The official rotation thread

[Jbrl]

Derailing the thread a bit to post my assigned rotations for next year (starting in May):

(1) Pharmaceutical industry - pharmacovigilance
(2) FDA hem/onc labeling
(3) Off
(4) Acute care/internal medicine - community teaching hospital affiliated with a major academic medical system
(5) Off
(6) Oncology - inpatient, federal hospital (not a VA)
*Winter Break*
(7&8) Ambulatory care - HIV and pediatrics primary care; community
(9) Health systems - psychiatric hospital

Goal: aiming for fellowships. Thoughts and feedback are welcome.


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Nice schedule. Two cycles off (I wish). Aiming onco? Have you had previous pharma exp? Does the pharma company offer fellowships?

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[Digsbe]

How many APPE hours do your school's require you to get? I finish P4 year in May, but I'll post my schedule if anyone has any questions about similar rotations you may have coming up.

June: Inpatient Hospital Staffing at a local community hospital.
July: Community Pharmacy at an independent.
August: Clinical Pharmacy Practice Management at a local community hospital
September: Ambulatory Care - local clinic
October: Heme/Onc at the VA
November: Lab Based Oncology Research in a biology lab
December: off
January: Internal Medicine at a community hospital
February: Inpatient Psychiatry at the VA
March: Stem Cell Transplantation at an academic medical center
April: A second ambulatory care rotation at another local clinic.

 

[y0ssarian87]

Nice schedule. Two cycles off (I wish). Aiming onco? Have you had previous pharma exp? Does the pharma company offer fellowships?

I'm tentatively interested in a few fields that I'm hoping to narrow down shortly: early clinical development, clinical operations, and clinical pharmacology. I have research experience from basic wet lab work to secondary data analysis and demographics research to PK/PD research. I also have some experience with industrial engineering with a very large company, which may (or may not) help with operations. Regarding disease states, I'm mostly interested in oncology and HIV/HCV, though I think I missed the wave for those antiviral products!

I don't have previous pharma experience, only hospital experience. I got an internship offer last summer from Novartis, but I turned it down in favor for another internship. The Novartis internship was more IT/data systems/social media related. I chose the additional clinical and research experience with my internship at the VA. That may hurt me, but I've had extensive clinical experience that will benefit me going forward through my internship -- seeing pts independently and longitudinally in AC clinic, lipid clinic, and in the cardiac ICU.

The pharma company that I'll be rotating with does not have fellowships.


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[y0ssarian87]

How many APPE hours do your school's require you to get? I finish P4 year in May, but I'll post my schedule if anyone has any questions about similar rotations you may have coming up.

June: Inpatient Hospital Staffing at a local community hospital.
July: Community Pharmacy at an independent.
August: Clinical Pharmacy Practice Management at a local community hospital
September: Ambulatory Care - local clinic
October: Heme/Onc at the VA
November: Lab Based Oncology Research in a biology lab
December: off
January: Internal Medicine at a community hospital
February: Inpatient Psychiatry at the VA
March: Stem Cell Transplantation at an academic medical center
April: A second ambulatory care rotation at another local clinic.

Great schedule! Our school requires that we complete 7 blocks of rotations that each last 5 weeks.

40 hr/wk * 5 wk/block * 7 blocks = 1040 hr
In addition we must complete a "pinnacle project" for an additional 40 hrs, thus 1080 hr of APPE.

If I'm not mistaken, we complete 360 hr of IPPE for a total of 1440 experiential hours.


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[Digsbe]

Great schedule! Our school requires that we complete 7 blocks of rotations that each last 5 weeks.

40 hr/wk * 5 wk/block * 7 blocks = 1040 hr
In addition we must complete a "pinnacle project" for an additional 40 hrs, thus 1080 hr of APPE.

If I'm not mistaken, we complete 360 hr of IPPE for a total of 1440 experiential hours.


