Episode 30 — Drs. Tabitha Sineath ('24) and Katie Cox on Specialty Pharmacy

Episode 31 — Dean Debbie Byrd on new state funding, Gatton's 20th anniversary, and answers to student questions

On this episode of White Coat Radio, we’re joined by Dr. Debbie Byrd, Dean of East Tennessee State University Bill Gatton College of Pharmacy. She discusses the latest news regarding state funding and reduced tuition [https://news.etsu.edu/articles/gatton-secures-additional-state-funding], the college’s 20th anniversary [https://news.etsu.edu/articles/etsu-gatton-college-of-pharmacy-celebrates-20-years], her philosophy for overcoming challenges, and answers questions from student pharmacists Dean Byrd is celebrating her 10th anniversary as dean of Gatton this year. In March, she was named a Distinguished Fellow of the Pharmacy Academy by the National Academies of Practice (NAP) [https://news.etsu.edu/articles/etsu-bill-gatton-college-of-pharmacy-dean-debbie-byrd-receives-a-top-fellowship], a prestigious honor that recognizes excellence and leadership in interprofessional health care. TRANSCRIPT: Dean Debbie Byrd I also view challenges as opportunities because I've seen that play out that when we do have those obstacles, many times they have resulted in some of our greatest successes.   Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and students pharmacists. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success.   Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. On this episode, we chat with Doctor Debbie Byrd, dean of ETSU Bill Gatton College of Pharmacy. This year, Doctor Byrd is celebrating her 10th anniversary, coming to Gatton as Dean in 2016. In March, she was named a Distinguished Fellow of the Pharmacy Academy by the National Academies of Practice (NAP), a prestigious honor recognizing excellence in leadership and interprofessional health care.   Stephen Woodward Learn more about Doctor Byrd on our website e-t-s-u dot e-d-u slash pharmacy. Now let's get to our interview. Well, Dean Byrd, welcome to White Coat Radio.   Dean Debbie Byrd Yeah. Thank you for having me. Glad to be here. It's great to have you here.   Stephen Woodward We'll start by telling us what is a typical day. Being a dean look like.   Dean Debbie Byrd You know, there's not a typical day. But I think that's probably one of the things that I enjoy most is just the variety and, you know, the work that I get to do internal to the college, which you know, most in the college would be, you know, very familiar with and, but there's also a lot of external work at the university and then even beyond the university.   Dean Debbie Byrd So, a lot of my time is spent problem solving. I've described myself as a fire chief sometimes, putting my fire hat on putting out fires. But it's it's usually not to that, that level, but it's, a lot of serving as a, as a soundboard for people. It's been a lot of time in meetings. And that's where a lot of that, you know, problem solving and coaching and, and just, you know, hearing what, what others have in mind to do. I know when I was new to this position, I was very taken aback by all the meetings or how much time I was spending in meetings. And I remember, talking to my boss at the time, Wilsie Bishop. And I said, you know, when I've just. I'm in meetings all the time. I went, when does. When will I do my work, you know, as these, and this is my first job as a dean, and she, you know, paused and smiled and looked at me and said, this is the work that is that is the work which is very different from what I had done previously. But, you know, whether it's meeting with, members of the leadership team or executive committee individually, or, you know, as a group, with the faculty council, we have the dean student advisory Committee today. I was kind of I had to think about it a little bit because there are so many different things. But, just all of the stakeholders within the college, and our alumni here, those, those meetings go on on a, on a pretty regular cadence. But then at Etsu, there are a number of different councils that I serve on the university council, academic council, deans, council meeting, council deans meet on a regular basis. So, you know, all of those things are, you know, trying to make things better, whether it's here at the college or at the university that, you know, even beyond the university, there's opportunities to, you know, work on behalf of the profession or the college in terms of advocacy with legislators. College has been very active with the Johnson City, Washington County Chamber of Commerce. So, yeah, there's just so many, folks to to meet with. And then there's lots of events that we have, at the college. And so I just represent the college in a lot of different, arenas.   Stephen Woodward Great. Thank you for sharing.   Michele Williams So the college's, of course, celebrating its 20th anniversary this academic year. What do you think are some of the biggest challenges the college is facing?   Dean Debbie Byrd You know, that's a great question. And I can say I think that, you know, Gaten is facing any challenges that are unique to us that are really any different than other colleges or schools of pharmacy or, or just higher education, in general. But challenges in general, I do think are accessibility and affordability for our students, is really paramount.   Dean Debbie Byrd The perception of the value of higher education, I don't think that that pharmacy faces, that as much as maybe other, degree programs, because the return on the investment for, a doctor pharmacy degree is pretty clear. You know, it's was life changing for me as a first generation college student. You know, really, generational change can come about, for those students who have those opportunities. And that's why that accessibility and affordability is so, important. Yeah. For us to focus on, I also have a philosophy which I would say is something that has developed, especially since becoming a dean is, I used to have the perspective of, I could prevent problems, you know, if I planned well and and that's true to a degree. But you can't plan away all the potential problems that that pop up. And so that perspective has changed as I've gotten wiser. But I also view challenges as opportunities because I've seen that play out that when we do have those obstacles, many times they have resulted in some of our greatest successes. That's so true as a college. And that's not at all how I used to think about problems. So I think it's important, important to have that mindset of just not that we like problems, but just embracing them. But they inevitably pop up and think of them as opportunities to, you know, make something better for someone. You know, face them with optimism and creativity because you might as well, and just roll up our sleeves and, and get to work.   Michele Williams That's, that's one of the things that I really love about working here and working with you is that when a problem comes up, there have been times when you come to my office and said, what are we going to do about this?   Dean Debbie Byrd Yeah, I, I love that. Yes. Like, oh, okay, let's problem solve us figure it out. So yeah. Yeah. Because it's not an option you know not to address the problem. It's that way. So we might as well. ...Yeah. And and I certainly don't have all the answers. And so, you're not the only person that I, that.... Well, what do you think about this? Yeah. You know, our, thinking about this. What do you think about that? To try to get to the best solution for whatever it may be?   Stephen Woodward Well, kind of along those lines, what are some of the those opportunities that you see for the college?   Dean Debbie Byrd Yeah. You know, I think there's no question that excellence is an important part of our culture here. So, we're always looking for ways to improve things, to make things better, whether that's, you know, for students or faculty or staff, you know, how do we just just make things run smoother in some cases, take something that's that's good and make it great. But we have made the most of some of our challenges here at the college. But I think some of the things, thanks are thanks are, are. My gosh, I probably should not go it, you know, we don't have any major, major things going on right now. We've had some major initiatives that the college is, is, you know, kind of bringing to fruition now a major curricular revision as one example, where I do want to give, you know, faculty and staff major kudos for that work because, you know, not only did they, you know, revise the curriculum, which happens periodically everywhere, but something that our faculty did really combined, you know, that academic excellence piece and, and thinking about student success, but they also really considered well-being in that and well-being in the perspective of, you know, what's the best combination to help our students perform at their very best? And to that end, you know, we looked at a lot of data and found that our curriculum at that time, before we revised it, had more credit hours than most programs in the country. And, and at that time, our students weren't performing where we would like for them to have been. We were thinking about the now flex. We were more, you know, just around the average or maybe just slightly above average. And so part of that we felt like, maybe it's just too much and there's a point of diminishing returns. And I think we can reach that with our students, that we were just overwhelming them in terms of just information and time. And, and so they were very thoughtful. The faculty were in really bringing it back to the essentials of, of what do our students need, to be the best pharmacists and to perform at their very best and to, to really, you know, learn and retain everything. It's not, you know, if you're just you can give them everything. But if they're only going to retain a third of it, what what's the point? And they've really given that a lot of consideration. So so with that in mind, you know, there's been a lot of, work at the college over the years about, student will be that I think, now we've shifted to, to think more about faculty and staff will be about the college. And, you know, there's a we oh, you're often, very data centric here as well. So, you know, there's a, faculty and staff well-being survey that's going to go out to get some good information. But during work that's already happened, several years ago, I served on, the American Association of Colleges of Pharmacy. I had a, a faculty workload task force and, trying to come up with, you know, the ideal workload policy and, and just the best practices when it comes to that. And one of the most important things was, just transparency and and helping, you know, faculty understand what the what the expectations are and matching that with effort. And the university is now embarking on some of that work with, workload policy and promotion of tenure guidelines. And so, you know, with that in mind, you know, that's something that aligning those things, I think is going to help, our faculty and staff will be, and then also just growing our faculty and staff as our enrollment has continued to grow. Obviously, that's going to help a lot with workload and supporting developmental opportunities. And then nurturing our positive culture. You know, that's a foundation that was laid at the very beginning. And I think it is something that could be taken for granted. If, if we're not intentional about nurturing that culture. So I think that's something that we're all very committed to. But I also think, as we consider, you know, bringing in new faculty and new staff, that we have to be very, considerate of that and making sure that that we bring in people that will continue, you know, this culture that's been built and, and supported for so long, you know, research and scholarship is something that is, is an Etsu initiative. I serve on their research, strategic planning task force. And so with that in mind, you know, how do we create opportunities for, for faculty to, you know, be more successful in those areas, whether it's setting aside time or, providing opportunities for collaboration, development? You know, our faculty are doing great work and there's no, no question, no shortage of great things for our faculty to share and write about. But I want them to have the opportunity to do that work and to ask the questions that they're passionate about and then share, you know, their findings with, with the world and, and practice. Transformation is one example of that that many of our faculty are very engaged with that's, unique, what they do every day, in their practice, and then I guess another opportunity and, and again, we're, we've been working on these things, but, just engagement and particularly alumni engagement. You know, when I first came here, there had only been a few classes that had even graduated. And so, we really didn't have any, sort of programing or anything intentional with our alumni. And so thinking about that, how do we bring those former students and those graduates back that we're so proud of, and give them opportunities to connect with one another and with the college? We started homecoming a few years ago, and, Etsu held tailgates last year. So, so hopefully those opportunities will continue to grow. We have another survey that's out with faculty and staff right now asking how how do we currently engage with our alumni, and whether it's in the classroom or with, professional organizations, student organizations where we currently dealing with our alumni. And then that's going to be shared back with the alumni and sort of sort of a menu of, here, here, the current opportunities and get their input on what else would you like me to be doing with the college and how would you like to, engage with that? So those are those are some of the things that I think are major opportunities for us on the horizon.   Michele Williams That's great. Yeah. So you mentioned the that our faculty are doing a lot of really exciting things. But in March, you were named the distinguished fellow of the Pharmacy Academy by the National Academies of Practice. Nap. And this is a prestigious honor recognizing excellence in leadership and interprofessional health care. Can you comment on this honor.   Dean Debbie Byrd And what it means to you? Yeah, it really does mean a lot because, throughout my career, I've been involved in interprofessional patient care. My practice, you know, was always with family medicine physicians. And and that work and within family medicine, residency training, practices in academic settings in some always worked in that you know, physician, pharmacist, interprofessional, you know, patient care model. And so, so that's something that's just been been part of my entire career, that practice piece and later the education piece. But I feel like that expanded greatly for me several years ago when, I was asked to be the interim dean for the College of Nursing. So I learned so much, you know, during that time period. And, and I was fortunate to be inducted with, one of my nurse faculty colleagues, at the ceremony last weekend. But, another piece of it that was, especially meaningful is I don't seek awards and recognition. You know, for myself, it's, you know, a college focus typically. And so, in this case, it was a nomination, you know, by a colleague that, I had given a presentation at, and a CCP meeting about the imposter syndrome, and, had encouraged him to, pursue something that he was thinking about. And, and he'd sent me an email several months later and said, you know, I did it and thank you. And then a couple of years later, he was he was inducted, and he was telling me about it, and I was like, oh, congratulations. That's really cool. And, and he said, well, you should be a member of this and I'm going to nominate you. So so that was special. Just that awesome connection as well. Yeah.   Stephen Woodward This spring we had some big news with state funding. Do you want to tell us more about that?   Dean Debbie Byrd Yes. I'm glad to you. So this is something that the college has worked on since 2017. When the college was founded back in 2005, the state really didn't have the funds to support a second college of pharmacy at that point. So the college was founded really based on a private tuition model. And because of that, is that being our only revenue, your tuition historically has been very high. So, you know, before we received any state funding, our tuition was as high as $38,000 a year, actually a little more than $38,000 a year, which was typical for a private college of pharmacy. But so many of our students are first generation. And, you know, come from rural areas. You know, when I came in as dean in 2016 and sort of learned, you know, the history, it just didn't seem fair. And it certainly limited accessibility and affordability for our students. Our debt load was significant as a result of that. So that was really the impetus for trying to achieve state funding for the college so we could pass that along to our student. So, you know, we worked on it for about six years before we received the first bit of state funding in 2023. And at that time, the state, appropriation was about half of what we asked for. And so we lowered tuition at that time. Actually, beyond what the state funding supported, with the idea that I guess the idea and the hope that we would receive the other half the following year, and unfortunately, we didn't it took us an additional three years to finally receive the other half. But in the meantime, I feel like that initial funding allowed proof of concept because our proposal was that if we receive state funding, we can lower tuition, our enrollment will increase. And particularly among Tennesseans. And so from, you know, 2023 to 2025, I guess, or the data that we shared with legislators, our enrollment went up from a class of about 45 students on average and had been for the last several years, to, I guess, the the year after funding, it was around 58 seniors and 64. Oh, wow. And and so this year we're expecting over 70 students grew in the percentage of Tennesseans that, you know, we we expected it to go up. But it was really remarkable that it went from, about 40% Tennesseans among, you know, our class, incoming classes to almost 70% at Tennessee and in our incoming classes. So we had those data. And by showing showing them that proof of concept that, you know, look, look what the state dollars, you know, have done. And then also, especially since 2017, there's a pharmacist shortage that has developed over that time. And so, there's a real need for pharmacists, and particularly in rural areas, that's where a lot of our students come from. They're willing to go back there. So, ultimately our tuition, was lowered and will go into effect July 1st, and it will apply to all of our students, not just our incoming students. For Tennesseans, tuition will be $24,785 a year, which will be significant savings for them, especially if you multiply that over four years. Their ultimate, you know, student loan debt will be significantly reduce over $50,000. They'll graduate with. And, tuition is also less for out-of-state students as well. So, our, our state tuition, starting July 1st, will be $30,329 per year. And really, our ultimate goal in terms of that accessibility and affordability was just to match the tuition of the other state school. We just felt like, you know, taxpayers, you know, our funding, the, the dollars that go to the state and, and, you know, that's who's going to benefit and that we felt like our students deserved, you know, the opportunity to to go to pharmacy school and, and then turn around and serve, you know, the people of Tennessee in this region. So, you know, it is very exciting to to finally, be at the point where we can offer that to our students. And I know they're very excited and, you know, we we expect, you know, ultimately, you know, our class size historically has been 75 to 80 students. And so, you know, we we did learn about state funding just with the legislative cycle until April. And our recruiting cycle is essentially done by the end. So we we didn't really expect it to affect, our class size for this fall, but we expect that we'll have, you know, full class and full classes going forward as a result. So, nine years total. We finally made it. We had some persistence going on, but I have to thank, President Noland for his support. We would not, have have achieved this without, you know, his commitment to the college and his willingness to, you know, really make us a priority, you know, this year and also in 2023 to, to make this happen. But also, you know, our local legislative delegation, you know, has always been supportive. And I would say they, you know, they were supportive from the very beginning. And in particular, Gary Hicks has been a huge champion on the House side. And, you know, from over that nine year period, you know, he was a new legislator whenever we started this effort. And over time, you know, he's become a leader in the House and and on the finance committee. And so, you know, that that time helped us in some ways to to have, some of our local delegation be in positions where they could have more influence with their colleagues. And, and then, you know, most recently with Senator Harshbarger, you know, as a pharmacist was very supportive of us as well. And, and I would say all the pharmacists, in the Senate, there are four pharmacists in that, Senate and the Tennessee General Assembly. And, and they were all supportive of us. And, and that meant a lot to you. So, so we're just we're just very pleased, to finally have this opportunity to to offer this to students. Yeah. One other, I think major piece to this in addition to that proof of concept that I was talking about earlier that I think really, helped, you know, push this across the finish line were our season outcomes? Yeah. Yeah. To be able to to, you know, show that, you know, we're worth the investment. And that students that come to get and we'll have, you know, a great outcome. And so, specifically speaking about our Netflix pass rate, you know, being top five in the country in 2023 and, again, with our class of 2025, I think definitely caught their attention. And many of the legislators that I met with commented on that. Yeah, they were they were impressed with, how well prepared our students are. And I think that helped them make the decision to be willing to invest in the college. And our students.   