Career Opportunities in Academic Pharmacy The American Association of Colleges of Pharmacy Presentations available at: –Click on Meetings.

Career Opportunities inCareer Opportunities inAcademic PharmacyAcademic Pharmacy

The American Association of Colleges of PharmacyThe American Association of Colleges of Pharmacy

Presentations available at: www.aacp.orgPresentations available at: www.aacp.org– Click on Click on MeetingsMeetings– Then click Then click Past Meetings and PresentationsPast Meetings and Presentations– Then click Then click AACP-Sponsored ProgramsAACP-Sponsored Programs– Then select Then select ASHP Midyear Clinical Meeting ASHP Midyear Clinical Meeting

20072007– (Slides from 2003-2006 also available)(Slides from 2003-2006 also available)

Trends in Pharmacy Trends in Pharmacy Education: Implications Education: Implications for New Faculty for New Faculty MembersMembers

Cynthia L. Raehl, Pharm, FASHP, FCCPCynthia L. Raehl, Pharm, FASHP, FCCPProfessor and Chair, Clinical Research and Professor and Chair, Clinical Research and DevelopmentDevelopmentTexas Tech University Health Sciences CenterTexas Tech University Health Sciences Center

2007-2008 President, AACP; Past President ASHP. 2007-2008 President, AACP; Past President ASHP. Active consultant pharmacist, teacher, administrator, Active consultant pharmacist, teacher, administrator, researcher, and national leader.researcher, and national leader.

OutlineOutline

Characteristics of the pharmacy education Characteristics of the pharmacy education enterprise. enterprise.

Diversity of pharmacy schools and colleges.Diversity of pharmacy schools and colleges. Issues and challenges in academic Issues and challenges in academic

pharmacy – looking to the future.pharmacy – looking to the future. Characteristics of pharmacy faculty.Characteristics of pharmacy faculty. Why would you want to join academic Why would you want to join academic

pharmacy? pharmacy? WHY NOT?WHY NOT? Choosing your first academic home – the Choosing your first academic home – the

next step. next step.

Characteristics of the Characteristics of the Pharmacy Education Pharmacy Education EnterpriseEnterprise Approximately 103 schools / colleges (some Approximately 103 schools / colleges (some

in preliminary stages of accreditation).in preliminary stages of accreditation). Accreditation by the Accreditation Council for Accreditation by the Accreditation Council for

Pharmacy Education is essential for Pharmacy Education is essential for licensure.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 Many existing schools are expanding class

sizes or developing satellite campuses.sizes or developing satellite campuses. All award the Doctor of Pharmacy as the only All award the Doctor of Pharmacy as the only

entry-level degree for practicing pharmacists.entry-level degree for practicing pharmacists.

From: SK Gershon, JM Cultice, KK Knapp, “How Many Pharmacists are in our Fulture.” www.hhs.gov/pharmacy/phpharm/howmany.html presented at ASHP June 5, 2000

First Professional Degree Enrollments 1992-2006

Diversity of Pharmacy Diversity of Pharmacy Schools and CollegesSchools and Colleges 42% are part of Academic Health Centers.42% are part of Academic Health Centers. Some have academic health centers Some have academic health centers

associated with their university at a distant associated with their university at a distant campus (e.g., U. Texas, U. Georgia, Purdue, U. campus (e.g., U. Texas, U. Georgia, Purdue, U. Connecticut)Connecticut)

Several are associated with osteopathic Several are associated with osteopathic medical schools.medical schools.

Some are associated with larger Some are associated with larger comprehensive universities.comprehensive universities.

Some are stand alone (e.g., St. Louis College Some are stand alone (e.g., St. Louis College of Pharmacy, Massachusetts College of of Pharmacy, Massachusetts College of Pharmacy).Pharmacy).

Diversity of Schools and Diversity of Schools and Colleges (continued)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 Four year Pharm.D.- Six year Pharm.D. from

high school –3year year-round programs.high school –3year year-round programs. Some institutions are research-intensive and Some institutions are research-intensive and

some are more teaching-intensive.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 Some are at institutions that are Historically

Black Colleges/Universities (HBCUs). Black Colleges/Universities (HBCUs). Some are parts of institutions sponsored by Some are parts of institutions sponsored by

specific religions.specific religions.

