Preparing for Pharmacy Clinical Rotations 101

All of us…emerging from winter. (Image)

Welcome to April, tl;dr! Ahhh, warmer weather, spring flowers, and…untanned legs blinding you on the sidewalks.

Also, for anyone not graduating pharmacy school next month, April also means starting to think about prepping for clinical rotations. Whether you’re heading for your first IPPE at the local independent pharmacy in May or you’re mildly freaking out about your upcoming critical care APPE (WHY is it scheduled FIRST?!?), it’s time to take the next steps of your pharmacy career.

As with any worthwhile journey, there are some things you can do to prep. Don’t be the student who shows up to rotation on day 1 without at least some clue as to what you’re stepping into.

As a preceptor, let me just say it’s THAT obvious.

To get off on the right foot, here are tl;dr’s Top 5 Preps for Clinical Rotations:

#1: Look the Part

I’m not trying to be shallow here by starting off with appearance, but you KNOW what they say about first impressions.

If this is your first rotation ever, or if you (like so many of us) maybe don’t quite fit into those clothes you bought last year before all the late night study (and snack) sessions, it might be time to (re)invest in some foundational work clothes.

You don’t have to spend a fortune! But please at least try to find some decent, professional pieces that are in good shape and fit comfortably. Also, I know summer’s coming and it’s going to be hot for those first few months… but please be cognizant of how much skin you’re showing. (Pharmacies are usually freezing anyway!).

This may seem obvious to you, but I only mention this because it happens. There’s always the one student who gets a smidge risqué (i.e. “Business Sexual”) or a wee bit too casual for rotation. So I’d rather just say it now and perhaps save everyone the awkward dress code convo.

How NOT to dress on rotation. Except maybe Wilson and Foreman, they’re apparently the only ones who got the professional dress memo. (Puh-lease Cuddy, you’re an administrator!) (Image)

Next, find comfortable shoes. If your rotation is in a retail arena, you’re going to be standing a LOT. If you’re in a hospital, you will be on the move, walking and taking the stairs (elevators take an eternity).

Aka, heels probably aren’t a good idea (unless you were born a runway model).

Know that white coat you’ve been wearing to compounding lab that is inevitably brown around the neck and wrists? Wash it, please! And an iron won’t kill you (you know, generally speaking).

Keep your hair and nails neat and trimmed. Call me old-fashioned, but we live in a world where we work with and take care of different generations, so be sure to think carefully about showing piercings and tattoos.

Determining ahead of time what you have in your closet already versus what you need will pay off when your alarm goes off that first day!

#2: Gather your Tools

Just like you should have the appropriate clothing to be a professional, you should also have the right tools at hand.

To avoid this level of panic, go find your badge. Now. (Image)

It may sound silly, but gathering the simple things like reliable pens, your name badge, a notepad, a calculator (or your phone if you’ve figured out how to use the natural log on the darn thing), and your pocket reference of choice will make day 1 much easier. (You don’t want to have to run around at 11 pm the night before trying to find your name badge. But if you are, check your fridge. It’s ALWAYS stuck to the fridge.)

Even the most technologically inclined student should have a notepad on hand. Hospital wifi can be finicky, and it’s often easier to jot notes by hand, especially if you’re dealing with math or physiology drawings.

You can also check out our ever-growing collection of cheat sheets. These are pretty much designed to save the day on your APPE rotations.

As for the pocket reference, what you choose is entirely up to you. Many rotation sites have drug references available for students on the site’s computers, but if you’re walking around or computers are in demand, it may be helpful to have a reference on your phone or tablet.

Before you purchase anything, check through your school, as you can often get a discounted subscription to some of the major drug reference libraries as a student! Also check with your preceptor (see Tip #4 below) before you drop a wad of money on references.

If you have a “peripheral brain” with highlights that you’ve been collating for a few years in school, go back through it to make sure you know how/where to find the information and to make sure it’s at least decently up to date and organized. Pulling out a sheaf of papers and trying to sort your way through it on the spot is not a good look…

#3: Do your Research

We live in an internet age, y’all. Use it.

