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The Many Faces of Clinical Pharmacy By Lily Qian Even as a third-year pharmacy student, I am still amazed at the wide range of tasks that a pharmacist can accomplish. When I met my RAMPS mentor, I expected to shadow a pharmacist on the heart and lung transplant team. However, that was just one of the services that Dr. Joyce Lee has work with as a clinical pharmacist at UCSF. I first met Dr. Lee last spring and right away, I noticed her friendly and easy-going personality. She attended UCSF as a pharmacy student, and worked as an intern in an outpatient pharmacy at a local hospital. It wasn’t until she went through her fourth-year clinical rotations at UCSF Medical Center that she realized she preferred to work as a clinical pharmacist. She completed a one-year pharmacy practice residency at UCSF, and then began her career as a clinical pharmacist with the cardiology service. Over time, her resume expanded to include experiences with the anti-coagulation service and the heart and lung transplant service. Currently, she works at the UCSF Comprehensive Cancer Center as an oncology clinical pharmacist. Dr. Lee’s interest in cardiology began when she was a fourth year student rotating through the service. She stayed at UCSF after her residency to work in the field as a clinical pharmacist, and that has led to opportunities in related fields such as anti-coagulation and heart and lung transplant. With the anti-coagulation service, Dr. Lee was part of a team that developed a quick reference pocket card on warfarin dosing. This guide was an asset to many health care professionals, as well as the students and residents who rotated through the site. Later with the heart and lung transplant service, Dr. Lee was an integral part of the transplant team in managing patients’ medication therapy post transplantation. She monitored immunosuppressant drug therapy levels, making sure each patient’s drug level was not too low to cause rejection or too high to cause side effects. She also assisted in the management of transplant complications such as rejection, infection, hypertension, dyslipidemia, diabetes and osteoporosis. Since transplant patients often take many medications, Dr. Lee monitored for drug-drug interactions and also provided education for transplant patients and their caregivers on the use and importance of their medications. Recently, Dr. Lee joined the oncology service, which is primarily centered at Mt. Zion. Her full-time schedule is divided among four groups. She works in the infusion center pharmacy two days a week, where she processes chemotherapy orders and assists in the preparation of intravenous medications. She divides the remainder of the week among three oncology services: breast care, gastrointestinal, and gynecology. At each of the oncology clinics, Dr. Lee works with physicians and nurse practitioners in managing patients undergoing chemotherapy. She assists the nurses in providing information to the patients and their caregivers regarding the chemotherapy treatment that they will be receiving, the side effects of the medications, and what to expect from the treatment. She also answers questions the patients may have regarding the potential interactions between the chemotherapy and their medications. Then, depending on the needs of each clinic, her job varies from resolving insurance issues to managing chemotherapy- induced side effects that the patients may be experiencing. From my shadowing experience with Dr. Lee, it was interesting to see the vast spectrum of experiences that she has had as a clinical pharmacist. New medications and treatment plans are constantly emerging, which give pharmacists a great opportunity to expand on their profession. This is especially true for relatively new and developing fields of medicine such as transplantation and oncology. I look forward to continuing my mentorship with Dr. Lee and hope that others will have the same opportunity through the RAMPS program. Lily Qian is a third-year pharmacy student.
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