Academic Pharmacy
The News Magazine of the American Association of Colleges of Pharmacy
NOW
Volume 14 2021 Issue 5
Care Interrupted The pandemic’s disruptive effect on healthcare delivery exposed a gap that pharmacists can fill in treating patients with substance use disorder. 14
Also in this issue: Expanding AACP’s DEIA Efforts 7 Innovative Tech Immersion at UConn 11
Pharmacists Help People Live Healthier, Better Lives.
who we are @AACPharmacy
Academic Pharmacy The News Magazine of the American Association of Colleges of Pharmacy
Pharmacists Help People Live Healthier, Better Lives.
1400 Crystal Drive, Suite 300 P Arlington, VA 22202 703-739-2330 P www.aacp.org
Founded in 1900, the American Association of Colleges of Pharmacy is the national organization representing the interests of pharmacy education. AACP comprises all accredited colleges and schools of pharmacy, including more than 6,600 faculty, approximately 63,800 students enrolled in professional programs and 4,800 individuals pursuing graduate study.
NOW
CEO & Publisher
Lucinda L. Maine Editorial Advisor
Lynette R. Bradley-Baker
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Jane E. Rooney
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About Academic Pharmacy Now
Academic Pharmacy Now highlights the work of AACP member pharmacy schools and faculty. The magazine is published as a membership service.
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Stephanie Saunders Fouch
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For address changes, contact LaToya Casteel, Member Services Manager, at lcasteel@aacp.org. ©2021 by the American Association of Colleges of Pharmacy. All rights reserved. Content may not be reprinted without prior written permission.
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Sean Clark
AACP’s Professional Supporter Program
Freelance Writer
Joseph Cantlupe
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Freelance Writer
Emily Jacobs
Freelance Writer
Athena Ponushis
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Academic Pharmacy NOW 2021 Issue 5
Volume 14 2021 Issue 5
@AACPharmacy a look inside
campus connection
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Bridging Scientific Discoveries With Disease Treatment
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The University at Buffalo School of Pharmacy and Pharmaceutical Sciences launched the first pharmacy school-based M.S. in clinical and translational therapeutics degree program in the country.
From Stance to Stride AACP’s Diversity, Equity, Inclusion and Anti-racism (DEIA) Committee established an advisory panel of members who are subject matter experts to help the association make good on its good intentions.
community impact
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Eye-Opening Tech Experiences University of Connecticut School of Pharmacy students gain practical knowledge in an immersive biotech work program.
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Care Interrupted The pandemic’s disruptive effect on healthcare delivery exposed a gap that pharmacists can fill in treating patients with substance use disorder.
@AACPharmacy
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Registration Now Open for INvigorate 2022
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community note publisher’s impact
Dear Colleagues: As I prepared to compose this final opening letter for Academic Pharmacy Now for 2021, the word “transformation” was top of mind. That is no accident, as AACP celebrated the official launch in November of the Center to Accelerate Pharmacy Practice Transformation and Academic Innovation. Ok, so that title is too long but so descriptive! For ease of use, we call it the AACP Transformation Center. On November 8 the national search for the best possible Center leader brought Melissa Murer Corrigan, CAE, to AACP’s senior staff. Melissa has many stellar qualities built upon her decades of national leadership in pharmacy, including her service as the founding executive director of the Pharmacy Technician Certification Board (PTCB). Read more about Melissa and the Transformation Center: https://www.aacp.org/transformation-center. For those who may not be clear about the purpose of this publication in AACP’s portfolio of communications tools and vehicles, it was designed 14 years ago to tell stories. The stories it tells so well are the ones that highlight the important activities that AACP members create in education, practice, research and community service. And stories are powerful! While our flagship journal, the American Journal of Pharmaceutical Education, shares members’ scholarly contributions and editorial opinions, and the AACP website and AACP Connect are rich repositories of resources and connections, Academic Pharmacy Now offers us the opportunity to share with each other and with influential stakeholders external to AACP and pharmacy how academic pharmacy makes a meaningful difference in peoples’ lives. The work of so many members and our Substance Use Disorder Special Interest Group in identifying new, expanded and meaningful ways that pharmacists, faculty and students can positively impact the lives of individuals afflicted with substance use issues is a timely and crucially important issue to highlight. Sadly, a record number of Americans succumbed to drug overdoses between April 2020 and April 2021. And while we recognize that many deaths are attributable to the challenges of the pandemic, deaths were rising in the pre-pandemic months already. Expanding pharmacists’ authority to provide naloxone and sterile syringes, as well as to become accessible points of care for medication assisted therapies, is possible. Regulatory frameworks and practice models exist and can be replicated. AACP routinely shares these perspectives as an active member of the National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic, serving on the Education and Training Workgroup. AACP has also significantly elevated its action to address diversity, equity, inclusion/belonging and anti-racism (DEIA) to achieve health equity for all. As described in this issue, our work runs wide and deep, touching our staff, leaders, members and the public. I’m excited that the second Equity, Diversity, and Inclusion Institute, a project fueled by the passion of former AACP President David Allen and co-sponsored by the University of Mississippi School of Pharmacy where he served as dean until mid-2021, will be held virtually in January to kick off another year of strengthening the work on DEIA in AACP and among our members. Accelerating these kinds of transformative priorities are central to the mission and vision of the AACP Transformation Center. By identifying opportunities to advance pharmacists’ contributions to help people live healthier, better lives, and making the replication and sustainability of such efforts more achievable through the networking and support of our members, AACP can help accelerate the transformations of pharmacy practice and education that I personally have been committed to for all 40-plus years of my career. I invite every AACP member and interested others to engage with the new Center, stay abreast of and help shape its priority projects, and ignite (or re-ignite) your passion for the profession that has so very much to offer to the world. Sincerely,
Lucinda L. Maine, Ph.D., R.Ph. CEO and Publisher
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campus connection
Bridging Scientific Discoveries With Disease Treatment The University at Buffalo School of Pharmacy and Pharmaceutical Sciences launched the first pharmacy school-based M.S. in clinical and translational therapeutics degree program in the country. By Joseph A. Cantlupe More colleges are embracing the need to coordinate medical research training from “bench to bedside” through clinical pharmacy and translational science. The National Institutes of Health has emphasized the importance of clinicians working on research with healthcare teams. There is a significant need for student pharmacists and other healthcare professional students to gain this advanced training as the “nation faces a critical decline of clinical scientists with experience in both patient care and research,” the NIH noted. The University at Buffalo School of Pharmacy and Pharmaceutical Sciences is going one step further in its academic programs, becoming the only pharmacy school-based program of its kind in the country, offering a Master of Science degree program in clinical and translational therapeutics. “The synergy between pharmacy together with the clinical and translational sciences facilitated the creation of a new tailor-made program specifically focused on treatment optimization,” said Dr. Brian Tsuji, professor and associate dean for clinical and translational sciences. Completion of the program, combined with a Pharm.D. or other health professions degrees, provides graduates with a
“remarkable advantage when applying for residencies, fellowships or employment in clinical pharmacy or industry,” said the university. The program “offers five therapeutic areas of concentration: clinical trials, pharmacotherapy, translational pharmacology, experimental therapeutics and pharmaceutical outcomes. The tracks combine rotations with a pragmatic focus on research to create a highly individualized experience,” according to the university. “UB has world-leading graduate training programs in pharmacokinetics and pharmacodynamics in the pharmaceutical sciences and an extremely innovative Pharm.D. curriculum,” Tsuji said in a statement. “Our M.S. in clinical and translational therapeutics truly stands on the shoulders of giants.”
