By: Maimuna Maula, PharmD Candidate c/o 2026
Your sixth year of pharmacy is unlike any other. Although you are still technically a student, you no longer have routine classes. Instead, this is a year meant for you to explore pharmacy beyond the classroom before you graduate and commit to one specific area.
I had mixed feelings as APPEs were approaching. One side of me was relieved that the daily classes were ending, and the other side was very intimidated to begin working in a pharmacy full-time. I felt like I wasn’t ready to bring classroom knowledge into the real pharmacy world yet. Pharmacy school is immensely rigorous, especially with the drugs and diseases (D&D) classes, where we learn massive amounts of information and quickly move onto the next topic. It was difficult for me to fully absorb material for long-term use. Because of this, I didn’t feel confident that I would have a smooth time during APPEs.
But I soon realized that this isn’t what APPEs are about. It is true that you are graded by your preceptors for your performance, but the concept of these rotations goes far beyond that. There are two different ways to look at your sixth year – just another hurdle to pass before you graduate, or a rare and invaluable opportunity to gain experiences that you may never receive again later in your career. The latter is the intended reason APPEs exist. The amount of exposure, networking, and knowledge you gain from this year is so impactful, and it is imperative that you maximize these opportunities as much as possible.
How to Address Feeling Intimidated by APPEs
APPEs are not as difficult as they might sound. Some sites may sound intimidating based on what you may have heard from others’ experiences, or you may feel that certain rotations expect higher than what your skill level can offer. But the truth is that you are ready. You do not have to know the answer to every question you are faced with. The key is that you need to show interest and effort when addressing situations.
For example, if your preceptor asks you about which drug is used for a certain disease and you do not know the answer, be honest about it. Admit you are not sure or take your best educated guess if you can. Then ask your preceptor follow-up questions about its side effects or other alternative therapies to this drug. Take initiative by researching it yourself on LexiDrug. Preceptors want to see that you’re truly interested and following along with what they are trying to teach. They value your curiosity and desire to critically think about the material.
You can also suggest pharmacy topics to them that you are interested in. Preceptors are always willing to hear student perspectives. You can take it a step beyond therapeutics and ask about what their daily work routine is like, advantages and disadvantages of different pharmacy settings, and more. But remember to stay professional and always read the room. Preceptors vary from being firm and meticulous, to more lax and lenient. No matter how they are, always show each one the same amount of respect. Preceptors are taking time out of their schedules to help teach you alongside their numerous other responsibilities, so be sure to make each conversation feel productive and worth it. Turn it into an ongoing discussion instead of making it feel like a lecture. It’s not simply for their satisfaction, but for your benefit as well. You are going to be in their position someday, so ask them as many questions as you can to build up your own knowledge. I was quite surprised when I realized how relevant D&D is in clinical practice outside of the classroom. There were so many topics that I thought I’d never see again, yet they still made an appearance. I would recommend keeping a notebook with you while you are onsite and writing down any new pharmacy fact you learn. I kept a notebook with me throughout each day at my inpatient care APPE, and many of those things still stick to me today because I experienced them in real life and manually wrote it down together. It was satisfying to see my classroom knowledge coming into full fruition in clinical practice. Find whatever method you can to help solidify information for you. Your preceptor will appreciate these efforts, and your future-self will too.
What Type of Mindset Should you Have When Choosing APPE Sites?
After you start working as a full-fledged pharmacist, chances are that you’ll be in one field for an extended period of time. It is possible to branch out and explore other outlets, but it’s much more difficult to do compared to your intern days. During your APPE internships, you have nine whole opportunities to experience different areas that you likely have never seen before. If you dislike one rotation, you do not have to stress, as it’ll be over in just four weeks. You will not be stuck in that site for years. If you do like one, you can use it as a stepping-stone to propel you towards a field you might want to commit to full-time in the future.
