clinical pharmacists are there as much for perspective as they are for knowledge. The problem is that there are those ego-cases on both sides of this and then there are professionals who genuinely want what's best for the patient.

The ego-cases say "what the eff right do you have to question me? (physician)" or "i wouldn't do that if I were you (pharmacist)". There are complete douche pharmacists out there who question the physician and are completely condescending. It's natural to pull out the "I know a hell of a lot more than you" card and tell them to buzz off. However, find your allies who honestly want to make sure that the physician has thought about all angles of the issue. Embrace these pharmacists b/c they are trying to help the patient and help you save your license from a potential error. A great pharmacist knows that they don't know all of the physiological details going on and that the doctor may have intentionally chosen the lesser of two evils. A crappy pharmacist assumes they know that whole issue and thinks that everything is black and white.
 
this topic somewhat brushes into some others that I tend to get involved in. there is another thread on nurses and their ability to "treat".
I completely agree that multiple perspectives are a very important thing. and if (god forbid) I somehow feel called to old-people medicine I will appreciate someone who is very used to juggling laundry lists of meds expressing concern if something seems off.
One of the things I tend to bring up in these threads is the concept of "I've seen it all" treatment approaches. basically, the totality of your knowledge is all you are aware of so it seems natural to think you know it all - but more often than not, without formal training, this feeling is more representative of a failure of imagination.

IMO nurses are very guilty of this - ive already been told by nurses not to be "one of those A-hole doctors", which is typically related to "i KNEW that pt had xxxxx and after i told the doctor he still didnt believe me and did all his 'unnecessary" tests before doing what I told him to in the first place". I've made this argument in the past but I think it is pertinent to most discussions on inter professional exchanges. from my understanding, its the doc who has his neck stretched out the furthest and it is relatively easy to be a monday morning quarterback from the perspective of nursing and pharmacy. so "not listening" or "stupid scripts" can potentially stem from the same sort of thinking. doctors are fallible, of course. but if we can adapt the football analogy, you dont really gain yardage by running the route YOU think is best when your quarterback called something else.
 
this topic somewhat brushes into some others that I tend to get involved in. there is another thread on nurses and their ability to "treat".
I completely agree that multiple perspectives are a very important thing. and if (god forbid) I somehow feel called to old-people medicine I will appreciate someone who is very used to juggling laundry lists of meds expressing concern if something seems off.
One of the things I tend to bring up in these threads is the concept of "I've seen it all" treatment approaches. basically, the totality of your knowledge is all you are aware of so it seems natural to think you know it all - but more often than not, without formal training, this feeling is more representative of a failure of imagination.

IMO nurses are very guilty of this - ive already been told by nurses not to be "one of those A-hole doctors", which is typically related to "i KNEW that pt had xxxxx and after i told the doctor he still didnt believe me and did all his 'unnecessary" tests before doing what I told him to in the first place". I've made this argument in the past but I think it is pertinent to most discussions on inter professional exchanges. from my understanding, its the doc who has his neck stretched out the furthest and it is relatively easy to be a monday morning quarterback from the perspective of nursing and pharmacy. so "not listening" or "stupid scripts" can potentially stem from the same sort of thinking. doctors are fallible, of course. but if we can adapt the football analogy, you dont really gain yardage by running the route YOU think is best when your quarterback called something else.

I think the one thing we can truly say is that every profession has a few jerks in it...whether pharmacy, nursing, medical, etc. It's pretty hard to generalize beyond that...
 
unfortunately, the curious and argumentative side of me doesn't have time to enroll in all of the various programs lol

I havent taken pharm yet while in med school, but I am aware that everyone hates it.
just looked up the final study guide from our inter-class share page... 102 pages, each page is a different classification of drug (beta-lactam ABX's, penicillins, carbapenems, for a few cell wall active drugs.... insulin analogs... glucosidase inhibitors.... clucocorticoids.... just a breif sampling of the page titles) each with 1-several drugs on it with mechanism of action, adverse reactions, common treatment protocols, contraindications, um.... no mention of price though (which covers a common pharmD complaint I hear about MD's prescribing the expensive stuff 😉)
I'm sure there are plenty of things about the curriculum that we do not cover, but physicians are, after all, the ones prescribing the drugs so I would hope we know as much about their use and action as a pharmacist would...

Some cases beg to differ. I'm not saying that this is the norm (at least I sure hope it isn't!) but it happens: http://www.startribune.com/lifestyle/wellness/136770958.html

As it has been stated several times in this thread already, generally speaking MD is superior in pathophys, diagnosis, etc. whereas pharmD is superior in drug knowledge... and there is nothing wrong with that as long as both professions acknowledge it and respect it. IMO knowing what you don't know is just as important as knowing what you do know.

