CRUCIBLE FOR
CAREER EXCELLENCE

Nancy Wu, PharmD’06, always knew she was getting a good education at the University of Michigan College of Pharmacy. But it wasn’t until she started her P-4 experiential training cycle that she truly appreciated just how good an education she had received.

“One thing I’ve taken away from all of my rotations is that Michigan’s development of PharmD students is on a completely different level than most other pharmacy programs,” Wu says. “I’ve been in rotations with students from other pharmacy schools, and I could clearly see the difference in how well we were prepared.”

Her observations were validated by comments from preceptors, residents, and fellows at each clinical rotation site. “They kept commenting that Michigan Pharmacy students are distinguishable by their professionalism, their work ethic, and their ability to handle themselves in new or unfamiliar situations. What I came to realize is that I should be proud of my PharmD program, and appreciative of the outstanding opportunities our experiential training program provides us.”

“Outstanding opportunities” describes to a T what Michigan’s experiential training program is all about. With over 450 preceptors at experiential training sites coast-to-coast, and more sites being added every year, the College has created a truly unique learning environment for its professional degree students.

“ For sheer number, quality, and diversity of clinical rotation sites, our experiential training program ranks at or near the top of all U.S. pharmacy programs.”

Associate Dean and Professor of Pharmacy, Lynda Welage

“Career opportunities in pharmacy have grown tremendously over the past few decades,” observes Associate Dean and Professor of Pharmacy Lynda S. Welage, BSPharm’81, PharmD. “So our continuing message to students is, ‘Don’t think of pharmacy or your career in rigid terms. With so many excellent career paths to choose from, your owe it to yourself to at least consider the incredible career options open to Michigan Pharmacy graduates.’ The basic goal of our experiential training program is to expose our students to as wide a range of practice settings as possible, and then let them choose, for themselves, the path that best suits their own career ambitions, unique talents, and life aspirations.

“For sheer number, quality, and diversity of clinical rotation sites, our experiential training program ranks at or near the top of all U.S. pharmacy programs. If there’s a setting where pharmacy is practiced, be it traditional or one-of-a-kind, chances are excellent that our College will have a willing preceptor ready to take on a Michigan student. Diverse and outstanding experiential training is one of the great strengths of our PharmD program, which is, itself, one of the best in the nation.”

“The driving philosophy of Michigan’s PharmD program is to prepare students to step directly from College into any entry-level pharmacy position, and to be competent at that job from day one,” says Nancy A. Mason, BSPharm’76, PharmD’81, director of the College’s Experiential Training Program. The final stage in that demanding four-year process is the 40-week, P-4 experiential training cycle.

But the build-up to that final stage begins in the P-1 year when students interview working pharmacists and shadow P-4 students on clinical rotations in order to gain better practice insights. By the time they are P-3s, Michigan Pharmacy students must spend a minimum six hours per week in a community pharmacy and another six hours per week in a hospital pharmacy in consecutive academic terms. P-3 experiences introduce students to both the dispensing functions of a pharmacist and the skills needed to provide comprehensive medication therapy management.

These practice exposures are in addition to students’ part-time and/or seasonal employment where they are working under the supervision of a licensed pharmacist.

The preparation process culminates in the P-4 year with a mixture of required rotations and personal interest electives.

Reaching Far Beyond ACPE Mandates

The P-4 advanced practice rotation schedule consists of 10, four-week blocks. Most students take nine in order to fulfill their requirements, with the option to take off one four-week block, if they wish. Often the 10th block is used for career development, such as attending professional meetings and/or interviewing for jobs, residencies, or fellowships.

The College’s advanced practice rotation requirements reach far beyond those mandated in Accreditation Council on Pharmacy Education (ACPE) guidelines. In purposefully choosing to raise the bar — that is, to create a learning environment of singular intensity, excitement, depth, and scale — the College reinforces a culture of excellence in its PharmD students. The self-confidence, resiliency, resourcefulness, poise, and breadth of experience that result from this distinctive brand of experiential training give Michigan Pharmacy graduates a competitive edge in the marketplace.

Where many pharmacy schools let students load up on repetitive community and hospital rotations — either because these schools lack alternative choices or because they endorse early career tracking, which Michigan does not — U-M requires all professional degree students to have at least eight core advanced practice rotations: four in patient care; and one each in drug information, advanced community practice, institutional practice, and a non-patient-care setting.

Students may waive a required rotation if they’ve amassed a comparable number of hours in a specific setting, as sometimes happens with students who’ve worked extensively in a community or hospital pharmacy. Similarly, students who envision a clinical residency after graduation could end up with four, five, or even six direct patient-care rotations — and those eyeing a career in industry may choose as many as two industry rotations. (Industry falls under the non-traditional practice category.) But the prevailing educational focus at Michigan is always to keep experiential training broad-based, Mason says.

“The driving philosophy of Michigan’s PharmD program is to prepare students to step directly from College into any entry-level pharmacy position, and to be competent at that job from day one.”

Nancy Mason, director of the College’s
Experiential Training Program

“We do not support the idea of creating specialists based upon the career plan a student may have at 22, 23, or 24 years old,” Mason remarks. “The P-4 year is a major personal and professional growth year for students. Every year, we have students who thought they knew precisely what career path they wanted to follow at the start of their P-4 rotation cycle, but who changed their mind simply because their universe of possibilities expanded.

