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Pharmacy Residency Podcast

Aug 30, 2020

Welcome to the pharmacy residency podcast on the pharmacy podcast network. I have Rachel Whitesitt on with me and she is a P4 at the University of Iowa in her fifth week of this academic rotation. And what we want to do is talk to her a bit about her journey, but also she's had the time to get two degrees as she's going through here. And, maybe some advice on virtual rotations and things like that. So Rachel, welcome to the pharmacy residency podcast.

Thanks for having me, Tony. I've really enjoyed this academic rotation, even though it's virtual. It's very different and I'm pretty flexible and really learn on my feet.

No I'm excited. Well, let's first talk about why pharmacy. Many people kind of start in pharmacy serendipitously. I went to the University of Maryland College Park and as part of the requirement to get into the premed club, I needed some kind of health profession something or other, and then I just volunteered at the pharmacy, but then I just never went back to premed. So that was my way of getting in. What was it that brought you into pharmacy school?

Yeah so, I did start working at a pharmacy when I was in high school. My cousin worked at an independent community pharmacy in our town as a tech and she was like, “Hey, do you need a job?” And I was a high school student, so yeah, I needed a job. I saw what the pharmacists were doing and how they were helping these patients. But they also had all this scientific knowledge and background to it as well, but we're able to translate that into educating patients and meeting them where they're at there. So I chose pre-pharmacy as my major, not sure what I really wanted to do it, but I just chose it. And then as I started at Iowa and was able to meet other pharmacists and then meet with the people at the school, I realized, yeah, this is what I want to do. Being able to talk to patients and then I also really liked the science of how the drugs work in the body. I think it's really interesting. So yeah, I've just stuck with pharmacy.

Okay. And you live down just South of Des Moines, so you could have readily gone down to Kansas or over to Omaha or North to Minnesota. We do have a lot of pharmacy schools around here or just gone a little bit North to Drake, but you just decided on Iowa. So what was it that made you first decide pre-pharmacy Iowa and then what made you decide to stay?

I wanted to choose a school that did have a pharmacy program cause that's where I was leaning towards doing. And then I chose to go to Iowa because I did kind of want a bigger state school because I love football and doing all those fun things and obviously the in-state tuition was good. But then as I learned more about the Iowa pharmacy program, I decided to stay because everyone that I met wanted me to learn and they wanted me to become the best pharmacist that I could be. I just felt like I really fit in well to the Iowa pharmacy family. So that's why I decided to stay there.

And when you sit at the stadium, are you in the I, O, W, or the A, because for those of you that don't know Kinnick stadium, you'll hear I O W A. Where do you guys usually sit?

Yeah, so we sit in the I, that's a student section. And I actually used to live really close to the stadium so I could see it out my window and I could hear that chant.

Okay. That's so cool. Well, let's talk a little bit about your leadership journey because those that are listening are generally interested in residency and they want to do the very best they can in those five areas of clinical, research, leadership, service, and teaching. Tell me a little bit about your leadership journey and what you were involved in. I know you've actually started local and maybe moved out a little bit more than most.

Yeah. My leadership journey has definitely changed and adapted as I've gone throughout pharmacy school. I think of it a little bit more as like servant leadership, so I also feel like I use my leadership position to touch on that service aspect a little bit as well. So one of my first positions I had was our APhA Operation Heart chair. I had actually originally run for our International Vice President position and did not get that. So that's one of those learning from your failures thing. But I really felt like Operation Heart Chair was where I was meant to be because I really enjoyed organizing health fairs and doing the screenings and then also helping to teach our fellow students how to do these screenings and also interpret the readings and then how to counsel patients on that as well. So I really enjoyed that position.

And then I was also very involved Phi Delta Chi, a pharmacy fraternity. I spent two years as my chapter’s what we call Worthy Correspondent, kind of similar to a secretary. We highlight throughout the year what our chapter has done and help communicate that out to our other chapters and to our regional and national officers as well. With that group, I was able to go to multiple regional and national meetings where I've really loved getting to meet other pharmacy professionals from around the region around the nation and make those connections. So this last winter, I ran for a regional position which I've started this year. I'm the Regional Correspondent and I help the 11 different schools in our region and help them with their reports, the same kind of reports that I wrote. And also problem solving, especially with COVID-19, how are they going to do their events. I'm really a touch person for them. I've really enjoyed that and getting to know them personally as well as professionally.

Awesome. Okay. So when you decided on career, so now you've, you've moved into some leadership positions. You started off in community and my understanding is you actually went into hospital for quite a long time. So tell me a little bit about choosing hospital. What you learned from hospital and maybe where the future is, whether hospital or community.

Yeah, so as I said, I worked in an independent community pharmacy for about two years in high school. And then when I went to college and I worked at the University of Iowa Hospitals and Clinics as an inpatient pharmacy technician for about four years. And there was so much going on, over an 800 bed hospital. It's a huge academic medical center, a level one trauma center. It was a really great opportunity. I just started there honestly, cause I needed a job. But then I was able to do a little bit more out from just our central pharmacy, help also in our satellite pharmacy, our children's hospital pharmacy, and then also do med recs as well.

And doing that has kind of helped me see that, personally, the inpatient side is not for me. You see these patients and we send them home and you hopefully never see them again. I prefer to build those relationships over time. I'm really taking a lot of the skills, a lot of the logistical and management skills that I've learned in this huge academic medical center, but also a lot with transitions of care. When I did med recs, you saw patients were sometimes confused about what medications they were on already at home. And so, especially when those patients will then transfer from the hospital setting back to the home setting that's where pharmacists can really be critical, which medications that they changed, which medications they stopped. I hopefully will be taking a lot of those skills I learned in the hospital setting and bring them to either community practice or ambulatory care practice in my future.

