winter 2017 inside experience at the fda submitted by ens ... · khaki uniform and my new shiny ......

Inside this issue:

Putting Myself in the Public Heath Service’s Shoes: Experience at the FDA

Submitted by ENS, Jennifer, Tsan

Asafirst-yearpharmacystudent,Ivolunteeredatmyschool’scommencementandwatchedthegraduatingclassreceivetheirdegrees.Icouldn’twaittobeintheirshoes!Duringtheevent,Irememberseeingamaninauniformandwonderedwhatanairplanepilotwasdoinghere.Ilaterlearned,frommyPublicHealthelective,thathewasanotapilot,butaUnitedStatesPublicHealthService(USPHS)Officer.

One may ask, what exactly is the USPHS?TheUSPHSisafederaluniformedserviceofhealthprofessionalsdedicatedtoprotectingandpromotingthepublichealth.AsIlearnedmoreabouttheUSPHS,IknewIwantedtobeintheirshoes.Todetermineiftheshoewouldfit,IappliedfortheJuniorCommissionedOfficerStudentTrainingandExternProgram(JRCOSTEP).Afterfinishingarigorousandchallengingsecond-yearofpharmacyschool,IwasonmywaytocompletingaJRCOSTEPattheFDAinSilverSpring,MDfortwomonths.

Ihadthedistincthonorofwearingthekhakiuniformandmynewshiny,blackPHSshoes.IwasstationedattheCenterofDevicesandRadiologicalHealth(CDRH)intheOfficeofCompliance(OC)andDivisionofPremarketandLabelingCompliance(DPLC).TheroleoftheFDAisnostrangertopharmacystudents.TheFDAimpactspharmacyandthelivesofpatientseverydaythroughpolicy,regulationsandpublicawareness.

MypreceptorCAPTRaquelPeatandmentorCDRJeeneBaileywereimmenselywelcomingandresponsive.Mymaindutiesincludedreviewingallegationsagainstavarietyofmedicaldevicestoensurethatfirmswerecompliantwiththepre-marketingrulesandregulations.ThisinvolvedutilizingtheCodeofFederalRegulations(CFR)andrelevantguidancesprovidedbytheFDAandperformingariskandbenefitanalysis.Myotherdutiesincludeddevelopingstrategiesfortheenforcementoffinalordersandstreamliningtheprocessforreviewingallegations.IalsodeliveredapresentationatadivisionmeetingabouttheNewDrugApplication(NDA)foracombinationproductthatconsistsofbothadrugandadevice.Inaddition,mypreceptorandmentorprovidedmethetoolsandsupporttocreateandpresentaresearchposterattheAnnualSalutetoScienceStudentPosterSymposiumattheFDA.Outsideofmyduties,IgottheopportunitytoattendpharmacylecturesofferedbytheFDAthatcoveredtopicsrangingfromtheprocessforgenericapprovals,reviewingadverseevents,orphanproductdevelopmentandthedrugshortageprogram.Inaddition,PHSpharmacistsspokeabouttheirexperiencesasofficers,describingthecareeropportunitiesandbenefitsavailablewithPHS.

CDRBaileyandJRCOSTEPENSTsanattheFDAinSilverSpring,Maryland.

UNIVERSITY POINT of CONTACTN E W S L E T T E R

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Winter 2017

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Experience at the FDA

Editors Note

Discovering Pharmaceutical Care in Native Communities

Intro to IHS: From Oregon to Alaska

Bureau of Prisons FMC Longitudinal Experience

Temple Univ. School of Pharm/CORPS Values

Advance Pharm. Practice Exp. at the FDA

Summer in South Carolina

Howard Univ. College of Pharmacy

Useful Info andResource Links

UPOC Newsletter Workgroup

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Putting Myself in the Public Heath Service’s Shoes: Experience at the FDASubmitted by ENS, Jennifer, Tsan

DuringmytimeattheFDA,Idevelopedrelationships,improvedmycommunicationskills,andfurtheredmyknowledgeofdruganddeviceregulations.Myexperiencewasnotonlyeducationalandfascinating,butalsorewardingandworthwhile.IgreatlyappreciatetheopportunitytoworkwithCAPTPeatandCDRBaileythispastsummer.I’velearnedsomuchfromtheprojectsI’vebeenworkingonandaboutthegreatmissionoftheUSPHS.Iamsogratefultohavehadtheincredibleopportunitytoseewhatit’sliketobeaPHSofficerandtobeintheirshoes.

JRCOSTEPENSTsanMeetingRearAdmiralSchweitzer

Editor’s Note:

TheUPOCnewsletterteamisdelightedtoreleaseourWinter2017issue.Ourteamaimstoproduceatop-notchnewsletterthatoffersbothstudentsandemerginghealthcareprofessionalsaglimpseoftheuniqueopportunitiesandexperiencesavailablethroughworkingforUHSPHS.

Thankyoutothecontributingwriters,bothstudentsandpharmacists,whowillinglysharedtheirexperienceabouttheirrotationorpharmacypracticesite.YourpersonalstoriesandreflectionsgiveourreadersabettersenseandacloserglanceatthediverseopportunitiesPHSoffers.AsEditor-In-Chief,Iinvitenewideasthatarebothfunandenlightening,andshowcasewhatit’sliketobeaPHSpharmacyofficer.

Students,wewishyouthebestofluckinschoolandyourcareerendeavors

HappyHolidays&BestWishesonyoursuccess,

LCDRShannonSaltclah,Pharm.D.,BC-ADM,NCPS

ThePHSofficerwhoIthoughtwasapilotturnedouttobeCDRJerryZeeand,duringmytour,IwasabletovisittheCentersforMedicaidandMedicare(CMS)andtomeetwithhim.HesharedhisexperiencewiththeBureauofPrison(BOP),IndianHealthServices(IHS)andIlearnedaboutthegrowingroleofpharmacistsinmanagedcare.IalsovisitedthePHSheadquarters,theCoastGuardheadquarters,thePentagon,andtheNavalSupportAcade-mywhereIlearnedalotabouttheseagencies.CAPTBrianLewisallowedmetoshadowhimattheVeteran’sAffairs(VA)HospitalinWashington,wherehepracticesasacardiologistandperformssurgerytoimplantpacemakers.BeingintheMarylandareaallowedmetoattendthe2017AmericanSocietyofConsultantPharmacy(ASCP)Mid-AtlanticconferenceinBaltimore,whereIhadtheopportunitytomeettheChiefPharmacyOfficer(CPO),RADMPamelaSchweitzer.

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Discovering Pharmaceutical Care in Native Communities SubmittedbyMs.SaraShahdoostMoghadam

OneofmyfondestmemoriesfrompharmacyschoolwillforeverbemyexposuretotheU.SPublicHealthService.Asafirstyearstudentpharmacist,IwasfortunatetobeofferedanexternshipattheBemidjiAreaOfficeunderthesupervisionofCDRMichaelVerdugo,wholaterencouragedmetoapplyforaJRCOSTEP.DuringmytimeinBemidji,Ilearnedabouttheworkthatgoesbehindscenestosetupanewpharmacy,thecomplexityofkeepingadrugdatabaseuptodate,aswellastheimportanceofbuildingrapportwiththeNativeAmericanpopulationwhileprovidinghealthcareservices.ImustadmitthatmyknowledgeaboutNativeAmericanculturewasverypoorwhenIbeganmyexternship,andIwasdeterminedtocomeoutofthisexperiencenotonlywithmoreclinicalknowledge,butalsowithmoreculturalsensitivity.

Acoupleofweeksintomyexternship,Iwasinvitedtomyveryfirstpowwow.Wordswillneverbeenoughtodescribethebeautyoftheceremonyorhowthebeatofthedrumsmademefeel;Icannotexplaintheintricacyoftheirartandtheincrediblerespecttheyhavefortheirsurroundings.Myfavoritepart,however,washavingawarmbowlofwildricesoupwhileconversingwithawomanwhopatientlytoldmeaboutthemeaningbehindeachdance,dress,andheaddress.Itwastrulyaneyeopeningeventthatmademerealizehowmuchmore

Asasecondyearstudentpharmacist,IwashonoredtoserveattheFondduLacBandofLakeSuperiorChippewa,bothattheirMinNoAyaWinfacilityinCloquet,MN,andattheirCenterforAmericanIndianResources(CAIR)clinicinDuluth,MN.MyexperienceatFondduLacwasnotonlymorethanwhatIexpected,butitalsohelpedmecultivatemyknowledgeclinically,culturally,andstructurally.OneofthereasonswhymyexperiencewassodifferentfrommyexternshipwasduetothefactthatMinNoAyaWinisatriballyrunclinic,whileCassLakeisfederallyrun.Ispentweekspinpointingthedifferencesandsimilaritiesofthesesystems–whichissomethingIencourageanyfutureJRCOSTEPtodo–notonlytolearnmoreabouttheenvironmentinwhichIwasserving,buttodrawonthebestaspectsofeachsitetolateronapplyittopractice.

Ms.SaraShahdoostMoghadam

Fromleftotright:MsSaraShadoostMoghadam,CDRMichaelVerdugo,DeannaHoule.

(Ms. Sara Shahdoost Moghadam, CDR Micheal Verdugo, and CPhT Deanna Houle after presenting at the Indian Health Service Regional Partnership Conference in Minneapolis, Minnesota.)

Ihadtolearninordertobetterservethispopulation.Thankfully,theUSPHSofficersatCassLakehospitalguidedmethroughthislearningprocessbyactivelyshowingmehowtotakecareofthesepatientswiththeuttermostrespectfortheirbeliefsandculture.SeeingtheimpactthatthedifferentUSPHSofficershadontheirpatients,aswellaswitnessingthedeterminationtheyhadforimprovingpatientcare,wasbeyondinspiring.ItwasbecauseofmyexperiencesinBemidjithatIdecidedthatItoowantedtoservethosewhoneeditthemost.

OneofthemanyaspectsofpharmacypracticesthatIadmiredfromMinNoAyaWinwasthegreatamountofinter-professionalcollaborationaswellasthetrustsystembetweenthedifferenthealthcareprovidersandthepatients.AtMinNoAyaWin,patientsarereferredtodifferentservicesofferedbythepharmacywhichincludesmokingcessation,asthma,cardiovascularhealth,andanticoagulationclinics,aswellasmedicationtherapymanagement(MTM)servicesandpatienteducationandcommunityoutreachprograms.ParticipatingintheseclinicshelpedmeputintopracticeeverythingIlearnedintheclassroom.Aspartoftheirpatienteducationandcommunityoutreachprogram,Iwasinvitedtoparticipateattheirannualhealthfair,whereIwasassignedtomeasurepatients’bloodpressureandwastaughthowtoperformlipidpanels.Iwasthenassignedtofollowupwiththepatientswehadseentoprovidetheirresultsoverthephone,whichwasagreatopportunityforpatienteducation.Additionally,IwasencouragedbybothmysitepreceptorandmyJRCOSTEPmentor,tocontinueexploringmyinterestsinambulatorycareanddruginformationthroughthedevelopmentandcompletionofprojects.ItwasthroughtheseassignmentsthatIcon-firmedwheremypassiontrulylies.

BeingpartoftheIHSstudentexternandUSPHSJRCOSTEPprogramsnotonlyhelpedmefurtherdevelopmyclinicalskills,butitalsoallowedmetoliveuptothemissionoftheUSPHSCommissionedCorpsofprotecting,promoting,andadvancingthehealthandsafetyofourNation.Asafuturepharmacist,Iamcommittedtoservingmypatientstothefullextentofmylicenseinanefficient,safe,caring,andculturallysensitivemanner.

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An Introduction to Indian Health Services: From Oregon to AlaskaSubmittedbyRochelleWolfram–PacificUniversitySchoolofPharmacyHillsboroOregon

AftermovingfromAlaskain2015toattendpharmacyschoolatPacificUniversitySchoolofPharmacy,IfeltveryfortunatetobeabletoexperienceAPPErotationsinOregonandtogohometoAlaska.SinceIhavedevelopedaninterestintheIndianHealthService(IHS),IpursuedtheopportunitytohavearotationatChemawaIndianHealthClinicinSalem,OregonandatAlaskaNativeMedicalCenter(ANMC)inAnchorage,Alaska.IwasoverjoyedtohavebeengrantedtheopportunitytohavetwoIHSrotationswithtwofacilitiesknownfortheirexcellenceinhealthcare.

