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PAGE 1
UNIVERSITY POINT of CONTACTN E W S L E T T E R
Inside this issue:
Winter 2017 Putting Myself in the Public Heath Service’s Shoes: Experience at the FDA
Submitted by ENS, Jennifer, Tsan
Asafirst-yearpharmacystudent,Ivolunteeredatmyschool’scommencementandwatchedthegraduatingclassreceivetheirdegrees.Icouldn’twaittobeintheirshoes!Duringtheevent,Irememberseeingamaninauniformandwonderedwhatanairplanepilotwasdoinghere.Ilaterlearned,frommyPublicHealthelective,thathewasanotapilot,butaUnitedStatesPublicHealthService(USPHS)Officer.
One may ask, what exactly is the USPHS?TheUSPHSisafederaluniformedserviceofhealthprofessionalsdedicatedtoprotectingandpromotingthepublichealth.AsIlearnedmoreabouttheUSPHS,IknewIwantedtobeintheirshoes.Todetermineiftheshoewouldfit,IappliedfortheJuniorCommissionedOfficerStudentTrainingandExternProgram(JRCOSTEP).Afterfinishingarigorousandchallengingsecond-yearofpharmacyschool,IwasonmywaytocompletingaJRCOSTEPattheFDAinSilverSpring,MDfortwomonths.
Ihadthedistincthonorofwearingthekhakiuniformandmynewshiny,blackPHSshoes.IwasstationedattheCenterofDevicesandRadiologicalHealth(CDRH)intheOfficeofCompliance(OC)andDivisionofPremarketandLabelingCompliance(DPLC).TheroleoftheFDAisnostrangertopharmacystudents.TheFDAimpactspharmacyandthelivesofpatientseverydaythroughpolicy,regulationsandpublicawareness.
MypreceptorCAPTRaquelPeatandmentorCDRJeeneBaileywereimmenselywelcomingandresponsive.Mymaindutiesincludedreviewingallegationsagainstavarietyofmedicaldevicestoensurethatfirmswerecompliantwiththepre-marketingrulesandregulations.ThisinvolvedutilizingtheCodeofFederalRegulations(CFR)andrelevantguidancesprovidedbytheFDAandperformingariskandbenefitanalysis.Myotherdutiesincludeddevelopingstrategiesfortheenforcementoffinalordersandstreamliningtheprocessforreviewingallegations.IalsodeliveredapresentationatadivisionmeetingabouttheNewDrugApplication(NDA)foracombinationproductthatconsistsofbothadrugandadevice.Inaddition,mypreceptorandmentorprovidedmethetoolsandsupporttocreateandpresentaresearchposterattheAnnualSalutetoScienceStudentPosterSymposiumattheFDA.Outsideofmyduties,IgottheopportunitytoattendpharmacylecturesofferedbytheFDAthatcoveredtopicsrangingfromtheprocessforgenericapprovals,reviewingadverseevents,orphanproductdevelopmentandthedrugshortageprogram.Inaddition,PHSpharmacistsspokeabouttheirexperiencesasofficers,describingthecareeropportunitiesandbenefitsavailablewithPHS.
CDRBaileyandJRCOSTEPENSTsanattheFDAinSilverSpring,Maryland.
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Experience at the FDA
Editors Note
Discovering Pharmaceutical Care in Native Communities
Intro to IHS: From Oregon to Alaska
Bureau of Prisons FMC Longitudinal Experience
Temple Univ. School of Pharm/CORPS Values
Advance Pharm. Practice Exp. at the FDA
Summer in South Carolina
Howard Univ. College of Pharmacy
Useful Info andResource Links
UPOC Newsletter Workgroup
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Putting Myself in the Public Heath Service’s Shoes: Experience at the FDASubmitted by ENS, Jennifer, Tsan
ThePHSofficerwhoIthoughtwasapilotturnedouttobeCDRJerryZeeand,duringmytour,IwasabletovisittheCentersforMedicaidandMedicare(CMS)andtomeetwithhim.HesharedhisexperiencewiththeBureauofPrison(BOP),IndianHealthServices(IHS)andIlearnedaboutthegrowingroleofpharmacistsinmanagedcare.IalsovisitedthePHSheadquarters,theCoastGuardheadquarters,thePentagon,andtheNavalSupportAcade-mywhereIlearnedalotabouttheseagencies.CAPTBrianLewisallowedmetoshadowhimattheVeteran’sAffairs(VA)HospitalinWashington,wherehepracticesasacardiologistandperformssurgerytoimplantpacemakers.BeingintheMarylandareaallowedmetoattendthe2017AmericanSocietyofConsultantPharmacy(ASCP)Mid-AtlanticconferenceinBaltimore,whereIhadtheopportunitytomeettheChiefPharmacyOfficer(CPO),RADMPamelaSchweitzer.
DuringmytimeattheFDA,Idevelopedrelationships,improvedmycommunicationskills,andfurtheredmyknowledgeofdruganddeviceregulations.Myexperiencewasnotonlyeducationalandfascinating,butalsorewardingandworthwhile.IgreatlyappreciatetheopportunitytoworkwithCAPTPeatandCDRBaileythispastsummer.I’velearnedsomuchfromtheprojectsI’vebeenworkingonandaboutthegreatmissionoftheUSPHS.Iamsogratefultohavehadtheincredibleopportunitytoseewhatit’sliketobeaPHSofficerandtobeintheirshoes.
JRCOSTEPENSTsanMeetingRearAdmiralSchweitzer
Editor’s Note:
TheUPOCnewsletterteamisdelightedtoreleaseourWinter2017issue.Ourteamaimstoproduceatop-notchnewsletterthatoffersbothstudentsandemerginghealthcareprofessionalsaglimpseoftheuniqueopportunitiesandexperiencesavailablethroughworkingforUHSPHS.
Thankyoutothecontributingwriters,bothstudentsandpharmacists,whowillinglysharedtheirexperienceabouttheirrotationorpharmacypracticesite.YourpersonalstoriesandreflectionsgiveourreadersabettersenseandacloserglanceatthediverseopportunitiesPHSoffers.AsEditor-In-Chief,Iinvitenewideasthatarebothfunandenlightening,andshowcasewhatit’sliketobeaPHSpharmacyofficer.
Students,wewishyouthebestofluckinschoolandyourcareerendeavors
HappyHolidays&BestWishesonyoursuccess,
LCDRShannonSaltclah,Pharm.D.,BC-ADM,NCPS
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Discovering Pharmaceutical Care in Native Communities SubmittedbyMs.SaraShahdoostMoghadam
OneofmyfondestmemoriesfrompharmacyschoolwillforeverbemyexposuretotheU.SPublicHealthService.Asafirstyearstudentpharmacist,IwasfortunatetobeofferedanexternshipattheBemidjiAreaOfficeunderthesupervisionofCDRMichaelVerdugo,wholaterencouragedmetoapplyforaJRCOSTEP.DuringmytimeinBemidji,Ilearnedabouttheworkthatgoesbehindscenestosetupanewpharmacy,thecomplexityofkeepingadrugdatabaseuptodate,aswellastheimportanceofbuildingrapportwiththeNativeAmericanpopulationwhileprovidinghealthcareservices.ImustadmitthatmyknowledgeaboutNativeAmericanculturewasverypoorwhenIbeganmyexternship,andIwasdeterminedtocomeoutofthisexperiencenotonlywithmoreclinicalknowledge,butalsowithmoreculturalsensitivity.
Acoupleofweeksintomyexternship,Iwasinvitedtomyveryfirstpowwow.Wordswillneverbeenoughtodescribethebeautyoftheceremonyorhowthebeatofthedrumsmademefeel;Icannotexplaintheintricacyoftheirartandtheincrediblerespecttheyhavefortheirsurroundings.Myfavoritepart,however,washavingawarmbowlofwildricesoupwhileconversingwithawomanwhopatientlytoldmeaboutthemeaningbehindeachdance,dress,andheaddress.Itwastrulyaneyeopeningeventthatmademerealizehowmuchmore
Ihadtolearninordertobetterservethispopulation.Thankfully,theUSPHSofficersatCassLakehospitalguidedmethroughthislearningprocessbyactivelyshowingmehowtotakecareofthesepatientswiththeuttermostrespectfortheirbeliefsandculture.SeeingtheimpactthatthedifferentUSPHSofficershadontheirpatients,aswellaswitnessingthedeterminationtheyhadforimprovingpatientcare,wasbeyondinspiring.ItwasbecauseofmyexperiencesinBemidjithatIdecidedthatItoowantedtoservethosewhoneeditthemost.
Asasecondyearstudentpharmacist,IwashonoredtoserveattheFondduLacBandofLakeSuperiorChippewa,bothattheirMinNoAyaWinfacilityinCloquet,MN,andattheirCenterforAmericanIndianResources(CAIR)clinicinDuluth,MN.MyexperienceatFondduLacwasnotonlymorethanwhatIexpected,butitalsohelpedmecultivatemyknowledgeclinically,culturally,andstructurally.OneofthereasonswhymyexperiencewassodifferentfrommyexternshipwasduetothefactthatMinNoAyaWinisatriballyrunclinic,whileCassLakeisfederallyrun.Ispentweekspinpointingthedifferencesandsimilaritiesofthesesystems–whichissomethingIencourageanyfutureJRCOSTEPtodo–notonlytolearnmoreabouttheenvironmentinwhichIwasserving,buttodrawonthebestaspectsofeachsitetolateronapplyittopractice.
Ms.SaraShahdoostMoghadam
Fromleftotright:MsSaraShadoostMoghadam,CDRMichaelVerdugo,DeannaHoule.
(Ms. Sara Shahdoost Moghadam, CDR Micheal Verdugo, and CPhT Deanna Houle after presenting at the Indian Health Service Regional Partnership Conference in Minneapolis, Minnesota.)
OneofthemanyaspectsofpharmacypracticesthatIadmiredfromMinNoAyaWinwasthegreatamountofinter-professionalcollaborationaswellasthetrustsystembetweenthedifferenthealthcareprovidersandthepatients.AtMinNoAyaWin,patientsarereferredtodifferentservicesofferedbythepharmacywhichincludesmokingcessation,asthma,cardiovascularhealth,andanticoagulationclinics,aswellasmedicationtherapymanagement(MTM)servicesandpatienteducationandcommunityoutreachprograms.ParticipatingintheseclinicshelpedmeputintopracticeeverythingIlearnedintheclassroom.Aspartoftheirpatienteducationandcommunityoutreachprogram,Iwasinvitedtoparticipateattheirannualhealthfair,whereIwasassignedtomeasurepatients’bloodpressureandwastaughthowtoperformlipidpanels.Iwasthenassignedtofollowupwiththepatientswehadseentoprovidetheirresultsoverthephone,whichwasagreatopportunityforpatienteducation.Additionally,IwasencouragedbybothmysitepreceptorandmyJRCOSTEPmentor,tocontinueexploringmyinterestsinambulatorycareanddruginformationthroughthedevelopmentandcompletionofprojects.ItwasthroughtheseassignmentsthatIcon-firmedwheremypassiontrulylies.
BeingpartoftheIHSstudentexternandUSPHSJRCOSTEPprogramsnotonlyhelpedmefurtherdevelopmyclinicalskills,butitalsoallowedmetoliveuptothemissionoftheUSPHSCommissionedCorpsofprotecting,promoting,andadvancingthehealthandsafetyofourNation.Asafuturepharmacist,Iamcommittedtoservingmypatientstothefullextentofmylicenseinanefficient,safe,caring,andculturallysensitivemanner.
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An Introduction to Indian Health Services: From Oregon to AlaskaSubmittedbyRochelleWolfram–PacificUniversitySchoolofPharmacyHillsboroOregon
AftermovingfromAlaskain2015toattendpharmacyschoolatPacificUniversitySchoolofPharmacy,IfeltveryfortunatetobeabletoexperienceAPPErotationsinOregonandtogohometoAlaska.SinceIhavedevelopedaninterestintheIndianHealthService(IHS),IpursuedtheopportunitytohavearotationatChemawaIndianHealthClinicinSalem,OregonandatAlaskaNativeMedicalCenter(ANMC)inAnchorage,Alaska.IwasoverjoyedtohavebeengrantedtheopportunitytohavetwoIHSrotationswithtwofacilitiesknownfortheirexcellenceinhealthcare.
