This past month, I was promoted to the rank of Associate Professor of Pharmacy Practice. I had started being an Assistant Professor in January of 2013. Before that, I had done a PGY-1 Pharmacy Practice Residency, and then a Geriatric Fellowship at the insitution that I am now a professor at, after deciding I'd like to stay on based on the environment.

Now, that I have some time, I wanted to reflect what it was like transitioning through all of those roles. When I was deciding to go into academia, it was difficult to find anything online, and I was more reliant on talking to colleagues and some mentors about what I was getting into, and in some things they were more than right, and in some other areas I realize I was never told what I was in for. 

So, if you are a resident, fellow, or someone looking to go into pharmacy academia, I hope this could be of some help. And for those of you that know nothing of pharmacy academics, maybe this will be of some interest in the roles and responsibility for an academic clinical professor.

What Exactly is the Job?

"What do you teach?" Get used to this question, and then realizing you have no idea what to say. My parents and family still don't understand what I do (maybe this will help, who knows, if they read it). It's difficult, most people envision a professor that goes to a school, lectures, and tests on a topic, and goes home. Ergo, you teach 'Class XX" on "Subject YY" and complete the conversation. Instead, you'll stumble as you try to explain you lecture in "Gibberish" while also maintaining a clinical site at "Location Y" while also doing "Duties blah blah blah." Yeah. My advice? Just say you teach people how to be a pharmacist, and if they delve into specifics name a topic area of your choice, and if it goes further then talk about the roles of a clinic and rotation students.

In any event, the job is focused on three areas:

1. Teaching - Your bread and butter. You will spend over 50% of your time doing some form of teaching. This may include spending all day at a clinic overseeing your rotation students, or half a day at the clinic and the other half on campus, or all day on campus. You will teach classes, coordinate courses, facilitate classes and laboratory experiences, proctor exams, and serve as a mentor in one format or another throughout the week. But it varies depending on your semester, so no day is ever the same for all intents and purposes.
2. Scholarship - "Publish or Die" If your institution is tenure based, you're gonna bust your ass to get some publications out there to prove you deserve that promotion. Most programs are now rolling contracts, and have a minimum to do. If you're interviewing, figure that out. This could all include applying for grants, running a study/survey, presenting it as a poster, and hoping to get it peer-reviewed. This could take a few months, or years. Hell, I just got to publish the research I started as a fellow five-years ago for instance.
3. Service - The all too uncertain role of 'What the hell am I doing at this place?" This was the hardest (and still is) part of the job. You will quickly be added to committees and taskforces for roles you have no idea accomplish because you are still adjusting to the culture of the university. Perhaps the one thing that is rarely talked about in academic interviews or topics, but will suck your soul in one fashion or another are the standing and impromptu meetings that you will have to plan out in your calendar regarding your membership to these areas. And with committees, comes more work and deadlines for activities you still are trying to make shape of in your head.

I was thinking how I wanted to break this down going forward, and I decided to break into a table over the 5 years of my experiences in those three areas if you want specifics, but will keep a chronological approach to the years overall in the text.

My Years as an Assitant Professor

Luckily (sarcasm) part of going up for promotion includes creating a document a couple hundred of pages long detailing what you did. So a lot of the past few years are fresh in my mind and by annual activity, reports are useful just to document my experiences.

The First Year (January - June, 2013)

So my first academic year started mid-cycle. Most residents and fellows hired as a new assistant professor to a pharmacy school will start in the summer (June/July) upon completion of their program. For others currently working, this can occur at any time, which is what happened to me as I was hired while still allowed to finish my fellowship at the same institution. So, for five months I was a transitionary fellow (I think? It's still hard to make out in my mind). 

 What did I do that first year then? My primary goal was actually to start getting my clinical site in order. Now, most pharmacy schools at minimum have two departments, Pharmacy Sciences, the people with doctorates in some science (biochemistry, pharmacology) and usually do bench research and teach the science-based courses at the campus. These people stay at the university and rarely have to leave. Then you have Pharmacy Practice, which includes faculty who are usually all practicing pharmacists, who teach (based on their experiences gained in practice and training) and then oversee students at practice sites on their rotations. So, pharmacy practice can be based on campus or off-campus depending on their duties between balancing teaching and patient-care responsibilities.

