Licensure.pdf

Licensure, Life-long Learning, Residency, and Fellowship JULIE J. WILKINSON, PHARM.D., MS, BCPS  Discuss life-long learning and continuous professional development for pharmacists Explain the process for obtaining a license to...

Licensure, Life-long Learning, Residency, and Fellowship JULIE J. WILKINSON, PHARM.D., MS, BCPS  Discuss life-long learning and continuous professional development for pharmacists Explain the process for obtaining a license to work as a pharmacist Describe the testing requirements for pharmacist licensure Learning Use websites and resources important to the licensure process Objectives Describe the different types of PGY-1 and PGY- 2 pharmacy residencies Describe pharmacy fellowships and how they differ from residencies Explain the benefits of completing a residency or fellowship Life-long Learning Overview Board Exams Residency Jobs, appointments, volunteer service Doctor of Pharmacy Licensure with continuing education 1–2-year renewal Masters Board Certification 7-year renewal Certificate Masters Certificate Conferences  Center for the Advancement of Pharmacy American  Education (CAPE Outcomes) Association  www.aacp.org/resource/cape-educational- outcomes of Colleges  American Association of Colleges of Pharmacy (AACP) of Pharmacy  Results of the Doctor of Pharmacy Education (AACP)  Included in the syllabi of the LECOM School of Pharmacy  Accredits schools of pharmacy Accreditation Council for Requires reporting and Pharmacy on-site visits Education (ACPE) Monitors performance of graduates  Complete the Doctor of Pharmacy degree Transcripts BOP Forms for degree verification Eligibility Apply for licensure with a state board of pharmacy Pick a state for Research the requirements of that state/jurisdiction Licensure Apply to NABP for eligibility to take their exams https://nabp.pharmacy/programs/naplex/ Registration Bulletin New version each year All states require the NAPLEX MPJE is state-specific Process of Application 1. Apply for licensure with a state board of pharmacy 2. Apply to NABP for eligibility to take the exams 3. The state BOP will notify NAPB after they determine that you are eligible to take the exams 4. NABP will email when you are allowed to purchase your exams 5. Purchase your exam and then you will receive Authorization to Test (ATT) from Pearson VUE 6. Schedule your exam at a Pearson VUE Testing Center (locate testing centers online)   Find the website and the most current information  Find the application for new graduates  Read the application process State Board  What documents do you need to gather and of Pharmacy  submit? LECOM registrar processes paperwork for individual states  [email protected]  [email protected]  Costs  NAPLEX Application Fee $100 Examination Fee $475  MPJE* Application Fee $100 Examination Fee $150  State Board Application Fees (Examples) FL: $295 + $55 for immunization certification PA: $45 + $30 for immunization certification *for each jurisdiction  Example Timeline  Graduates apply to BOP and NABP at the time of Commencement ▪ One-year timeframe for completion starts the day you submit  Graduates request transcripts or forms from LECOM if needed  LECOM submits transcripts to NABP after Commencement  Graduates receive email notification from BOP the application is approved  Graduates receive email from NABP allowing exam purchase ▪ NABP may take 10 days to process transcripts  Graduates purchase and schedule the exams with Pearson VUE   Each State Score Transfer $75 for NAPLEX  Only necessary if applying for more than one state Retake after failed attempt Extra costs   NAPLEX - 45 day waiting period and $575  Limited to 3 attempts within 12 months  After third failure, must reapply  Limited to 5 total attempts (if allowed by the state BOP)  MPJE – 30 day waiting period and $250  Limited to 5 total attempts (per state)  Fee for reschedule - $50  Missed appointment  $475 NAPLEX, $150 MPJE  30 minutes late to arrive or incorrect ID  Emergency - $170 NAPLEX, $100 MPJE Exam Administration   Pearson VUE  http://www.pearsonvue.com/nabp/  Testing software tutorial (Pearson VUE Demo)  Rules are specific to the NAPLEX and MPJE Test  Remember other people in the testing center are not under the same rules you are under administration  It is your responsibility to know your rules  Video of security procedures  https://home.pearsonvue.com/test- taker/security.aspx  Day of Exam  Arrive at testing center least 30 minutes early to allow for check-in procedures. You may be required to forfeit your appointment if you do not allow enough time.  