MyexperienceatChemawaIndianHealthClinicwasmainlyambulatorycarewithLCDRChristiSwabyandCDRGraceHuggettasmypreceptors.Ifellinlovewiththefacility’shealthcaremodelwhileworkingone-on-onewithpatients.Ihadtheopportunitytocounselpatientsonnewormaintenancemedications,smokingcessationandanticoagulationtherapy.Buildingarapportwithpatientsandlearningabouttheircommunitieswasbyfaroneofmyfavoriteaspectsoftherotation.Ialsohadopportunitiestocompletedrugutilizationreviews,analyzeantimicrobialstewardshipandgiveapresentationduringapharmaceuticalandtherapeuticsmeetingforformularyadditions.MypreceptorswereexcellentinguidingmetoensureIwasprovidingappropriatecareforeachpatient,whichhelpedmeexcelandgainconfidenceasastudentpharmacist.
MyrotationatAlaskaNativeMedicalCenterwasdividedintothreesettings:criticalcareunit(CCU),pediatric/neonatalintensivecare(PICU/NICU)andInternalMedicineserviceswhereIservedtohelpmonitordrugkinetics.IhadtheopportunitytoworkwithLCDRSeanBerkey,whojustcelebratedhis10-yearanniversaryasanessentialmemberoftheANMCteamandrecently
Whileworkinginotherdepartmentsonthehospitalcampus,Iwasabletoshadowpharmacist,JessicaSowinskiintheemergencydepartment(ED).Ilovedbeingabletocounselpatientsupondischarge,seehowtheEDpharmacistoperatesandbeinvolvedinthetransitionofcaresothepatientscanreceivemedicationsafteroutpatientpharmacyhours.Inaddition,IhadtheopportunitytoshadowtheInfectiousDiseasespharmacist,KatieGordon,whoseexpertiseinInfectiousDiseaseswasinvaluableandvital.DuringmytimewithKatie,IwasabletoattendanANMCAntimicrobialStewardshipmeetingforthehospitalandobservehowpharmacistsserveasthemainpharmacologicalresourcesforthehealthcareteam.Itwaseyeopeningandrefreshingtoseehowclosethepharmacistsworkwiththeinfectiousdiseaseproviders.
RochelleWolframewithoneofherpreceptors,CDRGraceHugget,duringherChemawaIndianHealthClinicRotation.
obtainedboardcertificationasaPediatricPharmacySpecialist.Hisknowledgeandexpertiseinpediatricpharmacyisastounding.Thiswasmyfirstexperiencewithpediatricpatients.Iwasabletoworkuppatientsandlearnaboutpediatricdiseasestates,pharmacotherapeuticmonitoringandbecomeapartofthedynamichealthcareteam,ensuredthattheirpediatricpatientsreceivedthebestcare.DidyouknowthatthereisresearchregardingtheidentificationofgenesequenceCarnitinePalmitoylTransferase,Type1A(CPT1A)ArcticVariantthatexpressesahardshipinfattyacidoxidationintheInupiaqandYu’pikpopulationsforimprovementofcare?Fascinating!IalsohadtheopportunitytoworkwithBoardCertifiedCriticalCarepharmacistCDRJohnCarothersandCDRMaryMackeyintheCCU.Duringthisrotation,Iwasamongtheactionbywitnessingtraumas,codes,evaluatingpatientchartsandexpandingmyknowledgeknowledgeondiseasestatesandtreatmentsoptions.Ontheinternalmedicinefloor,Iwasabletopracticefoundationalskillsofvancomycin,anticoagulationandrenaldosingmonitoring.
ThepharmacistswithinIHSaresomeofthemosthighlytrainedcliniciansandprovidehighqualitycarefortheirpatients.ItwasanhonortoworkwiththemasIlearnedsomuchfromeachpharmacist.Ilookforwardtomynextfourrotations,asInowfeelexceptionallypreparedbecauseofbothmyANMCandChemawaIndianHealthServicesrotationsandthepharmacyteamsIworkedwith.Iwanttothankeachoneofthemfortheirtimeanddedicationinfillingtheroleofpreceptor.
RochelleWolframeadventuringinSeward,AKatExitGlacier.
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Bureau of Prisons FMC Devens Longitudinal ExperienceSubmittedbyLCDRAnnaSantoro,PharmD;ZackaryLevine,MCPHSUniversityPharmDCandidateMay2018;AmandaMercadanteUniversityofRhodeIslandPharmDCandidateDecember2017;CallyRyan
MCPHSUniversityPharmDCandidateMay2018
Theuniqueaspectsofcorrectionalpharmacyhavechallenged,engagedandinspiredusduringourtimeattheFederalBureauofPrisonsFederalMedicalCenter(FMC)inDevens,Massachusetts.ThroughoutourclinicalrotationatFMCDevens,wehadmultipleopportunitiestoworkwithpharmacistsandinteractwithpatientsinclinicalsettingsforanticoagulation,anemia,diabetesandpsychiatry.Thisexperienceallowedustodirectlycounselpatientsonaone-to-onebasis,monitorprogress,discusssideeffects,patientadherence,andaddresspatientconcerns.
Alongwithgainingclinicalskills,wewerealsoabletoimproveuponourretailpharmacyskills.FMCDevensisuniqueintheaspectthattheyserviceafullfunctioning,retailtypeunitinadditiontotheirclinicalunit.Allofushadpriorexperienceintheretailsetting,solearninganewsystemwithScriptProandPyxiswasintimidating,butquicklybecamesecondnature.Welearnedanewwayofprocessingaprescriptionfrom“pickup”to“drop-off”,allwhileabidingbythelimitationsandsafety
Whetheritbeforasixweekperiodorathreemonthlongitudinalrotation,FMCDevensprovideduswiththemostcomprehensivepharmacyexperiencewehavereceivedtodate.Thevastopportunitiesprovidedtousweremorethanwecouldhavewishedforinarotationalsetting.ThisrotationhasopenedoureyestotheuniqueopportunitiesanddoorsthataPharmDcanopenforanindividual.ArotationwithinFMCDevens,oranyBOPlocation,ishighlyrecommendedbyusasitsuppliesawealthofknowledgeandsubmergesthestudentintoauniquecultureforwhichskillscanbeutilizedinalmostanyareaofpharmacypractice.
PharmacyStudents:(LtoR)AmandaMercadantefromURIandZackaryLevineandCallyRyanfromMCPHSattheirrotationsitewiththeFederalBureauofPrisons,FederalMedicalCenterDevens
concernsofthecorrectionalsystem.Wewereabletoimplementaworkflowsystem,centeredaroundteamwork,inorderthatallaspectswerecompletedasefficientlyandaccuratelyaspossible.
Temple University School of Pharmacy/ CORPS valuesSubmittedbyCDRParasM.Patel,RPh.,MBA
CDERDrugShortageStaff/OfficeoftheCenterDirectorFoodandDrugAdministration
May15,2017(Philadelphia,PA.),TempleUniversitySchoolofPharmacygraduationceremonyforClassof2017.Itwasagreathonortohavebeeninvitedtothe2017TempleUniversitySchoolofPharmacygraduationceremony.Duringtheceremony,RADMScottF.Giberson,AssistantU.S.SurgeonGeneral,wasbestowedwithanHonoraryDoctorofHumaneLetter,HonorisCausa,forcareerofworkfornationalandinternationalpublicservice,advancinginterprofessionalpracticeandthepharmacyprofessionandleadershipfortheU.SCommissionedCorpsEbolaResponse.CDRParasM.Patelwaspresentedwiththe2016-2017AdvancedPharmacyPracticeExperienceProgramPreceptoroftheYearAwardforoutstandingcontributionstotheExperientialEducationProgram.AdesumboOdunlami(Classof2018)wasawardedtheUnitedStatesPublicHealthServiceExcellenceinPublicHealthPharmacyAwardinrecognitionofhisdemonstratedcommitmenttopublichealthandthepharmacyprofession.
DeanPeterH.Doukas,Ph.D.presentedtoRADMScottF.GibersonanHonoraryDoctorofHumaneLetter,HonorisCausa.TheconferralwasthefirsteverhonorarydegreetohavebeengrantedbyTempleUniversitySchoolofPharmacy.DeanDoukasextendedwarmremarksashenotedRADMGiberson’scareerachievements,serviceanddedicationtopublichealth.RADMGibersonalsoservedasthe2017graduationceremonyhonorarykeynoteaddressspeaker.RADMGibersonopenedwithremarksnotingthathepersonallyshookhandswitheachgraduatingprofessionalpriortothestartoftheceremony.Thecurrentsocialaffinityfortexting,tweetsandsnapchatsshouldneverreplacethetrueconnectionsthataremadewithpersonaloneononeinteraction.He
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Temple University School of Pharmacy/ CORPS valuesSubmittedbyCDRParasM.Patel,RPh.,MBA
CDERDrugShortageStaff/OfficeoftheCenterDirectorFoodandDrugAdministration
spoketoallthoseinattendanceabouttheirinnerpotentialthatcanbedormantorbeignitedsimplybythechoicestheymake.Hetoldthegraduates,“Youhavetobelievethatyouaretheonewhowillmakethedifference.Thesechoicesthatdeterminetheimpactyouwillhaveacrossyourlife–professionallyandpersonally–areallwithinyourcontrol.”RADMGibersonclosedhisremarkswithachargetothegraduating2017classtobedynamic,lead,andexemplifyresilience.RADMGibersonperformedadditionaldutiesattheceremonybypresentingtheUnitedStatesPublicHealthServiceExcellenceinPublicHealthPharmacyAwardtoAdesumboOdunlami.Mr.Odunlami,Classof2018,wasrecognizedforthisdedicationtoserviceforpromotionofpublichealth.
TempleUniversitySchoolofPharmacyextendedtheirsupportfortheUSPHSbyawardingmethe2016-2017AdvancedPharmacyPracticeExperienceProgramPreceptoroftheYearAward.Itisaprivilegetohaveestablishedandmaintaineda16yearprofessionalrelationshipwiththeuniversityasastudentpreceptor,adjunctfacultyandUniversityPointofContact(UPOC).TheFDAStudentExperientialProgram(PSEP)providesauniqueopportunityforPharm.DcandidatestoparticipateinarobustfiveweekregulatoryrotationattheFoodandDrugAdministration(FDA).Thestudentsareintroducedtotheregulatoryandclinicalsciencesinvolvedwiththeapprovalofsafeandeffective
RADMScottF.Giberson,DeanPeterH.DoukasPh.D(TempleUniversityofSchoolof
Pharmacy),CDRParasM.Patel
drugproductsandmedicaldevicesforthenation.Further,studentsareabletointeractwithPHSofficerstogainperspectiveontheopportunitiesofferedbytheCommissionedCorpstobeabletoserveforthepromotionofpublichealth.ThepersonalhighlightwastheabilitytosharethisawardwithmyformerstudentShriyaPatel,Pharm.D(Classof2017).ShriyacompletedherrotationattheFDAin2016.Shewasallsmilesasshereceivedherdiplomawithherproudfamilyandfriendsinattendance.
RADM Giberson and I want to thank Dean Peter H. Doukas, Ph.D., esteemed faculty and staff for their dedication to higher education and for their support of the U.S Public Health Service. RADM Scott F. Giberson (’93) and CDR Paras M. Patel (’99), Temple University School of Pharmacy alumnus.