Stephen Woodward That's great. Well, thank you for your tireless effort and dedication to to doing that over the past nine years. Did you log how many trips to Nashville you've you've made it.   Dean Debbie Byrd I did that time. I probably should have stayed. Yeah, for sure I didn't, but, it's, you know, it was a long nine years, but, you know, I'd never had any, you know, responsibility before becoming a dean of interacting with legislators. And so I really came to enjoy that. Maybe not the trip. It'd be nice if I could, you know, just go across town, to meet with folks that, you know, just to develop those relationships over time and, yeah, you know, realize, I mean, they're, they're they're here to help us and that's that's their role. And, and, and they, they really work hard, you know, to help us. So I appreciate those relationships and the opportunity just to better understand the process and how things work. I really had no clear understanding of that either. So, it was a lot of work, but, certainly enjoyed it and were thrilled with the outcome.   Stephen Woodward Well, we asked some students to, to provide some questions for this interview. So P2 Bonilla asked, what has been the most challenging leadership decision you've had to make as Dean?   Dean Debbie Byrd Well, I think probably the hardest thing that, I have to do as a dean, unfortunately, it's very rare that it happens, but is to dismiss a student and, you know, any decision that affects a person, even if it's in their best interest, and it's the right thing to do is, is difficult. And, and I would say those decisions, because the question was, what's the most challenging decision? And the decision itself is, not necessarily challenging, you know, it's the right thing to do or that individual, and, and it could be, I think especially if you ask those questions, what is in the best interest of the profession of the university? What's in the best interest of the college, and what's in the best interest of the individual? Then the decision itself usually is pretty clear. And and how would I wish to be treated under these circumstances? The decision becomes pretty clear. But it's still, difficult to sure, you know, that you're, you know, going to cause pain for someone, even if it's in the short term and even if it is the right thing to do, it's always very difficult.   Stephen Woodward Brunella also asked if you weren't working in pharmacy or academia, what career do you think you would have pursued?   Dean Debbie Byrd Well, I initially I, I remember in the first grade.   (laughing)   Mrs. Highberger asked me to help her, do something. I don't remember what it was. You know, during recess one day, and I, I got off the school bus and ran inside and told my mom that I was going to be a teacher. When I grew up. And so that was, you know, my plan as a six year old and was was by playing for a little bit.   Dean Debbie Byrd And, and as I got older, you know, my family always, struggled financially. And so once I realized that maybe, being an elementary school teacher might not give me the financial security that was really, really important to me under those circumstances. And then I just said, okay, I guess I won't do that. And so it's been a real bonus career, you know, pharmacy school to be a pharmacist. I didn't think that I would get to be a teacher to. So I got to do both of those things that, another, I don't know if it would have been a career, for me, per se, but I had a backup plan going to college that, I was I was waiting for scholarships to come in and out. It was about two weeks before, classes started. I went to Middle Tennessee State University, and I had applied for one scholarship and hadn't gotten it. And I'd gotten, some Pell Grant funds, but it wasn't enough to to cover things. And so I applied come last chance scholarship to get and, and so my thought was, well, if I don't get that, then I was going to join the military and, to give me the opportunity to eventually go to college. I'm not sure if that would have been a career, but that was my my clear plan. At that point and then, maybe a more unique, career path that didn't come to me until about, I don't know, 10 or 15 years into my career. Just because I didn't know that it existed is forensic anthropology.   Michele Williams Oh wow.   Dean Debbie Byrd Yeah, totally. I  guess I didn't even know that was a thing, but, you know, Bill Bass is a forensic anthropologist, and that if you've read the Body Farm books, my my office at one point overlooked the body Farm, in Knoxville. And so, yeah, just the idea that you could, you know, look at bones to human osteology was one of your specialty areas or is one of his specialty areas. And. No, and not just, you know, is this male or female, but what kind of work they did? Because, you know, if they, you know, did work that, you know, required heavy lifting, like, you could see that in their bones that, so, I don't know, I was just I was fascinated by that. And so I kind of thought for the first time, well, you know, if I'd known this existed, I might have gone out On something like that. But I don't know. How many forensic anthropologist are really needed in the world. Whereas I think we need lots pharmacies now.   Michele Williams And lucky for us, you know. So, another student question that we have is from Ryan, who is actually the president of P-1 class. Class of 2029. His question is, leadership can be a challenging journey. Is there a specific mentor or role model who helped shape your own leadership philosophy? And what is the one piece of it of their advice that you still lean on today as the Dean?   Dean Debbie Byrd Yeah, there's there's not just one. You know, I if I started to name or try to name people, I would definitely leave people out. So, I think about, you know, the faculty member, I was an average student. And do not tell our students this all the time. I was a very average student in pharmacy school. Not for lack of trying effort, but, you know, I had a faculty member and preceptor that encouraged me to think about residency, and I'm not sure I necessarily would have thought about that. Even. You know, it's one of those things that, you know, sometimes a mentor is not someone that you necessarily are spending a lot of time with. Someone may just literally ask you a question, have you ever thought about it? So, I would just encourage, you know, everyone, whenever you see, something in someone and you're thinking in your head, oh, you'd be really good at, you know, whatever. Have you ever thought about to always ask those those questions?   Michele Williams It can be life changing.   Dean Debbie Byrd Oh, no, no, no, no doubt about it. And I mean, I had, you know, former students that, you know, went on to do something and years later would come back and say, oh, well, you're the reason I did this. And I would look at them in confusion and say, oh, remember that day? You ask me, you know, have I ever thought about. And no, I didn't remember that. But it does, you know, can make a real impact. So that's that's important. But I had other, you know, my residency preceptors, you know, who really, developed me exponentially. Department chairs, campus meetings and really, everybody I've ever worked for has has served as a mentor, the president and provost here. But fellow faculty and staff, meet your peers, you know, can be those mentors, because I do think a lot of it is just, you know, serving as a sound board and just being somebody that that listen, sometimes, you know, sometimes you know what to do, but you just need to say it all out loud and have somebody, you know, not at the end, you know, instead of running from the room that, you know. Yes, that's a good thing to think about that, you know, colleagues I've mentioned in professional organizations, certainly have been, students, teach me something. You know, every time. But I have an opportunity to interact with them. And it's interesting and just funny that you asked me because I had lunch yesterday with Wilsie Bishop, who, is the retired vice president for health affairs and, who I worked for for many years. And so, you know, she continues, at this point, even her in her retirement, you know, to serve as, as a mentor. But, my number one strength, according to Strengthsfinder. And I've taken it many times over many decades now, is learner. And so I think every experience that you have and every interaction that you have is an opportunity to to learn something and to gain something. And I think my experience has been that people are very generous. And so if you, you know, ask for advice or ask, to draw upon somebody's wisdom. So far, I haven't run across anybody that's been unwilling, you know, to to talk with me or, you know, listen to that dilemma that, I'm facing and, you know, give me their two cents. And so that's another encouragement that I would put out into the world that, you know, you never know until you ask. And, but it doesn't really matter who it is. I think sometimes we think, you know, a lot of the people that have the most wisdom and could potentially give the best advice are some of the busiest people. You know, in the world, potentially. And it's really easy to say, oh, gosh, I don't want to I want to bother them, I don't want to inconvenience them. But again, I found them. You know, it doesn't matter who you ask. I haven't had anybody turn me down. Yeah.   Stephen Woodward That's great. As we come to a close, is there anything else you'd like to to add to our listeners?   Dean Debbie Byrd You know, this is our 20th anniversary for the college. And, in July, I will have a big year, ten years. And so it's caused me to do, you know, some some reflecting, about the ten years and, and thinking about I don't think that I answered one part of the last question about, you know, what piece of advice of about do I lean on? And I, I think it's maybe a couple of things, you know, one is I mentioned earlier just treating people the way we want to be treated. I mean, many years ago, the college, did some developmental program with outward mindset. But that's really what it boils down to. But I think the other piece has is just being intentional, that, you know, just because you wish things were different doesn't mean that they're going to be different. That you're making those changes for the better and trying to think about, you know, how to make things easier, how to facilitate success, whether it's for students or faculty or staff. I think that's a big part of the job. And, you know, sitting here with you, too, I think the first new position that I created when I came here was the marketing position, and like you and. I kind of from that, you know, solving a problem I came here in realized I knew very little about this college, and nobody did. There were people in Johnson City that didn't even know that there was a College of Pharmacy, which is crazy to think about all the community support that we had. But, you know, I have lots of people, you know, moving to the area. So I was just then I was amazed by all the great things that were going on. So, you know, I feel like you've done a great job and, you know, getting the word out there about all the great things. And then maybe I'm not sure if it was literally the second position, but, we had a retirement and, academic affairs and we thought about, you know, what do we do? We want to just replace, you know, have the very same position, or do we want to, you know, reimagine what that would be. And that's when the director of student success position.   Michele Williams That was a great decision.   Dean Debbie Byrd But a lot of those, you know, student success efforts that that you have been led and, you know, we have relatively new student success coordinators. It's probably been the most recent addition to that. But, you know, we just are always thinking about, you know, who are our students. And as we've said, many of them are first generation, you know, coming from rural areas. And, and they, they bring, incredible assets that sometimes come with some things that have left them behind a little bit. And how do we take those, students that come to us with great potential and make sure that, you know, as long as they're doing the work, that they're going to be successful in the end. So just that intention with student success, you know, revamping our athletics prep, you know, is a big initiative that has certainly paid off, you know, for students recently. You know, admissions and enrollment is up. Yes, due in large part to marketing. But, you know, we have a full time recruiter, you know, now, and we haven't always had, you know, the ERP program, is something that is is new to the college, relatively new to the college. And I've mentioned, you know, some of the great engagement activities that happen. But, you know, there's those are all, I guess, circling back around to their problems or obstacles and some of the things that I think we're proud of, staff as a college came from a need to address, a problem or a situation as you have to see Will now.   Stephen Woodward Well, thank you for your service to the college and for being on the podcast today. We appreciate you coming.   Michele Williams Yeah. Thanks so much. Yeah.   Dean Debbie Byrd Well, thanks again for asking.   Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review to learn more about ETSU Bill Gatton College of Pharmacy, visit us at e-t-s-slash pharmacy or follow us on social media @ETSUpharmacy. We'll see you next time.

Episode 30 — Drs. Tabitha Sineath ('24) and Katie Cox on Specialty Pharmacy

On this episode of White Coat Radio, we’re joined by two specialty pharmacists making an impact in Tennessee. Dr. Tabitha Sineath (’24), an ETSU Bill Gatton College of Pharmacy alumna who earned both her PharmD and MBA through the college’s dual degree program, now serves as Lead Pharmacist at Walgreens Specialty Pharmacy in Nashville, where she is the Clinical Lead for Transplant and Chronic Inflammatory Conditions. She is joined by Dr. Katie Cox, who manages Walgreens Specialty Pharmacy in Knoxville. Together, they share insights into careers in specialty pharmacy, their work in women’s health, and the real-world applications of their training.  Full transcript: Tabitha Sineath Because you take back bits and pieces from every experience, whether that be as a student on rotations to your first job or what you ultimately grow into. It's the bits and pieces that you know as part of your experience that truly kind of define you over time. So don't. My advice to students is don't give up on that and continue to kind of seek those out because you know in your heart where your passion lies, you have to make the pathway. Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University. Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm one of your hosts, Doctor Michelle Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we welcome Doctor Tabitha Sign at the 2024 alumna from Gatton, who, in addition to earning her PharmD, also completed our dual degree program to earn a master of Business Administration while she was here. That prepared her to now serve as leave pharmacist at the Walgreens Specialty Pharmacy in Nashville, Tennessee, where she is a clinical lead for transplant and chronic inflammatory conditions. Stephen Woodward But today, we have not one but two specialty pharmacies joining us. Doctor Katie Cox, who manages Walgreens specialty Pharmacy in Knoxville, also stopped by. Let's hear from them now. Doctor Cox, doctor Sineath welcome to White Coat Radio. Thank you all for coming out today. Katie Cox Thank you for having you. Stephen Woodward Can you start by telling us about your roles at Walgreens and where you work? Katie Cox Yeah. Tabitha Sineath So I am, lead pharmacist at our specialty site in Nashville. And, oversee primarily our transplant in chronic inflammatory condition patients. Stephen Woodward Okay. Katie Cox So I work at Walgreens as well. I manage the, specialty pharmacy structure at Walgreens is a little bit different. I mean, it's the site that's in Knoxville. And, what's called registered manager, local specialty. So I'm over the whole site. I'll own kind of your accreditation and specific accreditation, not just for specialty pharmacies, but it does apply, within the specialty pharmacy field. Katie Cox Then there's an M.O., which is a pharmacy manager, and what we traditionally think of as a pharmacy manager. And then they're all kind of structured differently, which is what I love about specialties. It's like each side is a snowflake. It looks a little bit different. So the Nashville site has care. Teams are a little bit larger site. We are a newer site. Katie Cox I launched our site in 2023. And then we've got five pharmacists now, but we don't have a specific care team, so we kind of all share and own the disease state since we've structured a little bit differently than Nashville. Tabitha Sineath Yeah. And we talk about care teams a little bit. That's just kind of a delineation of what type of disease state we're managing. So in in Nashville, we're a little more bucketed. We have a virology and oncology pharmacist who oversees those patients, neurology, who oversees, like migraine and seizures. And, I oversee chronic inflammatory in our transplant, which includes not only solid organ but stem cell. Tabitha Sineath And we have a unique partnership with Sarah Kane and clinic across the street, as part of the tri star network, to help those patients. And then we have a lot of miscellaneous specialty that kind of filters in, that don't really fit nicely into a bucket. So that's kind of where we all cross-train and help out. Stephen Woodward Okay, cool. Thank you. Michele Williams Yeah, that sounds great. So can can each of you tell us a little bit about what led you to specialty pharmacy? What it is about your your background, your work experiences, those kinds of things. And, Tabitha, if we could start with you, that would be good. Sure. Tabitha Sineath I started out, as a pharmacy technician for Walgreens, many years ago. I'm not going to say save a year, but, a few decades back, and, my path has not been linear in that sense. But I advance kind of to the top of my level as a technician and wanted to go back into pharmacy to get my pharmacy. Tabitha Sineath And always had been that drive in that pull for me. And finally just took the dive. But I think the catalyst for me was more of like a personal experience that led me to specialty. When I was trying to start our family and a lot of family planning, we realized that we would need a lot of additional help. Tabitha Sineath So in terms of, fertility specialty, we had to go through in vitro fertilization. And with that came a lot of specialty medications that, there was not great education around. And these are really expensive medications. And I, I said to myself, you know, there's got to be a better way to handle this for patients. And so that was really my draw to say, you know, this is this is my niche. 00;05;24;09 - 00;05;31;21 Tabitha Sineath This is where my passion lies. And that's really what I want to do. I want to help those patients, and have great outcomes. Michele Williams That's wonderful. Yeah. Katie Cox So, I also have a very nontraditional path towards pharmacy. When I was in undergrad, I studied chemistry and biochemistry, and I did research for the government on, carbon nanotube technology. I went to medical school, and I got, my medical doctorate, and then I had some health issues, and was trying to figure out how to restructure balanced life. Katie Cox For someone who is a high achiever, that can't work less than 120%, and we give you a lot of leeway for the optimal work life balance. I did not know I would have the additional years that I got so thrilled and pharmacy kind of looked like a great career to dovetail my chemistry biochemistry interest, along with what I had learned in medicine. Katie Cox And so, I finished pharmacy school and I went and graduated in 2016, and I started in, management. So I started out as a staff pharmacist, was not there very long and then started managing. I mean, it's 5 or 6 different sites, kind of jokingly say I was like the cleaner where they would send me to a pharmacy that maybe needed to implement better workflow or had some structure issues, or maybe had lost a really good leader and was trying to kind of figure out how to get back to where they were. Katie Cox And so I would kind of get us realigned and going well. And then specialty pharmacy, which I think is a great topic to talk about because I think a lot of times when you think of Walgreens, you don't necessarily think of specialty pharmacy. But it is a huge section of Walgreens. And I even when I started working for Walgreens, I did not know that we had specialty pharmacies. Katie Cox At that time, there was not one in Knoxville on the closest ones were either Nashville or Bristol, Kingsport. And so I took the opportunity to go and shadow at those sites and kind of see what it looked like. And it was a really great niche sort of space and community where you still do a lot of clinical work. Katie Cox And have long term interactions with your patients. I similarly had a fertility journey when my husband, we were trying to have our daughter and so helping patients navigate some of the fertility and understanding how much of the communication gets dropped off between the patient walking out of the physician's office and then coming into the pharmacy or getting the medications, and how probably a lot of the issues with our health care system are kind of this lack of continuity of care or like regular check ins with the same person who knows your history. Katie Cox And so I feel like specialty pharmacy fits so great into that space. And it's kind of under utilized in some capacities for patients both with billing access and then like long term management. And so I always like to include to you, like when I talk to students, they say, well what is specialty pharmacy like? Why is it special? Katie Cox And I kind of always joke, you know, it's it's an interesting and really great question to ask because there's not technically a specific definition of specialty pharmacy. Right. Medicare, Medicaid, our two biggest payers don't actually define specialty pharmacy, which kind of means that it ends up being defined by third party payers in some capacity, by manufacturers and access points and by some capacity, because there's drugs that are limited distribution drug, you can only get certain places. Katie Cox But a really good point like definition would be highly