Whether you’re a first year student, have just finished your degree, or have over 30 years’ experience, it can’t be denied that the pharmacy world is changing, writes Sandra Minas

With so many more options to take your degree any way you wish, which path will you take?

The National Australian Pharmacy Students’ Association (NAPSA) encourages the exploration of the many pathways in pharmacy, allowing students and interns—our future pharmacists—to be inspired along the way.

Being passionate about your area of care is something NAPSA strives to inspire in our members.

Traditionally the question has always been “hospital or community?”

However, the future of pharmacy is here and the opportunities as a pharmacist are only growing.

Pharmacists are now able to be vaccinators, accredited mental health first aid trainers, work alongside GPs in general practice, specialise in areas such as radiopharmacy and gain antimicrobial stewardship, just to name a few.

Pharmacists as vaccinators

As the first point of call and the most readily accessible healthcare professionals within the community, pharmacists play a role a significant role in increasing accessibility to these vaccinations.

Additionally they not only are important in administering vaccinations but in advocating and educating.

By providing an understanding and awareness to patients about simple things such as hygiene, basic epidemiology and the differences between cold and flu, this could subsequently lead to a decrease in misuse of antibiotics and codeine preparations of cold and flu medications.

Another benefit is in reducing herd immunity and improving overall outcomes in flu coverage.

Through the national pharmaceutical society of Australia immunisation training program you are able to gain this accredited CPD activity that is recognised by all state and territory health departments around Australia.

Pharmacists in General Practice

A multidisciplinary healthcare collaboration delivers improved patient outcomes with increase in support of quality use of medicines.

Pharmacists in this multidisciplinary setting directly increase communication and understanding with not only general practitioners but also other healthcare professionals involved in patient care. Allowing for optimised patient outcomes through this approach shows that as a pharmacist your role is not limited to the dispensary.

Pharmacists in Specialised Practice

It may have been a foreign concept 10 years ago, but as a pharmacist the possibilities in specialisation are becoming more and more prominent. With advanced practice programs growing and residency opportunities to step up in your career, the need for knowledge in specialised areas of pharmacy are following.  Radiopharmacy is just one of these specialised areas and Adam Livori from The Austin Hospital, Melbourne is one of the few pharmacists in this field. I spoke with him to gain more insight into the world of radiopharmacy.

What the importance of this role?

Adam: The role of the radiopharmacist is in many ways the same as any pharmacist; we serve as a barrier to ensure the safe and appropriate use of medicines. Interestingly, radiopharmacy was the first certified area of specialty practice in America over 40 years ago, yet Australia has yet to recognise and foster this area. The main differences in my specialty, is that the medicines are radioactive and I am involved in both their synthesis and quality control.

The radiopharmacist has the responsibility of releasing these products for human use, and therefore requires knowledge of nuclear physics, nuclear chemistry and awareness of all TGA, PIC/S and GMP regulations. However, at the end of the day my focus is providing the best possible pharmaceutical care to my patients.

What does the role entail?

Adam: A typical day starts at 5:30 am. I will either elute a radionuclide generator or operate a cyclotron to produce various radionuclides. These are used in the sterile compounding and synthesis of radiopharmaceuticals.  I then perform quality control tests, which involve the use of HPLC and GC systems, all with modifications that allow the detection of radioactivity. In addition to running clinical compounds, I also am involved in developing experimental compounds and the development of new testing methods.

We work closely with nuclear medicine technologists, who acquire the images using gamma ray cameras, as well as working with chemists, particle physicists, medical physicists and nuclear medicine physicians. These other professionals have been a huge help in developing my skill set and knowledge within my field.”

How did you come into the role?

Adam: I had an interest in nuclear physics and chemistry and was studying a degree in nuclear medicine. I discovered the role of a radiopharmacist during a lecture and approached the radiopharmacist and asked, “What do I need to do to have your job?” He said I needed to become a pharmacist first, then branch off and specialise. 5 years later I completed my degree in an honours project in radiopharmacy, an internship at Peter MacCallum and now I am based at Austin Health. I am the first pharmacist in Australia, and one of the first two professionals within Australia to participate in a new radiopharmaceutical sciences specialist-training program through the Australasian College of Physical Scientists and Engineers in Medicine (ACSPEM). This will certify me in radiopharmaceutical science, which I will combine with my pharmacist degree to be certified radiopharmacist specialist. 

Pharmacists and Stewardship

As the development of new medications continues to grow, there is an increased need for understanding in specific areas of such medicines. Stewardship programs allow for this increased understanding to occur. With this continued professional development, pharmacists are able to be an even greater source of advice and knowledge in areas such as analgesics, anticoagulation and antimicrobials.

Antimicrobial stewardship has taken the lead with antimicrobial stewardship programs forming in hospitals around Australia. Kelly Cairns from The Alfred Hospital, Melbourne is an Antimicrobial Stewardship pharmacist. I spoke to Kelly about her experience.

Kelly: The role of the AMS pharmacist varies according to the hospital you are working in and the AMS program that has been implemented. My role is very broad, and generally no two days are exactly the same. My role includes coordination of the Alfred Health AMS program including coordination of multidisciplinary antimicrobial stewardship ward rounds, ensuring ACQSHC national safety and quality health service standards are met, education (including medical staff, pharmacists, nursing staff, pharmacy students), participation in research, supervision of post-graduate pharmacists, coordination of the Alfred Health Pharmacist Led Therapeutic Drug Monitoring program and policy and guideline development.

How did you come into the role?

Kelly: “I worked as a rotational clinical pharmacist in a NSW tertiary teaching hospital. During this time, I developed an interest in antimicrobials and infection management and I was fortunate that a full time position became available in Immunology and Infectious Diseases. After working in this role for four years, I applied for a specialist AMS pharmacist position at Alfred Health, which I have now been working in since 2011.

“Unfortunately, there is no dedicated post-graduate education program for ID and AMS, so much of my knowledge was learned on the job – components of ID and AMS are being incorporated into various programs, which is great to see. I enjoy teaching of junior pharmacists for this very reason.”

The Future

It’s evident that the professional services pharmacists are able to provide are expanding.

With this growth there is room for a greater appreciation of clinical development, multidisciplinary collaboration and further training.

Sandra Minas

Sandra Minas

Valuing each pharmacist in whichever path they choose has never been easier and immersing oneself to increase ones individual abilities is the first step.

So when someone approaches you with the question “hospital or community?” just know there’s no wrong answer because you can take your career in any direction you wish.

Sandra Minas

National President

National Australian Pharmacy Students’ Association