Landing your dream job - Canadian Healthcare Network
Transcription
Landing your dream job - Canadian Healthcare Network
A supplement from 2013/2014 Student Guide Landing your dream job By Sonya Felix New numbers show it has indeed gotten tougher out there for new pharmacy grads. But there are exciting opportunities for those who know where to look Contents Landing your dream job.............................. 1 Critical appraisal......................................... 4 The Pharm D shift....................................... 8 associate editor Brett Ruffell editor-in-chief Vicki Wood Art Director Lima Kim Publisher Jackie Quemby Account Managers Scott Tweed, Pauline Shanks Rogers Healthcare Group Executive Publisher Janet Smith Editorial Director Rick Campbell Rogers Publishing Ltd. Senior Vice-President and GM Steve Maich Vice-Presidents Immee Chee Wah, Patrick Renard Contents copyright 2013 by Rogers Publishing Ltd. The 2013 Student Career Guide is published by Rogers Publishing Limited. One Mount Pleasant Road, 7th Floor Toronto Ontario M4Y 2Y5 T (416) 764-2000 F (416) 764-3931 tising anywhere [...] in Canada. You should never settle for a job you hate just because it is in the right city. That almost never ends well.” Jason Perepelkin, assistant professor of social and administrative pharmacy, College of Pharmacy & Nutrition, University of Saskatchewan, agrees that the ability to secure a job in any of the 10 cities where schools of pharmacy are located in Canada is difficult and has always been that way, even during the time of bonuses and multiple offers. “[Students] should consider what opportunities are one to two hours away from their dream location,’” he says. “Many times a more rural location offers a greater scope-of-practice for pharmacists and one can learn many invaluable skills and improve one’s practice expertise that would help them secure that dream job in the future.” W hen Allison Tario enrolled in the pharmacy program at the University of Waterloo three years ago, she heard all kinds of horror stories about how hard it would be to find a decent job at graduation. “People said ‘Haven’t you heard that staff and salaries are being cut and drugstores are closing?’ and ‘Why would you want to be a pharmacist?’” says Tario, who has just started her fourth year and hopes to work at an independent community pharmacy after graduation. But despite all the worries about how lots of pharmacies would close as a result of drug policy reforms, she notes that hasn’t happened. “I think pharmacy has adapted well to the changes and will continue to evolve as long as we are open to new ideas and willing to keep learning. I am genuinely excited about the future.” Such optimism might be surprising to some, especially to those who are having trouble landing a job. While more than 92% of registered pharmacists were employed in pharmacy in 2012, more than two-thirds of the remaining 8% were seeking employment, according to the Canadian Institute for Health Information (CIHI), Pharmacist Workforce, 2012. But pharmacy still seems to be a good bet for a well-paid career. “Canada’s Best Jobs 2013,” an annual feature published by Canadian Business, ranked pharmacist as #27 this year, using Statistics Canada data to compare wages and employment prospects. Based on a median annual salary of $95,680 in 2012, pharmacist is the fourth highest paid among the top 50 jobs listed, with wages having increased by 21% between 2006 and 2012. Still, the projected job openings in 2020 are only 0.71 for every person looking for a job. That could mean that three in 10 “Students should develop their own personal brand by thinking about what image they want to project to colleagues and future employers” pharmacists who want a job won’t find one. With that in mind, we asked experts to share some career advice for tomorrow’s pharmacists. Small town advantages While Tario doesn’t yet have a job lined up, she is well aware that prospects are better in smaller communities. “I’m open to working in an underserviced area,” she says. That’s a good idea, according to David Edwards, Hallman director of the School of Pharmacy and associate dean, Faculty of Science, University of Waterloo. “The job market is definitely tighter than it once was. This is especially true in some of the larger urban centres, and I advise students to be open to prac- GOOD TIP: THINK ABOUT YOUR DIGITAL FOOTPRINT! “If something unflattering is posted online, there is a permanent record of that, even after you personally delete it,” cautions Jason Perepelkin, assistant professor of social and administrative pharmacy, College of Pharmacy & Nutrition, University of Saskatchewan. “The vast majority of employers today, before ever contacting you for an interview, will do a search of your digital footprint, and if there is something that doesn’t align with that organization’s brand, your chances of securing an interview are all but gone.” 2 pharmacypractice 2013 StudentCareerGuide CanadianHealthcareNetwork.ca Focus on acquiring skills