expensive, medications or medications that potentially would have chronic issues or adverse events that could occur because of the conditions that we're managing would make it more difficult to distinguish between like maybe an adverse event versus something that's happening with like multiple comorbidities. So it helps with tracking for data. Katie Cox So we learned in school, you know, about the four phases of studying drugs. And so I'll always talk about specialty pharmacy really fits into that post-marketing phase of study. And so always ask my students like how how did you decide. We tell patients 5% of patients have migraines, right? It probably wasn't the thousand patients we looked at in phase three is probably when it hit the market. Katie Cox And we were looking at phase four. Where do we where does that data come from? Right. And so specialty pharmacies usually provide data points. That go towards far more manufacturers and really also help us as pharmacists or clinicians tell patients about what to expect with the medications. But a lot of that is related to the adverse event reporting that we do. Katie Cox So we do track patients very much long term, talk to them on every refill, track adherence, track side effects, and then report that back so that that data can be used to help, you know, benefit patients in the future. And so it's really helpful. So you're kind of participating in the research around drug habit in specialty pharmacy, whether you recognize it or not, because there's so much data reporting that we do within the pharmacy industry, which is helpful in the long term for us to determine which patients should be optimally on that therapy, especially if it's an orphan drug or an unusual one that's going to have a small patient population using it. Katie Cox How do we get enough data to make that tractable for us to make better decisions in the future, when we're setting up guidelines or taking care of patients? Michele Williams I hadn't realized, although. Yeah. Stephen Woodward What does this what does your sites look like physically? Are they like the Walgreens on the corner, or does it look like something else? Tabitha Sineath Yeah, they're I mean, they're open door. So it's not, closed door pharmacy. We have patients that can come in and fill antibiotics if they want to. But primarily we serve more like a mail order type facility. Okay. Probably 95% of everything that we do goes out the door via Fedex. And that's just our courier that that we use. Tabitha Sineath But everything is communicated with those patients and, basically effectively shipped, so. Okay. But yeah, we have patients that walk in, in Nashville, we are situated very close to Vanderbilt University. So we have a lot of students that, even though there are two community sites that kind of flank us on either side, patients tend to find us either via walking route or some other way, but typically, our sites don't appear like a normal Walgreens, so you may pass it or you may just not even notice it in general, it's kind of very indiscreet. Stephen Woodward Okay. Tabitha Sineath And we don't have the big neon out front. And, you know, we always try to tell patients that are coming in to pick up either because of, you know, a delay. They don't want to wait for overnight delivery. I want to get started on therapy immediately. They're welcome to come in and pick that up, and we'll make those arrangements. Tabitha Sineath But we always for that visit. This is not your run of the mill big box. Stephen Woodward Yeah, I want to yeah. Katie Cox There's two. So there's two flavors of Walgreens specialty pharmacies. There's health systems and then there's community based. So health systems, what it sounds like do you located within the health system, usually inside a hospital. So within Tennessee we have one at Bristol. So the Bristol Regional Medical Center and then we have one in Kingsport. Those are both inside a hospital. Katie Cox Otherwise they're most often close to a campus, except for my site, which was the first or site in the company where a pharmacist flipped a retail site to a specialty site. So most specialty sites are built organically because the the structure inside the building looks different. I started with what was called a Cooper site, which was an ideal Walgreens had, where a lot of the, the, profit is made in the pharmacy. Katie Cox So it was a shrunken front end with a pharmacy and the main portion of it. And so we ended up converting that. So so what did we do? We gutted the front. So when you walk in. So ours is located in the strip mall, you'll notice, a lot of the community, specialty sites are located in the strip mall. Katie Cox And they'll say it'll say Walgreens Specialty pharmacy. But when patients walk in is when they notice a difference. So they might say, oh, Walgreens on the swing in here. And then they walk in and go, where's where's all your stuff, you know, and no, we have no friends. There's nothing. So there's just a counter. And then it's like, oh, I'm sorry, we only have like prescription medications here for you. Katie Cox And we do about the bulk of what we do. We also originally had a drive thru. We would close to that drive thru because, an a hole tell students when you come in and when you go to a normal retail site, where's the hustle and bustle? It's in the fill zone, right? Like if we're filling, we're checking prescriptions. Katie Cox We're counting at the window. When you're in a specialty site, the bulk of what we're seeing, the stress to you is a phone list that you're doing. And so you're going to see way more desks. You're going to see way more people on the phone. There's still patient interactions. It just looks a little bit different. And so anytime someone's been a traditional Walgreens pharmacist and they come to Cross-train in specialty, we kind of joke within the first hour, really high level, community pharmacists will go, oh, I see my skill set does not necessarily apply here because I'm used to the workflow structure being so different. Katie Cox And so it looks a lot different. So I always tell people, if you I hope you really enjoy talking to patients and having longer conversations, because that's kind of what we do here. And spend a good bit of time in doing a consultation with the patients. So before we dispense a drug, we do what's called an initial. Katie Cox And you may be on the phone with a patient for 30, 45 minutes, you know, very extensive discussions around the medications and what it might look like. And like we talked about before, continuity of care. Sometimes we're the first person really having a conversation with the patient about the diagnosis that they may have received. We have just found out I have multiple sclerosis. Katie Cox I've just found out that I've got Parkinson's. I've just found out I have cancer, you know, and now I'm talking to you all trying to navigate the drug aspect of this. And you're telling me very large numbers and lots of side effects, right. And so sometimes we call it kind of like a, we jokingly call it can like the specialty come down like you come in on the phone and then at the end we hope that you feel like, oh, I now understand a little bit of what I'm what I'm about to do and have some ownership in the process, being the patient in this and not feeling like I'm just kind of Katie Cox getting subjected to a lot of information and not knowing how to take like actionable next steps on it. And so example of that would be in specialty, which I think is a little bit different than a retail pharmacy is. We set a goal with the patient for every drug. And so how do we decide that that's the drug's working for you as an effective is it not effective. Katie Cox What does that look like? You know, we might have drugs that are very specific, like, oh, we're going to see a lowering of this lab, but you're not going to feel different versus another drug that might be, hey, this drug only allows you to live to a life of that. Right? So that's a good example I give to my students all the time, is that's a really specific drug that maybe we want a lot of adverse event data on, because while the drug is designed to let you live a little bit longer, unfortunately the condition that you have, most likely you will pass away when you're on this medication. Katie Cox So we want to make sure to tell them exactly specific of what to expect, what, how many days we think we're going to get and set a realistic and like logical goal for the patient. So maybe for a long drug, it might be I want to be able to play on Saturday when my grandkids come over, a lot of our pulmonary drugs, it's, my laundry room is downstairs. Katie Cox I can't do my laundry because I get out of breath. I have to sit down for an hour. So I want to be able to go down and come back up. And so I think it's really helpful in creating conversations for patients to determine, like, how do I decide this is going well, and then how do I use it appropriately to try to get the results that I'm talking to you guys about that are possible. Katie Cox And then even more so, maybe setting realistic expectations, right? Sometimes we feel like, particularly in this day and age, that we might have a cure all with a medication, and being able to set realistic expectations like, hey, this drug is going to help, with your liver, liver fibrosis, but we're also going to have to do like diet and exercise for you to achieve the goals that we're talking about and things like that. Katie Cox So that I feel like they really understand the process and can define what good would look like and how that might be different between different patients. Michele Williams That's very cool. So it's like really, really specific patient counseling relationships, talking about how the medication is really to a very specific degree. Katie Cox And then kind of gauging it based on the individual. Right. Something that we don't always in a lot of health care settings have the time to do. And that's one of the things I like about specialty pharmacy is you kind of have unlimited time. So I always joke to to my students, I'm like, it's like something so fantastic is something so terrifying, right? Katie Cox So somebody might go, oh my gosh, I can sit on the phone as long as I want. That sounds fantastic. And another person might go, oh, it sounds terrible. You know, I don't know where it's going to end. Right. And so it's like we're yeah, figuring out how to optimize it for what you feel like and how you want to be a pharmacist. Katie Cox And and that's one of the beautiful things about specialties. I feel like, like especially at a site like in Nashville, where you've been established for a really long time, you've got a lot of varied pharmacist roles at your site, and you can kind of gauge based on some of these goals and like what makes them happy at work, where you're going to pocket them for how much interaction they have with with patients and counseling versus leading to a team members versus, you know, like compounding or. Katie Cox Right. So you know, it's a beautiful profession because you can decide exactly what makes you happy during the day and then cater the role towards what you would you would want to get out of the day. Tabitha Sineath And there's so much variability even to between our care teams. I mean, I think the skill set for virology and oncology is very different from, say, miscellaneous specialty or somebody who's doing, a cardiac medication. And then we have, you know, non non-sterile, compounding that, we also do and we ship to ten different states. So with our site, we're dealing with patients from Maryland to Ohio to North Carolina. Tabitha Sineath I mean, it just varies all the way down to the south, Louisiana and Mississippi and Georgia. So our patients truly are all over, and really, I think you kind of hit on that. The beauty of what we do is the relationship building, because that in a sense, not only gets patients access, but it gets them engaged not only in their care, but also kind of what that outcome for them looks like. Tabitha Sineath And we can partner that with a lot of resources that we have the time and the functionality to do. And some of that is like the financial aspect because these medications are crazy expensive. Some of our neurology medications are about $100,000. Our, you know, hepatitis C treatment. You're looking at anywhere from 30 to 90,000, depending on which avenue in which vein we go down. Tabitha Sineath So, you know, in terms of like the payor aspect, you have to have great control, which is why access as many times is restricted just as specialty because of payers are going to be investing in that medication for that patient. They want to make sure that their outcomes are positive. So we do a lot of education and a lot of resource, facilitation with those patients to make sure that, you know, my goal is for them to walk out with zero. Tabitha Sineath So there's no out-of-pocket expenses to them. And we have access to grants and different foundations that can also kind of help funnel and provide those resources to make that happen. So when you talk to a patient who, you know, has a make applied prescription, that's $100,000, Tabitha Sineath That financial burden down to zero. I mean, that's that's the difference between, in some cases, life or death for these patients. Wow. Michele Williams So, thinking about our current students here again, what what sort of advice would you give? Student pharmacist who would be interested in going into specialty pharmacy? Tabitha Sineath I always say, if you can shadow get your foot in the door. Certainly work as a technician. Work in the field. That's going to give you the best access. You not only find out, is this really where you want to be? Because that's the most and part, the most important part of it. Nobody wants to, you know, show up day in and day out. Tabitha Sineath If that's not where your passion lies. Yeah. So finding that niche I think early on, is really helpful. But a lot of that begins with the proactive nature of that student. And then you have to step out of your comfort zone and say, this is something I'm interested in. How can I help facilitate that? You should network this around you. Tabitha Sineath Talk to people who are in that field. You know, we all have we all have connections. So it's really kind of navigating who, you know, and, drawing those, those webs together. Katie Cox You know, I get asked this question a lot by my students, and it's evolved over the last decade of me being a pharmacist. So I think when I was a newer pharmacist, I used to give the advice of like find a really good. And it's still not wrong advice. It's just evolved a little bit. I think in the beginning it was fun, a really good mentor and and make sure that you're like, find somebody who you feel like optimized in their career the way that you want to be, and then ask those questions and figure it out. Katie Cox And I think as I've been in the profession and trained a lot of students, I precept for for schools, I've recognized maybe two, just like how I define that for them, because we don't do a fantastic job in grad school, we're very focused on like making sure we enter the profession well, right. We're going to be good professionals. Katie Cox We want to learn what we have. And I kind of joke like we have we're really good at herd mentality, right? Like you're joining the profession of pharmacy, right? We're all joining this together. But self-awareness and like an individualized approach to your career is a trickier thing. And it makes sense because that's how we kind of do education. Katie Cox But I think a different way of saying find a good mentor is doing what you would like to in your career is saying find out, like become more self-aware of what makes you happy. So I always tell students when you're on rotations, and I know, you know, I always ask them their biggest fears to not like great on rotation around, but typically ask the question that I don't know the answer to. Katie Cox Well, let me tell you, you're going to get asked a question that you don't know the answer to. Precept. Every month I've teed you up so that I can teach you with the question. Right? So get over that hurdle and start thinking about what days when you're on rotations, do you leave and think, because we all have a day at work out where you leave and you're like, oh, I picked the right job. Katie Cox I'm so happy. I love what I do. This is a great day. And then equanimity of life, right? There's another day where you leave and you think, oh, oh shit, that's something else. I wish I'd opened that little shop I should have, like, learn how to do interior design. So you like, you know, it's like equanimity, right? It's both of those days. Katie Cox But I think there's if you can track like some trends to that, especially on rotation. That's the idea of rotations, right? The joke at school was always the moment you felt comfortable with where you were going, was the moment you were going to stop going there. Right about week 3 or 4, you start getting comfortable. You love the team you're with and and boom, it's like, oh, 48 hours later, you get to go on and like learn how to like adjust another month. Katie Cox That's a really great life skill to build on. And then recognizing when you're on those rotations, when you love the day or hate the day, what was it? Was it what you did? Was it who you were with? Was it your schedule? Was it the environment? You know, and then figuring out when with self-awareness like what that looks like, which is really hard with how we do grad school. Katie Cox Right? Like I joke, when I have most students, especially when I have a couple of them, I'll say before you make a decision, what do you do? Right? What do you do? You call your friend and you go, hey, I was thinking about doing this. Tabitha, what do you think about me doing this? You think I should do this? Katie Cox You think you should do this rotation? Do you think I should go and do this internship? You think I should take this job, right? We vet it from someone else. But. So I'll give the example. We have five girlfriends that all are pharmacists. We all have different jobs, we all live in different states and we all have different personalities. Katie Cox And so we all, so we have one who works at Kaiser Permanente. She's an inpatient doing it there. I have one who worked in a nonprofit HIV community clinic, that helps patients there. I have, me that means in a specialty pharmacy, I have someone else who manages a retail site. And we all have equal complaints because work is work, right? Katie Cox It's not one or the other, but we all have different personalities. So one of us loves talking to patients all day. Wonderful. One of us is like, no, I'm good on that. I'd like to lead over here in the office and not do that right. And she loves that. Right. And so I think sometimes we lose that in school, a little bit of of utilizing the APIs to learn about ourselves we get so stressed about like especially here at Gatton, like you're good, you're going to pass for that. Katie Cox Like you're going, you're going to be a pharmacist. So focus on being your happiest and best self and then figuring out how to use those APIs to figure out what is your best day look like. And then how do I figure out how to create a career for myself where I have the best day? And so I always tell my students, I'm like, I'm sure anyone can think of that one disgruntled person, right? Katie Cox He's like, well, I can't believe you went to pharmacy school, which I went through here, you know, waste your time. But it's probably not because of pharmacy, right? It's probably because they're not optimized to like, their self-awareness or their happiness. And so figuring that out early on and and then the other thing that I think is a really great piece of advice is careers aren't where they used to be. Katie Cox This is in the 40s and 50s where you picked your job, and that first job is the job you retired from, right? Like, you can move around in your career. And while change is hard for us as humans, I think it's great to be able to explore. So you're just looking for your first job, right? And then figuring out what you use that to leverage to the next. Katie Cox I'm actually my first job as a staff pharmacist, and I became a manager. Then I managed a bigger pharmacy. Then I decided I wanted to do specialty pharmacy. Now I manage a specialty pharmacy, and I'm hoping to launch that into managing more specialty pharmacies over different states. But so what's that next growth moment and like space moment for you and then figuring out how to optimize it for you as an individual. Katie Cox Instead of feeling like you need to fit yourself into the career of pharmacy. Tabitha Sineath I think those breadcrumbs along the way to kind of help like define what that pathway looks like, because you take big bits and pieces from every experience, whether that be as a student on rotations to your first job or what you ultimately grow into. It's the bits and pieces that you know as part of your experience that truly kind of define you over time. Tabitha Sineath So don't. My advice to students is don't give up on that and continue to kind of seek those out because you know in your heart where your passion lies, you have to make the pathway, but you have to be proactive about it. Katie Cox Yeah, I think when I was younger, I thought lifelong learner meant drugs. And now I'm like, no, no, no. It means so much more than that. It's not just the knowledge for like what you're doing in your work, but it's also like lifelong learner about myself, about my profession, about how to interact with patients and engage them and advocate for them and give them agency and what that looks like. Katie Cox And it changes over time as you change, but like recognizing that so that you don't get in there in a rut and think, well, I'm not happy now when I was well, you've evolved, you know, evolve your profession with you and you'll always be happy. Michele Williams That's such great advice. Yeah, that's really good advice. Stephen Woodward We've we really appreciate you all being here. I think that was a great note to end on. But, thank you all and hope to see you again soon. Katie Cox Absolutely. Thank you. Tabitha Sineath All. Thanks. Stephen Woodward Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review. To learn more about ETSU Bill Gatton College of Pharmacy, visit us at ETSU.edu slash pharmacy or follow us on social media at ETSUpharmacy. We'll see you next time.