Bring 2 forms of identification, at least one of which must be a current United States or Canadian passport, military ID, driver’s license, or state or province ID.  Name on ID must match name on exam registration and ATT Important! - Name Matching   Study materials are not allowed in the testing center Day of Exam  You will get a locker if necessary for coat, keys, etc.  Bring a water bottle and snack for breaks  Don’t look at your phone during a break! Leave it in the car.  Tissues and earplugs/headphones available at testing center upon request, you cannot bring your own  There is a list of comfort items that can be brought into the testing room  Exam Area  Every time you enter/exit you must call over a proctor to release you – scan palm and show ID every time  Must remain seated at your workstation  Cannot leave testing center for any reason once test has begun  You get a white board notebook and dry erase marker  On-screen calculator and may request basic calculator   The number of items on the exam is 225  200 count toward the score  25 are pre-test questions (not scored)  It is impossible to know which count NAPLEX  The time to take the exam is 6 hours with two Format 10-minute breaks that are scheduled and optional  The examination is not modified based on your choices   “Majority” of questions are asked in scenario- based format  Patient profile NAPLEX  Medical record Require scrolling, clicking tabs Format  Continued  Scoring uses difficulty weighting  All questions must be answered in order, cannot skip NAPLEX  Pass or Fail  If you fail, you will receive a Scoring report of your relative performance on the 6 major competency areas NAPLEX Blueprint  NABP Website lists the details of what may be covered  Area 1 – 18%  Find important patient information from a patient case  Lab values and drug monitoring  Area 2 – 14%  Pharmacology, mechanism of action, therapeutic class  Boxed warnings, pregnancy/lactation  Prescription/OTC, brand/generic NAPLEX Blueprint  Area 3 – 35%  Clinical determination of medication without an indication, untreated conditions, duplication of therapy  Contraindications, precautions, adverse effects, drug interactions  Application of clinical guidelines  Area 4 – 14%, Calculate:  Patient factors such as BSA, CrCl, ANC  Quantities of drugs to dispense and use for compounding  Nutrition, rates of administration, dose conversions, drug concentrations  Biostatistics and pharmacokinetics NAPLEX Blueprint  Area 5 – 11%  Sterile and non-sterile compounding including hazardous  Drug product properties for stability, compatibility, pharmacokinetics  Storage, packaging, disposal  Area 6 – 7%  Medication safety with the medication-use system  Prevention, screening, vaccination, antimicrobial stewardship MPJE  Multistate Pharmacy Jurisprudence Examination  120 Questions  100 count toward your score  20 are pre-test and do not count  Testing time is 2.5 hours  No scheduled breaks  The test is specific to a state  Must take a separate MPJE for each state if applying to more than one state MPJE Content  Laws and regulations that must be followed in pharmacy practice  Federal  State  Questions ask what pharmacists need to do in order to act in compliance with all the laws or regulations that relate to the action described  Board of Pharmacy members in each state write questions  Study resources from NABP https://nabp.pharmacy/resources/publications/  Pre-MPJE is available for $65  Students are responsible to apply Licensure   Must apply for licensure with at least Process one state  Register with NABP to take the exams  Schedule exams at Pearson VUE testing center  State-specific variations in the process and the requirements  MPJE is state-specific   Required to renew the pharmacist license  States set requirements through legislation  Pharmacy Practice Act Continuing  States clarify requirements through rules  Boards of Pharmacy Education  Number of hours are specifically defined  Certain subjects may be required  Manner of learning may be specific, such as requiring some hours received in live sessions  CE – Continuing Education Continuing   CPD – Continuing Professional Development Professional  Five components Development   Reflect on your practice Conduct a learning needs assessment  Develop a learning plan  Implement the learning plan  Evaluate the learning plan outcomes What is a pharmacy residency?  