Ep 8. Residency and Application Based APPE Pearls with Tola Adebanjo from UMES

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Fourth year student-pharmacist Tola Adebanjo shares her journey through application-based APPEs at Johns Hopkins Hospital in the Clinical Track Student Pharmacist Program, as an APhA Experiential Program Intern, and how she approached the Residency Showcase at ASHP in Orlando. She also outlines the benefits of the three-year PharmD at the University of Maryland Eastern Shore.


Full transcript:


Welcome to the Pharmacy Leader's Podcast with your host Tony Guerra. The Pharmacy Leader's Podcast is a member of the Pharmacy Podcast Network with interviews and advice on building your professional network, brand and a purposeful second income from students, residents and innovative professionals.

My name is Tolani Adebanjo, Tola Adebanjo and you're listening to the Pharmacy Leader's Podcast.

Welcome to the Pharmacy Leader's Podcast. My name's Tony Guerra and I am your host here at Des Moines Area Community College in Ankeny, Iowa. Connect with me on twitter at tony_pharmD or on YouTube, I have 1200 videos supporting my book, Memorizing Pharmacology which are all free. So today we have a really special guest from last year where we had a kind of a little fun contest for APHA and just seeing what kind of social networks people had. Tola Adebanjo is a final year pharmacy student from the University of Maryland, Eastern Shore. She's interested in pursuing a PGY-1 pharmacy residency in a large academic teaching hospital. So welcome to the Pharmacy Leader's Podcast.

Thank you Tony, thanks for having me.

Now you have in a very short period of time gone on the national pharmacy scene as a final year student. Student's really would like to know what is it that you've done in your leadership role to get from, just starting pharmacy school to now where you're doing a nationally recognized pharmacy rotations.

Well let me answer that first by saying I know that there's not exactly one road but I'll tell you a little bit about my experience. Just from really the first day at pharmacy school I knew I was in a new place, I was in a new state and for me getting to know people and getting to make relationships is very important. So my first thing was, how can I do that and just the involvement and realizing that there are a lot of organizations. I knew that I'd be able to start to meet people, start to get to know people and from that also have the opportunity to develop networks to start, you know, leading on a bigger level or getting involved on a bigger level.

Ok, well, you went to the University of Maryland Eastern Shore and Jim Bercet who is faculty there. He was a classmate of mine back when we graduated in 97. So it's been about 20 years and it's very exciting that we have some new pharmacy schools and when I say new that it's not new anymore but tell me a little bit about the three year program, how you like UMES, maybe what drew you to it because now after four years instead of having a pharmacy school graduation hopefully you'll have a PGY-1 graduation and I think that's the direction we seem to moving.

Yes, so I've a three year program. A lot of people kind of guess when you talk about that but I've really enjoyed being at UMES. The thing that really drew me to pursuing the three year program was just the idea that I did have the undergrad experience and then I did go into the working field. I was working as the chemist for about two years in between there but for me I knew that when I was going to pursue an education again, an higher education. I wanted to do that in a timely fashion as well as the appeal of UMES when I went there. I wasn’t sure if that was even possible because I was like, that's a lot of schooling, that's a lot of information to learn in a short period of time but what I found at UMES was the size. We've got about 60 people in a class give or take and the faculty, it was one on one very personal and relationships were very important to me as I had said before and so, you mentioned Jim Bercet and Jim Bercet actually was on the first day during a white coat ceremony, he had every student's name memorized. My name pronounced beautifully, memorized and so it was one of those things where you just felt a strong relationship right off the bat, very much open to our policy. They discussed that a lot and that meant a lot to them so I wanted to go somewhere I felt at home and didn’t feel like another number and that was just the environment where it matched for me.

So tell me a little bit about preparing for APPE rotations, something that really, I know, I'm going to be saying third year when it's not really the case for you guys but a third year in a traditional four year program very quickly has to figure out what rotations they want. And I feel like, there's kind of an expectation that from the residency directors that you're going to have a certain rotation schedule that they are going to expect to see. So you've done a really good job of maybe combining exploratory as well as focused. How did you setup to choose your APPE rotations or your Appy rotations?