Episode 29 — Dr. David Stewart on NAPLEX success

We’re joined in this episode by Dr. David Stewart, Associate Dean of Assessment and Academic Affairs. Dr. Stewart led Gatton’s efforts to improve NAPLEX pass rates, resulting in the college ranking among the top five accredited pharmacy schools nationwide for the Class of 2025 [https://news.etsu.edu/articles/etsu-student-pharmacists-rank-among-top-in-nation?_gl=1*3xw23b*_gcl_aw*R0NMLjE3NzA3NDE2NzAuRUFJYUlRb2JDaE1JMnJ2ejJxN1BrZ01WdE1MeUJ4MWpCakw1RUFFWUFTQUFFZ0t5R2ZEX0J3RQ..*_gcl_au*NzAzNjY2NTQwLjE3Njc2MjIyNjI.*_ga*MjA5OTYxOTY0Mi4xNzY3NjIyMjYy*_ga_LFDKHVHJPY*czE3NzE1OTY1NTIkbzExNiRnMSR0MTc3MTU5NjU1NCRqNjAkbDAkaDA.*_ga_337TTHXJQY*czE3NzE1OTY1NTIkbzExNiRnMSR0MTc3MTU5NjU1NCRqNjAkbDAkaDA.], as well as No. 1 in Tennessee and No. 2 in the Southeast. He shares his thoughts on the excellence of our student pharmacists, alumni, faculty, and staff, as well as the collaborative efforts that led to this success.   Transcript Introductory Teaser: David Stewart I think for a student that's either here at the College of Pharmacy or maybe thinking about coming to the Gatton College of Pharmacy. I hope it gives them confidence that when they finish our curriculum, they go through our training program, they're going to have the tools that they need to be successful as a pharmacist. They're going to be able to pass those exams. Main Episode: David Stewart They're going to be able to get a license. Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. Today we welcome Doctor David Stewart, associate dean of assessment and academic affairs, as well as professor of pharmacy practice. He is an inaugural faculty member at Gatton, joining the Department of Pharmacy Practice in 2007. Doctor Stewart led the college's efforts to improve its NAPLEX Pass rates, and today he shares about that process, as well as his thoughts on the excellence of our curriculum, our students and alumni, as well as faculty, staff, and the collaborative efforts that led to the college's success. Stephen Woodward Doctor Stewart, welcome to White Coat Radio. David Stewart Well thank you. Thanks for having me as a guest today. Stephen Woodward So we have some big news that happened at the college a few weeks ago. Demanded just tell us what happened. David Stewart Yeah. So every January we get a report from the National Association of Boards of Pharmacy or in NABP and they give us licensing reports on our licensure exams, the NAPLEX, and North American Pharmacy Licensure Exam, as well as the Multi-State Pharmacy Jurisprudence Exam, also known as the MPJE. And these are the two exams that students need to take in order to get licensed as a pharmacist. David Stewart And so we're able to compare our results against the results of schools across the nation. And so for the second time in three years, we had a really high pass rate. I'm proud to say that our class of 2025 was the number five, school in the country for first time pass rate on NAPLEX amongst all accredited schools in the United States. David Stewart Also was the number one school in Tennessee and number two in the southeast with a 97.7%, first time pass rate on the network's exam. Michele Williams That's amazing. Stephen Woodward That amazing. David Stewart Yeah. And then, you know, the cherry on top of that is that exam I mentioned the MPJE, our in-state first time attempt, pass rate on that. We were number four in the country, number one in the state and number two in the southeast again. So really strong work from our graduates in the class of 2025 for sure. Michele Williams They really did a great job. David Stewart Yeah. And I think the exciting thing for me is this is a, you know, just one group. It's it's mostly the students. We tend to celebrate a lot around here. But really see, alumni from the class of 2025 that did all the hard work and took the exam. But it does represent a team effort. It's the, you know, the students, the graduates taking the exam are faculty, staff working as a team to set them up for success. David Stewart So really, really proud of everyone's effort. Michele Williams So, you mentioned the people behind the, the, pass rates, including our amazing students and our faculty and staff. But these successes also reflect some recent changes to Gatton’s curriculum. Right? And so, what kinds of changes have taken place that sort of led to this success? David Stewart Yeah. So really, a couple of things. First, you know, we set out on a curricular revision. We've really been planning that revision since before the Covid 19 pandemic. Going back to the 2018, 2019. That did kind of put a damper on things. But in about three years ago, we launched a new curriculum. So our current P3 class is the first class that's, completely going gone through that new curriculum. David Stewart However, I will say that along the way, as we identified things that like foundational things that we needed to do better on a lot of that feedback from students after taking the exam or after going through our curriculum. Our faculty were really good, integrating small changes into our legacy curriculum. So I think that what we're seeing, even though these graduates weren't necessarily graduates of our new curriculum, they're graduating with a new curriculum philosophy in mind from the people that are delivering that curriculum to them. David Stewart So I do expect that things will only get better as we see graduates coming through our our revised curriculum, with our first class graduating in the new curriculum from, in 2027. Stephen Woodward And these recent results, as I've done, in my opinion, it's not just a one off like a few a couple of years ago, the class of 2023, they were ranked number two in the country for accredited pharmacy schools and number one in Tennessee and our region in the southeast. Right. So this is kind of part of continuing on from just incredible national recognition. David Stewart Yeah. And I think if you look back on the history of the Gatton College of Pharmacy, we've always been, you know, kind of at or above average, if you will, when about 4 or 5 years ago, we had, what I would say was a low point for us. I mean, we were right around the national average. David Stewart And, if you ask anyone here, our faculty and staff, no one's happy with average. We want to we want to have excellence in all that we do. And so we really embarked on this journey to improve our student success on those exams. And yeah, I think that class of 2023 that you referenced, there is a direct correlation with with some of those changes that we started 4 to 5 years ago about how to better prepare students for the exams. David Stewart Cool. Michele Williams So, what do you think these successes mean for the college and for students pursuing pharmacy? David Stewart Well, I think for a student that's either here at the College of Pharmacy or maybe thinking about coming to the Gatton College of Pharmacy, I hope it gives them confidence that when they finish our curriculum, they go through our training program, they're going to have the tools that they need to be successful as a pharmacist. They're going to be able to pass those exams. David Stewart They're going to be able to get a license. One of the newest things that we are doing that started last year with this class of 2025, is that we bring them back a month early, so they actually start their fourth year rotations or APPEs or advanced pharmacy practice experiences. In the month of April of their three year and then during the month of April of their four year right before graduation, we spend about four and a half to five weeks preparing them for the exam. David Stewart And that allows us to slow that process down and make sure that they have all the fundamental tools they need to be successful on that exam. I think the initial feedback, and that's been very positive, and of course, the results from this first class going through that model are very encouraging as well. So again, that's just another example of things that we're constantly changing and improving. David Stewart So if you're a student in our program or come into our program, you can rest assured that we're going to prepare you. And my goal, I tell them, in that training program, is that they're ready to walk across the stage and go the next week and take their exams and be licensed as a pharmacist without delay. Michele Williams So, Doctor Stewart, I know that this is a team effort. Certainly. But you were really the architect of this preparation program that you just described. Can you tell us a little bit more about your, your objectives in developing this program and, and how you put that program together? David Stewart Yeah, that's a that's a great question. And, and really speaks to I think it's something that's really important that we had to talk about and work through as a faculty and staff. I mentioned earlier about our our faculty and staff are always focused on excellence. And I think one of the initial, you know, knee jerk reactions when you start talking about exam prep is making sure you're not just teaching an exam, but we want our students to get the necessary skills that they need to go out and be successful. David Stewart Pharmacists in making a positive impact on health care and the profession of pharmacy. And so I feel like we really found a sweet spot where we made sure that what we were teaching in the classroom, was, was sound that we were getting those fundamentals in. But as we talked to students, one of the things I did early on is we started revision to this program was just gathered data. David Stewart What were the barriers that students were facing as they struggled with these exams? And there's just so many factors out there. Things like, for example, many students come to us now without taking the traditional standardized exams. A lot of folks don't know that. You know, SATs and Acts are not necessarily required for college admissions anymore. Several years ago, they, took away the, PCAT exam, which is the equivalent of the mCAT exam for medical school. David Stewart So some of our students, we realized, had never actually taken a high stakes external standardized exam before. So some so a lot of this wasn't necessarily that they didn't have the knowledge that they needed. They didn't necessarily know how to tackle a 5 to 6 hour, really large, standardized exam. And so some of the things we did was just prepare them for that exam process. Michele Williams So the environment you try to mimic that testing environment to give them a sense of so they're not surprised by it or they're not thrown off by it. David Stewart Yes. When we collected data from our first class that went through some of the revisions I've talked about, and this was about four years ago, one of the things they rated as the most effective in our program was a simulated nap. And at that point in time, we were able to put that together through practice exams that were offered through NABP David Stewart And now there's a new product from NABP called the NAPLEX Advantage, which we use for our students. It gives them more data. It gives us more data based on their performance. But it's basically a practice exam so they can take a simulated Nap exam beforehand. In addition to just taking that practice exam, we really strive to simulate the entire experience so the student knows what it's going to be like from the time that they pull up in their car, in the parking lot of that testing center, to the time that they walk out, that they're not surprised by anything in there. David Stewart So they're prepared and they can focus on the exam, in performing at the level that that they can perform at, versus being distracted by things that, that they didn't necessarily know were going to happen, like, oh, they're going to take my phone and put it in the locker. Oh, I have to turn my car keys in. David Stewart Oh, I forgot my driver's license. It's in the glove box of the car. It's just those little things that can get students flustered on exam day. And what we were hearing from students that weren't used to that or didn't expect that, is that made a big impact on their ability to think and perform well on the exam. Michele Williams That can really throw you off your game if you don't know how regimented that environment is. David Stewart Well, if you look at, you know, any you get high performing athletes. As an example, you can bet that they're simulating the game environment. They're preparing for that big game, whether it's the Super Bowl or the World Series or whatever. And we're trying to do the same thing for our students. We want to simulate that environment. And have them as prepared as possible for those things so they can focus on doing what they need to do. David Stewart And that's, using their knowledge to perform at their highest level on the exam. Michele Williams I think that's great. And then how did you put together the other elements of the the preparatory program? David Stewart Yeah. So the very first class, that, that I helped to go through the exam process, we did an assessment after the fact. And one of the things, that that is unique about, our data set, and we're in the process of publishing these data so that others can benefit from this is there's a lot of information getting students opinions and perceptions. David Stewart Preparatory materials or courses as they're in school before they take their exam. We actually surveyed our graduates after they sat for the NAPLEX exam. So their perspective may be different. And we found in some ways it offers additional information than a student who hasn't taken the NAPLEX exam. So then we use the information we got from those graduates after they took their knapsacks, asking them what components of our program set you up for success? David Stewart What was effective? What was less effective? And then each year in an iterative process, we make minor changes. But really the things that they said were the highest impact. The back to the the simulated exams, and then some of the, preparatory content that we provided for them. And then things that were less effective, like, for example, at one point we had faculty meeting with students every week during their fourth year. David Stewart The students told us that's really not effective. We don't feel like it helped as much as other things. So we've taken that away. It's less burdensome for the students. It's less burdensome for the faculty. Yet we're seeing a continual rise in our scores because we're focusing on the high impact interventions that we can make. Michele Williams So that constant feedback from students and at various points along the way have really informed the way you put this program together. David Stewart Yeah. We've really we've really room for a data driven approach to do all that we do. And looking at, you know, not just what do other people do but other people who have successes, what are they doing? You know, looking at your data from people that are in a position to tell us this is what was helpful for me to be successful on this exam. David Stewart And we're incorporating those things. Not that other perceptions aren't important, but we feel like those perceptions are more valuable in getting the outcome that we want, which is our students being successful on those exams. Michele Williams So it sounds like it's about a lot more than just, you know, the the content, the questions. It's it's the totality of the experience of being prepared for the exam. David Stewart It is. And I want to reiterate that this is really a curricular experience that starts in the P1 year. Yeah. And some of the things that we do are actually going back and reinforcing things like pharmacy calculations. Yeah. They're oftentimes questions on the exam are mirrored in the practice models that students are in in their fourth year. David Stewart And so we want to make sure that they know how to do those types of calculations. And if and when they show up on the exam. We also recognize that there are some things that our students do over and over and over and get really good at. But, for example, they probably are really good at taking care of patients with diabetes and heart failure. David Stewart Those are chronic diseases that we see a lot here in rural Appalachia. But not all of our students feel, real comfortable about, calculations around, nutrition support in an inpatient hospital setting. Yet there are questions about that on the exam. Had it in the curriculum, but they've not practiced it day in and day out. So we're just getting them. David Stewart I would I would say we're getting them reps on the types of things that they may not be doing every single day on rotations, that that we know are going to be on that exam so that when they see those questions, they're comfortable and able to appropriately, you're accurately answering them. Michele Williams So sort of a broader approach so that they don't get, you know, too much of a certain type of question, but kind of broader look at the content. David Stewart One of the things that I will tell the students is you can't re learn everything in our curriculum during your fourth year. There's a lot of things that you already know, as a fourth year student pharmacist, one of the goals of our program is to help our students self-assess what they know and then what areas they need to work on more, and then encourage them to focus their study time on the areas that they need to, that they need more work in. David Stewart And so it's not going to be the same for everyone. So while our program is somewhat of a one size fits all in that they all go through it in the same way, a lot of what we're coaching them and mentoring them on throughout the year is that self-assessment of don't waste your time studying the things that you know and are comfortable with. David Stewart I think, Doctor Williams, you probably see this in your own work as director of academic success and in my experience with students on rotation, was if a student understood, say, the pathophysiology and treatment of diabetes really well, they always wanted to talk about diabetes. They wanted to do their their presentations about diabetes. They wanted to pick up all the patients in the clinic or on the service that had the disease, diabetes, because they were comfortable with that. David Stewart One of my goals in this preparatory program is to get them to start focusing on the things they're comfortable in, and spend more time studying the areas that they're uncomfortable with so that they're prepared for that rigorous broad exam that ask questions across a plethora of disease states. Stephen Woodward Well, it's been really great talking with you, Doctor Stewart and seeing how Gatton is leading in licensure pass rates not only at the state level but on the national level. This is just been that's really exciting news. So we appreciate you coming out today. David Stewart Yeah. Well thank you. Thank you for having me. And again, just a shout out really to the graduates. Just the class of 2025. And we mentioned our graduates from the class of 2023 as well. They put in a lot of time and a lot of hard, hard work. So, the huge congratulations to any of our alumni that are out there listening today. Stephen Woodward Yeah, absolutely. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.edu, slash pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.

