When Alan Li and Marco Ho begin the fourth and final year of their pharmacy degree at the Chinese University of Hong Kong in September, they will bring with them experiences and new perspectives gained from their summer rotation at the Leslie Dan Faculty of Pharmacy.
The five-week rotation provided Li and Ho with the opportunity to learn about pharmacy practice in Ontario and Canada. Faculty course co-ordinators developed a diverse activity plan, placing the students with different preceptors from week to week and giving the two students the opportunity to take part in research, education and clinical observation activities.
Each week had a different focus, such as medication safety with time spent at the Institute for Safe Medication Practices Canada (ISMP Canada) and front-line clinical practice observation at the Centre for Addiction and Mental Health (CAMH). They also shared insights from pharmacy practice in Hong Kong with faculty, staff and students at Leslie Dan.
The clinical observation opportunity at CAMH, Canada’s largest mental health and addictions teaching hospital, was eye-opening for Li. “We don’t have many chances to work with mental health patients,” he says. “This was a first for me.”
At one point, both students observed a pharmacist as she met with patients in the CAMH emergency department and were impressed by how she interacted with an agitated patient whose mental health problems were worsening because of diabetes complications.
“What she did was mind-blowing,” says Li, describing how the pharmacist changed the patient’s mood from agitated to receptive and calm by having an empathetic approach and listening. “At the end of the interview, the patient even thanked her and us for having someone to talk with about his medication concerns. He was very sincere. This flips my understanding toward patients with mental health disorders and I will be able to take that home.”
For his part, Ho was inspired by a presentation delivered by Jamie Kellar, an associate professor, teaching stream, who is exploring the evolution of the professional identity of pharmacists.
“To be honest, I’ve been struggling to identify as a clinician and it was interesting to hear Professor Kellar question whether being a clinician is the only and ultimate goal,” says Ho, who adds that he is more drawn to pursuing research.
“I think there has to be more discussion about what a pharmacist is. Our work in Hong Kong is so focused on the clinical side, we may be missing out on other areas where pharmacists can contribute.”
Ho appreciated the opportunity to perform qualitative analysis on medication incident data using the Medication Safety Culture Indicator Matrix and the Multi-Incident Analysis methodologies developed by ISMP Canada. In Hong Kong, Ho is part of a hybrid research and outreach team called CU CHAMPION that provides services for the public and the elderly to deepen their understanding of disease prevention and drug safety.
“I’ve done a lot of surveys with that group and now that I’ve had the qualitative analysis, this can help improve recommendations for medication safety,” he says.
Li says that participating in the exchange “is to learn what is good on both sides, to learn from each other so we can each progress and improve faster.” In Hong Kong, health providers and patients benefit from an advanced informatics system that provides a unified patient record and medication history, something that is underway but not fully complete in Ontario.
On the flip side, working in clinical environments in Toronto was the first time Li and Ho saw medications being issued in secure vials and blister packs for patients who need it. “In Hong Kong, despite some of our advantages, we still dispense medication in plastic bags,” Li says.
On the street in Toronto celebrating the Raptors's NBA victory (photo courtesy of Marco Ho)
“I was brought up in Hong Kong and received pharmacy education in Toronto,” says Certina Ho, a lecturer and experiential education co-ordinator at Leslie Dan. “Having the opportunity to meet and work with Alan and Marco was something that I was looking forward to, even before their arrival. I was impressed by their curiosity and eagerness to learn and know more about not only the Canadian health-care system, but also the expanded scope of pharmacy practice here.
“It is very rewarding to see collaboration between pharmacy students from Hong Kong and our students.”
Both Li and Marco Ho say that the ultimate goal of their rotation was to bring something meaningful back to their classmates in Hong Kong and they are keen to share their experiences. Exploring the culture of Toronto was equally exciting and they were lucky enough to be in the city the night the Toronto Raptors won the 2019 NBA Championship.
Both joined the spontaneous celebration on the streets.
“It was incredible to see so many people out celebrating something positive together,” says Ho.