Tomorrow's Pharmacist October 1999 p33-35
Edited by Pamela Mason

Preregistration experience

Pre-registration experience…

A selection of hands-on experiences in the field: including in the community, in industry, in hospital, and at the NPA

In the community

A preregistration year working for Moss Chemists in Brighton and Hove.

By Sean McAteer, BSc, MRPharmS

in the community I spent my pre-registration year working for Moss Chemists both in a health centre pharmacy and also in a more traditional high street pharmacy. It is often said that working as a preregistration trainee in community pharmacy can be quite isolated compared with working in a hospital or industry environment where there may be other trainees. The camaraderie of university life soon becomes but a memory as relationships of a different kind need to be established. For some, the challenge of finding common ground with "Doris," the aged dispenser, can be a tough one, but learning to interact with others - patients and colleagues - is an essential part of community practice.

Opportunities
Working in a medical centre obviously provided special opportunities for me. One of these was the ease with which I could arrange to sit in on GP consultations. This is one way in which you can guarantee to establish a good relationship with the local doctors. I found this gave me a valuable insight into the work of medical practitioners and a better idea of how to put my skills to use in helping the local practice.
During my time at the health centre I also accompanied a district nurse on her rounds to see wound management in practice - a very enlightening (and smelly) experience! I also sat in on nurse-led asthma and diabetes clinics, both very interesting and informative, although it was a pity the same clinics could not involve a pharmacist.
In the region where I was based, Moss Chemists had established an excellent scheme with the local hospitals where community and hospital preregistration trainees could attend clinical lectures together. This was an easy way to brush up on my therapeutic knowledge without spending hours pouring over books! I was also fortunate enough to be seconded to Guys and St Thomas's hospitals for a week during the year, which gave me a deeper insight into clinical therapeutics and the varying role of the hospital pharmacist.

The exam
As far as the examination was concerned, Moss Chemists provided excellent training in the form of study days and residential courses. These gave me the chance to meet and socialise with others in similar preregistration placements and proved to be a great way to share experiences. Group sessions were held on topics such as oxygen therapy, compression hosiery, incontinence and law and ethics, to name but a few. In addition to courses, it is really important to make the best use of your preregistration tutor's knowledge and experience. Never be afraid to ask questions. I also found that working through Centre for Pharmacy Postgraduate Education (CPPE) training packs and keeping up to date with The Pharmaceutical Journal helped smooth the run up to the examination and qualification.
Finally, remember that the preregistration year belongs to you. Do not be pushed around in the dispensary all year - try to experience as much as possible in the time you have, and most of all, enjoy it!

Mr McAteer is a locum community pharmacist who graduated from Brighton university in 1998.

In industry

A six month sandwich preregistration placement undertaken at Glaxo Wellcome.

By Gillian Campbell

in industry Six months of my preregistration year was spent working for Glaxo Welcome in the pharmaceutical industry. This period of time gave me a brilliant insight into an area of pharmacy which, unlike hospital or community practice, is perhaps not as easy to try out for a short period of time either during your degree or after you graduate. The first thing I noticed was that industry is not full of boffins, and it is not as ridiculously challenging to the brain as you may imagine!
My time at Glaxo was spent working in a formulation team, which was involved in reformulating a drug contained within an aerosol, and currently available on the market as an inhaler device, to an ozone friendly CFC-free product. Working in parallel with my team was an analytical team and I was able to sample some of their workings to gain broader experience in all aspects of developing a new product.

Variety
Much like community and hospital based placements, preregistration placements in industry have learning requirements to be addressed by the trainee. The areas that these cover provide a huge variety of work and illustrate the numerous roles that pharmacists play within the pharmaceutical industry. These areas include manufacturing, analytical work, stability testing, quality control and designing, implementing and reviewing clinical trials. There is also huge scope for pharmacist involvement in regulatory work to enable medicinal products to be sent to the Medicines Control Agency or other licensing bodies around the world for approval.

Teamwork
I learned a great deal from my preregistration placement in industry. Working in a small team enabled me to have a lot of personal attention, while being able to rotate around different departments and experience other areas of work. Seeing the design and development of new medicines is quite fascinating and pharmacists undoubtedly have a huge role to play in the process. I would recommend some time spent in this industry to any student, regardless of their career aspirations.

Gillian Campbell is currently completing her second placement at Airdale hospital in Yorkshire. Ms Campbell is an undergraduate at Bradford University

In hospital

Preregistration experience in a large teaching hospital in central London.