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Yours doesn't look too bad either, I'm almost kinda jealous. We had to do 350 IPPE hours and a minimum of 1600 APPE (we usually wind up with ~1800). Our rotations are 10 one calendar month, 40hr+ per week with December being our month off. It kinda burns out really fast when you know your next "break" is months ahead and you don't get Spring/Thanksgiving or other holidays. However, I do feel that I've learned multitudes more this year than my 3 years of didactics. Make the most out of your rotations and take advantage of preceptors that want to teach you. You'll get a lot out of it. Are you interested in Onc? I am too so I had a few onc related rotations I put preferences in for (and luckily got). I noticed you have a few too.

 

[y0ssarian87]

Yours doesn't look too bad either, I'm almost kinda jealous. We had to do 350 IPPE hours and a minimum of 1600 APPE (we usually wind up with ~1800). Our rotations are 10 one calendar month, 40hr+ per week with December being our month off. It kinda burns out really fast when you know your next "break" is months ahead and you don't get Spring/Thanksgiving or other holidays. However, I do feel that I've learned multitudes more this year than my 3 years of didactics. Make the most out of your rotations and take advantage of preceptors that want to teach you. You'll get a lot out of it. Are you interested in Onc? I am too so I had a few onc related rotations I put preferences in for (and luckily got). I noticed you have a few too.

I am interested in oncology, but more from the pharmaceutical industry end of things. I'm hoping the FDA rotation will give me more exposure to the regulatory end of things, and the inpatient oncology rotation is at Walter Reed, which is just kind of cool.


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[Digsbe]

I am interested in oncology, but more from the pharmaceutical industry end of things. I'm hoping the FDA rotation will give me more exposure to the regulatory end of things, and the inpatient oncology rotation is at Walter Reed, which is just kind of cool.


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I started out very interested in the clinical side, now I'm leaning more towards research and regulation (although I still like the clinical aspect a lot). Make some connections while on that FDA rotation. I wish I had the plan back then to try and sign up for one like that. I was lucky that I landed a spot in a research lab but having one at the FDA or NIH would be fantastic. Are you going to do a fellowship?

 

[y0ssarian87]

I started out very interested in the clinical side, now I'm leaning more towards research and regulation (although I still like the clinical aspect a lot). Make some connections while on that FDA rotation. I wish I had the plan back then to try and sign up for one like that. I was lucky that I landed a spot in a research lab but having one at the FDA or NIH would be fantastic. Are you going to do a fellowship?

We'll see, I suppose, but that's the goal at the moment.


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[Jbrl]

I'm tentatively interested in a few fields that I'm hoping to narrow down shortly: early clinical development, clinical operations, and clinical pharmacology. I have research experience from basic wet lab work to secondary data analysis and demographics research to PK/PD research. I also have some experience with industrial engineering with a very large company, which may (or may not) help with operations. Regarding disease states, I'm mostly interested in oncology and HIV/HCV, though I think I missed the wave for those antiviral products!

I don't have previous pharma experience, only hospital experience. I got an internship offer last summer from Novartis, but I turned it down in favor for another internship. The Novartis internship was more IT/data systems/social media related. I chose the additional clinical and research experience with my internship at the VA. That may hurt me, but I've had extensive clinical experience that will benefit me going forward through my internship -- seeing pts independently and longitudinally in AC clinic, lipid clinic, and in the cardiac ICU.

The pharma company that I'll be rotating with does not have fellowships.

I don't think you'll be at a disadvantage. From the looks of it you have everything you need to articulate why you'd be a good fit for those 3 specialties. One question that you may have to answer is why fellowship vs. residency/academia, which you can address with your first cycle. For clin dev vs. ops vs. pharmacology, differences from what I've gathered (perhaps you know more) are foundational vs. executional vs. mechanistic. There's overlap but clin dev focuses on CRF/protocol development/writing and med data review while ops is about logistics of managing study sites and deliverables - planning, initiating, maintaining, closing - according to protocol and regulation. Pharmacology self-explanatory - PK/PD, dose escalation, POC testing, etc. Perhaps you can examine your strengths/weaknesses/personality to see what the best fit is from a skill/disposition standpoint. I'm guessing your rotation is at least somewhat related to those 3 specialties, but if not, doesn't really matter, as you can speak to people outside your dept. to get roped into projects if you convey your interest (under the initial guise of networking and learning about their work etc. etc.).

