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School of Pharmacy finding prescription for its future students

As SIUE program enters second decade, wide-ranging specializations in works

p01 pharmacy    EDWARDSVILLE — In the 10 years that it has been producing pharmacists, the SIUE School of Pharmacy has held closely to one ideal — that filling health needs is a mission.
    In 2015, the school hopes to continue its prescription for success by pursuing a diversity of programs tailored to specialties that go well beyond the neighborhood drugstore.
    “There are at least 25 areas you can specialize in,” said Gireesh V. Gupchup, professor and dean of the school.
    Approximately 80 graduates a year earn a doctor of pharmacy degree, and each of them, he said, is prepared to further their education in a field of specialty, through outside residencies that work cooperatively with SIUE.
    As the school here enters its second decade it is focused on serving an industry that has much different needs than it did just a few years ago. Today, specialization is the watchword.
    The impetus for the school was David Werner, the chancellor from 1998 to 2004.
    “At that time there was a real shortage of pharmacists in the country,” said Gupchup.
    The Aggregate Demand Index, used by the Pharmacy Workforce Center to study pharmacy needs by state, showed Illinois was among the most in need.
    “The (index) rate goes from 1 to 5, with 5 being the highest. Illinois had one of the highest demand indices in the country, at that point in time. That’s when the planning started,” Gupchup said.
    When it was launched in 2005, SIUE’s School of Pharmacy became the first such Illinois school outside of Chicago. The only other nearby school is the St. Louis College of Pharmacy and the next closest is Kansas City. Those factors remain in play today, although a number of other pharmacy colleges have been created elsewhere in the nation.
    The founding dean of the school, Dr. Philip Medon, was hired in 2004.
    “I had known Phil for several years. I was in New Mexico at the New Mexico Health Science Center as part of the faculty,” Gupchup said. Medon lured Gupchup to the SIUE campus to become associate dean, and Gupchup inherited Medon’s mantle of leadership six years later, 2010, when Medon moved on to Manchester University College of Pharmacy in Fort Wayne, Ind.
p22 gupchup    Today, the SIUE program is spread across five buildings in University Park. As of this year, it has graduated five cohorts, which are clusters of students progressing through classes together. Members get a doctor of pharmacy degree, also called a Pharm.D. About 80 students a year are admitted.
    “We can’t go more than that for several reasons,” Gupchup said. “One is space. Another is that 33 percent of our curriculum is experiential in nature (where students go out into the field to observe and work under the supervision of a pharmacist). It’s like any health-care field. You don’t want a dentist to learn how to pull a tooth on line. You don’t want a pharmacist, especially with all the areas of specialty, to learn things just in theory.”

