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My Time at Johns Hopkins for the ASHP Foundation Oncology Traineeship

By Kristine Tuttle posted 11-03-2013 12:22

  

The first of a three-part series in which ASHP Foundation Oncology trainees share their experiences.

I got the confirmation: I had been chosen for the 2012 ASHP Foundation Oncology Traineeship and to go to The Johns Hopkins Hospital. Johns Hopkins! I was thrilled for the opportunity to travel to such a place, a hospital we have all heard of before.

I am a clinical research pharmacist at Novant Health Oncology Specialists, an outpatient oncology clinic that is a department of a 1,000-bed hospital, which in turn is part of a health system that spans from Virginia to South Carolina. I worked with research and medication safety for 2 years as an inpatient pharmacist before transitioning to the outpatient oncology world. While I could apply the research principles I knew very well, I was for the most part training myself in the oncology details. I applied to the traineeship in order to have more structured learning and to be able to learn the practical tips and advice from other oncology practitioners. But Johns Hopkins!

Before going to Johns Hopkins, my preceptor emailed me to find out what my specific goals and particular interests were for the time there. I had already thought a lot about this very question and emailed him back immediately. My goals were to:
(1) Learn how I could fit into our medical team.
(2) Increase my oncology experience.
(3) Identify ways to improve our research department/my service line.

My co-trainee, Dr. Rachel Justus, and I arrived on our first day, excited and nervous.
Over the next 2 weeks, we met with various clinical pharmacists who led topic discussions and let us shadow them on their service lines. We went on inpatient rounds with the medical team. We worked up patients. We saw patients with solid tumors, hematologic malignancies, adverse drug reactions, and severe cases of expected side effects. We assisted with the outpatient clinics that focused on the long-term follow-up of patients who needed care in pain management, anticoagulation and GI complications.

At the conclusion of my time at Johns Hopkins, my head was spinning with information. I could not wait to return home and share what I had learned. My preceptor, Dr. Bradley Burton, did an amazing job structuring my time there so that all of my goals were met.

Here is how I met my goals:

Fitting into a medical team
After working with the medical team and seeing the interactions, it really came down to some simple principles.
(1) Review patients before rounds and anticipate questions.
(2) Look for gaps in care. For example, one pharmacist created charts for the complicated home medication regimens for the BMT outpatient clinic. This was a fantastic resource to her patients, and the rest of the team really appreciated them, too.
(3) Be an expert. Think about whether a patient’s medications are being used optimally.
(4) Speak up!

Oncology experience
Prior to the traineeship, we studied the BCOP review book and took quizzes for baseline knowledge. During the traineeship, we participated in topic discussions, journal clubs, tumor boards, CE programs, and looked up answers to drug information questions. One day, we even held a debate-style discussion with the residents to review some of the more controversial topics! This was particularly enjoyable, as I am an avid fan of “Law & Order”–I was able to apply courtroom rules when discussing the pros and cons of using bevacizumab. Not only did we fill our heads with the evidence-based reading, we also gained information from our preceptors and medical team about the practical, day–to-day knowledge – the kind of information that becomes “gut instinct,” that you can draw on later in similar situations.

Research
I’m sure it is no surprise that Johns Hopkins does an incredible amount of research. While I am proud of our number of protocols, Hopkins has us beat by far—they  have rolling bookshelves of protocols! The research pharmacists were more than willing to share the processes and systems they use to operate efficiently within all of these protocols.

I definitely believe that my goals for the traineeship were met. I am working on combining the knowledge that I gained to expand my research service line into part of the medical team. I am testing a program to become more involved in the care of patients who are on oral medication protocols (similar to medication therapy management programs). I am also working on ways to integrate our protocols into Tumor Board discussions. I am gaining the confidence to speak up and jump in! I greatly appreciate the ASHP Foundation and my preceptor , Dr. Bradley Burton.

I am also grateful to my clinic for giving me the time to spend at the traineeship and the resources to expand my service line.


For more information about the ASHP Foundation Oncology Traineeship, visit www.ashpfoundation.org/oncology. Applications for 2014 are being accepted through January 15, 2014.



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