How many APPE hours do your school's require you to get? I finish P4 year in May, but I'll post my schedule if anyone has any questions about similar rotations you may have coming up.

June: Inpatient Hospital Staffing at a local community hospital.
July: Community Pharmacy at an independent.
August: Clinical Pharmacy Practice Management at a local community hospital
September: Ambulatory Care - local clinic
October: Heme/Onc at the VA
November: Lab Based Oncology Research in a biology lab
December: off
January: Internal Medicine at a community hospital
February: Inpatient Psychiatry at the VA
March: Stem Cell Transplantation at an academic medical center
April: A second ambulatory care rotation at another local clinic.

1,440 here. We only have the possibility for one off-cycle.

How was your SCT rotation?

 

[y0ssarian87]

I don't think you'll be at a disadvantage. From the looks of it you have everything you need to articulate why you'd be a good fit for those 3 specialties. One question that you may have to answer is why fellowship vs. residency/academia, which you can address with your first cycle. For clin dev vs. ops vs. pharmacology, differences from what I've gathered (perhaps you know more) are foundational vs. executional vs. mechanistic. There's overlap but clin dev focuses on CRF/protocol development/writing and med data review while ops is about logistics of managing study sites - planning, initiating, maintaining, closing - according to protocol. Pharmacology self-explanatory - PK/PD, dose escalation, POC testing, etc. Perhaps you can examine your strengths/weaknesses/personality to see what the best fit is from a skill/disposition standpoint. I'm guessing your rotation is at least somewhat related to those 3 specialties, but if not, doesn't really matter, as you can speak to people outside your dept. to get roped into projects if you convey your interest (under the initial guise of networking and learning about their work etc. etc.).

Thanks for the wonderful reply and advice!

I just need to make a decision. I'm hoping to reach out to individuals on rotation who have these roles to pick their brain.


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[student089]

I will start rotation in June-ish, I think. We only have 6 rotations :/. I wish to do more, but they won't allow it.
block 1: off
2: PBM
3: IHS New Mexico ambulatory care
4: hospital medical safety
5: off
6: VA-institutional rotation
7: community pharmacy
8: hospital clinical rotation
I only have hospital and retail exp, not managed care and that's what I'm trying to get into.

 

[y0ssarian87]

I will start rotation in June-ish, I think. We only have 6 rotations :/. I wish to do more, but they won't allow it.
block 1: off
2: PBM
3: IHS New Mexico ambulatory care
4: hospital medical safety
5: off
6: VA-institutional rotation
7: community pharmacy
8: hospital clinical rotation
I only have hospital and retail exp, not managed care and that's what I'm trying to get into.

The PBM experience will be helpful, and hopefully at your hospital locations you can ask to get some P&T exposure.


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[Jbrl]

I will start rotation in June-ish, I think. We only have 6 rotations :/. I wish to do more, but they won't allow it.
block 1: off
2: PBM
3: IHS New Mexico ambulatory care
4: hospital medical safety
5: off
6: VA-institutional rotation
7: community pharmacy
8: hospital clinical rotation
I only have hospital and retail exp, not managed care and that's what I'm trying to get into.

Which site are you at? I have IHS cycle 3 also.

 

[student089]

Which site are you at? I have IHS cycle 3 also.

I will be at Crownpoint.

 

[student089]

The PBM experience will be helpful, and hopefully at your hospital locations you can ask to get some P&T exposure.


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hope so.

 

[Jbrl]

I will be at Crownpoint.

!!

 

[Bbed]

I am interested in oncology, but more from the pharmaceutical industry end of things. I'm hoping the FDA rotation will give me more exposure to the regulatory end of things, and the inpatient oncology rotation is at Walter Reed, which is just kind of cool.


