The importance of lifelong learning
I got this guest post submission from a student and found it pretty funny. I'd be there are a TON of pharmacists that are just as clueless here in the states. If you don't use it, you lose it. I know that I don't remember a lot of the intricate stuff I knew back during and right after school. But, I do read, learn, and occassionally challenge myself. This is one of the reasons I like to have students. Constantly explaining things to them helps me remember it, and at the same time, they will know things that I do not remember. Having them teach me benefits me with knowledge and them with recollection and presentation. If you want to keep up and remember stuff, get some students on rotations -- trust me. CE's are worthless in general. When compared to students, they are a waste of time.
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I understand the Unites States requires every pharmacist to get a doctorate prior to becoming qualified. However, in Australia, it isn’t required. It is still an undergraduate degree, so we come out after only four years of studying, do a year’s internship, pass our registration exams and we’re done. Every year, we have to enough “points” every year to remain registered as a way to encourage our ongoing learning.
As I’m still in my third year of my degree at the wonderful University of Sydney, we are required to undertake externships, where we get sent to pharmacies for “workplace experience”. I undertook my externship at a medical centre in Sydney’s north.
As one would presume, the entire purpose of my presence there was to learn. The medical centre pharmacy was small enough for only one pharmacist and pharmacist assistant to run the store.
I was questioning the pharmacist present at the time of the several of the drugs people came in for. One of them was quetiapine- as one should know- an atypical antipsychotic.
“What class of antipsychotic is quetiapine?” I asked.
The pharmacist replied curtly, “I don’t know.”
At that time, the pharmacist assistant, who is also qualified, hospital nurse, commented that he should know coz he just passed his registration exams a few months ago.
So I continued to ask: “Why do antipsychotics cause suicidal thoughts at times?”
“I don’t know.”
Do you fucking know anything?
Let’s try something else then. “Why do topical corticosteroids thin out the skin?”
“I don’t know.”
How much did you bribe the examiner to let you pass your registration exams?!
Ok, so I dropped that topic. So I asked about shingles. “I heard shingles is called herpes zoster, but it’s caused by the varicella virus. So does that mean herpes and varicella virus are the same?”
Again, “I don’t know.”
The pharmacist did not look at me the entire time, so I looked at the computer screen he was typing away at. He was on Wikipedia searching up shingles.
WIKIPEDIA.
SURELY, THERE ARE MORE RESPECTABLE & TRUSTWORTHY REFERENCES TO TURN TO? ALL OF THEM HAVE AN ELECTRONIC VERSION AVAILABLE. MEDSCAPE. AUSTRALIAN MEDICINES HANDBOOK. MIMS ONLINE. THERAPEUTIC GUIDELINES.
“I don’t know anything. Stop asking me questions.”
That’s exactly what I did. So for the rest of my externship that day, I didn’t ask any questions. This incompetent pharmacist went on to report me with an “attitude, and is not willing to learn”.
Oh wait, what? So did not see that one coming.
I have seen a variety of pharmacists in the professional field over the three years I’ve been studying and working in pharmacies. I’ve seen the best pharmacists who are able to treat palmoplantar psoriasis and various skin conditions better than doctors can. I’ve also seen the negligent; one pharmacist gave out Nurofen Plus to a patient with an active peptic ulcer just because they requested it by brand. Even with my incomplete education, I know that I should have offered an alternative, perhaps paracetamol [acetaminophen] for your headache?
The pharmacist I worked with during my externship rivals the worst pharmacists simply due to his knowledge gap. I don’t think customers realise it because all he does is assume the doctor has given all the instructions to the patient, so he doesn’t have to do it, and most customers are regulars so they’ve been on the medications for many years.
Being a young pharmacist isn’t an excuse for being ignorant. Pharmacists are the second most respected profession [second only to emergency workers] so don’t tarnish our reputation!
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December 19th, 2011 - 03:41
Hahahah. Students. While I agree that having students is beneficial, I would love to see this gal after even one year in retail pharmacy. My bet is she will be back at uni doing med.
I wouldn’t blame her. The outlook on pharmacy is not so good in the States — wonder what it’s like in other countries? I wouldn’t let my son/daughter go to pharmacy school for anything right now — other than if I owned an already successful, un-challenged by WAG, independent pharmacy somewhere in a rural area. Then you have something to hand over…or maybe the only other reason would be making sure that they completed a two year residency, got board certified, and stepped into one of those roles — which are expanding in many areas and ways. But retail pharmacy? We could all of us be screwed soon…
December 19th, 2011 - 11:40
The student sounds like one of those obnoxious little pissants who already knows the answers to all of their own questions, but asks them anyway to show off what a brilliant ass kisser he is. No patient has ever asked me what class of antipyschotic Seroquel is, because none of them give a crap. The only question they ask is why their med isn’t ready and why it costs $3 when their other meds are $1.
I don’t actually think that the questions were posed like that at the time. Because, you’re right, that would be a little silly. Either she didn’t know the answers when she asked them (and subsequently looked them up before writing this) or had some sort of assignment where there were a number of questions like that and they were to ask the pharmacist (or preferably look up) as a way to get credit for the externship. Regardless, in the story she says “3rd year” of schooling, and since we don’t know how their curriculum is designed, she may not have reached those lectures yet…never know!
Honestly, though, what you are saying is a moot point for most of the readers of this site. I am really talking about using students on doctoral rotations as a learning tool. These kids will have had 5 (or more) years of schooling and maybe even some other challenging rotations. These kids will, hopefully, be pretty sharp on most things drugs. The questions the preceptor would ask them should be very challenging (much moreso than ‘what class is quetiapine’ and ‘why do topical corticosteroids thin out the skin’ — and if they don’t know they will look up the answer. If the student ask a questions of the preceptor and the preceptor doesn’t know, they will look up the answer. I *may* tell them I’m not 100% sure of the answer, but I wouldn’t continually show them ineptitude like that guy did. That would definitely open up a bag of worms, potential for a disrespect, and a bad site experience.
December 20th, 2011 - 23:50
I disagree with Joe. I encourage all students to ask questions and I enjoy answering. It is the job of a student to learn and a preceptor should attempt to educate. Plus we are all busy and do not have time to always sit down and discuss relevant topics so asking questions is the best way to get knowledge out of a busy rph.
December 20th, 2011 - 23:57
I, like many pharmacists I believe, will always direct a student to look up the answers themselves. I am not a walking Medline…ahem..I mean I encourage self-learning.
I will double check (is this a pharmacist thing) their answers and direct them as necessary.
And I wouldn’t dismiss Wikipedia as a reference source as well. The trick of the trade is to recognise worthy articles and not summarise everything under the wiki banner as crap (EBM skills there).
But I do agree, having students is a blast, they do jot our memory about how in one cold day we were learning this thing called cyclic AMP thingy…