There are many specialties within the profession of pharmacy. If being a cardiovascular specialist pharmacist is something that you are considering, this post can help you.
One of the truly great aspects of being a pharmacist is the impressive breadth of our profession. Going back decades, pharmacists have always enjoyed ample choices for career paths: community, hospital, industry, academia, research, and even the military. While post-graduate training has existed for over 50 years, in the last decade there has been an explosion in the number of pharmacists completing anywhere from 1 to 4 years of additional training in either a pharmacy residency or fellowship. Contemporary post-graduate training, combined with the evolving complexity of the healthcare landscape, has created new opportunities for pharmacists to sub-specialize into areas that weren’t around even 10 years ago. That is where I currently find myself, practicing as a clinical pharmacy manager in heart transplantation and mechanical circulatory support at the NewYork Presbyterian Hospital Columbia University Medical Center. Reflecting back on my expectations of my career from when I was in pharmacy school, my current reality is so discordant that it’s almost unbelievable. However, the path that lead me here is even more non sequitur. Here are the top 5 instances in which my expectations failed to match reality as my career has evolved over the last 10 years.
1. I expected that I wouldn’t be a pharmacist when I was done with school
Perhaps a few of you may have grown up dreaming of being a pharmacist, however I’m confident that most of you did not. Pharmacists don’t star in glamorous television shows like physicians, lawyers, and police officers do. Many of you probably wanted to be something else when you grew up, and pharmacy ended up as your profession for one reason or another. On the other hand, some of you may have been like how I was, and saw pharmacy as a springboard to another career. All throughout pharmacy school my plan was to go to medical school after I finished my PharmD training, that is until I started my clinical rotations as a four year pharmacy student. I was blown away by the impact that a clinical pharmacist could have on patient care, and after having met my future mentor on my first rotation (cardiology, of course), I was having very serious doubts about my plans of becoming a physician. Ultimately I did matriculate into medical school, however I very quickly realized my mistake, and by the end of the following year, I was starting my pharmacy residency training at the Medical University of South Carolina. For those of you reading this who may be in a similar position (i.e. in pharmacy school but considering alternative careers), I would encourage you to keep an open mind towards your pharmacy training, especially if you haven’t been on clinical rotations yet.
2. That I would always live in my home state
I grew up in a small town outside of Detroit, MI. My whole family lived within a 10 mile radius, and I was the third generation to attend Wayne State University. I never envisioned that I would leave. However, the ability to relocate to any state and practice pharmacy by simply passing another MPJE (the multistate pharmacy jurisprudence exam or “Law test”) is one of the best facets of our profession. I have practiced pharmacy in four different states (Michigan, South Carolina, Florida, and New York). Each state has a distinct pharmacy “culture” and certain idiosyncrasies when it comes to pharmacy practice, and by experiencing new regions of the county I have broadened my understanding of our profession tremendously. There is no way that I could have become the pharmacist that I am today without these past experiences. So I would encourage those of you reading this who may be considering exploring other parts of the country to get out there and do it if possible. Whether this is through residency training or just for a job relocation, the benefits of diversifying your pharmacy background are immeasurable.
3. That I would be taking care of patients with chest pain all day
Once I finally settled back in Michigan after traveling for residency training, I figured that cardiology pharmacy was going to be fairly monotonous. Chest pain, heart attacks, heart failure, and arrhythmias constitute the majority of the cardiology pharmacist’s day, and this is what I saw myself doing for the rest of my clinical career. However this expectation was shattered very early. I was less than one year into my first post-residency job when I was assigned to cover the advanced heart failure service, which included patients with heart transplants and mechanical circulatory support (i.e. artificial heart pumps). I also started caring for patients who had undergone cardiac surgeries, such as bypass grafting or valve replacement. I was practicing in areas where I wasn’t initially trained, like critical care and immunology. It was a very dynamic and exciting environment, and I was constantly learning new things from my pharmacist and physician colleagues. My pursuit of this predilection for patients with advanced heart failure has landed me in New York City, about as far away from small town Midwest American that one can be. Never did I ever expect to be here. So again I would encourage the reader to keep an open mind to all possibilities when you’re new in your career. Don’t be afraid to say “yes” to new opportunities, even if they seem scary or aren’t quite what you thought you’d be doing after school or after residency. You may be surprised how things turn out…I haven’t taken care of a patient with chest pain since 2013.
4. That no one outside of my immediate professional circle would ever know my name
When I first started practicing as a cardiovascular pharmacist, I never envisioned that I would know very many pharmacists outside of the ones who worked directly with me. However, through the guidance of my pharmacy mentor, I started serving on various projects and committees within the American College of Clinical Pharmacy (ACCP) Cardiology Practice and Research Network (PRN). After a few years, I decided to run as the Secretary/Treasurer for the Cardiology PRN and lost. I stuck with it, and eventually I became the Secretary/Treasurer and then later the Chair of the PRN. It blew my mind that cardiology pharmacists from all over the country not only knew who I was, but trusted me to help to run our PRN for three consecutive years. Pharmacy is a very small profession, and there are ample opportunities for young leaders to serve. I have found my time with the Cardiology PRN to be one of the most enjoyable experiences of my career, and I have been fortunate to have made friends with colleagues from all across the country.
5. That I would never publish anything in a peer-reviewed journal
I don’t think that many of us think about scholarship and medical writing in the early days of our pharmacy training. Aside from focusing on trying to pass exams and complete assignments, most young pharmacists in training or those in early career are usually focused on patient care and the more traditional aspects of pharmacy practice. I was fortunate to find a mentor in my last year of pharmacy school who was very a very astute pharmacist-scholar, and he impressed on me early the joy and reward that can come from contributing to the medical literature. After my first paper was published I was hooked. Even though I’ve changed jobs several times since then, I’ve always found a way to incorporate writing and scholarship into whatever I was doing. So for those of you who are considering writing but are reluctant to try, I would strongly advise that you jump in and author your first piece. It doesn’t have to be something grand, even an article for a local pharmacist newsletter can be a good start. Finding a mentor or collaborator will help you immensely, as medical writing skills are quite unique and usually only develop with continued practice.
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