MyexperienceatChemawaIndianHealthClinicwasmainlyambulatorycarewithLCDRChristiSwabyandCDRGraceHuggettasmypreceptors.Ifellinlovewiththefacility’shealthcaremodelwhileworkingone-on-onewithpatients.Ihadtheopportunitytocounselpatientsonnewormaintenancemedications,smokingcessationandanticoagulationtherapy.Buildingarapportwithpatientsandlearningabouttheircommunitieswasbyfaroneofmyfavoriteaspectsoftherotation.Ialsohadopportunitiestocompletedrugutilizationreviews,analyzeantimicrobialstewardshipandgiveapresentationduringapharmaceuticalandtherapeuticsmeetingforformularyadditions.MypreceptorswereexcellentinguidingmetoensureIwasprovidingappropriatecareforeachpatient,whichhelpedmeexcelandgainconfidenceasastudentpharmacist.

MyrotationatAlaskaNativeMedicalCenterwasdividedintothreesettings:criticalcareunit(CCU),pediatric/neonatalintensivecare(PICU/NICU)andInternalMedicineserviceswhereIservedtohelpmonitordrugkinetics.IhadtheopportunitytoworkwithLCDRSeanBerkey,whojustcelebratedhis10-yearanniversaryasanessentialmemberoftheANMCteamandrecently

Whileworkinginotherdepartmentsonthehospitalcampus,Iwasabletoshadowpharmacist,JessicaSowinskiintheemergencydepartment(ED).Ilovedbeingabletocounselpatientsupondischarge,seehowtheEDpharmacistoperatesandbeinvolvedinthetransitionofcaresothepatientscanreceivemedicationsafteroutpatientpharmacyhours.Inaddition,IhadtheopportunitytoshadowtheInfectiousDiseasespharmacist,KatieGordon,whoseexpertiseinInfectiousDiseaseswasinvaluableandvital.DuringmytimewithKatie,IwasabletoattendanANMCAntimicrobialStewardshipmeetingforthehospitalandobservehowpharmacistsserveasthemainpharmacologicalresourcesforthehealthcareteam.Itwaseyeopeningandrefreshingtoseehowclosethepharmacistsworkwiththeinfectiousdiseaseproviders.

RochelleWolframewithoneofherpreceptors,CDRGraceHugget,duringherChemawaIndianHealthClinicRotation.

obtainedboardcertificationasaPediatricPharmacySpecialist.Hisknowledgeandexpertiseinpediatricpharmacyisastounding.Thiswasmyfirstexperiencewithpediatricpatients.Iwasabletoworkuppatientsandlearnaboutpediatricdiseasestates,pharmacotherapeuticmonitoringandbecomeapartofthedynamichealthcareteam,ensuredthattheirpediatricpatientsreceivedthebestcare.DidyouknowthatthereisresearchregardingtheidentificationofgenesequenceCarnitinePalmitoylTransferase,Type1A(CPT1A)ArcticVariantthatexpressesahardshipinfattyacidoxidationintheInupiaqandYu’pikpopulationsforimprovementofcare?Fascinating!IalsohadtheopportunitytoworkwithBoardCertifiedCriticalCarepharmacistCDRJohnCarothersandCDRMaryMackeyintheCCU.Duringthisrotation,Iwasamongtheactionbywitnessingtraumas,codes,evaluatingpatientchartsandexpandingmyknowledgeknowledgeondiseasestatesandtreatmentsoptions.Ontheinternalmedicinefloor,Iwasabletopracticefoundationalskillsofvancomycin,anticoagulationandrenaldosingmonitoring.

ThepharmacistswithinIHSaresomeofthemosthighlytrainedcliniciansandprovidehighqualitycarefortheirpatients.ItwasanhonortoworkwiththemasIlearnedsomuchfromeachpharmacist.Ilookforwardtomynextfourrotations,asInowfeelexceptionallypreparedbecauseofbothmyANMCandChemawaIndianHealthServicesrotationsandthepharmacyteamsIworkedwith.Iwanttothankeachoneofthemfortheirtimeanddedicationinfillingtheroleofpreceptor.

RochelleWolframeadventuringinSeward,AKatExitGlacier.

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Bureau of Prisons FMC Devens Longitudinal ExperienceSubmittedbyLCDRAnnaSantoro,PharmD;ZackaryLevine,MCPHSUniversityPharmDCandidateMay2018;AmandaMercadanteUniversityofRhodeIslandPharmDCandidateDecember2017;CallyRyan

MCPHSUniversityPharmDCandidateMay2018

Theuniqueaspectsofcorrectionalpharmacyhavechallenged,engagedandinspiredusduringourtimeattheFederalBureauofPrisonsFederalMedicalCenter(FMC)inDevens,Massachusetts.ThroughoutourclinicalrotationatFMCDevens,wehadmultipleopportunitiestoworkwithpharmacistsandinteractwithpatientsinclinicalsettingsforanticoagulation,anemia,diabetesandpsychiatry.Thisexperienceallowedustodirectlycounselpatientsonaone-to-onebasis,monitorprogress,discusssideeffects,patientadherence,andaddresspatientconcerns.

Alongwithgainingclinicalskills,wewerealsoabletoimproveuponourretailpharmacyskills.FMCDevensisuniqueintheaspectthattheyserviceafullfunctioning,retailtypeunitinadditiontotheirclinicalunit.Allofushadpriorexperienceintheretailsetting,solearninganewsystemwithScriptProandPyxiswasintimidating,butquicklybecamesecondnature.Welearnedanewwayofprocessingaprescriptionfrom“pickup”to“drop-off”,allwhileabidingbythelimitationsandsafety

Whetheritbeforasixweekperiodorathreemonthlongitudinalrotation,FMCDevensprovideduswiththemostcomprehensivepharmacyexperiencewehavereceivedtodate.Thevastopportunitiesprovidedtousweremorethanwecouldhavewishedforinarotationalsetting.ThisrotationhasopenedoureyestotheuniqueopportunitiesanddoorsthataPharmDcanopenforanindividual.ArotationwithinFMCDevens,oranyBOPlocation,ishighlyrecommendedbyusasitsuppliesawealthofknowledgeandsubmergesthestudentintoauniquecultureforwhichskillscanbeutilizedinalmostanyareaofpharmacypractice.

PharmacyStudents:(LtoR)AmandaMercadantefromURIandZackaryLevineandCallyRyanfromMCPHSattheirrotationsitewiththeFederalBureauofPrisons,FederalMedicalCenterDevens

concernsofthecorrectionalsystem.Wewereabletoimplementaworkflowsystem,centeredaroundteamwork,inorderthatallaspectswerecompletedasefficientlyandaccuratelyaspossible.

Temple University School of Pharmacy/ CORPS valuesSubmittedbyCDRParasM.Patel,RPh.,MBA

CDERDrugShortageStaff/OfficeoftheCenterDirectorFoodandDrugAdministration

May15,2017(Philadelphia,PA.),TempleUniversitySchoolofPharmacygraduationceremonyforClassof2017.Itwasagreathonortohavebeeninvitedtothe2017TempleUniversitySchoolofPharmacygraduationceremony.Duringtheceremony,RADMScottF.Giberson,AssistantU.S.SurgeonGeneral,wasbestowedwithanHonoraryDoctorofHumaneLetter,HonorisCausa,forcareerofworkfornationalandinternationalpublicservice,advancinginterprofessionalpracticeandthepharmacyprofessionandleadershipfortheU.SCommissionedCorpsEbolaResponse.CDRParasM.Patelwaspresentedwiththe2016-2017AdvancedPharmacyPracticeExperienceProgramPreceptoroftheYearAwardforoutstandingcontributionstotheExperientialEducationProgram.AdesumboOdunlami(Classof2018)wasawardedtheUnitedStatesPublicHealthServiceExcellenceinPublicHealthPharmacyAwardinrecognitionofhisdemonstratedcommitmenttopublichealthandthepharmacyprofession.

DeanPeterH.Doukas,Ph.D.presentedtoRADMScottF.GibersonanHonoraryDoctorofHumaneLetter,HonorisCausa.TheconferralwasthefirsteverhonorarydegreetohavebeengrantedbyTempleUniversitySchoolofPharmacy.DeanDoukasextendedwarmremarksashenotedRADMGiberson’scareerachievements,serviceanddedicationtopublichealth.RADMGibersonalsoservedasthe2017graduationceremonyhonorarykeynoteaddressspeaker.RADMGibersonopenedwithremarksnotingthathepersonallyshookhandswitheachgraduatingprofessionalpriortothestartoftheceremony.Thecurrentsocialaffinityfortexting,tweetsandsnapchatsshouldneverreplacethetrueconnectionsthataremadewithpersonaloneononeinteraction.He

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RADMScottF.Giberson,DeanPeterH.DoukasPh.D(TempleUniversityofSchoolof

Pharmacy),CDRParasM.Patel

ShriyaPatel,Pharm.D(GraduatingClassof2017),

CDRParasM.Patel

TempleUniversitySchoolofPharmacyextendedtheirsupportfortheUSPHSbyawardingmethe2016-2017AdvancedPharmacyPracticeExperienceProgramPreceptoroftheYearAward.Itisaprivilegetohaveestablishedandmaintaineda16yearprofessionalrelationshipwiththeuniversityasastudentpreceptor,adjunctfacultyandUniversityPointofContact(UPOC).TheFDAStudentExperientialProgram(PSEP)providesauniqueopportunityforPharm.DcandidatestoparticipateinarobustfiveweekregulatoryrotationattheFoodandDrugAdministration(FDA).Thestudentsareintroducedtotheregulatoryandclinicalsciencesinvolvedwiththeapprovalofsafeandeffective

RADM Giberson and I want to thank Dean Peter H. Doukas, Ph.D., esteemed faculty and staff for their dedication to higher education and for their support of the U.S Public Health Service. RADM Scott F. Giberson (’93) and CDR Paras M. Patel (’99), Temple University School of Pharmacy alumnus.

Temple University School of Pharmacy/ CORPS valuesSubmittedbyCDRParasM.Patel,RPh.,MBA

CDERDrugShortageStaff/OfficeoftheCenterDirectorFoodandDrugAdministration

RADMScottF.Giberson,AssistantU.S.SurgeonGeneral,servingashonorarykeynoteaddressspeaker.RADMGibersonwasbestowedwithaHonoraryDoctorof

HumaneLetter,HonorisCausa

spoketoallthoseinattendanceabouttheirinnerpotentialthatcanbedormantorbeignitedsimplybythechoicestheymake.Hetoldthegraduates,“Youhavetobelievethatyouaretheonewhowillmakethedifference.Thesechoicesthatdeterminetheimpactyouwillhaveacrossyourlife–professionallyandpersonally–areallwithinyourcontrol.”RADMGibersonclosedhisremarkswithachargetothegraduating2017classtobedynamic,lead,andexemplifyresilience.RADMGibersonperformedadditionaldutiesattheceremonybypresentingtheUnitedStatesPublicHealthServiceExcellenceinPublicHealthPharmacyAwardtoAdesumboOdunlami.Mr.Odunlami,Classof2018,wasrecognizedforthisdedicationtoserviceforpromotionofpublichealth.

drugproductsandmedicaldevicesforthenation.Further,studentsareabletointeractwithPHSofficerstogainperspectiveontheopportunitiesofferedbytheCommissionedCorpstobeabletoserveforthepromotionofpublichealth.ThepersonalhighlightwastheabilitytosharethisawardwithmyformerstudentShriyaPatel,Pharm.D(Classof2017).ShriyacompletedherrotationattheFDAin2016.Shewasallsmilesasshereceivedherdiplomawithherproudfamilyandfriendsinattendance.

