Clint Ross, PharmD, BCPP
CPNP Board of Directors Member-at-Large
Psychiatry and Psychiatric Pharmacy are continuously expanding fields with ever increasing interest among pharmacy students. Despite the growth in available psychiatric pharmacy positions, residencies, and Board Certified Psychiatric Pharmacists (BCPPs), there continues to be a relative lack of opportunities for exposure beyond the classroom for many interested students. Both within and outside academia, Psychiatric Pharmacists must look for ways to foster this interest for continued expansion of the profession. One common way to provide exposure beyond the classroom is through “shadowing” opportunities. While these can be incredibly valuable, they may not be consistently feasible in some settings for multiple reasons. Not to mention restrictions associated with the coronavirus pandemic, other challenges may include confidentiality restrictions at the facility, space or time concerns, or even a lack of an easy way to connect interested students at a school with available opportunities in the area.
At the Medical University of South Carolina (MUSC) Institute of Psychiatry (IOP), we developed a process for interested MUSC College of Pharmacy students to access various shadowing opportunities based on their level of interest in psychiatry. This change was made to increase access to such opportunities, while limiting the impact on patient care or confidentiality from students (beyond those who are on rotation) accessing patient care units on a consistent basis. The IOP is a 100-bed psychiatric hospital within an academic medical center. The psychiatric pharmacy team within IOP includes five full time BCPP’s and two PGY2 Psychiatric Pharmacy Residents. Our chapter of the Student Society of Health-System Pharmacists (SSHP) Psychiatry Special Interest Group (“SIG”) hosts annual events (eg, rapid round tables, expert lectures, Q&A’s, etc.) to introduce students to local Psychiatric Pharmacists. One of the IOP BCPPs generally serves as the faculty liaison for this group. Following this activity early in the year, students with ongoing interest are encouraged to reach out to begin a phased approach to shadowing, based on their level of interest.
Step 1: Students who are interested in shadowing are welcome to join our group (Psychiatric Pharmacists, pharmacy students, and pharmacy residents) for monthly “Case Discussions,” during which rotational students and residents present challenging, de-identified cases and their proposed evidence-based plans. This “Step 1” shadowing opportunity introduces students to the types of patients and cases we work with daily. Students are encouraged to participate by asking questions, including for clarification, when needed.
Step 2: Once students have seen the group cases, if they have an even stronger desire to learn more about Psychiatric Pharmacy specifically, we facilitate their attendance at a group “Topic Discussion.” Rotational trainees present on psychiatric disease states, medications, and publications. Students are encouraged to participate to their current level of knowledge and to ask questions.
Step 3: After engaging in steps 1 and 2, students who wish to learn more can join a Psychiatric Pharmacist-led Medication Education Group for patients and/or round with a Psychiatric Pharmacist to interact with our patients and teams. Following the experience, they are encouraged to ask questions of the Psychiatric Pharmacists. At this point, particularly interested students can go on to complete other Step 3 activities on different units or with different pharmacists.
These steps have been successful in facilitating student participation in one or a number of shadowing opportunities. Students are informed that this can be done over a period of weeks or years, depending on their interest and schedule. Preceptor feedback has been quite positive, as a staged approach limits receipt of multiple individual requests and often allows for several students to shadow at once.
While this is only one example of a successful shadowing model, elements of this approach can be applied in a variety of settings. Below are some final words for preceptors and students:
Preceptors: Consider collaborating with student groups that are affiliated with a nearby college of pharmacy. If there is not a local CPNP Student Chapter, consider working with other groups, such as SSHP. When applicable, it may be feasible to work with interested students on developing a CPNP Student Chapter. To limit impact on patient confidentiality, consider a layered approach to shadowing that varies based on patient interest and experience. As we become more comfortable with virtual meetings/rounds, you may even consider a virtual approach to increase shadowing availability and efficiency.
Students: When local opportunities for shadowing in psychiatric pharmacy at your school appear limited, reach out to the nearest psychiatric pharmacists (consider using CPNP’s “Member Directory”) and let them know of your interest. Be accommodating and flexible, and many pharmacists will look for ways to work with you.