P & T Competition

Hello prospective students, future pharmacy leaders and readers!

Today, I had an amazing experience of participating in the P & T competition. P & T competition, or Pharmacy & Therapeutic Competition, is a competition that decides whether or not a novel drug should be included in the formulary. It is held by the Academy of Managed Care Pharmacy annually. In this competition, the winners are awarded $2,500, an opportunity to present their case at the AMCP Annual Meeting & Showcase, and $4,000 stipend to cover for the expenses of travel. The case was released just before the winter break, so luckily, our team had most of the winter break to prepare for the monograph, a 25 minute presentation, and a paper explaining the criteria we considered to arrive at our conclusion. This year’s topic was Yervoy (ipilimumab), a melanoma cancer drug by BMS. To introduce a little bit about Yervoy, Yervoy targets to treat melanoma by binding to a receptor called CTLA-4 on antigen presenting cells, and inducing the upregulation of T-cell activity on tumor cells. Increased immune response, however, also means that there is an increased risk of the adverse reactions. It can include side effects such as colitis, rash, diarrhea, and neuropathy. One of the paper we examined showed that the overall survival of ipilimumab treated patients was the highest when compared with patients who had been treated with ipilimumab and gp 100 (unapproved melanoma vaccine). In the end, we concluded that while ipilimumab shows improvement in the health benefits, we are required to examine further on its efficacy considering possible side effects and compare it to current first line therapies such as PD1 inhibitor and interferons. Therefore, we recommended the ipilimumab to be a second line treatment, meaning it should be used in the patients who had tried other medications (first line agents) but failed to benefit from them.

First, I learned from this competition that a key to success in presenting the case comes from organization and preparedness. From research articles to practicing our presentation, we examined every detail and the possibility of economical, business-related, and clinical benefits and drawbacks.

Second, as with all the pharmacy materials, the information presented to us is phenomenally abundant, and daunting in its length and difficulty. What separates a good paper or presentation from a bad one is how one maneuvers this information to fit their position, and to incorporate one’s thoughts in a narrative, flowing manner that appeals to the judges.

Lastly, we went out to Sala Thai restaurant in Duluth when we were finished with the competition.

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(Picture by Min Sohn)

Pad Thai and vegetable dish were amazing! The owner picks up fresh, local ingredients each week, and does not cook unless they are perfectly in condition (she makes Mango and Rice desert only when the mango she picked up is sweet). She was also very knowledgeable and provided suggestions that left our tastes buds in heaven. What a perfect conclusion to our day.

Friendsgiving from Multidisciplinary Fields

The long-waited thanksgiving break has begun (and now is almost over..alas I am well-rested). After the big pharmacology exam that was 40% of our entire grade was over last Tuesday, it was time to gather our culinary talents (just in case there needs to be a career switch :)) to have a little friendsgiving.

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To the left: spinach salad, steamed broccoli, cucumber salad, kimchi friend rice, and potstickers

IMG_5620Norwegian traditional lefsa: potato-flour pancake eaten with sugar and sprinkles of cinnamon

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Pineapple cakes from Taiwan 🙂

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This group of friends, I keep in touch from participating in the Global Health Competition last year. One of the good things I gained from this experience, not only from increased clinical and business knowledge, is the ever lasting relationship with friends from medical school, math department, and pharmacy school, of course).

For anyone who is interested in learning more about this world-problem-solving multidisciplinary global health competition, please check out this short video from last year:

ASHP Clinical Skills Competition

 

