Career Opportunities in Academic Pharmacy The American Association of Colleges of Pharmacy Presentations available at: –Click on Meetings –Then click Past Meetings and Presentations –Then click AACP-Sponsored Programs –Then select ASHP Midyear Clinical Meeting 2007 –(Slides from also available)

Trends in Pharmacy Education: Implications for New Faculty Members Cynthia L. Raehl, Pharm, FASHP, FCCP Professor and Chair, Clinical Research and Development Texas Tech University Health Sciences Center President, AACP; Past President ASHP. Active consultant pharmacist, teacher, administrator, researcher, and national leader.

Outline Characteristics of the pharmacy education enterprise. Characteristics of the pharmacy education enterprise. Diversity of pharmacy schools and colleges. Diversity of pharmacy schools and colleges. Issues and challenges in academic pharmacy – looking to the future. Issues and challenges in academic pharmacy – looking to the future. Characteristics of pharmacy faculty. Characteristics of pharmacy faculty. Why would you want to join academic pharmacy? WHY NOT? Why would you want to join academic pharmacy? WHY NOT? Choosing your first academic home – the next step. Choosing your first academic home – the next step.

Characteristics of the Pharmacy Education Enterprise Approximately 103 schools / colleges (some in preliminary stages of accreditation). Approximately 103 schools / colleges (some in preliminary stages of accreditation). Accreditation by the Accreditation Council for Pharmacy Education is essential for licensure. Accreditation by the Accreditation Council for Pharmacy Education is essential for licensure. Zero to seven schools per state. Zero to seven schools per state. Many new schools. Many new schools. Many existing schools are expanding class sizes or developing satellite campuses. Many existing schools are expanding class sizes or developing satellite campuses. All award the Doctor of Pharmacy as the only entry- level degree for practicing pharmacists. All award the Doctor of Pharmacy as the only entry- level degree for practicing pharmacists.

From: SK Gershon, JM Cultice, KK Knapp, “How Many Pharmacists are in our Fulture.” presented at ASHP June 5,

First Professional Degree Enrollments

Diversity of Pharmacy Schools and Colleges 42% are part of Academic Health Centers. 42% are part of Academic Health Centers. Some have academic health centers associated with their university at a distant campus (e.g., U. Texas, U. Georgia, Purdue, U. Connecticut) Some have academic health centers associated with their university at a distant campus (e.g., U. Texas, U. Georgia, Purdue, U. Connecticut) Several are associated with osteopathic medical schools. Several are associated with osteopathic medical schools. Some are associated with larger comprehensive universities. Some are associated with larger comprehensive universities. Some are stand alone (e.g., St. Louis College of Pharmacy, Massachusetts College of Pharmacy). Some are stand alone (e.g., St. Louis College of Pharmacy, Massachusetts College of Pharmacy).

Diversity of Schools and Colleges (continued) Public (state funded) and private. Public (state funded) and private. Urban and rural and in-between. Urban and rural and in-between. Four year Pharm.D.- Six year Pharm.D. from high school –3year year-round programs. Four year Pharm.D.- Six year Pharm.D. from high school –3year year-round programs. Some institutions are research-intensive and some are more teaching-intensive. Some institutions are research-intensive and some are more teaching-intensive. Class sizes range from 30 to 250 students. Class sizes range from 30 to 250 students. Some are at institutions that are Historically Black Colleges/Universities (HBCUs). Some are at institutions that are Historically Black Colleges/Universities (HBCUs). Some are parts of institutions sponsored by specific religions. Some are parts of institutions sponsored by specific religions.

Issues and Challenges in Pharmacy Education Expansion to meet the pharmacist shortage Implementation of Institute of Medicine objectives to improve health care Curriculum changes to meet CAPE outcomes Faculty recruitment and retention Assessment

Evidence of a continuing pharmacist shortage: Estimated need for pharmacists to fulfill care and distributive roles in 2020 is 417,000; shortfall in supply estimated at 157,000 (Knapp, DA, Am J Pharm Ed 2002;66:421-9) Aggregate Demand Index continues to show imbalance between supply and demand (Knapp, KK, Pharmacists report “excessively high” workload (Schommer, et al. J Am. Pharm. Assoc. 2006:340-7) Number of elderly will double from ; # of prescriptions per patient is markedly higher for those over 65.

