Student life can be both a thrill and a challenge. Sheshtyn Paola looks at the highs and lows of being a pharmacy student in Australia today
Many of us can remember the excitement of taking those first steps onto a new university campus, meeting fellow students, and getting that taste for a novel area of academic inquiry.
But the excitement can soon give way to apprehension as insecurities, stress and concerns about the future mount.
The AJP spoke with a number of pharmacy students across the country to see how they’re feeling about uni life and the profession as a whole.
Forming an identity
Perceptions of pharmacy differ across students—some are enthusiastic about entering the profession, while others feel more apprehensive about their chosen career path.
Often students can experience peaks and troughs across their educational experience.
The 2016 National Pharmacy Students’ Survey (NPSS) found 78% of students were satisfied with their decision to study pharmacy, with 60% agreeing they would recommend pharmacy to others.
The year before that, the survey showed half (49%) of Australian pharmacy students were concerned about career advancement, and reported struggling for identity in healthcare provision.
Students’ perception of pharmacy and its place within the healthcare system makes a big difference to how they feel towards their chosen profession.
“I consider one of the major concerns to be the image of the pharmacist in the healthcare setting,” says Caela Crane, a fourth year student studying a double degree Bachelor of Pharmacy/ Bachelor of Pharmaceutical Science at the University of South Australia.
“The biggest frustration is that we go through four to five years of rigorous study and placement only to enter the workforce and to have our expertise trivialised with the view of ‘slapping a label on a box’,” says Crane.
Zac Whyte, a second year undergraduate pharmacy student at Curtin University, says most pharmacy students feel enthusiastic about the profession but adds that there are concerns about identity.
“Upon graduating, students are now able to enter a more diverse industry due to the increased scope of pharmacy practice,” says Whyte.
However he adds: “I know many pharmacy students who are worried about the public perception of community pharmacists; facing fears that they will be undervalued and seen as shopkeepers rather than health professionals.”
Third year pharmacy student Stephanie Samios, from the University of Queensland, believes some students lose sight of pharmacists’ value in the Australian healthcare system.
“My biggest concern for pharmacy students is that they are losing sight of what makes them such a valuable asset to a healthcare team,” Samios tells the AJP.
“Many people are unsure of their future in pharmacy, yet fail to actively pursue opportunities and experiences as a student.
“In places where pharmacist saturation is highest and wages are lower, such as central capital cities, I have heard from many students that the attitude is fairly negative towards the industry.”
Studies have shown that while Australian pharmacy students rate pharmacists quite highly on an empathy dimension, they rate pharmacists significantly lower in the areas of “power”, “pay” and “status”—especially when compared with doctors, who students rank highest on this level.
The ongoing oft-publicised “turf war” between GPs and pharmacists doesn’t help, says Benjamin Coghlan, who is in the final year of his Master of Pharmacy at the University of Canberra.
“Overall I think students are feeling positive about the profession,” says Coghlan, who was the 2018 Pharmacy Student of the Year.
“[However] the biggest two concerns for pharmacy students at the moment is their space within prescribing and developing a good relationship with GPs (especially the RACGP) and remuneration.
“Recent media coverage has shown that there is a large disconnect between the PSA and RACGP in regards to pharmacist prescribing, pharmacist-led health checks and vaccination.
“This is of concern as GPs and pharmacists need to have a good functional relationship to ensure best patient care and job satisfaction for both health professionals,” says Coghlan.
NAPSA national president Jessica (Han-Fang) Hsiao says while there has been a lot of negative talk in the media related to the relationship between GPs and pharmacists, she is confident this doesn’t reflect reality.
“As students are the future of the profession, I believe we are able to get over that barrier, especially since GPs and pharmacists are already happily working together in many communities.
“I think the majority of students are feeling positive about the profession. There is so much that pharmacists can get involved with now especially with the different health services and programs such as vaccinations, diabetes management, HMRs, etc.”
Curtin University student Antoni Ukalovic agrees. “I feel pharmacy students are very excited and very passionate about pharmacy,” he tells the AJP.
“As the medication experts, we will have a unique place in the healthcare system compared to other healthcare professionals, and we have high hopes for pharmacist scope of practice to expand, particularly pharmacist prescribing.”
Remuneration is the top issue for students right now, as well as for most employee pharmacists.
The majority (63%) of respondents to the National Pharmacy Students Survey 2017 (NPSS) said they do not believe there is adequate remuneration for the services pharmacists offer, and that it remains the biggest issue facing the profession.
Remuneration is closely tied with recognition, pharmacy students point out.
“Remuneration is an issue as pharmacists in the community are expected to do more and more by the community however, this increase/ up-skilling takes considerable pharmacist time and there is often no remuneration for this up-skilling,” says Coghlan.
Crane agrees: “Poorer wages in community pharmacy have long been a discussion and one that every student is concerned about. With lower wages brings up the conversation of job satisfaction and how the pharmacy industry is viewed by the wider community.”
Roles, recognition and remuneration are the three things that the PSA has vowed to tackle in the next five years and beyond.
National president Dr Shane Jackson says one of his core goals is getting more recognition of pharmacists and seeing improved remuneration across the profession.
“This is saying to pharmacists across our profession that ‘you are valued’,” said Dr Jackson.
“That you deserve to receive remuneration that is commensurate with your vital role in the healthcare system, that you deserve to be paid a fair day’s pay for your expertise and training and your level of responsibility in the healthcare system.”
Getting involved with peers and positive role models can help to ease the disillusionment that some students may feel.
“During my time at university I have noticed that positivity usually peaks at the beginning of a student’s university journey and slowly reduces as they are exposed to the profession,” Crane explains.
