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Pharmacy Residency Podcast

Feb 26, 2018

Riley Poe is a PharmD Candidate for May 2018 from Drake University College of Pharmacy and Health Sciences in Des Moines, Iowa. He is pursuing PGY1 pharmacy practice residencies with career interests in critical care, infectious disease, and emergency medicine.  In his free time, he loves to travel to foreign countries, explore the outdoors and try local restaurants.
Full Transcript:
welcome to the pharmacy leaders podcast
with your host Tony Guerra the pharmacy
leaders podcast is a member of the
pharmacy podcast network with interviews
and advice on building your professional
network brand and a purposeful second
income from students residents and
innovative professionals alright welcome
to the pharmacy leaders podcast today I
have Riley Poe who is a foreign D
candidate for may 2018 from Drake
University College of Pharmacy and
Health Sciences in Des Moines Iowa he's
pursuing PG y1 pharmacy practice
residency's with career interests in
critical care infectious disease and
emergency medicine in his free time he
loves to travel to foreign countries
explore the outdoors and try local
resident restaurants so Riley welcome to
the pharmacy leaders podcast Tony thanks
for having me a big fan in the podcast
I'm excited to be here with you and
everyone as they're listening today as a
guest great I'm really excited to have
another Drake student on we just had
Michelle nagas on who was a phenomenal
did some international travel you did
some as well but you also have some
unique interests that I kind of wanted
to delve into but first before we get
everyone's leadership road is a little
different tell me a little bit about
yours and how you got to where you are
yes I think my leadership started before
I even came to Drake my roots are in
sports I was huge into sport growing up
so I think my leadership and being part
of a team started with sports I was
never the most athletically gifted
person on the team but I was the one who
hustled and put in a hundred and ten
percent effort so I think around that my
teammates began to notice that and
respect that so my leader should have
kind of grew from that lead by example
type and be able to get everyone in the
camaraderie of the team to work together
and then once I got to pharmacy school
it kind of took me a little while to
find my footing and leadership and find
where I could fit in you know side of
pharmacy inside of school outside of
sports I was no longer an athlete once I
got to Drake and so I never had an
official role in any big organization on
campus I wasn't the president of APHA or
secretary of a SHP or anything like that
but I found ways to get involved
in leadership through my jobs down at
mercy and downtown Des Moines or to get
down involved in different projects
going around campus and then I got
involved with Adams Academy at Drake was
a which is a Leadership Institute that's
run by the University where students
from all the colleges get together and
they have guest speakers come in and
talk about leadership opportunities and
through that I was able to go out to the
Lincoln Leadership Institute in
Gettysburg which is run by Steven B
Wiley and it's a big Leadership
Institute that a lot of Fortune 500
companies bring their employees to
apples been there Pfizer's been there
just kind of to name-drop a couple of
the big names that train there at this
Leadership Institute and those kind of
really opened my eyes in two different
ways that we as leaders can impact the
people that were leading and through
that I came back to campus and I took on
the student representative role of
central Iowa's pharmacist Association so
I was essentially the student president
responsible for getting all members
involved getting students involved in
that community organization so for me
it's kind of been a journey that keeps
evolving and I'm continuing to learn
different leadership strategies and
learn from leaders and learn from role
models as I continue to go on as leader
in my professional journey so tell me a
little bit about traveling to the is it
the Steven be Wiley and Lincoln
Leadership Institute at Gettysburg I
think the out of state experiences tend
to be really impactful certainly people
are going to APHA for Nashville and
that's more traditional but tell me a
little bit about that I've never heard
about it Gettysburg was just a couple
hours from Baltimore where I lived so
what what do you do there how does you
know the war or the leadership during
the war kind of feed into the actual
leadership experience yes I'd say this
is one of the top experiences I had as a
student at Drake through Adams Academy I
was in the first group of students that
got to go and there's about 20 of us
students that had graduated Adams
Academy we drove a bus out to Gettysburg
in is 1820 hour bus ride out there with
everyone so we got we got there and
Steven B Wiley and his team there's PhDs
on his team there's
people who have more experienced
veterans and a lot of different diverse
people who are historians and really
scholars of that gap Battle of
Gettysburg in the Civil War so they used
those incidents of the battles of
Gettysburg to explore different
leadership concepts and kind of
leadership strategies that they'd like
to impart onto the people that come and
take part in the Institute so they
talked about positioning for a strategic
