Mateui, so far, how is pharmacy school for you? Are the courses intense, what have you learned, etc.

I'm really enjoying myself - but then again, I've always loved going to school. How my college works is that you only study one subject at a time for about a month or so, take one written final exam on it, then start a completely different subject and repeat the process. This is great. It really allows you to focus on one area at a time and not be bombarded with 4 different exams at the end of the school year. There is a lab component and critical appraisal+stats course that goes all year round, so there's some variety as well - you're not only doing one thing at a time. It's pretty balanced.

Year 1 did not feel at all like pharmacy. They make you take random sciences course like anatomy, physiology, microbiology, biochemistry, organic chemistry (ugh.. one whole year of organic crammed into one semester. Not fun at all! Especially if you've never taken it before.. which is what ended up happening to me.) The good thing about pharmacy here is that all your grades are Pass or Fail. Usually the cut off is 65%. If you get a 66% or a 99% it doesn't matter - in the end they're both Ps - which is good since you don't have to stress about getting good grades anymore. You just want to pass. There are certain courses that are intense and you really need to study a lot and be able to manage your time well - but it's definetely not as bad as med school (my sister is in it and believe me, her material is so much more vast and intense that I'm so glad I'm in pharmacy instead).

Year 2 gets more interesting since it finally becomes pharmacy-related. You learn about pharmacokinetics (a very math-oriented course where you use various equations to calculate initial doses, loading doses, clearance, absorption, etc.), nutrition, dermatology, eye & ear, respiratory, and GI. Basically, by the end of year 2 you know all the OTC products out there as well as a small chunk of prescription drugs. This is probably the easiest year material and study-wise. It's pretty relaxing for the most part since things make sense and you're not randomly changing courses from one area of science to another.

Year 3 is the most intense. It covers women's health issues (the easiest of the whole bunch and the exam I just wrote last week.. hopefully I passed! Our professor was a gigantic moron who got the job 2 weeks before our first class because the original prof left. She started our first lecture by introducing herself and saying that it's kind of ironic that they asked her to teach a course on women's health and contraception seeing as how she got pregnant by accident and didn't know it until 3 months went by!  Yeah, what a way to start... she was a mess!). Where was I? Oh yeah, the courses. So after that there's cardio, an intense 7 week course that covers everything and more that you wanted to know about cardiac conditions and their treatment, and then endocrine (stuff like diabetes) before christmas. That's supposed to be easy after going through cardio. After christmas you start the worse course ever - CNS - which covers all mental disorders, depression, etc. It's a very lengthy course and pretty dumb as you a large majority of drugs' mechanism of actions are "unknown", they just somehow effect something in your brain - or so I've been told. I'm really not looking forward to that. There's also Pain & Rheumatology and Infectious diseases at the end of the year. They're supposed to be ok.

Fourth year you only go to school for the first semester and cover a few subjects that you've missed (I can't think of then all at the moment, but I do know that Renal is there). Afterwards, for the second semester you go on two 6-week rotations, one at a community pharmacy of your choosing and another one at an assigned hospital. So, you're pretty much done schooling at that point but you're forced to work for free for those 12-weeks AND you have to pay tuition for that semester. AWESOME. 

While there have been a couple of times where I've been extremely frustrated and ready to breakdown, I've managed to get through it and in so far I've experienced far more positives than negatives. Pretty much everyone who's in Pharmacy is a perfectionist so it gets annoying to realize that there's just too much material to memorize and there's no way you can physically do it all. You just need to accept that you only need to pass... that's all. Pharmacy pretty much breaks your "must get As in everything" attitude, but that's alright. I'm actually more happier now not having to stress about getting high grades.

In terms of what I've learned, it's kind of scary that pharmacists actually know A LOT more about drugs than physicians do. Doctors take one course about pharmacology (in fact, they take it along with us) and that's it. They focus a lot about more on diagnosing, and then learn the drugs from the clinical experience of their mentors. Pharmacists are the drug-experts, and if you've ever wondered about how drugs work you'll love learning all there is to them.

