Commissioned Corps of the U.S. Public Health Service

Pharmacist Professional Advisory Committee

Click on one of the names below to see comments from one of the past BOP COSTEPS.

Summer 2023

LT Anthonia Azubikeole, Federal Correctional Center Butner, NC

University: School of Pharmacy, University of Maryland, Baltimore
Active Duty Date: Summer 2023
Duty Station: Butner, NC

FCC Butner comprises of 5 institutions: 2 Medium Level, Low level, Camp and medical center prison facilities. I work mostly at the medical center.  I work closely with other pharmacists and technicians, providers, nurses, correctional officers and inmates (patients). As a pharmacist I work as an inpatient pharmacist and outpatient pharmacist depending on my schedule. As an outpatient pharmacist, I review, process and verify prescriptions; prepare and administer vaccines to both inmate and staff and also help nursing departments to cover directly observed therapy medication shifts when needed. As an inpatient pharmacist; I am responsible for pharmacokinetic monitoring (vancomycin and aminoglycosides dose adjustments and level monitoring), anticoagulation monitoring and antimicrobial stewardship.

Working at the FCC Butner, gave me the opportunity to work with the underserved and under-represented in our society which is what I am passionate about. This is my first time working in this type of environment and I am fortunate to be working alongside great intellectuals that are dedicated in providing their expertise to help the underserved population while training the next generation of pharmacists. If there is anything that I have learnt early in my career as I am just starting, is that service to others is very rewarding and fulfilling, especially service to those who think they do not deserve it. As for future pharmacists, non-traditional pharmacy provides an opportunity for life-long learning.  If independent career growth and service to your country through helping the underserved population, sounds like something you would like to explore, I encourage you to join the United States Public Health Services.

ENS Kelly Abate, Federal Correctional Complex Hazelton, Bruceton Mills, WV

University: Nova Southeastern University College of Pharmacy
Active Duty Date: Summer 2023
Duty Station: Bruceton Mills, West Virginia

FCC Hazelton is a correctional complex that houses male offenders in a high security penitentiary, medium security institution, and a low security camp, in addition to female offenders in a medium security institution. As a pharmacist, I work closely with other pharmacy staff, as well as interdisciplinary staff such as doctors, mid-level providers, nursing, psychology, dental, optometry and radiology. Our patient population consists of male and female inmates with a variety of acute and chronic diseases. In a typical day, I process and verify medication orders, perform drug-utilization review, process non-formulary requests, counsel inmates on their medications, and answer questions from health service staff and custody staff. 

Pharmacists in the BOP manage disease states for a unique, yet broad, population of patients with complex disease states and comorbidities from a clinical perspective with collaborative practice agreements. When working with the same patients overtime, a pharmacist can objectively see an improvement in the chronic care conditions they manage. In the BOP, there is truly an interdisciplinary experience where providers are just down the hall to answer questions and are generally open to therapeutic recommendations. Those new to the profession can utilize experienced pharmacists and other healthcare professionals who are readily available for questions. The opportunity for personal and professional growth is endless. As I’ve grown more comfortable as a pharmacist, I can take on clinical roles managing inmates with chronic diseases such as diabetes, hypertension, dyslipidemia and anticoagulation. I’ve also had the opportunity to experience the administrative side of pharmacy as Acting Chief Pharmacist when the chief is on leave. I don’t think a student should let this opportunity pass them. I have had nothing but support and opportunity for growth since starting my career with USPHS and the BOP. I am truly grateful for the opportunity I was afforded and encourage anyone with interest to apply. 

Summer 2002

ENS Renee Dye, Federal Correctional Institution, Florence, Colorado

I was assigned to FCI Florence in Florence, Colorado. As a third year pharmacy student, I was given quite a bit of autonomy.

Of course, I did the conventional pharmacy duties, such as inputting prescriptions, filling, and counseling. However, I was also able to participate in other activities that aren't typically available in your average retail setting. For example, I was able to sit in with the staff psychologist and contract psychiatrist when they held their psychological clinics to evaluate the inmates.

I was also able to do a couple of drug utilization reviews, which I then presented to the P & T Committee. Additionally, I was allowed to participate in a Hepatitis C class by giving a short presentation to inmates on the therapy and treatment of Hepatitis C.