advantage so being able to do things in
to put yourself in a position where you
can be successful how do you engage your
followers how you keep them excited how
do you keep them wanting to come to work
and you know reach the company's goals
or the mission or take care of patients
in a way that embodies the hospital's
vision or how do you manage conflict or
professional disagreement and how can
you go about that and a tactical way to
keep that team and camaraderie together
so all in all just they use the battle
as a way to kind of shape how leadership
is and kind of show from a historical
view how a lot of leadership concepts
haven't changed in 200 years and those
kind of things are the same but the way
we implement them into our teams and our
businesses or our hospitals is changing
and helping us become better leaders in
that way they used we walked the
battlefields of Gettysburg and that was
kind of our experience there and really
a different learning experience for how
you can be a leader yeah so sunsoo I
think was a general that said every
battle is won and lost before it's ever
fought and you'll go into a pharmacy and
I guess it's maybe even disappointing
sometimes that the pharmacy is so quiet
that you know it's running so well there
there just aren't problems because
everything was kind of set up ahead of
time but tell me how you brought that
back to the central Iowa pharmacist
Association because you know you
mentioned you're not president of APHA
but you are in contact with
pharmaceutical representatives you're in
contact with the local pharmacists so
tell me a little bit about that
leadership yes
as student representative it's a
relatively underutilized under known
pharmacist Association from the student
level so we usually have about 10 to 15
students that are participating in this
so when I took over as student
representative as my job kind of to
increase awareness on campus so to be
able to get more members and get people
out into the community most of the
pharmacists that are part of this are
from Mercy downtown so working and
clinical pharmacists down at the
hospital and then we bring in speakers
whether they're for CII's or for new
drug presentations or pharmaceuticals
sponsored events to teach students about
new drugs teach pharmacists about new
drugs new disease states we let the
residents from Mercy and Methodist give
seee presentations so pharmacists can
both earn seee and students are able to
be there and learn something so I think
it's beneficial for everyone involved
it's good networking for student
pharmacists that want to work on the
inpatient side they get to meet people
who work on the inpatient side and talk
to him about their experiences and get
advice that way so being able to be the
lead of that and get people involved I
think was something that I benefited
from the leadership experience I had
prior to taking that role so tell me a
little bit about your publication that
you had in the APHA student pharmacists
publication that they have it was about
capitalizing on your rotation so you've
gone and kind of had these out-of-state
experiences you've brought that back and
you assumed a leadership role within the
community but now you're telling other
people and kind of leading them through
your words and and your experience how
do you get a publication out there I
know many people applying for residency
is like well how do I get a publication
I'm just a student what do I have to
offer so how did you put that together
because that's a national publication
yeah so the the publication kind of
stemmed right after my p3 year I met
with a faculty member at Drake to review
my CV and kind of look for things that I
could add to it how could I diversify it
how can
make myself stand out and having a
publication was something that we
thought would be a awesome experience
from a student perspective but also make
me stand out as a residency candidate
going forward so I started to brainstorm
some ideas I contacted the APHA student
magazine editor and said hey I'm looking
to get involved in writing an article
and through some dialogue with him and
figuring out what topics he thought
would be beneficial what topics I
thought I could write about we came to
nab a ceccolini gating the competitive
residency world and how we can
capitalise on your rotation so the
articles entitled capitalize any
rotations and it goes through from a
student perspective as a p4 back in
September kind of the thoughts that were
going through my head and how I thought
I could kind of disseminate that
information of my peers as we're all
going through this competitive residency
process and what things you can do you
know you can reach out to your mentors
get some advice you can have them set up
your letters of recommendation you can
make sure that you're learning
everything you can day in and day out at
your site whether that's going above and
beyond and watching a procedure or
learning something new or taking on
those opportunities so it's really about
how you can step outside your comfort
zone and take on opportunities as you're
going through your AP PE s to make
yourself stand out and be a better
candidate as you apply for residences
which we know are you know very
competitive now you're kind of fortunate
at Drake people tend to get there first
or second though they tend to get there
first choice actually most of the time