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Advanced Pharmacy Practice Experience at the FDASubmittedbyKwadwoA.Yeboah,PharmDCandidate2018,PreceptorLCDRLindsayWagner

Despitebeingriddledwithuncertainties,theAdvancedPharmacyPracticeExperience(APPE)yearisanexcitingyearforpharmacystudents.Thechallengingdidacticsareover,andwegettoapplyeverythingwehavelearnedovertheyears.MynameisKwadwoYeboah,afourthprofessionalyearstudentatPurdueUniversityCollegeofPharmacy.IspentthefirstfourweeksofAPPErotationsattheFoodandDrugAdministration(FDA)DivisionofDrugInformation(DDI).

OnthemorningofMay8,2017,IarrivedattheFDA,withmymindracingwiththoughtsofwhattoexpect.Whilewaitingformypreceptoratsecurity,itfinallyclicked:“Mypreceptorisapharmacist,Ishouldbefine.”Afewsecondsafterthiseurekamoment,LCDRLindsayWagner,mypreceptor,steppedthroughthedoorwithasmile.WedidourintroductionsandheadeduptoDDI’sfloor,whereIwasshownmyoffice,andgivenatourofthebuilding.Atthispoint,Ihadbeenintroducedtosomeprofessionalsinthedivision,mostofwhomarepharmacists.Thewarmwelcome,smiles,andinvitationbytheseprofessionalstostopbytheirrespectiveofficeswithquestionsorconcernscalmedmynerves,andmademefeelathome.

IfIweretodescribetheFDAPharmacyStudentExperientialPrograminoneword,Iwouldbegfortwootherwordsandcallit“extremelywellstructured”,andifdenied,Iwouldsettlefor“exceptional”.Rightfromtheonset,mypreceptormadesuremyschedulewaspackedwithactivities.Myprimaryresponsibilitywastointeractwithpatients,andhelpthemreportadverseeventsassociatedwithmedications.Iwasalsotaskedwithansweringquestionsaboutcommercialdrugsfromconsumersandsomehealthcareprofessionals.Throughthisexperience,Ilearnedhowtoprobepatientstoarriveatspecificmedicationissuesthatneededtobereported.Ialsolearnedhowtoefficientlyusedruginformationresources,whichIbelieveisoneofthecardinalskillsthatdefinesapharmacist.Inaddition,IwasfortunateenoughtobeinvolvedinaprojectthatwasgearedtowardseducatingpatientsandhealthcareprofessionalsaboutExpandedAccessorCompassionateUse.Priortothisexperience,IknewtheFDA’smissionistoensurethesafety,efficacy,andsecurityofdrugs,biologics,anddevices.However,itwasnotuntilmymonththerethatIgotanappreciationforhowpatient-centrictheAgencyreallyis.IfounditfascinatingthattheAgencytakesthetimetoacknowledgeandrespondtoeverypatientorpubliccorrespondence.Ialsoadmirethefactthateveryactiontakenbythedivisiontookthesafetyofthepatientsandconsumersintoconsideration.

IwentintothisrotationwithhighhopesoflearningaboutoperationswithintheFDA,andIwasnotdisappointed.TheFDAPharmacyStudentExperientialProgramplacesemphasisonexposingstudentstooperationsinvariousFDAofficesanddivisionsbyofferingdailylectures.WhetheritwasalectureontheOfficeofPrescriptionDrugsPromotions(OPDP)ortheroleoftheOfficeofPharmaceuticalQuality(OPQ)inensuringdrugquality;thelecturescollectivelygavemeadeeperperspectiveonhowtheFDAoperates.OneofmyfondestmemoriesthroughoutthisexperiencewasatanAdvisoryCommitteemeetingorganizedbytheFDA.Thetwo-daymeetingprovidedtheavenuetodiscussissuessurroundingtheimplementationofmandatorytrainingforopioidanalgesicprescribers.Ifoundthesemeetingsinterestingbecauseinadditiontoseeingourdemocracyatwork,experts,professionalorganizations,advocacygroups,andthepublicgottoshareideasaboutwhichpolicieswouldbebestforthenation.

IenjoyedmytimeattheFDA’sDivisionofDrugInformation.IappreciatethatIwasassignedresponsibilitiesandprojectsthatwouldpositivelyimpactAmericansandpatientsaroundtheworld.LearningmoreaboutotherFDAofficesanddivisions,andtheuniqueopportunitytotakeatouratthePentagonmademytimeattheFDAevenmoreeducationalandmemorable.ManythankstoLCDRLindsayWagnerandalltheprofessionalsIinteractedwithforagreatexperienceattheFDA.

Summer in South Carolina - JRCOSTEP Experience at the Catawba Service UnitSubmittedbyENSLaurenAbresch,PharmDCandidate2019andCDRMistiHouck

ItwasApril17thof2017thatIreceivedmyofficialacceptanceletter.Icouldn’tbelieveIwaschosentobeintheUSPHSJRCOSTEPProgram!Icouldn’twaittofindoutwhereIwasgoing,orwhoIwasgoingtomeet.Astheweekspassed,Iwasgrowinganxioustofindoutmyplacement.Finally,thedaycamewhenIfoundoutIwasgoingtospendmysummerinRockHill,SouthCarolina,servingtheCatawbaIndianNation.

TheCatawbaServiceUnitprovidesfullycomprehensivehealthcare,includingmedical,dental,nutrition,labandpharmacyservices.Iwasfortunateenoughtospendtimewitheachspecialty,whichhelpedmedevelopmyinterprofessionalcommunicationskills.Ilearnedaboutperiodontaldisease,asIchartedinthedentaloffice.Idispensedmedicationsandcounseledpatientsinthe

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ItwasespeciallyrewardingtoparticipateincommunityhealtheventsthatweresponsoredbytheServiceUnit.Duringmyfirstweek,IwasabletoparticipateintheannualcommunityhealthfairintheReservation’sLongHouse;Icollectedtobaccousesurveysandhadtheopportunitytoeducatethehealthfairparticipantsonoursmokingcessationclinicatthepharmacy.IalsoparticipatedinbloodpressurescreeningsattheSeniorCentertwicemonthly.Inaddition,onceamonth,adiabeticshoeclinicisheldattheServiceUnit,inwhichwewereabletoeducatediabeticpatientsonproperfootwearandfootcare.ThesearejustafewofthemanyeventsthatIparticipatedin.IdevelopedarealappreciationfortheimpactthatIcanmake,asafuturehealthcareprofessional,onthecommunity’shealthandwellbeing.

OneofthebestthingsabouttheCatawbaServiceUnitwasthateachandeverymemberofthestaffwaswillingtoteachyousomething–abouttheirprofession,aboutthetribe,orabouttheirlifeexperiences.IwassurroundedbymanyCommissionedCorpsofficerswhowerewillingtosharetheirstoriesabouttheirjourneyinthePublicHealthService.Thisgavemeabetterunderstandingofhowpublichealthcanplayaroleinmycareer.ThepharmacistsattheCatawbaServiceUnithelpedmetogainreal-lifeexperience,byallowingmetoapplytherapeuticknowledgetopatientcasesandbyshowingmehowtocollaboratewithaninterprofessionalteamofhealthcareproviders.IwasalsogiventheopportunitytospeaktomanytribalmembersaboutCatawbacultureandtraditions.BytakingthetimetolearnabouttheCatawbapeople,Iwasabletobetterservethecommunity.

LefttoRight:LCDRWilliamFreiberg,ENSLaurenAbresch,CDRMistiHouck,PPEstudentSarahDascanioattheCatawbaServiceUnit.

pharmacy,andIshadowedthepediatrician,whoprovidedvaluableinsightintothediagnosticelementofhealthcare.ThemultidisciplinaryapproachthatwasavailabletomehereattheCatawbaServiceUnitwillpreparemefortheever-expandingroleofthepharmacistonthehealthcareteam.

Ican’tsayenoughgoodthingsaboutmytimeattheCatawbaServiceUnitasaJRCOSTEP.TheexperiencethatIhavegainedherewillhelpmewhereverIgoinmyfuturecareer.Ihavegrownasapersonandasaprofessionalinthesepastfewmonths,andIlookforwardtoapplyingmynewknowledgeinotherclinicalsettings.ItwasaprivilegetoworkwitheveryoneattheServiceUnit,anditwasanabsolutepleasuretoservetheCatawbacommunity.

Summer in South Carolina - JRCOSTEP Experience at the Catawba Service UnitSubmittedbyENSLaurenAbresch,PharmDCandidate2019andCDRMistiHouck

Howard University College of Pharmacy SubmittedbyCDRDianaSolana-Sodeinde

LCDRAndrewGentlesandLTAndrewwithstudentleadersatHowardUniversity,CollegeofPharmacyonOctober18,2017

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OnOctober18,2017,PHSOfficersLCDRAndrewGentlesandLTAndrewCoogancoordinatedanafter-schoolstrategicplanningsessionwithstudentleadersfromP1-P3yearsatHowardUniversity,CollegeofPharmacyinWashington,DC.Thetopicforthenightwashowtocreatea“CalltoAction”onadvocatingfortheswiftpassageofrulesforCollaborativePracticeAgreement.Forover40years,federalagenciessuchastheVeteransAffairs,IndianHealthService,andBureauofPrisonshaveembracedandsuccessfullyutilizedcollaborativepracticeagreementtosuccessfullyimplementprogramssuchaspharmacist-managedanticoagulationclinics,immunizationprograms,chronicdiseasemanagementandevenstreamliningrefillpoliciesagreementsbetweenhealthcareprovidersandretailpharmacies.TheDistrictofColumbia’sBoardofPharmacyandMedicineismovingclosertohavingaworkingCPArulingpassedsincethelawwaspassedin2012.OnSeptember29,2017,thesecondproposedrulesandregulationsforCPAwerereleasedwitha30-daycommentperiod,whichendsonOctober27,2017.Ataskforceconsistingofstudents,WashingtonDCPharmacistAssociationandotherstakeholderswascreatedtoanswerthecallforactionandawarenessonadvocatingforthepassageoftheCPAruling.TheseofficersspenttheirtimeonOctober18,2017,describingwhataCPAis,aswellasgainingvitalstudentinputoncreatinganeffectiveletterwritingcampaign.AsofOctober25,2017thisletterwritingcampaignhasaccountedforover90%ofallstudentorganizationsatHUCOPvoicingtheirsupportforthepassageoftheCPArulesandover100studentshadpledgedtheirsupport.

HoorahtotheGreatTeamWork!!!

Howard University College of Pharmacy SubmittedbyCDRDianaSolana-Sodeinde

Advanced Pharmacy Practice Experience at the Federal Medical Center in Fort Worth, Texas

SubmittedbyMaricarConson,Pharm.D.Candidate2018.Preceptor:LTKristenKonoskyandLTChristopherDao

Asafourth-yearpharmacystudentattheUniversityofNorthTexasSystemCollegeofPharmacy,therewasanarrayofadvancedpracticerotationstochoosefrom.Beforelookingatthelistofpossiblerotationsites,IhadnotconsideredcompletinganadvancedpharmacypracticerotationwiththeUnitedStatesPublicHealthService.Specifically,withTheFederalBureauofPrisons–FederalMedicalCenterFortWorth(FMC-FTW)asIwasunfamiliarwiththishealthsystem.IwasunsureofwhattoexpectfromthisrotationasIwasthefirststudentfrommyschooltobegivenanopportunitytohavearotationwiththatsite.IamtrulygratefulthatIwasgiventheopportunitytocompleteoneofmyelectiverotationswithinTheBureauofPrisonsbecauseIwasabletoexperiencearotationthatwillneverbeduplicated.