Check out your rotation site’s webpage. What kinds of services are offered? Any particular patient populations served?

Stalker level expert. (Image)

Look up your preceptor. No, don’t be stalkerazzi… but you can at least see if there’s any information about their areas of practice and research, projects or publications, and whether they have any special responsibilities.

Please don’t then throw this info out on day 1 to brown nose. That’s not the point. The point is to know a little bit about who you’re learning from. If your preceptor is a guru in cardiology or holds an office with ASHP, perhaps you can hear about those specific experiences to guide your own futures in pharmacy.

Knowing these types of things ahead of time may lead you to ask questions like how did your preceptor get so good at evaluating the multitudes of cardiology trials? What tips and tricks can you learn from him? Or how does he balance professional organization responsibilities with day to day life and work?

Also, more mundane online research can be useful. Like where is the parking garage, or what food is in the area for lunch. Google Map your commute. And then add that extra buffer time to allow for traffic, or heaven forbid, The Flat Tire on Day One.

#4: Contact your Preceptor

Your preceptors are busy people, and although they are likely looking forward to having you on rotation, let’s be honest. They might need a reminder about who you are and when you’re starting!

Send your preceptor an email about 2-3 weeks prior to your start date. It’s always helpful to include some info about yourself, including your interests, any prior rotation/work experiences you may have had, and what you’re hoping to get out of the rotation. Ask them where and when you should meet them on that first day and if there’s anything in particular you should research before rotation or bring to the site.

This is also a good time to ask about the availability of those on-site drug references and whether you should bring your own laptop or tablet. Does your preceptor recommend that you invest in your own subscription, or is she confident that you’ll have access throughout the rotation?

Please be sure to double check your emails to make sure they’re clean and professional. Definitely start by addressing your preceptor by Dr. (or Mr./Ms. for RPhs) Last Name rather than first name. Life Rule: Best to start more formal and progress from there than to go the other way around.

#5: Refresh your Brain

Clinical rotations are when the rubber meets the road. All the lectures on guidelines and pathophysiology, all the late nights cramming for exams…they are finally APPLIED on rotations. It’s a beautiful thing when you begin to understand how the information you learned in school is used for individual patient scenarios that may or (more likely) may not be by the book. Patients rarely exactly fit the inclusion criteria and expected molds, and you will see just how much gray area there is in pharmacy.

Hopefully, you too will have some epiphanies putting it all together on rotation! (Image)

Because of this, preceptors expect that rotations will be a time of immense growth and learning. And we totally understand that you’re going to encounter things you’ve never seen before or drugs you’ve never heard of. Guess what, that happens to us too!

But that doesn’t mean you have to walk in on day one completely empty handed. Anticipating the types of patients you might see in your clinical practice site should lead you to review some background information BEFORE starting rotation!

For example, if you have a pediatric rotation, at least reviewing what makes the kiddos different with regards to drug absorption, distribution, metabolism, and excretion (ADME) will be a good baseline. If internal medicine is next, of course you can’t review EVERYTHING.

But guess what, VTE prophylaxis and associated medications would be a good place to start because that’s pretty universal for most patients. For your anticoagulation clinic rotation, review the DOAC studies and of course check out our Definitive Guide to Warfarin.

You get the idea.

Just know that the more you have under your belt when you walk in, the deeper you can dig when you’re discussing patients and having topic discussions for the next several weeks.

You will never have as much time to learn as you do when you’re a student. I’m not discounting everything you have to do on rotation because I know clinicals are BUSY and they’re hard. But your responsibilities only grow as you get into practice, and the amount of time you’ll have to investigate some new cool drug or disease state will shrink. So take advantage of this time dedicated to expanding your brain and make the most of it!

So there you have it. Take these tips, and together with a healthy dose of enthusiasm (and the usual nerves), you’ll be ready to dive into your rotations!

Good luck, and happy learning!