Issues and Challenges in Issues and Challenges in Pharmacy EducationPharmacy 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 continuingEvidence of a continuingpharmacist shortage: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, http://www.pharmacymanpower.com)

Pharmacists report “excessively high” workload (Schommer, et al. J Am. Pharm. Assoc. 2006:340-7)

Number of elderly will double from 2000-2030; # of prescriptions per patient is markedly higher for those over 65.

Can we meet the Can we meet the demand?demand?

There are sufficient qualified applicants.There are sufficient qualified applicants. Experiential education is a major limiting resource Experiential education is a major limiting resource

(Is the disseminated model of experiential (Is the disseminated model of experiential education the optimal model? What can be done education the optimal model? What can be done with simulation? How can we support with simulation? How can we support practitioners so they continue to be willing to be practitioners so they continue to be willing to be educators? How do we improve the quality of educators? How do we improve the quality of practices where our students are educated?)practices where our students are educated?)

Faculty members (full time and adjunct or Faculty members (full time and adjunct or volunteer are another limiting resource).volunteer are another limiting resource).

Many models of distance education are being Many models of distance education are being implemented and assessed.implemented and assessed.

Issues and Challenges Issues and Challenges in Pharmacy Educationin Pharmacy Education

Expansion to meet the pharmacist Expansion to meet the pharmacist shortageshortage

Implementation of Institute of Medicine Implementation of Institute of Medicine objectives to improve health careobjectives to improve health care

Curriculum changes to meet CAPE Curriculum changes to meet CAPE outcomesoutcomes

Faculty recruitment and retentionFaculty recruitment and retention AssessmentAssessment

Can we be part of the Can we be part of the healthcare improvement healthcare improvement solution?solution?

Healthcare in this country is uncoordinated, Healthcare in this country is uncoordinated, not patient-focused, inefficient and not patient-focused, inefficient and expensive.expensive.

IOM has recommended that health care IOM has recommended that health care become:become:– Patient-centered (coordinated, integrated)Patient-centered (coordinated, integrated)– Team-delivered (interprofessional)Team-delivered (interprofessional)– Evidence-basedEvidence-based– Informatics-supportedInformatics-supported– Safer; more efficient and more effectiveSafer; more efficient and more effective– Engaged in continuous quality improvementEngaged in continuous quality improvement

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

Issues and Challenges Issues and Challenges in Pharmacy Educationin Pharmacy Education

Expansion to meet the pharmacist Expansion to meet the pharmacist shortageshortage

Implementation of Institute of Medicine Implementation of Institute of Medicine objectives to improve health careobjectives to improve health care

Curriculum changes to meet CAPE Curriculum changes to meet CAPE outcomesoutcomes

Faculty recruitment and retention AssessmentAssessment

Type of AppointmentType of Appointment

76%

13%

8% 3%

Calendar FT

Acad FT

Calendar PT

Acad PT

Majority of pharmacy Majority of pharmacy faculty are on full-time, faculty are on full-time, calendar-year calendar-year appointmentsappointments

Tenure StatusTenure Status

Tenured37%

Tenure-track21%

Nontenure-track42%

Faculty Gender Faculty Gender DiversityDiversity

0

20

40

60

80

100

dean ast/ascdean

full prof asc prof ast prof instr0

20

40

60

80

100

dean ast/ascdean

full prof asc prof ast prof instrfemale

male

1991-92 Full-time faculty 2006-07 Full-time faculty

Three kinds of faculty Three kinds of faculty membersmembers Basic, translational, and clinical Basic, translational, and clinical

pharmaceutical scientists.pharmaceutical scientists. Practice faculty.Practice faculty. Social and administrative Social and administrative

pharmacy.pharmacy.

Discipline Discipline 2006-2007 Full-time faculty

Pharmacy PracticePharmacy Practice 21702170 Pharmacology/Biological SciencesPharmacology/Biological Sciences 632632 PharmaceuticsPharmaceutics 501501 Medicinal ChemistryMedicinal Chemistry 497497 Social/Admin SciencesSocial/Admin Sciences 326326 Continuing EducationContinuing Education 3939 Libraries/Educ ResourcesLibraries/Educ Resources 2525 Liberal ArtsLiberal Arts 2424

What do they have in What do they have in common?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 FacultyPractice Faculty    Doctor of Pharmacy Doctor of Pharmacy Residency Residency

(general; 1 year specialty) or additional (general; 1 year specialty) or additional practice experience. Some research practice experience. Some research training (exposure) training (exposure) faculty position. faculty position. Pharmacy practice is a significant portion Pharmacy practice is a significant portion of their job.of their job.