The best part about inter-professional healthcare is that people can look at a case from different perspectives to come up with the best treatment. The pharmacist's job and knowledge base is to inquire from a drug therapy point of view, and that's not always the best perspective. That's why it generally gets run by a MD who has a more comprehensive knowledge base before making changes.

As far as "picking your battles" goes when inquiring about possible DTPs... if it was my treatment (or say, your grandmother's as some people value such things more than their own) on the line, I would want the best possible and not want it to slide just because people want to avoid confrontation. It would be inefficient and tiring to argue every little point, but if it will make a difference in the patient's outcome then I say go for it. Do so in a respectful and tactful manner and hopefully it will be returned.

And yes... there are jerks in every profession. Always have been, always will be. LeSigh.
 
I think i know what you're saying but we are getting into specifics here. I can't really tell in the article if the mistakes that occurred were due to error or misunderstanding. i.e. did the doctor just goof or was the doctor unaware that this dose was inappropriate for the patient.

basically what I am getting at is, as far as dosing goes I can very easily see myself missing a drug interaction or screwing up a drug name or dose size at some point in my career. the "who knows more" debate seems to imply that a pharmacist would come to me with a script I have given that wasnt a simple error and I would simply be unaware of how my script is inappropriate. This doesn't make sense - a system like this would work better if PharmD's were writing scripts and MDs were just diagnosing.
so clinically and applicationally (no matter how i edited that word I couldnt get the red squiggle to go away.... so i guess ill go with it) I have a hard time accepting that pharmD's would have a broader knowledge of meds. however if we start talking formulations, familiarity with more obscure interactions (i.e. drugs that different specialists may routinely prescribe), alternative and equivalent treatments.... things of that nature I expect a pharmD would kick my butt. i also expect that as my scope of knowledge becomes more focused in residency that I will become more prone to missing things like drug interactions.
 
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I think i know what you're saying but we are getting into specifics here. I can't really tell in the article if the mistakes that occurred were due to error or misunderstanding. i.e. did the doctor just goof or was the doctor unaware that this dose was inappropriate for the patient.

You make a good point. Unfortunately, there's no way of knowing in this case. It's probably a mix given the high rate of errors. The analogy I would draw (probably a poor one... analogies are not my strong suit) is that a mechanic may be able to fix any type of car, but they often have specialties. If you have a BMW you'll want to take it to a mechanic that specializes in BMWs. They may not be able to fix every type of car as well as they would be able to fix a BMW, but they'll do a better job on the BMW than the general mechanic would. Such is MD/pharmD. MD can do a great job with meds, but in the end the pharmD will know better with respect to the meds. It's an imperfect analogy, but you get the idea. You can also look at it from the other perspective and say that a pharmD can look at the meds, but they generally don't have the background to diagnose and look at other possible treatment options outside of the meds.

Either way -- knowledge-related mistake or slip of the pen -- a mistake is a mistake (especially when 92% of the cases had some sort of error... no way is 100% of that oopsies or 100% of that lack of drug knowledge) and it's good to have a safety net in place and be able to acknowledge it. MDs, nurses, pharmDs, etc. are not infallible. The more we collaborate, the better the results will be... other than that collaboration takes extra time and discussion :laugh:. In a perfect world we'd work based on quality of care and not quantity, but at the end of the day the big guys are focused on at least breaking even, if not making a profit.

Edit: wrote this before I saw your edit. You make a good point about MDs diagnosing/pharmDs prescribing... theoretically, I would say that would work best. However, I have not and will never go through MD and you have not and probably won't ever go through a pharmD program, so we could argue in circles all day about who knows more about meds... but there's really no point as there is no finite answer. I imagine it would vary from person to person as well and specialty to specialty as well.
 
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You make a good point. Unfortunately, there's no way of knowing in this case. It's probably a mix given the high rate of errors. The analogy I would draw (probably a poor one... analogies are not my strong suit) is that a mechanic may be able to fix any type of car, but they often have specialties. If you have a BMW you'll want to take it to a mechanic that specializes in BMWs. They may not be able to fix every type of car as well as they would be able to fix a BMW, but they'll do a better job on the BMW than the general mechanic would. Such is MD/pharmD. MD can do a great job with meds, but in the end the pharmD will know better with respect to the meds. It's an imperfect analogy, but you get the idea. You can also look at it from the other perspective and say that a pharmD can look at the meds, but they generally don't have the background to diagnose and look at other possible treatment options outside of the meds.

Either way -- knowledge-related mistake or slip of the pen -- a mistake is a mistake (especially when 92% of the cases had some sort of error... no way is 100% of that oopsies or 100% of that lack of drug knowledge) and it's good to have a safety net in place and be able to acknowledge it. MDs, nurses, pharmDs, etc. are not infallible. The more we collaborate, the better the results will be... other than that collaboration takes extra time and discussion :laugh:. In a perfect world we'd work based on quality of care and not quantity, but at the end of the day the big guys are focused on at least breaking even, if not making a profit.
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I think that the contention here isn't whether pharmacists are useful or not. They are. They're super useful. The contention comes when people bring up clinical pharmacists.

