RPHARM program fulfills need for rural pharmacists

ROCKFORD, Ill. — Whether it’s prescribing antibiotics for an infection, drugs to ease pain after surgical procedures, lifesaving insulin for diabetes or being a health-care provider for a rural community, rural pharmacists have always filled a unique role in the medical community.

But with changes in health care, health insurance and health-care funding, the numbers of independent, rural pharmacies and rural pharmacists have dwindled in the last few decades. The need for their services, however, remains.

The Rural Pharmacy Education Program, known as RPHARM, at the University of Illinois College of Pharmacy, is part of the college’s rural health professions program. Those programs include RMED, the Rural Medicine Program, and RNURSE, the Rural Nursing Program.

The RPHARM program prepares students to practice pharmacy in a rural setting and educates students about the unique challenges of rural health care.

Students in the RPHARM program either come from a rural background or are interested in practicing in a rural community after graduation. The RPHARM program started in 2010 and the first class of rural pharmacists graduated in 2014.

Dr. Heidi Olson is a practicing pharmacist and the director of the RPHARM program. She talked to AgriNews about the RPHARM program and the challenges that rural pharmacy and rural pharmacists face.

Why did the RPHARM program start?

The university started the RPHARM program hoping to provide rural pharmacists to not only Illinois, but to rural areas across the U.S. One of the reasons for starting RPHARM, especially when we opened the Rockford campus, was to have people from rural parts of the state be in the RPHARM program on the Rockford campus and then hopefully return to their rural communities when they graduated.

What sets the RPHARM program apart from the standard pharmacy school program?

It is an add-on to the regular pharmacy curriculum. We don’t re-teach them anything they are already learning in the core curriculum. They get a lot on public-health concepts and community health. We want them to realize that, yes, you are going to be seeing individual patients, but as a health-care professional in a rural community, you are responsible for the overall health of the whole community.

We know about retail pharmacy, but what other kinds of pharmacy jobs are there for RPHARM graduates?

I help teach one of the first-year courses and within the first couple of weeks of class we have a panel of pharmacists, all from different types of pharmacy, that come in and talk about their journey, what their jobs entail, what they love about their jobs, things they wish they could change. Right away, our RPHARM students see that there are 80 or 90 different types of pharmacy they can go into after they graduate.

Years ago, every small town had its own pharmacy. Those have mostly disappeared. So, when we say “rural pharmacist,” where are the RPHARM graduates working?

I keep track of what our graduates are doing and where they are practicing. About 40% of our graduates are practicing in a community pharmacy, like a Walgreen’s, Walmart, CVS, Target. That also includes small, independent pharmacies. Another 40% are practicing in hospitals, critical access hospitals. About 12% are working for the government, like the VA, Indian Health Service and the Bureau of Prisons. We do have a decent number of graduates from RPHARM who are working in long-term care pharmacy, the pharmacists who are responsible for taking care of residents in nursing homes.

Do small town rural pharmacies even exist anymore?

One of the biggest reasons that independent pharmacies are closing is because they are just not getting repayment from insurance companies at the same rate as the chain pharmacies. They can’t keep the doors open. A lot of our rural independent pharmacists are older. They are at the point where they may barely be able to keep the doors open and they are at the point where they could retire. A lot of them are staying working way past retirement age because they know that, if they leave, there’s no one to replace them. A lot of times, when they decide they just can’t do this anymore, they close because there is not anyone to keep that pharmacy open. That is happening in rural communities across the United States. The amount of pharmacies closing in rural communities is increasing, when you compare to urban areas, where the amount of pharmacies is increasing.

Where do you recruit students for RPHARM?

We do workshops in the local area with 4-H kids to get the career in front of them. I attend the state and national FFA conventions. The college has a high school pharmacy camp and virtual sessions. Once they get into undergraduate, we have a program called Summer Pharmacy Institute, which is a weeklong immersion where they come to campus and they learn about different types of pharmacy and do lots of hands-on activities.

What students would be interested in pharmacy as a career?

From a really young age, we say to children and young people “Oh, you could be a doctor,” or “You should be a nurse.” Pharmacist just isn’t one of those things that people are aware of. I tell them, hey, guess what, with all of that science and math that you are really good at and you really love, you could be a pharmacist. That’s a viable option if you want to be in health care, but you don’t want to be a doctor or a nurse. It’s something that, if you want to serve your community, you can come back and serve your community as a pharmacist. I like to say that if you can handle the coursework, there is a type of pharmacy that you are going to find that is right for you, whether that is research or community pharmacy or you want to work in an emergency room or oncology or pediatrics. There is a pharmacy practice area that is going to fit you really well. You just have to have the patience to figure out what that is going to be.

Is working in an independent rural pharmacy still an option?

We have graduates who are working in independent community pharmacies and they are happy as clams. If you are really passionate about working in community pharmacy, you make your choices knowing what you are going into.

How has enrollment been in the pharmacy programs in general and the RPHARM program, in particular?

For pharmacy in general, enrollment is down significantly. Many, many pharmacy schools are not able to fill their classes because the class size is getting smaller. Our standard class size used to be 40 students. So, it wasn’t a stretch to find students in that group who were interested in RPHARM. Our RPHARM enrollment has decreased as our class size has gone down. I don’t know if that is because we are missing those rural communities and telling the youth in rural communities that pharmacy is an option and that there are pharmacy schools you can go to that don’t require you to live in an urban area.

Does a student have to have four years of college to be a pharmacist or to enter pharmacy school?

Typically, pharmacy students need at least two years of college before they can get into pharmacy school. They don’t have to have a bachelor’s degree. Some do, but it’s not a requirement. Pharmacy school is four years. Ideally, students join the RPHARM program during their first year of pharmacy school because the RPHARM program is a four-year curriculum. We do set it up so that if someone decides this is what I want to do, toward the end of their first year or the beginning of their second year, they can join RPHARM and we can get them caught up.