ShriyaPatel,Pharm.D(GraduatingClassof2017),
CDRParasM.Patel
RADMScottF.Giberson,AssistantU.S.SurgeonGeneral,servingashonorarykeynoteaddressspeaker.RADMGibersonwasbestowedwithaHonoraryDoctorof
HumaneLetter,HonorisCausa
Advanced Pharmacy Practice Experience at the FDASubmittedbyKwadwoA.Yeboah,PharmDCandidate2018,PreceptorLCDRLindsayWagner
Despitebeingriddledwithuncertainties,theAdvancedPharmacyPracticeExperience(APPE)yearisanexcitingyearforpharmacystudents.Thechallengingdidacticsareover,andwegettoapplyeverythingwehavelearnedovertheyears.MynameisKwadwoYeboah,afourthprofessionalyearstudentatPurdueUniversityCollegeofPharmacy.IspentthefirstfourweeksofAPPErotationsattheFoodandDrugAdministration(FDA)DivisionofDrugInformation(DDI).
OnthemorningofMay8,2017,IarrivedattheFDA,withmymindracingwiththoughtsofwhattoexpect.Whilewaitingformypreceptoratsecurity,itfinallyclicked:“Mypreceptorisapharmacist,Ishouldbefine.”Afewsecondsafterthiseurekamoment,LCDRLindsayWagner,mypreceptor,steppedthroughthedoorwithasmile.WedidourintroductionsandheadeduptoDDI’sfloor,whereIwasshownmyoffice,andgivenatourofthebuilding.Atthispoint,Ihadbeenintroducedtosomeprofessionalsinthedivision,mostofwhomarepharmacists.Thewarmwelcome,smiles,andinvitationbytheseprofessionalstostopbytheirrespectiveofficeswithquestionsorconcernscalmedmynerves,andmademefeelathome.
IfIweretodescribetheFDAPharmacyStudentExperientialPrograminoneword,Iwouldbegfortwootherwordsandcallit“extremelywellstructured”,andifdenied,Iwouldsettlefor“exceptional”.Rightfromtheonset,mypreceptormadesuremyschedulewaspackedwithactivities.Myprimaryresponsibilitywastointeractwithpatients,andhelpthemreportadverseeventsassociatedwithmedications.Iwasalsotaskedwithansweringquestionsaboutcommercialdrugsfromconsumersandsomehealthcareprofessionals.Throughthisexperience,Ilearnedhowtoprobepatientstoarriveatspecificmedicationissuesthatneededtobereported.Ialsolearnedhowtoefficientlyusedruginformationresources,whichIbelieveisoneofthecardinalskillsthatdefinesapharmacist.Inaddition,IwasfortunateenoughtobeinvolvedinaprojectthatwasgearedtowardseducatingpatientsandhealthcareprofessionalsaboutExpandedAccessorCompassionateUse.Priortothisexperience,IknewtheFDA’smissionistoensurethesafety,efficacy,andsecurityofdrugs,biologics,anddevices.However,itwasnotuntilmymonththerethatIgotanappreciationforhowpatient-centrictheAgencyreallyis.IfounditfascinatingthattheAgencytakesthetimetoacknowledgeandrespondtoeverypatientorpubliccorrespondence.Ialsoadmirethefactthateveryactiontakenbythedivisiontookthesafetyofthepatientsandconsumersintoconsideration.
IwentintothisrotationwithhighhopesoflearningaboutoperationswithintheFDA,andIwasnotdisappointed.TheFDAPharmacyStudentExperientialProgramplacesemphasisonexposingstudentstooperationsinvariousFDAofficesanddivisionsbyofferingdailylectures.WhetheritwasalectureontheOfficeofPrescriptionDrugsPromotions(OPDP)ortheroleoftheOfficeofPharmaceuticalQuality(OPQ)inensuringdrugquality;thelecturescollectivelygavemeadeeperperspectiveonhowtheFDAoperates.OneofmyfondestmemoriesthroughoutthisexperiencewasatanAdvisoryCommitteemeetingorganizedbytheFDA.Thetwo-daymeetingprovidedtheavenuetodiscussissuessurroundingtheimplementationofmandatorytrainingforopioidanalgesicprescribers.Ifoundthesemeetingsinterestingbecauseinadditiontoseeingourdemocracyatwork,experts,professionalorganizations,advocacygroups,andthepublicgottoshareideasaboutwhichpolicieswouldbebestforthenation.
IenjoyedmytimeattheFDA’sDivisionofDrugInformation.IappreciatethatIwasassignedresponsibilitiesandprojectsthatwouldpositivelyimpactAmericansandpatientsaroundtheworld.LearningmoreaboutotherFDAofficesanddivisions,andtheuniqueopportunitytotakeatouratthePentagonmademytimeattheFDAevenmoreeducationalandmemorable.ManythankstoLCDRLindsayWagnerandalltheprofessionalsIinteractedwithforagreatexperienceattheFDA.
Summer in South Carolina - JRCOSTEP Experience at the Catawba Service UnitSubmittedbyENSLaurenAbresch,PharmDCandidate2019andCDRMistiHouck
ItwasApril17thof2017thatIreceivedmyofficialacceptanceletter.Icouldn’tbelieveIwaschosentobeintheUSPHSJRCOSTEPProgram!Icouldn’twaittofindoutwhereIwasgoing,orwhoIwasgoingtomeet.Astheweekspassed,Iwasgrowinganxioustofindoutmyplacement.Finally,thedaycamewhenIfoundoutIwasgoingtospendmysummerinRockHill,SouthCarolina,servingtheCatawbaIndianNation.
TheCatawbaServiceUnitprovidesfullycomprehensivehealthcare,includingmedical,dental,nutrition,labandpharmacyservices.Iwasfortunateenoughtospendtimewitheachspecialty,whichhelpedmedevelopmyinterprofessionalcommunicationskills.Ilearnedaboutperiodontaldisease,asIchartedinthedentaloffice.Idispensedmedicationsandcounseledpatientsinthe
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Summer in South Carolina - JRCOSTEP Experience at the Catawba Service UnitSubmittedbyENSLaurenAbresch,PharmDCandidate2019andCDRMistiHouck
pharmacy,andIshadowedthepediatrician,whoprovidedvaluableinsightintothediagnosticelementofhealthcare.ThemultidisciplinaryapproachthatwasavailabletomehereattheCatawbaServiceUnitwillpreparemefortheever-expandingroleofthepharmacistonthehealthcareteam.
ItwasespeciallyrewardingtoparticipateincommunityhealtheventsthatweresponsoredbytheServiceUnit.Duringmyfirstweek,IwasabletoparticipateintheannualcommunityhealthfairintheReservation’sLongHouse;Icollectedtobaccousesurveysandhadtheopportunitytoeducatethehealthfairparticipantsonoursmokingcessationclinicatthepharmacy.IalsoparticipatedinbloodpressurescreeningsattheSeniorCentertwicemonthly.Inaddition,onceamonth,adiabeticshoeclinicisheldattheServiceUnit,inwhichwewereabletoeducatediabeticpatientsonproperfootwearandfootcare.ThesearejustafewofthemanyeventsthatIparticipatedin.IdevelopedarealappreciationfortheimpactthatIcanmake,asafuturehealthcareprofessional,onthecommunity’shealthandwellbeing.
OneofthebestthingsabouttheCatawbaServiceUnitwasthateachandeverymemberofthestaffwaswillingtoteachyousomething–abouttheirprofession,aboutthetribe,orabouttheirlifeexperiences.IwassurroundedbymanyCommissionedCorpsofficerswhowerewillingtosharetheirstoriesabouttheirjourneyinthePublicHealthService.Thisgavemeabetterunderstandingofhowpublichealthcanplayaroleinmycareer.ThepharmacistsattheCatawbaServiceUnithelpedmetogainreal-lifeexperience,byallowingmetoapplytherapeuticknowledgetopatientcasesandbyshowingmehowtocollaboratewithaninterprofessionalteamofhealthcareproviders.IwasalsogiventheopportunitytospeaktomanytribalmembersaboutCatawbacultureandtraditions.BytakingthetimetolearnabouttheCatawbapeople,Iwasabletobetterservethecommunity.
LefttoRight:LCDRWilliamFreiberg,ENSLaurenAbresch,CDRMistiHouck,PPEstudentSarahDascanioattheCatawbaServiceUnit.
Ican’tsayenoughgoodthingsaboutmytimeattheCatawbaServiceUnitasaJRCOSTEP.TheexperiencethatIhavegainedherewillhelpmewhereverIgoinmyfuturecareer.Ihavegrownasapersonandasaprofessionalinthesepastfewmonths,andIlookforwardtoapplyingmynewknowledgeinotherclinicalsettings.ItwasaprivilegetoworkwitheveryoneattheServiceUnit,anditwasanabsolutepleasuretoservetheCatawbacommunity.
Howard University College of Pharmacy SubmittedbyCDRDianaSolana-Sodeinde
LCDRAndrewGentlesandLTAndrewwithstudentleadersatHowardUniversity,CollegeofPharmacyonOctober18,2017
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OnOctober18,2017,PHSOfficersLCDRAndrewGentlesandLTAndrewCoogancoordinatedanafter-schoolstrategicplanningsessionwithstudentleadersfromP1-P3yearsatHowardUniversity,CollegeofPharmacyinWashington,DC.Thetopicforthenightwashowtocreatea“CalltoAction”onadvocatingfortheswiftpassageofrulesforCollaborativePracticeAgreement.Forover40years,federalagenciessuchastheVeteransAffairs,IndianHealthService,andBureauofPrisonshaveembracedandsuccessfullyutilizedcollaborativepracticeagreementtosuccessfullyimplementprogramssuchaspharmacist-managedanticoagulationclinics,immunizationprograms,chronicdiseasemanagementandevenstreamliningrefillpoliciesagreementsbetweenhealthcareprovidersandretailpharmacies.TheDistrictofColumbia’sBoardofPharmacyandMedicineismovingclosertohavingaworkingCPArulingpassedsincethelawwaspassedin2012.OnSeptember29,2017,thesecondproposedrulesandregulationsforCPAwerereleasedwitha30-daycommentperiod,whichendsonOctober27,2017.Ataskforceconsistingofstudents,WashingtonDCPharmacistAssociationandotherstakeholderswascreatedtoanswerthecallforactionandawarenessonadvocatingforthepassageoftheCPAruling.TheseofficersspenttheirtimeonOctober18,2017,describingwhataCPAis,aswellasgainingvitalstudentinputoncreatinganeffectiveletterwritingcampaign.AsofOctober25,2017thisletterwritingcampaignhasaccountedforover90%ofallstudentorganizationsatHUCOPvoicingtheirsupportforthepassageoftheCPArulesandover100studentshadpledgedtheirsupport.
HoorahtotheGreatTeamWork!!!
Howard University College of Pharmacy SubmittedbyCDRDianaSolana-Sodeinde
Advanced Pharmacy Practice Experience at the Federal Medical Center in Fort Worth, Texas
SubmittedbyMaricarConson,Pharm.D.Candidate2018.Preceptor:LTKristenKonoskyandLTChristopherDao
Asafourth-yearpharmacystudentattheUniversityofNorthTexasSystemCollegeofPharmacy,therewasanarrayofadvancedpracticerotationstochoosefrom.Beforelookingatthelistofpossiblerotationsites,IhadnotconsideredcompletinganadvancedpharmacypracticerotationwiththeUnitedStatesPublicHealthService.Specifically,withTheFederalBureauofPrisons–FederalMedicalCenterFortWorth(FMC-FTW)asIwasunfamiliarwiththishealthsystem.IwasunsureofwhattoexpectfromthisrotationasIwasthefirststudentfrommyschooltobegivenanopportunitytohavearotationwiththatsite.IamtrulygratefulthatIwasgiventheopportunitytocompleteoneofmyelectiverotationswithinTheBureauofPrisonsbecauseIwasabletoexperiencearotationthatwillneverbeduplicated.