As a PHS JRCOSTEP student, I decided to wear a uniform while working at FCI Florence. Although I did not receive any compensation for purchasing the uniforms, I felt it was necessary in order to be addressed professionally by the inmates and other staff members. Even as a female in an all-male prison, I never felt threatened or intimidated by the inmates. I was often in close quarters with the inmates, but typically, I wasn't alone with them, except maybe walking down the hallway.

I was well-trained and prepared by my preceptor to be in the setting. He was very helpful in letting me know what to do in an emergency, what I could and could not bring into the prison, and the general conduct to have with the inmates.

The medical staff at FCI Florence was great. Everybody was very helpful and patient with me while I was learning the ropes. They were an awesome group to work with for the summer. I would recommend this program to anybody who asked me about it. I had a great time and I learned a lot of things that you just wouldn't learn in a typical pharmacy setting. If I had it to do all over, I would definitely do it again. In fact, this experience has opened my eyes to a possible career with PHS.

If you want something new and exciting, this is a great place to find it!

ENS Stacey Skutack, Bureau of Prisons

This summer I was presented with the opportunity to do a JR COSTEP with the Bureau of Prisons. It was an amazing experience and I would encourage this opportunity to anyone who may be interested.

Many people seem to be frightened or turned away at the prospect of working with inmates, but this summer I learned a great deal about institutional health care. I learned how prisons function and how the health care system within them works to provide the inmates with the best health care possible. I saw how the pharmacy operates and the many jobs and roles that the pharmacists of the BOP undertake. I found this all to be a very challenging and worth-whiled experience.

I did so many things this summer, things that I would not be able to do if I was standing behind a counter counting pills, or dealing with insurance companies.

I was able to conduct a DUE on H. pylori treatment with in our institution and also one on the use of Ace-inhibitors in diabetic patients. I was allowed to counsel patients on their medications, and was able to observe a telemedicine clinic.

Telemedicine is a live conference via satellite with various health care providers discussing a particular patient's case. Since many of the patients are required to come to the pharmacy daily or weekly for their medications, you are able to learn more about the patients health concerns and monitor treatment on a individual basis. This allows for greater chance of positive treatment outcomes.

This was one of the features that I liked the best with in the prisons system. I also learned not only about many medications and their functions, but also about the disease states that they were treating. It was so wonderful to put what I learn in school and read in books into practice.

I would like to thank the BOP for presenting me with this opportunity and also thank my preceptor for making this a fantastic experience.

Summer 2000

ENS Nicole Beblo, Federal Correctional Institution, Anthony, TX-NW

University: Duquense University
Active Duty Date: Summer 2000
Duty Station: Anthony, TX - NM

For my JR COSTEP assignment, I traveled 1900 miles to dry, sunny El Paso, TX. I worked for the Federal Bureau of Prisons at the Federal Corrections Institution La Tuna in Anthony, TX-NM. Anthony is a small town that lies half in Texas and half in New Mexico. It is about 10 miles west of El Paso.

At La Tuna, I worked in the pharmacy under the direction of Sheila Veikune. The pharmacy is in the hospital portion of the prison and it is similar to a "caged" room. Only the tech and Sheila had keys to the pharmacy.

I had several projects to do: One on diabetes where I interviewed inmates (not alone of course!!) about their understanding of their disease state and I then presented my findings to the medical staff. I also completed a project on Lassa Fever and presented that to the medical staff. I did several self study projects including one on Tuberculosis and one on drugs of choice for infections.

During my time there I also helped fill prescriptions. While I was there they recieved a new computer system that was windows based, so I got to learn how wonderful it is to fill scripts on that system! I also greatly improved my patient counciling skills. Sheila feels that all the inmates should be counciled--whether or not their prescription is a refill. Also, since many of the inmates are Spanish speaking I not only counselled in English but Spanish as well!!

Overall, I had a wonderful experience. With the help of my Mom and a wonderful church congregation in El Paso, I found a family to stay with. They lived in an upscale neighborhood and had a pool, maid and gardner!!! The only payment they would accept, was for me to house sit and watch their 3 dogs when they went away. They were wonderful people!!

I also met many great contacts and great friends as well. The facility also had 2 dental PHS costeps that I grew quite close to. We even took a long weekend and drove 9 hours to San Antonio!! We also went to Juarez, Mexico..the "sister" Mexican town to El Paso.

The thing I miss most about El Paso by the great Mexican food. After living in Pennsylvania all my life I've now realized that Taco Bell and Chi Chi's doesn't hold a candle to real Mexican food!! What I would do for a flauta right now??? Anyway...I had a wonderful summer, one that I'll never forget!!