There's been a push in the pharmacy world for pharmacist prescribing and I think you'll be seeing that develop further in the near future. Pharmacists know a huge amount of information and it's kind of wasted if all they do is push pills. Pharmacists are pushing the government to get prescribing rights so it'll be interesting to see how far we're able to go.

Update: If I wanted to change my path to engineering, then I'd have a bit of a problem. I'm currently taking Intermediate Algebra(I could of taken higher but I didn't want to.) So, it seems colleges in NC, from the ones i've seen, seem to require that you take Calculus 1-3 + Differential Equations in CC. So, from where I am, I can only take Calculus 1 and that would be in the second semester of my second year. How can I work this out if I decided to change?

well yeah that is a pretty bad situation. you could try doing summer school. i think you could try asking your adviser if taking calc 3 and difeq at the same time would be possible. calc 2 is crucial for calc 3, but i am almost sure you could do alright in defeq without calc 3. i still havent taken difeq though.

what? I was in engineering (at NC State which is one of its only credentials), it didn't require you take calculus 1-3, I even started at calc 1 in college.

edit: I'm just not following this at all!

There's been a push in the pharmacy world for pharmacist prescribing and I think you'll be seeing that develop further in the near future. Pharmacists know a huge amount of information and it's kind of wasted if all they do is push pills. Pharmacists are pushing the government to get prescribing rights so it'll be interesting to see how far we're able to go.

I have always wondered about this.  A doctor should diagnose you with an illness, and a pharmacist should be the one who writes a prescription.

I don't know what kind of certifications pharmacists have to get but the doctor's got all your private info like your allergies and shit right so you'd think unless it was just a really basic sort of prescription then the pharmacist wouldn't be able to do that.

I have always wondered about this.  A doctor should diagnose you with an illness, and a pharmacist should be the one who writes a prescription.

I think that that would actually be a good idea. Even if it doesn't develop this far, I wish doctors would actually write their diagnosis on the prescription itself so that we can double check the appropriateness of the therapy prescribed. I can't tell you how often I've asked someone what their prescription is for and they're like "I don't know.. my doctor just wrote this and gave it to me". If there's one thing I love more than doctors with legible writing is that ones that end their SIG codes with "for [condition]" - like "Flovent 250mcg Inhaler 1 puff BID for bronchitis" - it just makes everything so much easier and all it takes for them is an extra 2-5 seconds to write it. Unfortunately too many doctors are rushed and lazy. (And then they get annoyed when we have to call them to get them to clarify what they meant to write).

I don't know what kind of certifications pharmacists have to get but the doctor's got all your private info like your allergies and shit right so you'd think unless it was just a really basic sort of prescription then the pharmacist wouldn't be able to do that.

We have all that. In fact some times we have more information on the patient than a walk-in doctor would get. If you go to the same pharmacy all the time then they have all your allergies listed, medical conditions, and all drugs you've taken in the past and are currently taking. With all this documented in one place it makes it simple for us to ensure that nothing you're taking is going to interact and cause a drug-related problem. (All pharmacies use a computerized database to fill prescriptions and house medical info).

I don't know what kind of certifications pharmacists have to get but the doctor's got all your private info like your allergies and shit right so you'd think unless it was just a really basic sort of prescription then the pharmacist wouldn't be able to do that.

Computerized medical records available through searchable databases online?

Computerized medical records available through searchable databases online?

Last year I had a job scanning medical records.  I still don't think they're done doing all that and they're a pretty small office.  If you think about all the offices that haven't even STARTED moving away from paper charts, this is many, many years in the future we're talking about.

edit: Also there are so many things in patient charts that it would probably be hard for a pharmacy to go through them all.

oh I thought it was private and only the physician knew and he just checks all that shit out before giving the prescription

oh you're already in college! I thought you were in highschool. yeah you sound kind of fucked!

Last year I had a job scanning medical records.  I still don't think they're done doing all that and they're a pretty small office.  If you think about all the offices that haven't even STARTED moving away from paper charts, this is many, many years in the future we're talking about.

edit: Also there are so many things in patient charts that it would probably be hard for a pharmacy to go through them all.