FMC-FTWhadaround1500inmateswhenIwascompletingmyrotation,withasubpopulationof40inmatesinthelong-termcarefacilitysectionoftheprison.TheskilledpharmacistsatFMC–FTWwereabletosetupandconductbetweenanticoagulationclinicfortheprison,whichIwasluckyenoughtoparticipatein.Iwasallowedtoconductinterviewsandtherebymakerecommendationsontheirtherapy,withgreatguidancefromthepharmacist.Thepharmacistsalsoallowedmetobeexposedtoafewpatientsthattheyfollowedinthelong-termcarefacility.Everyweekduringtherotation,Iwasabletoworkupandpresentonlong-termpatients.Byhavingmegiveweeklypresentations,thepharmacistsatFMC-FTWhelpedmetogrowasapresenterandgainconfidenceintheseskillsthatIwillbeabletotakewithmeontofuturerotations.Iwasabletointeractwiththeprisoners,bycounselingthemontheirnewlyprescribedmedicationsoranychangesintheirtherapy.TheteamalsoallowedmetoconductjournalclubpresentationsandtopicpresentationssothatImaybecomemoreproficientinutilizingprimaryliteratureinmyrecommendations.
WhileonmyrotationatFMC-FTW,IwasabletoattendmeetingsconductedbyUSPHSofficers,civilservants,andotherhealthcareprofessionalsastheydiscussedmattersoftheprison.Observinghowtheinterdisciplinaryteamcollaboratedtoprovidecarefortheprisonerswasremarkable.Astherearedifferentsubsetsofpatientpopulations,thenecessityofhavingskilledhealthcare
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Advanced Pharmacy Practice Experience at the Federal Medical Center in Fort Worth, Texas
SubmittedbyMaricarConson,Pharm.D.Candidate2018.Preceptor:LTKristenKonoskyandLTChristopherDao
professionalstocareforallofthemisdaunting.Yet,theteamatFMC-FTWdoesagreatjobincaringfortheirpatients.TheteamatFMCtrulycaresaboutmakingapositiveimpactonthehealthoftheinmates.Seeingtheinnerworkingsofhealthcarewithinaprisonmademeappreciatetheuniquenessofthejobsthathealthcareprofessionalshavewithintheprisonsystem.
Thisadvancedpharmacypracticeexperienceallowedmetogrowasafuturehealthcareprofessionalbyconstantlychallengingmetobecomemoreinnovativeinmywayofthinkinginregardtopatientcare.IdidnotknowmuchregardingtheopportunitiesforpharmacistswithintheUSPHSbeforethisrotation.However,aftercompletingarotationattheFederalMedicalCenterinFortWorth,myhorizonshavebeenbroadenedandtheexperiencemademerealizethatthefieldofpharmacyisnotjustanonehealthcaresystemfitsalltypeofthing.Iwouldhighlyrecommendthisrotationtofuturestudentpharmacistsastheywillbeabletogrowasastudentandexperienceauniquerotation.
Unique Deployment and Temporary Duty (TDY) Assignment Opportunities in the USPHS
SubmittedbyCDRMonicaReed-Asante,LCDRLysetteDeshields,LCDRAshleeJanusziewicz,LCDRSadhnaKhatri
OfficersintheUnitedStatesPublicHealthService(USPHS)helpachievethemissionoftheCorpstorespondtohealthneedsbydeployingandutilizingtheirvariedskillsetstoservepopulationsimpactedbypublichealthemergencies.Inaddition,USPHSofficersoftentakeonadditionalresponsibilitiesbeyondtheirroutinescopethroughtemporarydutyassignments(TDYs)tosupportareasofemergentneedforshortperiodsoftime.TherearemanyexcitinganduniqueopportunitiesfordeploymentsandTDYswithintheUSPHS.WehadthepleasureofinterviewingLCDRMozeke-BakeraboutherverymemorabledeploymentandTDYexperiences.
Question:Whatdeployment(s)andTDYhaveyoudoneandcanyoutellusmoreaboutyourdaytodayduties?
Answer:IhadaTDYin2014toassistwiththeUnaccompaniedMinorsCrisiswhilestationedwithDepartmentofHomelandSecurity(DHS).Iprovidedroutinecaretotheunaccompaniedchildrenandmothers.IalsodeployedtosouthernLouisianain2016tocareforfloodvictims.Mydutiesincludedadministeringmedications,providingdressingchanges,assistingwithactivitiesofdailyliving,andcoordinatingwithancillaryservices.IwasaffordedtheuniqueopportunitytodeploywithHurricaneHarvey/IrmaremotelyviaanIncidentManagementTeamforthreeweeks,whichrequiredworkingwithinanIncidentCommandSystem(ICS)andcallinghundredsoffirmstoassessforpotentialdamage.
Question:HowdidyoufindoutaboutthedeploymentandTDYopportunities?
Answer:InformationaboutdeploymentsandTDYopportunitiescomethroughvariouschannels.Forexample,myDHSsupervisornotifiedmeoftheDHSTDY.FortheLouisianaflooddeployment,IwasnotifiedoftheneedtoaugmenttheRapidDeploymentForceviaemailandphonecall.
Question:Whatsurprisedyoumostaboutyourexperiences?
Answer:IhaveeightyearsofexperiencethroughmyworkintheUSAirForce,inadditiontomyexperiencesworkingattheBureauofPrisons,DHSandcurrentlyasaConsumerSafetyOfficerwiththeFoodandDrugAdministration.Evenwithmydiversebackground,IamstillsurprisedthatdeploymentsandTDY’sbringoutthebestinpeople.Inthemostdifficultoftimesforsome,Iamsoproudofhowwe(allservicemembers)cometogethertoservethepublic.
Question:WhatpieceofadvicecouldyougivetoanofficerconsideringdoingaTDYbutisonthefenceforonereasonoranother?
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Unique Deployment and Temporary Duty (TDY) Assignment Opportunities in the USPHS
SubmittedbyCDRMonicaReed-Asante,LCDRLysetteDeshields,LCDRAshleeJanusziewicz,LCDRSadhnaKhatri
Answer:Doit!Stretchyourself,serveothersinvariouscapacities.Nomatterwhatyourclinicalbackground(e.g.pharmacy,nursingetc.)therearemanyuniqueopportunitiestodeployindiversecapacities.Theseexperiencesmaypropelandhumbleyou–professionallyandpersonally.
Question:Whatdidyoufindthemostchallenging?
Answer:Ibelievethemostdifficultchallengeistheprocessand/orlogisticsofgettingtothedeploymentorTDYlocation.Thesearesometimesausteresituationsandtravelcanbedynamic.
Question:Whatwasthemostrewardingaspect? Answer:Itisalwaysrewardingtoserveothers.Always!Icarrytheexperiencesandfacesofpatientsandotherservicemembers,evenasIfulfillmyrecentregulatoryduties.Itdrivesmypassionforadvocacyandcompetency.
Special thank you to LCDR Mozeke-Baker for volunteering for this interview
My APPE Rotation Experience at CMS New York Regional OfficeSubmittedByStephanieTse,Preceptor:CommanderJerryZee,PharmDMPHCPH
InlieuofcelebratingAmericanPharmacistMonththisOctober,IwasabletospendthemonthintheCentersforMedicare&MedicaidServices(CMS),locatedinManhattanbyshadowingCommander(CDR)JerryZeewhoistheRegionalPharmacistofNewYork,NewJersey,PuertoRicoandtheU.SVirginIslands.Asa6thyearstudentpharmacistwithacommunitypharmacybackground,Iwasexcitedandeagertoexploretheregulatoryaspectofhealthcare.ItwasabusymonthforusduetotheannualopenenrollmentperiodsforbothofMedicare,andtheAffordableCareActMarketplacerightaroundthecorner.But,IcouldnothavebeenmorethankfulformytimetherebecauseIwasabletolearnsomuchwithinashortspanoftime.
OnOctober5th,weattendedNewJersey’sRe-EntryRoundtableinJerseyCity,hostedbyNewJersey’sformergovernorJimMcGreevy.Themaintopicwasregardingre-entry.Thereweremanyparticipantsincludingphysicians,NJFamilyCareCommissioner,DHHSAssistantSecretary,andDHHSActingRegionalDirector.Everyoneworkedharmoniouslytogethertodiscussdifferentsourcesofaddiction,effectivemethodsforsupportingthosewithsubstanceabusedisorder,andthepersistentbattleindealingwiththeopioidscrisisinNJ.
TheweekofOctober9th,CDRJerryZeeconductedfourconsecutivedaysofinsuranceaudits.Observingtheevents,Icansaythatitwasaverymeticulousprocess.WeweretomakesureeverythingwasdonecorrectlyaccordingtotheMedicarerules,regulation,andstatutes.ItisimportanttoregulatetheMedicarehealthinsurance(PartC&D)planstoensurethatbeneficiariesareawareoftheirrightsandareabletoaccesstheirlife-savingmedicationsinasafeandtimelymatter.
OnOctober13th,Iwasabletoattenda‘CMS&You’TVshowtapingthattookplaceinaBrooklynrecordingstudio.ThesessionthattheyhaddonewasregardingthetoptipstheyhadforviewersregardingtheMedicareAnnualOpenEnrollmentperiodaswellasanyupdatesforvictimsusewereaffectedbytheHurricanes:Harvey,Irma,andMaria.ThiseventwasparticularlyexcitingbecauseIwasabletoseewhatCMSstaffmembersdooutsidetheirnormalplacement.
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StephanieTse
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My APPE Rotation Experience at CMS New York Regional OfficeSubmittedByStephanieTse,Preceptor:CommanderJerryZee,PharmDMPHCPH
OnOctober17th,CDRZeeandIwenttoRutgersClubatRutgersUniversityfortheNewJerseyPharmacistsAssociationConference.WeprovidedCMSregulatoryupdates,andothersdidthesamewiththeorganizationthattheywereapartof.
OnOctober23rd,CDRZeeandIwentuptoAlbanytotheDepartmentofHealthfortheNewYorkMedicaidPharmacyAdvisoryCommitteeMeeting.Therewereafewpresentationsthroughoutthedayregardingupdatesoninsuranceplans,themandatorycomplianceprogram,andfreeaccesstotheNaloxoneCo-paymentAssistanceProgram(N-CAP).
OnOctober24th,therewasaDHHSRegionIISummitaddressingthepublichealthandpublicsafetyoftheopioidscrisis.ThereweremanyimportantspeakersatthemeetingfromthePrincipleDeputyDirectorfromtheOfficeoftheSecretaryandtheOfficeofIntergovernmentalandExternalAffairstotheActingCommissionerfromtheDepartmentofCommunityMentalHealthinNewYork’sWestchesterCounty.TherewererepresentativesfromdifferentorganizationssuchasNYCRXStatWorkgroup,whichhelpsdevelopmeaningfulrelationshipsacrossgovernmentstoworktogetherindefeatingtheopioidcrisis.TheOfficeoftheU.SAttorneyalsospokeabouttheirroleinthesafetyofopioidcrisis,suchasprosecutingheroindistributionandbattlingagainstorganizationsthathavetakenoverneighborhoodsandcommunities.
OnOctober25th,IattendedtheCMSTraininginLincolnHospital.ItwasaveryinformationalsessionaboutthebenefitsofMedicareandhowtoapply,Medicareappealsprocess,Medicareprogramsforpeoplewithlimitedincomeandresources,thenewMedicarecard,andenrollmentresourcesfortheuninsured.Caregivers,patients,andcommunityprovidersattendedthiseventandtheturnoutwasgreat.Theattendeeswereveryattentiveandaskedmanyquestions.
OnOctober26th,theCMSstaffmembersandIwenttoSayreville,NewJerseyforthe‘2018NewJerseyAffordableCareActRoundable.’TherewerespeakersfromBlueCrossBlueShieldHorizon,OscarInsurance,andAmeriHealth.TheytalkedabouttheirmissionasacompanyandwhatkindofbenefitstheyofferbeneficiariesfortheupcomingannualopenenrollmentperiodfortheAffordableCareActMarketplace.
Lastly,onOctober27th,wewenttoTouroCollegeofPharmacy’sCareerFair,wherehospitalswithresidencyprograms,fellowshipprograms,theU.SPublicHealthServiceCommissionedCorps,andcompanieslikeCVSHealth,andWalgreenscameouttoeducatethestudentpharmacistslikemyself.Ateachbooth,Iwasabletopickupfliersandbrochuresabouteachprogram.Itwasagreatwaytomeetnewpeopleandpersonallyinteractwithpharmacistsindifferentfields.Theyalsohadan‘InterviewPanel’whererepresentativeswouldanswerquestionsfromthestudentsabouttipsonapplyingforresidency/fellowshipprogramsaswellasadviceforpost-graduation.