FMC-FTWhadaround1500inmateswhenIwascompletingmyrotation,withasubpopulationof40inmatesinthelong-termcarefacilitysectionoftheprison.TheskilledpharmacistsatFMC–FTWwereabletosetupandconductbetweenanticoagulationclinicfortheprison,whichIwasluckyenoughtoparticipatein.Iwasallowedtoconductinterviewsandtherebymakerecommendationsontheirtherapy,withgreatguidancefromthepharmacist.Thepharmacistsalsoallowedmetobeexposedtoafewpatientsthattheyfollowedinthelong-termcarefacility.Everyweekduringtherotation,Iwasabletoworkupandpresentonlong-termpatients.Byhavingmegiveweeklypresentations,thepharmacistsatFMC-FTWhelpedmetogrowasapresenterandgainconfidenceintheseskillsthatIwillbeabletotakewithmeontofuturerotations.Iwasabletointeractwiththeprisoners,bycounselingthemontheirnewlyprescribedmedicationsoranychangesintheirtherapy.TheteamalsoallowedmetoconductjournalclubpresentationsandtopicpresentationssothatImaybecomemoreproficientinutilizingprimaryliteratureinmyrecommendations.

WhileonmyrotationatFMC-FTW,IwasabletoattendmeetingsconductedbyUSPHSofficers,civilservants,andotherhealthcareprofessionalsastheydiscussedmattersoftheprison.Observinghowtheinterdisciplinaryteamcollaboratedtoprovidecarefortheprisonerswasremarkable.Astherearedifferentsubsetsofpatientpopulations,thenecessityofhavingskilledhealthcare

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Thisadvancedpharmacypracticeexperienceallowedmetogrowasafuturehealthcareprofessionalbyconstantlychallengingmetobecomemoreinnovativeinmywayofthinkinginregardtopatientcare.IdidnotknowmuchregardingtheopportunitiesforpharmacistswithintheUSPHSbeforethisrotation.However,aftercompletingarotationattheFederalMedicalCenterinFortWorth,myhorizonshavebeenbroadenedandtheexperiencemademerealizethatthefieldofpharmacyisnotjustanonehealthcaresystemfitsalltypeofthing.Iwouldhighlyrecommendthisrotationtofuturestudentpharmacistsastheywillbeabletogrowasastudentandexperienceauniquerotation.

Unique Deployment and Temporary Duty (TDY) Assignment Opportunities in the USPHS

SubmittedbyCDRMonicaReed-Asante,LCDRLysetteDeshields,LCDRAshleeJanusziewicz,LCDRSadhnaKhatri

OfficersintheUnitedStatesPublicHealthService(USPHS)helpachievethemissionoftheCorpstorespondtohealthneedsbydeployingandutilizingtheirvariedskillsetstoservepopulationsimpactedbypublichealthemergencies.Inaddition,USPHSofficersoftentakeonadditionalresponsibilitiesbeyondtheirroutinescopethroughtemporarydutyassignments(TDYs)tosupportareasofemergentneedforshortperiodsoftime.TherearemanyexcitinganduniqueopportunitiesfordeploymentsandTDYswithintheUSPHS.WehadthepleasureofinterviewingLCDRMozeke-BakeraboutherverymemorabledeploymentandTDYexperiences.

Question:Whatdeployment(s)andTDYhaveyoudoneandcanyoutellusmoreaboutyourdaytodayduties?

Answer:IhadaTDYin2014toassistwiththeUnaccompaniedMinorsCrisiswhilestationedwithDepartmentofHomelandSecurity(DHS).Iprovidedroutinecaretotheunaccompaniedchildrenandmothers.IalsodeployedtosouthernLouisianain2016tocareforfloodvictims.Mydutiesincludedadministeringmedications,providingdressingchanges,assistingwithactivitiesofdailyliving,andcoordinatingwithancillaryservices.IwasaffordedtheuniqueopportunitytodeploywithHurricaneHarvey/IrmaremotelyviaanIncidentManagementTeamforthreeweeks,whichrequiredworkingwithinanIncidentCommandSystem(ICS)andcallinghundredsoffirmstoassessforpotentialdamage.

Question:HowdidyoufindoutaboutthedeploymentandTDYopportunities?

Answer:InformationaboutdeploymentsandTDYopportunitiescomethroughvariouschannels.Forexample,myDHSsupervisornotifiedmeoftheDHSTDY.FortheLouisianaflooddeployment,IwasnotifiedoftheneedtoaugmenttheRapidDeploymentForceviaemailandphonecall.

Question:Whatsurprisedyoumostaboutyourexperiences?

Answer:IhaveeightyearsofexperiencethroughmyworkintheUSAirForce,inadditiontomyexperiencesworkingattheBureauofPrisons,DHSandcurrentlyasaConsumerSafetyOfficerwiththeFoodandDrugAdministration.Evenwithmydiversebackground,IamstillsurprisedthatdeploymentsandTDY’sbringoutthebestinpeople.Inthemostdifficultoftimesforsome,Iamsoproudofhowwe(allservicemembers)cometogethertoservethepublic.

Question:WhatpieceofadvicecouldyougivetoanofficerconsideringdoingaTDYbutisonthefenceforonereasonoranother?

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professionalstocareforallofthemisdaunting.Yet,theteamatFMC-FTWdoesagreatjobincaringfortheirpatients.TheteamatFMCtrulycaresaboutmakingapositiveimpactonthehealthoftheinmates.Seeingtheinnerworkingsofhealthcarewithinaprisonmademeappreciatetheuniquenessofthejobsthathealthcareprofessionalshavewithintheprisonsystem.

Advanced Pharmacy Practice Experience at the Federal Medical Center in Fort Worth, Texas

SubmittedbyMaricarConson,Pharm.D.Candidate2018.Preceptor:LTKristenKonoskyandLTChristopherDao

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Unique Deployment and Temporary Duty (TDY) Assignment Opportunities in the USPHS

SubmittedbyCDRMonicaReed-Asante,LCDRLysetteDeshields,LCDRAshleeJanusziewicz,LCDRSadhnaKhatri

Special thank you to LCDR Mozeke-Baker for volunteering for this interview

Answer:Doit!Stretchyourself,serveothersinvariouscapacities.Nomatterwhatyourclinicalbackground(e.g.pharmacy,nursingetc.)therearemanyuniqueopportunitiestodeployindiversecapacities.Theseexperiencesmaypropelandhumbleyou–professionallyandpersonally.

Question:Whatdidyoufindthemostchallenging?

Answer:Ibelievethemostdifficultchallengeistheprocessand/orlogisticsofgettingtothedeploymentorTDYlocation.Thesearesometimesausteresituationsandtravelcanbedynamic.

Question:Whatwasthemostrewardingaspect? Answer:Itisalwaysrewardingtoserveothers.Always!Icarrytheexperiencesandfacesofpatientsandotherservicemembers,evenasIfulfillmyrecentregulatoryduties.Itdrivesmypassionforadvocacyandcompetency.

My APPE Rotation Experience at CMS New York Regional OfficeSubmittedByStephanieTse,Preceptor:CommanderJerryZee,PharmDMPHCPH

InlieuofcelebratingAmericanPharmacistMonththisOctober,IwasabletospendthemonthintheCentersforMedicare&MedicaidServices(CMS),locatedinManhattanbyshadowingCommander(CDR)JerryZeewhoistheRegionalPharmacistofNewYork,NewJersey,PuertoRicoandtheU.SVirginIslands.Asa6thyearstudentpharmacistwithacommunitypharmacybackground,Iwasexcitedandeagertoexploretheregulatoryaspectofhealthcare.ItwasabusymonthforusduetotheannualopenenrollmentperiodsforbothofMedicare,andtheAffordableCareActMarketplacerightaroundthecorner.But,IcouldnothavebeenmorethankfulformytimetherebecauseIwasabletolearnsomuchwithinashortspanoftime.

OnOctober5th,weattendedNewJersey’sRe-EntryRoundtableinJerseyCity,hostedbyNewJersey’sformergovernorJimMcGreevy.Themaintopicwasregardingre-entry.Thereweremanyparticipantsincludingphysicians,NJFamilyCareCommissioner,DHHSAssistantSecretary,andDHHSActingRegionalDirector.Everyoneworkedharmoniouslytogethertodiscussdifferentsourcesofaddiction,effectivemethodsforsupportingthosewithsubstanceabusedisorder,andthepersistentbattleindealingwiththeopioidscrisisinNJ.

TheweekofOctober9th,CDRJerryZeeconductedfourconsecutivedaysofinsuranceaudits.Observingtheevents,Icansaythatitwasaverymeticulousprocess.WeweretomakesureeverythingwasdonecorrectlyaccordingtotheMedicarerules,regulation,andstatutes.ItisimportanttoregulatetheMedicarehealthinsurance(PartC&D)planstoensurethatbeneficiariesareawareoftheirrightsandareabletoaccesstheirlife-savingmedicationsinasafeandtimelymatter.

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StephanieTse

OnOctober13th,Iwasabletoattenda‘CMS&You’TVshowtapingthattookplaceinaBrooklynrecordingstudio.ThesessionthattheyhaddonewasregardingthetoptipstheyhadforviewersregardingtheMedicareAnnualOpenEnrollmentperiodaswellasanyupdatesforvictimsusewereaffectedbytheHurricanes:Harvey,Irma,andMaria.ThiseventwasparticularlyexcitingbecauseIwasabletoseewhatCMSstaffmembersdooutsidetheirnormalplacement.

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My APPE Rotation Experience at CMS New York Regional OfficeSubmittedByStephanieTse,Preceptor:CommanderJerryZee,PharmDMPHCPH

OnOctober23rd,CDRZeeandIwentuptoAlbanytotheDepartmentofHealthfortheNewYorkMedicaidPharmacyAdvisoryCommitteeMeeting.Therewereafewpresentationsthroughoutthedayregardingupdatesoninsuranceplans,themandatorycomplianceprogram,andfreeaccesstotheNaloxoneCo-paymentAssistanceProgram(N-CAP).

OnOctober24th,therewasaDHHSRegionIISummitaddressingthepublichealthandpublicsafetyoftheopioidscrisis.ThereweremanyimportantspeakersatthemeetingfromthePrincipleDeputyDirectorfromtheOfficeoftheSecretaryandtheOfficeofIntergovernmentalandExternalAffairstotheActingCommissionerfromtheDepartmentofCommunityMentalHealthinNewYork’sWestchesterCounty.TherewererepresentativesfromdifferentorganizationssuchasNYCRXStatWorkgroup,whichhelpsdevelopmeaningfulrelationshipsacrossgovernmentstoworktogetherindefeatingtheopioidcrisis.TheOfficeoftheU.SAttorneyalsospokeabouttheirroleinthesafetyofopioidcrisis,suchasprosecutingheroindistributionandbattlingagainstorganizationsthathavetakenoverneighborhoodsandcommunities.

OnOctober25th,IattendedtheCMSTraininginLincolnHospital.ItwasaveryinformationalsessionaboutthebenefitsofMedicareandhowtoapply,Medicareappealsprocess,Medicareprogramsforpeoplewithlimitedincomeandresources,thenewMedicarecard,andenrollmentresourcesfortheuninsured.Caregivers,patients,andcommunityprovidersattendedthiseventandtheturnoutwasgreat.Theattendeeswereveryattentiveandaskedmanyquestions.

OnOctober26th,theCMSstaffmembersandIwenttoSayreville,NewJerseyforthe‘2018NewJerseyAffordableCareActRoundable.’TherewerespeakersfromBlueCrossBlueShieldHorizon,OscarInsurance,andAmeriHealth.TheytalkedabouttheirmissionasacompanyandwhatkindofbenefitstheyofferbeneficiariesfortheupcomingannualopenenrollmentperiodfortheAffordableCareActMarketplace.

Lastly,onOctober27th,wewenttoTouroCollegeofPharmacy’sCareerFair,wherehospitalswithresidencyprograms,fellowshipprograms,theU.SPublicHealthServiceCommissionedCorps,andcompanieslikeCVSHealth,andWalgreenscameouttoeducatethestudentpharmacistslikemyself.Ateachbooth,Iwasabletopickupfliersandbrochuresabouteachprogram.Itwasagreatwaytomeetnewpeopleandpersonallyinteractwithpharmacistsindifferentfields.Theyalsohadan‘InterviewPanel’whererepresentativeswouldanswerquestionsfromthestudentsabouttipsonapplyingforresidency/fellowshipprogramsaswellasadviceforpost-graduation.