Clinician-educator model accepted; Clinician-educator model accepted; usually non-tenure track.usually non-tenure track.

Practice faculty and practitioners alike Practice faculty and practitioners alike are developing new modes or models of are developing new modes or models of practice; need to document, assess practice; need to document, assess impact on patient care outcomes and impact on patient care outcomes and publish. publish. 

Practice FacultyPractice Faculty Mostly teach in a practice setting. Mostly teach in a practice setting. May do some didactic teaching and May do some didactic teaching and

some research or scholarship; some research or scholarship; probably are developing new modes probably are developing new modes or models of practice; need to or models of practice; need to document it and determine the document it and determine the advantages and publish.advantages and publish.

Faculty freedom, independence, Faculty freedom, independence, lifestyle, long term financial reward, lifestyle, long term financial reward, flexible career path. flexible career path. You will make a You will make a difference!difference!

Faculty are change Faculty are change agents.agents. Requires pharmacists who are Requires pharmacists who are

competent and confident in their skills competent and confident in their skills and abilities.and abilities.

Requires pharmacists who understand Requires pharmacists who understand how to lead change and engage in how to lead change and engage in continuous quality improvement.continuous quality improvement.

Requires growth and maturation Requires growth and maturation obtained through residencies or very obtained through residencies or very significant life experiences. significant life experiences.

Issues and Challenges Issues and Challenges in Pharmacy Educationin Pharmacy Education

Expansion to meet the pharmacist shortageExpansion to meet the pharmacist shortage Implementation of Institute of Medicine Implementation of Institute of Medicine

objectives to improve health careobjectives to improve health care Curriculum changes to meet CAPE Curriculum changes to meet CAPE

outcomesoutcomes Faculty recruitment and retentionFaculty recruitment and retention Assessment: Measure our graduates

performance and the impact of the curriculum.

Issues in assessmentIssues in assessment

How do we achieve excellence in all How do we achieve excellence in all programs? How do we define excellence? programs? How do we define excellence? How do we measure and document our How do we measure and document our students’ performance and skills? students’ performance and skills?

ACPE is under pressure from the ACPE is under pressure from the Department of Education to develop more Department of Education to develop more standardized assessments. standardized assessments.

Progress exams? To assess individual Progress exams? To assess individual and/or institutional performance?and/or institutional performance?

Outcome exams? (should a standard Outcome exams? (should a standard Observed Structured Clinical Examination Observed Structured Clinical Examination (OSCE) be required prior to licensure?)(OSCE) be required prior to licensure?)

What skills should What skills should students demonstrate? students demonstrate?

Evidenced-based practice Evidenced-based practice determines evidence determines evidence based education.based education.

1.1. MortalityMortality

2.2. Length of stayLength of stay

3.3. Adverse drug reactionsAdverse drug reactions

4.4. Total hospitalization Total hospitalization costscosts

5.5. Medication errorsMedication errors

6.6. Med errors affecting Med errors affecting patient outcomespatient outcomes

7.7. Drug costsDrug costs

Core Skill SetCore Skill Set Drug protocol Drug protocol

management (7)management (7)• Medication histories Medication histories

(now mandated as med (now mandated as med reconciliation) (6)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 Why would you want to join academic join academic pharmacy?pharmacy?

What’s good about being a What’s good about being a faculty member?faculty member?

The ability to impact the future of the profession The ability to impact the future of the profession or your discipline nationally and internationally.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 Students are fun and challenging and keep you

intellectually young.intellectually young. You are constantly learning new things and can You are constantly learning new things and can

change your focus over time; sabbaticals!change your focus over time; sabbaticals! You have freedom to choose your interests and You have freedom to choose your interests and

to choose how you spend each day, within the to choose how you spend each day, within the mission of the school.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 Attributes of a successful faculty memberfaculty member

A passion for teaching.A passion for teaching. A passionate interest in one’s research or A passionate interest in one’s research or

practice area; a desire to improve practice.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 Independence and self-direction…combined

with a willingness to work with others.with a willingness to work with others. A strong work ethic and the ability to balance A strong work ethic and the ability to balance

one’s life.one’s life. Excellent post-Pharm.D. education and research Excellent post-Pharm.D. education and research

training – be prepared; don’t rush it!training – be prepared; don’t rush it!

Go for it!Go for it!

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