“By insisting that at least four of the nine total required clinical rotations are in direct patient care, we impart a good solid base of clinical practice. Having said that, we also allow, within that base, some flexibility to choose electives, to experiment. Students have the freedom to gain additional exposure in a practice direction they think they might eventually be interested in, or to choose clinical sub-specialty rotations within broad categories. Our PharmD program has always been structured to train highly qualified generalists, not specialists. We believe that residencies, fellowships, and post-doctoral programs are the best paths for PharmDs seeking specialty expertise.”

Proud Affiliation with a Premier Health System

One of the great distinctions of Michigan’s PharmD experiential training program is its affiliation with University of Michigan Health System (UMHS) — consistently rated one of the best, most comprehensive health systems in the U.S. With that tremendous clinical breadth and depth comes access to a large, diverse clinical faculty that only a major national health-care system can offer. This, too, is a Michigan Pharmacy advantage.

“Approximately one-third of our advanced practice rotations are at UMHS,” Mason says. “Our UMHS affiliates are drawn from inpatient, outpatient, and specialty care, and many are internationally acknowledged experts in their field. The number and quality of our UMHS clinical faculty are a tremendous asset. Their involvement guarantees a high level of quality control, system-wide. Our students are the direct beneficiaries.” Strict quality control also means that not every proposed clinical rotation site makes the approved rotation list.

“Alumni, friends, faculty, and students come to us constantly with new ideas for clinical rotation sites,” Mason notes. “Many of these are great ideas, but for one reason or another they don’t fit our educational profile or meet an existing need. There are several questions we have to answer when weighing whether or not to add a new clinical rotation site. For example: Does the range of offered activities meet our program objectives? Does it offer something unique, something we don’t already have? Will it be a sustainable site; that is, will there be qualified preceptors at that site every year, and will we have students who will want to go to that site every year?

“For more than 130 years, our College has offered a leading program in pharmacy education,” Mason adds. “We have a well-earned reputation for all-around clinical and educational excellence, and we work constantly to keep it that way.”

Preceptor Corps Committed to Excellence

Mason describes the College’s 450-plus-member preceptor corps as “the backbone of our experiential training program.” Associate Dean Welage echoes her assessment.

“The commitment of our preceptors — alumni and non-alumni — is exceptional,” Welage says. “For the most part, they are an allvolunteer faculty. Across the board, they are committed to the future of the pharmacy profession, and major contributors to the quality of our organization.

“For many of our alumni preceptors, there is an added motivation: the desire to give back, to pass the torch of excellence to a new generation of Michigan-trained pharmacists, and to help ensure that we sustain our tradition of leadership.”

The College continues to leverage its extensive alumni-and friends network to add new, different, and exciting experiential training sites well beyond UMHS and the State of Michigan. Among the new clinical rotations sites added to the College’s already expansive rotation roster are Kaiser Permanente ambulatory care sites in Santa Rosa, Calif., and Denver, Co.; a veterinary practice rotation at Michigan State University’s School of Veterinary Medicine; inpatient and outpatient pharmacy services rotations at Providence Alaska Medical Center; expanded offerings at Sanofi-Aventis in New Jersey; a rotation at Wolters Kluwer Health, a publishing co. in St. Louis, Mo., and in Indianapolis, Ind. (Wolters Kluwer is the publisher of Facts and Comparisons, among other pharmacy standard reference texts); and the list goes on.

Mason remarks that a considerable amount of College personnel time and effort is invested annually to ensure that preceptor sites measure up to Michigan’s demanding standards. Quality measurements include site visits, formal preceptor interview processes, CV reviews, preceptor training, and ongoing personnel and site review complemented by student site and preceptor critiques.

“Our preceptors go through the University’s adjunct faculty appointment process,” explains Mason. “They are considered faculty members of the College and are held to those standards. We are judicious in the selection process and meticulous in maintaining site quality. When we tell a student, ‘Here is what you’ll experience and here’s the knowledge you’ll come away with,’ we want to make sure that the description matches the reality.”

The same applies to the preceptors.

“We want the preceptor experience to be positive, productive, energizing,” Mason says. “To make that possible, we prepare our students through our academic curriculum so that they are able to integrate into the experiential learning environment quickly and benefit the preceptor’s organization. So many of our students and preceptors, past and present, have developed strong life-long bonds. Many students end up being hired by or, at the very least, offered employment with their host organizations. That is a strong endorsement of the quality of our program and the people who share our vision for educational excellence.”

Another critical measurement of experiential program quality is the success of College alumni and the organizations they work for.

“We set our standards and our expectations high from preadmission through graduation,” Welage explains. “Our approach to experiential training ties directly to the broader issue of career development. We start with the best students, and then create an educational environment to facilitate their success.

“The ultimate measurement of the success of our experiential training program — and, more broadly, our PharmD program — is the success of our graduates. Did we impart the skills they need to be successful? Did we provide the depth of training that gives our graduates a competitive advantage? I would argue that the success of our alumni, regardless of the professional path they’ve chosen, is evidence that we are achieving these objectives.”