Developing a Pipeline of Research Leaders Academics have stressed the importance and linkage of research to advance clinical practice, and the importance of evaluating and understanding the data to understand medications to apply to their patients. “Research is the foundation that links the basic sciences to eventual clinical practice,” said Gregory S. Gorman and Rachel R. Miller of the McWhorter School of Pharmacy at Samford University in a paper published this year.
“The synergy between pharmacy together with the clinical and translational sciences facilitated the creation of a new tailor-made program specifically focused on treatment optimization.” —Dr. Brian Tsuji
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“Interpreting data from research is an ability that many healthcare workers need to have to provide safe, effective and proficient patient care.” Translational research is typically characterized by short-term work, resulting in a more immediate clinical impact, the authors stated. “This type of research allows the students to see their laboratory data and monitor it as it translates into a clinical setting.” When institutions incorporate research as part of the curriculum, it “not only facilitates student learning, but also helps them to develop the critical thinking skills necessary to decipher research and to define new topics of research to translate into clinical practice,” according to the study. Tsuji’s team at the University at Buffalo is dedicated to clinical and translational approaches to combat antimicrobial resistance. He has won two NIH grants totaling more than $7 million since 2008 to research fighting antibiotic-resistant bacteria. His grants have been some of the largest in the history of the UB School of Pharmacy and Pharmaceutical Sciences. Multi-drug resistant bacteria have been classified as an urgent public health threat in the U.S. and around the
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globe, the university stated. “These bacteria are resistant to all current antibiotics and can cause a variety of diseases, from pneumonia and other respiratory infections, to serious blood or wound infections.” Tsuji’s superbug research investigates optimizing drug combinations to “maximize antibacterial activity and minimize resistance and toxicity.” On the university’s website, he noted, “This allows our team to push the boundaries of knowledge in antimicrobial pharmacology and it is our clinical focus which allows us to provide insights into translating these scientific findings toward the care of critically ill patients who are infected with resistant-Gram negatives.” The degree program, which has enrolled four students in its inaugural year, offers Pharm.D. undergraduate and healthcare professional students “a unique opportunity to engage in research and training to combat disease as well as help develop a pipeline of research leaders focused on therapeutic treatment,” he said. P Joseph A. Cantlupe is a freelance writer based in Washington, D.C.
campus connection
From Stance to Stride AACP’s Diversity, Equity, Inclusion and Anti-racism (DEIA) Committee established an advisory panel of members who are subject matter experts to help the association make good on its good intentions. By Athena Ponushis Policies only go so far. Plans must be put into action. If the pharmacy community wants the full benefits of diversity— cultural competency, improved patient outcomes, health equity—schools must help each other on their equity journeys. AACP aspires to turn pharmacy into a field where everyone feels included so they can do their best work and all patients can benefit. The association seated its most diverse board yet, so the members at the table represent the members on the ground. It named ‘leading diversity, equity, inclusion and anti-racism (DEIA) efforts’ as a standalone priority in its new strategic plan. And its DEIA committee brought experts from member schools together, forming an advisory panel to share insights and opportunities, helping other schools that want to do the work be successful with their DEIA endeavors. These insights will be shared over AACP platforms and at association meetings, as the Equity, Diversity and Inclusion (EDI) Institute will soon meet again.
“We are working on DEIA efforts in all areas,” said Cindy Ziegler, AACP associate director of governance and executive office operations. “We have put procedures in place so that we are not just hoping for the better, we are strategically thinking about how we can make it better, how we can be more diverse and inclusive, what changes can we make today for the profession we want to be tomorrow.” The aim of finding balance in the boardroom became a key goal for AACP in 2018. Past President David Allen formed a leadership pipeline development task force, which forged a diversity declaration, asserting that AACP shall strive to include and engage the full diversity of its membership in its leadership. The declaration recognized diversity of perspectives as vital, defining diversity as people who bring different viewpoints by virtue of their gender, gender identity, sexual orientation, race/ethnicity, physical abilities, as well as geography, disciplinary expertise and institutional classifications.