Well I was talking about like an ideal world in the future (the same conceptual world where people who specialize in pharmaceuticals decide which specific prescription drug you take for your illness).

Last year I had a job scanning medical records.  I still don't think they're done doing all that and they're a pretty small office.  If you think about all the offices that haven't even STARTED moving away from paper charts, this is many, many years in the future we're talking about.

It's pretty simple in a community pharmacy. Basically the only paper records that are kept are the actual prescriptions themselves. When a patient hands over a prescription to be filled that prescription is transcribed into the computer under that patient's name, and then a computerized printout is printed. The pharmacy adjudicates to the drug company, billing them for the prescription online. The prescription is then physically filled with the correct drug being counted out into the prescription vial. The label for the vial is on the printout and just needs to be sticked onto the vial. The pharmacist then ensures that the physical prescription and the computer printout match - checking everything from: correct patient, correct doctor, correct drug, correct strength, correct SIG code (instructions), correct number of refills, etc. They do this by making checkmarks on the printout as they check each item. The appropriateness of the therapy also needs to be verfified. Is this the correct dose for the indication that it is being used for? Are there any reasons why the patient shouldn't be taking this? (Drug allergies, interaction with current meds, etc.) Once all that is checked the drug can be dispensed to the patient with counseling by the pharmacist.

After the prescription has been dispensed the checked printout is stuck to the back of the actual prescription and that is filled away in this 2 ring prescription binder that holds ~300 prescriptions in it. Pharamacies here are legally required to keep up to 3 years of physical prescriptions on site. That's the only paper trial there is. Everything else is stored on the computer database software. Of course since it is so important that database is backed up every single day by the pharmacist on duty at store closing.

oh I thought it was private and only the physician knew and he just checks all that shit out before giving the prescription

We're bound to the same confidentiality agreement with patients as doctors are or any other health professional for that matter. Pharmacists often see a specific patient more than their doctor sees them because we're much more accessible so we really get to know certain people very well! (Perhaps too well in some cases! ​)

None of that has anything to do with pharmacists prescribing medicine themselves though.  That is what I was talking about.

man mateui what gay ass pharmacy do you go to where people know their patients so well. I've been in a pharmacy probably more than anyone at gw with the exception of you thanks to all the meds I needed for chemo, and we hand over the prescription, they hand over the meds, we go home. and my mom is extraordinarily friendly.

basically what UNIVERSE are you in because I had to be in pharmacies for my dad's cancer and it was the same deal. hell, most people prefer it that way rather than discussing their embarassing medical conditions with some fucko behind the counter.

I think you're kind of selling this a little high.

ahaha if I went to his pharmacy he'd think I was such an asshole

Mateui: SO HEY HOW YOU DOIN TODAY HAVIN A GOOd DAY?

ME: sure

Mateui: WELL THATS FANTASTI C IVE BEEN DOING PRETTY GOOD MYDSELF ITS BEIUTIFUL OUTSIED

Me:...

Mateui: THANKS OFR COMING BY MAKE SURETo COME BACK SOON!

*walks away

I think you guys need to visit Canada once in a while, especially the maritimes because EVERYONE is friendly here. Life is slow paced and relaxing, people don't rush all the time, they will always slow down to let you merge in traffic, I've never seen road rage here, people respect one another, etc. You're all missing out because sadly the majority of North Americans have been accustomed to facing people with rude dispositions all the time and it's hardened them to the point where they think that being friendly is weird... I find that extremely sad and disappointing.

I mean, I grew up in Ontario and when I moved to Nova Scotia I found it extremely weird at first too and way different from "normal" - but I soon began to appreciate the more positive environment. It really makes a difference in living.

im from the south dude trust me people are unnaturally friendly. maybe pharmacies are different in canada tho because you guys got cheaper drugs or somethin.

im from the south dude trust me people are unnaturally friendly. maybe pharmacies are different in canada tho because you guys got cheaper drugs or somethin.

Yeah, perhaps - plus we've got universal healthcare as well, which helps a lot. I can see how not having a government-based program to pay for your health care and having to pay out of pocket yourself would get you pretty ticked off.