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Southern Illinois University Edwardsville (SIUE) - School of Pharmacy
Pharmacy Across the Ocean
by Justin Shiau, P2, President-Elect, Southern Illinois University Edwardsville (SIUE) - School of Pharmacy (SOP) and Catherine Gilmore, PharmD Candidate 2020, Southern Illinois University Edwardsville (SIUE) - School of Pharmacy (SOP)
As part of the strategic initiative to develop global education opportunities, the SIUE SOP offers unique opportunities for students to travel to countries across the world. One of these opportunities is the Advanced Pharmacy Practice Experience (APPE) in India. Partnering with JSS College of Pharmacy in Karnataka, India, students experience pharmacy in an entirely different environment. SIUE students spend five weeks in India, while JSS students spend a total of eight weeks in the United States. Catherine Gilmore, a student pharmacist from the Class of 2020, has graciously shared her experience of traveling abroad to India through an interview.
Q: Tell us about your experience in India.
A: Traveling to India and experiencing pharmacy practice there was such a wonderful opportunity! We were able to spend 2 weeks at a private, 1800-bed hospital and see how they treated a variety of disease states, such as Dengue Fever, thalassemia, multi-drug resistant tuberculosis, and pediatric endocarditis. Since it was a teaching hospital, we were able to round with attendings, medical residents, medical students, and pharmacy students. We didn’t prepare for rounds each morning because there was only one paper chart available on each patient, so recommendations for changes in therapy came after rounds when chart was available. We then split the next week at a government-run cancer hospital and a government-run HIV hospital. We finished our time at a rural, government-run hospital at a hill station in the mountains, where most people were being treated for COPD. Here, the government supplies all medications free of charge. Pharmacists are involved when it comes to recommending medications on the government’s formulary and obtaining non-formulary medications when indicated. It was such a different experience than a medicine/hospital APPE rotation in America because while the treatment options are more limited the cost is so low.
Q: How is pharmacy different in India than it is here in the United States?
A: The PharmD degree is very new in India. The first cohort of PharmD students graduated in 2014, so clinical pharmacy is growing. Before, students received a Bachelors or Masters in pharmacy (and they still can), with most graduates pursuing a career in industry. They also have a Diploma in Pharmacy, which is an entry-level degree that takes approximately 2 years to earn, and is for those who want to practice more community-based pharmacy. From my understanding, there is not much clinical information taught with this degree and it is mostly how to run your own pharmacy. This degree was necessary for citizens in rural areas to have better access to medications. As the PharmD degree grows and more graduates are seeking advanced degrees, it is the intent of the Pharmacy Council of India to phase out the diploma program.
Q: If you could change one thing about pharmacy in the United States based on what you have learned in India, what would it be?
A: Prescription drug prices. Hands down. Medications are so incredibly cheap! We were in one of the pharmacies at the hospital looking at the various inhalers they had, and I picked up a budesonide/formoterol inhaler. I asked the pharmacy clerk how much the inhaler cost and she said “600 rupees.” I whipped out my calculator and converted that to dollars—it was a little over $8. And that’s the price the patient pays. Having insurance is not as common in India as it is in America, but the cost of healthcare is very low and fairly affordable for all patients. It is crazy that this same branded inhaler is over $300 in America, but is a fraction of the price in India.
Q: Would you recommend students experience this global opportunity to learn more about pharmacy in another country?
A: I would definitely recommend any global opportunity. It helps you to understand what pharmacy practice is like in other countries and how culture and religious beliefs can shape healthcare globally. This experience was unique for me since almost everyone I came into contact with spoke English, so language was not as large of a barrier as it might be with other experiences abroad. I think if students can step out of their comfort zone, even for a month or so, it helps you appreciate the things that we take for granted (e.g., toilet paper, drinking tap water, constantly smelling like bug repellant, etc.). Specifically, India also has SO much to offer! Mysore, the city where we spent most of our time, was home to many yoga studios and schools, as they teach Ashtanga Vinyasa yoga there. The south Indian food was absolutely fabulous, and we never had a bad meal. Mysore is home to the Mysore Palace, a beautiful palace open to the public that happens to be the 2nd most visited place in India. We took full advantage of visiting. There is so much to see and do in India and we were never bored!