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Have you worked in the industry? Applying for residency/fellowship?

 

[y0ssarian87]

Have you worked in the industry? Applying for residency/fellowship?

Unfortunately I don't have experience in industry. And I do plan to apply for fellowships and residency in parallel. With the timeline of the fellowship application process, I will hopefully know whether or not I get an offer prior to accepting residency interviews. But it's all extremely competitive, so we'll see how things pan out.


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[Bbed]

Unfortunately I don't have experience in industry. And I do plan to apply for fellowships and residency in parallel. With the timeline of the fellowship application process, I will hopefully know whether or not I get an offer prior to accepting residency interviews. But it's all extremely competitive, so we'll see how things pan out.


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how much are you expecting to earn as starting salary? is it worth the time and commitment?

 

[y0ssarian87]

how much are you expecting to earn as starting salary? is it worth the time and commitment?

I don't expect a fellowship salary to be much different than what you'd see in residency. But I do think it will pay off in the long run. There appears to be more room for career and salary growth in industry than in pharmacy practice. I think initial salaries after a fellowship tend to fall below what you would see in retail or hospital settings, but I'm not certain. I recommend asking someone more knowledgable than I am! I'm basing my information off of a handful of students/alumni at my school who pursued careers in industry.


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[yungnaira]

FDA, Industry, Cigna, NCPA, Mirixa (MTM)

Not sure what expect from the NCPA one

Starting salary for fellowship is comparable to residency. Although fellowships are a completely different environment.

I was advised to pursue a fellowship or residency BUT NOT BOTH

 

[2013pharmer]

if you are planning to do a hospital residency, what strategy should i use when selecting my rotation sites? choose acute care early?

 

[njac]

if you are planning to do a hospital residency, what strategy should i use when selecting my rotation sites? choose acute care early?

Acute care early, an inpatient elective before midyear if at all possible.

Shows initiative and planning ahead, and also allows for letters of recommendation based on your clinical knowledge.


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[Bbed]

I don't expect a fellowship salary to be much different than what you'd see in residency. But I do think it will pay off in the long run. There appears to be more room for career and salary growth in industry than in pharmacy practice. I think initial salaries after a fellowship tend to fall below what you would see in retail or hospital settings, but I'm not certain. I recommend asking someone more knowledgable than I am! I'm basing my information off of a handful of students/alumni at my school who pursued careers in industry.


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yeah that is a good point...i hear industry pharmacists start around 90 k or so with opportunity to earn more in bonus.

Anybody know industry pharmacist salary?

 

[pharmrx33]

My rotations are as follows:

May- General Medicine at teaching hospital
June- Amb Care at Family Practice site with my favorite faculty member.
July- Hematology at academic medical center
August- Admin at health system I currently work for
September- Transplant at community hospital
October- Cardiovascular ICU at academic medical center
November- BMT at academic medical center
December- OFF
January- Neonatal ICU at pediatric hospital
Feb.- OFF
March- Community at Large Chain

Goal: Residency and eventually critical care

Let me know what you think? Too specific? Not general enough?

 

[njac]

My rotations are as follows:

May- General Medicine at teaching hospital
June- Amb Care at Family Practice site with my favorite faculty member.
July- Hematology at academic medical center
August- Admin at health system I currently work for
September- Transplant at community hospital
October- Cardiovascular ICU at academic medical center
November- BMT at academic medical center
December- OFF
January- Neonatal ICU at pediatric hospital
Feb.- OFF
March- Community at Large Chain

Goal: Residency and eventually critical care

Let me know what you think? Too specific? Not general enough?

I think it looks great considering your goals.


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[2013pharmer]

My rotations are as follows:

May- General Medicine at teaching hospital
June- Amb Care at Family Practice site with my favorite faculty member.
July- Hematology at academic medical center
August- Admin at health system I currently work for
September- Transplant at community hospital
October- Cardiovascular ICU at academic medical center
November- BMT at academic medical center
December- OFF
January- Neonatal ICU at pediatric hospital
Feb.- OFF
March- Community at Large Chain

Goal: Residency and eventually critical care

Let me know what you think? Too specific? Not general enough?

how long is one rotation?