Getting a job isn’t as big a concern as finding one that encourages initiative, innovation and creativity, says Tario. “I realize I am picky, but I really want a job that is right for me.” To compete in the job market, she is preparing to differentiate herself. “No matter what pharmacy program you go through, the knowledge you acquire is basically the same. So extra skills and any community experience you have is important to show your initiative and leadership qualities.” Dr. Wayne Riggs, professor and associate dean, Faculty of Pharmaceutical Sciences at the University of British Columbia suggests that students prepare by enhancing their soft skills such as verbal and written communications, fostering leadership skills and developing their interpersonal skills. As well, he says that students need to be innovative in developing new practice models as opposed to fitting into current models that appear to be largely saturated. Getting as much experience as possible in a range of different types of pharmacy practice settings is also a good idea, says Edwards. “This will help identify what areas pharmacy students are passionate about.” Pharmacy students at UWaterloo have the advantage of a 16 months of co-op experience that allows them to make connections with a number of pharmacists and potential employers and understand what pharmacy practice is all about in the real world. The preparations for starting a career as a pharmacist should really start the day students receive their acceptance letter to pharmacy school, says Perepelkin. “Networking is a must, especially in a tight job market. Students should develop their own personal brand by thinking about what image they want to project to colleagues and future employers. What must not be lost is the fact that the faculty at your pharmacy school are well connected throughout the country—don’t burn bridges—this goes for employers while in school and SPEP preceptors.” CanadianHealthcareNetwork.ca WATERLOO STUDENTS PRODUCE DRAKE PARODY VIDEO The four University of Waterloo pharmacy students behind last year’s smash hit “Call the Pharmacy” have dropped their latest single. This time the group, which includes Danielle Paes, Bhupender Sayain, Kacie Lunn and Jaskiran Otal, parodied Drake’s “Started from the Bottom” video that the rapper filmed in an Ontario pharmacy. The students say their version, “Started from the Product”, is about pharmacists embracing new opportunities. It’s also about informing both the public and healthcare professionals about the profession. “At the very least, people can hear a little bit about how pharmacists are making a difference and see how the profession is evolving to address challenges within our healthcare system,” says Paes. Catch “Started from the Product” here, and their previous hit “Call the Pharmacy” here. Expect to work hard As Perepelkin notes, even though demand for pharmacists may be far greater than supply once the baby boomers retire, finding a dream job will always be a challenge to secure. “While building the desired practice many struggles occur, including failures, but the one thing that [successful] practitioners have in common is the will to continue on and learn from each experience—good or bad.” And don’t be afraid to dream big. As a new pharmacy student, Tario had never considered opening her own pharmacy, but the idea is growing on her. “Obviously, that won’t happen initially since I first have to find a job where I can continue learning as much as I can,” she says. “Pharmacy is at a delicate point where we are facing numerous budget cuts, changing our compensation model and needing to prove the value of patient-focused care to patients and government. We have to balance making money with providing patient services and I think having my own pharmacy could give me freedom to be as creative and innovative as I want. And that’s pretty exciting.” pharmacypractice 2013 StudentCareerGuide 3 In these changing times, fnding the right partner is essential Critical Appraisal By Bryan Gray 4 pharmacypractice 2013 StudentCareerGuide A drug half-life is defined as the time required for half the quantity of a drug to be metabolized or eliminated. A longer half-life can impart a longer duration of action. Now, what is the half-life of your pharmacy degree? Four years? Ten years? Twenty years? Whatever the actual number may be, it’s guaranteed that much of what you are learning now will drastically change over the span of your pharmacy career. New waves of research trials, guidelines, meta-analysis are being published at an unprecedented rate. At graduation, your CanadianHealthcareNetwork.ca GenMed®, a division of Pfzer Canada, provides a balance of experience and innovation. A Canadian-based supplier of quality generic medicines within one of the world’s largest biopharmaceutical companies, GenMed is committed to conducting business with integrity and the highest ethical standards. With the delivery of multi-source products and resources adapted to meet the demands on your business, partnering