Community pharmacy or hospital pharmacy? That is the question…

Or is it? These are actually just two options among an array of career pathways, with many pharmacists unaware of just how far their skills and qualifications can take them.

Outgoing NAPSA president Shefali Parekh says most of the time pharmacy students are only exposed to community and hospital pathways in university.

“If early career pharmacists turned their blinkers off, they would see that a pharmacy degree can take you anywhere,” she said.

We explore some career pathways and profile inspiring pharmacists to help spark your imagination…

1. Community pharmacist

Community pharmacy is one of the most common choices for young pharmacists, and perhaps the most visible—with pharmacies located in storefronts across Australia.

While this area may lead to ownership, a great option for those who are business and leadership oriented, a career in community pharmacy can take many different paths.

Jacqui Hagidimitriou from Samford Chemmart Pharmacy, Qld, says her role has changed in less than six years from being a part-time pharmacist to full-time dispensary manager, to now having a key role as the store’s Integrative Pharmacist.

“I am available to do natural medicines consultations directly with the customer as well as other professional pharmacy services,” she said.

“I am loving being able to carve out a niche role in the pharmacy… it is great to work somewhere progressive where we can think outside the box a little and try different ideas.”

Her interest in nutritional medicine also led her to pursue further study, completing a Bachelor of Health Science in Nutritional Medicine.

There are many ways to ‘upskill’ in community pharmacy: becoming a Credentialled Diabetes Educator; training to administer vaccination services; rolling out pain management services; becoming a Mental Health First Aid Officer; and more.

There is also potential to specialise in areas such as Aboriginal and Torres Strait Islander healthcare, especially if you are willing to relocate to rural and remote communities.

For example, Hannah Mann (pictured above) owns and runs Kimberley Pharmacy Services in remote WA. It was named Pharmacy of the Year in 2015 for its work treating Indigenous patients and collaborating with local Aboriginal Health Services.

2. Hospital pharmacist

Hospital pharmacy provides the opportunity to work in a supportive team and to be actively involved in patient care, explains the Society of Hospital Pharmacists of Australia (SHPA).

“It offers variety, both in the roles you can have, such as clinical or management, and in the types of hospitals you can work in—city or country, small or large, general or specialist,” the SHPA says.

“Working in a hospital is an option at any stage of your pharmacy career; some pharmacists start out in hospital practice while others move into it later for a different pharmacy experience.”

“Any registered pharmacist can work in a hospital—you don’t need additional qualifications, nor do you need to have done your internship in a hospital. In a hospital, you work in an environment where you are supported while you pick up new skills, regardless of the stage of your pharmacy career. The broad array of skills that you develop working in a hospital is highly sought after in other practice settings.”

There is also potential to progress into an advanced clinical role, for example specialising in antimicrobial stewardship.

In this role pharmacists monitor the appropriate use of antibiotics, while optimising antimicrobial use and monitoring clinical outcomes for all patients requiring antimicrobial therapy.

3. Consultant pharmacist

Accredited consultant pharmacists can conduct home medicines reviews (HMRs) and residential medication management reviews (RMMRs).

WA consultant pharmacist Deirdre Criddle

WA consultant pharmacist Deirdre Criddle says there are pros and cons to this career, but that it has become near impossible to practice full time as a consultant due to HMR caps.

“Pros include: working for yourself, choosing your partners, flexibility. Previously having some control over your destiny—short-lived when caps arrived. It encourages alternative models of working.”

“Cons are: limited income stream, work-flow and hence income stream is ad-hoc—and because the income stream is limited, the risk of having payments declined or not claimed through a third party in a timely fashion is heightened.”

Jenny Gowan, 2016’s AACP-MIMS Consultant Pharmacist of the Year, suggests that due to the uncertainty of funding, “people doing this role really need to diversify and should be multi-skilled, still doing a bit of practice in the community or hospital.”

Gowan, for example, has combined consultant pharmacy with work at a community health centre; work with chronic disease management groups; and providing nurse education.

4. Non-dispensing (general practice) pharmacist

Practice pharmacists deliver professional services from or within a general practice medical centre.

The concept is supported by both doctor and pharmacist groups, with the AMA and PSA working together to create a model for the role.

Trials are currently running across the country and have received positive feedback so far from GPs, consumers and participating pharmacists.

Pharmacist Anne Develin, a part-time participant in an ACT trial, also works in community pharmacy.

