A Facebook picture popped up recently reminding me of my PharmD graduation 10 years ago. While I have been a licensed pharmacist for almost 20 years now, it was only the last 10 years that I have dedicated myself to practicing in a variety of clinical settings.


Looking back, I think I have come along way. I remember doing my first PharmD rotation in infectious diseases in Toronto. I could barely remember how to treat urinary tract infection empirically, let alone to deal with an immunocompromised patient with a working diagnosis of extra pulmonary tuberculosis. To say the least, I was in constant fear. My knowledge and skills were so limited that I could barely deal with the day-to-day challenges in my rotations.  I thought my preceptor would fail me EVERY SINGLE DAY.

It was a time with lots of self doubt, sleepless nights and lots of caffeine to keep me going.

Somehow I managed to complete all my rotations. Whenever I have to face new challenges that may seem impossible, I would always look back at that time and remind myself that with hardworking and determination, anything is possible.

As I reflect on how I have survived, these are few things that has come to my mind.

  1. Get involved – No matter how vulnerable I felt in a team round, I always showed up and tried to stay up-to-date with the latest status for my patients.  Whether the medications have been stopped, started or doses adjusted, I tried to keep on top of all the changes. The greatest reward is that you get to observe how care is provided, how decision is made and how different clinicians approach things differently. Once in a while, I would be asked some questions to which I often did not know the answers. So my favourite line was: “Let me look it up and get back to you”.  Those questions turned into many teaching moments that stayed with me for a long time.
  2. Identify knowledge gaps – This may be somewhat self explanatory. But instead of randomly memorizing the latest guidelines or reviewing the details about the latest drug, self awareness of what I need to learn and pursue is key to learning the most relevant topics for my practice. There is way too much information out there and without some filter or strategies to identify what to focus, I will get lost in the sea of knowledge.
  3. Cultivate collaborative skills  – I am not sure if I was ever taught the “people skills” in school but this is so important when working in an interprofessional model. There will be different personalities,  different view points and different work ethics. One must learn to master the skills to dealing with all of these various traits.  I always remind myself that I have a job to do and need to do so within the team environment that I don’t always have control of.
  4. It takes time –  Finally, I realize that it takes time to develop the skills, the confidence, the knowledge base to be a competent practitioner. So don’t feel discouraged on day 1 but also need to put in my effort and time.

One resource that has helped me was reading Clinical Skills for Pharmacists by Karen Tietz. It might have been the first edition that I got but it explained all the lingo in clinical setting, the little details that I never learned in school and just a little useful resource for someone who has never set foot in a hospital or clinical practice.

So I look forward to the next 10 years!  Have you reflected on your career lately?

Thank you for reading my post.