with us can help you remain competitive within an ever-changing Canadian healthcare landscape. Talk to us today about our programs and services tailored to help grow your business. © 2013 Pfizer Canada Inc. Kirkland, Quebec H9J 2M5 GENMED is a registered trademark of Pfzer Canada Inc. GenMed, a division of Pfzer Canada Inc., Licensee ® Pfzer Inc., used under license Visit genmed.ca for more information. CA0113GEN005E How to extend the half-life of your education so that you’re always on the crest of the latest evidence-based practice wave FIgure 1 Intensive case/care management Level 3 Complex co-morbidity 3-5 % In person Disease/care management Level 2 Poorly controlled single condition 15-20 % phone Self management Level 1 Self-management 70-80 % of LTC fax Inequalities targeted high risk primary prevention Level 0 Population Wide Prevention, Health Improvement & Health Promotion The Kaiser Permanente Pyramid: When collaborating with prescribers, consider the urgency of the recommendation and best approach. For more minor recommendations, faxing is usually appropriate. For more urgent matters, a phone call is more effective. And if you have the luxury of working in close proximity to prescribers, nothing will get a problem solved faster than walking down the hallway! Modified from www.scotland.gov.uk/Publications/2009/12/03112054/4 clinical knowledge will be at the crest of the evidence wave and you are likely to be the most up-to-date you will ever be. After that…well, it’s up to you. So what’s the solution to extending the half-life of your education and riding that evidence wave for longer? The answer is critical appraisal skills—tools that enable you to assess the trustworthiness and relevance of evidence. Making the tough decision What is each day but a series of conflicts between the right way and the easy way? It takes less effort to swim downstream, taking the path of least resistance. Sure, you could let that prescription for atenolol be dispensed again. Hopefully the aspirin and warfarin will behave themselves and not interact. Perhaps StaYIng uP-to-date WIth evIdenCe Make Sure to SIgn uP For: dynaMed - dynamed.ebscohost.com/about/weekly-update BMJ Best Practice - bestpractice.bmj.com/best-practice/welcome.html MedScape - www.medscape.com/pharmacists BS Medicine podcast - therapeuticseducation.org Mental health - www.morethanmeds.com/more-than-meds-news.html Medication InfoShare - medicationinfoshare.com 6 pharmacypractice 2013 StudentCareerGuide this one time the ezetimibe will actually prevent heart disease. The thing is, you should be headed upstream. When you decide to turn your back on what’s comfortable, routine and what some would call common sense…well, that’s just the beginning of experiencing the challenges and rewards of evidence-based practice. It can be difficult explaining to patients that the diclofenac they’ve taken for years may cause a stomach ulcer or increase their risk for heart disease. It’s tough sharing with a woman that the hormone replacement therapy she’s taken for 10-plus years may increase the risk for breast cancer. From there it only gets tougher. So make sure you’re ready, because the easy way out will always be there, ready to wash you away. Stand true to your anchor of critical appraisal: relative vs. absolute risk reduction; NNTs and NNHs; surrogate vs. clinical outcomes. These are the tools you’ll require to ride the wave of evidence-based clinical practice. Patient-Centered Care: A paradigm shift The term patient-centered care will take on a new meaning. By helping patients make evidence-based decisions regarding their own CanadianHealthcareNetwork.ca health, they will in turn become their own biggest advocates. In using the best available evidence to facilitate patient education and self-management, you support enhanced health literacy and better health outcomes. In my experience, one of the most impactful moments is the completion of a Framingham risk score. The patient’s surrogate outcomes (age, gender, blood pressure, cholesterol) are entered into a risk calculator, which generates a meaningful number for their personal risk of developing heart disease—a clinical outcome. Here is when the patient will usually pause and think, and then look up to me and ask what they should do. This is a teachable moment. I then provide the relative risk reductions for each intervention—quitting smoking, reducing blood pressure, taking lipidlowering therapy—and let the patient decide where they want to focus. Offering recommendations to prescribers You’ve just written a comprehensive, thorough and accurate list of recommendations to the prescriber. As you dial the fated seven-digit number, the fax machine swallows your recommendation. Did it make it? Did the prescriber read it? Days later, your response curls out of the fax machine like a tidal wave. “No,” is the only response to your three-paragraph, 250-word recommendation with an attached reference. No explanation, no rationale, no nothing—just a “No”. This process is fraught with