“I’m enjoying spending quality time with patients, assisting them with their medications, and providing quality care and specialised services such as smoking cessation,” Develin says.

“Actually having time with patients allows me to have a conversation to identify any medication problems, such as dosage issues. In a busy pharmacy there’s not always time to identify [these problems]. So that’s been really valuable for the patients and professionally rewarding for myself.”

PSA vice-president Dr Chris Freeman (pictured above), a practice pharmacist since 2009, says he “provides practice level services which indirectly benefit the consumer such as providing drug information and education for GPs as well as conducting medicine use evaluations to improve prescribing quality”.

5. Researcher / academic

An ever-popular choice, pursuing research and/or academia after that first undergraduate degree is for those who enjoy working with ideas and may not want to give up the books just yet.

Through research and evaluation, pharmacists can make a huge practical difference to health policy and services.

And within academia, there is an opportunity to pursue the education of younger generations through tutoring, lecturing and supervising roles.

Some trained pharmacists have risen to the top of their field in academia. For example Lisa Nissen, professor and head of the School of Clinical Sciences at the Queensland University of Technology. She is well-known for her advocacy of quality use of medicines and professional services, including vaccination.

Pharmacy grads can pursue research in pharmacy practice, as well as a variety of other areas including pharmacotherapy, drug discovery, toxicology, clinical sciences, public health and much more.

6. Pharmaceutical industry / clinical trials

Pharmacists in this area support the management and delivery of clinical trials of new medicines.

The role involves coordinating studies from a medicinal perspective, ensuring that drugs used in the trials are imported, stored, accounted for, compounded, dispensed and used in accordance to strict protocols. It may involve liaising with hospital staff, counselling participants and carers, and educating medical and nursing staff.

7. Locum pharmacist

For those with an adventurous spirit, looking for flexibility and the opportunity to travel, consider a career as a locum pharmacist.

Get inspired by The Roaming Pharmacists—a duo comprising Liam Murphy and Luke Vrankovich, who travel all across Australia practising pharmacy, pursuing creativity and specialising in mental healthcare.

“It’s not for everyone, I can see that now,” Vrankovich says. “I spent three months living out of a 15kg suitcase and that was interesting because all I had with me was my footy and my clothes and my music speaker.

“And you don’t have your close friends around all the time, so you have to form those really good relationships over social media. So one thing that it’s taught me is to actually communicate via distance with all my friends and family.

“Initially what I didn’t like about locuming was that I didn’t really get to get hands on with managing, because I had the idea of eventually owning a pharmacy. But I’ve managed to swing a couple of locum stints where I was actually managing”.

The Roaming Pharmacists taking some time out.

8. Aged care pharmacist

Polypharmacy is common among older people, who are more likely to be taking several drugs at once. Older people are also at higher risk of experiencing side effects from their medicines, and difficulties with vision, hearing, memory or cognitive functions that can make managing medicines safely a lot harder.

dementia-friendly communities: older hand held by younger handsWorking as a pharmacist in aged care may involve carefully preparing and packing medicines, as well as conducting HMRs or RMMRs. You can deliver aged care pharmacy as part of a healthcare team, or as an independent accredited pharmacist (see pathway 3).

9. Government and NGO roles

Pharmacists have knowledge, skills and experience that can feed into advisory roles, both for the government as well as non-government institutions, such as health funds and private hospitals.

Government roles can focus on access to medicines, or eHealth, or public health… the list goes on.

Sarah Sinclair works full time in the public service while continuing to work part time in community pharmacy.

“I have been in the public service for just over 12 months now in the capacity of a pharmaceutical advisor,” she says.

“Working on developing and implementing pharmaceutical policy to ensure access to medicines is very different to what I have done in the past, but [it is] professionally satisfying.

“The multitude of pathways out there means that if you’re not suited to one type of practice, you might find success and satisfaction in another.”

Another pharmacist that has worked in this space is Alison Roberts, PSA’s Executive Director of Policy.

Dr Roberts, who has a PhD in change management, has worked in both government and non-government roles regarding pharmacy programs, funding and health services implementation.

She has just finished heading up the PSA’s Health Destination Pharmacy Program and was named the UTS Innovative Pharmacist of the Year in 2016.

10. Complex care coordinator

Being embedded in a hospital healthcare team as a care coordinator is a newly introduced role for pharmacists.

Deirdre Criddle, who combines work in this area with consultant pharmacy (see pathway 3), says she fell into the role after returning to hospital pharmacy part-time following the introduction of HMR caps.