in terms of where they're gonna go but I
was talking to residency directors at a
sh P and the one thing that I kept
hearing over and over again is that
there's this expectation that residency
directors have time to read carefully
through every little bit of your CV and
that's not usually the case I took a
glance at your CV and immediately I was
like oh this is a this is a hospital
residency B so tell me a little bit
about the AP Pease and how you set yours
up so that when I look at it it looks
like I'm like this guy's going to do a
hospital residency I can tell from the
from the rotations can you tell me first
how you set up
the witch resin which a PP is you're
going to do and then if you had any
opportunity what order you would
recommend putting them in if you're
trying to be in inpatient hospital
resident yes that's a good question I
know that p3 schedules just came out so
I know the students are excited about
that and looking forward to that for me
I set them up in a way to have diverse
learning experiences when I was a p3
student in December when we submitted
those into the experiential office I
wasn't a hundred percent set on hospital
residency so I wanted to make sure that
my experiences were diverse in a way I
started out at a specialty care
outpatient pharmacy that focused on
rheumatologic meds and it's a unique way
and they only have seven seven or eight
employees that work there so I got that
unique experience of a small business
feel and specialty pharmacy which is
up-and-coming right now a lot of people
want to get into specialty pharmacy and
then I had two rotations in acute care
that allowed me to partner with the
internal medicine team and be the
pharmacy representative on that team so
I got that good strong inpatient
experience but also the experience of
working on a medicine team and being
able to communicate with the residents
medical students and the attending to
make those interventions that we needed
and then I went to an outpatient setting
endocrinology clinic up in Minnesota
where pharmacy is is really driving
change Minnesota is one of those places
where pharmacists have a lot of autonomy
and in the practice I was at the
pharmacist that I worked with was
working directly with an endocrinologist
in that office to make medication
changes through medication therapy
management worked a lot through
collaborative practice to make those
changes and order labs or increase
insulin or start new medications or stop
medications that you didn't think we're
effective so there's a lot of autonomy
in that way so is an awesome learning
experience to be able to learn firsthand
and have those interactions with
patients but also be able to practice at
the top of our license and make those
adjustments that we felt were clinically
necessary next I went down to Sarasota
Florida so I got to
you know escape the Iowa winters go down
to Florida for three months total first
was Hospital practice down at Sarasota
Memorial Hospital it's a big teaching
hospital level one trauma center down in
Sarasota where the population is growing
like gangbusters down there and it was I
was in season when everyone from up
north comes down to Florida so the
hospital was constantly at capacity
census was always high so it's good
experience there to have an Hospital
practice where I can go around and see
different areas of the hospital and how
that worked is a good overview of a big
institution and how all the moving parts
kind of come together to take care of
patients my most recent rotation was
down there as well I did ten weeks down
at Sarasota Memorial and that was doing
critical care which was an awesome
experience for me I chose critical care
because I knew it would be a challenge
it's not something we get a lot of
experience with as students and our
patients are more acutely ill than we
see anywhere else they're not internal
medicine patients they have chronic
conditions compiled by acute conditions
and everything is kind of adding up in a
negative way for those patients they're
constantly changing labs are changing
four times a day you know patients are
going up and down up and down so there's
a lot of stuff that as pharmacy students
we can learn and a lot of interventions
that I've found on critical care the
next that will be going to a community
setting and outpatient hospital setting
so I'll get to deal with that transition
of care which is increasingly important
to try to keep our patients from being
readmitted to hospitals then last I will
be back in Des Moines at an internal
medicine clinic with the faculty so I'm
excited for my next two rotations and
you know kind of getting excited for
reservation graduation you know
graduation is you know 80 some days away
so getting excited for that and then as
far as setting up and any advice I could
give for recommending your order I think
it isn't important to have those
experiences that you'd like if you want
to go to a residency it's important to
have those inpatient experiences upfront
and a lot of people say that just so
that you you have those
so if you like it you know you like it
if you don't like it you figure out you
don't like it and you still have time to
change and maybe go into specialty
pharmacy or community residency or
community pharmacy or industry you have
that flexibility to figure out what you
like and that's kind of what your
rotations are for is to figure out what
you like but I would recommend you if