If anyone wishes to get more information about the Bureau of can email me at!! And I'll be more than happy to tell you all about it!!

ENS Carmen Carroll, Federal Correctional Institution Mila, Michican

University: Drake University
Active Duty Date: Summer 2000
Duty Station: Federal Correctional Institution Milan in Michigan

Eight and half weeks in a male, minimum-security prison... The thought of this, upon learning of my assignment, was both exhilarating and somewhat frightening. Many people could not understand why I would want to spend my summer in a prison administering health care. But the administration of health care was exactly why I wanted to go; I greatly looked forward to the interactions I would have and the challenge the environment would present.

My internship involved medication dispensing, counseling, staff and patient education, ensuring that all inmates allergies were correctly entered into our computer database, researching and presenting a CME, performing a DUE on a specific class of medications, and interviewing two inmates. For my CME and DUE I researched HIV medications, which led me into research involving the complexity of the disease itself and the drug therapy management of it. I found this project very interesting and I enjoyed the many hours I put into it. Presenting the CME to the staff was also fun for me to do, as I enjoy doing that sort of thing.

Overall, I am very happy with my internship, and found it very fulfilling. It helped me understand what my strengths and weaknesses are, which will be beneficial as I enter into the final two years of school. However, the best part of my internship was the health care team with which I worked. My preceptor was a very good mentor, and a highly honored BOP pharmacist. Working with one of the best in the field was very exciting and I enjoyed the opportunity to learn from her. Our MD and our PA's were always willing to answer any queries I had and allowed me to experience and see a lot of things.

Everyone in the facility was always friendly and welcoming, and the entire medical staff took it upon themselves to integrate me into the prison. By touring the prison, I was able to get a feel of the environment that our patient's experienced, which likewise allowed me to see the impact of the prison environment on our health care delivery.

I would highly suggest a BOP JrCOSTEP to any person who wants to be a part of a medical team, and who is willing to meet the challenge that the prison creates to deliver health care.

I will be starting my 5th year this fall. (3rd professional year).
August, 2000

ENS Ritu Chandel, Federal Correctional Institution Butner, Butner, NC

Active Duty Date: Summer 2000
Duty Station: Butner, NC

I spent June 2 - August 15, 2000 at FCI Butner, a medium-security, all-male institution outside of Durham, North Carolina. The institution serves approximately 1200 inmates, 200 of whom are mental health patients. The pharmacy also fills prescriptions for two prison camps within the state.

During my time at Butner, I met some wonderful people and was immersed in a variety of experiences, both on and off the job. At work, I took part in the daily pharmacy routines, namely prescription filling and dispensing medications at pill line. I helped out, weekly, with drug orders; and I learned about the policies and procedure followed by the Bureau of Prisons (BOP).

My summer project involved a drug-utilization evaluation of ciprofloxacin, lansoprazole, and simvastatin. It called for extensive research, and culminated in a presentation to the staff. Several times during the summer I also had exposure to a number of programs outside of the field of pharmacy. The institution has an excellent Drug Abuse Program and I was able to sit in on several of the offered classes. This allowed me to observe the inmates in an environment that was conducive to their personal growth. It was quite inspiring to see some of the men really trying to make a change, for the better, in their lives.

I also observed a Psychiatrist, joined a Forensics Team for its weekly meeting, sat in on several seminars, and enjoyed a luncheon hosted by the Commissioned Officers Association at a nearby restaurant. During an Arts & Crafts workshop, I joined a group of inmates working on such projects as belt-making, painting, and building.

The FCI is part of a complex (this includes a low-security prison, a prison camp, and a new medical center), so I was able to spend time at the other institutions, which allowed me to gain a broader perspective of the BOP.

Outside of the institution, I was fortunate enough to have a nice place to stay, and plenty to do with my free time. I often frequented the beautiful Duke University campus to get some exercise. I familiarized myself with the Research Triangle, and used my annual leave to make trips to Fort Bragg and the Outer Banks.

To list all of the places I went and things I did this summer would be a book in itself! There were so many things to take in and to learn, from the job, the staff, and the inmates. Life is what you make of it, and this job was no exception. Some advise for future interns: Ask lots of questions. Take advantage of every opportunity. Don't always wait for directions - forge ahead on your own. Start the job with an open mind and an eagerness to learn, and you will not come out disappointed. Actually, if you are like me, when your time with the BOP comes to an end, you will be sad to turn in your radio, belt, and keys, and walk out the doors for the last time.

