The 2020 survey list for 2021 APPEs. (photo/ Core-Elms)

The process leading to  Advanced Pharmacy Practice Experiences (APPEs) takes many weeks. After the first meeting, P5s can begin what’s known as the ranking process.

Ranking sites is ultimately the students’ way of telling the experiential office what places they would like to visit over other available ones. This first begins with surveys for sites who require early notification on how many students are requesting a rotation.

Surveys consist of available information on a site including what kind of rotations they offer, potential housing options through the facility. To complete them, students must list their available months and what specific type of rotation they want at that site; some locations also have a question on who the student would prefer to travel with, but these are few.

Regardless of their ideal final pharmaceutical profession, all P6s are required to work through 9 one-calender-month experiences. Within these experiences, students must complete these rotation types: 2 ambulatory care (general outpatient), 1 community (retail pharmacy), 1 general/internal medicine, 1 hospital, 1 critical care or pediatrics. In addition, they have 3 electives that can be any pharmacy site, but overall only one can be non-(human) patient care related (ie: teaching, research). However, students are limited by what prospective sites plan to offer.

Sometimes, the survey sites can widely vary in distances, experiences, and housing situations. This year, there are three different sites in Alaska: a community pharmacy, a long-term care facility, and an Air Force base hospital. Fort Peck in Montana is offering housing at reduced cost. In addition to standard hospitals and community pharmacies, there are two AIDS Resource Centers, three VA hospitals, and two compounding pharmacies.

As of November 6, 2020, the surveys have been officially concluded, and the experiential office is compiling all of the data. This will then be sent on to survey sites to get an idea of how many students want that particular site; how many spots that can be offered to each requesting school should be comparable, and this cannot happen if they do not have a good idea of how many people are asking. 

According to Dr. Jennifer Grundey from the experiential office, the initial decisions for those early decision sites should be returned by mid December. “Those will be in students’ schedules,” she said. “Students will then know what they got, and then we do the ranking.”

It is not uncommon for anticipated, shared-faculty/preferred sites to be absent from the surveys. These sites commit to providing the same number of slots every year, and as they are usually filled, many do not require an early survey. While some, like VA Cincinnati and the Cleveland Clinic, do require early notification, others like Lima Memorial, St. Rita’s Mercy Health, and Firelands can be asked for during the ranking process.

After the initial schedule is returned, students will have the opportunity to compile a list of most desired rotations to fill their remaining spots. Less restrictive sites, including shared-faculty/preferred, will be available at this time, and students must have five rotations within a shared site. Unfortunately, ranking a rotation as number one, or even number two, does not guarantee that rotation spot; ultimate decisions are made through a computer algorithm.

Unfortunately, this process is also dependent on the final decisions of organizations like the CDC. These places conduct their own screening of applicants and decide who they would prefer and when. The final schedule must then be built around these decisions.

Hopefully, in March, the final schedules will arrive, and students can begin planning what to do next. While the vast majority of students will rank where they know that they have available housing, the remaining few will be in limbo for a short while. Those select few will need to figure out where they’re going to live, how they’re going to make it to work everyday, and who they might be living with, but that’s ultimately a problem that can only be solved when the decisions are finalized.

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