In this article a pharmacy student reflects on her journey from being a medical laboratory scientist to future PharmD.
AUTHORED BY: Samantha Aguilar, MLS (ASCP), Pharm.D. Candidate
Last updated: 20 September 2020
What is it like going from working in a microbiology lab to going to pharmacy school? Can experience as a medical laboratory specialist be a game changer for pharmacy school? Is pharmacy school harder than medical laboratory scientist school? These question and more are discussed in this reality check article from someone who is currently a pharmacy student and has a background working in the microbiology lab as a medical laboratory specialist.
Some memes included for fun.
1. Pharmacy school won’t be that tough
Boy, was I wrong.
The most common way to become a Medical Laboratory Scientist (MLS), is to get a bachelor’s of science in Clinical Laboratory Science then become certified by the American Society for Clinical Pathology. The program required 12-18 hours of classes a semester, plus clinical rotations. Being a student in this program taught me how to discipline myself and dedicate my time to studying. Personally, I thought this was a challenging program that stretched my limits, so I assumed pharmacy school would be cake. It turns out, pharmacy school requires you to be all of these qualities and more. A. Whole. Lot. More. Pharmacy school is not just about the (very) heavy curriculum but it is about your involvement in organizations, your ability to effectively communicate, and your capability to have a holistic approach to patient care.
Can we talk about the heavy curriculum for a moment? Nobody warned me it was like drinking water from a fire hydrant. Since I started pharmacy school, I have enrolled in 18-24 hours of classes that have ranged from pharmacotherapy (PT) modules, to communication classes, to counseling classes, to evidence based approach classes. The PT lectures are insane. The HIV lecture from our infectious disease PT module felt like it was taught from a different language. A very beautiful language I wanted to master.
The norm as a pharmacy student is to keep going, despite any downfalls. If you scored bad in any particular, exam, quiz, or assignment, you had to find a way to pull yourself together for the next task. If you applied for a position for an organization and were rejected, you had to find the motivation to apply for other positions. If you got yelled at by a patient for not knowing the answer, you had to find ways to manage and diffuse the situation. I had to develop coping mechanisms through the stressful days and find peace in chaos.
So many of my preceptors and mentors have told me having too many projects and being stressed out comes with the profession. Which has made me accept my fate and just enjoy the ride.
2. I will just get a pharmacy job when I graduate
Okay let me explain. I was a server at Olive Garden while finishing my undergrad and got a laboratory job right after I graduated. I figured I would just work in the laboratory until I graduated pharmacy school THEN get a pharmacist job. Easy peasy lemon squeezy, makes sense. Well, that logic was flawed in so many aspecs.
- The job market of a pharmacist and a medical laboratory scientist (or other healthcare professionals) are completely different. I was unaware of the oversaturated pharmacy job market or how insanely competitive an applicant had to be. I did not know how many talented, driven, intelligent and passionate individuals I would be competing against for the same jobs.
- Working as a pharmacist intern is necessary to enhance and reinforce your skills. You familiarize yourself with the medications, the dosages, the common formulations, and the common side effects. You learn how to counsel patients effectively and build the necessary rapport in order to be a trusted health care provider. You collaborate with other healthcare providers to acknowledge patient barriers and work through them. Not only does this experience help you through the curriculum, it helps you as a professional as well.
- Experience is now necessary to be considered a competitive applicant. Since the competition for pharmacy jobs and residencies is high, residency directors and reginal managers are looking for applicants who have worked in a pharmacy setting.
Working as a pharmacist intern at a chain pharmacy and now at an inpatient hospital pharmacy have been priceless experiences. I can connect the dots during lectures and outside of lectures, because I feel more well-rounded. I can differentiate which antibiotics are IV, PO, or both because I pull them from the shelves, I can evaluate the appropriate infusion rate of vancomycin in order to avoid red man syndrome, and I can counsel patients who are being discharged on meds I just learned about. Pharmacy experiences are necessary, rewarding, plus… who doesn’t like cash.
3. The infectious disease pharmacotherapy module will be a breeze
Medical Laboratory Scientist (MLS) focus on four major disciplines; chemistry, hematology, immunohematology (aka blood bank), and microbiology. There are subsets within these specialties, but these are the common areas where MLS can specialize or become generalist. Microbiology has always intrigued me. The classes were so challenging, the bugs were so cute, and the clinical aspect fascinated me. So, it was a no brainer I decided to specialize in microbiology.
While working in a clinical microbiology lab, I realized how cool infectious disease pharmacists were. We would interact with ID pharmacist every day because they would go to the lab and check which microbes were growing for the patients that were admitted. They were so smart. I would always refer physicians or nurses to the ID pharmacist if they had a therapeutic question, or needed re-education. The ID pharmacist would also help our work flow by eliminating excessive testing if it was unnecessary.
As an MLS, you do not deal with patients. Some people love this, while others like me do not. So, it was always great to hear how each patient acquired the infectious microbe, what antibiotic they are on, and how they were progressing during their stay. I remember we had a child grow fusarium in their urine, sputum, body fluids (literally everywhere), and the ID pharmacist told us they had been involved in a car accident where they were ejected from the vehicle and fell on rocks covered in soil. This case forever has stuck with me because I learned in MLS school if we see a certain fusarium morphology under the microscope, the patient is more than likely not going to make it. We definitely saw this morphology nicknamed, “deathly bananas” microscopically, and the patient did end up passing away, despite all the therapeutic efforts.