I recommend a Public Health Service JRCOSTEP to any pharmacy student, regardless of whether or not he (or she) knows what he wants to do upon graduation. A BOP-JRCOSTEP position offers new experiences unattainable in any other area of pharmacy; it will only help you to become a better person and pharmacist. I chose to enter the BOP as a challenge to myself to try something new. I embarked on my own little adventure this summer, and through it, learned a little more about myself, others, and of a field which I will be proud to be a part of someday.

ENS D. Nicole Jennings, Carswell Federal Medical Center, Fort Worth, TX

University: University of North Carolina
Active Duty Date: Summer 2000
Duty Station: Fort Worth, TX

This past summer, I had the unique opportunity to spend my JR COSTEP rotation with the Bureau of Prisons. The Carswell Federal Medical Center in Fort Worth, Texas is different from many prison facilities because they treat acutely ill patients in the inpatient setting as well as provide chronic care management in the outpatient setting. I had the chance to become involved by spending one month in each of these pharmacies. My days were spent preparing medications for pill lines, counseling patients on their medications, filling prescriptions, mixing IVs, and doing chart reviews. It was a new perspective for me because it was all the responsibilities of a pharmacist without the frustrations and obstacles that would be presented in a retail or hospital setting. We were able to review every chart before processing a prescription, easily access the physician if there was a problem, and best of all, no insurance to bill!

I learned a lot about the practical aspects of pharmacy and the things they have not taught me in school. I also learned more about diabetes through my project. I was responsible for leading a series of seminars about diabetes and how to manage it to the Hispanic inmates. At first, I was very intimidated at the thought of teaching classes through a translator. I am so glad I had this opportunity because I really feel it was a learning process for both the patients as well as myself. I also had to present a summary to the medical staff about the guidelines of diabetic management. It is a challenge to provide education for patients as well as physicians because you have to really understand the topic from two different perspectives.

The summer was not all work; Fort Worth is a wonderful place to live. There are endless things to do in the area. I went to ball games, water parks, museums, San Antonio, Dallas. It is not everyday you have the opportunity to live somewhere new for the summer, so I definitely encourage everyone to take advantage of the opportunities the Public Health Service presents to students.

I can honestly say it was a WONDERFUL experience for me and I would not trade my summer for anything.

ENS Nicole Piscioneri, Carsell Federal Medical Center, Fort Worth, TX 

University: University ofConnecticut
Active Duty Date: Summer 2000
Duty Station: Fort Worth, Texas

After working in a Connecticut retail pharmacy for the past 4 years, I decided that this summer I was going to explore a new dimension of the pharmacy world. I never imagined that my desire for something new would take me 1,800 miles from home, nor did I ever expect that it would lead me to prison. Nevertheless, on June 1, 2000, I reported to the Carswell Bureau of Prisons facility in Fort Worth, Texas to begin my internship as a Jr COSTEP. Being a Federal Medical Center, this institution had more advanced medical capabilities than some of the other types of prisons in the Bureau. I was very impressed with the hospital and with all of the services/procedures that it offered.

Initially, I was a little overwhelmed by my environment and by the idea of working in a prison... with inmates. Yet my worries were immediately calmed by the warm welcome that I received from the Carswell pharmacy staff. They introduced me to the facility, to the daily pharmacy operations, and to the policies of the BOP. Under their superior guidance, I quickly became comfortable with my duties and surroundings. I began to regard my environment as a medical center, not as a prison, and to view the people that I serviced as patients, and not prisoners. As the summer progressed, I definitely learned a great deal about pharmacy in the Bureau of Prisons. Yet, I also gained valuable experience with pharmacy, as a profession, and learned skills that I will carry with me throughout my career.

In regards to my duties at Carswell, I spent the first half of the summer working in the outpatient pharmacy. It was here that I became acclimated with the BOP formulary, filled prescriptions from the patients charts, participated in drug utilization reviews with narcotic medications, and best of all, ran the daily medication lines. Twice a day, the inmates would line up to get their medications, and I would be responsible for counseling them on the directions and potential side-effects, and I would address any questions that they had. This was my favorite part of the job, for it taught me invaluable lessons on patient-counseling, a topic that cannot be learned in a classroom or with a textbook. Surprisingly, the inmates were very polite and appreciative, and I had an extreme sense of satisfaction when they would thank me for my help. During my inpatient time, I gained experience making IV's, filling the medication carts for the medical/surgical unit, filling the pyxis machines and keeping inventory on them, and for going on rounds with the pharmacist to the various units of the hospital. I was also fortunate enough to attend "Pharmacy and Therapeutics" meetings with our chief pharmacist; this was especially interesting because I was able to witness various members of the health care staff (physicians, nurses, PA's, and pharmacists) interacting as a team.