It is a post-graduate training program for pharmacists that lasts 1 year  Involves developing clinical skills in:  Direct patient care  Practice management  Pharmacy residency is optional but is highly encouraged for those interested in further refining their clinical skills after graduation Post-Graduate Years (PGYs) Post-Graduate Year 1 (PGY-1) Post-Graduate Year 2 (PGY-2)  Enhances general  Builds upon competencies competencies in established in a PGY1 pharmaceutical care residency  Builds upon skills, attitudes,  Focuses on a specialized area and abilities acquired from  Provides rotations that focus pharmacy school on that specialty area  Provides wide range of rotations in different areas of practice Types of PGY-1 Residencies Pharmacy Practice Community Pharmacy Managed Care PGY-1 PGY-1 PGY-1 Generalized Practice Pharmacy practice management in a management with Usually in a hospital community insurance or outpatient pharmacy companies facility Also focuses on Involves reviewing Can provide both business & new medications on inpatient and management market outpatient Commonly Analyzing cost data experiences practicing MTM Analyzing clinical study data Clinical Rotations During Residency  Pharmacy residencies allow the resident to follow a rotational schedule  Core rotations are required rotations that are 4-6 weeks long  Longitudinal rotations are required rotations that extend for the entire residency year but may be only 1-2 days per week  E.g. Hospital pharmacy staffing every Tuesday  Elective rotations are optional rotations that last 2-6 weeks and are selected based on the resident’s preference PGY-1 Pharmacy Practice Residency Example Schedule Core Rotations (4-8 weeks) Longitudinal Rotations (year-long)  Orientation (hospital pharmacy  Pharmacy staffing, leadership/academia, staffing and ambulatory care) research/drug information, ambulatory care  Internal medicine  Antimicrobial stewardship Elective Rotations (2-4 weeks)  Behavioral health  Ambulatory care, pharmacy informatics,  Long-term care post-acute care/transitions, emergency medicine, geriatric behavioral health,  Pharmacy management/patient pediatric behavioral health, outpatient safety behavioral health  Inpatient rehabilitation  May repeat any core rotation  Community What about PGY-2 residency?  After completing a PGY-1 residency, pharmacists may consider pursuing a PGY-2 residency  PGY-2 further enhances clinical skills of a pharmacist  A PGY-2 also helps pharmacists become specialized in a specific area of pharmacy practice  PGY-2 residencies also last 1 year in length Types of PGY-2 Residencies  Ambulatory care  Medication-use safety  Cardiology  Nuclear  Critical care  Nutrition support  Drug information  Neonatology  Emergency medicine  Oncology  Geriatrics  Pediatrics  Infectious diseases  Palliative care/pain Management  HIV pharmacy  Pharmacotherapy  Informatics  Health-system pharmacy administration  Internal medicine  Psychiatric  Managed care pharmacy  Solid organ transplant  Psychiatric pharmacy And much more! Residency Research  In both a PGY-1 and PGY-2 residency, pharmacists will be required to conduct a 1-year long research project  These projects primarily focus on improving patient care, increasing opportunities for pharmacists, or implementing new services  After completing a research project, residents may be required to present posters or presentations at conferences  Some may require research to be published in a journal Academia/Teaching  Some residencies may offer opportunities for residents to teach at a college of pharmacy  Residencies may also offer a teaching certificate which increases chance of acquiring a faculty position at a college of pharmacy  Completion of a teaching certificate may be optional or required depending on the residency Other Components of a Residency  Residencies can also include:  Resident to present a continuing education presentation  A medication-use evaluation  Precepting advanced pharmacy practice experiential (APPE) students  Additional opportunities to attend conferences Important Notes  Salary guide is 1/3 of what a pharmacist would make  Residents are usually offered full medical benefits (including vision and dental)  Residents generally get vacation days plus sick days  Residents may have to work holidays and may have to work weekends  It is very common for workload to exceed >40 hours per week Accreditation of Residencies  American Society of Health System Pharmacy (ASHP) is the organization that oversees and accredits most pharmacy residencies  Some organizations, such as