So tell me a little bit about choosing to do an MPH because a PharmD is rigorous enough. I know there's some overlap maybe, but tell me a little bit about the MPH and how does it fit into what you're going to do? Cause it seems like you've started, I don't want to say you started small, but you started local and you've expanded out. And my understanding is that the MPH is all about expansion and organizing those things on a much bigger level.

Yeah, definitely. So I chose to do the MPH because I'm a little bit more interested in the – I love direct patient care – but also more of the organizing behind it and doing more outreach and interprofessional work and all of that. And I felt that the MPH could really give me a little bit more background and training in that and just help give me a little bit more education in that area. So at the University of Iowa, we have the dual degree program. So some of our pharmacy classes will count for MPH and then our MPH courses count for our electives. And you can get it done in the four years. It doesn't take an extra year. We did have do summer classes, but they were not too bad. So I thought, why not go for it? You know, it's not going to take me any extra time. And I've really learned about why people do what they do and why do they make the health decisions? And then how can we take some of these public health theories and then use those in our marketing and communication about health issues as well? So yeah, hopefully to take this degree and use it in organizing immunization campaigns and targeting chronic diseases, cause that's really where we're going for public health 3.0 and working with the public health department and other organizations. I really think about it as reaching out to, other groups, whether it be the actual public themselves or other healthcare professionals. And that's where I see myself using public health degree.

Okay. Well, let's talk a little bit about virtual, not just virtual with the APPE and teaching students, but maybe you can kind of fill us in, on some of the virtual things that you were seeing and doing in your first APPE experience, which I think was in Maquoketa. Is that right?

Yes. Yeah. So I was at Osterhaus pharmacy in Maquoketa. That rotation was in person, but our lobby was closed to our patients so we did a lot more tele-health where we were calling patients to counsel them on their medications because they weren't able to come into the store and take that time to sit down with us. We did that over the phone. That was interesting since we're really kind of going towards telemedicine. So that was nice to see.

Okay. And then now you've been teaching students for almost five weeks. Maybe some things that you're picking up either you were able to apply from teaching clinically to teaching in the classroom or teaching in the classroom to something clinical. What's maybe, I hate to use the word Pearl it's so overused, but what's a best practice or, or something in terms of teaching that maybe somebody, let me give you an example. So something, a lot of students like to do is say, this is my first time doing this. So just go easy on me, which completely removes any credibility they might've just had, they took it away. It's like a wedding, nobody knows how it's supposed to go. It just goes the way it did. And that's what all the guests say. What's maybe something that you found out that would be helpful to someone that does a teaching rotation or that does have significant teaching in a community practice?

Yeah. Well, I would say really trying to find a way for the person that you're teaching to be involved. We would do some presentation during our zoom classes, but also having a Kahoot to allow the students to actually have to do something versus just sitting there with their mic off and camera off. And having them actually answer the questions I thought was helpful so they could gain gauge their knowledge, but also become a little bit more engaged in that. I think that's also important for when you're teaching patients, you have to teach or teach them to use like a new inhaler or something, having them show you how to use it engages them. And then it helps them become a little bit more competent in doing that as well.

Yeah. And I think even just today we had one where the students, half of them picked alprazolam, and half of them picked diazepam for a muscle relaxer. And that maybe was a point of distinction where they're saying, okay, well I get they're both benzos, but wouldn't both of them do the same thing with the muscle relaxer and kind of talking about specificity and things like that. So that's a great point. What about when we talk about virtual? What do you think about midyear? I know we haven't talked too much about it, but what do you think a virtual midyear is going to be like. What are maybe some advantages that, that it might have or  disadvantages that it might have? Because I saw that I want to say Wisconsin is having a virtual, there's a group in Wisconsin I think is having its first virtual showcase in just a week. So some of them are happening very quickly, but maybe something that you think would be important as you're going into a virtual midyear or virtual showcase.

Yeah. So I think students want to be a little bit more on our game about figuring out when are these since we don't know if there's going to be a full residency showcase. Is it going to be those three different sessions? I'm just figuring out when the programs that you want to check out. Are they or when are they going to be at this residency showcase or are they going to be having other opportunities to learn about them as well? So checking out their website and social media pages to see, and what other opportunities are they having to connect with them? If we're not necessarily going to be able to talk in person, it'll be important to be able to talk, whether it's over these chats or if you're going to have to maybe see their presentation and email them separately. We'll have to learn to communicate a little bit differently than just talking to them at the residency showcase.

Yeah. And even just with this rotation, maybe you saw how having good video quality, having good audio quality can make a difference in the impression that you make on someone or that they make on you. And you were able to kind of encapsulate what it is to record a presentation versus being in front of someone versus kind of seeing on the fly. Oh wait. So I thought they got this, but this is what actually they actually got out of it. Well, I've asked you a lot of questions. Is there anything that I haven't asked you about, or haven't mentioned that you'd like to maybe address,

I know I touched on a lot. I think just letting students know if there's something you're interested in, go for it. It’s never too late to do anything, especially now I'm in my APPE year and thinking a little bit about more about the five big categories you’ve got to touch on. If there's something you think you're lacking in or something you're more interested in, find people to help you with that. You know, I wanted to see a little bit more what teaching was like. And so that's why I ranked this rotation high and I thought it has been really interesting. It kind of opened my eyes to other kinds of teaching as well, and writing, and a lot of other things. So whatever you're interested in, go for it.

Awesome. Well, thanks so much for being on the pharmacy residency podcast.

Awesome. Thank you.