challenges. While many providers are eager to access the knowledge, skill and judgment of the pharmacist, others are less receptive. Issues of territory, hierarchy and politics are often front and centre. At times you may feel as if you are engaged in a battle to ensure that optimal medication management is provided. It can seem a little claustrophobic and scary. That’s just you—your fears; your doubts; your insecurities. It can be tough when your recommendations get shot down. Though you may have the most up-to-date evidence available, my suggestion is to tailor your approach based upon the level of urgency (please see the Kaiser Permanente Pyramid, fig. 1). Staying up-to-date Staying afloat with all the new evidence will be tough. Attend CanadianHealthcareNetwork.ca Student leader honoured You’ve likely heard about her vocal stylings (if not, see page 3). But the university of Waterloo’s danielle Paes, the 2013 Commitment to Care and Service award winner for Student leadership, has much more to offer than her mic skills. Paes belongs to a long list of professional associations (six at last count). Since her first year in the program, she’s also been active in the Canadian association of Pharmacy Students and Interns (CaPSI) and helped coordinate the ontario Pharmacy Students Integrative Summit. In 2012 she was vice president of the university of Waterloo Society of Pharmacy Students, welcomed new pharmacy students as orientation committee chair, and edited the school yearbook. this past year she sat on the pharmacy admissions interview panel at the university, was her student council’s member rep for the Canadian Society of hospital Pharmacists, and was elected to the CaPSI executive, where she is editor of the national newsletter. She takes her love of learning on the road, regularly attending national conferences and local interdisciplinary events. and in her spare time she volunteers with Community action now, helping with the soup kitchen and food drives. Paes is clearly driven by a passion for helping those in need. “I want to be someone who makes a difference in a stranger’s life,” the fourth-year student says on her nomination form. “Pharmacy has given me the opportunity to do this.” conferences, talks, lectures and presentations. Sign up for email updates from evidence databases. Talk with your peers, colleagues and other healthcare professionals. In the not-sodistance future when you eventually have your own pharmacy students working with you, ask them what they have just learned in school! As Theodore Roosevelt once said, “Believe you can and you’re halfway there”. So remember these tips when you get “no” for an answer: • Stay true to the anchor of critical appraisal. • Hone your collaborative relations. • Stay up-to-date. These approaches will help extend the half-life of your education so you can continue to provide the best level of care for your patients. pharmacypractice 2013 StudentCareerGuide 7 The PharmD Shift PHARMACY IS OPPORTUNITY AT SHOPPERS As schools upgrade to entry-level doctor of pharmacy programs, what will change and what will the move mean to you? By Joe McAllister S tudents Sumaira Hasan and Danielle Paes are happy with the way the University of Waterloo is instituting its new entry-level doctor of pharmacy (ELPD) degree. Although they’re still waiting for details of how they will transition into the program. The two pharmacy students are part of Waterloo’s existing bachelor of pharmacy program. But this January the school enrolled its first ELPD class. In December, Hasan finished a co-op turn at the Canadian Pharmacists Association in Ottawa. She hopes to transition to the PharmD program and is awaiting details on entrance requirements. “I am very happy with the curriculum changes being considered,” she wrote in an e-mail. “At the University of Waterloo, students are consulted at the end of every school year for their feedback regarding coursework, course load, and course con- tent … They take student consultations very seriously.” Fellow student Paes says she expects to graduate with a bachelor of pharmacy (BScPhm) degree, but is considering upgrading to PharmD status in the future. After the faculty held a number of town hall meetings about the change, she thinks about 90% of current Waterloo BScPhm students will upgrade. “I am thrilled that this option will be available to me.” Waterloo, like most of Canada’s faculties of pharmacy, seems to be ahead of the PharmD game. Canadian pharmacy faculties pledged two years ago to upgrade their curriculums to ELPDs by 2020. It looks like most will achieve their goal by enrolling their first ELPD classes three or four years before the deadline. Gradual acceptance Less than 10 years ago many in the pharmacy community were opposed to the upgrade. But the profession eventually under- Helping Patients Improving Outcomes Ongoing Learning Starting a career as a Pharmacist can be complicated. But it doesn’t have to be. It can be simple, if you start with Shoppers. Opportunity abounds here. Benefit