Oh I [00:05:11] couple of meaning. I think each of those rotations were very unique and I feel very lucky to have explored them but so in our second year at the traditional program's third year. We were told and explained how, they explained to us how the rotation lottery system would work as far as applying and being on the Eastern Shore of Maryland the number of opportunities there is limited so it is important that you really take a hand in how your rotation schedule's going to be set up. Especially if you know their certain places or experiences that you want to get, if they're not offered maybe on the Eastern Shore then it's necessary for you to kind of seek those out or maybe create them on your own. So a few of the opportunities that I had were programs that were offered by application only, so a few of those I, you know, just did as every other student who, you know, has big goals and I was excited for bigger experiences. I put through an application for those and others I actually ended up setting up so I knew I wanted to be able to spend a little bit of time back in the mid-west where I'm from. And so I did a little research and based on what areas of my rotation, kind of, curriculum that I needed to fill I was sure to kind of seek out opportunities in those areas and see who was willing to create kind of a new contract with the University of Maryland Eastern Shore in terms of having students come to complete a rotation there.

You know when I talked to Dallas Tolbert from UMES she was talking about not just being part of an organization but creating organizations and it sounds like now that we're seeing maybe some smaller classes in pharmacy schools that. Really that kind of entrepreneurial, if it's not there it's not that I'm going to accept that it's not there, I'm just, we'll create it, we'll set it up, we'll make it happen.

I agree.

Yeah, well tell me about Johns Hopkins, it's the IV league was, you know, is its own kind of, was a sports league but there what we call outside IVs, Duke, Stanford, Hopkins, places like that. Johns Hopkins is one of the most sort after experiences in the country. Can you tell me a little bit about your first experience which was at Johns Hopkins and how it was a more extended experience, it wasn’t a single block anymore?

Yes, so, I was very fortunate to have had the opportunity through my school that did a great job of setting up a contract I guess with the Johns Hopkins Hospital in terms of having students complete what they call the clinical track or acute care rotation. And in that I put out an application, the cover letter, letter of intent, those types of things, provided my resume and or CV and in addition just kind of was able to really pour through what my passion and my drive to pursue this type of rotation experience was. And lucky enough I was able to get it and it was of four years, oh, I'm sorry four months experience or four blocks. And ultimately I completed my acute care rotation there. I completed an ambulatory care rotation. I worked a little bit more on the administrative side working in as a like, with the managers in the pediatric department and then my final rotation was more of an elective and that was critical care collective where I worked with the sowed organ transplant team. More of the thoracic so heart and lung transplant and really the experience, it was a little intimidating because like, you said it was my first set of rotations coming out of the didactic portion of the curriculum but I think the amount of support you had when you were there was, it was incredible. I ultimately on my very first rotation which was in acute care I came in nervous, you know, did I learn enough, were these tests enough to test my knowledge but at the end of the day I think from the experience I was able to gain a lot as far as clinical decision making within the facility being able to work with the different team. So work with the different positions and within the pharmacy department there's just a lot of support there for student's growth, their learning and just the teaching there was just incredible.

So the rule of thumb is never do what you care as your first rotation.

I wouldn’t say that, you know, I joked with my family and some of my friends, you know, I almost felt like it was the sinker swim moment and it’s like, you know, you go in and some people try to plan their schedule. So it’s like, ok, they ease in to it which honestly I don’t know if in pharmacy you're ever easing into anything.


All these are very clinical based.


It's all very clinical based now so I think really it was just a matter of you got to put your best, everything that you have forward and show this is what I know and I'm willing to learn. If anything, just showing that you are open and willing to learn and seeking out those opportunities I think that was something that helped me while I was there as well as kind of showed that I was really driven and excited about the opportunity.

Can you tell me a little bit about each of them and we'll go through each one at a time because I feel like a lot of times you've got to kind of read the blurb on it and that's where you get your information but maybe we can give a little audio description of each one.


Explain what an acute care rotation is and maybe what you do on a daily basis and then amp-care and we'll just go one at a time but start with.


Acute care, what's that like, you're there in the first day and what's going on?