Episode 28 — Dr. Ralph Lugo on the role of AI, Gatton's culture, and its 20th Anniversary

We’re joined in this episode by Dr. Ralph Lugo, Senior Associate Dean and Professor at East Tennessee State University Bill Gatton College of Pharmacy. He has been with the college since its founding, joining in 2006 as the founding Chair of the Department of Pharmacy Practice and serving in that role for 17 years before being promoted to Senior Associate Dean. Dr. Lugo discusses the role of AI in pharmacy education, including both the benefits and risks of the technology. He also reflects on the college’s 20th Anniversary, how Gatton has grown and evolved over the years, and where he believes it is headed in the future. Transcript Teaser Introduction: Ralph Lugo What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools where you're going to know your professors and they're going to know you, and you're going to develop lifelong relationships with your colleagues.   That doesn't always happen in all schools.   Main Episode: Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success.   Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. On this episode, we talk with Doctor Ralph Lugo, senior associate dean and professor at ETSU Bill Gatton College of Pharmacy. He's been with the college since its founding, joining in 2006 as founding chair of the Department of Pharmacy Practice and serving in that role for 17 years before being promoted to Senior Associate Dean.   Stephen Woodward During this time, again, Doctor Lugo is primarily focused on administration, program development, and teaching. And before coming to Etsu, he served as vice chair of Pharmacotherapy at the University of Utah. Doctor Lugo‚Äôs practice experience and interest is in pediatrics, specifically in pediatric intensive care. His research interests include lifestyle medicine, pediatrics, neonatology, pediatric intensive care, analgesia, sedation, and his research has been supported by the National Institutes of Health.   Stephen Woodward Well, Doctor Lugo, thanks for coming to Waco Radio today.   Ralph Lugo Yeah. Thank you, Stephen, for having me. Doctor Williams, thank you for having me today. Look forward to our conversation.   Michele Williams We're happy to have you here.   Stephen Woodward So you came again as founding chair of the Department of Pharmacy Practice. Can you talk about your long history here and what roles you currently serve in?   Ralph Lugo Sure. I came to Gatton in 2006. I was hired in 2005, so I've been here 20 years now, which is just amazing to think that I've been here that long. And I was hired initially as the founding chair of the Department of Pharmacy Practice. As you all know, we have two academic departments Pharmaceutical Sciences and Practice. At the time, at the time, I was at the University of Utah as vice chair of Pharmacy practice and an associate professor in pediatrics.   Ralph Lugo I think most people know that my specialty area had been pediatrics in my up but in the air quotes. Former life as a as a clinician in the pediatric intensive care unit. And I had always wanted to come back to the East coast. Was born on the East Coast. I trained in North Carolina, worked in North Carolina. I really enjoyed the South East a lot.   Ralph Lugo So my wife and I, we started a family out in Utah, and we really had a desire to come back east and specifically the southeast. So I saw this position open up, and it was just a natural move for me to move from a vice chair position to a chair position. And I had been in academia long enough that 13 years at the time to be able to handle such a thing.   Ralph Lugo Of course, it's always very challenging, but really look forward to the opportunity. But there were some things in particular, I think, that really attracted me to Gatton. Number one, we were starting a college of pharmacy from scratch. There's not a lot of opportunities that come up in the country to start a pharmacy school from scratch, to no avail.   Ralph Lugo And and you know, there's as you go around the country and you train in different places, you realize that some things you know, I might do a little differently or the culture may not be as I would want it to be in certain places. And so here was this opportunity to start with a clean sheet of paper.   Ralph Lugo And I thought, what a wonderful professional opportunity that really doesn't come around very often. And and then I interviewed the for the position and was just overwhelmed by the community support for this for this college of pharmacy. Nothing I've really seen before coming from Salt Lake City. City of 1 million plus College of Pharmacy doesn't get much airtime or press.   Ralph Lugo And it seemed like here at the College of Pharmacy was in the newspaper towns, the city press constantly above the fold type of articles, on the news, on the marquees, on the bumper stickers. I mean, it was just all over and I was just amazed that the community support, so that really attracted me here, as well as meeting with Dean Calhoun at the time, really communicated a student centric focus to Gatton, which I really appreciated.   Ralph Lugo So between all of those things, the stars just aligned the right way from a career standpoint for me and Gatton seemed real attractive in a place that I wanted to live. And then, you know, the place sort of got pushed off into the background somewhat in front and center was there's a great opportunity here in Johnson City to establish something really unique, and I want to be a part of it.   Ralph Lugo So that's really what what got me here. And that's what's kept me here for 20 years.   Michele Williams That's great. So what is your favorite part about your job?   Ralph Lugo Well, I love working with students. I'm an administrator at least half my time, but I still teach a lot in the classroom. So depending on the semester, I may be teaching 30 or 40% of my time. In some semesters, I'm teaching 50% of my time. So I teach more than most administrators teach. And that's not something that I wish to give up.   Ralph Lugo I really enjoy being in the classroom. I really enjoy being around the students. That's not unique to being a founding chair of the department, but that's a part that I really wanted to hang on to and have hang on to, you know, because I could have given that up in various ways over the years, but I intentionally retain that, especially since I, I no longer practice, and I love practicing, too.   Ralph Lugo So I gave that up because there just wasn't enough time in the day to do all those things. So I gave that up, but did not want to give up teaching. So love teaching, love working with students, love working with the faculty. And that's the that was the hook for me about being a department chair is you really have an opportunity to work closely with the faculty and trying to create opportunities for faculty members, trying to promote them.   Ralph Lugo I don't mean promote the necessarily from assistant to associate, but promote them in their career development, to promote them in their daily practice and just just helping them come along as faculty members. That was something that was very attractive to me, and I've enjoyed that ever since. And that's the one thing I actually miss, in being in my current position right now, is I don't work as closely with the faculty members, but I still do work with them.   Ralph Lugo So, because I'm no longer department chair, I'm sure we'll get to that, soon, but, but those are the things I think that I really enjoy about my position.   Stephen Woodward Can you talk about your transition from department chair to senior associate dean now?   Ralph Lugo Right. So, so several years ago, after serving in that as a department chair for, for 17 years, Dean Byrd was, was provided with a wonderful opportunity to serve as interim dean of the College of nursing. And, in order to make that happen, we really needed to have somebody here that could assist, her to continue that leadership role.   Ralph Lugo And so she asked me to serve as it was at that point, it was called executive associate dean, which has since transitioned, entitled Who's Senior Associate dean. But essentially it functions in the same way. So, a few years ago, that transition occurred when she took over that, that interim role in the College of Nursing. And then she served in that role for a period of time and is now back full time here in the College of Pharmacy.   Ralph Lugo And I'm still in that position of senior associate dean. So that's how that transition occurred. That's what prompted that transition. I moved into the senior associate dean role, and then Sarah Thomas and moved into the department chair role. And it's been a wonderful transition, a wonderful new challenge for me as well. And I still do many of the same things I did before, even as a department chair, with the exception of working as closely with the faculty, as I mentioned earlier, earlier.   Michele Williams So, what is something that people at Gatton might not know about you?   Ralph Lugo I think.   Michele Williams Ralph Lugo I think many people, some people might know about my recent interests from a professional standpoint. As you all know, I trained in pediatrics, served in that capacity for a number of years, and still have an interest in that. But professionally, as the years went on, my interests sort of blossomed in other areas. And that particular area is lifestyle medicine.   Ralph Lugo And so about 25 years ago, an organization was formed called the American College of Lifestyle Medicine, and it was formed by a number of physicians. And the primary goal and mission of the American College of Lifestyle Medicine is to try to address the root causes of disease and try to improve health through lifestyle interventions. As we all know, we have a very needy, sick population in this country and we have various epidemics that are unfolding as we speak.   Ralph Lugo Certainly, diabetes would fall in the category Alzheimer's disease would fall under that category, and cardiovascular disease continues to be the number one killer worldwide and in the US, and of course, cancer as well. And all of these things absolutely need to be addressed. But there's not a lot of reimbursement opportunities to try to prevent disease and try to get at some of the root causes.   Ralph Lugo So that that has been an area that's been somewhat ignored over the years. So this organization was created to try to address root causes and lifestyle modifications. And lifestyle modifications are in many of the guidelines that currently exist for treating various diseases. But the problem is that when physicians say you need to change your diet or you need to change your lifestyle, that's as far as they go in many cases in terms of describing that.   Ralph Lugo And the patients don't necessarily know what that means. And if you ask ten patients what it means to change your diet, you're going to get 15 different answers. So so this organization is really about trying to prevent disease. So I really sort of latched on to that about ten years ago. And so I'm now working with a number of students, seven students actually to write four papers.   Ralph Lugo No, it's actually more than that. It's 8 or 9 students to write four papers on the pharmacist's role in lifestyle intervention, the community pharmacist in particular. So things like preventing dementia, things like preventing anxiety and depression, that's what we're writing on. We're writing on we're we're considering just writing on the pharmacist role in lifestyle modifications in the community pharmacy, trying to educate pharmacists and give them the tools necessary to be able to address these issues in their patients.   Ralph Lugo We have a captive audience here. We have patients coming to the pharmacy, and pharmacists are the most accessible health care workers. So there's a great opportunity for this intervention. But pharmacists need to be educated in this area of lifestyle medicine, and it's not currently in the curriculum. So I'm trying to champion more education about that. Part of the way I'm doing that is through scholarship, writing articles and engaging students.   Ralph Lugo I hope to develop an elective in this area in the near future, and I think a number of students would probably be very interested in that.   Michele Williams Definitely.   Ralph Lugo So I think if you just bring this back to your question, Doctor Williams, I, I think probably many students don't know that some faculty might know it, but not all faculty might know. And so I'd say that's that's an area that, that's probably at least known about me.   Michele Williams And they know it now. So yes, that's right. More requests for students to participate in that research. That's right. You're doing. Yeah.   Stephen Woodward What? And I know everybody knows about you that you're a huge fan of AI and that the rise of AI over the past few years is just it seems like it's taken over, not quite in like, Terminator style yet, but maybe we're getting close to that. Can you talk about how you got interested in artificial intelligence and what do you find most useful about.   Ralph Lugo Yeah, AI is is really interesting. I like to utilize technology as a tool, not just I, you know. Yeah, some of the faculty, they'll probably poke, poke fun at me because I'm always looking for a better app to do certain things. You know, whether it's project management and some faculty. I won't name any names, but some faculty may laugh at me in terms of, you know, the newest and the greatest project management tool, a doctor you logos using well, whether it's Trello or whether it's Clickup, which is which is what I'm using right now.   Ralph Lugo So there's a little bit of fun there that folks have with me. So I've always been very interested in utilizing technology to improve efficiency. I'm very much about maximizing efficiency, whether it's.   Ralph Lugo Driving a car that has good gas mileage or whether it's squeezing every dollar out of your budget or whether it's, trying to get the most work out of a work day. You know, that's just kind of like how I'm wired. And so technology has always been a part of that. So that got me interested. And then when I found out about I happened to be in a, I was in a, a faculty meeting on main campus, it was a it was a group of faculty members, that were addressing, it was actually a number of chairs that were meeting and we were addressing the charge to write a faculty handbook for new   Ralph Lugo chairs. This was about four years ago. And the, the, person that was leading this, this committee said I used ChatGPT to give me an outline of what a faculty handbook would look like. And he showed it and I was like, wow, that is amazing. Now, meanwhile, I had heard of ChatGPT. I wasn't quite sure exactly what it did or what it was, but I was amazed at the output.   Ralph Lugo So I started tinkering a little bit with it and then, you know, and then things began to snowball. And then we had a number of, faculty development sessions here at the college. I actually gave one of those sessions and, and we went to a number of national meetings where we had sessions on a all things I. So I learned a lot about it.   Ralph Lugo And now I would consider myself. I'm certainly not an expert at it, but I'm probably an early adopter and I'm very enthusiastic about its potential. I'm not completely ignorant about the downside of using AI. It certainly does have downsides and limitations and disadvantages, but I think a lot of things do, you know, and people say the internet has downsides.   Ralph Lugo Yeah. If you're in the wrong places at the wrong time, it can be very detrimental. Right? But it's got a huge upside to so it's just a matter of trying to balance that and learning when to best utilize and how to best utilize AI in order to help you in your productivity guardrails. So let me talk a little bit about guardrails with AI use, because that's what people will ask about is this like, how do we how do we put guardrails around its use so that it can be used wisely?   Ralph Lugo So I would say, first and foremost, we need as a foundational issue, we need transparency. It needs to be clear when AI is being used. It's a, it's a, some measure of academic honesty and, being genuine is to declare when AI is used in order to assist with certain things. And that's coming from a professional standpoint, but from a student standpoint, too, academic honesty really depends on disclosing when I was used.   Ralph Lugo And so we need to we need to set up guardrails about disclosure. And I think that needs to be in policies as we move forward. Things are changing so rapidly. Policies are being developed, guidelines are being developed. So I think those things will be important to include moving forward. The other part of guardrails is we need to be careful about not encouraging students to take shortcuts around critical thinking.   Ralph Lugo We are trying to teach critical thinking here at the College of Pharmacy. That is an important outcome, and there are certain exercises that require critical thinking. It's not necessarily we're trying to get the answer as quickly as possible. We're trying to put you through that exercise of critical thinking and synthesizing and taking all this information that you're learning over the years and coming up with a cohesive, cogent answer.   Ralph Lugo And that's the exercise. That's the benefit. You got to struggle a little bit with that. Well, we can assign that to AI and come up with an answer. And, a 10th of the time, perhaps, but the student will not have grown from that exercise of critical thinking, and they may not know how to critically think if they continue to take shortcuts.   Ralph Lugo So we need to have mechanisms in place to protect those critical thinking opportunities. Also, clinical reasoning students need to be able to reason through certain questions, and they need that practice. They need also to, demonstrate competencies. You know, our skills, we have these skills here in the in the college. They have certain things like oral exams or direct observations or practice labs where you have to display certain competencies.   Ralph Lugo You're able to do certain things. AI is not going to help you there. So so that's an important part of the guardrail as well. And then, faculty development from our faculty need to be, competent users themselves before they can be thoughtful regulators. So we as faculty need to create these guardrails. We need to create these policies.   Ralph Lugo But we also need to be able to utilize them, utilize AI ourselves so that we know where the pitfalls are, where the landmines are, and where students can get into trouble. So, we're in the process of, in AI and I say we I mean, college pharmacy, Etsu, the academy, the profession. You know, we're in the process of developing these things as we go along.   Ralph Lugo And in the meantime, we have people that are, like, totally embracing it. And we have people that are tepidly cautious. And then we have people that are naysayers. And so all the above, I, I'm, I'm enthusiastic, but not ignorantly, ignorantly. So in other words, I'm not just embracing everything. I, I think it needs to be within the context of guardrails.   Ralph Lugo Michele Williams I agree, I share some of your concerns about AI co-opting somebody's ability to think critically or to even just practice those skills of reasoning through a problem and problem solving. On their own. I know in the classroom they have opportunities to do that, but it, it does seem like it would be very tempting to get AI to do some of that.   Michele Williams So I think, yeah. What you talk about with, with guardrails and, and not only guardrails, but sort of offering rationales and helping students look further down the road to why is it that you need to be the person doing this sort of reasoning and thinking?   Ralph Lugo Yeah. And and how to use AI in the context of that reasoning? You know, I can be right. Appropriately, AI can be a tool in that reasoning process, maybe to provide them with some information as long as the information is double checked in terms of accuracy. But the reasoning is really important, and human judgment enters that reasoning very often.   Ralph Lugo So things like empathy, things like, context of patient care, you know, understanding Mrs. Jones social situation and the fact, whatever her limitations are socially, you know, she doesn't get out of the house or she limited mobility or all these things go into helping to make decisions for patients that I can't necessarily reason through. And you have ethical decisions as well that come up.   Ralph Lugo And I again, may not be able to help with that. I, we have to recognize that AI is trained on a data base that exists in the past. And so there may be some ethical situations that come up which are contemporary, which are not necessarily in the training data base that one needs to think through critically in order to come up with an answer to best fit that patient.   Ralph Lugo It's kind of like evidence based medicine in a way. We can have all of the objective clinical trial data on a drug. We can say very clearly, this is the most efficacious drug for this disease. State, but if Mrs. Jones is not going to take it, or if it's too expensive for Mrs. Jones, or if there's three other reasons why it's not going to work and Mrs. Jones, then it may not be the best drug for Mrs. Jones, even though it has the most compelling data.   Ralph Lugo So it's the same with I may gave you some very good objective information, but it needs to be contextualized so that you can determine what is best for this patient. That requires empathy, human reason, human judgment, contextualization and AI at this point doesn't do all of those things. Yeah.   