Several pharm students in the above post have stated that it is great to have a "second set of eyes" to double check medications. Absolutely, but that is what a pharmacist does. A clinical pharmacist is this new breed of pharmacist that rounds with physicians and answers questions. I don't really see the point, to be honest, and perhaps some of the pharmacy students can clarify for me. What is the difference in training between a pharmacist and a clinical pharmacist?

Clinical pharmacists should not be diagnosing patients. That is what doctors do. Pharmacists already double check medication orders when they are filled in the pharmacy, so we don't need clinical pharmacists for that. Physicians should know the available medications for the conditions they treat (i.e. that fall within their specialty). If they aren't comfortable treating a disease then they should probably refer it out to another specialty, not treat it themselves with a pharmacist advising them.

In my (limited experience), I have seen clinical pharmacists tagging along on morning rounds. They answer questions and provide advice on how to optimize medication treatments. They seemed to be very helpful to residents, who are still learning, but for the most part the attending physicians never needed to ask them an urgent question. If they did have a question, they could have easily called down to the pharmacy and asked (i.e. is this med on formulary?).
 
What is the difference in training between a pharmacist and a clinical pharmacist?

Clinical pharmacists should not be diagnosing patients. That is what doctors do. Pharmacists already double check medication orders when they are filled in the pharmacy, so we don't need clinical pharmacists for that. Physicians should know the available medications for the conditions they treat (i.e. that fall within their specialty). If they aren't comfortable treating a disease then they should probably refer it out to another specialty, not treat it themselves with a pharmacist advising them.

In my (limited experience), I have seen clinical pharmacists tagging along on morning rounds. They answer questions and provide advice on how to optimize medication treatments. They seemed to be very helpful to residents, who are still learning, but for the most part the attending physicians never needed to ask them an urgent question. If they did have a question, they could have easily called down to the pharmacy and asked (i.e. is this med on formulary?).
Clinical pharmacists have either one or two years of residency past their PharmD.

Pharmacists do not diagnose. Don't worry; nobody's treading on your bread and butter (and frankly, that's not what most of us would want to do).

Attending physicians do utilize the clinical pharmacists at times, especially when a patient is hospitalized and needs something that falls outside the range of knowledge of the physician's specialty (of course, your mileage will vary depending on the physician). Clinical pharmacists also look over patient charts and treatment plans and make sure they are covered for all the necessary medications they might need during the day, especially the ones that might fall through the cracks in more complicated cases (they usually bring these issues up at rounds, should they occur) and look over medication orders to ensure they are indicated, effective, safe and convenient for the patient.
Somehow I think that this thread has gone just a bit off track. :laugh:
I completely agree. I am officially done with it! :laugh: Poor first poster barely had his questions answered before the sidetracking...
 
Clinical pharmacists have either one or two years of residency past their PharmD.

Pharmacists do not diagnose. Don't worry; nobody's treading on your bread and butter (and frankly, that's not what most of us would want to do).

Attending physicians do utilize the clinical pharmacists at times, especially when a patient is hospitalized and needs something that falls outside the range of knowledge of the physician's specialty (of course, your mileage will vary depending on the physician). Clinical pharmacists also look over patient charts and treatment plans and make sure they are covered for all the necessary medications they might need during the day, especially the ones that might fall through the cracks in more complicated cases (they usually bring these issues up at rounds, should they occur) and look over medication orders to ensure they are indicated, effective, safe and convenient for the patient.

I completely agree. I am officially done with it! :laugh: Poor first poster barely had his questions answered before the sidetracking...

what text books are you guys using?
 
i'm not comfortable affiliating with a school per online shenanigans lol.

and our books are largely secondary to the lecture notes. We don't really use them :-/ so im not sure how to answer your questions. although many schools post curriculum on their sites

also, our "syllabi" contain all of the lecture notes, many of which are intellectual property. I suspect I could get myself in hot water for posting them
 
and our books are largely secondary to the lecture notes. We don't really use them :-/ so im not sure how to answer your questions. although many schools post curriculum on their sites

That's mostly how it is here, too. The lecture notes are much more useful, relevant, and important in comparison with the textbooks (though the texts can be useful for confusing lectures).
 
That's mostly how it is here, too. The lecture notes are much more useful, relevant, and important in comparison with the textbooks (though the texts can be useful for confusing lectures).