In addition to assisting with the pharmacy operations, I also worked on a project during my COSTEP internship. It was a multi-part assignment, focusing on the HIV population in our facility, and on their therapeutic regimens. To begin with, I reviewed all of the patients charts, documenting their reported side-effects, CD4 cell counts, and HIV RNA viral load values. I then conducted patient interviews and offered patient education classes on HIV (as a disease state) and on the medications used to treat it. However, due to the sensitive confidentiality issues surrounding HIV, I had to offer 18 individual sessions, rather than hosting one large classroom lecture. One on one, I discussed the patient's specific drug therapy, the potential adverse drug reactions from the antiretroviral agents, the importance of compliance, and the meaninig of their laboratory values. I also provided each patient with information on agencies that would assist them, financially, with their medications once they left our institution. Finally, I offered a power-point presentation about antiretrovirals medications to the hospital staff during their weekly "Grand Rounds" gathering.

Overall, my summer at FMC Carswell was a phenomenal learning experience for me. I became familiar with the Public Health Service and with all of the benefits that it offers. Not only did I learn about pharmacy practices in a prison setting, but I also learned about different career options within the pharmacy profession. Furthermore, I spent the entire summer in an amazing city and met a wonderful group of co-workers, who quickly became my friends. I would strongly recommend this institution to any student willing to accept a challenging, educational, and exciting experience.

ENS Jeffrey Vang, Federal Correctional Institution Florence, Florence, CO

University: Wayne State University
Active Duty Date: Summer 2000
Duty Station: Florence, Colorado

My experience at the Federal Correctional Institution in Florence, Colorado was an exceptional one. I worked with a group of professionals on a health care team. They taught me many things that will enlighten my career as a pharmacist. Perhaps they may have influenced me to think Public Health Service by the time I graduate next year.

What I did at the FCI this past summer was a retrospective study on the use of simvastatin. The results turned out to be interesting.

I looked at inmates' charts to see the strength they were on, whether there were any labs done (LFTs): baseline, every 6 months, and every year, etc.; excercise and dietary counseling documents on chart or not, and were the inmates' cholesterol being controlled or not according to the National Cholesterol Guidelines. I found that most of the inmates' cholesterol levels have not been controlled, and the labs were not monitoring according to the guidelines. The reason for the uncontrolled cholesterol levels may be due to lack of excercise and inappropriate diet.

I like the FCI is because I liked the working environment. I did not have to deal with third party insurance, no doctor calls, and less stress for me than in a community pharmacy. The health care teams are right there, and you can communicate with them directly. I feel that this is what I want to do in my profession.

Besides that I had a great time, I love the weather in Colorado. I also like the clean atmosphere down there. If you have any questions, don't hesitate to call or email me.

Summer 1997

ENS Jacob Olson, U.S. Penitentiary Levenworth, Leavenworth, Kansas

Active Duty Date: Summer 1997

"I'm going to jail!" was the first thought when I learned that I would be spending my summer internship as a JR COSTEP inside the walls of "The Hot House"; U.S.P. Leavenworth. My name is Jake Olson, a Pharm.D. student in the College of Pharmacy at the University of Iowa. U.S.P. Leavenworth is a charming federal maximum security penitentiary located just outside Kansas City, Kansas (45 minutes from Kauffman Stadium.) The institution was the first federal prison built and is celebrating its centennial this year. A popular saying with the Bureau of Prisons is that, "No one is sentenced directly to Leavenworth, an inmate must earn his way there." How you may ask? "By screwing up everywhere else."