Withthat,mytimeatCMScametoanend.Iaminspiredtokeepexploring!
United States Public Health Service Excellence in Public Health Pharmacy Award
SubmittedbyCrystalSalgado,PharmD
Everyyear,theUnitedStatesPublicHealthService(USPHS)ExcellenceinPublicHealthPharmacyAwardrecognizespharmacystudentswhohavemadesignificantcontributionsinpublichealth.Nomineesarestudentswhohavedemonstrateddedicationby:AdvancingthegoalsandobjectivesofHealthyPeople2020bypromotingqualityoflife,eliminatingdisparities,andimprovingthehealthofallgroups;focusingawarenessoncurrentpublichealthissuesaroundtheopioidepidemicandZikavirusthroughtheirtimeandcontributions;andhighlightingprioritiesthroughprogramssuchasTobaccoFreeLiving,HealthyEating,andMentalandEmotionalWell-BeingaspartoftheNationalPreventionStrategy.ItwasagreathonortoreceivethisawardinMayof2017forthecontributionsthatweremadethroughtheprojectTakeChargeofYourHealth.
CreatedbythefacultyattheUniversityofArizonaCollegesofMedicine,Pharmacy,andPublicHealth,ProjectTakeChargeofYourHealthendorsedinter-professionalismamongthedifferentdisciplineswhileencouragingimprovementinpatients’healthandwellness.LocatedinsouthernTucson,theFredArcherCommunityCenterisalocalrecreationcenterthatprovidesyouthandseniorprogramstothesurroundingresidents.Overan8monthperiod,atotaloftwenty-sevenstudents(Medical:7,Pharmacy:15,Public
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United States Public Health Service Excellence in Public Health Pharmacy Award
SubmittedbyCrystalSalgado,PharmD
TeamMembersofTakeChargeofYourHealthProject
Health:5)andten-facultymembers(Medical:5,Pharmacy:3,PublicHealth:2)participatedintheprogram.Asinter-professionalismwasakeyhighlightoftheproject,fiveteamswerecreated,eachwithoneormorestudentsfromthedifferentdisciplines.Participantswerethenassignedtotheirspecificteamfortheentiretyoftheprogram.OneSaturdayamonthforthreehours,participantswouldstartwithfreehealthanddiseasemonitoring,includingbloodglucosereadings,weightmeasurement,bloodpressure,A1C,cholesterol,andmedicationreconciliation.Theremainderofthemorningincludeddiscussionswithparticipantsaboutgoalsorchallengestheyfacedthemonthbefore,followedbyatwentyminuteexercisefocusedactivity,andfinallyafifteen-minutehealthyeatingactivity.Eachgroupwasresponsiblefordesigningtwosessionsthroughouttheprogram,whichastimeprogressedbecamemoretailoredtoourparticipants.Afterourparticipantsleft,studentsandfacultywoulddiscusstheprosandconsthatoccurredduringthatsessiontohelpimprovethenextSaturday.Duringthosemonthsitwasawhirlwindofactivitythatprovideduniqueandpersonalinteractionswithpatients.
The last session my group organized, I was assigned the exercise session of that day. As a lot of the sessions previously included some form of aerobic exercise or weight lifting, I contemplated the best activity that would be new and rewarding to our patients and played with my strength and knowledge of yoga. I decided to introduce our patients to a yoga practice called Pranayama: breathing exercises. Participants went through various breathing exercises and we discussed how hard it can be to sit and just be present, not to worry about tomorrow or stress about mistakes that happened yesterday, but focus on that moment. I talked about the importance of taking just 10 minutes a day just for yourself and practicing self-care. The activity generated lots of laughter as we joked about the thoughts that would come up trying to sit in silence and breathe, but what I found the most touching occurred after the activity. A few participants approached me after the session and thanked me, stating how the discussion and breathing techniques touched topics very close to their hearts. It was inspiring to sincerely impact our participants with our words and deeds and to motivate them to make small changes in their lives. Taking Charge of Your Health helped me acquire skills that made me successful in my Advance Pharmacy Practice Rotations and future endeavors.
Thispastyearhasemphasizedtheunpredictabilityoflifeandtheimportanceoftakingonedayatatime.OnaweekendtripinJuly2016,myfriendwentintocardiacarrestandpassedawaywhilewewereonanaturetrailinMonumentValley.Sometimeswordsareinadequatetoexplainasituation.Ibelieveit’ssimplertosaythatgettingupandmovingforwardwithsmallgoalswasthebestcourseofactionforme.Graduatingontimeandstartingtotravelmoreweresmallgoals.Beyondthat,Iamworkingforacommunitypharmacy,whichallowsmetheoptiontore-evaluateotheropportunitiesavailableinayear.Iwouldliketothankmyteammates,participants,andDr.TheodoreTongattheUniversityofArizonaCollegeofPharmacyforprovidinganextremelyuniqueandemotionallyfulfillingexperience.IconsidermyselfblessedtohavebeennominatedandchosenfortheUSPHSExcellenceinPublicHealthPharmacyAward.Fromlefttoright:LCDRBotkins,
CrystalSalgado,LCDRGreen
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Promoting and Protecting the Health of Minorities: A Pharmacy Practice Experience
SubmittedbyAxelVazquez-Deida,Pharm.D.Candidate2018,PreceptorCDRChristineMerenda
Pharmacistsareideallypositionedtoimprovepatientoutcomesbybeingdirectlyinvolvedinhealthpromotion,educationandpatient-centeredcare.However,pharmacistsalsoplayamajorroleinensuringthehealthoftheNationthroughactiveinvolvementinpublichealthinitiatives.Asafourth-yearstudentpharmacistattheUniversityofMinnesota,IhadtheopportunitytocompleteanAdvancedPharmacyPracticeExperience(APPE)attheUnitedStatesFoodandDrugAdministration(FDA)OfficeofMinorityHealth(OMH)inSilverSpring,MD.TheOMHaimstoimproveregulatorysciencebyincreasingtheamountofclinicaltrialsdataavailableonracial/ethnicminoritiesandpromotinghealthandsafetycommunicationtominoritypopulations.Duringthefive-weekAPPE,Iworkedalongsidemypreceptor,CDRChristineMerenda,onaprojectthatconnectedthetwoprogramsofOMH,theResearch&CollaborationsProgramandtheCommunications&OutreachProgram.
Throughoutpharmacyschool,Ihavebeeninvolvedinvariouspublichealthinitiatives,especiallyviatheUniversityofMinnesota’sstudent-runHealthofPeopleEverywhere(HOPE)clinicfortheunderserved,thestudentchapteroftheCommissionedOfficersAssociation(COA)oftheU.S.PublicHealthService(USPHS)andtheMinnesotaPharmacyStudentAlliance.IcompletedtwoJuniorCommissionedOfficerStudentTrainingandExternProgram’s(JRCOSTEP)withtheIndianHealthService(IHS),furtherstrengtheningmypassionforpublichealthandprovidingmewiththefoundationsofhowtointegratepublichealthpracticeintodirect-patientcare.However,Ihadnotexperiencedpublichealthatagreaterscale,atalevelthatsuchdecisionswouldimpacttheentirecountry.Therefore,IwastrulyexcitedtobeattheFDAandtobeabletocontributetotheagency’smission.Fromlefttoright:CDRChristineMerenda,Preceptor,and
AuthorAxelVazquez-DeidaattheFDAWhiteOakCampus
TheFDA’sPharmacyStudentExperientialProgramisstructuredtoallowpharmacystudentstolearnabouttheFDA’smultidisciplinaryprocessesforaddressingthepublichealthissuesthecountryfaces,specificallyregardingdrugs,biologicsandmedicaldevices.DuringmyfiveweeksattheFDA,Iwasabletoattendweeklylecturesthatallowedmetolearnmoreaboutthedutiesofvariousofficesanddivisions.SomeoftheseareasincludedtheOfficeofGenericDrugsandtheDivisionofPharmacovigilance,theDivisionofMedicationErrorPreventionandAnalysis,andtheDivisionofDrugInformationfromtheCenterforDrugEvaluationandResearch,amongothers.TherotationalsoallowedmetoparticipateinvariousUSPHSmeetingsandjoinRADMPamelaSchweitzer,ChiefProfessionalOfficerforthepharmacycategory,foronedayattheCentersforMedicare&MedicaidServices(CMS).IalsovisitedtheheadquartersoftheAmericanSocietyofHealth-SystemsPharmacists(ASHP)andthePentagon.PerhapsoneofthemostmemorableopportunitieswasattendingtheVaccinesandRelatedBiologicalProductsAdvisoryCommitteeMeeting.Duringthismeeting,thesafetyandefficacyofanewHepatitisBvaccinewerediscussed,thusdemonstratingtheFDA’sroleasnotonlyaregulatoryagencybutalsoasapublichealthauthority.
Duringtherotation,IworkedonassessingtheprevalenceanddisparitiesoftobaccouseandexposureamongU.S.racial/ethnicminoritiesandevaluatingtheeffectivenessofallFDA-approvedtobaccocessationpharmacotherapies.Ialsoreviewedtheconstituentspresentinvarioustobaccoproducts,aswellasinsecond-andthird-handsmoke.Asaresult,IwasabletodevelopEnglish,SpanishandNativeAmericanculturallysensitivefactsheetsthattheOMHwillusetoeducatethepublic.Throughthisproject,Iwasabletoexperienceinterdisciplinarycollaborationatitsbest,workingwithphysicians,nurses,scientistsandpublichealthadvisorsinanalyzingandtranslatingtheinformationforoutreachtothepublic.ThisrotationwasanincredibleexperiencethatallowedmetowitnesshowtheFDAtranslatestheirpublichealthworkintocommunity-accessibleresourcesthatcanpromotechange.Aspharmacists,weareverywellpositionedbetweenthecommunitiesweserve,clinicaladvancesinhealthcare,anddrugregulation.Havingsuchapositionallowsustouseourexperiencesinthefieldandbedriversofchange,thus,impactingthelivesofdiversepatientsacrossthecountry,whilegivingbacktothepracticeandprofessionofpharmacy.AxelVazquez-Deda,PharmD..
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Alaska Native Medical Center Pain ManagementSubmittedbyLisaEpperlyPharmD/MBACandidate,2017,PreceptorAimeeYoung,PharmD,BCPS,CPE
InJulyof2017,Iboardedanine-hourflightcomingfromWestVirginiatoAnchorage,AKtostartmyin-patientpainmanagementrotation.TheanticipationofworkingatAlaskaNativeMedicalCenter,whichisthelargest,mostcomprehensiveTribalHealthorganizationintheUnitedStates,hadbuiltupsinceIfirstappliedfortherotation,ninemonthsearlier.Itwasmyfirsttimeoutofthe48contiguousUnitedStates,andthefirsttimetreatingAmericanIndiansandAlaskaNatives.Ianticipatedlearningnewmethodstomanagepainandbecomingmoreknowledgeableonacuteandchronicpain.Mypreceptor,CDRAimeeYounghelpedmenotonlylearnaboutpainmanagementbutprovidedmewithnumerousopportunitiestobeexposedtootherareasofmedicine.
Atypicaldaystartedwithattendingmultidisciplinarysurgeryrounds,wherewewouldofferassistanceifpatientshadunmanageablepainormedicationrelatedquestions.Afterrounds,wedocumentedthedosageofnarcoticsusedinindividualpatientcontrolledanalgesiapumps.ThenIwouldworkuppatientsthatthepainservicewasconsultedon;thisincludedpatientswhohadanepidural,ketaminedrip,orsimplydidnothaveadequatepainrelief.Laterinthemorning,wewouldmeetwiththepainmanagementnursepractitioner(NP)androundedontheconsultedpatients,providingmedicationrecommendationsasneeded.TheNPvisitedeachpatientandsometimesIwouldroundwithhertoseethepatientsweweretreating.BelowareafewofthedifferentopportunitiesIwasfortunateenoughtoseethroughoutmyrotation.
