The University of Waterloo's innovative pharmacy co-op program is designed to give students the opportunity to learn on the job and to apply their academic skills to the real world. It differs from summer jobs in that preceptors are required to teach students in more depth and show students the roles of pharmacists in a variety of environments, including community, hospital, governmental and research sectors. It is distinct from internships because students are able to experiment and determine which practice settings they might like to enter in their future careers. As a strict requirement in Waterloo's pharmacy curriculum, the co-op program has, to some degree, helped compensate for the summer job losses students have experienced over the past few years.
It was during the pursuit of my first co-op placement that the provincial governments began to ban the professional allowances paid to pharmacies. Since our first-year class was competing with third-year students for job placements, many pharmacies opted for the more experienced students to fill the few positions they had available. Yet, because Waterloo believes it is imperative for pharmacy students to gain on-the-job experience, the university enlisted co-op advisors to help their co-op coordinator find work for all the students. These advisors worked day and night searching for potential jobs all over the country and managed to find a placement for every student by the end of the term. Waterloo's dedication to the pursuit of quality pharmacist mentoring is inspiring.
Although I had only completed my first year in pharmacy at the time, I believed I had already gained many skills and much knowledge through my work experience in the community setting these past months. To me, this experience has been at least as valuable as the lessons I've learned through my academic studies. For instance, pharmacists have taught me about different pharmacy settings and how difficult it may be to shift from one to another, depending on your experience. Both community and hospital practice have their merits and I would be happy working in either, but I wouldn't be aware of the differences if I hadn't received this information from an experienced pharmacist.
My co-op experience in community pharmacy has taught me that pharmacists must be able to stay calm under pressure and work quickly and efficiently. My first shift was on an extremely busy night. At one point, I looked at my preceptor and noticed that he was cool and collected despite all the chaos around him. He radiated an aura of calm that helped me and the technician relax; he even managed to soothe some of the frustrated patients. The technician — a former nurse with 30 years of experience — was extremely competent and had the patience to teach me even though she was busily performing multiple tasks.
Communication is another key aspect of being a pharmacist, and the co-op work experience has contributed to my understanding of its importance in everyday practice. A pharmacist needs to know what kind of information and language is suitable for patients, physicians and fellow pharmacists. In the community pharmacy setting, I have improved my ability to listen to patients, as well as gather clues from their body language and unspoken meanings. I have learned several communication tips to use when dealing with difficult patients; the most important lesson, in my opinion, being “it's not what you say; it's how you say it.” Telling the patient that you “can't” or “won't” be able to help him will arouse aggravation, whereas telling him “we'll work on this” or “I'll have it done by this other time” can help calm him, while still communicating the message.
The work program has also allowed me to hone my academic knowledge in a practice setting and experience first-hand the effects of this knowledge on patient health. One pharmacist I work with regularly assigns me side projects intended to demonstrate patient-focused care. This includes situations requiring in-depth research on the patient's behalf. On one particular occasion, one of our diabetic patients was planning a trip to a tropical destination where he would not have access to a fridge for his insulin for at least a week. After completing my research, I found that insulin stored at 37oC did not significantly differ in blood glucose–lowering performance compared to insulin stored at 5°C.1 Regardless, the temperature at which insulin is stored should be kept as low as possible and I suggested that the patient store the insulin in a lunch bag that had a reflective coating on the inside and maintain a lower temperature using instant ice packs (so that the environment for the insulin would be kept cold when he needed it to be). Not only was the patient extremely thankful on the phone, he visited the pharmacy a few days later for the sole purpose of thanking me for my work. This particular project taught me something new about insulin's shelf-life and how to serve patients on a more direct level.
In addition to the skills I am developing through the co-op program, I have been given the opportunity to work with excellent pharmacists. One of them has won the Canadian pharmacist of the year award, mainly due to his MacGyver-like ideas and fierce intellect. I have learned a lot from him and his constant medication quizzes, such as what to do in certain situations and how to deal with tough cases. Without him, I would not know that we can request that doctors give samples of rosuvastatin to patients who do not possess sufficient funds or a drug plan or how pharmacists can act as a patient advocate, assisting with arranging coverage of expensive drugs. Pharmacists like him earn patient appreciation and improve patient quality of life through their deep reservoirs of knowledge and compassion. It is because of these mentors that I am compelled to learn as much as possible for the sake of my current and future patients.
The future of pharmacy is dependent on the competence of the next generations of pharmacists. Though co-op programs are not the only means of improving the quality of practice of future pharmacists, they are a major step in the right direction, providing pharmacy students with a better understanding of the pharmacy world.
1. Vimalavathini R, Gitanjali B. Effect of temperature on the potency and pharmacological action of insulin. Indian J Med Res. 2009;130:166–9.[PubMed]