Can we meet the demand? There are sufficient qualified applicants. There are sufficient qualified applicants. Experiential education is a major limiting resource (Is the disseminated model of experiential education the optimal model? What can be done with simulation? How can we support practitioners so they continue to be willing to be educators? How do we improve the quality of practices where our students are educated?) Experiential education is a major limiting resource (Is the disseminated model of experiential education the optimal model? What can be done with simulation? How can we support practitioners so they continue to be willing to be educators? How do we improve the quality of practices where our students are educated?) Faculty members (full time and adjunct or volunteer are another limiting resource). Faculty members (full time and adjunct or volunteer are another limiting resource). Many models of distance education are being implemented and assessed. Many models of distance education are being implemented and assessed.

Issues and Challenges in Pharmacy Education Expansion to meet the pharmacist shortage Expansion to meet the pharmacist shortage Implementation of Institute of Medicine objectives to improve health care Implementation of Institute of Medicine objectives to improve health care Curriculum changes to meet CAPE outcomes Curriculum changes to meet CAPE outcomes Faculty recruitment and retention Faculty recruitment and retention Assessment Assessment

Can we be part of the healthcare improvement solution? Healthcare in this country is uncoordinated, not patient-focused, inefficient and expensive. Healthcare in this country is uncoordinated, not patient-focused, inefficient and expensive. IOM has recommended that health care become: IOM has recommended that health care become: –Patient-centered (coordinated, integrated) –Team-delivered (interprofessional) –Evidence-based –Informatics-supported –Safer; more efficient and more effective –Engaged in continuous quality improvement

The CAPE outcomes and ACPE suggest similar curricular focus. Pharmaceutical care Pharmaceutical care Systems management Systems management Public Health Public Health

Issues and Challenges in Pharmacy Education Expansion to meet the pharmacist shortage Expansion to meet the pharmacist shortage Implementation of Institute of Medicine objectives to improve health care Implementation of Institute of Medicine objectives to improve health care Curriculum changes to meet CAPE outcomes Curriculum changes to meet CAPE outcomes Faculty recruitment and retention Assessment Assessment

Type of Appointment Majority of pharmacy faculty are on full-time, calendar- year appointments

Tenure Status

Faculty Gender Diversity Full-time faculty Full-time faculty

Three kinds of faculty members Basic, translational, and clinical pharmaceutical scientists. Basic, translational, and clinical pharmaceutical scientists. Practice faculty. Practice faculty. Social and administrative pharmacy. Social and administrative pharmacy.

Discipline Discipline Full-time faculty Pharmacy Practice2170 Pharmacy Practice2170 Pharmacology/Biological Sciences632 Pharmacology/Biological Sciences632 Pharmaceutics501 Pharmaceutics501 Medicinal Chemistry497 Medicinal Chemistry497 Social/Admin Sciences326 Social/Admin Sciences326 Continuing Education39 Continuing Education39 Libraries/Educ Resources25 Libraries/Educ Resources25 Liberal Arts24 Liberal Arts24

What do they have in common? They all teach pharmacy students. They all teach pharmacy students. They all engage in scholarly work or research. They all engage in scholarly work or research. They all publish their work. They all publish their work. They all participate in service activities. They all participate in service activities. They all are experts in their fields. They all are experts in their fields. The balance of teaching/research/service and the expectations placed upon them will vary with the mission of the school and the university it is part of - know that before you take a position!!

Practice Faculty  Doctor of Pharmacy  Residency (general; 1 year specialty) or additional practice experience. Some research training (exposure)  faculty position. Pharmacy practice is a significant portion of their job. Clinician-educator model accepted; usually non-tenure track. Clinician-educator model accepted; usually non-tenure track. Practice faculty and practitioners alike are developing new modes or models of practice; need to document, assess impact on patient care outcomes and publish. Practice faculty and practitioners alike are developing new modes or models of practice; need to document, assess impact on patient care outcomes and publish.