Indian Health Services, provides their own residencies separate from ASHP  ASHP also hosts their national conference “Mid- Year” for pharmacy students to scope out potential residency programs ASHP Midyear Conference  National conference for residency programs to meet and scope out new candidates  Conference occurs each year in December  Opportunity to network and become involved! https://www.qleanair.com/qa/resources/15/1512463300878/ASHP%20QA2_f48b.jpg Residency Application  When applying to programs, most residencies will require:  Your curriculum vitae (CV)  A written letter of intent for each program  At least 3 letters of reference from mentors, faculty, preceptors, and/or bosses  Standardized recommendation form: https://www.ashp.org/-/media/assets/professional- development/residencies/docs/phorcas-recommendation-form.pdf  Please note that some residency programs may require additional components The “Match”  After midyear, pharmacy students begin to apply to residency programs  Programs generally start interviewing throughout January – February  Following interviews – students create a ranked list of their programs of interest in a computerized system called “PhORCAS”  “The match” is a computerized system that follows an algorithm that links candidates to a program they ranked and that also ranked them  “Match Day” occurs in March - everyone receives notice about the program they will be a resident of for the upcoming year What if you don’t match?  If a student does not match, they can go through “phase 2” of the match  Students will continue to apply to programs and interview and create a new ranked list that will try to “match” them again  If THAT doesn’t work, the students can partake in the “scramble”  In the scramble, students apply to any programs with open positions and interview to attempt to receive an offer Jobs After Residency  Clinical pharmacist  Clinical coordinator  Clinical faculty at a school of pharmacy  Consultants in nontraditional pharmacy settings  Shared faculty positions  Pharmacists working toward owning or managing a community pharmacy  Ambulatory care pharmacy  Hospital pharmacy manager  Consultant pharmacist in nursing home  Managed care pharmacist Benefits of a Residency  Increased job opportunities  Easier to acquire board certification in area of specialty  Enhancement of clinical skills  Residency work equivalent to 5 years experience How do I get a pharmacy residency?  Application process is rigorous and very competitive  Become involved in several organizations  Take on leadership roles  Study hard – GPA does play a factor  Work as an intern  Do research with faculty/pharmacy preceptor  Consider taking the residency elective during P2 year  NETWORK! NETWORK! NETWORK! How do I get a pharmacy residency?  Start investigating residency programs  https://accreditation.ashp.org/directory/#/program/residency  Reach out to advisors/faculty members to discuss your interests and career goals  Review the general process/timeline of applying to residency programs through the match  Check out when & where ASHP’s midyear conference will be during your final year of pharmacy school More Residency Information… More information on residencies can be found here: https://www.ashp.org/Professional-Development/Residency- Information/Student-Residency-Guide More information on how a timeline should look for a final-year pharmacy student about to apply for residencies: https://www.accp.com/docs/stunet/compass/ApplicationTimeline.pdf What is a fellowship?  A pharmacy fellowship is a postgraduate program that prepares a pharmacist to become an independent researcher  Focuses to develop competency in scientific research process  Most fellowships focus on training individuals to prepare for drug development & design Types of Fellowship  Traditional Fellowships:  Academic fellowship that focus on research (up to 80% of time) and clinical experience (20% of time)  Industry Fellowships:  Fellows work in a pharmaceutical industry to gain experience in different departments of a company  May include drug information, health economics, and pharmacovigilance Fellowship Peer-Review  Unlike residencies, fellowships are not accredited by ASHP  However, American College of Clinical Pharmacy (ACCP) does peer reviews of many pharmacy fellowships to assess quality of the program  Having ACCP peer-review fellowships are voluntary but highly recommended as it will improve reputation Other Facts About Fellowship  Some fellowships may be geared toward a class of drugs or a specific disease state  I.e. cardiology, infectious disease, pulmonology, endocrinology  Length of a fellowship may vary  Could go from 1-3 years in length  Some fellowships may not require a fellow to be licensed  Fellowships are typically affiliated with a college of pharmacy or pharmaceutical industry Ways to find fellowships?  