you can get your harder rotations
upfront that kind of stands out and
gives you something to talk about when
you go to residency interviews because
you've had those experiences on the
inpatient side which are extremely
important for showing that you've that
you've had that experience you've worked
with medicine teams you've made
interventions on the inpatient side so I
think if you can structure your
rotations in any way to your advantage
that would be what I recommend so tell
me a little bit about coming to the
critical care residency you you were in
I guess block five or block six but
somewhere somewhere around there and
there's you don't want it too early that
you're just starting but you were kind
of at the point where you had been done
almost half of your rotations what does
it feel like when you come into a
critical care one which is one of the
you know obviously most difficult ones
or most challenging ones how
well-prepared did you feel for that did
you feel pretty comfortable and you did
a double there with the two back to back
so you're already familiar with like EHR
and things like that how well-prepared
did you feel for that a PPE yeah having
ten weeks there I think was extremely
important because I could use that first
five weeks to explore the EHR know where
to find different things and get to know
people and that kind of stuff so when I
got to critical care I was able to hit
the ground running on that front but
clinically it's very the learning curve
as if it was very steep there's a lot of
things that you never see drugs you
don't see drips you don't see when you
work on the internal medicine side or
not on critical patients so that
learning curve was steep for me I had an
awesome preceptor at that experience
that basically was a stepwise approach
so for the first week I was shadowing
and she took me in the room and showed
me how the vent worked and the pumps and
the PCA is
and things like that just on the first
week it's just a baseline of critical
care and what we look for and how we
monitor those patients and we went
through each consult and how we work up
those consults in our patients and we
have Benko consults and warfarin
consults and propofol consults so going
through each one of those individually
and teaching me how to do it and what
things I need to look for and monitor on
these patients was extremely important
and then as we built up I was able to by
week 5 I was working up eight patients
and doing all the consults for those
eight patients by the time I was done
there so I had my entire unit to myself
I rounded by myself and made
interventions with the intensivist in
that way so I think having that stepwise
approach and building from week to week
it was important I am NOT a critical
care pharmacist from that five weeks but
I definitely have exposure and I've felt
that that exposure has helped me through
residency interviews having a strong
critical care experience and having that
experience dealing with those critical
patients was important and they'll the
learning curve was tough at first I do
you think I learned a lot of stuff and
since I did that critical care rotation
I think it's an advantage for me hey
some residency applicants are absolutely
terrified about the case so that you
know you're gonna get asked a certain
case and you're gonna be asked to solve
that case how did you feel you did with
that particular question or what was it
that best prepared you for the scenario
or case questions that came from the the
residents or the interviewers there most
of the cases I had and I will say some
places didn't have a case some cases do
some places have a written case or soap
note some places kind of just
intertwined clinical questions
throughout the interview so it totally
depends where you interview but I didn't
have anyone asked me any specific
critical care questions I didn't have
them asked you know we have this patient
who's sedated on 80 mics of propofol how
what's your plan to decrease that into a
safe range or how are we going to adjust
the PCA so no questions were critically
are focused but I do think having that
experience helped me out so preparing
for the clinical cases I think is
something that yeah it does it scared me
when I didn't know what what do you
expect but I think if you focus on
common disease states and things that
you've learned over and over and those
more internal medicine general acute
care topics and you're interviewing for
an inpatient residency are the things
they're gonna focus on they're gonna try
to challenge you they're gonna ask you
things that you maybe know something
about but don't know a lot about to test
your critical thinking skills and see
how you think on the fly because many
times they're not asking to know if you
know the exact right answer but they
want to see if you can process the
information if you know what labs you
need to look at or what patient
characteristics you should look at to
make that decision so looking more at
the clinical thinking process and how
you actually think then whether you get
to the exact right answer at that time
they know it's a learning experience and
you're still only a student and
residency is to help build those skills
so that's more what they're looking for
in that case so I didn't have anyone
that asked me specifically a critical
care case okay what having the critical
care experience I was able to speak to