•EndofLifeNursingEducationConsortiumonPalliativeCare oItwasagreatopportunitytolearnhowtohelpmanagepatients’symptomsaswellasatouchingexperience hearingtestimoniesandwhatsomepatientsgothroughtowardstheendoflife.•PalliativeCareECHO(ExtensionforCommunityHealthcareOutcomes)meetings oThesemeetingsaredesignedtohelppromotepalliativecareservicesthroughouttheAlaskaTribalHealth Systeminruralareas.Themeetingstartswithaneducationallecturefollowedbythepresentationofapatient casewhichisworkedthroughamongtheintra-professionalteamandendswithrecommendations.•Shadowedanurseanesthetistandwatcheddifferentsurgeriesforaday•PresentationonIntranasalNaloxoneforoverdosetotheBureauofIndianAffairs oCDRAimeeYoungandLTKristinAllmarasgavethepresentationasIwasabletoaccompanythemtothe lecture.•Attendedthe2ndannualAuroraBorealisCommissionedOfficerAssociationPromotionCeremony•ListenedtoCDRKaraKing,PharmacyDirector,giveamotivationalspeechabouttheU.S.PublicHealthService
WhileIwasinAlaskaforfiveweeks,Itookeveryavailableopportunitytoexplorethebeautifulscenerythatsurroundedme.ItraveledtoSeward,AKandwentonawhalewatchingcruiseandexploredtheporttownthatalsoholdsthestartofthehistoricIditarod.IwenttoDenaliNationalParkandtookinthebreathtakinglandscapecenteredaroundthetallestpeakinNorthAmerica,Mt.Denali.Iwentonnumeroushikestoseedifferentareasofinterest,exhaustedwhenIgottothetop,butwortheverydropofsweatandmusclepainthatcamewithit.Igottowalkonaglacierandseeawidearrayofwildlife.ThelastweekofmyrotationIwasabletocrossseeingtheNorthernLightsoffofmybucketlist.TheseareonlyasmallfractionoftheamazingexperiencesIhadwhileinAlaska.
ThisrotationgavemetheopportunitytoworkwithU.S.PublicHealthServiceCommissionedCorpsandAlaskaNatives.WorkingwithCDRAimeeYoungandvariousotherhealthcareproviderswasawonderfuleducationalandculturalexperience.IwasabletoseeadifferentsideofpharmacythroughtheU.S.PublicHealthService.Iwalkedawayfromtherotationgainingknowledgein,notonlypharmacy,butAlaskaNativesaswell.IhighlyrecommendAlaskaNativeMedicalCenterforstudentswhoarewillingtoputforthacademiceffort,desiretoexperienceanewenvironment,andwhowanttohaveanadventureofalifetime
(L-R):LisaEpperlyandCDRAimeeYoung
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Pharmacy in the Last FrontierSubmittedbyDakotaRichart,PharmDCandidate–PurdueUniversityCollegeofPharmacy
Whenrankingrotationsduringmythirdyearofpharmacyschool,Iapproacheditwithanopenmind,withthehopeofseizinganyopportunitytobroadenmyhorizons.WhenIcameacrosstheopportunitytotraveltoAnchorage,Alaskaforarotation,Iwasintrigued.IwasevenmoreexcitedtofindoutthatIwasservingatanIndianHealthServicefacility..Luckily,Ihadrankedtherotation,applied,andlaterfoundoutthatIwouldbespendingfourweekscompletinga“TransitionsofCare”(TOC)rotationattheAlaskaNativeMedicalCenter(ANMC).
DuringmyTOCrotation,mypreceptorLCDRMichelleLockehadnumerousopportunitieseverydaytobuilduponmyclinicalknowledgefoundation.Iattendeddailymultidisciplinaryroundswithpharmacists,chargenurses,providers,hospitaladministrationandothermembersofthehealthcareteam.Thesebedsidemeetingsprovidedabetterunderstandingofthedailyhospitalneeds,issuesthatarised,andplansfordischargeatthe167-bedmedicalcenter.Ialsometwitheverypatientbeingdischargedfromthehospitaltocounselthemontheirnewprescriptionsandanychangesmadetotheirhomemedicationregimen.Iwasabletoclarifyinstructions,answerquestions,provideclinicalrecommendations,andassistinasuccessfultransitionbetweeninpatientandoutpatientcare.
WhileatANMC,IwasabletoattendaPharmacyandTherapeuticsCommitteemeeting.Iassistedwithcreatingthemeetingminutes,andIobservedthehospital’sinterdisciplinaryinteractions.Thisrelationshipbetweenpharmacistsandotherhealth-careprovidersisthereasonwhyIchosepharmacyasaprofession.Ialsohadtheopportunitytocompleteavarietyofprojectswhileonthisrotation.Iwasabletodevelopvarioushandoutsforprovidersandhospitalstaff.Iledtopicdiscussionsoncommondiseasestates,draftedSOAPnotesforpresentationandreviewandansweredpharmacistandproviderdruginformationquestions.Ialsoledajournalclubforpharmacistsandproviders.AdditionalprojectsthroughouttherotationincludedupdatingANMC’sopioidconversionsguidelines,includingnewguidelinesformethadoneandtransdermalfentanyl.Thisupdateallowedmetocreateanewsletterinformingallhospitalprovidersandstaffoftheseconversionchanges.Finally,IassistedinthecreationofastatewideMedicationReconciliationtoolkitthatwasmodeledafterthetransitionalcarepracticesatANMC.ThistoolkitwillserveotherremotehealthcarefacilitiesthroughoutthestateofAlaskaindevelopingandimplementingmedicationreconciliationprocessesattheirfacilities.
ThisrotationnotonlyallowedmetostepoutofmycomfortzonefromtheMidwestandexperiencethebeautyAlaskahastooffer;therotationalsoprovidedawell-roundedambulatorycarepharmacyexperience.IwaspleasedtolearnaboutthenumerousopportunitiespharmacistshavewithintheCommissionedCorpsoftheUnitedStatesPublicHealthService(USPHS)andunderstandthemissionofUSPHS“toprotect,promote,andadvancethehealthandsafetyoftheNation”.
DakotaRichartatopFlattopMtn.inAnchorage,AK.
I am Forever GratefulSubmittedByMs.La-KasiaT.BestPharmDCandidate2018,Contributor:CarolynVolpe,PharmD.,MS
Greetings,IamLa-KasiaBest,afourthyearDoctorofPharmacyCandidatefromFloridaA&MUniversityCollegeofPharmacyandPharmaceuticalSciences(FAMU).Ihadthepleasureofcompletingafour-weekAdvancedPharmacyPracticeExperience(APPE)attheU.S.FoodandDrugAdministration(FDA),workingwiththeCenterforDrugEvaluationandResearch(CDER),OfficeofCompliance(OC)andtheOfficeofUnapprovedDrugsandLabelingCompliance(OUDLC).
Physiciansandnursesarethroughoutmyfamily,buttherearenotanypharmacists.SoIthought,whynotbecomethefirst!Duringmyfirstyearofpharmacyschool,Iwasintroducedtoanarrayofpharmacyfields.Manyofwhicharelessknowntothepublicthancommunityorhospitalpharmacy.Sincethen,Ihavealwaysbeeninterestedinthenon-traditionalpharmacyopportunities,suchasgovernmentalpharmacyandpharmacybusinessmanagement.WhenIwasgiventheopportunitytojointheFDAtocompletea
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I am Forever GratefulSubmittedByMs.La-KasiaT.BestPharmDCandidate2018,Contributor:CarolynVolpe,PharmD.,MS
rotation,Iwasoverwhelmedwithjoy.Arrivingwithnoexpectations,Ihadanopenmindandawillingnesstolearnandnetwork.Whatinterestedmemostwaslearninghowlaws,policyandregulationswereimplementedattheFDA.Ibelieveasstudents,wemustoptimizeouropportunitiestoreachourhighestpotential.
Themostgratifyingexperiences,whilecompletingmyAPPEattheFDA,wereparticipatinginseveralimportantprojects.Myfirstprojectinvolvedtrackingthedrugshortagesfrom2015tothepresentthattheOUDLCassistedinalleviating.Inadditiontotrackingdrugshortages,Iassistedwithdraftingabackgrounddocumentthatdiscussedthetimelineofeventsfromapprovalofsingle-ingredientcolchicinethroughtheremovalofunapprovedsingleingredientcolchicinefromthedomesticmarkettopresentday.ThedocumentelaboratedontheimportanceoftheseactionsandwillbeusedbytheOUDLCtopromoteitsunapproveddrugprogram.Furthermore,Ico-presentedalecturetomypharmacycolleaguestitled,TheHistoryoftheFederalFood,DrugandCosmeticActandTheUnapprovedDrugProgram.Lastly,IlearnedhowtowriteawarninglettertopharmaceuticalfirmsformarketingunapproveddrugproductswiththeintentionofassistingthemwiththesubmissionaNewDrugApplication.Beingabletoparticipateinthesenumerousprojectsgreatlyincreasedmypassionfornon-traditionalpharmacyoccupations.
SomethinguniqueaboutmyrotationwasthatIwasacceptedasthefirststudentmemberofanewFDAworkgroupfocusedontopicsrelatedtoprofessionalandpersonalchallengesfacingwomeninthefederalworkplace.Thefocusofthisgroupistoenhancebothprofessionalandpersonaldevelopmentforleadershipopportunities,careeradvancementandwork-lifebalanceinwomen.Thisworkgrouphasplanstopartnerwithotherinternalfederalorganizationstoincreasediversity,employeeengagement,outreachandrecruitment.Iattendedthefirstcommitteemeeting,whereIcontributedgreatideasforpublicinformationpacketsandrecruitmentevents,specificallyexternaloutreachforthestudentpopulation.Afterspeakingwiththefacilitatorabouttheorganization,IfeltthatImadetherightchoicetojointheorganizationexternally.Ilookforwardtobeginningmyjourneywiththisorganization.
Businesswaspriority,butmystayinWashington,DistrictofColumbiawasnotallbusiness.Duringmyvisit,Iwasablevisitsomeofthemostvaluedsitesintheworld:theWhiteHouse,theWashingtonMonument,thePresidentialMemorials,thePentagon,theNationalInstitutesofHealth,theUnitedStatesCoastGuardHeadquartersandavarietyofmuseums,includingtheNationalMuseumofAfricanAmericanHistoryandCulture.Iwouldsuggestallstudentsexplorethisverywonderfulcityandenjoythehistorybehindourcountry.
Knowledgeispower,butcommunicationisrequired.ThroughoutmytimeattheFDA,InetworkedwithFDAemployeesandpharmacystudentsfromacrosstheworld.Bybuildingrelationshipsandgainingknowledgefromtheseindividuals,theyhavehelpedmefurthermycareerandtobecomethebestpharmacystudentandpharmacyleader.Meetingtherightpeopleattherighttimecanmakeadifferenceinyourlife.Afteroneofthestudentlectures,IwassointriguedthatIset-upaone-on-onemeetingwiththepresenteranditwasthenthataforeverbondbegun.WeconnectedandIwasofferedtheopportunitytogainamentor.Inmyopinion,amentoriswillingtobeavehicletoyoursuccess.Theyaidinpioneeringyourlearningjourney.Thisindividualbelievedinmeandgavemeachancetobecomeabetterme.
IwouldliketothankFloridaA&MUniversity,theFDAandmypharmacycolleaguesformakingmyrotationanexperiencetoremember.IneverimaginedthatIwouldhaveparticipatedinsuchalifechangingandfulfillingrotation.Lifeisfilledwithunexpectedopportunitiesandwhentheypresent,wemusttakeadvantage.ThepurposeandmissionoftheFDAprovidesawidespectrumoflearningopportunities.IamforevergratefulthatmyjourneyattheFDAwaspurposefulandagreatlearningexperience.Theexperiencesolidifiedmyloveforpharmacyandmypassionforutilizingtheknowledgeandexpertisegainedtocreateamorehealth-consciousnation.
