VCU news

By Dina Weinstein

Most Doctor of Pharmacy students in Virginia Commonwealth University’s School of Pharmacy complete their clinical rotations in the Richmond area or elsewhere in Virginia. But this summer, ahead of their fourth and final year of school, five Pharm.D. students went farther afield in America. Much, much farther.

At the Alaska Native Medical Center in Anchorage, the students spent five weeks doing serious work amid some of America’s most stunning scenery. The Alaska rotation is one of several VCU partnerships that can take pharmacy students far from their usual classrooms to develop their skills – and give them perspectives that may be far from their own experiences.

“I like taking advantage of experiences where I get to work with different patient populations from what I’m used to,” Josephine Gresko said. “I think that’s helpful for understanding your own perspective of different cultures – and how you see other people, practicing cultural humility – and reminding ourselves that when we’re treating a patient, we have to treat the whole person and not just whatever illness they’re facing.”

Gresko’s work focused on administration, supporting the medical center’s accreditation efforts and its medication safety protocols. Emma Ager, with an emphasis on transitions of care, counseled patients about medications when they were discharged from the hospital. Bryn Damico worked in the oncology department in an outpatient infusion pharmacy, while Linda Lyons served in various inpatient hospital settings. And Jessica Torres focused on ambulatory care, which included clinics and specialty pharmacies outside the hospital.

As part of the Indian Health Service, the Alaska Native Medical Center serves 158,000 Alaska Natives and other Native Americans in the state. The rotation, which ran from late June to the end of July, provided insight into socioeconomic disparities and specific health issues facing those citizens.

“I am learning about different patient populations that I have not been able to see before and learning how to help those specific patient populations,” Lyons said from Alaska, where her inpatient settings included emergency, pediatric and intensive care units. “I feel like I become exponentially smarter every single day that I’m here.”

During the students’ rotations, a weekly journal club allowed them to explore common issues by presenting articles on a clinical trial or a pharmacy topic relevant to the Alaska institution. That also helped them evaluate medical literature, and discussions with medical staff focused on practices that could be implemented, as well as potential outcomes.

One such issue was the impact of high tobacco use on their patients’ health, which includes notable rates of lung cancer. Damico took note of the strong partnership between the staff oncologist and pharmacist in determining chemotherapy treatments.

“It was really interesting seeing all these drugs that we just learned about in the classroom, out in real-world practice, and being able to differentiate what cancer goes with which drug and what are the guidelines for best practices for the best individualized plans,” said Damico, whose work included counseling patients on their home medications.

Torres also embraced her direct connection to patients. Her rotation included work at an outpatient pharmacy and a diabetes clinic, where she instructed patients on using insulin, pumps and glucose monitors.

“It’s very diverse,” she said of the work. “It’s really fun being able to see the different sides of an outpatient pharmacy.”

Fourth-year rotations, in settings such as acute care, community pharmacy, hospital administration and ambulatory care, aim to ensure that students are developing into well-rounded pharmacists upon graduation.

Gresko hopes to work as a medication safety officer, and her work in Alaska included an annual report encompassing the latest safety and efficacy alerts, as well as performing environmental rounds. She said the experience “has been validating for my future career choices. … This has been reinforcing that I should go toward a more nontraditional administrative pathway.”

Of course, Alaska provided experiences outside the medical center, too. Local menu selections like reindeer sausages and yak burgers offered some culinary adventure. And nature’s glory – from midnight sun and cool summer temperatures to a daily commute framed by snow-capped mountains and the water – was a big highlight.

“We went on a whale, marine wildlife tour and we got to see probably eight different humpback and fin whales that breached out of the water,” Lyons said.

“It’s amazing. There’s so much wildlife,” Damico added. “We’ve done hikes every weekend, and they’re insane.”

“But it’s so worth the work,” Torres said. “The hikes here are usually about 3 miles or longer, so it does take up a big chunk of our day. We’ve gotten to see some really pretty mountains, some really beautiful lakes – and just enjoy each other’s company.”