And when they arrived here, it was my job to help provide the necessary pharmaceutical care. There are approximately 2,000 inmates currently residing at the prison; 1,700 inside of the walls of maximum security and 300 located in a minimum security camp located just down the hill. All of these "patients" are overseen by a medical staff consisting of 2 pharmacists, 10 physician's assistants, 3 physicians, 2 dentists, a plethora of contract technicians, and one unarmed guard. My duties for the summer include reviewing medical charts, entering the needed medications into a data base, filling and refilling the prescriptions, and dispensing them to the inmates. Dispensing can be a little hectic at times. Try and counsel as many as 200 inmates in 2 hours that the pill line is open, through 1 inch thick steel bars and bullet-proof glass. Now tell me again how hard your summer at Wal-Mart was. I also spent time doing projects such as updating medical records, Drug Use Review's for our AIDS and other special medication populations, making presentations to the staff, and sneaking in a few therapeutic interventions. Other pharmacy things have to be done like ordering and receiving of stock medications, returning outdated medications to the manufacturers, and even a little compounding. Another exciting duty was to go on rounds with the PA's to the lock down areas of the institution. It is very similar to the rounds in a hospital except that examination in a hospital is not done through a small hole in a steel door. This is also an interesting way to get to see the places they don't show you on the tour, and also learn a few new ways to say phrases in many different languages.

This has been one of the most exciting learning experiences of my life to date. It was an excellent way to get first hand experience of the health care that is provided inside a prison. It has not been that much different than my experience in other hospitals, just that this one happens to be inside a prison.

ENS Angela Turner, Fderal Correctional Institution Butner, NC

University: Cambell University, North Carolina
Active Duty Date: Summer 1997
Duty Station: Butner, NC

I spent my summer at the medium security facility at the Federal Correctional Institution in Butner, North Carolina. This facility on average houses 1,000 male inmates with 200 of those being mental health inmates. The Health Services department of the facility serves both prisoners inside "the fence" and those housed at the camp next door.

There are two pharmacists and one full-time technician at this site. Pharmacist duties at the FCI typically included filling prescriptions from the chart and making sure refills were current. We were also responsible for all of the day to day duties of keeping the needle logs and stocking the two inpatient nursing stations.

The experience at Butner differs from some other institutions due to its mental health emphasis. There are three mental health units which serve the aforementioned 200 inmates. During my time at Butner, I participated with the psychiatrists and psychologists on seclusion and forensic consult teams. There were sessions held once a week to monitor the progress of the inmates in a group setting. Many of these inmates were sent to Butner to determine competency to stand trial or to determine if the inmate can be held accountable for his actions. I also had the chance to accompany a psychiatrist once a week on his outpatient consults. This was a unique way to become familiarized with various mental health conditions.

Besides the usual activities of the work week, I had the opportunity to observe several other unique programs at the institution. Art therapy was one program that I found particularly interesting. The therapist showed me interpretations of inmate artwork that she used to help diagnose illnesses. I also sat in on a lecture about suicide and its prevention. There was also the opportunity to observe the drug and alcohol dependency program and the sex offenders program.

Let me assure you that I can not do justice to this COSTEP site on paper or on the web for that matter. This summer definitely was one of learning. I had honestly never dreamed of working in a prison. This job taught me many things about pharmacy and medicine with strong emphasis on mental health. This job also taught me an invaluable lesson that there are no boundaries to pharmacy. With that I challenge all of you to leave no stone unturned in your search to find your niche in the Pharmaceutical World.

ENS Vinita Meha, FCI Seagoville, Seagoville, TX

University: University of Illinois at Chicago
Active Duty Date: Summer 1997
Duty Station: Seagoville, TX

I never thought of pursuing my pharmacy career in a prison until I discovered the Public Health Service. My name is Vinita Mehta, and I was assigned at a low-security correctional facility located at Seagoville, TX right outside of Dallas. Before coming here I wasn't sure what to expect. After my arrival, I realized that some of the same activities that take place in any pharmacy are seen in prisons. We processed new prescriptions and refills which were then picked up by the patients. Of course, we didn't have to ask for an insurance card in a prison. The patients had the usual illnesses that you would see in the general population such as hypertension, diabetes, athlete's foot, and so forth. We also had some of the more rarer treatments such as hormone therapy for sex changes, which also can be seen elsewhere.

However, this COSTEP assignment provides experiences that are unique to the BOP. For example, the inmates on psychotropic and TB medications, insulin, and injections receive each of their doses at the pill line. This requires us to hand them the appropriate medications and confirm that they have taken them by looking in their open mouths. You definitely will not see that on the outside.

Some situations that are normally considered harmless are viewed as dangerous in a prison setting. This is due to the fact that we are dealing with convicts, many of whom have been arrested for drug use and trafficking. Precautions are taken with cortisporin otic suspension even though it is not a narcotic or psychotropic drug, but because it has a dropper which can be altered and used as a syringe.