Practice Faculty Mostly teach in a practice setting. Mostly teach in a practice setting. May do some didactic teaching and some research or scholarship; probably are developing new modes or models of practice; need to document it and determine the advantages and publish. May do some didactic teaching and some research or scholarship; probably are developing new modes or models of practice; need to document it and determine the advantages and publish.  Faculty freedom, independence, lifestyle, long term financial reward, flexible career path. You will make a difference!

Faculty are change agents. Requires pharmacists who are competent and confident in their skills and abilities. Requires pharmacists who are competent and confident in their skills and abilities. Requires pharmacists who understand how to lead change and engage in continuous quality improvement. Requires pharmacists who understand how to lead change and engage in continuous quality improvement. Requires growth and maturation obtained through residencies or very significant life experiences. Requires growth and maturation obtained through residencies or very significant life experiences.

Issues and Challenges in Pharmacy Education Expansion to meet the pharmacist shortage Expansion to meet the pharmacist shortage Implementation of Institute of Medicine objectives to improve health care Implementation of Institute of Medicine objectives to improve health care Curriculum changes to meet CAPE outcomes Curriculum changes to meet CAPE outcomes Faculty recruitment and retention Faculty recruitment and retention Assessment: Measure our graduates performance and the impact of the curriculum.

Issues in assessment How do we achieve excellence in all programs? How do we define excellence? How do we measure and document our students’ performance and skills? How do we achieve excellence in all programs? How do we define excellence? How do we measure and document our students’ performance and skills? ACPE is under pressure from the Department of Education to develop more standardized assessments. ACPE is under pressure from the Department of Education to develop more standardized assessments. Progress exams? To assess individual and/or institutional performance? Progress exams? To assess individual and/or institutional performance? Outcome exams? (should a standard Observed Structured Clinical Examination (OSCE) be required prior to licensure?) Outcome exams? (should a standard Observed Structured Clinical Examination (OSCE) be required prior to licensure?)

What skills should students demonstrate? Evidenced-based practice determines evidence based education. 1. Mortality 2. Length of stay 3. Adverse drug reactions 4. Total hospitalization costs 5. Medication errors 6. Med errors affecting patient outcomes 7. Drug costs Core Skill Set Drug protocol management (7) Drug protocol management (7) Medication histories (now mandated as med reconciliation) (6) Medication histories (now mandated as med reconciliation) (6) Medical rounds (5) Medical rounds (5) ADR management (4) ADR management (4) Inservice education (3) Inservice education (3) Drug information (3) Drug information (3) A 20 year study of US Hospitals. Bond and Raehl

Why would you want to join academic pharmacy?

What’s good about being a faculty member? The ability to impact the future of the profession or your discipline nationally and internationally. The ability to impact the future of the profession or your discipline nationally and internationally. A wide variety of opportunities, including travel. A wide variety of opportunities, including travel. Students are fun and challenging and keep you intellectually young. Students are fun and challenging and keep you intellectually young. You are constantly learning new things and can change your focus over time; sabbaticals! You are constantly learning new things and can change your focus over time; sabbaticals! You have freedom to choose your interests and to choose how you spend each day, within the mission of the school. You have freedom to choose your interests and to choose how you spend each day, within the mission of the school. It is the BEST job in all of pharmacy! It is the BEST job in all of pharmacy!

Attributes of a successful faculty member A passion for teaching. A passion for teaching. A passionate interest in one’s research or practice area; a desire to improve practice. A passionate interest in one’s research or practice area; a desire to improve practice. Communication skills (oral and writing). Communication skills (oral and writing). Interpersonal skills. Interpersonal skills. Independence and self-direction…combined with a willingness to work with others. Independence and self-direction…combined with a willingness to work with others. A strong work ethic and the ability to balance one’s life. A strong work ethic and the ability to balance one’s life. Excellent post-Pharm.D. education and research training – be prepared; don’t rush it! Excellent post-Pharm.D. education and research training – be prepared; don’t rush it!

Go for it! My advice: Try it out by getting some teaching experience as a resident; and then….