from our strong brand, ongoing education and a network of support. Work as a Community Pharmacist, to improve patient outcomes, learn new skills and work with a caring team in your community to build a rewarding career. Learn more. Do more. Find more ways to care with Shoppers Drug Mart. BUILD YOUR CAREER FOR THE BETTER www.shoppersdrugmart.ca/pharmacy Scan with your mobile phone to watch a video and hear what it’s like working as a Pharmacist at Shoppers Drug Mart. 8 pharmacypractice 2013 StudentCareerGuide CanadianHealthcareNetwork.ca stood the need to change to meet the challenges pharmacists will face in the future, as front-line professionals dealing more directly with patient’s needs. “I’m all for it,” says David Hill, Dean of Pharmacy and Nutrition at the University of Saskatchewan. Hill also chaired the Blueprint for Pharmacy Task Force , a collaboration of national and provincial pharmacy organizations. The task force reported in 2009 and, among other groups, lent its support to the move to PharmD. “It is a move that had to take place. I spent a number of years at the University of Colorado where the first professional degree is a PharmD. The idea of going back to a baccalaureate program makes little sense. The complexity of the healthcare system, drug therapy and patient management problems are such we can no longer pack all of that in a four-year baccalaureate program.” The first class of PharmD students at the University of Saskatchewan will be enrolled in 2016. “We are like most of the other schools right now, engaged in specific curriculum redesign processes that will lead to new curriculums (and) new doctor of pharmacy programs. Apart from the programs already there— Toronto, Montreal and Laval—the rest of us have committees in place that are actively engaged in the redesign process. “Our target date is 2016 … and the other universities all seem to be converging around 2015 or 2016 for the start of new programs.” The two Quebec universities are ahead of other schools; the University of Montreal has already graduated its first PharmD class, while Laval enrolled its first PharmD students two years ago. The University of Toronto enrolled its first class of PharmD student in September, 2013, and has now had its program approved by accrediting agencies. U of T and UBC’s existing postgrad PharmD will continue. The University of Waterloo, which operates on a semester system, was able to enroll its first PharmD class in January, 2014. AlbertA hAs other plAns students in the first years, says Dr. David Edwards, dean of the faculty of pharmacy at the University of Waterloo. “The classroom component won’t be changing too dramatically. (We) only started our pharmacy program in 2008, so it didn’t require drastic change. The most substantial change is the change in clerical experience our students will get,” The four BScPhm co-op placements, which were part of Waterloo’s curriculum, will be reduced to three, and a sixmonth clinical rotation focused on direct patient care added. “At Waterloo, co-op is the strength of the university, and we’ve applied that to pharmacy program. We have been met with a lot of success and enthusiasm. We’ve had a focus on the business aspect of pharmacy and I’m sure other programs will put their own unique twist on the program as well,” says Edwards. Despite Waterloo’s emphasis on co-op, he thinks Canadian pharmacy programs will all be similar. “They won’t be wildly different. We all have to meet the same accreditation standards.” As pharmacists’ scope of practice has expanded, we need to ensure the curriculum reflects that What change will look like Although entrance requirements will probably include more foundation courses in science and other subjects before acceptance, ELDP students won’t find a huge difference from BScPhm 10 pharmacypractice 2013 StudentCareerGuide The U.S. example The Canadian programs will be similar to the established American PharmD programs, familiar for many in Canada’s pharmacy faculties. Many, like Hill and Edwards, have taken advanced degrees, or taught, in the U.S. Neil MacKinnon, a Canadian, has crossed the border more than once. He earned his doctorate at a U.S. university, returned to Dalhousie for 12 years in the pharmacy faculty, served as president of the Canadian Society of Hospital Pharmacists, and was appointed dean of the University of Cincinnati this past year (2013) after a stint teaching at the University of Arizona. “It’s an interesting dynamic in that the U.S. made the move 10 or 15 years ago, so it is all entry-level PharmD here. “It’s a very large change in Canada … I think there is a sense in the profession that it is a good thing. As pharmacists’ scope of practice has expanded, we need to ensure the curriculum reflects that.” But he adds a word of warning for students enthusiastic about the change: “Putting my scientist, evidence-based hat on and asking where is the evidence that pharmacists graduating with a PharmD do better than those with a bachelor’s degree? There really is none as far as