Rotations Cancelled

[owlegrad]

My college just sent an email informing preceptors that for this block and next students will not be physically present for the rotation and instead rotations will be virtual. They ask for preceptors to accommodate that decision and make that experience available. I can’t speak for other preceptors but I certainly am not equipped to do that and I don’t suspect that most preceptors will be either. They say for blocks after next the situation is “fluid”.

I wonder how many students won’t be able to graduate on time due to this. Or if each “virtual” preceptor will agree to take 30+ students at a time.

---

Members don't see this ad.

 

[Sine Cura]

Might as well just make it a glorified NAPLEX prep block. We all know some of these students could benefit from that time assuming they know how to study.

Even retail though you can learn a lot about how pharmacists handle (or fail to handle) crap in real time. Cannot simulate that effectively

 

[mentos]

"Fluid" is the buzzword of 2020. Every damn staff meeting and conference call includes that word 100 times.

 

[Hels2007]

"Fluid" is the buzzword of 2020. Every damn staff meeting and conference call includes that word 100 times.

I don't think I have heard it at all... maybe it's just your organization.

I fail to see how a 'virtual' rotation would work unless, maybe, it's a drug information rotation.

 

[owlegrad]

I forgot to mention my favorite part of the communication is that it was just a week ago they communicated how critical students are to pharmacy and what a great opportunity this is for them to learn how to handle major public health issues blah blah blah. What a difference a few days can make.

 

[Hels2007]

That's like my school saying "pharmacists are essential personnel, so even when the whole city shuts down for a snowstorm and icy roads, pharmacy students should show up for class" - and then a student was killed in a car accident on the way to class. After that, they started to cancel classes whenever the rest of the university did.

 

[owlegrad]

Yeah the doublespeak is off the charts for this one.

Another fun one - we received a communication today that suggested that if we run out of masks or other PPE for our IV dept (a very real concern - thank you to the people who are creating a needless shortage) the BOP might allow for “pharmacists discretion” in dealing with that situation. I don’t know wtf that means but if my bosses want me to initial a product that I know wasn’t compounded to USP standards I am going to need a hell of a lot more that “use professional discretion”. TF does that even mean?

 

[farm4real]

Yeah the doublespeak is off the charts for this one.

Another fun one - we received a communication today that suggested that if we run out of masks or other PPE for our IV dept (a very real concern - thank you to the people who are creating a needless shortage) the BOP might allow for “pharmacists discretion” in dealing with that situation. I don’t know wtf that means but if my bosses want me to initial a product that I know wasn’t compounded to USP standards I am going to need a hell of a lot more that “use professional discretion”. TF does that even mean?

The obvious interpretation : all financial liabilty is held by the pharmacist... approve or disapprove either way

 

[Dred Pirate]

I got the same letter today - glad I don't have any students for at least 6 months - not sure how the heck I could do a emergency medicine rotation virutally - especially since I try to focus on the common sense, real life applications of what a rph does (vs the pie in the sky view often taught in school). I have a feeling schools will be scrambling, but they will come up with something to avoid keeping kids from graduation (rotations taught virtually by their academic staff using simulated patients, etc)_

 

[KARM12]

Honestly, with all the crap going on the last thing I have time for is to set up a virtual rotation.

 

[RxEvileye]

Have seen schools cancel rotations but if there were just a couple weeks left they say the students had enough hours and are just set to graduate now.

For any doing "virtual" rotations I would think you can just give them a bunch of projects or topic discussions? Maybe patients (deidentified if no remote access) to work up for you and present here and there?

 

[zelman]

If they aren’t willing to end up on a ventilator because they were taking care of patients they can GTFO of pharmacy. Show up or drop out. It’s not like last year’s graduates can skype into the IV room.

 

[gwarm01]

If they aren’t willing to end up on a ventilator because they were taking care of patients they can GTFO of pharmacy. Show up or drop out. It’s not like last year’s graduates can skype into the IV room.

Now THAT'S passion

 

[lord999]

If they aren’t willing to end up on a ventilator because they were taking care of patients they can GTFO of pharmacy. Show up or drop out. It’s not like last year’s graduates can skype into the IV room.