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“If we are striving to accomplish health equity for all, our pharmacists need to understand the people they are serving, the communities they are serving. This is where the advisory panel gets really exciting because there are schools that are doing some very innovative and creative things in their communities, helping to prepare student pharmacists as graduates to best serve all communities.” —Terri Moore
This ensures that there’s more than one woman, one person of color, one LGBTQ person on the board and that not all members live on the West coast and work at private schools. “We have seated our most diverse board this year and I am encouraged by that,” Ziegler said. “We want our board to be a good representation of who our members are.” Ziegler served as staff liaison for the leadership pipeline development task force and can feel the genesis of the DEIA committee in its deliberations. In late 2019, AACP created the committee to carry on the diversity, equity and inclusion work. The murder of George Floyd in 2020 elevated the conversation and reignited the movement for racial justice. Senior staff knew they needed to expand the committee and add anti-racism to its title. “Racism has led to so many disparities and inequities in healthcare. AACP felt it was important to shine a light on the racial component,” said Terri Moore, AACP senior director of academic services. The DEIA committee expanded with members and purpose. It was designed with three pillars, one for staff (including the board and leadership), another for members and affinity groups, the third focusing on external partners and stakeholders. Committee members pondered, ‘Why does this committee exist? What do we plan to do?’ and crafted a charter, affirming that the DEIA committee aims to provide guidance and recommendations for actions to achieve AACP’s diversity, equity and inclusion goals and needs. “We wanted to show we have more than good intentions,” Moore said. “We wanted to say, ‘We are going to put together a plan, we are going to get things moving, we are going to do things.’ This isn’t just another statement of our intent, it’s how we are going to generate action.” The committee, made up of mainly staff, recognized that they were not necessarily subject matter experts but knew that they had access to members with expertise who were doing this work and could provide counsel. So, the committee
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decided to create a DEIA advisory panel that would comprise experts who could lend guidance and strategy for action. The committee put out a call to members earlier this year to gauge their interest in joining the panel. “Close to 40 people responded and we said, ‘We are going to take them all,’” said Moore, who leads the member pillar of the DEIA committee. “How can we exclude anyone when this is about inclusion? Anyone who is interested and has experience can be on this panel. If someone raises their hand and says, ‘I want to be included on this panel,’ then welcome.” Different institutions are at different levels on the DEIA continuum. Moore believes that’s the brilliance of the panel: it creates a place where members can share ideas and information, learn what is happening elsewhere, be inspired and implement like-minded actions at their home institutions. The panel was not designed to run like other committees. It is meant to be less structured, it does not have a chair and it does not have to meet every month. Rather, as Moore said, “As we figure out what we need, we want to have a group of members to advise us as we trek this journey together.”
Diminish Disparity by Promoting Diversity Schools want to know what’s going on at other schools. That’s what makes the advisory panel so influential. “Our panel members are our boots on the ground to help us understand what the DEIA needs are, to share the challenges and successes with us, so we can help exchange that information,” Moore said. AACP has launched a DEIA page on its website. The panel will add content and share resources there. Topics, strategies and school endeavors will be featured. AACP has also established a DEIA Connect Community, where members can pose questions and share suggestions. The DEIA panel will plant topics and questions to get the conversation started, then let the members take it away. The
campus connection
beauty of a Connect Community is that it’s driven by those who are part of that community. “Again, under the goal of inclusivity, this Connect Community will be open to any members who want to join,” Moore said. “We are not excluding anybody. It’s just going to be one of those communities that has a lot of people in it, but hey, tell me what’s wrong with that? It’s all for the better.” AACP’s strategic plan has been evolving in tandem with the thinking of the DEIA committee. Initially, the strategic planning committee did not list DEIA as its own priority, instead weaving it throughout all priorities. But when they started vetting the draft out to members for feedback, “We heard loud and clear, DEIA warrants its own space. It needs to stand alone because it is a priority,” Moore said. The plan now names leading DEIA efforts as a priority to help diminish health disparities and promote health equity. One goal focuses on strengthening the pipeline to cultivate learners from more diverse backgrounds, which will improve cultural competency and patient care outcomes. Cultivating and supporting a more diverse faculty is another goal, to reflect and support more diverse learner and patient populations. AACP also wants to provide DEIA professional development activities for all its stakeholders, continuing the EDI Institute and featuring DEIA topics at all meetings. And the association will advocate for all pharmacy schools to integrate DEIA topics into curricula. “If we are striving to accomplish health equity for all, our pharmacists need to understand the people they are serving, the communities they are serving,” Moore said. “This is where the advisory panel gets really exciting because there are schools that are doing some very innovative and creative things in their communities, helping to prepare student pharmacists as graduates to best serve all communities. As we share these ideas and opportunities with more schools, who knows where the ripples of that might flow.” The fifth goal focuses on expanding research and external collaborations, which aligns with the third pillar of the DEIA committee. AACP recently became a partner organization collaborating on a demonstration project that looks at health disparities made by dubious policies. The project, “Eliminating Generational Racial Health Disparities,” funded by the U.S. Department of Health and Human Services through its Office of Minority Health, intends to identify and evaluate policies that may perpetuate health disparities through structural racism. Dr. Richard
Braylock, principal and COO of BHK Consulting, a unity, equity and justice consulting firm, will serve as project director. AACP will examine policies that create barriers to supplying a capable pharmacy workforce ready to address the unmet needs of communities where health disparities prevail; policies surrounding federal student financial aid; the lack of scholarship and loan repayment programs; and the content of pharmacy curriculum and continuing professional development programs. “This is a big step in the right direction. I mean just to have the Office of Minority Health put this out there and for AACP to be part of this conversation and do some of the work, it’s huge,” Moore said. “We are positioning ourselves to find funding to take on more of these projects and we are going to need our member institutions, we are going to need our advisory panel. This is exactly what we need to be doing not only to move our own DEIA efforts forward but to achieve health equity and dispel health disparities.”
A Collaborative Effort On the staff side, AACP has joined CEO Action for Diversity & Inclusion, a CEO-driven initiative to advance DEIA efforts in the workplace. The group has served as a resource, giving AACP many topics, tools and workshops, such as a model for an April Day of Understanding, which AACP led with its staff. The day started with a series of kickoff discussions surrounding unconscious bias. Then staff broke off into smaller groups, giving individuals a more intimate space to share stories. “The real goal of that day, as its name states, was to think about how we understand DEIA-related concepts and how does that help us to better understand others who may be different than we are? That’s what diversity is all about,” Moore said. “The day was rich in terms of conversation, staff was engaged and now we can recommend this day to members as something they may want to do at their own institutions.”