By Audrey O'Reilly, BSc, MRPharmS

in hospital I undertook my preregistration training within the Guy's and St Thomas's NHS Trust. Both hospitals are large teaching hospitals in central London, and after a year spent working in various pharmacy rotations I feel ready to reflect on my placement and what being a hospital preregistration trainee was all about. There was certainly more to it than making cups of tea!
Having enjoyed a fairly sociable three years at Portsmouth university, I was worried that the beginning of my preregistration year would signal the end of my social life. So it was a nice surprise to find that I would be working alongside seven other preregistration trainees for the year. The pharmacy departments at both hospitals proved to be very friendly and welcoming, with much socialising going on outside the workplace.

Clinical expereience
As my year was to be spent in well established teaching hospitals, I was never in any doubt that the clinical training I would receive would be of a high standard. This has indeed proved to be true, with preregistration trainees receiving ward based clinical training in a variety of therapeutic areas almost every day - no matter what rotation they happen to be on. However, hospital pharmacy is not just about clinical pharmacy and I think the variety of rotations I experienced through the year reflected this. During my time in London I worked in drug information, in inpatient and outpatient dispensaries, non-sterile and sterile production, aseptic manufacturing and in specialist oncology dispensaries. Other rotations included time in quality control and radiopharmacy.
As you can imagine, to co-ordinate so many rotations for eight preregistration trainees takes a lot of organisation! This feat is achieved by a preregistration facilitator who works with the trainees on behalf of their tutors. Our facilitator also organised study sessions every Monday afternoon where we could discuss any problems and share our experiences.

Meetings
Preregistration trainees in the South Thames region receive training on both a local and regional level, with over 60 trainees regularly meeting for study days and residential courses. I found this particularly useful for brushing up on more community centred aspects of practice, such as response to symptoms. This is something hospital preregistration trainees spend very little time doing but need to know - everybody sits the same exam at the end of the year! A short secondment with Boots the Chemists also helped to build my confidence in dealing with over the counter prescribing and health promotion topics.
While there was much variety in my rotations during my preregistration year, one aspect of my training remained constant throughout. Although I was expected to work as hard as everybody else, I was treated as supernumerary, with colleagues eager to provide training and answer any questions I may have had. Thus I was never just "an extra pair of hands" - something a preregistration trainee should never be.

Ms O'Reilly is basic grade pharmacist, Guy's & St. Thomas's hospitals.

The National Pharmaceutical Association

Six months of unusual and exciting preregistration experience, spent mainly in the information department.

By Lizzie Mills, BPharm, MRPharmS

The National Pharmaceutical Association (NPA) is an organisation, which looks after the interests of community pharmacists and promotes awareness of the role of the pharmacist as a health professional. A six month preregistration placement is available at the NPA, and this involves working mainly in the information department, the other six months being spent in a community pharmacy.
My first day at the NPA headquarters in St Albans went something like this: "This is the 'phone, this is how the computer works, there are the reference books - now go for it and answer the first call!". So, with a tentative but beautifully practised, "Hello, information, Lizzie speaking", I took my first call, praying that it would be something I could answer. Typically, my first call was one of the more unusual queries. It took weeks to find an answer, but that was what I really came to enjoy about helping commmunity pharmacists out there with their queries and problems. You never knew what was coming next! Learning how to solve problems is a process which, as I have come to realise in my time in community pharmacy, is a major element of practising effectively as a pharmacist.
From a preregistration point of view, working at the NPA offers many opportunities. One of the obvious ones is to become familiar with medical and pharmaceutical reference sources - not just the BNF and Martindale - but the more specialist reference texts such as paediatric formularies. I must say, though, it can be quite frustrating when you practise knowing that a great reference book exists and you cannot get your hands on it! But, I guess that is what makes the NPA and its information department such a valuable source of information and advice for practising pharmacists.
During my six months with the NPA, my enthusiasm for pharmacy soared. There are so many opportunities out there and they are achievable, especially with an organisation like the NPA to support pharmacists who are willing to get involved. The other thing I valued as a preregistration trainee at the NPA was the number of people available to discuss difficult queries with. I think I have seen so many different ways of thinking around problems that now it is time to take a little from each and develop my own style.

Ms Mills is a London based community pharmacist, who spent her preregistration year working for the National Pharmaceutical Association in St Albans and for Moss Chemists in North London.

Tomorrow's Pharmacist October 1999 p33-35 Edited by Pamela Mason

Preregistration experience