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the only time I use them is when some lecturer goes against the grain and either adopts some screwy organization system to their material or decided a bullet point skeletal outline is better than actually handing us informaiton
 
ya i dont get that lol. they loan out to us everything we will need.... and even having worked for a few years before starting med school.... my pay grade would literally only remove a drop from the bucket of debt ill be in at the end of all of this. so id rather enjoy my weekends and evenings lol. and oncee 3rd year hits, good luck holding a part time job (this is for med students)
 
I would say that the simple explanation of where the "clinical" pharmacist comes in they are looking closer into the disease states than the normal staff pharmacist. The staff pharmacist will look at meds and interactions as the drugs are ordered/prescribed. The clinical pharmacist is checking those things, but also asking other questions more particular to each patient.

Are we treating this post-MI patient appropriately (ASA, Plavix, ACE-I, B-blocker, statin....are we missing one on purpose or was it an oversight?) Do you really want to treat this infection with an antibiotic that lowers seizure threshold for someone admitted to the ICU with a seizure? Pt was started on a pretty high dose insulin drip, do you want to start a potassium replacement protocol so you don't get a call in the middle of the night? Pt's symptoms and labs could be caused by polyethylene/propylene glycol toxicity from their Ativan drip...maybe choose a different sedative to see if that's the case? Are you sure you'd like to start a 100mcg/hr fentanyl patch on someone who's opioid naive? One of my doc's just tells me to "fix it" in a lot of cases and basically gives me free reign to do something smart (and within my scope of practice/knowledge) that will make the problem go away.

It's a lot of things that the doctors already know, but we're just trying to make sure there's not any gaps in thought process and think one step further than whether the current therapy is safe or not. If they already have thought through it, they'll usually let me in on their thought process and make me a better professional at the same time.

One tip: in order to get the best help from your ancillary staff, be nice and thank them for questioning you even when you're in a bad mood. That way more questions get filtered your direction because they know they won't have a confrontation as a result of their question.
 
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what text books are you guys using?

As a PharmD in medical school, I can tell you that I already owned several of the books I use in med school such as Robbins, Costanzo, Lippincotts Biochem/Microbiology, Abbas Immunology, Goodman&Gillman and Katzung. Of course in pharm we don't study embryology, gross anatomy (I think some schools may), and pathology.

My go to book in pharm school was DiPiro's Pharmacotherapy, which comes in handy in med school too.
 

I believe that is my quote... I am not a troll (but first time I've been called a troll... so thats a milestone)

ya i dont get that lol. they loan out to us everything we will need.... and even having worked for a few years before starting med school.... my pay grade would literally only remove a drop from the bucket of debt ill be in at the end of all of this. so id rather enjoy my weekends and evenings lol. and oncee 3rd year hits, good luck holding a part time job (this is for med students)

I'm making enough (per diem pharmacists here make between 50-60 per hour) to save enough to pay tuition out of pocket for second and third year, I obviously won't work third year, but plan on picking it up again 4th year (if I feel like it). The flexibility is the beauty of per diem work.

So to sum it up for the OP... having a PharmD doesn't count for anything when you enter med school (and for the most part, no-one cares that you have one). One benefit is that pharm lectures are a breeze, which is awesome- and pharm is ~20% of USMLE (or so I've heard). It is not unheard of for PharmD's to go on to medical school (although there will be haters- esp from the pharm world)- we should make a group or something.

Bonus- you can combine your degree as xxxxxx PharM.D.
 
I believe that is my quote... I am not a troll (but first time I've been called a troll... so thats a milestone)



I'm making enough (per diem pharmacists here make between 50-60 per hour) to save enough to pay tuition out of pocket for second and third year, I obviously won't work third year, but plan on picking it up again 4th year (if I feel like it). The flexibility is the beauty of per diem work.

So to sum it up for the OP... having a PharmD doesn't count for anything when you enter med school (and for the most part, no-one cares that you have one). One benefit is that pharm lectures are a breeze, which is awesome- and pharm is ~20% of USMLE (or so I've heard). It is not unheard of for PharmD's to go on to medical school (although there will be haters- esp from the pharm world)- we should make a group or something.

Bonus- you can combine your degree as xxxxxx PharM.D.


I agree.
 
Hi,

I finished my PharmD and went straight into medical school.

From my experience every PharmD program varies dramatically.
Some share classes with medical students while some doesn't.
Some program focuses on research and detailed PK, PD while some focus on graduating more clinical or retail oriented pharmacist.

I found that not only the pharm classes were easier but some other aspects could be easier as well.
For instance, in pharm school I have learned a lot of physiology and biochemistry that are pretty heavily focused in med school as well. The treatment guidelines and algorithm we learned and used during clinical rotation definitely helped in learning and picking out disease treatments on exams.

Don't get me wrong, I still have to study a lot and not like the other post, didn't really have time to work per diem as a pharmacist. That being said, I did know a pharmacist who went to med school and worked almost part time and ends up doing really well in medical school.

Anyhow, if you have any other question feel free to PM me.

best of luck!

-Marke
 
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