Withthat,mytimeatCMScametoanend.Iaminspiredtokeepexploring!

OnOctober17th,CDRZeeandIwenttoRutgersClubatRutgersUniversityfortheNewJerseyPharmacistsAssociationConference.WeprovidedCMSregulatoryupdates,andothersdidthesamewiththeorganizationthattheywereapartof.

United States Public Health Service Excellence in Public Health Pharmacy Award

SubmittedbyCrystalSalgado,PharmD

Everyyear,theUnitedStatesPublicHealthService(USPHS)ExcellenceinPublicHealthPharmacyAwardrecognizespharmacystudentswhohavemadesignificantcontributionsinpublichealth.Nomineesarestudentswhohavedemonstrateddedicationby:AdvancingthegoalsandobjectivesofHealthyPeople2020bypromotingqualityoflife,eliminatingdisparities,andimprovingthehealthofallgroups;focusingawarenessoncurrentpublichealthissuesaroundtheopioidepidemicandZikavirusthroughtheirtimeandcontributions;andhighlightingprioritiesthroughprogramssuchasTobaccoFreeLiving,HealthyEating,andMentalandEmotionalWell-BeingaspartoftheNationalPreventionStrategy.ItwasagreathonortoreceivethisawardinMayof2017forthecontributionsthatweremadethroughtheprojectTakeChargeofYourHealth.

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CreatedbythefacultyattheUniversityofArizonaCollegesofMedicine,Pharmacy,andPublicHealth,ProjectTakeChargeofYourHealthendorsedinter-professionalismamongthedifferentdisciplineswhileencouragingimprovementinpatients’healthandwellness.LocatedinsouthernTucson,theFredArcherCommunityCenterisalocalrecreationcenterthatprovidesyouthandseniorprogramstothesurroundingresidents.Overan8monthperiod,atotaloftwenty-sevenstudents(Medical:7,Pharmacy:15,Public

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United States Public Health Service Excellence in Public Health Pharmacy Award

SubmittedbyCrystalSalgado,PharmD

TeamMembersofTakeChargeofYourHealthProject

Health:5)andten-facultymembers(Medical:5,Pharmacy:3,PublicHealth:2)participatedintheprogram.Asinter-professionalismwasakeyhighlightoftheproject,fiveteamswerecreated,eachwithoneormorestudentsfromthedifferentdisciplines.Participantswerethenassignedtotheirspecificteamfortheentiretyoftheprogram.OneSaturdayamonthforthreehours,participantswouldstartwithfreehealthanddiseasemonitoring,includingbloodglucosereadings,weightmeasurement,bloodpressure,A1C,cholesterol,andmedicationreconciliation.Theremainderofthemorningincludeddiscussionswithparticipantsaboutgoalsorchallengestheyfacedthemonthbefore,followedbyatwentyminuteexercisefocusedactivity,andfinallyafifteen-minutehealthyeatingactivity.Eachgroupwasresponsiblefordesigningtwosessionsthroughouttheprogram,whichastimeprogressedbecamemoretailoredtoourparticipants.Afterourparticipantsleft,studentsandfacultywoulddiscusstheprosandconsthatoccurredduringthatsessiontohelpimprovethenextSaturday.Duringthosemonthsitwasawhirlwindofactivitythatprovideduniqueandpersonalinteractionswithpatients.

Thispastyearhasemphasizedtheunpredictabilityoflifeandtheimportanceoftakingonedayatatime.OnaweekendtripinJuly2016,myfriendwentintocardiacarrestandpassedawaywhilewewereonanaturetrailinMonumentValley.Sometimeswordsareinadequatetoexplainasituation.Ibelieveit’ssimplertosaythatgettingupandmovingforwardwithsmallgoalswasthebestcourseofactionforme.Graduatingontimeandstartingtotravelmoreweresmallgoals.Beyondthat,Iamworkingforacommunitypharmacy,whichallowsmetheoptiontore-evaluateotheropportunitiesavailableinayear.Iwouldliketothankmyteammates,participants,andDr.TheodoreTongattheUniversityofArizonaCollegeofPharmacyforprovidinganextremelyuniqueandemotionallyfulfillingexperience.IconsidermyselfblessedtohavebeennominatedandchosenfortheUSPHSExcellenceinPublicHealthPharmacyAward.

The last session my group organized, I was assigned the exercise session of that day. As a lot of the sessions previously included some form of aerobic exercise or weight lifting, I contemplated the best activity that would be new and rewarding to our patients and played with my strength and knowledge of yoga. I decided to introduce our patients to a yoga practice called Pranayama: breathing exercises. Participants went through various breathing exercises and we discussed how hard it can be to sit and just be present, not to worry about tomorrow or stress about mistakes that happened yesterday, but focus on that moment. I talked about the importance of taking just 10 minutes a day just for yourself and practicing self-care. The activity generated lots of laughter as we joked about the thoughts that would come up trying to sit in silence and breathe, but what I found the most touching occurred after the activity. A few participants approached me after the session and thanked me, stating how the discussion and breathing techniques touched topics very close to their hearts. It was inspiring to sincerely impact our participants with our words and deeds and to motivate them to make small changes in their lives. Taking Charge of Your Health helped me acquire skills that made me successful in my Advance Pharmacy Practice Rotations and future endeavors.

Fromlefttoright:LCDRBotkins,CrystalSalgado,LCDRGreen

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Promoting and Protecting the Health of Minorities: A Pharmacy Practice Experience

SubmittedbyAxelVazquez-Deida,Pharm.D.Candidate2018,PreceptorCDRChristineMerenda

Pharmacistsareideallypositionedtoimprovepatientoutcomesbybeingdirectlyinvolvedinhealthpromotion,educationandpatient-centeredcare.However,pharmacistsalsoplayamajorroleinensuringthehealthoftheNationthroughactiveinvolvementinpublichealthinitiatives.Asafourth-yearstudentpharmacistattheUniversityofMinnesota,IhadtheopportunitytocompleteanAdvancedPharmacyPracticeExperience(APPE)attheUnitedStatesFoodandDrugAdministration(FDA)OfficeofMinorityHealth(OMH)inSilverSpring,MD.TheOMHaimstoimproveregulatorysciencebyincreasingtheamountofclinicaltrialsdataavailableonracial/ethnicminoritiesandpromotinghealthandsafetycommunicationtominoritypopulations.Duringthefive-weekAPPE,Iworkedalongsidemypreceptor,CDRChristineMerenda,onaprojectthatconnectedthetwoprogramsofOMH,theResearch&CollaborationsProgramandtheCommunications&OutreachProgram.

Throughoutpharmacyschool,Ihavebeeninvolvedinvariouspublichealthinitiatives,especiallyviatheUniversityofMinnesota’sstudent-runHealthofPeopleEverywhere(HOPE)clinicfortheunderserved,thestudentchapteroftheCommissionedOfficersAssociation(COA)oftheU.S.PublicHealthService(USPHS)andtheMinnesotaPharmacyStudentAlliance.IcompletedtwoJuniorCommissionedOfficerStudentTrainingandExternProgram’s(JRCOSTEP)withtheIndianHealthService(IHS),furtherstrengtheningmypassionforpublichealthandprovidingmewiththefoundationsofhowtointegratepublichealthpracticeintodirect-patientcare.However,Ihadnotexperiencedpublichealthatagreaterscale,atalevelthatsuchdecisionswouldimpacttheentirecountry.Therefore,IwastrulyexcitedtobeattheFDAandtobeabletocontributetotheagency’smission.

TheFDA’sPharmacyStudentExperientialProgramisstructuredtoallowpharmacystudentstolearnabouttheFDA’smultidisciplinaryprocessesforaddressingthepublichealthissuesthecountryfaces,specificallyregardingdrugs,biologicsandmedicaldevices.DuringmyfiveweeksattheFDA,Iwasabletoattendweeklylecturesthatallowedmetolearnmoreaboutthedutiesofvariousofficesanddivisions.SomeoftheseareasincludedtheOfficeofGenericDrugsandtheDivisionofPharmacovigilance,theDivisionofMedicationErrorPreventionandAnalysis,andtheDivisionofDrugInformationfromtheCenterforDrugEvaluationandResearch,amongothers.TherotationalsoallowedmetoparticipateinvariousUSPHSmeetingsandjoinRADMPamelaSchweitzer,ChiefProfessionalOfficerforthepharmacycategory,foronedayattheCentersforMedicare&MedicaidServices(CMS).IalsovisitedtheheadquartersoftheAmericanSocietyofHealth-SystemsPharmacists(ASHP)andthePentagon.PerhapsoneofthemostmemorableopportunitieswasattendingtheVaccinesandRelatedBiologicalProductsAdvisoryCommitteeMeeting.Duringthismeeting,thesafetyandefficacyofanewHepatitisBvaccinewerediscussed,thusdemonstratingtheFDA’sroleasnotonlyaregulatoryagencybutalsoasapublichealthauthority.

Fromlefttoright:CDRChristineMerenda,Preceptor,andAuthorAxelVazquez-DeidaattheFDAWhiteOakCampus

Duringtherotation,IworkedonassessingtheprevalenceanddisparitiesoftobaccouseandexposureamongU.S.racial/ethnicminoritiesandevaluatingtheeffectivenessofallFDA-approvedtobaccocessationpharmacotherapies.Ialsoreviewedtheconstituentspresentinvarioustobaccoproducts,aswellasinsecond-andthird-handsmoke.Asaresult,IwasabletodevelopEnglish,SpanishandNativeAmericanculturallysensitivefactsheetsthattheOMHwillusetoeducatethepublic.Throughthisproject,Iwasabletoexperienceinterdisciplinarycollaborationatitsbest,workingwithphysicians,nurses,scientistsandpublichealthadvisorsinanalyzingandtranslatingtheinformationforoutreachtothepublic.ThisrotationwasanincredibleexperiencethatallowedmetowitnesshowtheFDAtranslatestheirpublichealthworkintocommunity-accessibleresourcesthatcanpromotechange.Aspharmacists,weareverywellpositionedbetweenthecommunitiesweserve,clinicaladvancesinhealthcare,anddrugregulation.Havingsuchapositionallowsustouseourexperiencesinthefieldandbedriversofchange,thus,impactingthelivesofdiversepatientsacrossthecountry,whilegivingbacktothepracticeandprofessionofpharmacy.AxelVazquez-Deda,PharmD..

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Alaska Native Medical Center Pain ManagementSubmittedbyLisaEpperlyPharmD/MBACandidate,2017,PreceptorAimeeYoung,PharmD,BCPS,CPE

InJulyof2017,Iboardedanine-hourflightcomingfromWestVirginiatoAnchorage,AKtostartmyin-patientpainmanagementrotation.TheanticipationofworkingatAlaskaNativeMedicalCenter,whichisthelargest,mostcomprehensiveTribalHealthorganizationintheUnitedStates,hadbuiltupsinceIfirstappliedfortherotation,ninemonthsearlier.Itwasmyfirsttimeoutofthe48contiguousUnitedStates,andthefirsttimetreatingAmericanIndiansandAlaskaNatives.Ianticipatedlearningnewmethodstomanagepainandbecomingmoreknowledgeableonacuteandchronicpain.Mypreceptor,CDRAimeeYounghelpedmenotonlylearnaboutpainmanagementbutprovidedmewithnumerousopportunitiestobeexposedtootherareasofmedicine.

Atypicaldaystartedwithattendingmultidisciplinarysurgeryrounds,wherewewouldofferassistanceifpatientshadunmanageablepainormedicationrelatedquestions.Afterrounds,wedocumentedthedosageofnarcoticsusedinindividualpatientcontrolledanalgesiapumps.ThenIwouldworkuppatientsthatthepainservicewasconsultedon;thisincludedpatientswhohadanepidural,ketaminedrip,orsimplydidnothaveadequatepainrelief.Laterinthemorning,wewouldmeetwiththepainmanagementnursepractitioner(NP)androundedontheconsultedpatients,providingmedicationrecommendationsasneeded.TheNPvisitedeachpatientandsometimesIwouldroundwithhertoseethepatientsweweretreating.BelowareafewofthedifferentopportunitiesIwasfortunateenoughtoseethroughoutmyrotation.