So, yeah, back to creating a practice site. I was offered several possibilities, but I was going to be an 'Ambulatory Site' preceptor at the end of the day, which is just outpatient clinical care. I ultimately went with a nearby large academic medical university hospital to join the outpatient heart failure management team. I had no idea what I was going to do, but I wanted to find a way to bring my knowledge and skills to that role I felt. So, I bumbled around for a few months trying to get a workflow that made sense together that would involve me seeing patients, doing therapeutic workups, patient follow-ups, and other duties that could use a pharmacist on the floor. Now my school has six rotation blocks that run 6-weeks at a time. Since I was hired at an odd time, and still finishing my fellowship, I didn't start taking rotation students in January 2014. Now, my school has us generally taking 18 APPE (advanced pharmacy practice experience) students, and in my first year, I took 6, which were for all intents and purpose were guinea pigs. At the end of the day, it was a good learning experience on what the workflow for my students would look like at the end and what assignments I would give them.

Now, regarding other teaching responsibilities, I was in a panic. I entered when the faculty presence was decent, and no substantial shortage in having classes being taught. Thus, I had to find some classes to teach based on immediate needs, or what other current faculty members were willing to pass up (and trust me, faculty will be happy to offload courses they have been teaching to free up - after all, they get promoted and get other duties to address as well). My advice? Be cautious of what is given to you, especially as a new faculty as what may seem to be a great opportunity at first could be a class several years down the road you hope to pass on to someone else. Luckily, this didn't happen to me, and I got to teach a few classes that I still teach now. The one thing to consider as well, with teaching and gaining classes in the beginning, is to factor in that while you are trying to set up your practice site, and have no APPEs, you may not feel as busy. Once you have a full APPE load and classes to teach as well, you could be swamped, plan accordingly.

For scholarship, I focused on finding new projects to work with current faculty with. To be honest, in my case, I actually used this as an opportunity to explore my passion for technology and went crazy with it (which is what this website is focused on). I wrote my first paper by myself during the winter break of 2012, which I then focused on publishing during 2013. The advice I want to give to new faculty with writing: Talk to editors. Call them, email them, don't be scared. Ask faculty for feedback on your writing. Lastly, failure is inevitable. You will get rejections. Submit to another journal again, do not abandon work unless it's a lost cause, and let others help you figure that out. I think new faculty struggle with writing due to the trepidation of the process at the end of the day. They want to make the perfect paper before submitting, and then days drag into months as they work on it. There's a reason peer-review exists, use it if your substance is worth the addition to the body of knowledge.

So that was my first year! A lot of stumbling around asking faculty for advice on what to teach, how to run a site, coordination, and learning what to do. Notice I didn't talk too much about service? That's because I was still onboarding to areas. I didn't get added to many committees the first year, just one in admissions, and even then it wasn't a lot of work off the bat. This would come to bite me in my proverbial ass years later I feel like I was unprepared when I got slammed with a lot more work as I was acclimated to the college.

The Second Year (July 2013 - June 2014)

The second year was much more fun in many regards. At this point I had an idea of what I was doing with students in the clinic, you can see my workflow below for instance. I was active and spending a lot of my time there as well. This was also my first year participating in the white coat ceremony and taking in a new class. I swear, that experience stands out to you, because when you see them graduate years later, you will realize this was your first full cohort of many. But I think the first class stands out the most.

Again, I was a bit lost, some things were changing in the curriculum, we were up for reaccreditation, and I was being thrust into more committees and task forces as such. My work ratcheted up a bit, but teaching was still lower than what I wanted. I started teaching in our other healthcare programs, including optometry, physical therapy, and physician assistants schools. This was due to other faculty exiting the topics themselves, so I picked them up. I was joining in labs to facilitate, and doing as much work as I could find. 

At this point, I was then asked to coordinate a class. Now, this is something I think that is hard to explain at times. Coordination does not mean you teach, rather, you get a bunch of lecturers together, make sure you have people facilitating labs and break out sessions, and makes sure all quizzes and tests and materials are set. It's not easy, it's not classroom work, and it is a lot of work at the end of the day that students rarely see. But it's part of the job. That was an eye-opener for me. In this case, I was coordinating a mishmob class that spanned two semesters that dealt with teaching students how to conduct and understands physical and clinical assessment - but often it could be a dumping ground for other topics. I think every pharmacy school has one; I know the one I attended did as well.