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Yesterday, I had an amazing experience of participating in the ASHP Clinical Skills Competition. For those who are not familiar, ASHP Clinical Skills Competition is held annual in Twin Cities and Duluth campus and is organized by American Society of Health-System Pharmacists (To see examples of cases, click here). Basically, each group of two students is presented with a real-life scenario of clinical case encountered in a hospital setting. Then, we navigate through a mirage of health conditions, uncontrolled disease states, and current medication list to construct a therapeutic case plan. Each case plan identifies goals of the treatment (ex. To lower blood cholesterol level in 2 weeks), recommendations for therapy (ex. Provastatin 10 mg PO once daily), and the methods of monitoring parameters (At the next visit, follow up with a lipid panel: Total cholesterol must be <200mg/dl, and LDL level <190mg/dl). The time limit is 2 hours. Then, we present our case to the panel of judges from Twin Cities and Duluth in 15 minutes. We are asked why we were given specific agent over the other, and what was our rationale in choosing specific therapy (ex. Why did you decide to prescribe both provastatin and rosuvastatin for cholesterol therapy?). At the battle field (read competition), I saw a glimpse of what real clinical pharmacist may encounter on a daily basis. First, it is not always black and white as to which symptoms the patient is experiencing corresponds to which health condition. A rise in temperature may signal that she has a cold (based on her present symptoms of a runny nose, headache, and stuffy nose). OR, it may due to her diagnosed condition of periocardititis (inflammation of pericardium, a thin membrane surrounding the heart). So when we explore possible monitoring parameters, we must be specific as to what we are looking for for the clearance of condition. Also, for the patients who has multitude of conditions such as diabetes, hypertension, hyperlipidemia, and COPD, it is imperative to ensure there are no drug-drug interactions between the medications she currently takes. For example, the inhalers prescribed for COPD, such as albuterol, are beta agonists, which bind to the beta receptors on the lungs and stimulate the dilation of bronchial muscles, leading to the relaxation of airways. For hypertension, the patient is also prescribed beta antagonists, which also produces the opposite effect on the bronchial muscles by binding to the beta receptors in the lungs and inhibiting the action of dilation of bronchial muscles. Such interaction between two opposite class of drugs may increase the risk of bronchospasm. As a pharmacist, we must be aware of the fact that one medication may bind to different receptor sites in our body, and cause different results on the different parts of our body (called reduced selectivity). It is our role to ensure that each medication has the specificity (determines the rate of the effect) and selectivity (determines the site of the action) to act on the organ of interest, and to weigh the benefit to risk options to provide the safest and the most effective therapy for the optimal health of the patient.

Gone With the Wind

Gone with the wind: fall break that is. It seems as though yesterday I was both excited and grateful for arrival of the fall break. Since then, the time has flied so quickly, and so did the colors of the leaves! Over the break, I went down to Illinois to see my family, and went to see some beautiful leaves in Starved Rock State Park in Utica, Illinois. For anyone who is an avid lover of hiking and/or taking pictures, I would highly recommend it.

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Just before the Fall Break, we had a pharmacology exam I that was 40% percent of our grade. We had had a practice exam the Monday before, a high-stake, low-grade exam, that was only 5% of our grade, meant to help us prepare for the real exam. Well, this was good because it gave me some realistic sense of how much studying was needed to be done. During the real pharmacology exam, with the materials tested on hypertension medications (ARBs, ACEI, diuretics), I hope we all did better than the excruciating pain practice exam brought. So when it was done, it was time for some celebration with friends and, of course, food! We went out to Va Bene to have some delicious food (recommend: steak tip salad)

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And this aethereal view of the Lake Superior overlooking the Aerial Lift Bridge: *jaw drop*

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The Weekend (Is Gone)

Several things happened this weekend!

  • Esko Health Fair
  • MPSO Potluck
  • Kappa Psi Little Bro/Big Broesko health fair
  • Blood pressure readings, glucometer, and cholesterol reading were provided to the patients. Other free health screenings included bone density measurement and counseling by P3 & P4 students. Overall, it was a very rewarding experience to be  talking to the patients and answer their questions to our best knowledge.
  • unnamedMulticultural Student Pharmacy Organization held their first annual potluck at Summit Ridge. There were a lot of scrumptious food such as Cambodian beef skewer, pumpkins, bubble tea drinks, udon, and chocolate chip cookies with lots of chocolate chips!
  • Next week is the official Big Bro/Little Bro week for Kappa Psi!. Over the course of the next week, I will introduce him to my favorite things/hobbies, hometown, etc. and leave him with clues as to who I am. It is a fun way to get to know each other, and I am glad to be doing this as a big bro this time.
  • Okay, back to studying for pharmacology practice exam . . .