•EndofLifeNursingEducationConsortiumonPalliativeCare oItwasagreatopportunitytolearnhowtohelpmanagepatients’symptomsaswellasatouchingexperience hearingtestimoniesandwhatsomepatientsgothroughtowardstheendoflife.•PalliativeCareECHO(ExtensionforCommunityHealthcareOutcomes)meetings oThesemeetingsaredesignedtohelppromotepalliativecareservicesthroughouttheAlaskaTribalHealth Systeminruralareas.Themeetingstartswithaneducationallecturefollowedbythepresentationofapatient casewhichisworkedthroughamongtheintra-professionalteamandendswithrecommendations.•Shadowedanurseanesthetistandwatcheddifferentsurgeriesforaday•PresentationonIntranasalNaloxoneforoverdosetotheBureauofIndianAffairs oCDRAimeeYoungandLTKristinAllmarasgavethepresentationasIwasabletoaccompanythemtothe lecture.•Attendedthe2ndannualAuroraBorealisCommissionedOfficerAssociationPromotionCeremony•ListenedtoCDRKaraKing,PharmacyDirector,giveamotivationalspeechabouttheU.S.PublicHealthService

WhileIwasinAlaskaforfiveweeks,Itookeveryavailableopportunitytoexplorethebeautifulscenerythatsurroundedme.ItraveledtoSeward,AKandwentonawhalewatchingcruiseandexploredtheporttownthatalsoholdsthestartofthehistoricIditarod.IwenttoDenaliNationalParkandtookinthebreathtakinglandscapecenteredaroundthetallestpeakinNorthAmerica,Mt.Denali.Iwentonnumeroushikestoseedifferentareasofinterest,exhaustedwhenIgottothetop,butwortheverydropofsweatandmusclepainthatcamewithit.Igottowalkonaglacierandseeawidearrayofwildlife.ThelastweekofmyrotationIwasabletocrossseeingtheNorthernLightsoffofmybucketlist.TheseareonlyasmallfractionoftheamazingexperiencesIhadwhileinAlaska.

ThisrotationgavemetheopportunitytoworkwithU.S.PublicHealthServiceCommissionedCorpsandAlaskaNatives.WorkingwithCDRAimeeYoungandvariousotherhealthcareproviderswasawonderfuleducationalandculturalexperience.IwasabletoseeadifferentsideofpharmacythroughtheU.S.PublicHealthService.Iwalkedawayfromtherotationgainingknowledgein,notonlypharmacy,butAlaskaNativesaswell.IhighlyrecommendAlaskaNativeMedicalCenterforstudentswhoarewillingtoputforthacademiceffort,desiretoexperienceanewenvironment,andwhowanttohaveanadventureofalifetime

(L-R):LisaEpperlyandCDRAimeeYoung

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Pharmacy in the Last FrontierSubmittedbyDakotaRichart,PharmDCandidate–PurdueUniversityCollegeofPharmacy

Whenrankingrotationsduringmythirdyearofpharmacyschool,Iapproacheditwithanopenmind,withthehopeofseizinganyopportunitytobroadenmyhorizons.WhenIcameacrosstheopportunitytotraveltoAnchorage,Alaskaforarotation,Iwasintrigued.IwasevenmoreexcitedtofindoutthatIwasservingatanIndianHealthServicefacility..Luckily,Ihadrankedtherotation,applied,andlaterfoundoutthatIwouldbespendingfourweekscompletinga“TransitionsofCare”(TOC)rotationattheAlaskaNativeMedicalCenter(ANMC).

DuringmyTOCrotation,mypreceptorLCDRMichelleLockehadnumerousopportunitieseverydaytobuilduponmyclinicalknowledgefoundation.Iattendeddailymultidisciplinaryroundswithpharmacists,chargenurses,providers,hospitaladministrationandothermembersofthehealthcareteam.Thesebedsidemeetingsprovidedabetterunderstandingofthedailyhospitalneeds,issuesthatarised,andplansfordischargeatthe167-bedmedicalcenter.Ialsometwitheverypatientbeingdischargedfromthehospitaltocounselthemontheirnewprescriptionsandanychangesmadetotheirhomemedicationregimen.Iwasabletoclarifyinstructions,answerquestions,provideclinicalrecommendations,andassistinasuccessfultransitionbetweeninpatientandoutpatientcare.

WhileatANMC,IwasabletoattendaPharmacyandTherapeuticsCommitteemeeting.Iassistedwithcreatingthemeetingminutes,andIobservedthehospital’sinterdisciplinaryinteractions.Thisrelationshipbetweenpharmacistsandotherhealth-careprovidersisthereasonwhyIchosepharmacyasaprofession.Ialsohadtheopportunitytocompleteavarietyofprojectswhileonthisrotation.Iwasabletodevelopvarioushandoutsforprovidersandhospitalstaff.Iledtopicdiscussionsoncommondiseasestates,draftedSOAPnotesforpresentationandreviewandansweredpharmacistandproviderdruginformationquestions.Ialsoledajournalclubforpharmacistsandproviders.AdditionalprojectsthroughouttherotationincludedupdatingANMC’sopioidconversionsguidelines,includingnewguidelinesformethadoneandtransdermalfentanyl.Thisupdateallowedmetocreateanewsletterinformingallhospitalprovidersandstaffoftheseconversionchanges.Finally,IassistedinthecreationofastatewideMedicationReconciliationtoolkitthatwasmodeledafterthetransitionalcarepracticesatANMC.ThistoolkitwillserveotherremotehealthcarefacilitiesthroughoutthestateofAlaskaindevelopingandimplementingmedicationreconciliationprocessesattheirfacilities.

ThisrotationnotonlyallowedmetostepoutofmycomfortzonefromtheMidwestandexperiencethebeautyAlaskahastooffer;therotationalsoprovidedawell-roundedambulatorycarepharmacyexperience.IwaspleasedtolearnaboutthenumerousopportunitiespharmacistshavewithintheCommissionedCorpsoftheUnitedStatesPublicHealthService(USPHS)andunderstandthemissionofUSPHS“toprotect,promote,andadvancethehealthandsafetyoftheNation”.

DakotaRichartatopFlattopMtn.inAnchorage,AK.

I am Forever GratefulSubmittedByMs.La-KasiaT.BestPharmDCandidate2018,Contributor:CarolynVolpe,PharmD.,MS

Greetings,IamLa-KasiaBest,afourthyearDoctorofPharmacyCandidatefromFloridaA&MUniversityCollegeofPharmacyandPharmaceuticalSciences(FAMU).Ihadthepleasureofcompletingafour-weekAdvancedPharmacyPracticeExperience(APPE)attheU.S.FoodandDrugAdministration(FDA),workingwiththeCenterforDrugEvaluationandResearch(CDER),OfficeofCompliance(OC)andtheOfficeofUnapprovedDrugsandLabelingCompliance(OUDLC).

Physiciansandnursesarethroughoutmyfamily,buttherearenotanypharmacists.SoIthought,whynotbecomethefirst!Duringmyfirstyearofpharmacyschool,Iwasintroducedtoanarrayofpharmacyfields.Manyofwhicharelessknowntothepublicthancommunityorhospitalpharmacy.Sincethen,Ihavealwaysbeeninterestedinthenon-traditionalpharmacyopportunities,suchasgovernmentalpharmacyandpharmacybusinessmanagement.WhenIwasgiventheopportunitytojointheFDAtocompletea

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I am Forever GratefulSubmittedByMs.La-KasiaT.BestPharmDCandidate2018,Contributor:CarolynVolpe,PharmD.,MS

rotation,Iwasoverwhelmedwithjoy.Arrivingwithnoexpectations,Ihadanopenmindandawillingnesstolearnandnetwork.Whatinterestedmemostwaslearninghowlaws,policyandregulationswereimplementedattheFDA.Ibelieveasstudents,wemustoptimizeouropportunitiestoreachourhighestpotential.

Themostgratifyingexperiences,whilecompletingmyAPPEattheFDA,wereparticipatinginseveralimportantprojects.Myfirstprojectinvolvedtrackingthedrugshortagesfrom2015tothepresentthattheOUDLCassistedinalleviating.Inadditiontotrackingdrugshortages,Iassistedwithdraftingabackgrounddocumentthatdiscussedthetimelineofeventsfromapprovalofsingle-ingredientcolchicinethroughtheremovalofunapprovedsingleingredientcolchicinefromthedomesticmarkettopresentday.ThedocumentelaboratedontheimportanceoftheseactionsandwillbeusedbytheOUDLCtopromoteitsunapproveddrugprogram.Furthermore,Ico-presentedalecturetomypharmacycolleaguestitled,TheHistoryoftheFederalFood,DrugandCosmeticActandTheUnapprovedDrugProgram.Lastly,IlearnedhowtowriteawarninglettertopharmaceuticalfirmsformarketingunapproveddrugproductswiththeintentionofassistingthemwiththesubmissionaNewDrugApplication.Beingabletoparticipateinthesenumerousprojectsgreatlyincreasedmypassionfornon-traditionalpharmacyoccupations.

SomethinguniqueaboutmyrotationwasthatIwasacceptedasthefirststudentmemberofanewFDAworkgroupfocusedontopicsrelatedtoprofessionalandpersonalchallengesfacingwomeninthefederalworkplace.Thefocusofthisgroupistoenhancebothprofessionalandpersonaldevelopmentforleadershipopportunities,careeradvancementandwork-lifebalanceinwomen.Thisworkgrouphasplanstopartnerwithotherinternalfederalorganizationstoincreasediversity,employeeengagement,outreachandrecruitment.Iattendedthefirstcommitteemeeting,whereIcontributedgreatideasforpublicinformationpacketsandrecruitmentevents,specificallyexternaloutreachforthestudentpopulation.Afterspeakingwiththefacilitatorabouttheorganization,IfeltthatImadetherightchoicetojointheorganizationexternally.Ilookforwardtobeginningmyjourneywiththisorganization.

Businesswaspriority,butmystayinWashington,DistrictofColumbiawasnotallbusiness.Duringmyvisit,Iwasablevisitsomeofthemostvaluedsitesintheworld:theWhiteHouse,theWashingtonMonument,thePresidentialMemorials,thePentagon,theNationalInstitutesofHealth,theUnitedStatesCoastGuardHeadquartersandavarietyofmuseums,includingtheNationalMuseumofAfricanAmericanHistoryandCulture.Iwouldsuggestallstudentsexplorethisverywonderfulcityandenjoythehistorybehindourcountry.

Knowledgeispower,butcommunicationisrequired.ThroughoutmytimeattheFDA,InetworkedwithFDAemployeesandpharmacystudentsfromacrosstheworld.Bybuildingrelationshipsandgainingknowledgefromtheseindividuals,theyhavehelpedmefurthermycareerandtobecomethebestpharmacystudentandpharmacyleader.Meetingtherightpeopleattherighttimecanmakeadifferenceinyourlife.Afteroneofthestudentlectures,IwassointriguedthatIset-upaone-on-onemeetingwiththepresenteranditwasthenthataforeverbondbegun.WeconnectedandIwasofferedtheopportunitytogainamentor.Inmyopinion,amentoriswillingtobeavehicletoyoursuccess.Theyaidinpioneeringyourlearningjourney.Thisindividualbelievedinmeandgavemeachancetobecomeabetterme.

IwouldliketothankFloridaA&MUniversity,theFDAandmypharmacycolleaguesformakingmyrotationanexperiencetoremember.IneverimaginedthatIwouldhaveparticipatedinsuchalifechangingandfulfillingrotation.Lifeisfilledwithunexpectedopportunitiesandwhentheypresent,wemusttakeadvantage.ThepurposeandmissionoftheFDAprovidesawidespectrumoflearningopportunities.IamforevergratefulthatmyjourneyattheFDAwaspurposefulandagreatlearningexperience.Theexperiencesolidifiedmyloveforpharmacyandmypassionforutilizingtheknowledgeandexpertisegainedtocreateamorehealth-consciousnation.