So in my acute care rotation when I was at the Johns Hopkins Hospital, I was able to work with amazing preceptor and she ultimately had both her role, she was PCPS certified and she had the role of working with an internal medicine team and so what we did was, we had a team while we were there and we would go on rounds with the team and she served as like, right then and there kind of making this critical decisions as far as what medication adjustment is needed to be made, what new start type medications needed to be done and then on top of that she served kind of in a staffing role as well within the central, I'm sorry not central but the adult in-patient pharmacy. And so she managed a lot of I guess, have a lot of hats that she wore but every day we kind of patient list anywhere from 10 to 15 patients in the beginning of the rotation. Of course, you know, they try to ease you into it as far as, you know, this is what we want you to focus on whether it be disease states specific but we were looking at patients with congested heart failure, patients with diabetes and they are more like the acute complications of those disease states and the necessary actions that need to be taken to take care of those patients.

Ok and then acute care and amp-care tend to be the two hottest fields I guess you would say if you're talking about residencies. When I went to the ASHP meeting and went through that residency showcase I did see a lot of attention to the amp-care and acute care but tell me a little bit about what it means to be doing amp-care at Hopkins.

So when I was at the Johns Hopkins Hospital I was able to work, this was actually kind of a new where, I don’t know exactly how to describe the way that it was set up but what they did have was, I was doing on college, you know, ambulatory on college and what it was. There were pharmacist who again, they were PCPS certified and they were individually assigned to certain types of cancer so I specifically worked with a pharmacist who was working specifically with multiple myeloma and so in that setting I was able to visit with the pharmacist alongside the oncologist in the clinic setting. And so each day we would check the clinic schedule for that specific oncology or oncologist and then we would go into the clinic and we would sit and see the patients. The pharmacist role was to manage their world chemo therapy agents as well as managing their overall treatment regimen. And so what these patients, we would talk about whether they were experiencing side effects from the medications. We would talk about, you know, if they were no longer getting the wanted benefit from the medication and we would start to explore other options alongside the physician and furthermore we were really just very much involved with their al-patient care as far as calling these patients on a weekly basis. Seeing how their medication regimen is going and if there were any issues and adjustments that need to be made we were in kind of that point of contact to them again go back to their specific oncologist and speak with them about what should be done to continue to help the patient.

Ok, I know one peads pharmacist down at Xavier and Louisiana, Joel O' Russel and he's very clinical but the peads rotation you did you said was a little bit more of a managerial role. So there's certainly many many aspects to any type of care for pediatrics. Can you tell me a little bit about what it is to do in administrative or managerial elective?

Yes and I will say this first of all is what I think I found most exciting of all the rotation experiences that I have and specific to the ones we're discussing now is each of the preceptors did a great job of really just trying to identify what your passion as a student was and what you wanted to get out of the rotation. In a while, you know, I clearly want to pursue a role within a hospital setting and really be working alongside patients and in a team of physicians. There's more to it than just that and so when I was able to do this pediatric rotation I got to continue in the clinical role where I was able to go in the ED I was able to go into the necu and as well as explore pediatric oncology. But what I was doing on during some other times within the rotation was attending important meetings as far as whether it be formulary meetings, whether it be safety meetings, drug shortage meetings, I was able to sit in and there were projects assigned with those meetings where I would be whether I might have to, you know, make a newsletter to inform the pediatric pharmacy what drug shortages are occurring or I might have to present what the current drug shortage is within the actual meeting. So there were several opportunities where you were able to really facilitate the conversation and you know, you had to go do the research behind the scenes and you would work alongside. There were two managers specifically that I worked with within the peads department but again I was working with multiple. With the different divisions within the entire hospital.

Oh, and this next one I know a little bit about because I just heard an RX radio podcast on solid organ transplant pharmacist and what he did and I wanted to first find out from, what does Hopkins do because I understand that some can just specialize and start in organs, for example, kidney tends to be one organ that because those are two organs because you can donate it this tends to be one that we see quite a bit but he said that it was so satisfying to see someone that was having organ failure and just how they present physically and then after the transplant to see how well they are doing and then also that they're switching from one regimen of medications to a completely different regimen post transplant. So can you walk me through what interested you in transplant and then what your experience was?

