Written By: Juhi Hegde, Second-Year Student Pharmacist
Editor’s Note: This post is the first in a series of Summer Reflections authored by student pharmacists at the School of Pharmacy who participated in study abroad experiences during their summer breaks.
My first year of pharmacy school was an invigorating experience, as I transitioned from a small undergraduate university to a larger, urban institution. Along the way, I got involved in a number of student organizations, particularly the American Pharmacists Association-Academy of Student Pharmacists (APhA-ASP). After listening to a panel of students speak about their experiences abroad at an APhA-ASP meeting, I found myself interested in pursuing the same opportunity and began an application process through the International Pharmaceutical Students Federation (IPSF). IPSF is an international advocacy organization for pharmacy and pharmaceutical science students. It houses the world’s largest Student Exchange Program, and places more than 900 students in professional pharmacy internships around the world each year.
My Journey Across the Atlantic
After submitting my application, I learned that the British Pharmaceutical Students Association (BPSA) had received my application and that my placement was to be in Lincoln, England, a town two hours north of London by train. Thanks to the help of Jonathan, a student pharmacist at the University of Lincoln, my arrival to the U.K. went very smoothly — one seven-hour plane ride, a one-hour subway (or tube) ride, and two trains later, I was in Lincoln! Everyone I met was incredibly welcoming and friendly. I was placed at the Lincolnshire Coop Pharmacy for four weeks, from July 2-27, and took the opportunity to travel on the weekends to other nearby cities such as Southampton, York, London, and Edinburgh.
Pharmacy Practice in the U.K.
One observation that I noted at my placement was that pharmacists in the U.K. play a very large role in medication compliance and lifestyle management of the patient. My placement site had programs focused on patient well-being, and there were many other programs offered by the National Health Services (NHS), including a 12-week weight loss program, cholesterol and blood pressure checks, and smoking cessation programs. Addiction treatment was another service offered, which involved dispensing methadone to patients battling heroin addiction in conjunction with a pharmacist-led counseling session.
In addition, I learned that the pharmacy offered other services known as Medicines Use Reviews (MURs) and New Medicines Services (NMS). These two services are among the most important for patients, as MURs help ensure that the patient reviews their understanding and administration of the medication with a pharmacist, and NMS helps pharmacists properly introduce patients to any new medications they are prescribed to help improve patient adherence. The NHS hopes to improve overall health outcomes across the U.K. by requiring pharmacies to meet a certain monthly goal for these two services.
Further adding to my knowledge of pharmacy administration, I became familiar with the Drug Tariff, which provides information on the value of individual drugs as well as the additional fees that pharmacies receive through reimbursement, and the British National Formulary, which is heavily used by pharmacists, as it contains medication names, uses, contra-indications, side-effects, costs, doses, and other medication management information.
No Insurance? No Problem.
Another key observation that I noted during my placement is that the process of receiving and paying for prescriptions in the U.K. is drastically different from the U.S. Medications are not processed through insurance; instead, there is a flat rate that all patients pay. Most patients are also afforded exemptions to this flat rate, such as those living with a chronic condition like diabetes, full-time students, and pregnant women. As a result, most patients usually do not have to pay for their prescriptions as long as they provide proof of their exemption.
Reflecting on My Experience
I cannot finish this post without giving a shout out to my pharmacy family across the pond! From understanding the small differences (e.g., learning that “OD” means “once daily” instead of “right eye” in the U.K.) to overcoming the larger ones (e.g., not needing to process prescriptions through insurance), my co-workers were there to guide me through it all. I highly recommend my placement site, as well as the town of Lincoln for any student pharmacist looking to experience pharmacy abroad in the U.K.