Wir Warren In Deutschland – Germany APPE, Truly the Trip of a Lifetime!


I present to you: The Wolfsrudel (AKA Adam and the Amsterdam Seven). L-R: Emily Kranz, Neil Bland, Adam Shiell, Allison Scott, Brittany Karns, Steph Hacker, Ryan Galloway, Sarah Nagl. Germany APPE Class of 2012- the best one there ever was!

Adler Apotheke – Jochen Pfeiffer’s Pharmacy in Velbert, DE

There is literally not enough good I can say about this trip and no way to summarize it in one blog post. Or even many. I am so incredibly lucky to have gone and to have gone with such an incredible group of my friends. As Herr Foerster (Nic), one of the Adler Apotheke German professors is in Minneapolis this week to attend the German & American Healthcare Conference and members of each of the past classes of the Germany APPE are trying to meet with him, it seems like an appropriate time to write about my experience there. (This got a bit long winded, definitely check out the pics even if you can’t read all of it.)

THE TRIP OF A LIFETIME? YES!. Absolutely every single one of us came back saying so. 1000% worth the extra cost (many of us took out extra loans—and all agree it was totally worth it!).


View of Berlin from the Reichstag Dome.

ON rotation hours: Velbert, Dusseldorf, Kӧln (Cologne), Wuppertal, Essen, Berlin (with phenomenal personal tours from our preceptors including the Brandenburg Gate, Checkpoint Charlie, the Reichstag, the 1936 Munich Olympics Stadium, the Fan Mile, Alexanderplatz, and so many of Berlin’s other sights), Potsdam, Hamburg, and others! Our home-base was Velbert, a smaller city between Dusseldorf and Cologne where Josh owns his pharmacy, the Adler Apotheke. We stayed at an amazing hotel (the Bürgestube) where the staff truly made us their friends and family and fed us more amazing food than we could ever possibly eat!

OFF rotation hours: We made gooood use of travel time! Amsterdam (Netherlands, Munich, Dachau, Salzburg (Austria), Rhein River Valley, Cologne, Dresden, Prague (Czech Republic), Copenhagen (Denmark), and we all traveled for a week after the end of our rotation, some in London, some in

View over Prague (Praha)!

Venice and Paris, some in Spain! We traveled quite a lot on-rotation, and even more with three-day weekends! Wish I could have stayed all summer!

It was heart-breaking to try to pair the photos I included down from the 5,000+ that we took on our trip. Feel free to flip through any of ours on Facebook to see more!! You better believe we came back with soooo many stories!! (What goes out the window in Munich stays in Munich…)


Das Pharmacists. On our way to Parliament.

Yes, we really did work amid all of that traveling and fun! The focus of our trip was two parts- the main one being learning about the German and American healthcare systems, focusing on best practice elements of both and considering them in the context of the cultures in which they were developed. The second part consisted of advocating for clinical pharmacy services, something we all are


Our meeting with the presidents of the Bundesvereinigung Deutscher Apothekerverbände (ABDA), the Federal Pharmacy Board, and the Bundesverband der Pharmaziestudierenden (BPhD), the Student Pharmacy Organization.

taught and understand the value of from our curriculum and seeing pharmacy in practice here, but which is very new to Germany- traditionally pharmacy has been solely retail and industry focused- clinical pharmacy has only been recently added to the standard pharmacy school curriculum and MTM and hospital/clinical practice are not common (yet). We went to many many meetings during our visit, including meeting with presidents of the regional and national pharmacy organizations, regional and national medical associations, insurance groups, wholesalers, the Joint Commission (some similarities to the FDA), members of parliament, visited community pharmacies (including a Turkish one), two hospitals, a middle/high school (gymnasium), the pharmacy technicians association, and others! In each of these places we learned extensively about how the organizations are structured and operate  how they are a part of or govern the distribution of healthcare finances in the country, and how they work with pharmacists. We were officially received by the city’s political officials and got to sign the city’s guest book. We also visited three different colleges of pharmacy at which we discussed the differences

Presenting in a German College of Pharmacy

in our education systems and presented patient cases (various topics from hypertension to cystic fibrosis) to compare differences in solving them and differences in national guidelines. We also got to spend some time IN Adler Apotheke learning about how the pharmacy runs day-to-day, the differing roles of pharmacists and techs, the differences between chain and independent in each country, got to practice compounding and – one of the highlights – learned about herbal teas and got to make our own blends! We traveled on oh-so-many trains and buses to attend all of our meetings, it was a grueling (but fabulous!!) schedule.


The Reichstag: Parliament Building of Germany in Berlin. One of the most interesting and beautiful buildings I’ve visited. Personalized tour of the interior and visiting the dome were highlights of the trip.

SO many things. I’m skipping the majority of the academic content (the health care system itself) and going for some of the other main take-home messages of the trip.  I was very impacted by seeing a culture that has been operating with what we might call a ‘socialized’ medical system for decades and see their reaction to America’s resistance to such a system. I will certainly carry this with me. I learned a lot about the struggles that all systems have – Germany’s is so different from ours, operates at a much lower cost and operates well, but has its own battles on the health care and political levels, just as ours does. I also learned a lot about the change process- I was reminded just how slow and long it takes to create true, lasting change. On that note though, it was also pleasant to see some very positive reactions to our visits and our advocacy for clinical pharmacy services and using pharmacists on the healthcare team and in the hospitals. It was also amazing to see how well our preceptors networked and carefully work to maintain their professional relationships.

We learned much about the differences between our pharmacy education and theirs – our education is so clinically focused, whereas theirs is currently comprised of mostly natural science and chemistry classes with a large industry component. Clinical pharmacy has just been added within the last few years and is only one class somewhere in your last didactic year with the option to take an additional elective course in it.