    Recruiters tell SIUE that the job picture has changed. The Aggregate Demand Index has now dropped to 3.43 in Illinois. A level of 3.0 reflects a point where demand and supply are about equal.
    “As a state school we are trying to keep an eye on where the jobs are and how many there are. What we know from the recruiters is that health care is quite recession-proof, but with the increased number of pharmacy schools, the demand for pharmacists has gone down.”
    More lately, demand has picked up a bit, and in some states the demand exceeds 4.0, he said.
    “In 2005, recruiters were clamoring for entry-level pharmacists; the shortage now is in the specialty areas,” he said.
    Pharmacists can become board certified under a variety of specialties, including pediatrics, cardiology, psychiatry, nephrology, urology, internal medicine, surgery and many others.
    Gupchup, a native of Mumbai, India, got his pharmacy degree in India before coming to the United States, settling first in Toledo, Ohio.
    “My master’s degree was in manufacturing pharmacy. It was a combination of engineering and pharmacy, putting the principles of chemical engineering and pharmacy together,” he said.
    He went on to get doctorate in health services research, principally in pharmaceutical economics, which looks at comparing cost effectiveness of drugs.
    While he was in New Mexico, he was director of the State Medicaid Drug Utilization Review Program.
    “We looked at such things as what do you put in a formulary (a list of approved drugs), how much we paid, the negotiations with pharmaceutical companies. We managed the pharmacy benefit for new Medicaid patients in New Mexico,” Gupchup said.
    Since becoming dean of the
Edwardsville school, Gupchup has been thinking long-term.
    “While Phil was a dean, he was focused on getting us fully accredited, which we are. Since I’ve become dean we are looking to develop a portfolio of programs that give our students and alumni an edge,” he said.
    For instance, he has worked with SIUE’s business school to develop a joint Pharm/MBA program to allow students to graduate with both degrees at the same time.
    “That gives them an edge with certain management-level jobs,” he said. “And we’re working on other joint-degree programs that will give them an edge on many other spheres of life.”
    The school has also partnered with Saint Louis University College of Professional Studies to create online certificates in organizational leadership and health information systems.
    “We’re also looking to start a graduate program in pharmaceutical sciences, which is a research area,” he said.
    One of the most exciting developments, he believes, is the planned addition of a pharmacogenomics specialization to explore the growing field of how drugs interact with the human genome.
    “Medicine is changing. When we broke the human genome less than a decade ago, pharmacogenomics was born.” That discovery led pharmaceutical researchers to determine that even brothers might react differently to the same dosages of the same drug.
    The specialization will focus on both pharmacodynamics, which is the study of what a drug does to the body, and pharmacokinetics, which is the study of what the body does to a drug.
    SIUE would be among the first pharmacy schools to add a genomics specialization, Gupchup said.
    The Pharm.D. program already allows students to specialize in pediatrics or education.
    SIUE pharmacy students need two years of pre-pharmacy coursework and then an additional four years of Pharm.D. Their undergrad work can be done at SIUE or at community colleges and other universities.
    All graduates have a working knowledge of basic pharmacy. Getting a specialty requires a lot more effort.
    Proceeding to areas of specialization is a lot like a medical education. The Pharm.D. is entry level degree, and students must proceed to a residency. SIUE offers 12, first-year and two second year affiliated residencies. The first year is a general practice residency that gives students an idea of specialties. A second year of residency focuses specifically on a specialty.
    SIUE’s School of Pharmacy has 14 affiliated residencies. Geographically they range from Peoria and OSF Health System to the north all the way south to the Veterans Administration in Marion. Students can also opt to seek a residency where they are available anywhere in the country. To get a residency a student must go through a placement service and be matched with appropriate programs.
    Twelve of the residencies are first-year residencies. Two of them are second year specialized residencies, one in pediatrics with OSF Peoria, the other in infectious diseases at St. John’s Hospital in Springfield.
    Job prospects are quite good. Gupchup said that all students to date have been offered employment upon graduation.
    The Pharm.D. degree can be used in all 50 states, but to get a job, graduates must be from an accredited school, then sit for a national board exam, the North American Pharmacists Licensure Exam. They must take the applicable state’s exam dealing with laws. It’s all done under the National Association of Boards of Pharmacy, which implements licensure requirements in all states.
    The license is not for life — continuing education credits are also necessary, and the SIUE school offers those.
    All of the didactic work required by students is based in the five pharmacy school buildings in University Park. But 33 percent of the coursework is experiential in nature.
    Experientials are practical experiences in a variety of settings. There are four required at the SIUE program — ambulatory care, hospital pharmacy, community pharmacy and acute care/general medicine. Four electives, such as cardiology, nephrology and psychiatry, are also required.
    The experientials are coordinated through preceptors, who are practicing pharmacists or faculty who host the experiential instruction.
    “We have around 450 preceptors across the country. We have people doing experientials in Alaska, in South Dakota, in New Mexico …,” Gupchup said, ticking off a long list.
    There are challenges in meeting what is likely to be a need for pharmacists as the population continues to age. They come down mainly to funding and resources for the schools involved.
    Funding for higher education has gone down for all state universities. While funding for private universities comes primarily from tuition, state schools rely both on tuition and state appropriations, which is like a subsidy.
    “Twelve years ago, the state would match 2.5 dollars for every dollar brought in, in tuition. Now, the state gives approximately 60 cents to the dollar that we bring in on education,” Gupchup said.
    SIUE School of Pharmacy tuition has gone up by about 89 percent since 2006, he said. It is now around $22,000 a year for the Pharm.D. and is subject to increases. (As opposed to undergraduate tuition, which is locked in for a four-year period.
    The cost of an education is a big concern, Gupchup acknowledges, and it’s affected by constant changes to curriculum and technology. Simulation and research equipment are costly but students must be exposed to them, he said. At the same time some of the classroom technology is getting quite old, though it still superior to what Gupchup sees at some other schools.
    “It’s what all schools are facing,” hesaid.
    Recognizing that students are hitting a plateau when it comes to tuition, members of the SIUE pharmacy alumni council “did a wonderful thing,” deciding to raise $100,000 for scholarships by way of inscribed brick pavers that will surround a small medicinal garden on site.
    “The best thing is the idea was conceived by our alumni. They understand,” Gupchup said.
    Some 400 students have gained degrees at the SIUE School of Pharmacy, which enjoys a 93 percent graduation rate. It’s 97 percent if six years of schooling are factored in.
    Meanwhile, the school itself continues to find new ways to be cost effective, by creating partnerships and having alumni come back as volunteer preceptors.
    “It all depends on the experience they have here. When they go out and become alumni they’ll want to return here and pay it forward,” he said.
    The school is accredited through 2015. In November it was visited by an accreditation committee as part of the process to continue accreditation to 2023. That visit went very well, Gupchup said.

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