Pharmacy Student

Adventures of a P4: Navigating Rotations Far from Home

Keaton Higgins begins his third rotation at Eli Lilly and Company in Indianapolis, IN. Learn how he navigates being hours away from home and stepping into a non-clinical role.

One of the most exciting things about the last year of pharmacy school is that we are required to complete several rotational experiences at different locations and practice settings. On the one hand, this can be fun because it's an immersive, hands-on way to experience many different potential career pathways. Rotations are typically the first- and only-time pharmacy students aren't required to spend several hours a day in a classroom and study for weekly exams. But on the other hand, it's also the first time we don't spend almost every day with our friends and supporters when our rotations can take us anywhere around the world. The rollercoaster of emotions that is our final year of pharmacy can lead to it being the most challenging yet rewarding and insightful year of school.

Every program can be a little different, but at the University of Iowa, we complete eight five-week rotations with one five-week off cycle. In general, most programs require eight to ten four-to-six-week rotations spanning the length of an entire year. During these rotations, students typically work directly with a pharmacist and are expected to learn how to serve in the same capacity as a pharmacist. Depending on the site, this may include additional projects, research and presentations based on the practice setting.

From the start of my rotational year to now, I have already given three Journal Club presentations, led two general healthcare-related topic discussions, one patient case presentation, taught a disease-state over ulcerative colitis and Crohn's Disease, and have done extensive research on increasing patients' access to medications. 

New call-to-actionAside from the abundance of clinical knowledge, I am gaining during rotations, I have been pleasantly surprised by the number of opportunities I have already received to strengthen my public speaking and communication skills – two skills that are immensely valuable for any pharmacist. However, these opportunities have merely scratched the surface of what I have learned during this journey – professionally AND personally.

Between being born and raised in Iowa for and pursuing eight years of postsecondary education in Iowa as well, I have had a growing itch to travel and explore the world outside of the Midwest. Growing up, my family would take a summer vacation to a new state every year. While this was great for me to get a feel for different areas of the country, I was always pretty young and didn't have quite the freedom to explore as I would now as an adult. Fun fact, I'm probably (hopefully) the only person you know that has cracked their head open while on family vacation… twice!

Fast forwarding to this year, I find myself with my first opportunity to spend a significant amount of time in several different parts of the country, thanks to my rotational year. As I mentioned in an earlier blog, pharmacy students at the University of Iowa are fortunate to have dedicated and passionate alums and connections from all across the nation. These connections give us students many opportunities to explore wide-ranging practice settings in almost every part of the United States. I have friends traveling from California to New York – and many are traveling overseas too! Again, every program is different, but it is not uncommon for many various pharmacy programs to offer similarly robust options.

1202321374809791.A9J36oHeBtv40SQqecks_height640I was lucky enough to have applied for and been chosen for two nationwide rotational sites. The first is with Eli Lilly and Company in Indianapolis – where I find myself currently – and the second is with the American Pharmacists Association in Washington DC later this fall. I also got to kick off my rotational year by traveling back to my hometown - Belmond, IA, which gave me three rotational sites that required travel and relocation. Including trips to Philadelphia to present at a national convention in June, Las Vegas for ASHP's Mid-Year Residency Showcase in December, and Phoenix for APhA's Annual Meeting in March.  So, with these additional opportunities, I will have even more of a chance to explore and connect with many individuals from across the nation.

This flexibility was vital for me and my journey - not only to explore the country and meet new people but also to explore the vast range of potential career paths as a soon-to-be pharmacist.


I find myself currently taking that first non-Iowa step in my journey as I have recently taken up temporary residence in Indianapolis for Rotation #3 at Eli Lilly and Company. Compared to my first two rotations, which were both very clinically focused hospital sites, it's almost like learning another language regarding my typical daily routine at Eli Lilly. Since Eli Lilly is a large pharmaceutical manufacturer, the skillsets and knowledge required of a pharmacist at the company are much different than one working in a more traditional pharmacy role. The pharmacist I work with is part of the Lilly Value and Access team, and we spend much of our time on business development and contracting. The business terms and terminology were enough to make my head swim for several days since we weren't necessarily exposed to these types of pharmacist roles during school. Since there aren't many other pharmacists on our team of more than two dozen, one of our responsibilities is to provide the clinical background and knowledge to the decision-making processes that drive our business.

