What makes your career path unique?
I am the clinical pharmacogenomics coordinator at St. Jude Children’s Research Hospital. The academic and career path that led me to this position is very unique!
I received my PharmD from the Lebanese American University (LAU) in Lebanon. Although the pharmacy school had been established about eight years before I graduated, my class was the first to graduate after it became the first school of pharmacy to be accredited by the Accreditation Council for Pharmacy Education (ACPE). This made my path to residencies much easier because one of the requirements of ASHP-accredited residencies is to have graduated from an ACPE accredited school of pharmacy.
After completing a PGY1 in pharmacotherapy at Hackensack University Medical Center, I pursued a PGY2 in Pediatric Oncology at St. Jude Children’s Research Hospital. It was during this time that I fell in love with the mission of St. Jude—no child should die in the dawn of life.
My love for the St. Jude Children’s Research Hospital’s mission led me to my next career step, which was joining their team of excellent clinical pharmacy specialists. I served as the ambulatory care solid tumor and neuro-oncology specialist for eight years.
During this time, pharmacogenomics researchers in the U.S. and across the globe were busy publishing their findings. The pharmaceutical department at St. Jude decided it was time to move pharmacogenomics into clinical practice. In 2012, I became the first pharmacist whose job was solely devoted to the implementation of pharmacogenomics into clinical practice.
What does a typical workday look like for you?
My typical day involves running the clinical pharmacogenomics service at St. Jude Children’s Research Hospital.
Although I coordinate the efforts for successful implementation, I would not be able to function without the close working relationships with my other team members inside and outside of the pharmaceutical department. Collaborations with the clinical laboratory, informatics department, physicians, and patient educators are all vital to the success of the program.
On a daily basis, I analyze patients’ pharmacogenomic results, place results in their medical records, and create educational materials for patients and clinicians. During all of this, a PGY2 clinical pharmacogenomics resident shadows me to learn how to become an independent practitioner after graduation.
I also help other centers establish similar programs at their own institutions. You can read more about what my team and I do daily on the St. Jude Children’s Research Hospital website.
Describe the most rewarding day of your career.
There have been many rewarding days throughout my career.
The first one occurred when I was a student in my pediatric APPE rotation. I was assigned to follow a patient who was receiving chemotherapy for the treatment of pediatric leukemia. He was experiencing a large amount of toxicity because of the chemotherapy regimen he had received, so I looked at his chart to see how I could help him. After reading through the chart, I noticed that he had not been given the rescue medicine that is typically given after his specific form chemotherapy. Once I informed the attending physician and fellow about it, they were very thankful that I brought this to their attention. We gave the rescue medicine to the child and he progressively improved.
The second rewarding day occurred after I had been practicing as a clinical specialist for a couple of years. One of the patients that I had been taking care of for a while was admitted to the hospital with a multi-drug resistant infection. Because he was a very complicated patient taking lots of other medications and was suffering from liver dysfunction, the physician taking care of him asked me to come up with a treatment regimen that would be best suited for this specific patient.
This is very typical, but this interaction is memorable for me because this physician was not very fond of having pharmacists make drug therapy selections. Since that day, she has recognized me as a valuable and necessary member of her team.
Describe the most challenging day of your career.
The most challenging days in my career have all occurred when I had to work with my team to come up with a plan to provide alternative therapy recommendations. This typically occurs because the intended medication is not currently available on the market due to a drug shortage.
Switching modalities of therapies in oncology is always a concern because patients may not benefit as much from the modified regimen as they do when they’re treated with the originally-assigned regimen.
What most attracted you to pharmacy over other healthcare professions?
At first, I was interested in pharmacy school because I very much enjoyed the topics of chemistry and biology in high school. I felt that pharmacy school provided me with the right balance of both.
I come from a family of pharmacists (they practiced in industry and retail), so I was very familiar with these two practice sites. That said, I was very much unaware of the option to practice clinical pharmacy as a career. I discovered clinical pharmacy when I started my rotations, and I quickly decided that this was the path I wanted to follow.
What steps did you take to enter into this career path?
Because I was the first pharmacist to hold a full-time pharmacogenomics position, there wasn’t any training available to people like me who wanted to pursue a career in genomics at the time. I had advanced knowledge and interest in the field, which was the best that could be done. Instead of obtaining specialty training, I had to learn on the job.
Today, pharmacy students interested in pursuing a career in pharmacogenomics would need to earn a PharmD, then complete PGY1 and PGY2 residencies in clinical pharmacogenomics.
What advice would you give to a student entering pharmacy school?
Pharmacists can be found practicing in many diverse settings. I would encourage students entering pharmacy school to take every opportunity they have to shadow pharmacists in as many different fields as possible. This will allow them to better choose their career path when they are closer to graduation.
I would also tell them not to hesitate to ask questions when they don’t understand something. Their preceptors and teachers will learn as much from their questions as students will learn from their answers.
Finally, I would advise future pharmacy students to enjoy the time they spend at school and the friends and connections they make, because they will last forever.