Credentials: PharmD, BCPS, FCCM
Position/Title: Associate Professor
Organization: Texas Tech University Health Sciences Center School of Pharmacy
Primary Specialty: Critical Care
Becoming a clinical pharmacist will require a Doctor of Pharmacy degree. Completion of a pharmacy practice residency is not required, but is highly recommended. In order to learn the skills necessary to become an effective practitioner in a specialty field, completion of a specialty practice residency is also highly recommended. Many clinicians go on to sit for the pharmacotherapy specialization exam administered by the Board of Pharmaceutical Specialties, which recognizes expertise in advanced practice.
Type of Patient Population Served
Care for the critically ill patient can be extremely complex. The issues for these patients center on maintaining good oxygenation and tissue perfusion. Patients are often on multiple medications, including vasopressors and inotropes to maintain blood pressure and cardiac output; sedation and pain control, antimicrobials, prophylactic medications to prevent stress ulcers and deep vein thrombosis, enteral and parenteral nutrition, as well as the medications they were on at home for their previous medical histories. This makes the role of the pharmacist even more important, as you are constantly monitoring the patient to find the optimal agents to use, watching for drug interactions and adverse effects, and adjusting medications for renal and hepatic impairment.
Roles and Responsibilities
Clinical pharmacists serve as an important member of an inter-disciplinary team in the intensive care unit (ICU), which includes physicians, nurses, respiratory therapists, physical and occupational therapists, and social workers, among others. Most interventions and recommendations affecting patient care are made during patient care rounds, but you can expect to be paged by the ICU team at any time as conditions change and new information becomes available. The pharmacist also participates in policy and protocol development in the ICU, which serves to standardize regimens to optimize patient care. Often these projects serve as the background for clinical research, and their results can be presented at a variety of national or international forums.
How I Got Where I am Today
As a third and fourth year student at the University of Kentucky College of Pharmacy, Steve developed a strong interest in clinical pharmacy practice. After graduation, he completed a Pharmacy Practice residency at Baptist Memorial Hospital in Memphis, TN, where he had the opportunity to work with several mentors in the area of critical care, including Dave Kuhl, PharmD, Rex Brown, PharmD, BCNSP, and Brad Boucher PharmD, FCCM. These mentors helped foster an interest in the area of critical care, and Steve then decided to pursue a Critical Care Pharmacy Practice residency at University Hospital in Cincinnati, OH under the mentorship of Clyde Miyagawa, PharmD. He stayed on at University Hospital after his training, serving for seven years as a Clinical Pharmacist in Critical Care. He then spent four years as a clinical associate professor at the University of Houston College of Pharmacy. Currently, he is an Associate Professor at the Texas Tech University School of Pharmacy, and an Advanced Practice Pharmacist in the MICU at the North Texas VA Medical Center.
Advice for Students Pursuing this Career Path
Becoming a clinical pharmacist will require a Doctor of Pharmacy degree. Completion of a pharmacy practice residency is not required, but is highly recommended. In order to learn the skills necessary to become an effective practitioner in a specialty field, completion of a specialty practice residency is also highly recommended. Many clinicians go on to sit for the pharmacotherapy specialization exam administered by the Board of Pharmaceutical Specialties, which recognizes expertise in advanced practice. My advice is to find an area of pharmacy that makes you happy. There are so many doors and opportunities that can be opened with a pharmacy degree. It may take an extra year or two of training, but it will be well worth it in the long run.
Professional Organizations/Activities Outside Day-to-Day Job Responsibilities
Steve has become involved in professional organizations, serving on several committees for the Society of Critical Care Medicine and the American College of Clinical Pharmacy. He has been elected as chair of the ACCP critical care PRN, and as chair of the clinical pharmacy section of SCCM. He has also become involved with the American Society of Health-System Pharmacists serving as a Residency Learning System instructor conducting workshops at national meetings and serving as a residency accreditation site surveyor for the Commission on Credentialing. He has also been involved with the ASHP Foundation for Education and Research, serving on the development committee and as one of the first on-site preceptors for the Critical Care Traineeship, and also on the development and selection committees for the Pharmacy Residency Excellence Awards.
You can reach Steve by e-mail at firstname.lastname@example.org