Ms.La-KasiaT.BestPharmDCandidate2018

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The USPHS: History, Student and Career Opportunities,and Integration of S.T.E.A.M. Principals

SubmittedbyLCDRPatrickHarperandLCDRChristopherLaFleur

Recently,LCDRPatrickHarperandLCDRChristopherLaFleur–bothstationedinChicago–teamedupwiththeLeaveNoVeteranBehindorganizationanditsS.T.E.A.M.programstoeducateChicago-areastudentsontheUSPHSandhowhighschoolacademicsconnectwithPHScareers.LeaveNoVeteranBehind(LNVB)seekstobuildbettercommunitiesthroughemploymenttraining,transitionaljobs,andveteraneducationdebtreliefscholarship.ItsS.T.E.A.M.programsconsistofProjectInnovationandGreenCorps:highschoolbasedprogramsfocusedoneducationalandvocation-alopportunitiesinthefieldsofScience,Technology,Engineering,Arts,andMath.AtChicago’sLindblomMath&ScienceAcademy,LNVBconductsProjectInnovation,wherestaffandVeteranswithS.T.E.A.M.backgroundsworkwithhighschoolstudentsinanextracurricularsettingtoleadhands-onS.T.E.A.M.-relatedprojectsandoffereducationonpossibleS.T.E.A.M.careers.

AttheinvitationofLNVB,LCDRsHarperandLaFleurpresentedtostudentsonthehistoryofthePHSandeducatedthemonthenumerouscareeropportunitiesthatexistwithintheCorps.ThepresentersspecificallyhighlightedthevarietyofwaysthatS.T.E.A.M.principalsserveasthefoundationforthenumerousrolesPHSofficershold.StudentsexpressedgreatinterestinthebranchofservicepreviouslyunknowntothemandwereparticularlyexcitedbythenumerouswaysinwhichtheCorpservestheunderserved,abackgroundthatmanyofthestudentsshared.Thisledtoarobustquestionandanswersessionthatmadethedayveryenjoyableforallinattendance.

LCDRHarperandLCDRLaFleurarealumniofSt.LouisCollegeofPharmacy,wheretheybothserveasaUniversityPointofContact(UPOC)today.LCDRHarperisaPublicHealthAnalystfortheBureauofHealthWorkforceinHRSA’sChicagoRegionalOffice.LCDRLaFleuristheAssistantHealthSystemAdministratoroftheBOP’sMetropolitanCorrectionalCenterinChicago.

(L-R)::CDRLaFleurandLCDRHarperpresentingtothestudentsofLeaveNoVeteranBehind’sProjectInnovationatthe

LinblomMath&ScienceAcademyinChicago,IL.

United Nations visit in New York CitySubmittedbyArjunChauhanandThanhTruongPharm.DCandidates2019

OnFridayOctober6,2017,studentsfromTempleUniversitySchoolofPharmacy(TUSP)weregiventheopportunitytovisittheUnitedNationsheadquartersinNewYorkCity.ThistripwasincorporatedintothePublicHealthcoursegivenatTUSPbyDr.NicoleSifontis,andallowspharmacystudentsanopportunitytomergetogetherpharmacyandhealthcarewiththerestoftheworldanditsevents.

Duringouryearsinpharmacyschool,welearnamyriadofclinicalinformationthatwecanusetohelptreatourpatients,butwedonotalwaysknowhowtoapplyournewfoundskillsonaninternational,orevennationalscale.Today,itisrarewhenpublichealthtopicsdonotmaketheheadlinenews.Forexample,naturaldisasters,civilwars,ornationsthatareinaperpetualstateofhealthcrises,unfortunatelyseemtobemoreandmorecommon.

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United Nations visit in New York CitySubmittedbyArjunChauhanandThanhTruongPharm.DCandidates2019

ThroughparticipationinTUSP’sPublicHealth,wehavebeenabletolearnmoreabouthealthcarebeyondthelocalcommunitieswherewetreatpatientsinourregularpractices,buttoalsoexperiencethechallengesoftreatinginternationalpatientsandtheirfurtherreachingglobalneeds.OurstudentcohorthasfocusedontheUnitedNation’sSustainableDevelopmentGoals,whichisasetof17globalgoalswhichfocusonabroadrangeofsustainabledevelopmentissues.ActuallyvisitingtheUNgaveusthechancetoseenotjustwhere,butalsoknowhowtheUNfunctionsintheirquesttocreateabetterworld.

ThegoalsoftheUNconsistof3mainfacets:humanrights,peaceandsecurity,anddevelopmentfortheworld’spopulation.ThroughourtouroftheUN,weexploredthefourmainchambersandlearnedthesignificanceofeach.ThemajorGeneralAssemblyHallisthelargestanditiswherethe193memberstatescongregatetodiscussworldissues.TheSecurityCouncil,whichconsistsof15members,10ofwhichrotateeachyeartoensureeveryvoiceisheard.TheonlypartoftheUNwewereunabletoseewasthe“InternationalCourtofJustice”becauseitisintheNetherlands.

SpanningtheentirecorridoracrosstheentrancetotheGeneralAssemblyHallarethe30BasicHumanRights;theUNbelieveseachpersonisentitledtoreceivethesebasicandfundamentalneeds.Thesimplicityofthedisplayisextremelyfittingasthesearetherightsallhumansshouldbeendowed,nomattertheirstatusorplaceinsociety,andshouldbeguaranteedtoeveryone.Althoughtheserightsarenotlegallybinding,theprincipleshavebeenemployedinvariouswaysasacitationforthosewhofightfortherightsofpeopleworldwide.With370differenttranslations,theUN’sBasicHumanRightsisthemosttranslateddocumentintheworld.Wehopethatitcanbeusedabasisforallgovernmentstofollowwhendecidingontheirownlaws.

AftervisitingtheUnitedNationsheadquarters,weexperiencedfirst-handhowmuchworkandcooperationisrequiredtodeliverqualityhealthcaretotheentireworldpopulation.TheUNcertainlyprovestobeanextraordinaryinstitutionthataimstobringunitytoallnationsandpeople;aimingtoprovideeachpersonwiththedignitytheydeserveregardlessofrace,color,gender,orientationoranyothercategorizationthatcouldbeconstruedasabarriertounity.Aspharmacystudents,thistripallowedustoseehowtheUNworkstowardstheachievementoftheseSustainableDevelopmentGoals,toassurehealthandsecurityacrossthememberstates.WewerealsoabletoseetheimpactthatourcountryhasonotherswhenitcomestodedicationtothebasichumanrightsandthegoalsoftheUN.Afterreturningfromthetripandreflectingontheimpactithadonus,weareconfidentthatthisuniqueexperiencewillallowustobetterourserveownpatientsinamoremeaningfulandimpactfulway.

Advanced Pharmacy Practice Experience at the Food and Drug AdministrationSubmittedbyMs.IreneeIbrahim

InMay2017,IcompletedafourweekrotationattheFoodandDrugAdministration(FDA).Thenontraditionalrolesofpharmacistshavealwaysintriguedme,soIwasveryexcitedtobegrantedthisopportunity.Priortopharmacyschool,andeventhroughout,IknewthattheFDAregulatedfoods,cosmetics,anddrugsintheU.S.market,butthatwasabouttheextentofit.BeingattheFDAopenedmyeyestoallofthedetailsandinnerworkingsthatoccurintheagency.MyrotationwasfilledwithmanydifferentlearningopportunitiesandexperiencesthatIwouldnothavebeenexposedtoatatraditionalrotationsite.

Duringthemonth,IworkedunderColleenO’Malley,mypreceptorintheCenterforDrugEvaluationandResearch’s(CDER),OfficeofCompliance,OfficeofUnapprovedDrugsandLabelingCompliance(OUDLC).ThefirstthingthatIquicklycametorealizewashowmanydifferentbranchesandofficestherewereattheFDA.OUDLCregulatestheunapproveddrugmarketandtakesenforcementactionagainstdrugcompanieswhodonotcomplywithfederaldruglawsandregulations,andthereforeposeapublichealthconcern.EnforcementactionsbyOUDLCinclude:settingexpectationsofvoluntarycompliancebyfirmswithviolations,holdingregulatorymeetingswithfirmstogivenoticeofnon-compliance,sendingoutwarningletters,seizureofdrugsthatareinviolation,andinitiatinginjunctionsagainstfirmstostopthemanufacturinganddistributionofunapproveddrugs.

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NotonlydidIlearnabouttheworkdonebyOUDLC,butIwasabletolearnaboutwhatsomeoftheotherofficesattheFDAdobyattendingvariousstudentlecturesgivenbystaffindifferentdepartmentswithinFDA.IwasalsoabletopresentatthestudentlectureheldatOUDLCforfellowpharmacystudentsrotatingthroughFDA.ThishelpedtoreinforcetheconceptsthatIlearnedduringmyrotation.Throughthestudentlectures,IalsohadtheopportunitytovisittheheadquartersoftheAmericanSocietyofHealth-SystemPharmacists(ASHP)andtheStablerLeadbeaterApothecaryMuseum.AtASHP,IbecamemoreinformedaboutASHP-accreditedresidenciesandthematchingprogram.TheStablerLeadbeaterApothecaryMuseumwasalsoawonderfulexperiencebecauseIwasabletotouroneoftheoldestbusinessesinAlexandria,Virginia.ThisrotationexposedmetomanythingsthatIwouldnothavehadtheopportunitytoexperienceotherwise.

Advanced Pharmacy Practice Experience at the Food and Drug AdministrationSubmittedbyMs.IreneeIbrahim

IwasfortunateenoughtoattendtwodifferentAdvisoryCommitteeMeetings.ThesearemeetingsinwhichtheFDAbringsinapanelofexpertsfromoutsidetheagencytodiscussatopicathand(usuallycontroversial)inorderfortheFDAtogainmoreperspectiveandmakethebestdecisionregardingthetopicmatter.Notonlydoestheagencyallowtheexpertstogivetheiropinions,buttheyalsoopenuptheforumtothepublicandpermitanopenpublichearinginwhichtheyacknowledgetheopinionsofconsumers.ThefirstoneIattendedwasaPharmacyCompoundingAdvisoryCommitteeMeeting,inwhichtheydiscussedaspecificformulationandwhetherthatformulationshouldbeonthe“difficulttocompound”list.ThesecondwasanOncologicDrugsAdvisoryCommitteeMeeting.ThiswasparticularlyinterestingbecausetheywerediscussingthepossibleapprovalofNeratinibfortheextendedadjuvanttreatmentofHER2-positiveearlystagebreastcancer,basedonitsrisk-benefitratio.IgotachancetolistentotheperspectivesofPumaBiotechnology,theinnovatorofthisdrug.Ialsolistenedtomanysurvivingbreastcancerpatientswhospokeabouttheirexperiencesusingthedrug.Inbothmeetings,IfelthonoredbeingintheroombecauseIfeltasifIwaswatchinghistoryinthemaking.

Inadditiontoalloftheselearningopportunities,IwasassignedanoverarchingprojectregardingtheDrugEfficacyStudyImplementation(DESI)program.Priortomyrotation,Iwasunawareofthisprogram,butIwasabletounderstandwhattheprogramwasandtheFDA’sroleinitthroughtheproject.In1938,CongresspassedtheFood,Drug,andCosmeticAct(theAct)whichrequiredthatdrugsbeprovensafepriortomarketing.In1962,theKefauver-HarrisAmendmentrequiredthatdrugsbeproveneffectiveaswellassafepriortomarketing.Sincethedrugsapprovedbetween1938and1962hadonlybeenassessedforsafety,theFDAbegantheDESIprogram.TheroleofDESIistoassesstheefficacyofdrugsapprovedbetween1938to1962.Tothisday,therecontinuestobesomeopenDESIproceedingswhereafinaldeterminationofeffectivenesshasnotbeenmade.AslongastheDESIproceedingremainsopen,thatspecificdrugisallowedtostayonthemarketuntilitsproceedingclosesandthedrugisdeclaredineffective.TheagencyintendstoclosealloftheopenDESIproceedingsinthenearfuture.IwasabletoassistwiththisinitiativeanditwasaverysatisfyingexperiencebecauseIknowthatitwillbringthepubliconestepclosertoasaferdrugmarket.