Ralph Lugo You know, I might I might mention another thing. And I know Doctor Williams, this kind of resonates with you with regard to professional identity formation. I know that's an area of interest for you. But, you know, one of the things as we're trying to develop professionals here at the Gatton College of Pharmacy is we want students to be able to wrestle with difficult questions and sometimes failure, sometimes critique, sometimes not having the right answer, sometimes struggling and being corrected helps with that professional identity formation so that it helps them become a better professional.   Ralph Lugo And, you know, I can think we were just having a conversation just recently, another faculty member and I, about some of the students in the past that may have had some academic or behavioral challenges, shall we say. And I'm talking about the distant past. And I think in some cases, some of these some students may be young. They may they may not have that full maturity.    Ralph Lugo Certainly they're not fully matured professionally, that professional identity formation. But they've they went through a process that helped to correct them, to guide them, to corral them and shepherd them. And in that process, they came out on the other end and have created wonderful careers for themselves through that process. And sometimes a few hard knocks along the way will help people correct course, correct along the way, and help them become more successful.   Ralph Lugo So that's, you know, it's not always about having the right answer. That's true. And having all your eyes dotted and t's crossed, which I tends to do. Right. Great answer. I now let's put it in the context of training pharmacy students.   Michele Williams I agree, I agree.   Stephen Woodward It's got to be pretty satisfying to see a student from a long time ago struggle, but then come out on the other side and then go on to in a career.   Ralph Lugo Yeah. Very much succeed. Right. Yeah. And and you don't appreciate it or recognize it immediately until years down the road and you kind of look back and you say, wow, this person's really made a name for herself or himself. And and it's not always about making a name for yourself, but that making a name for yourself is usually because you're a great pharmacist and you take care of patients in a in a great way.   Ralph Lugo And, you do all the things necessary to be a wonderful practitioner. And so that's really what it's about, whether you make a name for yourself or not. Yeah.   Stephen Woodward Well, so you talked about you came to Gatton, I think you were hired in 2005, which was at the time of the founding 20 years ago. We're celebrating our 20th anniversary this academic year. Talk about the importance of our 20th anniversary here at Gatton, how far you've seen us come and where you think we're going in the future.   Ralph Lugo Yeah, that's a that's a great question. 20 years is a great milestone. So it's 25 and we'll probably have, you know, even a bigger celebration at 25. But it sort of represents similar milestones in some respects. And what I mean by that is that many of our founding faculty are still here, and we can look back at the early days and we can appreciate the struggles, and we can appreciate the challenges, and we can appreciate where we have come from and what we have built over the years.   Ralph Lugo So in many respects, 20 years, 25 years represents as somewhat of an inflection point where you have enough people here that were here in the beginning that recognize that the first 20 years was like maybe chapter one, or maybe it's, you know, maybe it's one with various sub chapters, but really it's it was when we started, it was we were getting things off the ground, and we achieved a number of wonderful things in those first 20 years in not only accreditation and re accreditation, of course, but we also achieved great academic, achievements nationally.   Ralph Lugo You know, winning a CCP clinical Challenge award twice, community service awards at the national level. Our operation study is an award winner. Now I think it's 12 years in a row, either national or regional. And it's just it's just amazing to think that a new school would achieve that level of national recognition and, national prowess, in the first two decades.   Ralph Lugo I think as we look forward, not only oh and I'll, I'll mention one more thing about those first 20 years is that we grounded ourselves in an amazing and outstanding culture. And that's where Gatton really shines in many respects. There are a lot of good schools academically. There are a lot of good schools that do community service.   Ralph Lugo When I tell applicants that that, applied to Gatton is you can get a pharm.d from many places where academically you're going to get a great education. What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools, where you're going to know your professors and they're going to know you, and you're going to develop lifelong relationships with your colleagues, that doesn't always happen in all schools.   Ralph Lugo And so in the beginning, that was our aspiration to create that culture. That was the vision of Larry Calhoun, our founding dean. And he did that very well. And he articulated that to the faculty and the students and to the leadership team. And we just have propagated that forward over the last 20 years. And now, of course, Dean Debbie Byrd is in place for the last ten years.   Ralph Lugo And she of course, that's what she's about as well. So it was like we didn't even misstep when we changed deans. And so it's been this continuous progress of developing this amazing culture. Great place to work, great place to learn, student centric, people come first, you know, all bathed in academic excellence and, and community and student service.   Ralph Lugo Right. So that's a great three legged stool, right? Service. Community service, academic excellence and culture. Now in the next 20 years, we're going to have people retire. We're going to have people that maybe weren't here in the beginning. So there's going to be a little bit of a different flavor. But I'm fully anticipating that the culture is here to stay because we have foundationally set it in concrete and then the concrete is dry.   Ralph Lugo So I don't think it's going anywhere. And, you know, in the first three years or five years, maybe the concrete hadn't dried yet, but but now I think the concrete is dry. Everybody carries this culture, you know, inside of them. It's part of the fabric of who the faculty and students are. We talk about it a lot. We cultivated and and so I don't think it's going to change in the next 15, 20 years.   Ralph Lugo So that's going to continue. But now we've added some other things, you know, now we're we're working on streamlining our curriculum to become the most relevant, essential curriculum for training pharmacists. So that's what we just recently did in our curricular revision. And and also we're looking out towards our research and trying to improve our scholarship and our productivity from a research perspective so that we can become better known for our scholarly output and our research productivity, especially in the context of Etsu use research strategic plan and their, desire to improve scholarship as headed up by Nick Haggar.   Ralph Lugo Meyer, who's also one of us, here at the College of Pharmacy. So I think as we project out, it's a little bit of an inflection point. Just to summarize a little bit of an inflection point. And over the next 10 to 20 years, you're going to see people are not going to remember the beginning anymore. But I think we've wound this thing up sufficiently that there's enough momentum keeping it moving forward in the ways that are important, these high impact ways that it's not going to turn around anytime soon.   Ralph Lugo And we can just build on our successes and make it even a better place next decade, next two decades. Good to great is kind of our motto.   Stephen Woodward I love what you said about culture. I feel like, I mean, I've been here almost seven years. I don't think I realized how important culture is for just organizations in general. But hearing you articulated, kind of experiencing it here from a newer, newish organization like it's super important as the foundation and just helps lay the groundwork for everything else that is laid upon it as a like a good, solid structure.   Ralph Lugo You know, I think that's the reason why we've been so successful in, attracting students. I mean, every, every year we sit down with the PS1 students. The dean has a lunch with subgroups of the P-1 class, 8 to 10 at a time. And we ask them why they came here and what are the things that attracted them about Gatton College of Pharmacy?   Ralph Lugo And everybody talks about there are a number of things that attracted them. Of course, geographic location is always important, and there's a number of things that are important. But the culture and the receptivity and the warmth. Yeah. On their interview day is somewhat unmatched by other places. And so they felt at home here immediately, and that that's what attracts them.   Ralph Lugo Also, I think that's what keeps people here, both staff and faculty. Is that it? For that reason, it's a good place to work. You don't you don't have the, some of the, problems that other universities have with, disgruntled employees and backstabbing and competitiveness, and it just doesn't exist here. So it's just from that standpoint is just a wonderful place to work.   Ralph Lugo And I think we probably after a while, we probably take that for granted. And, you know, if you went to another school someplace else, you might say, oh, I think things a little bit differently. Yeah. So, you know, I've been to a number of schools around the country, and, things are different here again.   Michele Williams Yeah. And I, I think that culture is very intentional. That's not, it it doesn't just accidentally work like.   Ralph Lugo Yeah. That's right. Yeah. Yeah, it is definitely something you have to work at. It's got to it has to be something that's articulated from the leaders of the college initially. And, and it needs to be reinforced regularly. And it needs to not just be said you actually need to live the words walk the walk talk the talk.   Ralph Lugo You know, do all of those sayings. Right. And, and eventually people start to embrace it and it becomes clear when somebody is operating outside of those cultural boundaries. And I think there is just this natural pressure towards in a good way towards this is how we are. I get, you know, this is the Gatton way. You know, people have said that before, right, that this is not the Gatton way or this is the other way.   Ralph Lugo So it helps us and everybody knows what that means. You know, and probably I would say the students know what that means too. So it's something that that is cultivated, something that is repeated. And we even talk about it in our strategic plan, you know, in terms of environment. Yeah.   Michele Williams This has been such an interesting and sort of far reaching conversation. I've enjoyed every minute of it. Are there any other things that that you would like to talk about or that we haven't asked you about?   Ralph Lugo Well, you know, I think something just came to mind, that I think may be worth discussing and that's wellbeing and something that Gatton is all about to, and that's somewhat unique among colleges is we pay a lot of attention to the well-being of our students, the well-being of our faculty and staff. We're doing a survey this year for our staff, for wellbeing faculty and staff, for wellbeing.   Ralph Lugo And of course, we surveyed the students and we have for a number of years now. So we're able to track their well-being in all of the domains that Gallup would promote. And we track that over time, and we can see where students will drop in their wellbeing scores. And that's a great time for us as a college to intervene and try to promote wellbeing during that time.   Ralph Lugo So, with that as a background or a backdrop, I, the faculty advisor, one of the faculty advisors on the wellbeing Student Wellbeing committee. And one of the things that I'm working on with the research subcommittee of the Student Wellbeing Committee, that's a lot of work.   Stephen Woodward That and also loves its committees.   Ralph Lugo Yes. That's right. Yeah. Great committees. So that's the research subcommittee. We're working on ways that we can take the current research dealing with wellbeing and wellness and lifestyle medicine. As I mentioned earlier, this all fits together right. And yeah. And and draw on the research that is coming out relative to nutrition, relative to physical activity, relative to stress reduction, relative to social connection and, and encourage our students to promote their wellbeing through being aware of the research, adopting the research habits and patterns that are being developed.   Ralph Lugo So for example, we're just we're working on our first push out. I think that's a word. We're working on pushing out our first, I'll call it publication. Our first, information from this student wellbeing subcommittee, research subcommittee. And we're trying to do it in ways where students will appreciate the the presentation. So we're thinking about maybe infographics.   Ralph Lugo We're thinking about a short podcast of maybe, like 5 or 6 minutes with some graphics of a video podcast. We're thinking about a short written document. So just ways that we can encourage students to adopt some of the, contemporary research findings relative to wellbeing. And, and then at the same time, they learn about this to help their patients in the future.   Ralph Lugo So it's not just about them, it's about helping their patients as well. So we're going to be coming out with our first, stuff publication, here in the next few weeks. I had a meeting with them this week, and we've prepared some materials. Which I would actually meant to bring down so you all can look at it and see it.   Ralph Lugo I'd love to share that with you and get your thoughts on it before it gets pushed out. But, yeah, we're we're really excited about this aspect of, the Gatton culture, because that is really part of our culture too, is to try to enhance wellbeing.   Stephen Woodward Yeah. That's great. Thanks for sharing. I think that's a wrap. Thank you for being here. I appreciate your time.   Ralph Lugo Thank you for this podcast. And this podcast has been amazingly successful. So, kudos to both of you. And in creating this and keeping it going. And I think it does a great service to our students and faculty and staff, our community, and even across the country.   Stephen Woodward So we appreciate it. Thank you very much.   Michele Williams Thank you. All right.   Stephen Woodward I'll get it off. Thanks. Awesome. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsy.com, slash pharmacy or follow us on social media at Etsy Pharmacy. We'll see you next time.   Ralph Lugo What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools where you're going to know your professors and they're going to know you, and you're going to develop lifelong relationships with your colleagues.   That doesn't always happen in all schools.   Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success.   Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. On this episode, we talk with Doctor Ralph Lugo, senior associate dean and professor at ETSU Bill Gatton College of Pharmacy. He's been with the college since its founding, joining in 2006 as founding chair of the Department of Pharmacy Practice and serving in that role for 17 years before being promoted to Senior Associate Dean.   Stephen Woodward During this time, again, Doctor Lugo is primarily focused on administration, program development, and teaching. And before coming to Etsu, he served as vice chair of Pharmacotherapy at the University of Utah. Doctor Lugo‚Äôs practice experience and interest is in pediatrics, specifically in pediatric intensive care. His research interests include lifestyle medicine, pediatrics, neonatology, pediatric intensive care, analgesia, sedation, and his research has been supported by the National Institutes of Health.   Stephen Woodward Well, Doctor Lugo, thanks for coming to Waco Radio today.   Ralph Lugo Yeah. Thank you, Stephen, for having me. Doctor Williams, thank you for having me today. Look forward to our conversation.   Michele Williams We're happy to have you here.   Stephen Woodward So you came again as founding chair of the Department of Pharmacy Practice. Can you talk about your long history here and what roles you currently serve in?   Ralph Lugo Sure. I came to Gatton in 2006. I was hired in 2005, so I've been here 20 years now, which is just amazing to think that I've been here that long. And I was hired initially as the founding chair of the Department of Pharmacy Practice. As you all know, we have two academic departments Pharmaceutical Sciences and Practice. At the time, at the time, I was at the University of Utah as vice chair of Pharmacy practice and an associate professor in pediatrics.   Ralph Lugo I think most people know that my specialty area had been pediatrics in my up but in the air quotes. Former life as a as a clinician in the pediatric intensive care unit. And I had always wanted to come back to the East coast. Was born on the East Coast. I trained in North Carolina, worked in North Carolina. I really enjoyed the South East a lot.   Ralph Lugo So my wife and I, we started a family out in Utah, and we really had a desire to come back east and specifically the southeast. So I saw this position open up, and it was just a natural move for me to move from a vice chair position to a chair position. And I had been in academia long enough that 13 years at the time to be able to handle such a thing.   Ralph Lugo Of course, it's always very challenging, but really look forward to the opportunity. But there were some things in particular, I think, that really attracted me to Gatton. Number one, we were starting a college of pharmacy from scratch. There's not a lot of opportunities that come up in the country to start a pharmacy school from scratch, to no avail.   Ralph Lugo And and you know, there's as you go around the country and you train in different places, you realize that some things you know, I might do a little differently or the culture may not be as I would want it to be in certain places. And so here was this opportunity to start with a clean sheet of paper.   Ralph Lugo And I thought, what a wonderful professional opportunity that really doesn't come around very often. And and then I interviewed the for the position and was just overwhelmed by the community support for this for this college of pharmacy. Nothing I've really seen before coming from Salt Lake City. City of 1 million plus College of Pharmacy doesn't get much airtime or press.   Ralph Lugo And it seemed like here at the College of Pharmacy was in the newspaper towns, the city press constantly above the fold type of articles, on the news, on the marquees, on the bumper stickers. I mean, it was just all over and I was just amazed that the community support, so that really attracted me here, as well as meeting with Dean Calhoun at the time, really communicated a student centric focus to Gatton, which I really appreciated.   Ralph Lugo So between all of those things, the stars just aligned the right way from a career standpoint for me and Gatton seemed real attractive in a place that I wanted to live. And then, you know, the place sort of got pushed off into the background somewhat in front and center was there's a great opportunity here in Johnson City to establish something really unique, and I want to be a part of it.   Ralph Lugo So that's really what what got me here. And that's what's kept me here for 20 years.   Michele Williams That's great. So what is your favorite part about your job?   Ralph Lugo Well, I love working with students. I'm an administrator at least half my time, but I still teach a lot in the classroom. So depending on the semester, I may be teaching 30 or 40% of my time. In some semesters, I'm teaching 50% of my time. So I teach more than most administrators teach. And that's not something that I wish to give up.   Ralph Lugo I really enjoy being in the classroom. I really enjoy being around the students. That's not unique to being a founding chair of the department, but that's a part that I really wanted to hang on to and have hang on to, you know, because I could have given that up in various ways over the years, but I intentionally retain that, especially since I, I no longer practice, and I love practicing, too.   Ralph Lugo So I gave that up because there just wasn't enough time in the day to do all those things. So I gave that up, but did not want to give up teaching. So love teaching, love working with students, love working with the faculty. And that's the that was the hook for me about being a department chair is you really have an opportunity to work closely with the faculty and trying to create opportunities for faculty members, trying to promote them.   Ralph Lugo I don't mean promote the necessarily from assistant to associate, but promote them in their career development, to promote them in their daily practice and just just helping them come along as faculty members. That was something that was very attractive to me, and I've enjoyed that ever since. And that's the one thing I actually miss, in being in my current position right now, is I don't work as closely with the faculty members, but I still do work with them.   Ralph Lugo So, because I'm no longer department chair, I'm sure we'll get to that, soon, but, but those are the things I think that I really enjoy about my position.   Stephen Woodward Can you talk about your transition from department chair to senior associate dean now?   Ralph Lugo Right. So, so several years ago, after serving in that as a department chair for, for 17 years, Dean Byrd was, was provided with a wonderful opportunity to serve as interim dean of the College of nursing. And, in order to make that happen, we really needed to have somebody here that could assist, her to continue that leadership role.   