Each year, participants are selected from Taipei Medical University Hospital, Shuang Ho Hospital and Wanfang Medical Center. Pharmacists with two years of service or those who hold a degree equivalent to the U.S. Doctor of Pharmacy (Pharm. D.) can compete to train at an international university or hospital allied with TMU’s College of Pharmacy.
Dr. Jie-ru Han, Shuang Ho Hospital
During her university studies, Dr. Jie-Ru Han often heard that clinical pharmacy in the U.S. provides advanced training and was a model for Taiwan’s pharmacy sector. She says she was very honored to participate last year, and that experiencing the working life of U.S. colleagues expanded her understanding of pharmacy’s many clinical roles.
From February through July, she interned at the University of Illinois at Chicago, working mostly in the ICU and attending ward rounds, topic discussions and meetings. She also spent time in the infectious disease division and the HIV and hepatitis clinic. Dr. Han says she found that U.S. and Taiwanese pharmacists’ jobs and information systems differ significantly.
In addition to clinical work, pharmacists in the U.S. also conduct research. She said entire medical teams often take more daring approaches in treating patients, breaking away from recommended guidelines to provide treatments based on their judgement or on relevant case studies. Much less complicated administrative procedures also allow the team to better focus on clinical services.
Dr. Han believes huge improvements can be made in Taiwan’s pharmacy sector. Although the U.S. system cannot be fully applied to Taiwan, she said it can provide directions for improvement over time given cooperation from care team members.
Shuang Ho pharmacist Dr. Jie-Ru Han (second from left) shares her experiences with international pharmacists during a U.S. study course
Dr. Shi-Ying Zheng, TMU Hospital
TMU Hospital’s Dr. Shi-Ying Zheng received US training from February through August, with the first four months spent observing pharmacological care at Ohio State University’s James Cancer Center. Then she spent 2 months at the NorthShore University Health System’s Evanston Hospital learning pharmacogenomics applications.
At the former post she joined pharmacists on daily ward rounds, discussed patient conditions and participated in groups on immunotherapy and bioequivalent drugs, gaining insights into how pharmacists help draft internal guidelines and medication use policies. As James Cancer Center is one of the few Phase I/Phase II Clinical Trial Centers established and funded by the U.S. National Cancer Institute, it emphasizes monitoring and care for clinical trial patients. Dr. Zheng learned how to use new medications, how to comply with agreements and educate patients, and how to advise physicians on medication use.
As NorthShore was the first U.S. medical center to offer pharmacogenomics consultations, its pharmacists help the public and staff understand the value of pharmacogenomic testing. Dr. Zheng said the complete integration of such test results with the physician order system can provide helpful alternatives. She said she valued the chance to study U.S. medical institutions, particularly the roles clinical pharmacists play in cancer treatment and precision medicine. This training program will help others in hospital internships and the new 6-year pharmacy degree program.
Pharmacist Shi-Ying Zheng with NorthShore Molecular Medicine Center team
Dr. Ya-Ting Zhuang, Wanfang Medical Center
Dr. Ya-Ting Zhuang interned at Ohio State University, University of Illinois at Chicago and the Community Regional Medical Center from February through August. She worked in a variety of areas (ICU, infectious diseases, medication consultation office, ER, outpatient treatment and internal medicine) to learn U.S. pharmacy norms.
She said that compared with Taiwan’s physician order systems, U.S. systems offer more diverse templates for patient records: subjective, objective, assessment/analysis, plans and standard procedures. She noted that many shortcut keys make pharmacists’ jobs easier, as U.S. information technologies promote efficient use of human resources, saving time and broadening pharmacists’ development potential.
In terms of teaching, Dr. Zhuang observed that the U.S. uses guided thinking to help students move from books to bedside. This means letting students think about questions and search for answers while instructors reward them for thinking “outside the box.” Dr. Zhuang said U.S. pharmacists know proven approaches but are not slaves to them, given frequent challenges for which no single correct answer exists. At this point pharmacists must rely on logical problem-solving, which she said can be taught.
Pharmacist Dr. Ya-Ting Zhuang (right) with a Wanfang Medical Center colleague
Dr. Zhuang said U.S. pharmacy students go into the community to interact with patients at a very early stage of their training, and are encouraged to help both junior colleagues and students from other departments. For example, Dr. Zhuang tutored pharmacy students in non- prescription medication courses. She said this gives communication experience that is helpful when students enter their hospital internships, as they have taught others and know how to communicate with staff in other disciplines.
A U.S. pharmacist (first from right) and pharmacy students conduct medication interviews at a senior citizens’ center