Welcome to our series on the plethora of careers in pharmacy. Dr. Lara Tran ’23 is a clinical pharmacist at St. Joseph’s Health, a regional health system based in Syracuse, N.Y. (She is pictured above following ACPHS' May 2023 Commencement at the Saratoga Performing Arts Center.)
What do you do as a clinical pharmacist in the hospital?
Inpatient pharmacists have a variety of roles. Some go to ICUs or the emergency department or oncology clinic. After graduating from a PGY1 (postgraduate year one) residency here, I now work with the teaching teams at my hospital, which include medical residents, an attending physician, sometimes medical students and of course a pharmacist.
We do rounds in the medical resident’s office. We go through our 20-plus patient census and develop a treatment plan for each patient. My role is providing recommendations — dose-adjusting medications, streamlining antibiotics, resuming a patient's home medications for depression, heart failure, whatever it may be — and sometimes answering drug-information questions.
Pharmacists are clinicians. We provide a lot of knowledge to the team.
Do you have direct contact with patients?
Yes, especially at the transitions of care. If we have a patient on our team who is going home, I provide discharge counseling. I review their medication list and ensure there are no discrepancies – for example, ensuring that a medication that may have caused their hospitalization is not continued. I spend most of my time counseling patients on their new medications, as they might not even know why they are starting them, which may cause confusion and stress when they return home.
Being discharged from a hospital can be overwhelming. Many people come through a patient's room on discharge day, giving them a ton of new and important information. Sometimes, patients are not even aware they will go home on new medications. Having a pharmacist involved in that transition of care can prevent readmissions. It may even be lifesaving.
How did you choose to start your career in this area of pharmacy?
I was always fascinated with medicine. I come from a long line of physicians in my family, but I wanted to be more behind the scenes. ACPHS provided me with the academic knowledge and the hands-on experiences to develop my passion for inpatient pharmacy.
The curriculum provides a strong foundation in pharmacotherapy, and I really enjoyed the courses that tackled complex patient cases. I was able to implement all that knowledge I learned in my last year during my APPE (Advanced Pharmacy Practice Experience) rotations, which gave me the hands-on exposure. I was able to see how critical a pharmacist is on interdisciplinary teams, helping to manage complex cases and developing specific medication regimens for patients.
Inpatient pharmacy combines my love for clinical problem solving, my interest in pharmacotherapy and my desire to make a meaningful difference in patients’ lives.
What do you like most about your work?
Working with the health-care team — the nurses, the medical providers, even the dietitians or respiratory therapists. I love how inpatient pharmacy allows a pharmacist to work on a collaborative team with different specialties, with the goal of treating each patient to the best of our abilities.
What kind of person would be best suited to this environment?
Someone who is always open to learning; I am learning new things every single day. Also someone who is dedicated to patient care and willing to embrace challenges.
Inpatient pharmacy is not an easy line of work. There will be days when you are stuck on a patient, when you need to do more research, you need to pull out some resources. Especially if you work in internal medicine, you see everything — infections, heart failure, atrial fibrillation, diabetes, it's not one niche disease state. You need to be quite comfortable with a lot of things.
What advice would you give to someone interested in pursuing this career path?
My best advice for a student is to be involved on campus. A lot of professional organizations target different clinical areas. There’s a pediatrics organization, a geriatrics organization, a clinical one and so on.
Also, I would say, get comfortable with not being comfortable. During my fourth year of pharmacy school, I had a few rotations that I knew I was not going to be comfortable in. But at the end of the day, those were my most valuable rotations. The clinical knowledge as well as the interpersonal skills I gained shaped me into who I am today.
Is there anything else you’d like to share about your work?
This career path is very rewarding. I leave work every day feeling like I've made a difference — whether it's something small, like adjusting someone's medication for their renal function, or something big, like recommending an antibiotic for a multi-drug-resistant bug.