“I’ve never learned anything at a CE”

The Ole’ Apothecary writes:

I believe that the continuing education (CE) requirements for U.S. pharmacists are woefully inadequate. They should be increased, in both number and difficulty.

To start with, the number of required CE hours should be doubled in every state. They have not been changed in 30 years. Also, at least half of these hours should be live, at least to get us to interact with educators, and, at most, to get us to interact with our peers in the profession.

I couldn’t agree more. I think pharmacists should have to take a periodic exam to assure basic clinical competence as well. I’ve had pharmacists ask me to do their CEs for them, which I find appalling behavior. It is my opinion — and after 6 years behind the counter, I’m not as naive and enthusiastic as I once was — that you should take pride in your profession, and that you should want to keep up with developments in the field of medicine. Even non-drug therapies, in my non-humble opinion. You didn’t go to school to learn to count to 30 and slap a label on a bottle. Any jackass can do that, and every jackass with half a clue learns the necessary behavioral tricks to survive standing behind that counter, too.

(Well, maybe you did go to school to learn to count to 30 because you thought that since you planned on standing behind that counter, you might as well make some money while doing it. That’s alright, I guess, but I wouldn’t want you as my pharmacist. No offense or anything.)

What boggled my mind were some of the comments left on TOP’s entry. By pharmacists. The vitriol that follows isn’t directed at these people specifically, but rather at the lackadaisical attitude in general that many pharmacists have towards keeping up with their profession.

Even if you cheat like I do and go straight to the questions without reading the program, you still get SOMETHING out of it because you still have to look for the answers.

Well I am a 63 YO RETIRED Pharmacist and honestly I never learned much, if anything, from any of the CE courses I have taken over the years…

All were a total WASTE of time..

Look, I know CEs are seen as an onerous chore. (“OMG! It’s December and I haven’t finished gotten all of my credits yet! … Will you do this CE for me?”) Maybe you’ve got kids, and your family takes up your free time. In retail there’s that fantastic work-home life divide. Work stops as soon as you leave the pharmacy, and the retail environment isn’t the place to try to learn anything, unless you work in the slow store. Frankly, this divide between work and home is no excuse to not stay current. You’re a professional, for fuck’s sake, not a factory worker. This is one of the things that sets professionals aside from non-professionals — you have to make some effort on your own to stay current. Whether or not you are paid for the time you spend is not even a question. It’s just something you do.

I don’t believe for one minute that you actually retain anything that you “go back and find” to get the correct answers. Not for more than a day or two, in any meaningful detail.

I’m bringing this up now because one of the pharmacists I work with recently gave a patient the wrong answer. (Which may breed another entry for later about stepping on toes.) It was a basic question about statins — and she got it wrong. It wasn’t even a hard question. It was “When is the best time to take simvastatin?” It doesn’t matter how busy your pharmacy is. If you can’t answer the most basic question someone could ask about the most popular HMG-CoA reductase inhibitor in America, you’re doing something wrong. And she’s in her early 30s — nowhere near retirement age.

I cringe at the thought of the 63 year old retired pharmacist who never learned anything doing CEs. Unless you’re reading journals, and staying current of your own accord — which you’re probably not — you probably didn’t know much about modern medicine while you were still working. How many major classes of drugs came out since you graduated pharmacy school?

Well let’s see. There’d be the PPIs, statins, quinolones and fluoroquinolones, macrolides (things have changed a lot since erythromycin), atypical antipsychotics, SSRIs, COX-2 inhibitors, AIDS drugs, the entire field of asthma management, ARBs, T2DM management… I could keep going. Without even going near the biologics. ALL of the drugs in these classes have their basic similarities, but equally importantly, their differences.

Wait a minute! That’s basically the entire list of the top 200 drugs prescribed in America! You learned about all these things when you were in school? Are you up on them? Even the basics? Gee, a statin’s for cholesterol… whoopty freakin’ do. You’re a goddamn genius.

Do you even know what cholesterol actually is?

And not to mention that our understanding of the mechanisms of action of some older drugs have changed since you were in school. Theophylline is an old drug that springs readily to mind as a drug about which our understanding has changed over time. Perhaps since you first learned about it all those years ago.

For shits and giggles last night, I went back to some older issues of the clinical publication my chain puts out. My mind was boggled at how much our understanding has changed about even “basic” problems like ADHD and depression in just 8 short years. Almost nothing is hammer -> nail anymore.

Just like formal schooling, you get out of CEs what you put into them. I have no doubt that a great many of them are useless. CEs may not be an ideal answer, but they do serve, if you make the effort. Some of the information is undoubtedly redundant. Some of it you undoubtedly learn by osmosis. But I guarantee you that if you pick up a CE and really read it, you will learn something.

Plagakis would probably say that “we’re all clinical”. The Ole’ Apothecary asks if some are more worthy than others.

The answer is “yes” but it doesn’t matter if the letters after your name are “RPh” or “PharmD”. Some are inevitably more clinical than others — and that’s okay. But there needs to be some basic standard of clinical competence, otherwise you’re just a glorified pharmacy technician with some extra liability padding and a key to the safe who takes home a fat paycheck every other week.

And if you’ve never learned anything at a CE, you should be looking in the mirror for the reason instead of pointing a finger at the system.

3 thoughts on ““I’ve never learned anything at a CE”

  1. OTP,

    Great timing for you comments, and thank you–great timing because I am flying out tomorrow evening for a 15-hour live CE seminar. I, too, wince at the cavalier attitude that so many of our colleagues take toward continuing education, especially your mention of those who want you to do their CE for them.

    I recall one occasion way back in 1988 when a live CE program included something I really wanted to get understand: the theory and practice of using blood glucose monitors, which were a new thing at the time. The lecturer was doing a brilliant job, and had several machines out for the pharmacists to work with. BUT, DURING HER LECTURE, TWO BOZOS WERE **SLEEPING!** Had I any cohones, I would have blown a sports whistle in their ears. This lady was sent from a distant city to speak, and these two pieces of crap were mocking her by snoozing through her hard-crafted presentation.

  2. Great post! I never could understand why some pharmacists just blow off the CE. Pharmacy has changed so much just in the last few years, let alone the last ten or twenty or more since some pharmacists graduated. Why would you choose to stay ignorant of current treatments? One of my formers PICs was recently disciplined by the state board for lying about his CE participation on his renewal license. His name was drawn during a random audit, and he didn’t have documentation for any CE (It’s a waste of time, he told me once). He was fined $3,000 initially, plus $3 a day for every day between the original renewal date and the date he got the CE completed. If I were the district manager, I would have suspended him until the CE was done and his license properly renewed, but I don’t believe anything happened to him at work.

    When I first graduated, I didn’t have to do the full amount of CE. In fact, I don’t recall being required to do any. I still did about 40 hours worth (that I actually submitted for credit) and read a ton more. I want to keep up with what’s going on. I would love to have more live CE, or certain disease states required. My state has no guidelines, so you can do stuff like treatments for the common cold and other random things and not be required to read about diabetes and hypertension.

    Nobody likes having to bring work home with them, but if you don’t have time at work to do CE, then it has to be done at home. That’s part of being a professional and having integrity.

    Pharmer Jane.

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