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The Struggle: Why tl;dr pharmacy exists

Studying (2759729091)

(not the authors)

Hey everyone! Brandon and Sam here. We're the founders of tl;dr pharmacy. 

Let's just come out with it: Pharmacy School is hard. No matter what program or year you're in, pharmacy school is the dominant part of your life. And what a stressful life it is. 

Top Ramen chicken flavor

Sleepless nights. Tests. Quizzes. Quizzlets. Exams. Quizzams. Presentations. Group projects. Monographs. Clinical labs. Sitting through 8 hour lecture days (and being expected to pay attention). Navigating a sea of professional organizations and fraternities. Ignoring friends and family for weeks at a time because you're "too busy." A growing six figure pile of debt. Picking up hours as an intern so you can buy food. Fire and brimstone falling from the sky. Cats and dogs living together, mass hysteria. 

It's something we've come to call "The Struggle." Every pharmacy student intuitively understands it, but no one can really explain it to someone outside of the profession.

The good news is that you're not the first person to go through this. There are others that went before you. It wasn't so long ago that we were in your shoes ourselves.

If we made it through, so can you.

However, dusting ourselves off after school and residency, we couldn't help but think that there must be a better way. Something to simplify The Struggle and make it all fit together. Something to help pharmacy students make the transition from students into practitioners. Resources in this department are few and far between.

Warning: If you are a member or employee of ACPE, please skip the following paragraph. 

There is a disconnect between what you are taught in pharmacy school and what is required of you during life as a pharmacist. Although they'd never admit it, your school is "teaching you to the test." Maybe not intentionally, but they are. That's because your school is evaluated and accredited based largely off of their NAPLEX pass rates. No matter what rhetoric is used to spin it, the primary objective is for you to pass a multiple choice, minimum competency test.

We're not saying this is a bad thing, but it's important to recognize the limitations of what you're working with.

You will never encounter a situation in your practice where you are asked the following: 

"My patient, FG, is currently taking warfarin and has experienced a GI bleed. Which of the following is the most likely cause:"

a. She recently took a 3 day course of [Bactrim] for a UTI
b. She has been taking [Allegra] for seasonal allergies
c. She recently started eating a salad with every meal
d. She regularly plays bridge with a group of friends several times a week


Real life is not a multiple choice test. Prescribers don't care about the mechanism of action of a drug. They will never ask you what the first line treatment for hypertension is. They can look all of that up easily. You are more likely to be asked about renal dose adjustments, Y-site compatibility, 3rd party rejects, and the 4th line therapeutic recommendation. Things that get glazed over in most pharmacy school programs.

To be very clear, we are not attacking pharmacy education. You can't just learn this stuff overnight. You need to develop a solid foundation of the basics--the core things you need to grasp just so you can understand everything going on in real life situations. Your school likely does a great job at this. 

The difficulty, however, is learning to think critically and to apply that foundation. You have to develop the ability to recognize drug interactions and renal adjustments without being presented a list of options. A wide open patient profile. A blank slate of potential interventions you can make (or not make) as a pharmacist without any guidance. You and you alone have to decide what is clinically relevant.

This is very hard, especially when you first start your practice career. This is how you stop being a student and start being a pharmacist

tl;dr pharmacy exists because it needs to. This is what we were begging for during our time in The Struggle. tl;dr pharmacy is a tool that will help you tie everything together. We'll point out common mistakes on multiple choice tests. We'll cover pathophysiology so that instead of memorizing and regurgitating factoids on a test you'll actually understand what the hell is going on. Most importantly, we'll show you how it all applies in actual clinical situations. The times when practice differs from the NAPLEX. 

And if you're interested in developing your professionalism skills or getting into residency or practice of your dreams, we'll help you there too.

We're not claiming to be the greatest pharmacists in the world. We're not saying we are infallible and above reproach. We make mistakes and you cannot put blind faith into everything (or anything) you read here.  However, we are pretty damn good at explaining things. We can take difficult topics and break them down in a way that is easy to understand.

Both of us tutored all four years we were in pharmacy school. We were inducted into Rho Chi. We passed the NAPLEX, BCPS, and several MPJEs each with flying colors on the first attempt.  We both matched at our top-ranked PGY1 residency choice. Afterwards, we were both were offered (and accepted) jobs at our residency institutions. We continue to teach students; both in the classroom and as preceptors in the practice setting.

We know The Struggle. We know the pain. We know the stumbling points. And we created tl;dr pharmacy to help you get through them. 


PS: Interested in residency? Check out our new guide, Mastering the Match: How to Secure a Pharmacy Residency!

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