H.O.P.E Clinic orientation, Kappa Psi Laser Tag Night, and MSHP Mid-year Clinical Meeting

Hi Everyone!

Time sure flies quickly when we are in school. It is almost mid-end September! So far, the start of September has been exciting with meeting old & new faces, attending events and lunch meetings to learn more about student organizations, and networking with pharmacists at MSHP mid-year clinical meeting.

1. HOPE Clinic Orientation:

On September 13th, HOPE executive board from medical and pharmacy school held orientation session for P1 students interested in volunteering at student-run, non-profit clinic in the heart of downtown Duluth. For those of you who are unfamiliar, HOPE clinic is equivalent of Phillips Neighborhood Clinic in Twin Cities. We serve underserved populations and CHUM residents (http://www.chumduluth.org) by examining their basic health issues, and making referrals to nearby clinics if needed.

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The orientation itself was separated into three sessions : 1. learning how to take blood pressures, 2. being introduced to the roles in the clinic, 3. tour of the clinic and AICHO (pharmacy located about 3 blocks away). After Ben and I introduced the first year students to taking blood pressures, I ran to the kitchen and joined Allison (2nd year medical student) and helped her with preparing lunch for CHUM residents. After the tour ended, the students sat down with CHUM residents and chatted with them over ham (or turkey) sandwiches, cookies, and chocolate milk. Overall, it was an integral part of the introduction to the year-long service we will provide to the CHUM residents and the community.

2. Kappa Psi Laser Tag Night

Fast forward to the 16th, was the night of laser tag with Kappa Psi brothers, plus first year pharmacy students. It was a lot of fun playing laser tag and arcade game at the Adventure Zone near the harbor in Downtown Duluth.

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P1s & P2s & P3s don’t mess around.

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SyHui, Elaine, Jaimie and I = Kappa Psi brothers 4 Life

3. MSHP Mid-year Clinical Meeting

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MSHP (Minnesota Society of Health-System Pharmacists) held their mid-year clinical meeting at the Earle Brown Heritage Center located in Brooklyn Center, Minnesota. We had to drive on the day at 4 am (now, why would you do that??) but it was totally worth it. The whole day was filled with key note speakers from different hospitals, including Mayo Clinic, Fairview Hospital, and University of Minnesota Medical Center, and more. One particularly interesting presentation talked about Serotonin Syndrome and the difference between SS and NMS. It was interesting that the two diseases are similar in symptoms but their treatments vary according to their condition, so it is imperative to be able to distinguish between them. After the presentations, we also had a residency showcase to learn more about different residency programs offered by schools and hospitals across Minnesota and Mid-West. I had a chance to talk with Dr. Tamara Bezdicek from Fairview hospital in the ICU unit. She showed us around the industry showcase and talked with sales representatives from different pharmaceutical companies. It was an amazing day being able to learn about healthcare issues and meet new people and talk to the residents, sales representatives, and fellow students from Twin Cities campus.

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Minnesota State Fair and Starting Fair

Hello everyone!

School has officially started for us P2s. I would like to outline the classes that I am taking this semester, as this will give a clearer idea of the new curriculum.

1) Pharmacokinetics: this course is taught as an extension of Drug Delivery from the first year. We are looking to learn more in depth about the drug concentration-time profile. Additionally, we will be learning about ADME (absorption, distribution, metabolism, and elimination) of a drug. It is amazing what happens to a drug once it enters the body via various routes. I am looking forward to learning more about the specifics of ADME, and the factors that increase or decrease the efficacy of a drug. 

 

2) Cellular Metabolism/ Nutrition: this course fairly resembles Biochemistry. So far, we are learning about the individual steps of glycolysis, and what happens to the glucose molecule as it passes a series of enzymatic reactions. Essentially, this course is about metabolic pathways of certain cellular processes/ biosynthesis, and the errors that contribute to disease states. At the end of the semester, we will be learning about vitamins, herbal remedies, and toxins in food. 