I know.” CanadianHealthcareNetwork.ca And he doesn’t believe all of Canada’s new PharmD graduates will end up utilizing their advanced skill set. “There is considerable variation between jurisdictions, provincial or state, with a very wide variation of what pharmacists are doing. Some community pharmacists are still more traditional dispensing and a bit of counselling. In others they are doing disease management. In the U.S. there is something called Medication Therapy Management (MTM), while in Canada there are obviously medication reviews, among other things. “In the hospital setting there is a similar dynamic. Some hospital pharmacists are still doing distributive functions, maybe not seeing patients at all, where others are using very, very advanced skills.” More real world experience At his school, fourth-year students spend the entire year in clinical placements, which is part of the reason tuition is about $17,000 a year. That figure is low for U.S. pharmacy schools. Yearly tuition can be $40,000-plus at U.S. private, as opposed to state-run, universities. “Part of it is additional costs for preceptors. That is a challenge every pharmacy school in Canada is going to have to face in the first years,” he says. Canadian students may not find the additional clinic work is as valuable as they hoped. “As we move into PharmD will schools have bachelor-trained pharmacists precept PharmD students? That is an interesting question. Until there are a large number of PharmD preceptors, that is a challenge the schools will face.” In the sparsely populated Prairies, the University of Saskatchewan does not have access to the many sites for clinical experience available in population centres like Southern Ontario, admits Hill, but he doesn’t foresee problems. “We do know this is going to be a major undertaking for our college, as it will be for all the other programs ... We know getting the clinical sites are going to be a challenge for all of us. “We’ll probably have a broader range of clinical placements than we have ever had before. We will be innovative and creative about the type of practice sites we have available. I expect international placements will be part of our plan. “Saskatchewan’s healthcare system has developed a number of primary-care centres new to the province, and these have great environments to place students to train in a professional environment with physicians and nurses.” At Waterloo, Edwards says, “We’ve been going out around CanadianHealthcareNetwork.ca the University of Alberta is not going to an entry-level to pharmacy doctorate route. this past fall the faculty enrolled its first dozen bscphm graduates into its inaugural pharmD course, a 14-month program that will concentrate on patient care. the bachelor’s program will still lead to professional accreditation. In future years, the pharmD program is expected to attract practising pharmacists who wish to upgrade their qualifications. the U of A has also introduced Canada’s first MbA/ bscphm program in pharmacy, a 12-month course-intensive business program taken before the fourth year of a bscphm program. students completing the requirements graduate with a dual MbA/bscphm degree. the province talking to hospital and community pharmacists and pharmacists in family health teams. I think there is a lot of enthusiasm, and I’m optimistic we will have enough clinical training sites. “Because we are in a smaller urban setting without teaching hospitals, we needed to reach out to the pharmacy practice community in the province.” What about my bachelor’s degree? Another problem most schools will face is how to handle existing BScPhm students or recent graduates. At Waterloo, Hasan will probably be allowed to transition into the PharmD program with an extra year of schooling, while Paes will have the opportunity to upgrade her degree after graduation. At Saskatchewan, the school will offer distance learning courses allowing present BScPhm grads to earn their PharmD designation. Hasan says she understands at Waterloo that the 2016 graduating class will be the first to have the opportunity to transition from BScPhm to PharmD. “Being a young pharmacy school, Waterloo has taken advantage of the feedback that students provide, and they actively incorporate all comments and concerns into the curriculum.” No one expects the quality of students or number of applicants to change greatly. At most schools up to 50% of students already hold a BScPhm before being admitted to pharmacy. Most schools already have admittance criteria placing emphasis on a candidate’s personal and community interaction, and not just academic marks. “Personally, I am quite happy and encouraged to see our curriculum transform to meet the educational needs for our evolving pharmacy practice. As a result of the modifications made to our training, I believe pharmacy students graduating today will be well equipped to take on the expanding scope of pharmacists within Canada’s healthcare system,” agrees Paes. pharmacypractice 2013 StudentCareerGuide 11