Featuring: Christina Swiger, PharmD Candidate c/o 2023
By: Justin Budz, PharmD Candidate c/o 2023
Christina Swiger is a sixth-year pharmacy student at St. John’s University. Christina was inspired to pursue a career in healthcare by her mother who is a store manager at a community pharmacy. Growing up, Christina was able to aid in the care of a close relative, building her curiosity in the pharmacology behind medications. Finding a perfect fit in pharmacy practice, Christina is currently completing her APPE rotations near her home in Pennsylvania, where she has had several unique experiences, including a rotation in pharmacy association.
What clubs and organizations have you been a part of at St. John’s?
I’m a member of the American Pharmacist’s Association (APhA), the American College of Clinical Pharmacy (ACCP), and the Student Society of Pediatric Pharmacy (SSPP).
What was your favorite experience out of these organizations?
As a member of ACCP, you can sign up to have mentees. Last semester, I started with two mentees that were both second-year students. This year, I have a fourth-year student. I think it’s special to be able to build connections with younger students while also being able to guide them through school and classes.
How were you able to complete most of your APPE rotations from Pennsylvania?
I’m probably the first student from St. John’s who’s ever done a majority of their APPE’s out-of-state. My first two rotations were with faculty. Other than an online rotation I have coming up, I managed to get six of the nine APPEs in Pennsylvania. I reached out to every connection I have ever made and wrote, “I know you take students from these schools, but what would your opinion be on taking a student from out-of-state?” Although I got a lot of rejections, I eventually did find enough people that did say yes.
What is the process to get an out-of-state APPE rotation approved by St. John’s?
When a preceptor first agrees to take you as a student, you send that email communication back to the experiential office. Dr. McAvoy handles all the out-of-state contracts. There are multiple forms that need to be signed by both the preceptor and St. John’s. It’s a lengthy process and can take a lot of work, but if you’re motivated enough to do it, it’s possible.
What has been your favorite experiential rotation thus far?
My favorite experience has been with the two rotations in the Impact Bundle. The first rotation was with Dr. Ezzo in an ambulatory care setting with medical residents. I would work up three or four patients each day and go through all their medications and labs. It was nice to have that experience straight out of classes so that I could apply everything that I learned. The second rotation was in the Impact Clinic, which was made up of four faculty-run clinics. The Impact Clinic mainly provides care to Medicaid patients. Our focus was on improving healthcare costs to come up with the best options for patients with minimal financial resources. At the Impact Clinic, I was able to follow 10 to 12 patients each day and present their cases to the attending physician and medical residents.
What was an important lesson that you learned from the Impact Bundle?
Although we have so much knowledge as pharmacy students, it’s okay to not know an answer. Going into rotations, some students may be scared that you have to have all the answers. In reality, most people are more than okay if you say, “I don’t know this, let me look it up and I’ll get back to you”.
Tell us about your APPE rotation in association management.
The APPE rotation was with the Pennsylvania Pharmacists Association in Harrisburg, Pennsylvania. I was able to attend a lot of committee meetings, including poster committees, nomination committees, and government relations committees. These meetings gave me the opportunity to speak with the overheads of different national associations like the American Society of Health-System Pharmacists (ASHP) and the American Pharmacists Association (APhA). During these meetings, we would talk about the different legal advances in pharmacy happening within different states.
I also had a unique opportunity to work with different teams to make the Prep Act permanent. In Pennsylvania, interns can’t immunize legally, except with the Prep Act, which became active during the COVID pandemic to allow interns to administer COVID and influenza vaccines. One of my projects was to make an appointment with my local house representative and senator. I got to sit down with them individually and talk to them about the importance of making the Prep Act permanent.
During my rotation, I also got to see a bill get passed in Pennsylvania. The bill granted the Auditor General legal authority to audit Pharmacy Benefit Managers (PBMs). This process has been ongoing for around two years now, so I got to see it passed on the last day of session. It all happened because one of the members of the Pennsylvania Pharmacists Association formed a relationship with their local representative, who ended up being one of the last people to sign on to the bill which is what got it passed. This goes to show that sitting down with local representatives and forming relationships can help create conversations and move pharmacy forward.
Lastly, I got to meet with many student pharmacists. Students from Duquesne University came to the capitol where we met up and taught them about our work within the Pennsylvania Pharmacists Association. I also got to travel to Jefferson University in Philadelphia and talk to students about the importance of our organization and its impact on pharmacy practice.
What made you want to pursue an APPE rotation in association management?
I’m very clinically focused so I wanted to do something that I’m not comfortable with to help me become more well-rounded. This rotation helped me gain a better understanding of how everyone works together. Without this experience, I would never have known about how intensive legal processes can be and how closely different organizations are pursuing provider status for pharmacists.
What tips do you have for pharmacy students as they progress through pharmacy school?
In terms of coursework, remember that it’s not the end of the world if you don’t do as well on an exam as you may have hoped. There are always options to figure out how to work through difficult courses. In terms of moving into APPEs, it’s okay to go into a rotation feeling confused. It’s okay to admit that you don’t know something, as long as you take steps to figure it out. Getting comfortable with this idea will help you be more than successful on rotations.
What are your post-graduation goals?
I want to pursue a residency. I have very strong interests in pediatrics, as well as in ambulatory care. My rotations have helped me learn more about these areas, so either of those focuses would be perfect.