 

3) Med Chemistry and Pharmacology: As the name suggests, this course is about medicinal chemistry and pharmacology. (Obviously) Different structures of cellular and drug molecules, receptor binding, and medications that bind to them. Notably, alpha, beta, and muscarinic receptors, which are potential and highly promising molecule target for possible drug discovery. As Dustin mentioned, we had a 70-minute, 30-question proficiency exam on our first day of class. Well, it surely wasn’t a fun one. (collapses)

 

4) Colloquium I : I am actually excited about this class! This course is a version of Pharm IV Paper, but is spread throughout two years. I have always wanted to delve into the research area of pharmacy, and this course just enables me to find a topic I am interested in, and to write a research proposal based on current available data. I for sure would be writing more about this topic, and am excited to talk to my mentor (Dr.Hager) throughout the progress.

 

Other classes include EPPE, Pharmaceutical Care Lab, and PDAD. In PDAD, we are asked to revisit the concept maps on the definitions of pharmaceutical care. In our next class, we will be teaching P1s on these very definitions! It will be a good refresher for us, and (hopefully) smoother transitions into Pharmaceutical Care for the first year students.

 

On a brighter, less-scholarly note, fellow Pharmers and I went to Minnesota State Fair last weekend.

Fried Oreos! I am already having withdrawals.

Fried Oreos! I am already having withdrawals.

Beer Gelato--with a considerable amount of (real, not flavor) beer, as to my surprise.

Beer Gelato–with a considerable amount of (real, not flavor) beer, as to my surprise.

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Other food items we devoured include a giant turkey leg from Texas Steak Out, Alligator sausage, Australian baked potatoes, fried pickles (my favorite from last year), and strawberry kiwi smoothie. Next time, I would try going on the rides and maybe go two days in a row!

 

Puebla Service Trip

The clinic we saw over 200 patients. The temperature was approximately 100F.

The clinic we saw over 200 patients. The temperature was approximately 100F. Dr.T, Elizabeth, and Megyn

Hello everyone!

As the summer is winding down, I am back in Duluth. Summer has been a lot of reading and moving in stuff to my new apt in Summit Ridge. In the Beginning of the summer break, however, I had an incredible chance to part-take in the Puebla Service Trip organized by MPSA. It was a week long trip, approximately, in May. Some of the highlights of the trip personally, were :

1) We saw over 494 patients total. One day, our group saw about 200 patients in one clinic. A lot of local villagers came for a1c testing, blood pressure reading, and counseling.

2) Major drawback for me, was communicating with the locals. My knowledge in Spanish has deteriorated, since, 8th grade. However, there were translators who volunteered to come with us. From them, I learned simple phrases for taking the in-patient form.

3) Puebla is a gorgeous city. The day we went, they were having “international day” at the local market. We had a chance to eat great food from the world, waffles, lemonade, and kebob.! and learn about the cultures.

4) We were over three different villages, before we arrived in Puebla. We provided height & weight measurement, blood pressure reading, blood glucose and cholesterol testings, and counseling session.

All in all, it was an amazing experience. After an year long of lab and textbooks, it was time to practice interacting with patients in a real healthcare setting. It was also an amazing time to get to know my classmates as well as the students in Twin Cities. After hundreds of pictures uploaded on Facebook in our special album, we bid farewell to see each other again next May.

Things I would consider before joining the trip:

Learn Spanish.

