An Unexpected Path
Deciding exactly what you want to do or where you want to go in life is difficult. What if you don’t like where you end up? What if you change your mind? Dr. Stephen Small is a prime example of what it looks like to not only change your mind but to embrace the unexpected. Dr. Small is a pediatric clinical pharmacist specialist but if you had asked him years earlier, he would not have thought that he would end up working with children, “Pediatrics was actually the only specialty I intentionally avoided in pharmacy school due to my fear that I would make a medication error and harm a child.” So how did he end up in pediatrics?
From Pharmacy Graduate to Pediatric Specialist
Dr. Small earned his Pharmacy degree from Butler University after which he pursued a residency. A residency involves one to two years of paid postgraduate clinical training supervised by a preceptor. Residents develop skills and competence in providing pharmaceutical care across diverse hospital settings, accelerating growth beyond entry-level experience. The training is divided into two postgraduate years, with PGY-1 offering generalized training and exposure to a broad range of clinical scenarios.¹ It was during a required rotation in pediatrics during PGY-1 that Dr. Small found a love of healing children saying, “My required pediatrics rotation in my PGY1 residency at Denver Health opened my eyes to how important pharmacists are for helping this vulnerable population, and I shifted away from my initial infectious disease clinical interests to go into pediatrics instead!”.
A Day in the Life
Dr. Small now works at Denver Health Medical Center, a level 1 trauma center. There, he oversees clinical pharmacy services for inpatient pediatric, neonatal and obstetrics units. Each day is slightly different but always exciting! He conducts rounds in the NICU or PICU alongside a healthcare team of physicians and nurses. He consults on various patients’ treatments and provides nutrition recommendations as well. Some days are more hectic than others as Dr. Small also responds to pediatric and neonatal medical emergencies, “… including trauma team activations in our pediatric emergency department and emergent deliveries in our labor and delivery unit.” He also passes along his expertise and training to future pharmacists as a clinical assistant professor leading a pediatrics rotation for local pharmacy students.
Navigating the Challenges
Working in pediatrics is definitely challenging. Dr. Small says, “I witness families live their worst nightmare when something tragic happens to their child.” Nevertheless, he wouldn’t trade his position for anything, reflecting, “Despite this negative side of my position, I am also proud to be part of team that has saved so many lives—sometimes against all odds—and given families healing and hope.” Helping children and their families is a passion for Dr. Small, so much so that he and his team of pharmacists published a well-received journal article all about the need for more obstetric clinical pharmacists, “Based on our experience, we wrote about how there are clinical pharmacists working in so many specialties except obstetrics. This is especially concerning since pregnancy outcomes in the U.S. have continually worsened, and we discussed our thoughts on how pharmacists can improve this population’s care.”²
Advice for Future Pharmacists
One thing’s for certain, pharmacists are needed in every facet of healthcare and Dr. Small has some excellent advice for future pharmacists looking to fill this need, “I recommend students explore all possibilities—even options that you may have once thought impossible or unappealing… and utilize your mentor’s wisdom to guide you on your lifelong pharmacy career.”
Interested in joining Dr. Small and other pharmacists in this impactful profession? Check out all the resources the Pharm4Me website has to offer and sign up for the monthly Pharm4Me Newsletter, so you don’t miss out on new information and opportunities!
1 What is a residency and how do I get one?. ACCP. (n.d.). https://www.accp.com/stunet/compass/residency.aspx
2 Small SM, Paratore PD, Peterson SD, Lucia RA, Reiter PD. Obstetric clinical pharmacy: A necessary birth of a new specialty. Am J Health Syst Pharm. 2023;80(15):1026-1031.