So I think the biggest interest is, kind of exactly what you just discussed, like, these patients they're coming in and they are, you know, some of them very very much critically ill or they'd been waiting for an organ for quite a while and for me the thing that was so unique is in school, you know, you get some, these are more specialty areas, you get some education as far as transplant is concerned but you don’t really get to see it first hand and see all that goes, you know, on behind the scenes and so from the pharmacy perspective when I was at Hopkins I got to work specifically as I'd said, lung and heart transplant. And just as you had, you know, spoken to, we had patients who came in and they were, you know, not doing well and after the transplant within a week, you know, they were going home and you see them doing well, you know, their medications are working and they're feeling well, they're feeling great, they're thinking the team for, you know, such a profound recovery and then, you know, there's also unfortunately the other situations where, you know, this is where these pharmacist really come in hand and the team plays a huge role in their care and it saves patients who maybe after the transplant aren’t doing well, you know, maybe there's retraction of the organ or maybe their medications that they're using aren’t, you know, the anti rejection meds aren’t working as well as they should be. So there's a lot of adjusting and there's a lot of monitoring as those drug concentrations as well as the side effects from the medications that they are taking. So for me it was really cool to see each day all the things that the pharmacist were monitoring. I felt like in this area there were a lot of not fires to be put out but it was just a lot of constantly, a lot of things that were coming in as far as messages to the pharmacist or calls to the pharmacist about what level, did you see the level, what do I need to do, what adjustment should be made and those types of things. So the pharmacist really have a huge role that they play in soled organ transplant.

Ok so now from there, we're just going down i-95 for about half an hour but we are completely going to a different world, going to APHA. My wife actually did that rotation, I want to say like, eight or nine years ago because she wanted to be near me and I was living in Baltimore. And she helped setup for the APHA meeting, she was I think in March or April somewhere around there but tell me a little bit about APHA and how you get that rotation first of all then what you did at the rotation?

Yes, so for me going from the Johns Hopkins Hospital to APHA was almost a complete 180. I mean I was using a lot of the same skills in completing some projects in that same type of respect but at the same time I went from dealing with patients and physicians and pharmacists all day to more of an office typesetting and so for me I was like, do I wear my white coat? Like, what is going on but no the APHA experencial rotation was an amazing opportunity. I was able to obtain that rotation through again, this was a national application process where through the website they have the whole application and I would strongly recommend it to any student who just wants to understand, you know, especially if you were involved within pharmacy organizations, APHA has meant a lot to me as I've been a student and so to see it kind of on the other side not just within the student's chapter of it but from the pharmacist level these practicing pharmacist and to see what impact we're having on the national level. It was very amazing but so each day at that rotation I was working specifically with the practice side of things so we were looking at new initiatives for different pharmacist within all practice settings. We wanted to know what types of continuing education that they needed, we wanted to know how we could make their membership more meaningful whether like I said, through CEs or through tool kits as [indecipherable 00:21:39] as ways that they could strengthen their practice and really show the meaning of what's the practices that pharmacist do have.

Ok, and then I thought that, you know, going home was a really important thing and although I lived in Baltimore during pharmacy school and my parents live in North Platonic which is maybe 45 minutes, it can tend to be a world away so I made sure to do one rotation at there where I lived actually with my grandparents and if you're not from the DC area we talk in metrostop so my grandparents provide the white flint metro.


And so that was where I was at and then APHA that would've been down by metrocenter, is that right? Where is it?

It's Foggy Bottom.

Foggy Bottom, ok, so.


Alright, and then so you decided, ok, I've been to Hopkins, I've been to DC it's time to just go home for a little while and so now you're back in Kansas with your sister. Let me a little bit about your VA experience that you're with now and vision.

So my experience with the VA has been a great one. I was able to again, I'm very thankful for my program and I don’t know how many schools get this opportunity but to actually create rotations. So while our school has access to several VAs there wasn’t one in Kansas city so to do a rotation in Kansas back at home I needed to set that up and I was lucky enough to be able to find one with the Veteran's Integrated Service Network and for people who aren’t familiar with that, ultimately there's these networks that are kind of overseeing and in charge of working with several VA hospitals within that network. So for me there's seven hospitals within the Cairtlyn network in the mid-west, you maybe familiar with the heart of America.