 

Before Entering PD1 Year …

Here are my thoughts to the questions received from the prospective students as the end of the semester is drawing closer:

1. Is it necessary to purchase a tablet and to take notes with a stylus during the lectures?

– The students use both laptop and tablets to take notes for class. For classes that require extensive note-taking, such as case studies in Applied Pharmaceutical Care, it maybe preferable to use the laptop to type the words. For classes such as Drug Delivery and Immunology, it may be sufficient to download the lectures posted on Moodle on iPad and then to add in a few descriptive words for further understanding. For classes that require drawing of the molecular structures and metabolism reactions (i.e. Medicinal Chemistry and Pharmacology), stylus and iPad save a lot of papers. “Notability” is a very versatile app that enables students to organize class notes using different colors, highlighters, and post-its. (http://www.gingerlabs.com/)

2. When is the appropriate time to apply for internship, and what is the process of getting an internship license?

The past two semesters, there were recruiters from Cubs, Thrifty White and Target looking to interview pharmacy students for internship. Prior to applying, e-mails are sent out about the possible internship opportunities, and the students who are interested are encouraged to sign-up for a time slot.

At the end of the first pharmacy year, there is a presentation from the Board of Pharmacy about the process of getting an intern license. Usually, it requires an online registration of filling out a document, and an application fee. Anyone who completed the first year of pharmacy school is eligible to apply.

3. What are some types of organizations offered in the Duluth campus?

There are many organizations in the school of pharmacy. For example,  Kappa Psi, and H.O.P.E clinic. Kappa Psi is a nationwide fraternity organization. The brothers organize volunteering, health fairs, Diabetes Walk, social gatherings and weekly meetings. H.O.P.E Clinic is a non-profit clinic for the uninsured, underserved population in Duluth. Pharmacy students and medical students are encouraged to sign up once or twice every semester to serve the local patients. For pharmacy students, there is an opportunity to sign-up for a student pharmacist, front-desk attendant, or patient advocate.

Once the school starts, there is a long stream of informational sessions about different organizations, and e-mails about how to sign up to be a part of the organization of one’s choice.

4. Is it possible to work during the academic year?

It is certainly possible to work during the academic year. About 50% of our class hold jobs. Others are involved in school or volunteering. It depends on how one would like to portray yourself after graduating, and what kind of experiences one is looking to have during the pharmacy school journey. For example, if planning a residency after graduation, GPA and extracurricular leadership are what one may consider more than working.

5. How can one find a housing?

There is graduate housing on campus:

http://www.d.umn.edu/housing/ (Duluth : have to specify “Graduate Housing” on the application)

http://www.housing.umn.edu/graduate/ (Twin cities)

There is also a google doc of the list of housings available to the pharmacy students during the summer and the academic year. This will be e-mailed during the semester and will be visible to pharmacy students who are looking for roommates for the next term.

Kappa Psi YMCA Healthy Kids Day + ACCP Meeting

Kappa Psi had a pledge project at the YMCA center today. YMCA Healthy Kids Day was to help set up & interact with kids with activities such as arts & crafts, face painting, and bouncy house. I was glad to have taken my time out of the weekend to volunteer with my fellow Kappa Psi Pharmers.

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Scrumptious lunch at Va Bene. A must-go Italian restaurant in Duluth

Scrumptious hummus panini at Va Bene. A must-visit when you are in Duluth!

 

Two weeks ago, I attended ACCP meeting that was held in Chicago. The topic was “How to Become a Standout Residency Candidate.” Over the course of two days, we heard speeches from the directors and professors from pharmacy schools across the states about researches, building resumes, and preparing for the interview. One of the tips that resonated with me came from Dr. Rodgers, a clinical associate professor at the University of North Carolina, Chapel Hill. She said that when confronted with questions that one does not know, it is quiet appropriate to say “I do not know the answer to this question, but I promise that I will get back to you after researching it.” This is not necessarily a bad answer; but it is an honest answer. In addition, she empathized the importance of a Thank You note. Email works fine, but a sincere, hand-written note after interview is always the best. After the speeches, we had CV-resume workshop and a roundtable where we were free to ask any questions to current residents in pharmacy.  CV workshop was tremendously helpful: I fixed mine and added some details, that I would have never caught if I had not reviewed it with a P3 pharmacy student from New York who sat next to me. (For example “volunteered as a student ambassador” vs. “volunteered three times a semester as a student ambassador”). I never considered going into residency prior to attending this meeting, however, I was able to come out of it with a hopeful and competent mindset that residency is one of the possible areas I could explore in my P3 year.

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