Working in the sector myself, I disagree. If you're not prepared to work, get out of the way, but don't necessarily step out of the health care profession. We are supposed to police ourselves on when we are not up to the task, and step back for those who can. Some students don't have that level of preparation, and I understand. The last thing we want is some undertrained student doing something catastrophically stupid, and they don't have the professional level to measure up when their lack of knowledge could be consequential.

Now, if you do work in a situation where that's a known hazard as a fully qualified and licensed pharmacist, I agree somewhat with you. Although the above still applies in terms of competency, there is a level of expectation that we can measure up to the work environment and it's on us to do so. But, there are exceptions. I'd send the >70 yo pharmacists home for remote verification than have them here over the risks. In the place I'm working right now, we are definitely not confined to the same areas so that we don't co-infect each other, and there is forced relief to avoid overworking.

 

[owlegrad]

Have seen schools cancel rotations but if there were just a couple weeks left they say the students had enough hours and are just set to graduate now.

For any doing "virtual" rotations I would think you can just give them a bunch of projects or topic discussions? Maybe patients (deidentified if no remote access) to work up for you and present here and there?

I don’t want to speak for other preceptors but honestly six weeks of remote topic discussions, journal club, and case presentations sounds like hell to me. There is no way I could (or would want to) do that and keep up with my actual job.

For me, rotations are all about practical experiences. I just weave topic discussions into our work. You don’t get practical experience doing BS classroom work from home.

 

[VA77]

Can you submit virtual hours to state BOP for required hours? I going to guess so cause it is a free for all right now.

 

[297point1]

First: this is a crap plan by UF. Virtual or simulated hours have a limited place in core APPEs, and can't be the entire rotation- ACPE has said as much. This is sketchy.

That being said: it is beyond bad to be asking preceptors to babysit APPE students. Isn't that what the clinical faculty are for? A good number of them aren't allowed to have students at their sites anyways- they should be the ones stepping up to develop and execute whatever UF is trying to do here. In most instances, it's not like the hospitals are paying their salaries.

This all sounds so shady; UF alums should be embarrassed. I'm embarrassed for you.

 

[KARM12]

Let the faculty in the college of pharmacy figure it out.

 

[Cyanisland]

My university's college of medicine canceled their clerkships, but our dean keeps saying similar things to above, that we are indispensable assets to the healthcare team and this is what we signed up for. Not only did the University cancel graduation, they eliminated in-person classes for the rest of the semester, extended undergrad spring break by a week, and are screening all staff and public entering the hospital. Most surgeries were canceled as well. Discharges have been expedited to free up space in the hospital. After all that, they aren't allowing us to stay home. Students aren't even allowed to work on or with COVID cases altogether. I feel like ACPE won't be that petty as to hold everybody back......I just matched at one of my top sites for residency too. That'd be a bummer if they messed it all up.

 

[sfachine]

Yeah the doublespeak is off the charts for this one.

Another fun one - we received a communication today that suggested that if we run out of masks or other PPE for our IV dept (a very real concern - thank you to the people who are creating a needless shortage) the BOP might allow for “pharmacists discretion” in dealing with that situation. I don’t know wtf that means but if my bosses want me to initial a product that I know wasn’t compounded to USP standards I am going to need a hell of a lot more that “use professional discretion”. TF does that even mean?

It means take the stupid regulation book out of your ass and apply common sense,

 

[owlegrad]

It means take the stupid regulation book out of your ass and apply common sense,

That's nice. And when a patient gets sick or the board decides your judgement was wrong? I am fine with the board saying that in the event you run out of masks you may "sterile" compound without them, but I am not ok with bring told "use professional judgement". Does that mean I should outsource all sterile compounding until we can get more masks? That I should find a mask no matter what it takes? After all "common sense" tells me it is impossible to make a sterile compound product without a mask.

I don't even REALLY mind if my employer told me to compound without a mask. After all, what are we going to do, outsource all our IVs? Not likely. What I dislike, and what I was referencing, was the hypocrisy of not just coming out and saying it. Don't flower it up with euphemism, just come right out and say it. The purpose of saying "use professional judgment" to me seems like it is a way to shift liability/responsibility to the pharmacist.