In front of the incredible Kölnerdom (Cologne Cathedral)- We got an amazing tour from professor Nic!

It gave me a heightened appreciation for the PharmD program and the opportunities to work clinically and operate in a highly cognitive career. However it also gave me new respect for the amount of knowledge I lack on subjects like herbal medicine (they learn extensive botany, including the active ingredients and mechanisms of a many, many plants, how to extract them and from what part of the plant, what region the plant must be from, what season harvested in, etc) and my utter lack of knowledge of industry (typical German students have over 20 hours of lab a week). This also illustrates a cultural difference which includes a large amount of historical plant and herbal tea use in Germany and reemphasized just how much pharmaceutical industry there is in such a small country (roughly the size of Minnesota!). Learning about the German pharmacy education system and meeting a few students from other countries also made me realize how many differences (and similarities!) there likely are between all nations who teach and practice pharmacy. I also realized how weak some of my chemistry skills have grown, topics in which our German


Visiting the Lenin Wall in Prague, a famous graffiti wall born under Communist rule.

counterparts are completely proficient. I also made many contacts with German students at the universities we visited and hope to keep in some form of contact.

We also learned much about German culture and its people. We received an overwhelming amount of hospitality and kindness from absolutely everyone we met with and we learned a lot about how Germany’s culture has been shaped by its history. It was really only unified in the late 1800’s (1871- it’s a younger country than ours, even!), before having been composed of disparate Germanic Tribes. The central government system established in that time by Chancellor Otto von Bismarck was given to us as a huge explanation for the differences between German and US attitudes towards government funded health care today, as Germans have been accustomed to such provision for well over a century. We also got a feel for the impact that WWII had on German people including Hitlers rule and how slow things have been to recover and heal after. We were told that German Pride has really only resurged since 2006- before this people did not feel they could openly hang flags, cheer for their nation, or be proud of their people such as at sporting events- truly astounding that it has taken so long for such recovery. We also got quite a taste of communism- we saw firsthand communist-built communities and Checkpoint Charlie and got a feel for life in Eastern Germany under that rule, as well as how tricky but (it seems) successful the re-unification of Germany has been. While much of this is just of interest (I’m a slight bit of a history geek- but only a slight bit), much of it was genuinely important because it taught us just how much a

Overlooking Salzburg

healthcare system (as well as political and other) is impacted by the culture in which it is developed. This is taught us an important lesson- you cannot transplant one system into another place and culture. Even if  I thought the German system was the absolute best system that could ever be developed and America should adopt it- a straight transplant wouldn’t work because our cultures are too different, even though there are many similarities. Germany has been shaped by some very powerful historical events, just as every country is, and this goes on to shape how healthcare and governing are instituted and practiced. We might be able to borrow and integrate elements of their system that seem ideal if we wanted and change aspects of our system, but even these will

Socializing in the Biergarten with pharmacy students from the University of Bonn!

have to be done in such a way that they fit America and the American people, and vice versa. The mission of our rotation was

to examine both systems and pick the best practice elements of both, and while the lesson of how culturally developed healthcare and politics is sounds basic, it is extremely important and was very powerfully made on our trip. This is something that I will remember as I continue to watch the changes our system is attempting and developing my opinions and giving input.

We learned so, so much more- I could write about 5 more pages. Overall, it was *truly* the experience and trip of a life time.

We got to travel so much but also to interact and experience events that would never come from just travelling on your own as a tourist. Perhaps one of the greatest lessons that I will carry forward and share with others is the very fact that

Compounding in Adler Apotheke with Frau Zimmerman

it took going there to understand. Not that I fully understand their system and culture or ever could as a non-German, but I certainly could never have learned it staying here on American soil, or not even ¼ as well. And perhaps it also took going there and experiencing to realize that you can’t just learn that while staying here. I am so very grateful that this APPE was offered and that I got to attend- The preceptors were unbelievably knowledgeable and involved with us, we traveled and experienced things I will never have the opportunity to access again, we got to advocate for and learn about pharmacy, and I can only wish I got to do it again next year.



We took an amazing cruise down the Rhine River- saw a dozen or more castles and beautiful wine country!

During this time of change in American healthcare, it is more important than ever to look at other systems and consider their high and low points and the cultural context in which they operate to continue making wise decisions for ourselves. Completely separate from overt study of pharmacy or healthcare, though, international experiences, from traveling abroad to getting to know visitors who come to the US, are extremely important just to learn about people. Learning about other cultures, other philosophies, and other ways of thinking that remind us of our own context and how we fit into the world. They also expand our viewpoints and our understanding of, patience for, and interest in working with others. But perhaps most importantly, they help us to realize that all people are essentially the same. We all have common interests like health and happiness. The more international experiences you have the more you have the opportunity to know about the world and other people and the more open-minded you become and able to understand other people. The more such opportunities I have the more I realize I want to have! I hope to travel much and work with international guests often in my future, and completely recommend such experiences (and especially this APPE!) to others.

If you’ve made it this far, I thank you for reading! The only last thing I have to say is that Nic and Josh are AMAZING teachers, we are so lucky to have had their undivided attention for five weeks, and also that I could not have traveled with a better group of people. LOVE YOU, WOLFSRUDEL! Wolf-family for LIFE.

Cheers and tschu-uuusss,


We spent a little time learning the BEERS list criteria in Berlin

The Wolfsrudel in Salzburg
Learning and sorting herbal teas

Showing off our true selves…

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1 Comment

  1. Samantha Selke

     /  June 6, 2013

    Thank you so much for this blog! I just started pharm school and would LOVE to do this APPE. Could you send me information or tell me what school you went to so I could apply?! Thank you so much!


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