“Students who have their mind set on pharmacy and have areas of interest within the industry appear optimistic.
“I have come to realise that by being actively involved in the profession— whether this is by attending conferences, immersing yourself in the PSA ECP [early career pharmacist] working groups, being involved in your local pharmacy students association or simply by surrounding yourself with like-minded, positive pharmacy colleagues—you are more inclined to be influenced towards optimism about the profession and the industry as a whole.
“Pharmacy has so much to offer. Yes there are challenges as with every profession, but I believe that today’s pharmacy students are able to lead change within the industry and be the difference for the future of the industry.”
Mentoring can also be a positive solution towards bolstering students’ confidence in their future career.
Research shows that mentoring programs across community and hospital pharmacy settings can lead to increased networking, gaining insight, receiving advice and helping students to decide on their fields of interest.
Mentorship can also help pharmacy students to cope with stressful or overwhelming situations.
“As students, sometimes we are not sure where we’re going and what we will end up doing, which is where a mentor comes in,” says Sandra Minas, immediate past president of NAPSA.
“Throughout each role I had a clearly defined mentor to help with my specific role. But I also had mentors who probably didn’t even know they were my mentors. Those that were successful, that I looked up to and took advice from, they shaped my ideas and actions. Do you have a mentor and don’t know it?”
Preparing young grads
Pharmacy schools are increasingly building mentoring and practical placements into their programs.
Tina Brock, director of Pharmacy Education at Monash University, has been the driving force for the university’s newly reinvented pharmacy course, which launched in February last year.
She says they are aiming to include more mentoring inside the course, so students don’t have to look outside to get it.
“What we’re trying to do is flip that and say, let’s make that part of the course.
“All of our students are assigned in groups of about 10 to a skills coach, somebody who works with them and meets with them every two weeks.
“This skills coaching is absolutely the magic pixie dust that makes it work.”
The pharmacy school is also trying to include more placements from the beginning.
“We spent a lot of time listening to our practitioners and our preceptors— so people who work with our students in placement—and they would say things to us like, your students are very smart, but they can’t do very much.
“We’ve really tried to flip that and focus on ‘what can they do?’
“Now with this new course, they go out on placements from first year. Practical training starts at the beginning, and it’s really about identity foundation, having them think from the start not that ‘I’m a student’ but that ‘I’m a pharmacist in training’.”
Students agree that practical experience right from the beginning is critical.
“The transition from student to professional is a highly stressful and nerve-racking period. Many students feel under prepared to enter the workforce with a high proportion of student’s never being exposed to a real-life pharmacy environment before placement, which usually only occurs in their final year of study,” says Crane.
“I believe that there are many skills that can’t be taught in a classroom and are only learnt through experience and exposure. Not only do we need more exposure and placement but possibly further exposure to those pharmacies that deliver health benefit services. This is an area that can be improved through initiating student placements earlier in their degree.”
Alfred Health intern Jessica Bailey, who was Pharmacy Student of the Year 2017, encourages students to do placements and to consider doing them in a rural setting.
“There is so much support, both financial and logistical, to encourage students to go rural,” says Bailey, who completed a six-week rural/remote placement in Broken Hill, NSW.
“Usually they will count as part of your normal required placements you have to complete, and your placement coordinators will assist you.
“Rural pharmacies that host students often are very passionate in doing so and therefore you are likely to have a good experience. Given the demands for pharmacists in rural areas you may even have a job offer at the end of a rural placement. While I am not currently practicing rurally it is definitely something I would consider in the future.”
Bailey also says obtaining part-time employment in a community pharmacy is an “essential” part of your pharmacy degree.
“If possible find a pharmacy where you’ll have a lot of time working directly with the pharmacist on duty. There you will develop essential communication and problem-solving skills, both of which are difficult to gain from university lectures.
“Part-time employment also provides an excellent taste for what practicing in the profession will entail.”
Dealing with stress
Pharmacy students deal with pressure in keeping up with studies, assessments, exams, placements, work experience and more.
The latest Stress and Wellbeing Survey of Australian Pharmacists, Intern Pharmacists and Pharmacy Students (2017) shows that pharmacists report higher stress levels than the general population.
Those under 30 years of age and/or with less than 10 years of experience (i.e. students and early career pharmacists) reported the highest levels of stress.
Worryingly, most of the respondents did not have established coping strategies to deal with stress.
In the past year, pharmacy students comprised about 5% of the calls to Pharmacists’ Support Service (PSS). The total calls to PSS were 318.
“The overall number is small but significant,” says PSS executive officer Kay Dunkley.
“The sorts of issues raised by students when they ring PSS include anxiety about study and exams, concerns about workplace practices—especially when they see practices which do not reflect the way they are taught at university, employment issues such as bullying in the workplace or their rights as an employee, mental health issues, personal and family issues and financial concerns.
“In addition a student can be caught up in an incident in the pharmacy such as a hold-up or an aggressive customer.
“I think it is valuable for students to have a good network of friends, support and encouragement from their family, a supportive workplace and to feel confident to approach university lecturers and tutors. I also believe that students need to feel connected to the pharmacy profession and to start to develop a sense of where they see themselves working in the future.
“To assist this, many of the pharmacy organisations offer free or low-cost membership for students which is very valuable to develop a sense of identity with the pharmacy profession and for the networking which is necessary to find work in pharmacy.
“Linking up with professional organisations also helps students to understand the various opportunities which a career in pharmacy can provide,” says Ms Dunkley.
“Pharmacy students are the future of the pharmacy profession and as a profession we need to nurture and encourage them as well as providing opportunities for them to develop skills, including leadership opportunities.”
This article was originally published in October 2018 print issue of AJP.
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