Strategic Priority 3
Leading Diversity, Equity, Inclusion, Goal Statement 3.1
and Anti-racism (DEIA) Efforts
Goal Statement 3.4
Attract a more diverse student pharm acist population.
Promote a more diverse student popula tion to foster innovative learning, and to improve cultural competence and patient care outcomes for an increas ingly diverse patient population.
Goal Statement 3.2
Cultivate and support a more divers
e faculty.
Ensure representativeness among our faculty to support increasingly diverse student and patient populations.
Goal Statement 3.3
Lead in creating and providing DEIA professional development activities.
Enhance curricular and co-curricular activities.
Advocate for colleges and schools of pharmacy to integrate topics related to DEIA throughout their curricula as well as those student leadership and learnin g experiences that support their curricu la.
Goal Statement 3.5
Expand collaborations and research.
Expand AACP’s research and externa l collaborations related to DEIA.
Make available workshops, trainings, and other specialized programming to all AACP stakeholders, including faculty, staff, Board of Directors, students, and external partners.
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campus connection
“We have revised two of the current oath’s statements and added one statement that is focused on diversity, equity, inclusion and justice. We wanted to make sure the statements were timeless so they will resonate with future pharmacists. We are inspired by how this will personally impact every student pharmacist coming into the profession now.” —Rosie Walker Ziegler, who leads the staff pillar of the DEIA committee, served as a panelist at a CEO Action workshop on building a diverse board, while Executive Vice President and CEO Dr. Lucinda Maine attended the annual summit for CEOs. AACP has also started holding lunch and learns for staff, the first one acknowledging Hispanic Heritage month. The Encore EDI Institute, hosted by AACP and the University of Mississippi School of Pharmacy, will take place in early 2022. The inaugural institute drew more than 200 participants, exceeding expectations, and focused on developing EDI strategic plans. The second annual EDI Institute, a virtual event, will concentrate on implementing those plans. Organizers are bringing back the student voices panel. Its resonance was powerful, as it reminded participants why
Learn More AACP Diversity Statement: “AACP affirms its commitment to foster an inclusive community and leverage diversity of thought, background, perspective, and experience to advance pharmacy education and improve health.” www.aacp.org/article/aacp-diversity-equityinclusion-and-anti-racism-committee-charter www.aacp.org/article/equity-diversity-andinclusion-edi-initiatives AACP Special Taskforce White Paper on Diversifying Our Investment in Human Capital: www.ajpe.org/content/early/2019/12/10/ajpe6819 2022 Equity, Diversity and Inclusion Institute: (learn more on page 22): www.aacp.org/edi2022 Revised Oath of a Pharmacist: https://bit.ly/OathofaPharmacist2021
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they are doing this work and how it impacts student lives. Last year, one student shared that as the nation confronted racial injustice, there were some faculty members who made themselves available who said, ‘If you have any issues, feel free to come see me,’ but then there were other faculty members who reached out to students to check in on them. The student shared that there were maybe 12 underrepresented minorities in the class. “It’s great to have that open message of being welcoming, but it’s another level to take initiative to reach out personally because students may be apprehensive about reaching out themselves,” said Rosie Walker, AACP director of recruitment and diversity. “That was one story that stayed with me—actually reaching out to students as opposed to having them come to you.” Walker, who leads the DEIA committee pillar focusing on external partners, was also involved with revising the oath of the pharmacist to be more inclusive of DEIA values. Walker served as the primary liaison for AACP in that joint effort with the American Pharmacists Association (APhA). Several town halls took place (one for APhA members, one for AACP members, one for students) to solicit feedback regarding the proposed changes. “We have revised two of the current oath’s statements and added one statement that is focused on diversity, equity, inclusion and justice,” Walker said. “We wanted to make sure the statements were timeless so they will resonate with future pharmacists. We are inspired by how this will personally impact every student pharmacist coming into the profession now.” Revisionists hope the oath will be available for the graduating class this May. Walker emphasized that while AACP may be leading a number of DEIA initiatives, it takes the members to make it successful. “In order for our DEIA work to be effective and to impact change, this has to be a collaborative effort,” Walker said. “We cannot do this work without our members.” P Athena Ponushis is a freelance writer based in Ft. Lauderdale, Florida.
community impact
Eye-Opening Tech Experiences University of Connecticut School of Pharmacy students gain practical knowledge in an immersive biotech work program. By Emily Jacobs Laboratory work and clinical rotations provide crucial hands-on learning for student pharmacists. However, they may not offer an immersive experience that challenges students to apply their knowledge in creative ways. Real-world experience can elude many student pharmacists until well into their pursuit of an advanced degree. Enter the Technology Incubation Program (TIP) at the University of Connecticut School of Pharmacy. Launched in 2012, this immersive, 10-week summer program matches students with host startup companies located in UConn’s technology incubators in Storrs, Farmington and Stamford. This program encourages the startups’ development and research while giving students practical experience in a setting that combines business and technology. It is open to students of any major at UConn and has included pharmacy and Pharm.D. students since 2016. “It has been a wonderful collaboration,” said Dr. Caroline Dealy, UConn Health faculty member and TIP Innovation Fellows program founder and director. “[School of Pharmacy] Dean [Philip] Hritcko has been just so supportive of the program.” Both the startups and the students must apply to participate in the program. To join TIP, startups must assign a mentor from their team for the participating student. They also must describe their qualifications and plans for the program to UConn, ensuring that the student will be engaged and productive. Approved startups review students’ applications and choose individuals to work with for the summer. UConn deans provide funding for the students’ fellowships. Students in TIP also have the opportunity to continue their project after the end of the 10 weeks for research credit.