But so I was able to set up a rotation there with their pharmaco-economics pharmacist and ultimately in the role of like, TBM we're all as well as looking at a lot of their safety initiatives within all of the facilities. Right now we know that OPOD crisis has been a very strong and high point where pharmacist can play a large role and so a lot of the programs that I was involved with working on projects for INVOLVED, the OPOD safety initiatives within the VA as well as their pacts programs. These are patient one care teams that our pharmacy lead initiatives. So I was able to work a lot on projects revolving around that and then the pharmaco-economic side I was able to mostly work on like, drug cost analysis for certain drug classes within each of these facilities to identify different cost savings initiatives.

Ok and then tell us just briefly what other APPE rotations you have as you're going to round out your career.

So right now I'm going to continue with this break and work on the process of applying for residencies but once I get back in the, for the spring semester in January I've got two more rotations and then I'll be done but my next rotation is with geriatric pharmacy. It's ultimately one of the pharmacist from my school, is a geriatric consultant pharmacist. So I'll be able to work with her and what she does is, she has several nursing home settings and manage care type settings where she'll go in and do consultant work as far as looking in on certain patients regimens and those sorts of pharmacy tasks.

Ok and then the last one, yeah.

So in my last one I'll get to go home to my work-home so I work as a pharmacy intern at the Peninsula Regional Medical Center in Salisbury Maryland which is on the Eastern Shore. And I'm going to be doing a community rotation but it's in the al-patient pharmacy at the hospital there.

Ok, awesome. Alright, so now it's time to go to Orlando and we're going to talk a little bit about ASHP and I want to kind of hear what your thoughts were so there were three residency showcase times. I think they were three hours each and they were nice enough to spread the boost up pretty well.


But it took, I was up there with some PGY-1s and we were watching and it took about 11 minutes for the people to get in. So it was thousands of people. What was your strategy and you don’t have to name specific ones but what was your strategy in getting the information that you needed in what is controlled chaos?

So what I will say is I definitely think, if you're attending the medium meeting as a student and you're pursuing PGY-1 or PGY-2. It is important to do some research while there are maybe some people out there that are able to go in and ling it. I think it’s very important to have some sort of strategy and ASHP does a great job of providing you with resources to do that. ASHP provided on website what looks like an excel document where they listed every sort of every residency that was going to be present. So it was a list of over, I think just about 2000 facilities that we were going to be there at programs that were offering PGY-1, PGY-2 type residencies. The thing that I think helped me the most was really just identifying your personal programs that you thought or that you think are going to be a fit for you. Doing your research ahead of time as far as, you know, what are the mandatory rotations within the pharmacy residency. What are the, what's the size of the facility whether it be an al-patient clinic that you want to work with or whether it be an in-patient facility. And then pursuing those really just kind of going down, it gives you an opportunity to explore as there's states or programs that you look at and you're like, oh, I've heard about that. It gives you an opportunity to look at that and see if those are going to be a fit for you. But really what I would say is once you kind of identify those programs use the resources they provide you, they provide you with a map. Where they're going to be sitting on the day of the showcase, really kind of identify where it is because when you get in there I will admit, I did not go in right away any of the days. I waited 30 minutes, I mean, I don’t think I'm a person who gets really overwhelmed or stressed out but when you see that many students, you know, we're all dressed up to the nine as best as we can, you know, and we go in there, we've got the portfolios, we’ve got our business cards, we're very eager to meet with the residency directors and residents. I think it's important to just take a moment to figure yourself out, don’t compare yourself to other students, don’t compare your approach to other students because that will stress you out. There are going to be students who, they've got it in an app, what they're going to do, they've got it with down the highlighted color coded.

I've seen some of these treasure maps, yeah.