 

[hye345]

Tomorrow is the last day of my last rotation: my (only) retail rotation at an independent pharmacy. This was actually one of my more challenging rotations: most of my experience (both in rotations and in internships) has been in hospital/inpatient setting, so it was a learning curve learning about insurance, counseling, etc... rotations like cardiology, acute care and psych were a cake walk compared to this one.

 

[njac]

Tomorrow is the last day of my last rotation: my (only) retail rotation at an independent pharmacy. This was actually one of my more challenging rotations: most of my experience (both in rotations and in internships) has been in hospital/inpatient setting, so it was a learning curve learning about insurance, counseling, etc... rotations like cardiology, acute care and psych were a cake walk compared to this one.

Honestly, that's awesome.

I fully believe everyone's job has challenging elements and we should respect and validate that. I'm impressed that you didn't blow off the retail rotation at face value and had this experience.

I have zero retail experience, but I shudder when my coworkers belittle the concept. Being a great retail pharmacist may not help you much at our job, but it doesn't mean that it doesn't come with its own challenges and skill sets


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[dbarth101]

how long is one rotation?

One month.

 

[Bbed]

My rotations are as follows:

May- General Medicine at teaching hospital
June- Amb Care at Family Practice site with my favorite faculty member.
July- Hematology at academic medical center
August- Admin at health system I currently work for
September- Transplant at community hospital
October- Cardiovascular ICU at academic medical center
November- BMT at academic medical center
December- OFF
January- Neonatal ICU at pediatric hospital
Feb.- OFF
March- Community at Large Chain

Goal: Residency and eventually critical care

Let me know what you think? Too specific? Not general enough?

wow! 10 rotations? do people usually get this many rotations?

 

[BenJammin]

wow! 10 rotations? do people usually get this many rotations?

We had 9 month-long rotations. January to May, off June and July, then finish off with August to November.

 

[Rockinacoustic]

Derailing the thread a bit to post my assigned rotations for next year (starting in May):

(1) Pharmaceutical industry - pharmacovigilance
(2) FDA hem/onc labeling
(3) Off
(4) Acute care/internal medicine - community teaching hospital affiliated with a major academic medical system
(5) Off
(6) Oncology - inpatient, federal hospital (not a VA)
*Winter Break*
(7&8) Ambulatory care - HIV and pediatrics primary care; community
(9) Health systems - psychiatric hospital

Goal: aiming for fellowships. Thoughts and feedback are welcome.


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The first two rotations will have you set with experiences and hopefully projects to talk about for fellowship interviews. Your school has a good alumni pool of past and current fellows in industry (unfortunately not myself). Be sure to touch base with them before applications come due.

 

[y0ssarian87]

The first two rotations will have you set with experiences and hopefully projects to talk about for fellowship interviews. Your school has a good alumni pool of past and current fellows in industry (unfortunately not myself). Be sure to touch base with them before applications come due.

Thanks for the kind words. I'll be sure to reach out to alumni and other current or former fellows to get some help.


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[Bbed]

We had 9 month-long rotations. January to May, off June and July, then finish off with August to November.

So 3 weeks per rotation? Is that enough time to learn?

 

[KatleyS]

Rotations I remember offered at my university back in the day when I was a student: (FYI, I didn't do all of these, just what I remember)

Drug Information - some Pharmacy journal (unique because it exposes you to the world of publishing)
Indian Health Service - Amb Care
VA - Amb Care
Oncology/Transplant/Surgical - Community Hospital
Infectious Disease/Internal Med/Pediatric ICU/Critical Care/Cardiology - Tertiary Care Hospital/Academic Medical Center
Anticoagulation - (somewhere in Texas - I forget - you had to send an application)
Diabetes Care - some Independent pharmacy
Burn ICU - County Hospital
Compounding - some independent pharmacy

Of course, some of the above were purely elective. I think the most desirable one was the Indian Health Service because it also offered free housing at the site. I don't know if any site does that anymore in this day and age.