Regarding scholarship, I started to make connections, attend national meetings, and find topic matter to publish. Now, unless lucky, you're not going to start conducting large trials and studies your first few years into your academic life as a pharmacy practice member. Hell, I am just starting to get to that point. Maybe I could have networked better, but I think that's a big part. Mentorship can be a pro and con depending on who they are, but think beyond your university for collaborators as well especially if your interests are niched (like mine).

And that was the second year, really still getting my feet wet, but seeing everything from start to finish.

Third Year (July 2014 - June 2015)

By my third year, I got married, and life got more grounded as I got into a rhythm I feel. My site was running well, I had more classes, and I was running an elective during the summer with another professor based on our joint interests in technology (Basically a "Technology in Pharmacy" elective). 

I feel I concentrated a lot more on scholarship this year and would have some publications in multiple journals and an E-book by the end. I also was being invited to talk at some events across the US, which was cool too. 

Now, the thing is, just when I think I had things down, we did a significant change. We were updating and changing our curriculum. Whee... 

This meant more committees and task forces on how to do this. The course I was coordinating was going to be gutted in two-years, and I had to start thinking of how to roll it out. This became a drain. I started to spend less time at the clinic with students. Where at one time I was at clinic 3-4 days a week for 6 hours at a time on average, I was dropping down to 3 days a week, and coming back to campus breaking up my day. Luckily I lived in a condo between the hospital and campus and was a 5-10 min commute, either way, depending on traffic, so this wasn't too big of a problem.

I would say, the third year went by quick. A lot of changes on campus really stood out to me. But my teaching and scholarship were on track; I just didn't know my service would start ratcheting up and making it worse.

Fourth Year (July 2015 - June 2016)

My wife and I decided we wanted to have kids. I really need to preface that because it was going to make things really ramp up on me. We decided to go on a long trip to Italy, and do a lot of vacations beforehand, so that was a big thing for me during this time.

And yet, all hell felt like it was breaking through on campus for me. Service was killing me. I had so many meetings and things to attend in preparation for the curriculum change and classes and syllabi to make, and comparisons with another faculty to discuss I felt like I was losing my mind at times. I look back at my calendar, and I just feel a wash of dread remembering it. Nonetheless, new faculty, if you aren't organized or have a way of keeping organized, figure it out. Also, if people love to use 'Doodle,' I would suggest blocking out time selected so that you don't overlap if another five committees and working groups decide to choose the same time and accidentally double-book yourself. It happens, but you'll learn. I did. I still do.

My site wasn't doing as well as I liked, I found that I could not be as flexible with the clinic schedule as I had the previous three years, and the staff noticed. Luckily I worked with great people who knew my priority was my students and role at the school and were very accommodating. I would say that, at the end of the day, remember who pays you. You are at the site to help students learn, and you are there for your continued practice experience to bring back to the classroom. But for as much as you may call yourself a clinician and have clinical roles if the school needs you - then something is going to give. 

My classes were doing well, but I was working on drafting up material for the following new curriculum. The issue was that half the time I wasn't sure what I was going to teach. Then my wife was pregnant and due the following year. And suddenly I realized I needed to get all the projects and other items off my plate because I saw a sudden countdown out of the corner of my eye for when my son was due.

Fifth Year (July 2016 - Now)

I busted my ass, the best way to put it. I submitted my promotion packet (which let me tell you was more work than I expected and then some), got all scholarly work out of the way, told different offices and made arrangements to be on leave, and really just had to get everything ready. I look back on this year, and it is a blur.

And maybe that's the thing, I started to coordinate a new class, developed new lectures and content, and had even more meetings and such to attend. I feel like there were several days a week of just endless meetings.

Then my son was born, and the world slowed down, for a time. I really started to question what I wanted to do, going forward. I'm not talking academia, but more or less what I wanted to make sure I spent my time doing what mattered to me and my growth and to maximize my students learning opportunities. 

