January 25, 2024

Until he started a job as a pharmacy technician (prior to getting his professional degree), Kyle Quirk, PharmD ‘18, didn’t really know what a pharmacist did. What he observed on the job led him to the College of Pharmacy at the University of Michigan (U-M), yet he still had no idea what palliative care was until the first day of his rotation in that area.

 

Now, he has found his niche as a Palliative Medicine Clinical Pharmacy Specialist at the Ohio State University Wexner Medical Center (OSU), in a role that blends patient care, teaching and mentoring, and plenty of clinical research.

In a conversation with Quirk, he credits the rigor of his PharmD program and many supportive and inspiring faculty for preparing him to succeed in all three areas.

“I do a lot of precepting. I enjoy teaching. I had amazing teachers, preceptors, and mentors at Michigan. I got to work with Mike Smith, Amy Vandenberg, Bernie Marini, Amy Thompson, Greg Eschenauer, and Rima Mohammad, just to name a few. That is both a privilege as a learner and an example to follow. That’s one reason to choose a pharmacy education at the University of Michigan — there are so many leaders in their fields.”

Seeking a career that combines scientific medicine and working with people.

With an undergraduate degree in Cell and Molecular Biology, many people go on to do bench research, which is awesome.” he recalls. But that wasn’t the direction he wanted to take because he also wanted to work more with people - so he sought a career that would combine both scientific medicine and patients and found that pharmacy offered many career paths. He reflects on how he gets to “talk about medications with physicians and patients daily, which is a very rewarding combination for me.” 

Having found a passion in his rotation for palliative care, this is the direction he specialized in and currently works. Palliative care gives him an opportunity to work closely with care teams to minimize patients’ symptoms and suffering and optimize their quality of life with the right mix of medications.

“I’m mostly seeing cancer patients, from age 18 to 100 plus,” Dr. Quirk explains. As part of a six-person palliative pharmacy team (which is part of the much larger Palliative Division), he provides hands-on care in both inpatient and outpatient settings. “I can see patients at any point throughout the course of their disease, from recently diagnosed to end of life. Depending on where they are in their disease stage changes how I approach the patient: if they are expecting to be cured, expecting to live 10 years, or are close to the end of life.”

“Pain is what we help with the most, but there are a lot of different types of pain — cancer pain, comorbid chronic pain, post-surgical pain, etc. We try to help the care team and patients separate the kinds being experienced. Sometimes they have had cancer so long that their cancer pain becomes chronic pain.” In addition, cancer patients experience many other symptoms, which can include nausea, constipation, diarrhea, agitation and delirium, a lack of energy and sleep, anxiety, depression, and more, and Dr. Quirk plays a role in helping the care team treat and minimize the discomfort of those symptoms.

Advancing impact by treating cancer patients with substance misuse.
In February 2024, Dr. Quirk will take on a larger role with the Palliative Harm Reduction & Resiliency Clinic, which opened in 2020 to treat cancer patients in palliative care who also have a history of substance misuse or substance use disorder (SUD). They may need opioids, but since they have misused prescription or illicit drugs in the past, physicians can be reluctant to prescribe these substances to treat patients’ pain and symptoms. The clinic also sees patients who have active, untreated addictions when they are diagnosed with cancer; “We’re sometimes taking over SUD management for those patients,” he says. He is looking forward to helping this often neglected population with complex needs.

A Passion for palliative care research, precepting, and teaching.

Another large part of his role is precepting, teaching, and research. “I think research is very important; it’s intrinsically tied to doing quality patient care. In palliative care, there are not a lot of robust clinical studies out there. There are a lot of gray areas, a lot of things we don’t know,” he notes. “Research is part of how I get better at my job. If there are unanswered questions, how can we try to answer them? If we're learning more about how to do a good job taking care of our patients, how do we share that with others? And that comes down to publishing and presenting.”

Quirk, his students, and residents are also learning through doing the research — “so much research,” he says wryly, adding that he’s juggling about eight active projects. “One of the projects I’m most excited about here is our use of intravenous buprenorphine. There is very little published about it, and even less in cancer patients. I’m trying to collect data on it and publish, so others can learn from us. That’s pretty exciting; I could talk about it for hours.”

Dr. Quirk recalls that he felt a bit daunted by the idea of research when he began his PharmD degree. The way the College built structure and support around the research requirement in the PharmD program and “broke up the scary idea into digestible chunks” really helped, he recalls. “It’s a rigorous program with very supportive faculty, so I felt fully prepared when I started my PGY1,” he says. Building on his degree with two years as a resident in the research-centered culture of Michigan Medicine, where the expectation of publishing quality scholarship is high, locked him into research mode. When he got to OSU, “I just continued where I left off during residency” and “kept doing research alongside my clinical duties,” he says.

Dr. Quirk found his professional home in an academic medicine setting but says that classmates who chose different roles and careers are equally well prepared. “It’s a college that is going to do its best to make sure that you are ready for whatever career direction you take. If you’re serious about pharmacy school and your career, Michigan is an amazing place.”