For example, some of my classmates were considering a hospital pharmacy career – but after going through their inpatient care APPEs, they realized that this field isn’t for them. As for me, I’ve never worked in a chain retail pharmacy before, so I decided to challenge myself and try an APPE there. Some people love it, but I learned that it’s just not for me. I still enjoy community pharmacy though, and this experience helped me distinguish which aspects of it I care about the most.
My first APPE was an academic administration elective where we learned about the inner workings of what it takes to be a faculty member in a PharmD program. This rotation offered a behind-the-scenes look at how the whole pharmacy educational system works from the perspective of a faculty member, which was very fascinating to me. I was considering getting into academia beforehand, and this APPE helped me paint a better picture of what it takes to do it. This field is something that most students don’t know about until they take this elective, and I’m very grateful to have had such an opportunity. I also have an upcoming APPE with the New York City Poison Control Center. It’s a non-traditional field that offers exposure to toxicology and public health services. Although it’s not a common field, I decided to try it out. Even if it doesn’t line up with my career goals, at least I will have gained the exposure.
APPE sites can be impactful even when it is least expected. Before starting my general inpatient APPE rotation at a rehabilitation center, I always thought it would not be an enjoyable experience for me. I previously had no interest in working in a hospital as a clinical pharmacist, so that rigid mindset damaged my impression of this site before even entering it. But after completing it, I have to admit that I actually enjoyed it. This field is still not the main priority for me, but I do consider it an actual option now. This rotation was much more influential than I had ever imagined it’d be.
I do not have any rotation located in a true hospital setting. I intentionally designed it that way because I was hesitant to work there. I recently realized that once I finish my APPEs, I will never have seen what that type of environment is like. I also wish I had picked at least one pharmaceutical industry site on my schedule. For all upcoming APPE students, aspects like these should really be taken into consideration. There are so many fields out there, and I urge all students to not approach these APPEs as just mere assignments to trudge through. Do not only pick the places you think are ideal fits for you. Think of each APPE as a preview to a full-time career. At the end, see which one you gravitate towards the most. One of those sites might define the rest of your professional life.
Networking during APPEs
During my years of classes, I always kept a low-profile. I was a very quiet student, and I didn’t understand what the benefit of networking really was. But now I can confidently say that I have a strong professional network with me. Every student will get at least two faculty preceptors, which are professors that are part of St. John’s University’s pharmacy program. I chose to have five of them. Many students are hesitant to choose faculty preceptors due to the fear of difficulty, but the reality is that you will receive nothing but positive experiences from working with them. Every single preceptor I’ve had has been nothing short of helpful in teaching and answering any sort of question I have. After your four weeks are over in their rotation, don’t consider that as the end of your interaction with them. Stay in contact by emailing them – ask questions, notify them of something interesting that happened during your work, and congratulate them on their professional achievements. They value these connections more than you may realize. Don’t restrict yourself to doing this with only your faculty preceptors though. Do it with all your preceptors, especially ones in areas you’re really interested in. I have noticed that pharmacy is such a small world. Many of my preceptors know my other preceptors, even in the most unexpected areas. They’re all somehow connected one way or another, which can really help you build valuable references. One of the tips I learned was to list every one of your preceptors’ names on your CV, because there’s a high chance the person reading it will recognize at least one of them. If you’re interested in becoming a part of industrial pharmacy, networking is especially fundamental. Industrial pharmacy is a very competitive field, and while networking is not the sole path to getting there, it still serves as a powerful advantage. Leverage the connections you make during your rotations as much as possible no matter which path you are inclined towards, because no path is ever a straight line.
Final Thoughts
Your final year of pharmacy is a once-in-a-lifetime opportunity. It’s not just about applying what you learned in school, but a chance to influence what the rest of your professional life could look like. You are offered nine glimpses of pharmacy careers, all of which could steer you in directions you may or may not have expected. Exposure is what matters the most. It might be an intimidating leap transitioning from classes to full-time APPEs, but your preceptors are there to guide you along the way. Choose each rotation very wisely and try your best to diversify them as much as you can. Approach each rotation with curiosity, effort, and an open mind.