Ralph Lugo And so she asked me to serve as it was at that point, it was called executive associate dean, which has since transitioned, entitled Who's Senior Associate dean. But essentially it functions in the same way. So, a few years ago, that transition occurred when she took over that, that interim role in the College of Nursing. And then she served in that role for a period of time and is now back full time here in the College of Pharmacy.   Ralph Lugo And I'm still in that position of senior associate dean. So that's how that transition occurred. That's what prompted that transition. I moved into the senior associate dean role, and then Sarah Thomas and moved into the department chair role. And it's been a wonderful transition, a wonderful new challenge for me as well. And I still do many of the same things I did before, even as a department chair, with the exception of working as closely with the faculty, as I mentioned earlier, earlier.   Michele Williams So, what is something that people at Gatton might not know about you?   Ralph Lugo I think.   Michele Williams Ralph Lugo I think many people, some people might know about my recent interests from a professional standpoint. As you all know, I trained in pediatrics, served in that capacity for a number of years, and still have an interest in that. But professionally, as the years went on, my interests sort of blossomed in other areas. And that particular area is lifestyle medicine.   Ralph Lugo And so about 25 years ago, an organization was formed called the American College of Lifestyle Medicine, and it was formed by a number of physicians. And the primary goal and mission of the American College of Lifestyle Medicine is to try to address the root causes of disease and try to improve health through lifestyle interventions. As we all know, we have a very needy, sick population in this country and we have various epidemics that are unfolding as we speak.   Ralph Lugo Certainly, diabetes would fall in the category Alzheimer's disease would fall under that category, and cardiovascular disease continues to be the number one killer worldwide and in the US, and of course, cancer as well. And all of these things absolutely need to be addressed. But there's not a lot of reimbursement opportunities to try to prevent disease and try to get at some of the root causes.   Ralph Lugo So that that has been an area that's been somewhat ignored over the years. So this organization was created to try to address root causes and lifestyle modifications. And lifestyle modifications are in many of the guidelines that currently exist for treating various diseases. But the problem is that when physicians say you need to change your diet or you need to change your lifestyle, that's as far as they go in many cases in terms of describing that.   Ralph Lugo And the patients don't necessarily know what that means. And if you ask ten patients what it means to change your diet, you're going to get 15 different answers. So so this organization is really about trying to prevent disease. So I really sort of latched on to that about ten years ago. And so I'm now working with a number of students, seven students actually to write four papers.   Ralph Lugo No, it's actually more than that. It's 8 or 9 students to write four papers on the pharmacist's role in lifestyle intervention, the community pharmacist in particular. So things like preventing dementia, things like preventing anxiety and depression, that's what we're writing on. We're writing on we're we're considering just writing on the pharmacist role in lifestyle modifications in the community pharmacy, trying to educate pharmacists and give them the tools necessary to be able to address these issues in their patients.   Ralph Lugo We have a captive audience here. We have patients coming to the pharmacy, and pharmacists are the most accessible health care workers. So there's a great opportunity for this intervention. But pharmacists need to be educated in this area of lifestyle medicine, and it's not currently in the curriculum. So I'm trying to champion more education about that. Part of the way I'm doing that is through scholarship, writing articles and engaging students.   Ralph Lugo I hope to develop an elective in this area in the near future, and I think a number of students would probably be very interested in that.   Michele Williams Definitely.   Ralph Lugo So I think if you just bring this back to your question, Doctor Williams, I, I think probably many students don't know that some faculty might know it, but not all faculty might know. And so I'd say that's that's an area that, that's probably at least known about me.   Michele Williams And they know it now. So yes, that's right. More requests for students to participate in that research. That's right. You're doing. Yeah.   Stephen Woodward What? And I know everybody knows about you that you're a huge fan of AI and that the rise of AI over the past few years is just it seems like it's taken over, not quite in like, Terminator style yet, but maybe we're getting close to that. Can you talk about how you got interested in artificial intelligence and what do you find most useful about.   Ralph Lugo Yeah, AI is is really interesting. I like to utilize technology as a tool, not just I, you know. Yeah, some of the faculty, they'll probably poke, poke fun at me because I'm always looking for a better app to do certain things. You know, whether it's project management and some faculty. I won't name any names, but some faculty may laugh at me in terms of, you know, the newest and the greatest project management tool, a doctor you logos using well, whether it's Trello or whether it's Clickup, which is which is what I'm using right now.   Ralph Lugo So there's a little bit of fun there that folks have with me. So I've always been very interested in utilizing technology to improve efficiency. I'm very much about maximizing efficiency, whether it's.   Ralph Lugo Driving a car that has good gas mileage or whether it's squeezing every dollar out of your budget or whether it's, trying to get the most work out of a work day. You know, that's just kind of like how I'm wired. And so technology has always been a part of that. So that got me interested. And then when I found out about I happened to be in a, I was in a, a faculty meeting on main campus, it was a it was a group of faculty members, that were addressing, it was actually a number of chairs that were meeting and we were addressing the charge to write a faculty handbook for new   Ralph Lugo chairs. This was about four years ago. And the, the, person that was leading this, this committee said I used ChatGPT to give me an outline of what a faculty handbook would look like. And he showed it and I was like, wow, that is amazing. Now, meanwhile, I had heard of ChatGPT. I wasn't quite sure exactly what it did or what it was, but I was amazed at the output.   Ralph Lugo So I started tinkering a little bit with it and then, you know, and then things began to snowball. And then we had a number of, faculty development sessions here at the college. I actually gave one of those sessions and, and we went to a number of national meetings where we had sessions on a all things I. So I learned a lot about it.   Ralph Lugo And now I would consider myself. I'm certainly not an expert at it, but I'm probably an early adopter and I'm very enthusiastic about its potential. I'm not completely ignorant about the downside of using AI. It certainly does have downsides and limitations and disadvantages, but I think a lot of things do, you know, and people say the internet has downsides.   Ralph Lugo Yeah. If you're in the wrong places at the wrong time, it can be very detrimental. Right? But it's got a huge upside to so it's just a matter of trying to balance that and learning when to best utilize and how to best utilize AI in order to help you in your productivity guardrails. So let me talk a little bit about guardrails with AI use, because that's what people will ask about is this like, how do we how do we put guardrails around its use so that it can be used wisely?   Ralph Lugo So I would say, first and foremost, we need as a foundational issue, we need transparency. It needs to be clear when AI is being used. It's a, it's a, some measure of academic honesty and, being genuine is to declare when AI is used in order to assist with certain things. And that's coming from a professional standpoint, but from a student standpoint, too, academic honesty really depends on disclosing when I was used.   Ralph Lugo And so we need to we need to set up guardrails about disclosure. And I think that needs to be in policies as we move forward. Things are changing so rapidly. Policies are being developed, guidelines are being developed. So I think those things will be important to include moving forward. The other part of guardrails is we need to be careful about not encouraging students to take shortcuts around critical thinking.   Ralph Lugo We are trying to teach critical thinking here at the College of Pharmacy. That is an important outcome, and there are certain exercises that require critical thinking. It's not necessarily we're trying to get the answer as quickly as possible. We're trying to put you through that exercise of critical thinking and synthesizing and taking all this information that you're learning over the years and coming up with a cohesive, cogent answer.   Ralph Lugo And that's the exercise. That's the benefit. You got to struggle a little bit with that. Well, we can assign that to AI and come up with an answer. And, a 10th of the time, perhaps, but the student will not have grown from that exercise of critical thinking, and they may not know how to critically think if they continue to take shortcuts.   Ralph Lugo So we need to have mechanisms in place to protect those critical thinking opportunities. Also, clinical reasoning students need to be able to reason through certain questions, and they need that practice. They need also to, demonstrate competencies. You know, our skills, we have these skills here in the in the college. They have certain things like oral exams or direct observations or practice labs where you have to display certain competencies.   Ralph Lugo You're able to do certain things. AI is not going to help you there. So so that's an important part of the guardrail as well. And then, faculty development from our faculty need to be, competent users themselves before they can be thoughtful regulators. So we as faculty need to create these guardrails. We need to create these policies.   Ralph Lugo But we also need to be able to utilize them, utilize AI ourselves so that we know where the pitfalls are, where the landmines are, and where students can get into trouble. So, we're in the process of, in AI and I say we I mean, college pharmacy, Etsu, the academy, the profession. You know, we're in the process of developing these things as we go along.   Ralph Lugo And in the meantime, we have people that are, like, totally embracing it. And we have people that are tepidly cautious. And then we have people that are naysayers. And so all the above, I, I'm, I'm enthusiastic, but not ignorantly, ignorantly. So in other words, I'm not just embracing everything. I, I think it needs to be within the context of guardrails.   Ralph Lugo Michele Williams I agree, I share some of your concerns about AI co-opting somebody's ability to think critically or to even just practice those skills of reasoning through a problem and problem solving. On their own. I know in the classroom they have opportunities to do that, but it, it does seem like it would be very tempting to get AI to do some of that.   Michele Williams So I think, yeah. What you talk about with, with guardrails and, and not only guardrails, but sort of offering rationales and helping students look further down the road to why is it that you need to be the person doing this sort of reasoning and thinking?   Ralph Lugo Yeah. And and how to use AI in the context of that reasoning? You know, I can be right. Appropriately, AI can be a tool in that reasoning process, maybe to provide them with some information as long as the information is double checked in terms of accuracy. But the reasoning is really important, and human judgment enters that reasoning very often.   Ralph Lugo So things like empathy, things like, context of patient care, you know, understanding Mrs. Jones social situation and the fact, whatever her limitations are socially, you know, she doesn't get out of the house or she limited mobility or all these things go into helping to make decisions for patients that I can't necessarily reason through. And you have ethical decisions as well that come up.   Ralph Lugo And I again, may not be able to help with that. I, we have to recognize that AI is trained on a data base that exists in the past. And so there may be some ethical situations that come up which are contemporary, which are not necessarily in the training data base that one needs to think through critically in order to come up with an answer to best fit that patient.   Ralph Lugo It's kind of like evidence based medicine in a way. We can have all of the objective clinical trial data on a drug. We can say very clearly, this is the most efficacious drug for this disease. State, but if Mrs. Jones is not going to take it, or if it's too expensive for Mrs. Jones, or if there's three other reasons why it's not going to work and Mrs. Jones, then it may not be the best drug for Mrs. Jones, even though it has the most compelling data.   Ralph Lugo So it's the same with I may gave you some very good objective information, but it needs to be contextualized so that you can determine what is best for this patient. That requires empathy, human reason, human judgment, contextualization and AI at this point doesn't do all of those things. Yeah.   Ralph Lugo You know, I might I might mention another thing. And I know Doctor Williams, this kind of resonates with you with regard to professional identity formation. I know that's an area of interest for you. But, you know, one of the things as we're trying to develop professionals here at the Gatton College of Pharmacy is we want students to be able to wrestle with difficult questions and sometimes failure, sometimes critique, sometimes not having the right answer, sometimes struggling and being corrected helps with that professional identity formation so that it helps them become a better professional.   Ralph Lugo And, you know, I can think we were just having a conversation just recently, another faculty member and I, about some of the students in the past that may have had some academic or behavioral challenges, shall we say. And I'm talking about the distant past. And I think in some cases, some of these some students may be young. They may they may not have that full maturity.    Ralph Lugo Certainly they're not fully matured professionally, that professional identity formation. But they've they went through a process that helped to correct them, to guide them, to corral them and shepherd them. And in that process, they came out on the other end and have created wonderful careers for themselves through that process. And sometimes a few hard knocks along the way will help people correct course, correct along the way, and help them become more successful.   Ralph Lugo So that's, you know, it's not always about having the right answer. That's true. And having all your eyes dotted and t's crossed, which I tends to do. Right. Great answer. I now let's put it in the context of training pharmacy students.   Michele Williams I agree, I agree.   Stephen Woodward It's got to be pretty satisfying to see a student from a long time ago struggle, but then come out on the other side and then go on to in a career.   Ralph Lugo Yeah. Very much succeed. Right. Yeah. And and you don't appreciate it or recognize it immediately until years down the road and you kind of look back and you say, wow, this person's really made a name for herself or himself. And and it's not always about making a name for yourself, but that making a name for yourself is usually because you're a great pharmacist and you take care of patients in a in a great way.   Ralph Lugo And, you do all the things necessary to be a wonderful practitioner. And so that's really what it's about, whether you make a name for yourself or not. Yeah.   Stephen Woodward Well, so you talked about you came to Gatton, I think you were hired in 2005, which was at the time of the founding 20 years ago. We're celebrating our 20th anniversary this academic year. Talk about the importance of our 20th anniversary here at Gatton, how far you've seen us come and where you think we're going in the future.   Ralph Lugo Yeah, that's a that's a great question. 20 years is a great milestone. So it's 25 and we'll probably have, you know, even a bigger celebration at 25. But it sort of represents similar milestones in some respects. And what I mean by that is that many of our founding faculty are still here, and we can look back at the early days and we can appreciate the struggles, and we can appreciate the challenges, and we can appreciate where we have come from and what we have built over the years.   Ralph Lugo So in many respects, 20 years, 25 years represents as somewhat of an inflection point where you have enough people here that were here in the beginning that recognize that the first 20 years was like maybe chapter one, or maybe it's, you know, maybe it's one with various sub chapters, but really it's it was when we started, it was we were getting things off the ground, and we achieved a number of wonderful things in those first 20 years in not only accreditation and re accreditation, of course, but we also achieved great academic, achievements nationally.   Ralph Lugo You know, winning a CCP clinical Challenge award twice, community service awards at the national level. Our operation study is an award winner. Now I think it's 12 years in a row, either national or regional. And it's just it's just amazing to think that a new school would achieve that level of national recognition and, national prowess, in the first two decades.   Ralph Lugo I think as we look forward, not only oh and I'll, I'll mention one more thing about those first 20 years is that we grounded ourselves in an amazing and outstanding culture. And that's where Gatton really shines in many respects. There are a lot of good schools academically. There are a lot of good schools that do community service.   Ralph Lugo When I tell applicants that that, applied to Gatton is you can get a pharm.d from many places where academically you're going to get a great education. What you're going to get here at Gatton is a great education, where you also have high impact opportunities and a wonderful culture, a community focused culture, a student centric culture with relatively small class sizes compared to many other schools, where you're going to know your professors and they're going to know you, and you're going t

Episode 27 — Maddie Stacey, Early Admission Pathway student