The ID pharmacist my lab collaborated with, was intelligent, kind, passionate, charismatic, and had an aura about her presence. I looked up to her, and I decided to pursue a career in infectious disease pharmacy. I had three years of experience in the lab prior to enrolling into pharmacy school. I learned all about common and uncommon pathogens isolated in specific sources, what antibiotics were reported for what organisms from certain sites, and what additional antibiotics were needed for resistant organisms. I want to say, I had a pretty strong background in clinical micro and thought the infectious disease pharmacotherapy module was going to be easy. I thought, I wouldn’t have to study as much, I could relax and coast by with my background.
Well it turns out, the infectious disease module was a monster. A big fascinating monster that needed to be dissected. We had ten instructors lecture us throughout the module at fire speed. I remember I had to study as hard, if not harder on this pharmacotherapy module than any other module. The only difference between this module compared to the others, was that I was extremely motivated to learn. The lectures did not feel like work, they felt like reading a very interesting book that was hard to put down. However, I did rely on my background a lot. Every time we had a question recommending the appropriate antibiotic for a specific organism, I would think about the panels I report out at work and choose the appropriate treatments that way.
Pharmacy school helped me understand why we perform certain laboratory test in certain organisms. For instance, we confirm penicillin susceptibility in Staphylococcal species by one test, and methicillin resistance by another test. One test detects beta lactamases, the other test detects a PBP2a target protein change. Before pharmacy school, I thought these two test detected different beta lactamases, so now when a provider asks me to test cefepime (yes it has happen) on a methicillin resistant Staph aureus, I can tell them the MecA gene is expressed and this organism will be resistant to all beta lactams. Another important aspect my job taught me was about antimicrobial resistance. I was trained to recognize intrinsic resistance as well as acquired resistance. I knew we had to suppress certain antibiotics, but did not make the connection as to why until pharmacy school. An example of this would be the SPACE (SPACKE now?) organisms that develope resistance to third generation cephalosporins during the actual hospital stay.
Tying my laboratory background in pharmacy practice has been helpful in many aspects as I can offer a laboratory insight into clinical judgements. Despite my background and interest in infectious diseases, there is no question that I will have to continuously work hard to succeed in this career field. For any pharmacy students who are about to embark on their PT ID module, brace yourselves.
4. I will specialize in Infectious Disease Pharmacy
Okay, okay this is still my goal. I plan on applying to a PGY1 pharmacy practice residency and then a PGY2 residency specializing in infectious disease pharmacy. We can all have hopes and dreams, right? The reality of pursuing residency is that it is very competitive. Not only that, so many students look similar on paper and have great personalities during interviews.
Another drawback I have to consider is, I will probably have to move for both residencies, and then move again for a job. I look on indeed and SIDP often for ID pharmacist job availabilities and they are not exactly numerous. It looks like only the best of the best will fill these positions, so I either have to go hard or go home – literally.
The silver lining to this realization is that there are infectious disease applications everywhere. In community pharmacy, you fill anti-infectives every day, counsel patients on these medications, and provide vaccinations to the community. As a compounding pharmacist, many common medications being made are antibiotics. The compounding pharmacist at the inpatient pharmacy I currently work for, manages the IV antibiotics being made in every floor. As an ambulatory care pharmacist, you will have to dose antibiotics, counsel on them, and monitor a patient’s infection. As a critical care or emergency medicine pharmacist, you will manage patients coming in with septic shock. As a transplant pharmacist, you will have to treat the odd infections and weird bugs that are acquired from being placed on immunosuppressive therapies. Infectious diseases are everywhere, you don’t even have to look too hard for them.
Despite all that, I do plan on trying my absolute hardest to become what I originally went to pharmacy school for, an infectious disease pharmacist. Life is too short to not pursue your dreams. So here is to shooting my shot. I hope you all enjoyed this read and laughed along with my previous perspectives throughout my journey of transitioning between careers.
For any MLS out there looking to pursue pharmacy: if you find yourself missing interacting with other people or see your assets more valuable as a clinician, I would say go for it. Think about what makes you happy then pursue it. You are equipped with the necessary skillset to thrive in this profession, you’re just going to have to work hard for it.
ABOUT THE AUTHOR
Samantha Aguilar is a third year Pharmacy Doctor Candidate Class of 2022, from the University of Texas at Austin. She is passionate about bugs, drugs, public health, HIV, and helping people live healthy lives. She is interested in pursuing a PGY1 and a PGY2 residency specializing in Infectious Disease Pharmacy. Currently, she serves as the Clinical Exposure Chair for the UT Student College of Clinical Pharmacy and is the Central Texas of Health-System Pharmacy Representative for the UT Student Society of Health-System Pharmacist.
She works at the local county hospital as a Clinical Microbiologist and at the Veterans Hospital as a Pharmacy Technician. Lastly, she is working on a research project analyzing Carbapenem Resistant Enterobacteriaceae in South Texas and a second research project regarding COVID-19 vaccines. Her hobbies include her cat Andromeda, cosplaying, watching anime, and working out to k-pop
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