Ms.La-KasiaT.BestPharmDCandidate2018
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The USPHS: History, Student and Career Opportunities,and Integration of S.T.E.A.M. Principals
SubmittedbyLCDRPatrickHarperandLCDRChristopherLaFleur
Recently,LCDRPatrickHarperandLCDRChristopherLaFleur–bothstationedinChicago–teamedupwiththeLeaveNoVeteranBehindorganizationanditsS.T.E.A.M.programstoeducateChicago-areastudentsontheUSPHSandhowhighschoolacademicsconnectwithPHScareers.LeaveNoVeteranBehind(LNVB)seekstobuildbettercommunitiesthroughemploymenttraining,transitionaljobs,andveteraneducationdebtreliefscholarship.ItsS.T.E.A.M.programsconsistofProjectInnovationandGreenCorps:highschoolbasedprogramsfocusedoneducationalandvocation-alopportunitiesinthefieldsofScience,Technology,Engineering,Arts,andMath.AtChicago’sLindblomMath&ScienceAcademy,LNVBconductsProjectInnovation,wherestaffandVeteranswithS.T.E.A.M.backgroundsworkwithhighschoolstudentsinanextracurricularsettingtoleadhands-onS.T.E.A.M.-relatedprojectsandoffereducationonpossibleS.T.E.A.M.careers.
AttheinvitationofLNVB,LCDRsHarperandLaFleurpresentedtostudentsonthehistoryofthePHSandeducatedthemonthenumerouscareeropportunitiesthatexistwithintheCorps.ThepresentersspecificallyhighlightedthevarietyofwaysthatS.T.E.A.M.principalsserveasthefoundationforthenumerousrolesPHSofficershold.StudentsexpressedgreatinterestinthebranchofservicepreviouslyunknowntothemandwereparticularlyexcitedbythenumerouswaysinwhichtheCorpservestheunderserved,abackgroundthatmanyofthestudentsshared.Thisledtoarobustquestionandanswersessionthatmadethedayveryenjoyableforallinattendance.
LCDRHarperandLCDRLaFleurarealumniofSt.LouisCollegeofPharmacy,wheretheybothserveasaUniversityPointofContact(UPOC)today.LCDRHarperisaPublicHealthAnalystfortheBureauofHealthWorkforceinHRSA’sChicagoRegionalOffice.LCDRLaFleuristheAssistantHealthSystemAdministratoroftheBOP’sMetropolitanCorrectionalCenterinChicago.
(L-R)::CDRLaFleurandLCDRHarperpresentingtothestudentsofLeaveNoVeteranBehind’sProjectInnovationatthe
LinblomMath&ScienceAcademyinChicago,IL.
United Nations visit in New York CitySubmittedbyArjunChauhanandThanhTruongPharm.DCandidates2019
OnFridayOctober6,2017,studentsfromTempleUniversitySchoolofPharmacy(TUSP)weregiventheopportunitytovisittheUnitedNationsheadquartersinNewYorkCity.ThistripwasincorporatedintothePublicHealthcoursegivenatTUSPbyDr.NicoleSifontis,andallowspharmacystudentsanopportunitytomergetogetherpharmacyandhealthcarewiththerestoftheworldanditsevents.
Duringouryearsinpharmacyschool,welearnamyriadofclinicalinformationthatwecanusetohelptreatourpatients,butwedonotalwaysknowhowtoapplyournewfoundskillsonaninternational,orevennationalscale.Today,itisrarewhenpublichealthtopicsdonotmaketheheadlinenews.Forexample,naturaldisasters,civilwars,ornationsthatareinaperpetualstateofhealthcrises,unfortunatelyseemtobemoreandmorecommon.
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United Nations visit in New York CitySubmittedbyArjunChauhanandThanhTruongPharm.DCandidates2019
ThroughparticipationinTUSP’sPublicHealth,wehavebeenabletolearnmoreabouthealthcarebeyondthelocalcommunitieswherewetreatpatientsinourregularpractices,buttoalsoexperiencethechallengesoftreatinginternationalpatientsandtheirfurtherreachingglobalneeds.OurstudentcohorthasfocusedontheUnitedNation’sSustainableDevelopmentGoals,whichisasetof17globalgoalswhichfocusonabroadrangeofsustainabledevelopmentissues.ActuallyvisitingtheUNgaveusthechancetoseenotjustwhere,butalsoknowhowtheUNfunctionsintheirquesttocreateabetterworld.
ThegoalsoftheUNconsistof3mainfacets:humanrights,peaceandsecurity,anddevelopmentfortheworld’spopulation.ThroughourtouroftheUN,weexploredthefourmainchambersandlearnedthesignificanceofeach.ThemajorGeneralAssemblyHallisthelargestanditiswherethe193memberstatescongregatetodiscussworldissues.TheSecurityCouncil,whichconsistsof15members,10ofwhichrotateeachyeartoensureeveryvoiceisheard.TheonlypartoftheUNwewereunabletoseewasthe“InternationalCourtofJustice”becauseitisintheNetherlands.
SpanningtheentirecorridoracrosstheentrancetotheGeneralAssemblyHallarethe30BasicHumanRights;theUNbelieveseachpersonisentitledtoreceivethesebasicandfundamentalneeds.Thesimplicityofthedisplayisextremelyfittingasthesearetherightsallhumansshouldbeendowed,nomattertheirstatusorplaceinsociety,andshouldbeguaranteedtoeveryone.Althoughtheserightsarenotlegallybinding,theprincipleshavebeenemployedinvariouswaysasacitationforthosewhofightfortherightsofpeopleworldwide.With370differenttranslations,theUN’sBasicHumanRightsisthemosttranslateddocumentintheworld.Wehopethatitcanbeusedabasisforallgovernmentstofollowwhendecidingontheirownlaws.
AftervisitingtheUnitedNationsheadquarters,weexperiencedfirst-handhowmuchworkandcooperationisrequiredtodeliverqualityhealthcaretotheentireworldpopulation.TheUNcertainlyprovestobeanextraordinaryinstitutionthataimstobringunitytoallnationsandpeople;aimingtoprovideeachpersonwiththedignitytheydeserveregardlessofrace,color,gender,orientationoranyothercategorizationthatcouldbeconstruedasabarriertounity.Aspharmacystudents,thistripallowedustoseehowtheUNworkstowardstheachievementoftheseSustainableDevelopmentGoals,toassurehealthandsecurityacrossthememberstates.WewerealsoabletoseetheimpactthatourcountryhasonotherswhenitcomestodedicationtothebasichumanrightsandthegoalsoftheUN.Afterreturningfromthetripandreflectingontheimpactithadonus,weareconfidentthatthisuniqueexperiencewillallowustobetterourserveownpatientsinamoremeaningfulandimpactfulway.
Advanced Pharmacy Practice Experience at the Food and Drug AdministrationSubmittedbyMs.IreneeIbrahim
InMay2017,IcompletedafourweekrotationattheFoodandDrugAdministration(FDA).Thenontraditionalrolesofpharmacistshavealwaysintriguedme,soIwasveryexcitedtobegrantedthisopportunity.Priortopharmacyschool,andeventhroughout,IknewthattheFDAregulatedfoods,cosmetics,anddrugsintheU.S.market,butthatwasabouttheextentofit.BeingattheFDAopenedmyeyestoallofthedetailsandinnerworkingsthatoccurintheagency.MyrotationwasfilledwithmanydifferentlearningopportunitiesandexperiencesthatIwouldnothavebeenexposedtoatatraditionalrotationsite.
Duringthemonth,IworkedunderColleenO’Malley,mypreceptorintheCenterforDrugEvaluationandResearch’s(CDER),OfficeofCompliance,OfficeofUnapprovedDrugsandLabelingCompliance(OUDLC).ThefirstthingthatIquicklycametorealizewashowmanydifferentbranchesandofficestherewereattheFDA.OUDLCregulatestheunapproveddrugmarketandtakesenforcementactionagainstdrugcompanieswhodonotcomplywithfederaldruglawsandregulations,andthereforeposeapublichealthconcern.EnforcementactionsbyOUDLCinclude:settingexpectationsofvoluntarycompliancebyfirmswithviolations,holdingregulatorymeetingswithfirmstogivenoticeofnon-compliance,sendingoutwarningletters,seizureofdrugsthatareinviolation,andinitiatinginjunctionsagainstfirmstostopthemanufacturinganddistributionofunapproveddrugs.
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NotonlydidIlearnabouttheworkdonebyOUDLC,butIwasabletolearnaboutwhatsomeoftheotherofficesattheFDAdobyattendingvariousstudentlecturesgivenbystaffindifferentdepartmentswithinFDA.IwasalsoabletopresentatthestudentlectureheldatOUDLCforfellowpharmacystudentsrotatingthroughFDA.ThishelpedtoreinforcetheconceptsthatIlearnedduringmyrotation.Throughthestudentlectures,IalsohadtheopportunitytovisittheheadquartersoftheAmericanSocietyofHealth-SystemPharmacists(ASHP)andtheStablerLeadbeaterApothecaryMuseum.AtASHP,IbecamemoreinformedaboutASHP-accreditedresidenciesandthematchingprogram.TheStablerLeadbeaterApothecaryMuseumwasalsoawonderfulexperiencebecauseIwasabletotouroneoftheoldestbusinessesinAlexandria,Virginia.ThisrotationexposedmetomanythingsthatIwouldnothavehadtheopportunitytoexperienceotherwise.
IwasfortunateenoughtoattendtwodifferentAdvisoryCommitteeMeetings.ThesearemeetingsinwhichtheFDAbringsinapanelofexpertsfromoutsidetheagencytodiscussatopicathand(usuallycontroversial)inorderfortheFDAtogainmoreperspectiveandmakethebestdecisionregardingthetopicmatter.Notonlydoestheagencyallowtheexpertstogivetheiropinions,buttheyalsoopenuptheforumtothepublicandpermitanopenpublichearinginwhichtheyacknowledgetheopinionsofconsumers.ThefirstoneIattendedwasaPharmacyCompoundingAdvisoryCommitteeMeeting,inwhichtheydiscussedaspecificformulationandwhetherthatformulationshouldbeonthe“difficulttocompound”list.ThesecondwasanOncologicDrugsAdvisoryCommitteeMeeting.ThiswasparticularlyinterestingbecausetheywerediscussingthepossibleapprovalofNeratinibfortheextendedadjuvanttreatmentofHER2-positiveearlystagebreastcancer,basedonitsrisk-benefitratio.IgotachancetolistentotheperspectivesofPumaBiotechnology,theinnovatorofthisdrug.Ialsolistenedtomanysurvivingbreastcancerpatientswhospokeabouttheirexperiencesusingthedrug.Inbothmeetings,IfelthonoredbeingintheroombecauseIfeltasifIwaswatchinghistoryinthemaking.
Inadditiontoalloftheselearningopportunities,IwasassignedanoverarchingprojectregardingtheDrugEfficacyStudyImplementation(DESI)program.Priortomyrotation,Iwasunawareofthisprogram,butIwasabletounderstandwhattheprogramwasandtheFDA’sroleinitthroughtheproject.In1938,CongresspassedtheFood,Drug,andCosmeticAct(theAct)whichrequiredthatdrugsbeprovensafepriortomarketing.In1962,theKefauver-HarrisAmendmentrequiredthatdrugsbeproveneffectiveaswellassafepriortomarketing.Sincethedrugsapprovedbetween1938and1962hadonlybeenassessedforsafety,theFDAbegantheDESIprogram.TheroleofDESIistoassesstheefficacyofdrugsapprovedbetween1938to1962.Tothisday,therecontinuestobesomeopenDESIproceedingswhereafinaldeterminationofeffectivenesshasnotbeenmade.AslongastheDESIproceedingremainsopen,thatspecificdrugisallowedtostayonthemarketuntilitsproceedingclosesandthedrugisdeclaredineffective.TheagencyintendstoclosealloftheopenDESIproceedingsinthenearfuture.IwasabletoassistwiththisinitiativeanditwasaverysatisfyingexperiencebecauseIknowthatitwillbringthepubliconestepclosertoasaferdrugmarket.