“I was ‘in the right place at the right time’ as I followed in the footsteps of my predecessor Bruce Williamson. In 2013, Bruce virtually demanded a role for a clinical pharmacist within the Complex Needs Coordination Team—a newly formed interdisciplinary team of nurses, social workers, occupational therapists and physiotherapists working with people who ‘fall between the gaps’.

“The job involves providing early post-discharge medication review and follow-up plan for patients identified as being ‘high risk’ by hospital clinicians. These are patients who do not have ready access to usual medication management services in the community.”

Criddle says there is emerging interest in this practice area, with SHPA recently launching a Specialty Practice group for Pharmacists in Primary Care and Transitions of Care, for a diverse group who are seeking or employed in roles outside the traditional hospital or community pharmacies.

11. Drug safety officer

Be responsible for pharmacovigilance activities, including receiving and processing reports of adverse drug events and conducting regular conciliation with health authorities.

A pharmacist in this role would be liaising with TGA, Medsafe, consumers, other health care professionals and organisations such as Medicines Australia.

12. Entrepreneur

Got a great idea? Entrepreneurship is all about innovation, creativity and tenacity.

One inspiring pharmacist entrepreneur is Gerard Stevens, the founder and managing director of Webstercare. More than 30 years ago, Stevens introduced the controlled dosage system to Australian nursing homes, an idea that represented a revolutionary approach for pharmacy service providers to support their nursing homes.

This system evolved into the Unit Dose Webster system and Unit Dose 7, now predominantly used in residential aged care facilities throughout Australia.

In 1985 he introduced the Multi Dose Webster‐pak system, which is used in Residential Aged Care Facilities and the broader community through a national network of community pharmacies.

Gerard Stevens, founder and managing director of Webstercare. Photo: AJP

And being one of the first pharmacists in Australia to qualify to provide RMMRs, he established Meditrax, a leading provider of RMMR services in Australia today.

Another Aussie pharmacist with entrepreneurial spirit is Robert Sztar, the face behind Pharmactive—a company that aims to help pharmacy owners integrate automated technology into their businesses.

He has published a guidebook and supports this with a series of mini-‘transpharmation’ workshops delivered both in-person and online.

Sztar also runs a 12-month program where he works directly with pharmacy owners to tailor a solution for their individual businesses.

13. Regulatory affairs associate

Working in regulation involves ensuring the appropriate licensing and legal compliance of pharmaceutical and medical products. It includes ensuring that a company’s products comply with regulations and legislation.

Key responsibilities include preparation, submission and maintenance of registration applications to the TGA and Medsafe; creation and review of Product Information and CMI documents for registered products; support for the preparation and set-up of bioequivalence studies; and more.

14. Management & mentorship

This comprises a variety of roles. You can become a pharmacist in charge, managing pharmacist, or a representative at a pharmacy organisation. Some roles can also merge pharmacy with another area, such as business or technology.

One example is Aaron D’Souza, a Brisbane pharmacist and former owner who is currently serving as the general manager for pharmacy.com.au.

D’Souza says he is driven by Rhonda White’s philosophy that “there’s always a better way”, which has led him to combining the use of technology with his everyday pharmacy practice.

“I was blessed to have the opportunity to head to the USA and work for the Pharmacy Guild of Australia, with a pharmacy-technology company for the ultimate delivery of the GuildCare programs and services.

After GuildCare was established in Australia, I dedicated myself to business, owning and managing a pharmacy.

“After selling my pharmacy… the Guild approached me to drive this eCommerce initiative (pharmacy.com.au) and I’m excited to be behind the wheel.”

15. Politics

Some pharmacists decide to move into politics before, during or after working in pharmacy.

A current example is Emma McBride, the Federal MP for Dobell (Labor, NSW). She was formerly chief pharmacist at Wyong Hospital and is now deputy director of Pharmacy for Central Coast Local Health District.

McBride was also a councillor for Wyong Shire Council from 2008 to 2012.

Emma McBride

Terry White is well-known through his franchise model of pharmacies, and purchased his first pharmacy in 1958.

However White was also a politician, elected to Queensland parliament in 1979, and rising to leadership of the state Liberal Party and serving for a time as a Minister. He stayed in politics until 1989.

After leaving parliament, he and wife Rhonda built up their franchise. In 2016 Terry White Group merged with Chemmart and has about 500 stores.

This list of career options is not all-inclusive. Please let us know if there are other pharmacy career options you’d like to read about.