when they asked what's the most
challenging rotation you've had and I
had a good story to say I came in not
knowing much about critical care and by
the end I was able to take care of and
manage eight patients work them up round
on them and also complete the consults
for them so I think in that is a good
learning experience for me okay and even
that number I don't know if that's a big
number or a small number but it sounds
like if you're in critical care that
would actually be a lot yeah so my
preceptor had managed like 24 patients
so I was third a third a third of what
she had okay by the end all right and so
you know you've done the rotations here
you're on your way tell me a little bit
about how you approached a SHP for those
that are going to be hitting a SHP next
year or what what your process is going
into kind of deciding which residency's
because there are hundreds of them how
did you you know kind of what's your
thought process with going into where do
I go to look for residency's and things
what advice could you give yeah I think
first you have to kind of sit down and
think about your career goals is the
first thing that you need to do you need
to make sure that you want a residency
because sometimes residency is just one
of those things you think you should do
after but it doesn't really match your
career goals it's not really what you
want to do so once you've established
that residency is what you want to do to
decide whether you want a community
residency and am care residency and
inpatient residency so going through
that and then SHP has a awesome website
platform that can take you through the
different kind of residences and break
it up by state so if you're
geographically located you can look at
the PGI one pharmacy practice residency
is in the state of Wisconsin or the
state of I or California wherever you
may want to go and then from there each
residency is going to be different in
the core rotations they have the
elective rotations they have it's all
it's all going to be different in that
way you know you're gonna have some
hospitals that are academic medical
centers and they have you know hundreds
of beds there you can have places that
are smaller that have 100 beds some
places have two residents some places
have 16 so there's a lot of things to
kind of consider and it all goes back to
your career goals and how you can find a
residency that matches those career
goals is the most important thing
somewhere that's going to allow you to
learn at the best of your ability and
allow you to practice the way you want
to practice pharmacy for me it was a lot
of I guess it started out figuring out
what I wanted and figuring out programs
that met that but then also narrowing it
down to a geographic area it's hard to
look at programs in California and then
look at programs in Florida or look at
programs in New York and you know
there's becomes too many programs and
like you said you know there's hundreds
and or thousands of programs out there
residency spots so being able to have a
focus either on a specific type of
program that you're willing to go
anywhere for or focusing more on a
geographic area that has programs that
are going to help you meet your needs
and then as far as preparing for
mid-year I think once you
that list of programs it's important to
prepare and know something about the
program so you know what you want to ask
them when you go to the booth
it's a busy it's busy there and if you
don't know what you want to ask
sometimes someone gets in front and ask
the question so knowing what you want
from a program and what you want to know
from them there it's all about the
perspective residents in that and they
do a lot to present their program and
help you learn more about it so that one
in time comes time to submit your
application you know if you want to
submit it there don't want to submit it
to that place
it sounds good well I've asked you a
bunch of questions are there any things
that you wanted to talk about or any
advice you want to give that I haven't
asked you about I think so so I don't I
don't have a lot of advice to give so
probably some advice that I've received
that I could pass on is a Vincent van
Gogh quote oddly enough but it says
normality is a paved road it's
comfortable to walk but no flowers grow
on it so for me that kind of means that
everything that is on a paved road it
has already been done and that's the
path that someone else took to get there
but nothing is growing you're not
growing yourself you're not growing your
skills if you just walk down that road
that someone else has already paved so
there's no one way to reach a goal and
if you took ten pharmacists that are
practicing in the area that you want to
practice in all ten of them probably
have different experiences and different
paths that led them to that position so
if I could impart advice that people
have imparted on me throughout my
journey is that go off that paved path
and step outside your comfort zone
get yourself unique experiences that
make you different from the person next
to you and all those experiences will
build up and help you be successful in
whatever career path you choose well
Riley thanks so much for being on the
pharmacy leaders podcast
thank you Tony thanks for having me and
thanks for everyone for listener support
for this episode comes from goodnight
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