And you know, they look great and it's awesome but if that's not your style or that doesn’t work for you be authentic to yourself ultimately because at this point in time when you're at ASHP for med-year they tell you over and over again, these residency program directors are there for you to see, you know, they're there to answer your questions. They're there to answer what you have. Some programs did a great job, you know, they gave an overview because, you know, maybe you stumbled upon or made a new connection while you were there that you weren’t originally thinking about but it's important that you recognize that do what you feel you're comfortable with so find questions that you think you weren’t able to, you know, gather from the actual online information, you know, some of the information kind of what you need but if there's something personal to you, research opportunities or specific types of, you know, is there a teaching certificate and what that program specifically looks like. Ask about those things and just get face to face but also remember that it's not just during the residency showcase that you have opportunities to network. I'll tell you that I had countless moments where I would be in line for food or during my poster presentation where there would be, you know, program directors or residents that come up to you, those are opportunities as well to kind of engage. So don’t always think that the residency showcase is the only place you're getting that opportunity at med-year.

Yeah, no that's great advice. I'd spent a lot of times, I went to three of the events afterwards which would be after six o'clock. So I went to one where I'm preceptor at the Maryland reception and then also PTCB and there they are residency directors with no line.


So it was just kind of, you know, such a great insight that you have with that. Well now, what does it look like now with what you're doing, so you've gone to the meeting, now forecast is your best friend for a couple more weeks? What's your kind of process for getting everything out there, it sounds like in creating these narratives for the national APPEs. Maybe you had some experience in creating the types of documents you're going to need for this but what's your process now?

So the process now, I think it's really, I've had a little, under a week, to kind of reflect, about a week to reflect on my experience at ASHP med-year. You know, you go in there thinking, oh, I've got somewhat of a list of the places I think I'm going to apply but like I said, during like, poster presentations and your meetings, you kind of develop conversations and network with maybe programs that you didn’t even know you were interested in until you really got to know somebody from that program. And so there were a few like that that popped up that I've been exploring and just kind of really walking in, you know, is this somewhere I could see myself and from that I've been, you know, uploading all the information in to forecast. So really cut down my CV, have a few more people edit that, I've been looking at making sure my letters of recommendation are, you know, on top of the game to get those turned in on time. And then ultimately finishing up, well, yeah, finishing up slash starting some of the letters of intent.

Ok, well, we do want to keep it maybe under an hour. I can't believe how quickly this time has gone.


But I just want to ask you a three quick questions at the end here that maybe can help people understand on more of a day to day basis. What it is you do that makes you successful? So on a day to day basis what is it that you do to keep your work on track?

As far as I.

So are you a list person or you.


What kind of management strategy do you have for time and tasks?

I very much am a list person. Anybody who really knows me knows I have a planner that is sometimes color coded. I kind of lost track of that as much as I used to be but I really do like to plan out things so this whole application process is a little overwhelming and just kind of time down a few task each day that you want to get done and being, you know, flexible to the fact that they might not happen or something might take longer. But just knowing that you are thoughtfully understanding that each of these has a set amount of time that you can give to it and it needs to, you know, start to get done. That's really important to me.

What's the best career advice you've ever given or received? And if Jim Burcet gave it to you that's quite alright, he's a smart guy and.

Yes he is.

And was a leader within our class during my pharmacy time and then he's been continue to leader after.


And UMES, is definitely lucky to have him but what's your, what's the best advice you've gotten or given career wise?

I think the best advice I've ever gotten career wise that I've received a several from several people. It's, never stop looking for opportunities and just say yes. I know that sounds like, you can't say yes to everything of course but at the same time as a student, I mean, we're here to learn and we're here to gain, grow from the opportunities that were given. And so for me I don’t think there was really anything in pharmacy school I had said no to. You know, maybe a conflict of dates but a lot of the experience I've been afforded and the opportunities that I've had have been because I just said yes. I didn’t know, maybe I didn’t know what the organization was about, maybe I didn’t know what the conference was truly about but getting to go and explore those opportunities. You can speak to those later, they provide you with so much more understanding of how the entire career of pharmacy works rather than just within your own isolated bubble of this was what I planned. So just say yes to opportunities and explore.

And then the last question, what inspires you?

Me, what inspires me, my mother inspires me. She's a lot of the reason I push and I drive for the things that I want to accomplish. She was an amazing woman so every day I kind of hold that dear to me and continue to let her be my inspiration.

Well, Tola thanks so much for being on the pharmacy leader's podcast.

Thank you so much for having me. It's been great speaking with you.

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