American College of Clinical Pharmacists (ACCP) Residency and Fellowship directory  https://www.accp.com/resandfel/search.aspx  The Industry Pharmacist Organization  www.industrypharmacist.org Fellowships at Midyear  Many fellowship programs will also be at ASHP’s Midyear conference  Additional opportunity is allowed for students to meet preceptors/mentors of these programs  Students have the chance to interview for fellowships at the Midyear conference Personal Placement Services (PPS)  PPS is a service offered during the Midyear conference that allows students to interview for programs during the meeting  Many fellowships have students interview through PPS & may require them to go to multiple interviews  Some residency programs may also offer interviews through the PPS program How do I get a fellowship?  Application process is rigorous and very competitive  Become involved in several organizations  Take on leadership roles  Study hard – GPA does play a factor  Work as an intern  Do research with a faculty/pharmacy preceptor  NETWORK! NETWORK! NETWORK! Jobs After a Fellowship  Work in a pharmaceutical industry  Faculty at College of Pharmacy  Work in drug design/formulation  Work in drug development Benefits of a Fellowship  Increases opportunity for research  Increases opportunity to discover new drugs/therapies  Acquiring knowledge in drug approval/development process  Increased opportunity for teaching/academia  Increased opportunity for board certification Residencies vs. Fellowships Residencies Fellowships  Always 1 year  May be >1 year  Always requires licensure  May or may not require licensure  Typical settings are hospital,  Typical settings are pharmacy outpatient, or community school or industry  Accreditation is through ASHP  No formal accreditation process  A lot of patient interaction  May not include patient interaction Both are very competitive What is board certification?  Board certification is when a pharmacist becomes certified in a specialized area of practice  The Board of Pharmacy Specialties (BPS) is the organization that offers board certifications to pharmacists  Certification usually requires certain number of years of experience and passing a certification exam  BPS certification may help increase job opportunities and may even be a requirement for certain jobs Board Certification through the Board of Pharmacy Specialties Compounded Ambulatory care Cardiology Critical care Geriatric sterile preparations Infectious diseases Nuclear Nutrition support Oncology Pediatric Solid organ Pharmacotherapy Psychiatric transplantation www.bpsweb.org Certificates (Examples) ASHP APHA ACCP Schools of Multidisciplinary Pharmacy Opioid Medication Research and Teaching and Advanced Stewardship Therapy Scholarship precepting Cardiovascular Life Management Support (ACLS) Diversity, Equity Immunization Leadership and Research and Diabetes and Inclusion Management scholarship Management (BC-ADM) Anticoagulation Cardiovascular Teaching and Disease Asthma (AE-C) Learning management Medication Travel Health Diabetes (CDE) Reconciliation Informatics Health Information Systems (CPHIMS) Emergency HIV (AAHIVP) Medicine Academic Degrees (Examples) Doctor of Masters Doctoral Philosophy (PhD) Pharmacology Health Services Osteopathic Pharmaceutical Administration Medicine Sciences Public Health Education Pharmacy Biomedical Health Administration Ethics Administration Regulatory Affairs References  American Society of Health-System Pharmacists. https://www.ashp.org/. Accessed August 24, 2021.  Fellowships 101: Q&A with a Residency and Fellowship Director. Pharmacy Times. https://www.pharmacytimes.com/publications/career/2015/pharm acycareers_february2015/fellowships-101. Accessed August 24, 2021.  Board of Pharmacy Specialties. https://www.bpsweb.org/bps- specialties/. Accessed August 24, 2021. Disclaimer This presentation is based on the NAPLEX/MPJE Registration Bulletin published by the National Association of Boards of Pharmacy. The presentation does not provide all the needed information to become licensed. Licensure is separate from the Doctor of Pharmacy education and each student must plan accordingly.