Q&A: As a new practitioner in a clinical role, what are the most important things to focus on in my first year of clinical pharmacy practice?

As a new practitioner in a clinical role, what are the most important things to focus on in my first year of clinical pharmacy practice?

Thomas Wert, Pharm.D. 

PGY1 Pharmacy Resident

Vanderbilt University Medical Center 

Nashville, TN

Your first year of clinical practice is a turning point in both your personal life and your professional life as a clinical pharmacist. It is finally the end of the residency experience, and you feel as if you can press play on other aspects of your life. As you transition into this new, exciting, and possibly overwhelming time, I recommend being mindful of at least three key things during your first year in clinical practice: (1) relationship building, (2) creation of a sustainable workload, and (3) evaluations for success. These three things helped me tremendously in my first year. They also helped provide a solid foundation on which to grow my site.

Relationship Building

Professional relationships can make or break your happiness at your new clinical site. Building good rapport both within your department and interprofessionally will help with building trust, advancing your practice, and advancing the profession. People may have certain preconceived notions of what you can do and what you can bring to the team. Some of these notions can be great, whereas others may greet you with resistance. Take everything in stride, and find people who will be your champions. For example, very few prescribers at my site had ever worked with a clinical pharmacist. They had no idea of our training or what we could do legally within the realm of collaborative practice. Once they realized it and got to know me as a competent health care professional, they drastically increased their referrals and uptake of my recommendations. Easy ways to build rapport include sitting in on interprofessional meetings, attending interprofessional CE dinners, and attending as many work functions as you are invited to. People tend to be more responsive and approachable once you get to know them and interact with them on a more humanistic level.

Creation of a Sustainable Workload

Creating a sustainable practice isn’t as easy as it sounds. I personally found it very difficult as a new clinician to say no to anything. However, one crucial tool for creating a sustainable practice is implementing timelines for clinical activities. These clinical activities may vary depending on whether your site is new or established, whether you are in a faculty role, whether you plan to take student or resident learners, and the types of services you and your site are interested in. It is vital to remember that you are no longer a resident on a supersonic speed timeline. This is the first year of many! Timelines need to be reasonable and mutually agreed on by you and your supervisor. For example, as a new clinician, I was coming into a brand-new clinical site as a faculty member, where I would be precepting student and resident learners. My department chair and I outlined a 2-year plan whereby I would build up to my full potential. We were also very deliberate on my plans to prevent burnout, practice self-care, and promote sustainability. All of these practices helped me establish a good work-life balance and even start a family.

Another part of creating a sustainable practice includes having a plan to stay up to date with the literature to maintain your clinical expertise. Keep on top of new advances within the field in whatever way is easiest for you. Some of the methods I have found helpful to improve efficiency include hand-picking the student journal clubs and topic discussions that align with recent updates and my interests. Another method that keeps me up to date and invigorated with my profession is staying involved in professional organizations like ACCP.

Evaluations for Success

Finally, keep in mind how you will be judged for success in your new clinical role. There is no PharmAcademic in the real world (thank goodness), but every employer will have standards regarding how you will be evaluated for success. Your evaluation standards will likely be a mix of personal goals and standards that everyone in your department is held to. Make sure you understand these going into your role, and make strides to meet these goals. Knowing these goals may also help justify the projects you dedicate your time to. For example, if you know research is part of your evaluation, try to be efficient and expand your practice into something that will be researchable after you have a year or so of data under your belt. This is one reason I liked implementing mutually agreed-on timelines, because it aided in the objective measurement of success in my role.

Try your hardest not to compare yourself with others early in your career because they are likely in other phases of their journey. It is good to have strong ambitions, but don’t let those stop you from celebrating your everyday accomplishments and everything you’ve done to earn your position! Don’t let your first year of clinical practice overwhelm you. Many others have gone through this process. It can be normal to feel a sense of imposter syndrome, but you have put in the time and dedication to get to this point. Have confidence in yourself but know you have created a lot of connections through your training. As you cultivate new professional relationships, don’t forget to keep in contact with the vital preceptors and mentors you established as a resident. I still keep in contact with this network, and they can also help you navigate your time as a new practitioner.

Kimberly L. Zitko, Pharm.D., BCACP, BCGP

Assistant Professor, South College School of Pharmacy

Ambulatory Care Clinical Pharmacist, Trinity Medical Associates

Knoxville, TN