I was spending less time at my site. Some weeks only two days in the clinic. I was not happy about that. So, I decided to look for another site. In conjunction with all of this, I had been doing really well with my interest in technology and wanted to do hands-on research involving patients, and I saw some opportunity with several companies. This led me to look to go into the home healthcare sector, which I will start this coming cycle (or my sixth year). So I spent my fifth year figuring this all out, while on leave with my kid. 

My wife took the first three months out of maternity leave, and then I took another three months on FMLA for paternity leave. That was tough financially, but we had been saving, and bought a home and moved in towards the end of my leave. So yeah, had a kid and bought a house. Fun times. 

Then I returned to work and found myself playing catch up for the previous three months of work I missed. It was exciting and devastating. It took a lot of time to acclimate, and I still am. 

Before and After a Kid

Take, for instance, the difference in my time. I had a short commute, and no kid, more leisure time. It was great in a way, and I attribute it to my ability to really spend a lot of time on scholarship.

Now? Well, my days fluctuate depending on my wife's schedule. If she works mornings my day starts earlier, and I can have some free time in the evening to still do some extra work (because it's time for my wife to see our son). But on days my wife works late? Well, then I take care of the kid and put him to bed after his bath before his mother gets home. At that point, I really don't have the time to do extra work that I did in the past. 

So What Do I Teach Now?

Couldn't resist, could you? Well, at this point, looking at my current path, this is my map.

As you can tell, I am lighter (currently) in the fall of the year. I work at an accelerated program, so the 4-year PharmD is 3-years since we are teaching in summer. No breaks. Spring is my busiest and still one of the things I am trying to get a hold of at this time.

So if you read all of this, and still find the experience intriguing, here is some advice I have. I will add as I see fit in the future.

Advice to those considering Academia

• Why do you want to teach? Really ask yourself that question. If you are finishing a fellowship, and see academia as a way to get into a clinical position at a big name hospital and teach as well, that's great, but don't use it as an excuse to get that clinical position. Because, you will come to an eventual fork in the road on who you answer to, and the answer will be the school because that's who employs you. So if you want a clinical job, get a clinical job. Don't do academia.
• Recognize it's more than teaching. Hell, even teaching in the classroom will be a small part of what you do. I track how many hours I teach a class on the podium, and it's a little percentage of what I do overall for the job. Just know that otherwise you may be disappointed. Teaching has many hats and duties instead of just lectures. 
• Find a good site. I mean this, don't choose a site (if you have options) that you aren't ready for. And don't overload yourself at your site. You're going to be not to busy your first and second year (likely) on campus and may be tempted to make up for that shortage at the site. But, if you make that site eat up all your time like a full-time position, and the work on campus starts ratcheting up, you're going to disappoint someone. So just get that balance, quickly.
• Do you like to write? Do you like reading? If not, I wouldn't recommend academia. Scholarship is a part of your job, in some fashion. You will need to do some form of research. You will need to present that work. You should publish that work. If you don't, then it's hard to progress academically. Look, you could be an awesome clinical teacher, with a stellar practice suite and all the docs love you, but when your review comes up, or you go for promotion, people are going to be looking for some citations. You're an academic, and academia loves those citations.
• Do you want a 9-5 job? Don't do academia. You are always working, because email, service duties, and scholarship never end. Ever.

Advice to New Faculty

• Time management is key. Get a good organizer or electronic system. I still have the issue where I use Google Calendar, and my school is in Outlook. This causes problems; I'd recommend just keeping your complete calendar on your academic account to save some ease of mind.
• Get a good mentor. Be clear with them. If it doesn't work out, find another. It will help you in the long run, because bad advice can make your life harder and delay your progress.
• Connections are key. Make them at meetings. I am not always good at this, and still working on it. But I recognize the importance of what it can bring. Especially if you find yourself struggling with certain things, like scholarship or service.
• Don't hate your students. I think it's easy to get jaded by the bad ones (I was a bad one I feel). You can tackle these multiple ways, but I think remembering why you wanted to be a professor is key. Hold onto that. 
• I'll add more as I think of them...

And that's it. I've enjoyed the path I've taken so far. I hope my role as an Associate Professor will be as much fun as I have had so far. And let me make that clear, I love how much this job changes from day to day. I love teaching my students and seeing them grow, and I hope to grow myself each day as well.