"We NEVER told our pharmacists to break USP standards, it is common sense to follow all laws and we are SHOCKED our pharmacists would not use their professional judgement to solve this problem in accordance with all laws and company policy, SHOCKED I say!"

 

[Pharmacy is a Scam]

This is just the beginning. If all testing centers like Pearson Vue are shut down indefinitely then even if ACPE waived requirements to let the 2020 grads graduate anyways, they will still be in limbo and unemployable because they won't have a pathway to getting licensed. Speaking of which, it looks like Pearson has already closed down for the next month:

Important test delivery information pertaining to COVID-19 (coronavirus)

Find the latest information about the impact of the COVID-19 (coronavirus) on Pearson VUE testing in affected areas.

home.pearsonvue.com

and given that schools are being cancelled until at least the summertime, I doubt they will be letting anyone test until starting in July. It can't get any worse for this year's graduating class.

 

[VA77]

That's nice. And when a patient gets sick or the board decides your judgement was wrong? I am fine with the board saying that in the event you run out of masks you may "sterile" compound without them, but I am not ok with bring told "use professional judgement". Does that mean I should outsource all sterile compounding until we can get more masks? That I should find a mask no matter what it takes? After all "common sense" tells me it is impossible to make a sterile compound product without a mask.

I don't even REALLY mind if my employer told me to compound without a mask. After all, what are we going to do, outsource all our IVs? Not likely. What I dislike, and what I was referencing, was the hypocrisy of not just coming out and saying it. Don't flower it up with euphemism, just come right out and say it. The purpose of saying "use professional judgment" to me seems like it is a way to shift liability/responsibility to the pharmacist.

"We NEVER told our pharmacists to break USP standards, it is common sense to follow all laws and we are SHOCKED our pharmacists would not use their professional judgement to solve this problem in accordance with all laws and company policy, SHOCKED I say!"

I wonder if New England compounding said they were using professional judgement. Yep, it is just a way to shift the liability. Sometimes you can cause more harm by trying to overextend what you can safely do.

 

[sakigt]

Between working my shifts, sleeping and taking care of my kids (not just keeping them alive and fed but taught!) the last thing I need on my plate is virtual teaching. Luckily my student saw most of the stuff he needed to see so I feel comfortable passing him.

 

[SClENCE]

Maybe the student could have access to patient charts from home via hospital laptop and work up every pt each day then present the pt on the phone/video chat? That's the only way I could see the rotation going unless they just do DI questions/topic discussions/busywork the entire month.

That's how my internal med rotation went anyways. Get a list of 8 patients each having 10 problems, show up at 7am, have 2.5 hours to work up 8 patients, then meet preceptor at 9:30am to present every pt and go to real rounds at 10am. Then I went on ID rotation and had 4 hours to work up just 2 patients lol.

 

[Pharmacy is a Scam]

Maybe the student could have access to patient charts from home via hospital laptop and work up every pt each day then present the pt on the phone/video chat? That's the only way I could see the rotation going unless they just do DI questions/topic discussions/busywork the entire month.

That's how my internal med rotation went anyways. Get a list of 8 patients each having 10 problems, show up at 7am, have 2.5 hours to work up 8 patients, then meet preceptor at 9:30am to present every pt and go to real rounds at 10am. Then I went on ID rotation and had 4 hours to work up just 2 patients lol.

Hospital laptop lol. I doubt most hospital PHARMACISTS have a laptop, let alone their own PC.

 

[SClENCE]

Hospital laptop lol. I doubt most hospital PHARMACISTS have a laptop, let alone their own PC.

Every hospital I went to they had a laptop or surface book to take on rounds and their own office

 

[confettiflyer]

One of my schools outright cancelled rotations, which is MUCH better than telling preceptors “hey develop a remote rotation with a few weeks notice”


Sent from my iPhone using SDN

 

[mentos]

Now THAT'S passion

Should be no issue since every pharmacy student has a passion for pharmacy. That's the main reason they joined the profession right?

