Professional Advice / Opinions:

Surviving APPE Rotations

By: Aleena Cherian, Co-Copy Editor [Graphics-Focused] and Jenny Prakash, PharmD Candidate c/o 2014

Starting your rotations in 5th year usually brings mixed emotions. On one hand, it’s a relief to finally be finished with labs and D&Ds…imagine, a whole year without any exams! But on the other hand, now you have to test how well your book knowledge stands up to real world application. Here are a few tips to help you navigate the world of rotations and to make the most of your experience.

Be prepared!

We can’t stress enough how important it is to prepare yourself for each rotation- whether it’s paperwork, travel and parking arrangements, or reviewing drugs and disease states prior to starting. Nothing kills adjusting to a new site like having to make up for lost time, especially since you only have 4 weeks.

First, always contact your preceptors using their preferred method of contact one to two weeks before the start of each rotation to introduce yourself, and to let them know you are coming and when you are coming. Don’t forget to ask them if they need any site-specific documents or clearance, and always ask if there is anything you can do to prepare for the rotation. Some preceptors may require readings or assignments to help you prepare for the specific duties of that site.

      Complete and bring all required paperwork and documentation, especially your health clearance. Keep track of when it expires, and make sure to complete all requirements prior to the expiration date. Starting this year, this also includes getting your flu shot each season!

If the specific site has provided any documents or information on RxPreceptor, make sure to read up on the rules, expectations, dress code, and anything else available to you, so you know what to expect when you start. If you’re starting a specific clinical elective, take some time to brush up on things like clinical guidelines and drug classes so you’ll be much more prepared to handle the work.

      Learn the travel directions to your site ahead of time, and if it’s completely unfamiliar to you, consider visiting the site before the rotation begins to avoid any surprises. In hospitals or specialty centers, you may also need to find out where the pharmacy is located in the building if your preceptor hasn’t arranged to meet you. If you are driving, note that not all sites have parking lots available, so be prepared to find street parking or make other travel arrangements. Always give 15-20 minutes of extra time for lost or empty MetroCards, accidents and road closures (especially in the winter!), subway or LIRR delays, getting lost, finding a parking spot, and any other complications that could come up on the first day.

Get to know your References and Guidelines

You will be asked many drug information questions by your preceptors, by patients, or by other medical staff. It’s ok to not know every answer at first, but you should always know where to look it up!

Some useful apps for your smartphone or tablet include Micromedex for drug reference and Epocrates for drugs, interactions, and tablet identifiers. Also, if you are in a diverse area, consider apps such as MediBabble to translate basic medical phrases to other languages, especially Spanish, in order to accommodate the Spanish speaking patients whom you’ll encounter frequently in the NYC area.

For clinical information, always refer to reputable and up to date sources and clinical journals (no textbooks or class notes!), such as Pharmacists/Prescriber’s Letter or New England Journal of Medicine. Familiarize yourself with clinical guidelines for the most common disease states (e.g. JNC 8 for hypertension, the ADA Guidelines for diabetes, and various CHEST guidelines for cardiac and thrombotic conditions), and always keep track of when they are updated so you refer to the most recent edition.

Stay Updated

Now that you’re no longer in class, you won’t have your professors to tell you when there is a new guideline, a new drug on the market, drug shortages, or drug recalls. During rotations and in your future, it is essential to take the initiative to stay updated for the changes and new developments in the profession.

Some useful resources to keep up with newly approved drugs and indications include the FDA website and the “Product Showcase” section of APhA’s Pharmacy Today, which is available online. Medpage Today ( is also a great website for recent news and events in the medical and healthcare field, and you can sign up to receive free daily updates via e-mail.

Make the most of your time

It sounds cliché to say that rotations are “what you make of them,” but in the end, it is up to you to use the time you spend at the site to your advantage. If no one is watching over your shoulder, it’s tempting to sit back and let the hours pass, killing time on your phone, “Instagram-ming” your lunch or updating Twitter. However, being proactive will make all the difference – ask if there’s anything you can do to help the site, take on new projects, or in your downtime, read up on new developments or drugs.

Think Ahead!

Even though graduation still seems a long way ahead, it’s never too early to begin thinking about your postgraduate plans. As you consider staff positions, residency, research, fellowships and more, tailor your rotation experience to meet your long term goals: ask preceptors if you can work on projects in your area of interest, speak with pharmacists about their own education and the career paths which brought them to where they are today, and ask if there are any research opportunities you can get involved with, especially a long term project on which you can present a poster or abstract. Build good relationships with your preceptors and consider asking them to review your CV or even write a letter of recommendation before you finish at the site.

Be Professional & Confident

While this may go without saying, remember that you are representing yourself as well as the University, so conduct yourself with the highest standard of professionalism, whether you are dealing with pharmacists, other healthcare providers, or patients. Dress professionally but comfortably (business casual) and adhere to any site-specific dress codes. Also remember to wear your (clean) white coat, name tag, and if applicable, ID badge for the site.

Don’t be afraid to say that you don’t know the answer to something, but always know where to look it up (see above), and simply say you will “get back to them with more information.” When you provide recommendations to patients or physicians, be able to back up your information with reputable sources and studies and always present the information in a clear, informed manner.

When you speak to others, especially to preceptors and other medical staff, being confident with a pleasant demeanor will make a tremendous difference. While knowing your clinical information and being prepared is a large part of speaking with confidence, your tone of voice, body language and other nonverbal communication (remember from speech class and CPP) also speak volumes.

The idea of leaving the familiarity of classes may be daunting, but remember that you’ve been preparing four and half years for this and it will be one of the most rewarding times of your pharmacy career. Take initiative and be prepared, and you’ll be able to make the most of this experience!

Published by Rho Chi Post
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