WorkingwiththeFDAforfourweekswasaninvaluableexperience.Iwouldstronglyrecommendittoanypharmacystudent.Therearesomanydifferentopportunitiesforpharmacistsattheagency,anditwaswonderfultobeabletoseesomenontraditionalpharmacistsinaction.Thisrotationalsohelpedexpandmyprofessionalnetworkbygivingmethechancetomeetmanydifferentpharmacistsandinquireabouttheircareerpaths.Indoingso,Iwasabletounderstandhowvastandversatiletheprofessionis.Iamthankfulforthisexperience,andithastrulyinspiredmetobecomeabetterpharmacist!

Ambulatory Care Practice Experience at Lawton Indian HospitalSubmittedby:CathyDunton,PharmDCandidateandPreceptorLCDRJessicaSteinertPharmD

Thedrivewesttook14hours,andthescenerychangedgraduallyfromtalltreesandurbanstructurestomoreidyllicfarmlands.EachmomentremindedmeofhowfarIwasawayfromhomeandhowuniquethisrotationwillbe.IhavebeeninterestedincompletingarotationatanIndianHealthService(IHS)sitesinceitwasintroducedtomeatmyfirstpharmacyschoolinterview.WhengiventhechancetoselectanIHSsiteasoneofmyrotations,Ijumpedattheopportunity.Myfive-weekAPPErotationatLawtonIndianHospital(LIH)ambulatorycareclinicsprovidedmewiththeopportunitytolearnandpracticeprovidingdirectpatientcareundertheguidanceof

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mypreceptor,LCDRJessicaSteinert,PharmD.Underherguidance,IalsolearnedagreatdealabouttheU.S.PublicHealthService(USPHS)andhowuniquelyIHSservesitstargetpopulation.

Ambulatory Care Practice Experience at Lawton Indian HospitalSubmittedby:CathyDunton,PharmDCandidateandPreceptorLCDRJessicaSteinertPharmD

Lawton,OklahomaisaboutoneandahalfhourssouthwestofOklahomaCity.LIHislocatedonfederallandandservesadiversepopulationofNativeAmericantribes.Theoutpatientpharmacydispensesanaverageof1,100-1,800prescriptionsperday,servingboththeimmediatecommunityintheoutpatientpharmacyandmailorderprescriptionsforpatientswholivefaraway.Thepharmacyisservicedbymanypharmacistsandtechnicians,someofwhomareCommissionedCorpsofficers.Thepharmacyalsohas4pharmacist-runclinicsandparticipatesinmanyhospital-wideinitiatives.Inthetobaccocessationclinic,IpracticedmotivationalinterviewingandactivelisteningasIhelpedpatientswithcopingstrategiesandmedicationstoencouragethemtoquitsmoking.Intheanticoagulationclinic,patientscameinforweekly,biweekly,ormonthlyvisitstohelpmonitortheirINR,possiblesideeffects,andlifestylemodifications.IwasabletohelpmanagetheirwarfarindosesandprovideeducationonamyriadoffactorsthatmayaffectwarfarineffectivenessandINRlevels.

In2015,LCDRSteinertestablishedtheHepatitisCClinicaspartofOklahoma’sHepatitisCCUREProject,forwhomsheisaCUREunitcoordinator.ThisprojectallowshertonetworkwithotherfederalIHSHepatitisCclinicswithinOklahomaandtoestablishedaplatformforstandardizedcureandcare,aswellastosharereportingforoutcomes.Priorto2015,therewasjustoneHepatitisCclinicinfederalOklahomaIHSsites,andtoday,thisprojecthasexpandedtoprovideHepatitisCtreatmentacrossOklahoma.In2017,LCDRSteinertreceivedaNationalIHSDirector’sAwardforsuccessfullyestablishingtheHepatitisCclinicatLIH.Tothisday,thisclinichashada100%curerateforallcompliantpatients.

Pharmacist-runclinicsarestillgrowingatLIH.In2016,LTIkjaeChin,astaffpharmacist,establishedtheAdultAsthmaClinictowhichproviderscanreferpatientsforbetterasthmacontrol.Theasthmaclinichelpsprovidecounselingandeducationforinhaleruse.Partneringwiththerespiratorytherapists,theclinicalsoseesallpatientswithnewlydiagnosedasthmawithaPulmonaryFuntionTest(PFT)referraltocontrolsymptoms.

Outsideoftheclinics,Iwasinvitedtoattendandparticipateininitiativesaspartofamulti-disciplinaryteaminthehospital.Iattendedbimonthlyantimicrobialstewardshipmeetingswhereprimarycareproviders,pharmacists,andhospitaladministratorsdiscussedjudiciousantibioticprescribingpracticesandotherwaysLIHcanfurtherincorporateCDCrecommendationsintoitsantimicrobialstewardshippractices.Atthemeetings,Ialsopresentedsomeoutpatientclinicstrategiesthathaveshownevidenceofreducingunnecessaryantibioticprescribing.TheothermajorinitiativethatIparticipatedinwascombattingtheopioidcrisis.ThelocalHeroinOpioidPainEfforts(HOPE)committeemirrorsthenational-levelIHSHOPEcommitteeandholdsmeetingswithamulti-disciplinaryteamofadministrators,clinicians,pharmacists,andbehavioralhealthandnursingstaff.Theydiscussedandimplementedstrategiesforreducingopioidoverprescribingandpreventingopioidabuseandoverdose.Aspartofanefforttostartanaloxoneclinicinthepharmacy,Ihelpedperformchartreviewstoexaminepainmedicationprescribingpractices.Itwasmyfirstexperienceseeingopioidoveruse,anditexpandedmyoverallunderstandingofthecomplexityoftheopioidcrisis.

Beyondmytimeinthepharmacy,ItookfulladvantageofallthatOklahomahastooffer.Myweekendswerecomprisedofattendinglocaleventsandoutdooractivitieswiththepharmacystaff.IntheshortfewweeksinLawton,Iattendedmyfirstrodeowhenitcametotown,andacoupleweekslater,IattendedtheannualAmericanIndianExposition45minutesawayinAnadarko.Myfavoritetimeherewasspentintheoutdoors.Just20minuteswestofthehospitalistheWichitaMountainsWildlifeRefuge,whereIhikedandkayakedwithLCDRSteinertandotherpharmacystaff.FromthesummitofMountScottintherefuge,Itookintheviewofthebeautifulprairieterrainbeyondasmatteringoftownsandwindmills.Theunexpectednaturalbeautyoftheplacetookmybreathaway.

Iamthrilledtohaveventuredoutofmycomfortzonetoexperiencethisuniqueambulatorycarerotation.IencourageanyonewhowantstoexplorethebreadthofacareerinpharmacytocompletearotationatanIHSsite.Theskillslearned,thesightsseen,andtheexperiencesfelthereatLIHwillshapemeasIadvancemyeducationandcareer.Iamgratefulfortheopportunitytogaininsightintothisaspectofpharmacyandpublichealth,andIencourageanyonetogetoutandseektheirownadventuresatanyoftheIHSsitesfortheirrotations.

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University of Pittsburgh School of Pharmacy Graduate Megan Dunlop Receives Prestigious 2017 “United States Public Health Service Excellence

in Public Health Pharmacy Award” SubmittedbyCDRNicoleZelenak

RecentUniversityofPittsburghSchoolofPharmacygraduate,MeganDunlop,PharmD,waspresentedwiththeUnitedStatesPublicHealthServiceExcellenceinPublicHealthPharmacyAwardbyCDRNicoleZelenakonApril28,2017duringtheSchool’sGraduationDinnerandHoodingCeremonypriortoCommencement.Thisprestigiousawardwasestablishedin2003andbestoweduponstudentpharmacistscommittedtopublichealth.

Megan’sdedicationtopublichealthisevidentthroughheractionsduringhertimeinpharmacyschool.Recognizinganeedinthecommunity,MeganworkedwiththeAlleghenyHealthDepartmenttoinitiateaprogramtomaintainastandingnaloxoneorderinPittsburgh.Throughherpassionandhardwork,shewasabletoinformalargenumberofpharmaciesofthisprogram.Whenpresentedwiththechallengeofsomepharmaciesnotbeingreceptivetostockingnaloxone,Megansetouttodeterminewhytheremaybereluctancebycreatingandimplementinganinterviewguidewhenspeakingwithpharmacistsandpharmacystudents.Aftercompletingherresearchproject,entitledBarrierstoDispensingNaloxoneinCommunityPharmacies,Meganpresentedaposteronthetopicatthe2017PennsylvaniaPharmacistsAssociationMid-YearConference.

Followinghercommitmenttoimpactingpublichealththroughaddressingtheopioidepidemic,Meganalsoensuredthatherfellowpharmacystudentswerewellinformedontheuseofnaloxoneintheopioidepidemicbyhostingcounselingsessionsandbringinginoutsidespeakerstoaddressthisimportanttopic.

Megan’spassionandhardworktrulyspeaktoadedicationtopublichealth,whichshebringstohercurrentpositionpost-graduationasaCommunityPharmacyPracticeresidentwithDuquesneUniversityandMainlinePharmacy.Sheplanstocontinuefollowingherpassionofcombatingtheopioidepidemicinthecommunitypharmacysetting.Meganhopestoincludecommunityserviceandpublichealthinherfuturecareer.

(LtoR):PatriciaKroboth,Ph.D.,DeanUniveristyofPittsburghschoolofPharmacy,

MeganDunlop,Pharm.D.,CDRNicoleZelenak

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Useful Info and Resource Links

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United States Public Health ServiceProtecting, Promoting, and Advancing the health and safety of our Nation.

CORE VALUESLeadershipProvidesvisionandpurposeinpublichealththroughinspiration,dedication,andloyalty.

ServiceDemonstratesacommitmenttopublichealththroughcompassionateactionsandstewardshipoftime,resources,andtalents.IntegrityExemplifiesuncompromisingethicalconductandmaintainsthehigheststandardsorresponsibilityandaccountability.ExcellenceExhibitssuperiorperformanceandcontinuesimprovementinknowledgeandexpertise.

Did you know?TheUPOCNewsletterispotentiallyreadbythe1,276subscriberstothePHS-pharmacistslistservandover767subscribersonthepharmacystudentlistserv.Intotal,thereareover2,000readersoftheUPOCnewsletter.BUT…it’suptoyoutodistribute.PleasetakethetimetodistributetheUPOCNewslettertoyourUniversitiesortakeacoloredcopyforyourCareerFairRecruitmenttable.

Thank you from the UPOC Newsletter Workgroup!

Editor-in-chief&UPOCNewsletterWorkgroupLeadLCDRShannonSaltclah,Pharm.D.,BC-ADM,NCPS

Wewantyoursubmissionofarticlesandpictures!Pleaseemail LCDR Shannon Saltclahandshewillforwardthemtotheappropriatesectionleads!

UPOC Newsletter Workgroup

LCDRStevenRodgersLCDRAyanaRowleyLCDRMichelleWilliamsLCDRLynetteWassonLCDRDanicaBrownLCDRChristopherMcKnightLTMichelleLockeLTBrettWhiteheadLTKristinaSnyder

CDRHawyeeYanCDRJerryZeeCDRJoshuaWiremanCDRCarolynVolpeCDRNicoleZelenakCDRMonicaReed-AsanteLCDRLyshetteDeshieldsLCDRJoshuaHuntLCDRSadhnaKhatriLCDRAshleeJanusziewiczLCDRSalvatorePepe

COPY EDITORS:CDRVictoriaFerretti-AcetoCDRReneeTaylorLCDRStephanieDaniels-CostaEditorial Staff:CAPTJoAnnHittieCDRRayFordCDRG."Brent"HobbsCDRRobertKoskoCDRKelleySimmsCDRChristinaThompson

RADM Pamela SchweitzerUSPHS Chief Pharmacy Officer