In this episode we chat with first-year student pharmacist Maddie Stacey, who found confidence — and a community — through ETSU Gatton College of Pharmacy’s Early Admission Pathway [https://www.etsu.edu/pharmacy/admissions/early_admission_pathway.php]. A native of Kingsport, Stacey learned about the college’s EAP program while in high school. For her, the program has made the adjustment to pharmacy school much easier.  Open to high school seniors and first-year ETSU students, the Early Admission Pathway enables students to earn both a Bachelor of Science and a Doctor of Pharmacy degree in just six years. EAP students also join the college’s Pre-Pharmacy Student Organization, designed to introduce them to different specialties in pharmacy and to foster connections with their classmates. Learn more at www.etsu.edu/RxEarlyAdmit [https://www.etsu.edu/pharmacy/admissions/early_admission_pathway.php].   Transcript Teaser Introduction Maddie Stacey I think some of the things that the early admissions pathway has made me as a student as confident. I would say that the transition pathway is very smooth. They again, they put everything in line for you. I mean, they give you your schedule, they tell you what you need to do. And so I think that it makes everything much more cohesive. Main Episode: Michele Williams Welcome to White Coat Radio, a podcast from East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm one of your hosts, Doctor Michele Williams, assistant professor and director of academic success. Stephen Woodward And I'm Stephen Woodward, marketing and communications manager. First year student pharmacist Maddie Stacey from Kingsport, Tennessee, sat down for us to talk about her experience going through Gatton's early admission pathway opened high school seniors and first year ETSU students. The early admission pathway enables students to earn both a Bachelor of Science and the Doctor Pharmacy degree in just six years. Stephen Woodward The pathway offers students the assurance of a seat, mentoring, scholarships, research opportunities, and flexible start options for the pharmacy curriculum. For Stacey, the early admission pathway has made the adjustment to pharmacy school much easier and helped her to find confidence and a community. The deadline to apply is March 31st, 2026. Learn more at Etsu Edu slash. Early admit. Stephen Woodward Let's hear more about her experience now. Well, hi, Maddie, welcome to White Coat Radio. Start by telling us what got you interested in pursuing pharmacy. Maddie Stacey I'm interested in pursuing pharmacy because when I was younger, I realized how much one medication could do for one person. Right? And if it can just do so much to change a person's life, to make it more accessible, I want to know everything about how that drug was able to do that for that person. And what else can it do for another person? Maddie Stacey So I'm really interested in pursuing pharmacy because I want to know how all the drugs can help people be better and function in their lives and be able to enjoy their lives. And so I really love that about pharmacy. Stephen Woodward Well, what was it like going through our early admission pathway, which is for high school seniors attending ETSU and ETSU freshmen? Maddie Stacey I got really interested in pharmacy when I was in high school. And in high school they start to tell you about college options. And when you look at ETSU, you figure out that there are a lot of opportunities. So I was invited to a event for the Honors College and at the Honors College, they have a lot of the other colleges come and set up like Quillen and Gatton. Maddie Stacey And at that event, Becky Dunkelberger was there and she was there representing Gatton. And that's when I first got to figure out that there was a place here in Johnson City, really close to my hometown, Kingsport, that was offering a pharmacy program, which was very exciting. I was excited about that. And she told me there were a lot of opportunities. Maddie Stacey So the Early Admissions Pathway isn't just, you get here as soon as you can. It's a you create what you want to do. So there was a two years of undergraduate, and then you go in and you can start getting those requirements for your PharmD. Or if you want to get chemistry, biology, health sciences, any of those, you can do three years of undergraduate and then go in. Maddie Stacey And Becky explains all this very well. For me, I chose to go ahead and do the two years, and I also chose to get a Bachelors of Pharmacy studies, which is an option, and I chose to do that. It's just a few more requirements. But again, I never had to worry the school was with me along the way. Maddie Stacey So when you choose to be an Early Admissions Pathway student, you meet once a semester with either Steve Ellis or Becky, and they're like, okay, here's where you're at. Here's what you need to do. How does that sound? And you either are like, yeah, I can do that. Or, you know, this class is full. I don't think I can take this. Maddie Stacey And they help you every step of the way. If you can't do it, if you can do it. So, it sounds like a lot. Being like, oh, I need to do everything before I come to pharmacy school. But you do it one step at a time. And I love that. About the early admissions pathway. And I would do it again if I, if I was asked, I would definitely do it again. Maddie Stacey It's very smooth transition. Stephen Woodward Talk about your experience in the pre pharmacy student organization at Etsu. Also known as. So what was that like. Maddie Stacey So when you decide to become an early admissions pathway student Becky invites you to join pre pharmacy student organization which is so and so this organization works to invite pharmacists from the surrounding areas, from the faculty to come and speak about their specialties, their advice or their disciplines. And pharmacy. And it gives students like a wide range of options to see, oh wait, pharmacy is not just something that happens behind the counter at a Walgreens or a CVS. Maddie Stacey There's so much more to pharmacy and that's something I really loved about pre pharmacy student organization. So once you start going it's like once every other Wednesday night. And something great about pre pharmacy student organization is that as an early admissions pathway student it's a requirement. So obviously everybody there is also going to be in your program or a year behind you maybe a year ahead of you. Maddie Stacey But you're connected with all of these students that go to Etsu and are going to go with you to that program. So my class is 63 people, and of that 63 going in, I knew about 30 people, which is pretty incredible considering that, you know, they're students from out of state that didn't have that same opportunity. And that's just something that the early admission pathway offers. Maddie Stacey If you go to Etsu as well. And I loved getting to do that. And in addition to doing that, our faculty advisor is Doctor Thigpen. He's one of the pediatric pharmacists, and he's a faculty member. So, as president of the club, I got to talk to him a lot and make a relationship with him. And that was really great, because coming here, whenever they matched me up with an advisor, he actually ended up being my advisor to sorry, already had that relationship. Maddie Stacey And that's just like something that just falls into place. Something really great I can say about him is that when I was first starting with the requirements, you have the option of an elective, but my class was one of the first where physiology was a requirement, but, physics wasn't. And so I had a question. I was like, you know, is this still an option for an elective? Maddie Stacey Like. And it was like getting close to deadline. I was nervous, I was like, what if they just don't let me in because I didn't know there is an elective? And he was really fast to get back to me within, you know, a day he was like, yeah, that's all good. Get inside. That's okay. And it's like, I had that relationship with him. Maddie Stacey I was able to ask me that question, and I got my answer within a day because I knew him. And I think that connection was really great to have from that club to. Stephen Woodward So what advice would you give someone interested in applying for the early admission pathway? Again? Maddie Stacey Something that I think is a really big deal. Gatton is not just about having good grades or, you know, making the best grades. I think it's really important that you're going to be somebody that cares about your patients. And I think they care about seeing that in your essays. So I would say the essay portion is a big part of the admissions. Maddie Stacey And I would I would challenge, people who are interested in joining the program to ask themselves, what impact are you making right now, whether that be in an area and shared, say you help with child care. You do volunteering at a certain place. What impact are you making now? And, you know, I would ask, you know, how can you connect that in your essay to say, how does being a pharmacist help you make more of an impact in that area? Maddie Stacey What is being a pharmacist do to make an impact for you? And I think that's important because when you're connecting that, you're really showing how, you're not just interested in it for, you know, maybe the life, but you're interested in it for the way that you're going to impact patients. And getting is very patient centered. And I love that. Maddie Stacey That's why I chose, again, they love their patients and they love making people, the best they can be in that area. Stephen Woodward So as you know, getting offers a unique two week bridge program to help students transition into pharmacy school ... What was that experience like? Maddie Stacey Getting Ready is the first two weeks of your first year of pharmacy school. So in those two weeks you get introduced to all the classes. You will be taking, in the following semester. So you it's a little bit different from what your actual schedule will be like, but it encourages you to think about how you are going to balance and time manage the rest of the semester, which is the most important part that I feel like I got from getting ready. Maddie Stacey I think that it's nothing more challenging than you have done. I think that they prepare you in everything that is in the first two weeks you can do. It just feels like a lot because it kind of is. Everything is all at once in those first two weeks, and then, you know, after your first week, you have to prepare for your white coat ceremony, too. Maddie Stacey So it's just a lot of events at first, and I think that can be the most challenging. But as far as the transition, I would say that it got me prepared to think about what materials I wanted to use. You know, pharmacy school, there's a lot of notes, and I thought I was going to come in and do a lot of paper notes. Maddie Stacey But after that first two weeks, I was like, you know what? I think I'm actually gonna go digital for the first time. So I think those first two weeks really show you how the rest of your semester can go and what you want to do that works best for you. And I think that's what a lot of my peers would say, too. Maddie Stacey It's about learning about how you want your semester go and how you're going to attack your semester. So, you know, I'm really glad that I went digital. It helped me keep up in class. And a lot of people will tell you that, too. When you're just covering so much volume of material, it's faster when you're able to highlight the PowerPoints. Maddie Stacey And addition to that, you get to meet all of those advisors and all of those, professors in the first two weeks, which was really great. They were very helpful. They clearly outline how you can meet with them when you can meet with them. If you have questions where you can get those resources. So I really enjoyed that part. Maddie Stacey I think trying to think if there's anything else that I could say about, getting ready other than it's, it's not bad. I think I was, I was, I was intimidated, I was really scared. I was like, oh, they're trying to win me out here. This is where if I don't want to do it, they're trying to get me out. Maddie Stacey But it's not as scary as it sounds. So that's that's the comforting part. Stephen Woodward What? So what was the interview day process like for you as an early admission pathway student? Maddie Stacey So the interview process for me was during Covid. So unfortunately, I wasn't able to come on to campus and get to interview. I had my interview online and it was a set of two separate interviews in the same day. And once you one was with a small group and then one was individual with a mine was with a student instead of a faculty member. Maddie Stacey And it may have just been, Covid. I'm not sure how they do it now. And then once you get accepted, something that is very good about the early admissions pathway is that as long as you're on track, you have a seat reserved at the pharmacy school. So there's no second applications, there's no second essays, there's no second interviews. Maddie Stacey Once you're accepted, you have a shot at being here and you have that seat ready for you. When you're ready. Stephen Woodward You know, we hear from a lot of our students, alumni, faculty and staff that the culture and people are just highly valued at the college. How would you describe our culture here as a first year student pharmacist? Maddie Stacey I absolutely adore our staff so much. I can't tell you how much I adore them. You know, one thing I'd love to highlight as a pharmacy student and coming there are like obviously a million people for you to meet. Add on the professors, add on the the patients. Like there are just so many people for you to meet. Maddie Stacey I just want to give a shout out to Demers. She did so great. You know, introducing herself, making herself very approachable, you know, tells you about her career and something that I love you do as a pharmacy student. First year, you get to have lunch with the dean, which is so cool. So you have the small group, you come meet with the dean, she asks you these questions and like individually as you, it's not like, oh, I don't know your name. Maddie Stacey It's oh, she knows your name. She's already looked at your picture and the book. She knows who you are. How are you doing? Where are you at in this process? And that is so awesome. I don't know if other pharmacy schools do that, but we do here, and that's something I love. And then the one other thing I wanted to comment on was a time I was struggling and an advisor helped me, which was great because they're not even my personal advisor. Maddie Stacey They're just the professor of that class and offered to help me. I was really, really scared of vaccines. I was afraid of hurting somebody. I was afraid that I was going to make somebody really like. I was so afraid of hurting somebody, which I think is reasonable when you're starting to learn that. And when I started, after I got certified, the first thing I did when I gave vaccines was I would shake really bad because I was just so afraid of hurting people, you know? Maddie Stacey And it made me really upset. And I felt really disappointed in myself because I couldn't give a vaccine. And instead of, you know, just being quiet about it, letting that go on for four years, I reached I reached out to doctor J. Rob and Doctor Alexander. I was like, hey, I'm struggling, I'm not doing good and I'm okay. Maddie Stacey Admit that. Can you help me? And, doctor J. Rob. She was like, hey, come to my office at 8 a.m. and we can talk about it. And I thought we were just gonna be talking about it. And she had brought, syringes, needles. She brought saline, and she's like, we can get better today, and I will let you give me a shot in both my arms. Maddie Stacey And what what other school is going to have professors that offer up their arms? You know, when I say, hey, I'm struggling, I don't know how good I am. She's like, that's okay, you can do it on me. That's that's a pretty big ask. And then on top of that, she said, and down the hall, Doctor Dowling, you can give her two shots. Maddie Stacey Two after you give them to me. So she's just offering up everybody's arms. What other school are you going to get that that professors would be brave enough to be confident in me that, you know, I know you're struggling, but I know that you can. You're here because you can. So I think that's a really great, you know, a testament to how great the faculty is that they would be willing to give their arm for me to learn. Maddie Stacey So I love that. Stephen Woodward All right, well, tell us what you want to do when you graduate. Maddie Stacey So I think something to remember is, even if you're a first year student, you don't have to make plans as soon as you get here. You don't have to know what you want to do. As soon as you get here. Obviously, you're here because you're interested in pharmacy. In my case, though, I have a vision and I would love to see myself working at a pediatric hospital. Maddie Stacey I would love to see myself helping that population of patients. So right now, after I finish pharmacy school, I would absolutely love to go on to a residency that has a PGY1 and a PGY2, which, is focused in pediatrics. But something that I would really love is to be close to home. So the one that I'm looking at that I'd be very interested in is wake Forest. Maddie Stacey They have a pharmacy general, your first one, which means, you get to see all the disciplines within pharmacy and they have, I mean, a lot of different patients. I see a lot of different cases. And I think that would be a great learning opportunity. And, if I could get there my first year, I would love to apply to their pediatric program, which will be intensive. Maddie Stacey And that population of patients, how you work with them in those different areas. And I would absolutely love to continue to learn that. I love helping, children. And it's a lot of different dosing. They're not just little humans. They are they have different metabolism, different things they need. And I would love to learn more about that. Maddie Stacey So that's where I would love to see myself after Gatton. Stephen Woodward Was, you know, getting offers. A lot of student organizations and leadership opportunities. Tell us about what you're involved in and why that's important for students here. Maddie Stacey Okay, I'm in a few clubs and organizations here at Gatton. I am in the Pediatrics Pharmacy Association club, and what they do is they meet once a month and they go over some pharmacists or patient cases that pharmacists look at in their day, and they talk about how there's a range of cases and then you have volunteering opportunities in that club. Maddie Stacey And then I'm also in a residency based club. And what they do is they bring in, pharmacists that have either been through residency or, or who are very specialized in residency and, can help you a lot with looking at that. And that's a really great club to be in. I think if you are interested in residency, because it tells you early on what to expect, how can you make yourself competitive? Maddie Stacey And that one also meets about once a month. And the best part about clubs at Gatton is you have a free period. Usually in your day it's, lunch and then they call it common time. And most of the clubs meet during that day, so you don't have to commit extra time outside of school because it's within schools within those hours. Maddie Stacey So you have extra time to still work and, you know, have your work life balance. And that's something I think is really great about the clubs that you don't get an undergraduate. I would love to be a student ambassador. And that comes out at the end of the semester. You get to start to apply for those things, and it just gives you more opportunities to represent Gatton and get to look into the types of students that want to apply and get to talk to them and just encourage them about what's going on here. Stephen Woodward What impact do you think the early admission pathway had on you as you transition to Gatton? Now that you're going through your first semester? Maddie Stacey Yeah, I think some of the things that the early admissions pathway has made me as a student as confident, I would say that the transition pathway is very smooth. They again, they put everything in line for you. I mean, they give you your schedule, they tell you what you need to do. And so I think that it makes everything much more cohesive. Maddie Stacey Whereas if I was applying and for years I would be getting everything together myself, I would be applying to multiple things. I would be looking for all of these things. But the early missions pathway gives you everything in one place, and I think that's something really great. And that's something that has made me confident now, because again, I know those people coming in and I met a lot of advisors coming in and I know who to ask if I have questions. Maddie Stacey I think that's something the programs offered me. Stephen Woodward So of course, Gannon's mission is to train pharmacists who help serve rural and underserved patients. Service is really important here at the college. Talk about why that's important to you. Maddie Stacey Yeah. Something great about Gatton is how it aligns with what I want to do, whether that's in my values and morals. And I think that the college has done a great job. So something that we often talk about at Gatton is how important it is that we give back to our community, whether that's in the rural and underserved area or any of those areas around that we can do. Maddie Stacey And I think the school has really supported me and the ability to do that because they're consistent and constant volunteering opportunities in our area. And something that I think is really cool. We do, it's in combination. So Gatton and Quillen both work together. And this thing, it used to be called street medicine, but now it is under a different name and it helps to look at the people in our area, look at who is not getting enough healthcare, how can we help them? Maddie Stacey How can we bridge the gap and make sure that they're getting what they need? And, something great about Gatton again is that we're always considering those factors. So something they often tell you is, someone may need their insulin, but do they have a place to keep it? And, you know, we never want to make that patient feel bad just because they can't keep their insulin somewhere. Maddie Stacey And I love considering those things. I think it's so important that it's not just about helping people, but how can we make sure that the people were helping can stay healthy? Stephen Woodward Well, Maddie, we're really thankful that you would be part of this interview and be part of some of the publicity that we're rolling out as part of showcasing the early admission pathway and helping to educate students, in high school and at Etsu, about this pathway, as well as our other flexible admissions pathways. Can you kind of talk about your passion for Gatton, Etsu, and the early admission pathway? Stephen Woodward What is it about the university in the college that makes you just want to encourage others to to follow in the same path? Maddie Stacey That's a good question. I think something that Gatton does for me that makes me want to support them so much is the reason that they chose to support me. You know, when you apply to schools, you choose them. And it's at that point they have their opportunity to choose you. It's their turn. And you know, when Gatton chose me, they didn't just give me one opportunity. Maddie Stacey They have continuously given me opportunities. And you know, I have love how supported I felt here. And if I was to, tell our students about my experience, I'd want to be honest. I'd always be honest, and I don't have anything bad I can say about what they've done for me. You know, even more, I go further to say that if I did have something bad, I could tell them and they'd be like, okay, well, let's think about how we can fix it. Maddie Stacey I mean, and that's what, lunch with the Dean is like, as I was talking about, she wants to know what's going on. She wants to know how she can help us. And that's why I would constantly and consistently say that Gatton has made this a great experience for me. They will do whatever they can to make sure that I get the best education, and I feel like that's why I talk so well about them, because I want other students to get to experience what I have, and I don't want anybody miss out on that experience because it's really great. Stephen Woodward Well, Maddie, thank you so much for joining us today. Thanks for listening to White Coat Radio. If you haven't already, be sure to subscribe and leave this review wherever you listen to podcasts. To learn more about East Tennessee State University Bill Gatton College of Pharmacy, visit us at etsu.edu slash pharmacy or follow us on social media @ETSUPharmacy. We'll see you next time.