I enjoyed the Indian Health Service one the most, but I didn't see myself working there because of how isolated the hospital was from everything. I liked the breadth of services they offered at the time which was epo injections, flu shots, diabetic counseling, medication counseling, etc. Also, I recall the staff were really warm and friendly so that made a difference.

I probably learned the most in the Pediatric ICU but also felt like I really hated pharmacy at that time. It was a tough rotation.

Our rotations were also 8 - 1 month long rotations with the option to do an extra rotation. Some people opted to do the extra.

I probably received a residency advantage in matching because I rotated at one of the sites, so I guess you could say that one of my rotations led to a job offer?

 

[BenJammin]

So 3 weeks per rotation? Is that enough time to learn?

4 weeks and I thought so. It allowed me to get exposure to more types of pharmacy.

 

[njac]

4 weeks and I thought so. It allowed me to get exposure to more types of pharmacy.

Ours were 4 as well.

I enjoyed that we had time for electives.

6 weeks is too long (from preceptors perspective), maybe 5 weeks is the sweet spot.


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[y0ssarian87]

Ours were 4 as well.

I enjoyed that we had time for electives.

6 weeks is too long (from preceptors perspective), maybe 5 weeks is the sweet spot.


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I think "the grass is always greener" applies. Our program does seven 5-week blocks, but we only get 3 electives with a max of 2 non-patient care electives. I'd love to have 4 or 5 electives.

We're required to do the following:
- 1 block acute care/internal medicine
- 1 block health-systems
- 1 block community
- 1 block ambulatory care
- 1 block advanced patient care elective
- 2 blocks any elective

My "any electives" are FDA and a med affairs industry rotation, and my advanced patient care elective is an inpatient medical oncology rotation. I'd love to be able to do an additional critical care or cardiology elective.


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[Bbed]

Did your school let you off for spring break during your rotations?

 

[2013pharmer]

Ours were 4 as well.

I enjoyed that we had time for electives.

6 weeks is too long (from preceptors perspective), maybe 5 weeks is the sweet spot.


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Every school has its own schedule from 4 to 6 weeks. How do the perceptors coordinate this?

 

[njac]

Every school has its own schedule from 4 to 6 weeks. How do the perceptors coordinate this?

Depends.

We have a master schedule and just plug them in.

After one failed experiment I no longer take mor than one trainee (resident +/- student) on rotation simultaneously. So if the spot is already blocked off, it's taken.


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[2013pharmer]

Depends.

We have a master schedule and just plug them in.

After one failed experiment I no longer take mor than one trainee (resident +/- student) on rotation simultaneously. So if the spot is already blocked off, it's taken.


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Do preceptors usually get paid?

 

[njac]

Do preceptors usually get paid?

Depends. Many of the newer schools pay the site for taking a student, but I don't know anyone who actually sees the money.

Our department spends it mostly on educational materials to benefit the whole department.


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[2013pharmer]

Depends. Many of the newer schools pay the site for taking a student, but I don't know anyone who actually sees the money.

Our department spends it mostly on educational materials to benefit the whole department.


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Just curious how much do preceptor gets pay per student?

 

[njac]

Just curious how much do preceptor gets pay per student?

Depends.


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[2013pharmer]

Depends.


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on what factors? what is the price range? i am sure hospital rotation would be more expensive

 

[njac]

on what factors? what is the price range? i am sure hospital rotation would be more expensive

Not prt of my job. I don't believe it's negotiable, I believe it's set by the school. But each school pays differently.


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[Bbed]

Just curious how much do preceptor gets pay per student?

I hear from several hundreds to a couple of thousands.

 

[2013pharmer]

I hear from several hundreds to a couple of thousands.

damn so if a hospital takes 10 students x 2 k = 20 k? do it several times a year!