 

[RxEvileye]

I don’t want to speak for other preceptors but honestly six weeks of remote topic discussions, journal club, and case presentations sounds like hell to me. There is no way I could (or would want to) do that and keep up with my actual job.

For me, rotations are all about practical experiences. I just weave topic discussions into our work. You don’t get practical experience doing BS classroom work from home.

Agree not ideal, more suggestions for finishing out a rotation in progress, not a substitute for an entire block.

Developing an entire remote rotation out of your existing work instead of just having students get a different experience like admin/drug info etc is asking a lot. Hope it works out for you.

 

[Xenophylia]

I personally think the idea of virtual education is great! After all, the most these students will ever have are "virtual" jobs so it seems kinda fitting, doesn't it?

 

[zelman]

Now THAT'S passion

I assure you, it’s entirely devoid of passion. It’s work ethic.

 

[Pharmacy is a Scam]

I personally think the idea of virtual education is great! After all, the most these students will ever have are "virtual" jobs so it seems kinda fitting, doesn't it?

If by "virtual" jobs you mean no jobs (and therefore they are permanently 'working at home' [on their resumes]) then yes I agree with you.

After all, letting students run amok on a "virtual" rotation is still infinitely better than the alternative.

 

[Pharmacy is a Scam]

One of my schools outright cancelled rotations, which is MUCH better than telling preceptors “hey develop a remote rotation with a few weeks notice”


Sent from my iPhone using SDN

I mean the schools already collected your spring tuition check so they could care less if you had an actual rotation or not at this point.

 

[Xenophylia]

If by "virtual" jobs you mean no jobs (and therefore they are permanently 'working at home' [on their resumes]) then yes I agree with you.

After all, letting students run amok on a "virtual" rotation is still infinitely better than the alternative.

I mean virtual as in they can pretend they have a job by filling rxs for play dough in their safe space in their parents' basement. Is that a bit more clear?

 

[Pharmacy is a Scam]

I mean virtual as in they can pretend they have a job by filling rxs for play dough in their safe space in their parents' basement. Is that a bit more clear?

Yeah. I suppose anyone can say that they "have a job" regardless of income status. If a "stay at home mom" is considered by society to be a full-time job (and there's nothing wrong or stigmatizing about that), then a "stay at home new pharmacy grad with $200k+ debt" is also a full time job that shouldn't be stigmatized, right?

 

[JustFillIt]

I just agreed to take a student starting next Monday.. I told them no at first as I am very limited in my line of work right now. They asked me, “can you be creative?”... I agreed with the idea that they will be doing a lot of remote work.

 

[confettiflyer]

I mean the schools already collected your spring tuition check so they could care less if you had an actual rotation or not at this point.

Just shoot out some power points. I don’t want to babysit their students online.


Sent from my iPhone using SDN

 

[farm4real]

My university's college of medicine canceled their clerkships, but our dean keeps saying similar things to above, that we are indispensable assets to the healthcare team and this is what we signed up for. Not only did the University cancel graduation, they eliminated in-person classes for the rest of the semester, extended undergrad spring break by a week, and are screening all staff and public entering the hospital. Most surgeries were canceled as well. Discharges have been expedited to free up space in the hospital. After all that, they aren't allowing us to stay home. Students aren't even allowed to work on or with COVID cases altogether. I feel like ACPE won't be that petty as to hold everybody back......I just matched at one of my top sites for residency too. That'd be a bummer if they messed it all up.

Indispensable team members are usually not shuffled off to watch “Khan academy” type videos and answer a few questions to finish their doctorates....

Pharmacists are the “Fredo”s of health care....just give us something to do so we feel important (virtual rotations ......I’m smart !!!!!) and leave the important stuff to real health care workers (???)

Shame APhA!

