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FEATURE STORY 03/01/1999
Author: Michael Samsot  
Externships Vary Experience for Pharmacy Students
In his position as Director of the Professional Experience Program (PEP) for pharmacy students, Registered Pharmacist Louis Fortin says he considers it part of his mission to encourage students to face new challenges and to investigate avenues of the profession that they haven't previously encountered. Fortin is on staff at the Albany College of Pharmacy (ACP), Albany, New York, and is responsible for the interviewing and placement of fifth-year students in their spring semester rotations, or externships.

"In the Bachelor of Science program, each student has to do three rotations in the spring semester of the fifth year," Fortin says - one each for community experience, institutional experience, and clinical experience. He explains that there are actually four five-week rotation periods during the semester, but the student has one of them off. Fortin consults with each student in determining the rotation order and placement that will be most beneficial, depending on that student's personal experience and personal needs.

One of the reasons for broadening the students' experience, he says, is that they often will tend to try to make career choices based on what they've done during these externships - or during their internships, which take place before the fifth year. "Perhaps they've had an internship with a particular drug chain, or one of their externships has gone particularly well, and the student comes back and says, 'Guess what, Mr. Fortin; they offered me a job!' They may even have been going to school with a partial scholarship from that firm, with the understanding that they will come to work for them once they have finished school - and that's great," he says.

Nevertheless, Fortin believes deeply in encouraging students to look at the broad range of opportunities that are available. They have had some students who, once they started looking, found other job opportunities in which the hiring firm wanted the student so much that they offered to pay off scholarship money given by the first firm, Fortin says. "We find," he says, "that even though these students are in their fifth year, many of them still have a pretty narrow idea of what they want to do for a living. That's why I try to have them get as many different experiences in the rotations as they can. I see it as my job to widen the field of vision for graduating students, so that they will know there are plenty of job opportunities out there."

The rotations, Fortin says, consist of positions under selected "preceptors who have been trained into our program. We have a one-day training program for any pharmacist who is going to be a preceptor; we tell them what to expect from the students who will be with them, we tell them what the students are likely to expect from them, and then for 25 days [five academic weeks], they share their workday with a student. Preceptors don't get paid for this and, unlike with the internship, students don't get paid either. Therefore, it's essential that this is something the preceptor wants to do."

Fortin emphasizes that a lot of care goes into selecting the preceptors. "if I have to twist someone's arm to get them to take a student, then maybe this is a person who shouldn't take one. Being a preceptor takes a lot of work and a lot of talking." Before Fortin joined the teaching staff at ACP, he himself was a preceptor for the college for ten years, so he understands he requirements from both ends. Students choose preceptors from a list that Fortin maintains, "but it's a negotiated choice between the student and myself," he says. "I tell them that even if they're afraid they won't like it, it's not for that long a time; they can do anything for five weeks."

Occasionally, though, Fortin says, a student and a preceptor might not hit it off, and I tell them that if they see that they are going to have problems they can't resolve, to call me right away and we'll make other arrangements. That's part of my job, too - to make sure that the relationship works well enough that both parties are going to come away feeling that they've benefited from the externship." In a case where things don't click, he says, "there might be some juggling that we can do. That's why for three weeks out of each of these five week periods, I'm out on the road, visiting each of the students doing an externship, seeing how they are doing, and keeping the relationship with the preceptors positive so that they'll be willing to do it again."

He talks about one of his biggest challenges in his current position. "With the consolidation of health care organizations, HMOs, hospitals, and nursing homes - [and with] the sale of many community pharmacies to large chains, my greatest challenge is finding and keeping quality externship sites," he says. "Pharmacists/preceptors are pressured by their organizations to be more productive with less support and that often gives them less time to devote to student teaching."

Fortin began his current position at ACP in 1990 after having owned a community pharmacy in East Greenbush, New York, for 18 years. His partner in that ownership was his wife Marilyn, who is also a pharmacist. (Apparently, pharmacy is a "family thing," he says, because he also has a brother who is a pharmacist and a son and the son's wife, who are employed in the pharmaceutical industry).

When he was in retail pharmacy, he had a relationship with professional organizations that inspired a requirement that he asks today of all his students. "I require each of the fifth-year students to attend two professional meetings and get them documented. This is for the sole purpose of letting them know that there are groups out there that will provide them with support and ideas. You'd be surprised at how much these groups will do for their members if help is needed," he says.

Fortin's teaching duties, he says, "are limited to fifth-year students in the PEP Orientation class during the fall semester and then in one-on-one situation during the on-site visits. This process is repeated during the summer with students who elect to track in to our Pharm.D. program, and again in the fall for a class of evening students. The school has slightly less than 700 students, encompassing both our B.S. students and those who are pursuing the Pharm.D. degree."

The orientation class Fortin teaches in the fall provides students with a number of things, he says: "HIV confidentiality training, infection control training, how to read a patient chart. If I don't teach these things myself, I'll bring in guest speakers, experts, to teach them. It's another part of my job," he adds, "to prepare the students for what opportunities they might see after they're out of school - jobs in industry, consulting pharmacy practices (such as pharmacists who work in nursing homes, jails, or long-term care facilities)."

In the fall, ACP has a career day, when the college invites potential employers to interview the students. Beforehand, Fortin adds, he will have invited a speaker to instruct students on what to include in a resume, and on what they should expect in getting through the interview.

"Then, there's a program we do," he says, "called 'A Matter of Trust.' In it, we show a little video that deals with the communications skills necessary to handle a situation where a prescription error was made. Should a mistake be made, the pharmacist could be on the brink of losing patients' trust, or losing an employer's trust. How you handle that mistake, and the communications skills you use, could determine what happens to your career afterwards. The program and video are provided to the college by the Food Marketing Institute."

Fortin counsels students that good communications skills can help them get through bad situations. "We like to make the students aware of their own communications style and their shortcomings, so we do an interpersonal communications self-assessment quiz. There are no right or wrong answers; rather the students use the answers as a tool to help them understand their general behavior patterns in problem situations with others. They learn how the tone of their voice affects others, whether they tend to remain angry when someone upsets them in a work situation, and what to do if they do. We have a test that determines their empathy/listening score, their assertiveness/anger score. I keep the scores, anonymously, and at the end of all their rotations, they take the quiz again to see how they have changed.

"Recent Gallup polls over the last [ten] years have shown that when people are asked about whom they trust the most, pharmacists come out on top. We want to take care not to lose that trust," Fortin says.

Working toward that goal and toward the goal of achieving the best experience for his students he comments, "I find my position at the college extremely interesting and varied. I function as the link between the business world and the college to keep each party aware of changes in academia and in the business aspects of the profession. I enjoy my one-on-one relationship with the students during my visits with them at their rotation sites. Preparing them for their new role in the profession, and exposing them to areas of practice that they haven't even heard of, is very rewarding."

Louis Fortin received his Bachelor of Science degree in Pharmacy from Albany College of Pharmacy, Albany, NY, in 1958. With his wife, Marilyn Fortin, he owned a retail pharmacy from 1972 until 1990; and from 1980 until 1990, served as a preceptor for students at Albany College of Pharmacy.

Michael Samsot is a freelance writer in Fairfax City, VA. She is on the Editorial Staff of NEWSLine for Pharmacists.
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