WorkingwiththeFDAforfourweekswasaninvaluableexperience.Iwouldstronglyrecommendittoanypharmacystudent.Therearesomanydifferentopportunitiesforpharmacistsattheagency,anditwaswonderfultobeabletoseesomenontraditionalpharmacistsinaction.Thisrotationalsohelpedexpandmyprofessionalnetworkbygivingmethechancetomeetmanydifferentpharmacistsandinquireabouttheircareerpaths.Indoingso,Iwasabletounderstandhowvastandversatiletheprofessionis.Iamthankfulforthisexperience,andithastrulyinspiredmetobecomeabetterpharmacist!
Advanced Pharmacy Practice Experience at the Food and Drug AdministrationSubmittedbyMs.IreneeIbrahim
Ambulatory Care Practice Experience at Lawton Indian HospitalSubmittedby:CathyDunton,PharmDCandidateandPreceptorLCDRJessicaSteinertPharmD
Thedrivewesttook14hours,andthescenerychangedgraduallyfromtalltreesandurbanstructurestomoreidyllicfarmlands.EachmomentremindedmeofhowfarIwasawayfromhomeandhowuniquethisrotationwillbe.IhavebeeninterestedincompletingarotationatanIndianHealthService(IHS)sitesinceitwasintroducedtomeatmyfirstpharmacyschoolinterview.WhengiventhechancetoselectanIHSsiteasoneofmyrotations,Ijumpedattheopportunity.Myfive-weekAPPErotationatLawtonIndianHospital(LIH)ambulatorycareclinicsprovidedmewiththeopportunitytolearnandpracticeprovidingdirectpatientcareundertheguidanceof
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Ambulatory Care Practice Experience at Lawton Indian HospitalSubmittedby:CathyDunton,PharmDCandidateandPreceptorLCDRJessicaSteinertPharmD
mypreceptor,LCDRJessicaSteinert,PharmD.Underherguidance,IalsolearnedagreatdealabouttheU.S.PublicHealthService(USPHS)andhowuniquelyIHSservesitstargetpopulation.
Lawton,OklahomaisaboutoneandahalfhourssouthwestofOklahomaCity.LIHislocatedonfederallandandservesadiversepopulationofNativeAmericantribes.Theoutpatientpharmacydispensesanaverageof1,100-1,800prescriptionsperday,servingboththeimmediatecommunityintheoutpatientpharmacyandmailorderprescriptionsforpatientswholivefaraway.Thepharmacyisservicedbymanypharmacistsandtechnicians,someofwhomareCommissionedCorpsofficers.Thepharmacyalsohas4pharmacist-runclinicsandparticipatesinmanyhospital-wideinitiatives.Inthetobaccocessationclinic,IpracticedmotivationalinterviewingandactivelisteningasIhelpedpatientswithcopingstrategiesandmedicationstoencouragethemtoquitsmoking.Intheanticoagulationclinic,patientscameinforweekly,biweekly,ormonthlyvisitstohelpmonitortheirINR,possiblesideeffects,andlifestylemodifications.IwasabletohelpmanagetheirwarfarindosesandprovideeducationonamyriadoffactorsthatmayaffectwarfarineffectivenessandINRlevels.
In2015,LCDRSteinertestablishedtheHepatitisCClinicaspartofOklahoma’sHepatitisCCUREProject,forwhomsheisaCUREunitcoordinator.ThisprojectallowshertonetworkwithotherfederalIHSHepatitisCclinicswithinOklahomaandtoestablishedaplatformforstandardizedcureandcare,aswellastosharereportingforoutcomes.Priorto2015,therewasjustoneHepatitisCclinicinfederalOklahomaIHSsites,andtoday,thisprojecthasexpandedtoprovideHepatitisCtreatmentacrossOklahoma.In2017,LCDRSteinertreceivedaNationalIHSDirector’sAwardforsuccessfullyestablishingtheHepatitisCclinicatLIH.Tothisday,thisclinichashada100%curerateforallcompliantpatients.
Pharmacist-runclinicsarestillgrowingatLIH.In2016,LTIkjaeChin,astaffpharmacist,establishedtheAdultAsthmaClinictowhichproviderscanreferpatientsforbetterasthmacontrol.Theasthmaclinichelpsprovidecounselingandeducationforinhaleruse.Partneringwiththerespiratorytherapists,theclinicalsoseesallpatientswithnewlydiagnosedasthmawithaPulmonaryFuntionTest(PFT)referraltocontrolsymptoms.
Outsideoftheclinics,Iwasinvitedtoattendandparticipateininitiativesaspartofamulti-disciplinaryteaminthehospital.Iattendedbimonthlyantimicrobialstewardshipmeetingswhereprimarycareproviders,pharmacists,andhospitaladministratorsdiscussedjudiciousantibioticprescribingpracticesandotherwaysLIHcanfurtherincorporateCDCrecommendationsintoitsantimicrobialstewardshippractices.Atthemeetings,Ialsopresentedsomeoutpatientclinicstrategiesthathaveshownevidenceofreducingunnecessaryantibioticprescribing.TheothermajorinitiativethatIparticipatedinwascombattingtheopioidcrisis.ThelocalHeroinOpioidPainEfforts(HOPE)committeemirrorsthenational-levelIHSHOPEcommitteeandholdsmeetingswithamulti-disciplinaryteamofadministrators,clinicians,pharmacists,andbehavioralhealthandnursingstaff.Theydiscussedandimplementedstrategiesforreducingopioidoverprescribingandpreventingopioidabuseandoverdose.Aspartofanefforttostartanaloxoneclinicinthepharmacy,Ihelpedperformchartreviewstoexaminepainmedicationprescribingpractices.Itwasmyfirstexperienceseeingopioidoveruse,anditexpandedmyoverallunderstandingofthecomplexityoftheopioidcrisis.
Beyondmytimeinthepharmacy,ItookfulladvantageofallthatOklahomahastooffer.Myweekendswerecomprisedofattendinglocaleventsandoutdooractivitieswiththepharmacystaff.IntheshortfewweeksinLawton,Iattendedmyfirstrodeowhenitcametotown,andacoupleweekslater,IattendedtheannualAmericanIndianExposition45minutesawayinAnadarko.Myfavoritetimeherewasspentintheoutdoors.Just20minuteswestofthehospitalistheWichitaMountainsWildlifeRefuge,whereIhikedandkayakedwithLCDRSteinertandotherpharmacystaff.FromthesummitofMountScottintherefuge,Itookintheviewofthebeautifulprairieterrainbeyondasmatteringoftownsandwindmills.Theunexpectednaturalbeautyoftheplacetookmybreathaway.
Iamthrilledtohaveventuredoutofmycomfortzonetoexperiencethisuniqueambulatorycarerotation.IencourageanyonewhowantstoexplorethebreadthofacareerinpharmacytocompletearotationatanIHSsite.Theskillslearned,thesightsseen,andtheexperiencesfelthereatLIHwillshapemeasIadvancemyeducationandcareer.Iamgratefulfortheopportunitytogaininsightintothisaspectofpharmacyandpublichealth,andIencourageanyonetogetoutandseektheirownadventuresatanyoftheIHSsitesfortheirrotations.
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University of Pittsburgh School of Pharmacy Graduate Megan Dunlop Receives Prestigious 2017 “United States Public Health Service Excellence
in Public Health Pharmacy Award” SubmittedbyCDRNicoleZelenak
RecentUniversityofPittsburghSchoolofPharmacygraduate,MeganDunlop,PharmD,waspresentedwiththeUnitedStatesPublicHealthServiceExcellenceinPublicHealthPharmacyAwardbyCDRNicoleZelenakonApril28,2017duringtheSchool’sGraduationDinnerandHoodingCeremonypriortoCommencement.Thisprestigiousawardwasestablishedin2003andbestoweduponstudentpharmacistscommittedtopublichealth.
Megan’sdedicationtopublichealthisevidentthroughheractionsduringhertimeinpharmacyschool.Recognizinganeedinthecommunity,MeganworkedwiththeAlleghenyHealthDepartmenttoinitiateaprogramtomaintainastandingnaloxoneorderinPittsburgh.Throughherpassionandhardwork,shewasabletoinformalargenumberofpharmaciesofthisprogram.Whenpresentedwiththechallengeofsomepharmaciesnotbeingreceptivetostockingnaloxone,Megansetouttodeterminewhytheremaybereluctancebycreatingandimplementinganinterviewguidewhenspeakingwithpharmacistsandpharmacystudents.Aftercompletingherresearchproject,entitledBarrierstoDispensingNaloxoneinCommunityPharmacies,Meganpresentedaposteronthetopicatthe2017PennsylvaniaPharmacistsAssociationMid-YearConference.
Followinghercommitmenttoimpactingpublichealththroughaddressingtheopioidepidemic,Meganalsoensuredthatherfellowpharmacystudentswerewellinformedontheuseofnaloxoneintheopioidepidemicbyhostingcounselingsessionsandbringinginoutsidespeakerstoaddressthisimportanttopic.
Megan’spassionandhardworktrulyspeaktoadedicationtopublichealth,whichshebringstohercurrentpositionpost-graduationasaCommunityPharmacyPracticeresidentwithDuquesneUniversityandMainlinePharmacy.Sheplanstocontinuefollowingherpassionofcombatingtheopioidepidemicinthecommunitypharmacysetting.Meganhopestoincludecommunityserviceandpublichealthinherfuturecareer.
(LtoR):PatriciaKroboth,Ph.D.,DeanUniveristyofPittsburghschoolofPharmacy,
MeganDunlop,Pharm.D.,CDRNicoleZelenak
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Useful Info and Resource Links
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United States Public Health ServiceProtecting, Promoting, and Advancing the health and safety of our Nation.
CORE VALUESLeadershipProvidesvisionandpurposeinpublichealththroughinspiration,dedication,andloyalty.
ServiceDemonstratesacommitmenttopublichealththroughcompassionateactionsandstewardshipoftime,resources,andtalents.IntegrityExemplifiesuncompromisingethicalconductandmaintainsthehigheststandardsorresponsibilityandaccountability.ExcellenceExhibitssuperiorperformanceandcontinuesimprovementinknowledgeandexpertise.
RADM Pamela SchweitzerUSPHS Chief Pharmacy Officer
Did you know?TheUPOCNewsletterispotentiallyreadbythe1,276subscriberstothePHS-pharmacistslistservandover767subscribersonthepharmacystudentlistserv.Intotal,thereareover2,000readersoftheUPOCnewsletter.BUT…it’suptoyoutodistribute.PleasetakethetimetodistributetheUPOCNewslettertoyourUniversitiesortakeacoloredcopyforyourCareerFairRecruitmenttable.
Thank you from the UPOC Newsletter Workgroup!
Editor-in-chief&UPOCNewsletterWorkgroupLeadLCDRShannonSaltclah,Pharm.D.,BC-ADM,NCPS
Wewantyoursubmissionofarticlesandpictures!Pleaseemail LCDR Shannon Saltclahandshewillforwardthemtotheappropriatesectionleads!
UPOC Newsletter Workgroup
COPY EDITORS: CDRHawyeeYanCDRJerryZeeCDRJoshuaWiremanCDRCarolynVolpeCDRNicoleZelenakCDRMonicaReed-AsanteLCDRLyshetteDeshieldsLCDRJoshuaHuntLCDRSadhnaKhatriLCDRAshleeJanusziewiczLCDRSalvatorePepe
CDRVictoriaFerretti-AcetoCDRReneeTaylorLCDRStephanieDaniels-CostaEditorial Staff:CAPTJoAnnHittieCDRRayFordCDRG."Brent"HobbsCDRRobertKoskoCDRKelleySimmsCDRChristinaThompson
LCDRStevenRodgersLCDRAyanaRowleyLCDRMichelleWilliamsLCDRLynetteWassonLCDRDanicaBrownLCDRChristopherMcKnightLTMichelleLockeLTBrettWhiteheadLTKristinaSnyder