 

[allantois]

This is just the beginning. If all testing centers like Pearson Vue are shut down indefinitely then even if ACPE waived requirements to let the 2020 grads graduate anyways, they will still be in limbo and unemployable because they won't have a pathway to getting licensed. Speaking of which, it looks like Pearson has already closed down for the next month:

Important test delivery information pertaining to COVID-19 (coronavirus)

Find the latest information about the impact of the COVID-19 (coronavirus) on Pearson VUE testing in affected areas.

home.pearsonvue.com

and given that schools are being cancelled until at least the summertime, I doubt they will be letting anyone test until starting in July. It can't get any worse for this year's graduating class.

states could issue some kind of provisional licenses

 

[farm4real]

states could issue some kind of provisional licenses

God no!!! Given the quality of new graduates, many of whom can’t even pass naplex, this would be a danger to the public.

BOPs are there to protect the public first

 

[Pharmacy is a Scam]

states could issue some kind of provisional licenses

Provisional licenses are a new grad's dream

 

[bacillus1]

My coworker and I are holding a virtual internal med rotation. The VA just lifted its ban on non-VA-sanctioned teleconferencing software to reach patients, so they can counsel patients via Zoom. We are co-precepting 2 students, so we won't necessarily need to both meet the students every day. A lot of it will be, as someone above said, a "glorified NAPLEX prep block", but we will still send de-identified patient data to them. For now, our census is down, so we have some time to dedicate to the students. I'm sure the situation is completely different in a retail setting.

 

[cuedee]

A virtual/remote rotation is possible depending on your practice setting. I work in ambulatory care and managed care environment. My student worked in the office for maybe 2 weeks then I sent her home to work when COVID19 cases emerged in our area. She attended meetings via telephone, completed transitions of care, managed anticoagulation and many other assignments remotely. Working with her in the office for a few weeks really helped her build a rapport with me and other members of the team which helped facilitate communication when she worked remotely.

 

[Traziiramate09]

If they aren’t willing to end up on a ventilator because they were taking care of patients they can GTFO of pharmacy. Show up or drop out. It’s not like last year’s graduates can skype into the IV room.

Booo!

 

[297point1]

A virtual/remote rotation is possible depending on your practice setting. I work in ambulatory care and managed care environment. My student worked in the office for maybe 2 weeks then I sent her home to work when COVID19 cases emerged in our area. She attended meetings via telephone, completed transitions of care, managed anticoagulation and many other assignments remotely. Working with her in the office for a few weeks really helped her build a rapport with me and other members of the team which helped facilitate communication when she worked remotely.

That all works well and fine in your setting (and thank you for stepping up to help out students). Some of our students who have industry or managed care rotations are doing them remotely, and I don't have a problem with that. I can even begrudgingly accept the internal medicine rotation that @bacillus1 described- it's not ideal, but it checks the boxes.

I can't accept that people are going to get a quality community pharmacy or institutional pharmacy rotation while staying at home. It's just not the same; how do you simulate dispensing prescriptions or working in a USP 797 compliant compounding environment? I've seen plans that other pharmacy programs are utilizing to create and deliver these virtual rotations - they are an absolute joke. ACPE cracked open the door a little bit, and some schools have not only kicked the door open, they also took the door off of its hinges and are storing it in the basement. [Yes, this has me fired up.]

 

[Pharmacy is a Scam]

I can't accept that people are going to get a quality community pharmacy or institutional pharmacy rotation while staying at home. It's just not the same; how do you simulate dispensing prescriptions or working in a USP 797 compliant compounding environment? I've seen plans that other pharmacy programs are utilizing to create and deliver these virtual rotations - they are an absolute joke. ACPE cracked open the door a little bit, and some schools have not only kicked the door open, they also took the door off of its hinges and are storing it in the basement. [Yes, this has me fired up.]

They should just hold all the P4's back from graduation 6-9 months if they can't do their rotations then. Not like there will be a shortage of pharmacists if we didn't let this class of 15,000 students hit the market. Plus, nobody is going to be able to take their board exams for at least the next 3 months anyways so no point in graduating on time.

 

[BidingMyTime]

If they aren’t willing to end up on a ventilator because they were taking care of patients they can GTFO of pharmacy. Show up or drop out. It’s not like last year’s graduates can skype into the IV room.

I suspect one of the issues is liability. A student on rotation gets sick and dies of COVID, so their parents/spouse/children sue the school, for sending their child to an unsafe rotation.

 

[Thoughtfulsinner]

Pharmacy rotations are useless anyway.