Insight into Startups Depending on the startup and their projects, TIP students can experience both the business and science aspects of the startup. TIP participants may have opportunities to accompany their mentors to pitches for venture funding. Other students, whether their major is science- or business-related,
may be invited to sit in on meetings and observe day-to-day operations. “This is not really an internship,” Dealy noted. “The companies that host students are aware that this really is a labor of love on their part, to mentor the students and [introduce them to] the whole environment of a startup, which is so different than an academic laboratory or a desk in the accounting department of a big company. It’s a very different experience than a traditional internship.” Besides accessing hands-on learning opportunities within a startup, TIP participants also attend weekly seminars. These often feature speakers on innovation and entrepreneurship, providing insights that STEM students may not otherwise hear. TIP also includes career development topics, such as setting up a LinkedIn page and preparing a CV. Before COVID-19, the program included a symposium at the end of the summer, which program leaders hope to revive in 2022. Three UConn School of Pharmacy students participated in TIP this past summer. Two of them, 2023 Pharm.D. candidates Saba Azam and Roxanna Monshi, worked in the laboratory of the startup Encapsulate. Based in Farmington, Encapsulate produces tumor-on-a-chip systems that can grow cancer cells outside the patient’s body. Researchers use these cells to test the efficacy of chemotherapeutic drugs, which could help determine the best course of treatment for cancer patients. Under the mentorship of Encapsulate CEO Armin Tahmasbi Rad, Azam and Monshi were able to apply their pharmaceutical knowledge to help develop the startup’s technology. “We actually used some resources that were provided to us by the school, such as drug databases, and we looked at what the current dosing standards are and stuff like that, to kind of work with his [tumor-on-a-chip] device,” explained Azam. “Every year, we have had the privilege to work with UConn’s most talented students from the School of Pharmacy, School of Engineering and School of Business. I truly enjoyed how our two interns from the School of Pharmacy, Saba and Roxanna, brought their pharmaceutical knowledge and expertise and
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“It definitely opened our eyes to a different perspective within what pharmacists or pharmacy can lead to within a career path. We’d never really worked with a company like Encapsulate before, so it was a really good experience overall, just to get exposure to that and the different aspects that play into a startup company.” —Roxanna Monshi
Photo credit: Tina Encarnacion/UConn Health photo
UConn Pharm.D. candidates Saba Azam and Roxanna Monshi worked in the laboratory of the startup Encapsulate, which produces tumor-on-a-chip systems.
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community impact
contributed to our product development significantly,” Rad said.
Past TIP participants have seen more long-term benefits from their time in the program. Dr. Brendan Clark, manager of Health Economics & Outcomes Research at Boehringer Both Azam and Monshi are still students, but their TIP exIngelheim, was one of the first School of Pharmacy students periences have already had an effect on their future careers. to participate in TIP in 2016. “It was the first long-term Although they are not certain that they will pursue a career in work experience I had,” recalled Clark, who worked with the biotechnology specifically, their work with Encapsulate has same startup from the summer of 2016 through the sumgiven them a new appreciation for the options available to mer of 2017. After his involvement in TIP, Clark completed a pharmacy graduates. “Working at a startup really made me two-month pharmacy rotation at Biohaven Pharmaceuticals. realize that the profession itself can be integrated into any Participating in TIP “showed that I had good research expart of health sciences or any part of medicine,” Azam said. perience and I would be a good candidate to work with this pharmaceutical company.” This made TIP “a good stepping “It definitely opened our eyes to a different perspective stone” to his current position with Boehringer Ingelheim. within what pharmacists or pharmacy can lead to within a “Having broad experiences is helpful, no matter what career career path,” Monshi agreed. “We’d never really worked with path you go down,” Clark said. a company like Encapsulate before, so it was a really good experience overall, just to get exposure to that and the differ“Students…want to be able to have access to different kinds of ent aspects that play into a startup company.” She added, “I experiences that aren’t so traditional as what’s been availdo want to continue impacting patients, like on a large scale. able in the past,” Dealy said. “There’s nothing like hands-on I would say [the TIP experience] helped solidify that I chose experiential learning to build career skills and life skills.” P the right career.”
Emily Jacobs is a freelance writer based in Toledo, Ohio.
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Care
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community impact
Interrupted The pandemic’s disruptive effect on healthcare delivery exposed a gap that pharmacists can fill in treating patients with substance use disorder. By Jane E. Rooney
Disruptions in care due to the pandemic created headaches and delays for many providers and patients. But for some populations, such as individuals being treated for substance use disorder, those disruptions went beyond being inconvenient to becoming dangerous or even deadly in some instances. Last month the Biden administration announced that more than 100,000 people died of drug overdoses between April 2020 and April 2021—the first time that drug-related deaths have reached six figures in any 12-month period. The pandemic appears to be at least partly responsible for the increase.
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An article published by the American Psychological Association in March noted that the early months of the pandemic brought an 18 percent increase nationwide in overdoses compared with those months in 2019. It also reported on findings from the American Medical Association that as of last December, more than 40 states had seen increases in opioid-related mortality. Healthcare providers across the country have observed an uptick in quantity and frequency of drug use during the pandemic. The isolation brought on by lockdowns, added stress related to finances and childcare and difficulty accessing treatment exacerbated an already tenuous situation. “There was acute destabilization for a system that already had limitations,” noted Dr. Lucas Hill, clinical associate professor and director, Pharmacy Addictions Research & Medicine Program, The University of Texas at Austin College of Pharmacy. “This is a patient population that is likely experiencing other major struggles in their life on a day-to-day basis, such as chronic health issues—sometimes psychiatric—maybe difficulties with transportation getting to a clinic. Any minor disruption can throw them into severe crisis of not being able to access medication. One thing that has been missed a bit during COVID is that if you look back at the available data on drug overdose deaths in the U.S., they began to trend upward in August 2019 through February 2020. It definitely accelerated after lockdowns and social isolation, but there’s no doubt that drug overdose death was increasing prior to COVID. Those numbers have increased almost exclusively due to potent synthetic opioids. The pandemic certainly made things worse, but we were already on a problematic trajectory.” The disruptions in healthcare over the past year and a half have prompted conversations about expanding the pharmacist’s role in caring for patients with substance use disorder and how to address any future gaps or disruptive events. “As pharmacists we’ve been trying to figure out what our appropriate role is, not only in preventing misuse but expanding access to treatment and harm reduction services,” Hill said. “The COVID disruption has shined a spotlight on the role we need to play going forward and areas we need to improve.”
