Pharmacy: Not your normal nine-to-five

There's a host of unexpected career paths and rewards for adventurous pharmacists, says Amy McLellan

Love pharmacy but can't picture yourself working in a dispensary day in, day out? Don't worry: this is a career, whether working as a pharmacist or technician, that can take you worlds away from the high street.

"My aspiration was always retail pharmacy because of the patient contact and the opportunity to get involved in people's lives," says Colonel Graham Stuart, a pharmacist with the Royal Army Medical Corps (RAMC). "But I found retail dispensing wasn't challenging me at all and a lot of the strategy was dictated by the management practices of the chain I worked for."

Frustrated by his experiences on the high street, Stuart, at the age of 24, decided to make a complete career break and joined the Army. "When I went into the recruiting office, my desire was to be in the Army," he recalls. "But when they found out about my skills, it was a bonus that I would be allowed to practice."

If he was looking for a challenge, he got it. Stuart was posted to Catterick in Yorkshire, where he ran pharmacy services for the whole of north Yorkshire and southern Scotland. He was also quickly working in hospital pharmacy and general medical supplies, with a remit for sourcing everything from aspirin to X-ray machines.

It didn't stop there. Since joining the Army, Colonel Stuart has worked in all aspects of pharmacy, from community and hospital pharmacy to drug research and formulation design. He is currently working in strategic planning, which involves resource allocation, professional status negotiations and policy.

On top of that there's the challenge of working in a military environment: wherever the Army is deployed there will be a pharmacy function. During conflict, the pharmacist is responsible for the timely distribution of drugs, dressings and medical equipment to all units in the theatre of operations.

In field hospitals, they provide support and advice on all pharmaceutical matters including storage, distribution, security and the prescribing, dispensing and supply of drugs. Barracks-based pharmacists can expect plenty of variety, from sudden notice of operational exercises to unique clinical challenges.

There is a wide network of pharmacists and pharmacy technicians in the military. In the Army there are 15 uniformed pharmacist posts and 44 uniformed pharmacy technicians. In addition to the uniformed personnel, there are 20-25 civilian pharmacists and even more technicians working for the MoD. The RAF and Navy have roughly the same numbers.

There is a shortage of pharmacists in the RAMC and the Army has been working to improve its appeal to the profession. There is a perception that the pay is poor yet Stuart says that when subsidised housing, an excellent pension scheme and other perks are added, most Army pharmacists have more disposable income than their equivalents on civvy street. It also used to be seen as something of a career dead-end, the misperception being that a relatively fit population would provide little clinical challenge.

"We have people coming back with medicine from different countries so we have to make clinical assessments all the time," says Stuart. "And operational deployment and worldwide travel can create some issues which are fairly unique to military pharmacy."

Pharmacists joining the military can expect to be fast-tracked to managerial roles, even at a junior level. "Outside, in retail or the NHS, responsibility comes with time served but in the military we train people to adopt that managerial role very early on," says Stuart. "The whole military ethos is about stretching yourself and pushing your own limits."

This can be a great career boost. As an addition to your CV, a stint in the Army with its focus on managerial training and self development can be very attractive. "We want to keep people in the Army and give them a whole life career but not everybody wants to do that," says Stuart. "So we also try to prepare people for the outside world and it seems to be well received by employers."

Tempted? To be accepted as a pharmacist in the RAMC, you must be 34 or younger, hold a degree in pharmacy and be a registered member of the Royal Pharmaceutical Society of Great Britain. There are also opportunities to be sponsored during your undergraduate degree.

Of course, it's not just the Army that offers something outside the usual run of high street or NHS pharmacy. The Prison Service is also keen to attract pharmacists and this is an exciting time to join. From 2003 the responsibility and funding for prison health has been shifting from the Home Office to the Department of Health and local primary care trusts. This change has increased the visibility and resources of pharmacists within prisons, enabling them to take on a greater role in the delivery of health care.

Historically the prison pharmacy department was used almost exclusively as a supply service and the clinical skills of the pharmacists and technicians were not used. It was seen as an inferior branch of pharmacy and this has resulted in a recruitment shortfall. Yet recent changes in the structure and funding of the prison pharmacies means it's now an exciting career avenue and one that can really stretch your professional horizons.

Around 140,000 prisoners pass through the prison system every year. It's a population that suffers from poorer health than the wider community, with 90 per cent having a diagnosable mental health or substance misuse problem or both. Definitely not your normal nine-to-five.

Stella Simpson: 'I've been able to expand my skillset more than I would have in the NHS'

Stella Simpson is principal pharmacist at HMP Holloway, Europe's largest women's prison.

I started here as a locum 14 years ago and have been here as a permanent member of staff for four years. I work here with five pharmacy technicians and a locum pharmacist but we're also looking for another full-time pharmacist.

It's a very challenging environment. As well as the general primary care needs, about 75 per cent of the women here have substance misuse, mental health issues and learning disabilities. Many of them haven't had any access to medical care. We are on the front line. There are also the stresses and strains of being in a prison environment. There's a lot of self-harming and distressing situations and we have to be able to help.

There's a perception that going into prison pharmacy is a career dead-end but I've been exposed to a lot more responsibility and opportunities to expand my skills than I would working in retail or the NHS. I work with my colleagues on Islington PCT, run a drugs and therapeutics committee, write policies, advise doctors on medicine management issues and make presentations for the National Prescribing Centre. There's been a lot of increased funding in prison pharmacy to bring it in line with the high street, so there's money for training and professional development. I've got a postgraduate certificate in psychiatric therapeutics and have done a supplementary prescribing course.

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