Another large part of my rotational experience at Eli Lilly is meeting with several of the dozens of pharmacists working here in varying roles. Having these conversations with pharmacists in all sorts of roles –business development, health outcomes research, regulatory affairs, policy and many more – has been truly eye-opening and refreshing. While it may seem unusual for pharmacists to work in nontraditional roles such as these, it's much less uncommon than one may think. Seeing these individuals thriving in their careers while utilizing various parts of their schooling has only strengthened my belief that graduating from pharmacy school and obtaining a PharmD degree signifies a development of a unique and valuable skillset instead of just a piece of paper and a job description. This has been one of the biggest lessons that rotations have reaffirmed for me so far.

Another big difference in my rotation here at Eli Lilly compared to my previous sites is the type of work that we look to accomplish. While traditional pharmacy settings have workflows and daily tasks that many are familiar with, much industrial pharmacy work is project-based. This means another opportunity to develop my time-management and prioritization skills – a topic I touched on in a previous blog. In my experience serving as the Iowa Pharmacy Association's Executive Intern last summer, project-based work can be tricky to navigate for many pharmacy students. For me, this was such a seismic shift in mindset, considering I had worked in a community pharmacy setting for several years that was always fast-paced and metric-driven. Going from that to my preceptor telling me that I l can leave for the day "whenever I get my work done" is quite the change. Typically, project-based work is longitudinal and may have timeframes of several days or weeks. Learning to prioritize several different projects and managing time effectively throughout the day are keys to being effective in this type of work setting – especially with much of this time being absorbed by meetings and other events. This is another lesson that I am continually learning and refining as this rotation chugs along.

But as you may imagine, moving to a new state to live by myself with hardly any preexisting connections hasn't been all sunshine and rainbows. Of course, navigating a brand-new city for a few days was difficult, and I've taken too many unintentional detours to get to where I needed to be, but I expected that. For me, it's fun exploring new places and learning about the cultures of historic cities. I was expecting this when I decided to apply for these rotations.

1202321374809792.JTfzhGIgNi6leng0vdJD_height640I wasn't expecting how challenging it can be to meet new people starting from scratch. Since I have lived in Iowa my whole life, this is the first time I have been several hours away from almost everyone I have ever known for an extended period. It has been nice getting closer with people from work over the last couple of weeks, and everyone that I have met is amicable and doesn't hesitate to invite me to outings every once in a while. However, this still leaves me with a lot of time for personal reflection and a chance to learn more about myself as an individual. As a big supporter of life-long learning and personal development, this has been good for me. Having the uninterrupted opportunity to reflect on my days and the current situations I find myself in will serve me well as I start making major life decisions in the coming months.

Speaking of those major life decisions, after finishing up my time here in Indianapolis with Eli Lilly, I return home to Iowa City for my bye cycle, where I will both be working as much as humanly possible to recover my bank account after traveling and helping teach an elective pharmacy course entitled "Leadership and Political Advocacy" alongside one of my favorite mentors and many of his friends. After that, I leave for another five-week adventure to the capital of our great nation – Washington, DC. After that, I will attend ASHP's Midyear Residency Showcase, where I will come face-to-face with my next step as a pharmacist after graduation. It's too early to tell, but my time here at Eli Lilly has further solidified my desire to pursue a nontraditional pharmacy career as I look to provide the value and impact I hope to accomplish for this profession. I hope my next few rotations will help me continue honing my passions and keep a light shining on my path.

It's all exciting. But it can be terrifying. But that's okay. It's all part of the adventures of a P4. 

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