Opportunities to Expand Services The loss of in-person support for those with substance use disorder and the pandemic’s toll on mental health led to more substance use and overdose death. That reality hit rural communities especially hard, explained Dr. Keri Hager, associate professor and co-associate dean for clinical affairs, University of Minnesota College of Pharmacy, because the already limited access to providers coincided with staffing shortages. “The pandemic opened the dialogue about access via pharmacies with the vaccine and testing, so that’s opened a broader dialogue about the role pharmacists can play in public health, especially in rural areas,” Hager said. “In rural Minnesota, we’re having more conversations about providing harm reduction services. We can sell syringes without a prescription here and we can provide naloxone. We’re trying to find ways to enable the pharmacists working in these rural areas to provide that level of service. Our state association annual meeting is coming up and we have a few sessions around that issue. What can we do to stem overdose death through pharmacy services? [In my clinic] I’m providing comprehensive medication management services. Taking a compre-
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“There are good signals that there are things states can do to increase stocking of [buprenorphine and naloxone kits]. That is the most important area where we could have an impact. We need to expand education for community pharmacists about the role these medications play in opioid response. If community pharmacists could maintain a supply of these, it would go a long way in showing that pharmacists can play a helpful role.” —Dr. Lucas Hill
hensive look at all of the medications for my patients and helping connect and bridge across the treatment plan has been really important, and I can see an opportunity for expansion there.” Hager’s colleague Dr. Laura Palombi, associate professor, University of Minnesota College of Pharmacy-Duluth, agreed that, particularly for patients in recovery, losing their social connections and support groups was a major setback. “There are more barriers to shifting to online treatment in rural communities. There are also transportation barriers,” Palombi said. “There are a shortage of treatment facilities and patients often have to go long distances to get treatment. In rural communities, people don’t have the same ability to telework. Their jobs require them being there and doing something in person. If those places shut down, they don’t have the resources. That’s another barrier as well—people can’t just take time off to go to treatment.” Perhaps the biggest barrier, Hager pointed out, is stigma. “We did a survey with the recovery community. What came out loud and clear is how stigmatized people feel if they have a substance use disorder. My colleagues have done some work in surveying to understand pharmacists’ perceptions of harm reduction strategies for individuals who inject drugs and need sterile equipment so we can better create educational interventions.” While the pandemic presented few silver linings, it did allow the pharmacy community to consider the opportunities that exist to offer their services when care is disrupted. “Pharmacists and pharmacies did adapt quickly. In our state it was ‘all hands on deck’ figuring out how we really expand access to the vaccine because so much needed to be delivered as quickly as possible,” Hager said. “I saw a lot of collaboration among associations and organizations across the state. There are ongoing conversations about how we respond in a more coordinated way. I have seen a lot of innovative pharmacies that were quick to deliver both the vaccine and COVID testing. We should be working better to mobilize quickly.”
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“It’s saving lives and saving money but some pharmacists still have a problem dispensing sterile syringes. As pharmacy educators we need to do a better job showing the benefits. We are working on this at pharmacy schools across the nation. I would like to see community pharmacies selling sterile syringes and referring people to treatment facilities and engaging more with the public health community and harm reduction agencies. Ambulatory or hospital pharmacies can take on greater roles and become experts in that area.” —Dr. Laura Palombi
Telehealth was another silver lining in terms of bolstering infrastructure, she acknowledged, but not everyone in rural areas has access to that technology. While telehealth is likely here to stay, a needs assessment about clinical pharmacy services that Hager is undertaking indicates that physicians prefer to have a pharmacist on site. UT-Austin’s Hill said that at the national level, professional organizations and research funders are working on engaging pharmacists in learning about treatment for substance use disorder as well as providing community pharmacists with training and support and addressing underlying barriers. “Ongoing projects are seeking to engage pharmacists in co-management of opioid use disorder, safe use of medications and testing out different levels of autonomy for clinical pharmacists,” he noted. “I’m hopeful that early findings from these novel approaches will lead to pharmacists being more intentionally included when federal regulators are considering how they manage access to these medications.” Hill and some colleagues conducted an audit of 5,000 pharmacies in the U.S. and found that most were not prepared to supply buprenorphine and naloxone kits. “There are good signals that there are things states can do to increase stocking of those medications. That is the most important area where we could have an impact. We need to expand education for community pharmacists about the role these medications play in opioid response,” he said. “If community pharmacists could maintain a supply of these, it would go a long way in showing that pharmacists can play a helpful role. Pharmacists could identify certain moments when a person is showing signs that they might have substance use disorder and could use help. For example, if someone is buying syringes without a prescription, the pharmacist could sell syringes to that
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individual, recognizing that increased access to sterile syringes helps [to limit adverse outcomes] and also offer naloxone. There would be potential to discuss ongoing treatment. Building that credibility and connection to members of our community who might need support is really an important area where I think we could grow.” As Palombi suggested, “We know our healthcare systems are stretched extremely thin. How can we support our healthcare system and also practice at the top of our license? As more people see the value in [offering medications for substance use disorder treatment], hopefully there will be more demand. We can play a huge role with our accessibility. It makes sense for us to have those conversations about how to train our students to be in those roles and how we adapt as a profession.”
Providing Stability to Patients One of the biggest disruptions for patients with substance use disorder during the pandemic was decreased access to syringe service programs, according to Hill. “Those are the people in the most need of support. Those programs are run by volunteers and are underfunded but they provide services directly to those individuals,” he emphasized. “When they weren’t operating for several months, people needed to be able to turn to a pharmacy. We could be that support system when other services are not available. There’s a role for clinical pharmacists as well. In hospitals, they play a role in ensuring that buprenorphine can be initiated during a hospitalization. It can be important to ensure that patients don’t experience withdrawal or leave the hospital too early. Outpatient clinical pharmacists can help prescribers stay up to date on guidance related to buprenorphine. Pharmacists can provide support for ongoing evaluation and medication management.” At Minnesota’s College of Pharmacy, the curriculum is frequently updated to ensure that student pharmacists are prepared to treat patients with substance use disorder and to discuss naloxone use. “It is so important and so underprescribed. We want them to be well-versed in naloxone,” Palombi said. “They can talk to patients about it and have it become part of transitions of care. Now our students are trained in it in the fall of their first year. When it comes to syringe access, a lot of community pharmacies struggle. There is bias and stigma within the field. How do we self-check to make sure we are not contributing to the stigma? We are constantly adapting our curriculum and we look to AACP for guidance and competencies and we are talking to other schools. We’re always learning from each other about what’s working and what’s not.” Local community partners in public health also offer guidance in terms of where pharmacy practice could expand. A recent study involving focus groups with students from eight pharmacy schools helped identify gaps in the curriculum. “I think across the Academy this is an area [we need to address]…it is tough to convince some pharmacists of the value of syringe access,” she continued. “It’s saving lives and saving money but some pharmacists still have a problem dispensing sterile syringes. As pharmacy educators we need to do a better job showing the benefits. We are working on this at pharmacy schools across the nation. I would like to see community pharmacies selling sterile syringes and referring people to treatment facilities and engaging more with the
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Support for Pregnant and Postpartum Women Pregnant and postpartum women represented another population that struggled with disrupted care during the pandemic. Isolation, stress, childcare concerns and an increase in domestic violence were some of the factors leading to a rise in mental health issues and substance use disorder among pregnant and postpartum women. “We have seen many changes to healthcare due to COVID,” said Dr. Alicia Forinash, professor of pharmacy practice, St. Louis College of Pharmacy at the University of Health Sciences and Pharmacy. “Early during the pandemic, several changes took place. In an effort to reduce potential exposure to COVID, we were able to transition many patients to telehealth visits, reducing face-to-face obstetric visits when possible. For a while they stopped allowing support persons for appointments and in hospitals, which directly impacted our obstetric patients. Patients lost access to inperson classes and centering programs focused on patient education and support during the pandemic.” The lack of in-person pregnancy groups that met to get education, support, even group obstetric care, was particularly difficult for some patients, she added. “A nursing journal interviewed nurses and patients related to changes due to COVID. Patients mentioned the lack of support and connection from providers. Obstetric classes weren’t the same virtually as they were live.” A recent study funded by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) entitled, “The effect of the COVID-19 pandemic on alcohol use and psychosomatic health in pregnant and postpartum women with intersecting vulnerabilities,” co-led by Dr. Sharon Ruyak and Dr. Ludmila Bakhireva at The University of New Mexico’s Health Sciences Center, found that some respondents reported feeling that support from their prenatal care practice worsened during the pandemic. A majority of study participants said that the pandemic significantly worsened their state of mental health and stress level. “The pandemic has dramatically changed the way healthcare is delivered, and I think the healthcare system will continue to leverage these changes to meet patient needs, including expanding the scope of pharmacy practice,” noted Ruyak, an assistant professor at The University of New Mexico College of Nursing. “This highlights an opportunity for community pharmacists to provide support to this population by maximizing the opportunity
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to provide education on topics such as vaccines during pregnancy and breastfeeding. The role of the pharmacist is particularly important in New Mexico, given that approximately 30 percent of the population lives in rural areas. For many residents, community pharmacists are the most accessible healthcare providers.” Forinash agreed that pharmacists have an opportunity to provide care to women facing these challenges. “It is imperative that pharmacists are non-judgmental, open and supportive of patients. Mental health issues and substance use disorder can occur with patients across all demographics,” she said. “We need to be educating our patients and taking time to talk to them about medication use and the risks of leaving medical conditions untreated and uncontrolled. For example, uncontrolled depression can increase the chance for several risks, including the chance for low birthweight and higher risk of NICU admission. If a woman who is in the third trimester of pregnancy is prescribed a medication that has been associated with cardiac malformations, using that medication would be low risk because the period of organogenesis is complete.” Pharmacists can also have influence when it comes to preventive health, such as helping individuals stay up to date on vaccinations. “Pharmacists can play a huge role in preventative health during pregnancy including assisting with smoking cessation, providing and educating on naloxone and educating on the importance of taking a prenatal vitamin throughout the pregnancy,” she noted. Forinash said the Academy could consider adding more training for student pharmacists on obstetric-related healthcare as well as addressing the stigma and implicit bias surrounding mental health, especially during pregnancy. Communication skills and listening to patients are key. “I talk with my students about the importance of developing strong communication skills, establishing rapport while being empathic and advocating for our patients. We also need to meet the patients where they are while addressing potential barriers such as transportation, cost, childcare and so forth. Acknowledging these challenges allows us to connect and advocate with our patients to provide excellent healthcare,” she said. “There is an opportunity for pharmacists to be more involved in obstetric-related healthcare.”
community impact
public health community and harm reduction agencies. Ambulatory or hospital pharmacies can take on greater roles and become experts in that area.” Hager agreed that more can be done to expand curricular offerings regarding addiction, treatment and the pharmacist’s role in harm reduction. “I would love to see community pharmacy practice [expand] and for pharmacists and technicians to feel empowered to be the first line champions and cheerleaders for anyone with a substance use disorder,” Hager said. “Have the welcome mat out for those who come to a pharmacy just like they would for any other patient. Think about having empathy and compassion for a person using drugs. Meet them where they are. If they need sterile equipment, provide that and ask if they are connected with testing to make sure they are safe. Help people get what they need. If they show up and you are open and kind, that goes a long way. It’s being a portal to them getting treatment. All of medicine is harm reduction.” And for many patients, the counseling and a supportive recovery community is crucial, Palombi added. “People do get better. As the recovery community grows, that’s helpful for pharmacists to hear those stories because maybe they just see the negative. How to help patients connect to those social services is just as important as the drug itself.” Hill noted that he has heard encouraging stories about small community pharmacies connecting with treatment programs and engaging in proactive outreach to ensure that patients have stable access. “That’s a lot to ask of pharmacists who already have full plates, but reaching out now when things aren’t quite as stressful to see what collaborations can be developed would be important. The number one thing we need to convey to pharmacists is that we should be taking a harm reduction-oriented approach,” he said. “Many of us were trained in a time when enforcement and prevention were prioritized in our education. We were seen as a gatekeeper to prevent drug misuse. That’s a role we need to play in some cases, but we don’t want to prevent access to buprenorphine and we need to ensure that people with a substance use disorder don’t feel so uncomfortable entering a pharmacy that they don’t seek us out for support, that they won’t obtain naloxone because of a fear of how we see them. Being compassionate is a crucial mindset going forward as opioid deaths are only accelerating.” Hager encouraged pharmacists to take a “there’s no wrong door” approach for people with substance use disorder who are seeking help. “This is a primary care issue. We have a huge opportunity to step up and improve this public health emergency specifically in the community pharmacy setting and specifically in the rural setting where the pharmacy may be all that’s there.” P Jane E. Rooney is managing editor of Academic Pharmacy Now.
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@AACPharmacy
Registration for the Virtual Equity, Diversity and Inclusion Institute is Open: www.aacp.org/edi2022 The virtual Equity, Diversity and Inclusion Institute, co-hosted by the University of Mississippi School of Pharmacy, returns Jan. 19–21, 2022, to help members further advance diversity, equity, inclusion and antiracism efforts at their institution and throughout the Association. In this train-the-trainer model, institutional teams will have the opportunity to collaborate with other faculty and staff across the Academy to help enrich their own plans moving forward. Sessions at this year’s Institute will build upon the work of the 2021 Institute and provide additional breadth and depth to critical issues within higher education and our society, including: a panel of diverse pharmacy students, sharing their experiences in pharmacy education; examples of EDI progress in medical schools across the country and examples of how pharmacy schools are recognizing and valuing EDI work; and guidance on how to be an ally and cause good trouble, while also taking care of yourself when doing the work. AACP encourages any faculty member, administrator or staff person to attend, including participants at the 2021 EDI Institute. Attendees who did not attend the 2021 Institute will complete additional pre-work prior to the 2022 Institute. Registration for the full institute is $129 per person. Prior to registering, team composition should be determined, and schools/colleges are encouraged to have all team members register at the same time to ensure the full team can attend. The team maximum is 10 individuals per team. If a school is unable to send a full team, individuals may still register for the institute using the online form. Registration for the EDI Institute will close on Friday, January 7, 2022 or when space is full.
AACP Awards Now Accepting Submissions Scholarship of Teaching and Learning Grant: This grant provides research funding for active members of AACP who are engaging in educational research. It is important to the future of the Academy that faculty are engaged and creating new knowledge in this area in order to further advance the discipline of teaching and learning. Application deadline: January 12, 2022, https://bit.ly/SoTLGrant Award for Excellence in Assessment: This award acknowledges an assessment initiative or project that uses systematic collection, review, and use of information to improve the Pharm.D. program. Application deadline: Feb. 9, 2022, https://bit.ly/ExcellenceInAssessment Emerging Teaching Scholar Award: This award is designed to recognize excellence of our academic pharmacy faculty engaged in and/or supporting scholarly teaching and the scholarship of teaching and learning. Application deadline: Feb. 25, 2022, https://bit.ly/EmergingTeachingScholar 22
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@AACPharmacy
Registration Now Open for INvigorate 2022 Informative sessions will address: AACP INterim Meeting
2022 February 19–22 * San Diego, CA www.aacp.org/invigorate2022 Plan to join your colleagues Feb. 19–22 in San Diego, Calif., for three-and-a-half days of networking, learning and problem-solving. You’ll leave re-energized and ready to implement new ideas and strategies to help you prepare for transformation in pharmacy education and practice. Start planning your travel to San Diego and register today at www.aacp.org/INvigorate2022.
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The importance of establishing connections between academic pharmacy and national pharmacy organizations
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How institutional leadership can create a welcoming environment to support DEIA efforts
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Innovative approaches to transform pharmacy practice on all fronts, and with everyone who plays a role
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Making global connections with schools of pharmacy and the impact an international experience abroad can have on students
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Best practices from across the Academy to promote and maintain the well-being of students, faculty and staff
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CAPE outcomes, EPAs, competency-based education and the opportunity to provide input on their implementation
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Ways to support faculty at every stage in their career with mentorship and professional development opportunities
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Pharmacists Help People Live Healthier, Better Lives.
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Renew Your Membership by Dec. 31! Over the past year, AACP has helped members establish meaningful connections, build upon new and existing relationships, and access valuable career resources. Renew your membership today to take advantage of all the networking and professional development that AACP has to offer in 2022:
Join discussions relevant to your field. Collaborate virtually throughout the year with faculty, administrators and staff via AACP Connect. More than 3,000 discussions have been posted this past year! Access valuable resources. Learn from your peers in members-only Special Interest Groups or Sections. And join numerous programmatic Webinars, many with CE credit, to take advantage of professional development resources and opportunities. Last year, AACP hosted more than 80 member webinars on a variety of pharmacy education topics. Stay up-to-date on pharmacy education news and opportunities. Explore valuable content from publications such as Academic Pharmacy Now magazine, the American Journal of Pharmaceutical Education, bi-weekly AACP E-lert newsletters and monthly Career Center notifications.
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View industry trends by accessing institutional research data, including the Profile of Pharmacy Faculty report and the quarterly Pharmacy Demand Report. Bolster your career development. Immerse yourself in a year-long leadership experience through AACP’s Academic Leadership Fellows Program (ALFP). And much more at www.aacp.org.