Working as a pharmacy COSTEP in a prison was a great experience that I would recommend to anyone. This was an opportunity to observe an integrated health system and see its positive effects on therapy outcome. It was a place where I was able to improve my patient counseling skills. Most importantly, I learned so much more working here than I did in my classes.

ENS Libby Hearin, FPC Seymour Johnson, Glosboro, NC

On May 12, I walked into the Federal Prison Camp at Seymour Johnson Air Force Base and into the world of the Bureau of Prisons (BOP). This experience has satisfied my expectations of exploring various agencies within the PHS, roles of pharmacists and other health care providers, and aspects of the Federal prison system. From the beginning, the Seymour Johnson staff made it clear that I was invited to work in each area in health services and each compound department. Little did they know how often I would bug them with questions and "pop-in" visits.

I initially focused on the elements within health services by tagging along with the doctor, physician assistants, nurse, dental hygienist, and dentist. Anytime anything exciting happened, such as the removal of a sebaceous cyst or tooth extraction, I helped. Instead of simply spending a day or two with each practitioner, I continually interacted with the entire staff. The Health Services Administrator (HSA) also introduced me to the business and administrative aspects of the department. By understanding the other functions of health services, I walked into the pharmacy with a well-defined idea of the pharmacist's role.

Of course, I appropriately spent the majority of my time in the pharmacy, or should I say, with the pharmacist. My preceptor showed me other responsibilities pharmacists have, particularly in government settings. Our dispensing services consisted of providing two, day-time pill lines for about 450 inmates by filling medication orders. We counseled all in-coming inmates, as well as those inmates that requested our attention, on their conditions and medications. I found that patients tended to feel comfortable talking to pharmacists about their health in general and not simply their medications. In addition to these duties, we coordinated staff wellness activities, departmental quality assurance, and pharmacy therapeutics committee meetings. We made an impact on the health care services team in and outside of the pharmacy.

In addition to helping with health care needs, I experienced shake-downs, rounds with detail officers, inmate team meetings, and activities of every other department. Some educational field trips included tours of Federal Correctional Institution Butner, Butner-Low, and Cherokee Indian Reservation.

Overall, this summer provided a well-rounded introduction to the Public Health Service and the BOP. I know there is more to explore and there always will be, but I now have a better grasp on the realities of pharmaceutical opportunities. I also enjoyed learning from various professionals who helped me discover more about my likes and dislikes. I look forward to more challenges and adventures with the PHS.

ENS Jeffrey Chupka, FCI Tallahasee, FL

Last fall I began to think about what I was going to do with my last summer off before I entered into the so-called "real world". I wanted something that would fully challenge my pharmacy education, but more than that I wanted a new experience. Retail and mail-order were already part of my resume, and hospital pharmacy would be part of mandatory school rotations. So what's left? I began a quest and started investigating early in the school year. The Public Health Service caught my eye, and working in a prison definitely fulfilled my "new experience" need.

When I reported to work at the Federal Correctional Institution in Tallahassee, Florida, I was not sure what to expect. We learn in school how pharmacy should be and the ways it should be practiced - then we get into the "real world" and find it is not feasible to counsel, see charts, and discuss drug therapy with physicians. To the contrary, this summer I saw a patient's medical record for every prescription I filled, the physicians were a phone extension away or just down the hall, and there was no insurance to deal with. Patient compliance was easily monitored since they came to pill lines for every psychotropic dose. My preceptor, LT Allison Underwood, was able to actually teach me the skills and knowledge I was interning for since I was not there to just fill a position, but rather was actually an extra person to learn and interact. The two pharmacists at FCI Tallahassee, LT Underwood and LT Josh Feldman, had both been JR COSTEPs and SR COSTEPs for the Bureau of Prisons, and thus were able to share those experiences with me. Taking all of this into consideration, I felt like I was in control of the patient care that I offered patients. It seems that in this day of changing roles of pharmacists, the Public Health Service offers the avenues and room to change and grow into the future.

ENS Kathleen Blanton, FCI Sheridan, Oregon

University: University of Kentucky

After working in a retail setting for the past two years, going to the Federal Correctional Institution in Sheridan, Oregon took some adjustment. Although a very different population, it was not difficult to work with inmates - I just learned to be more cautious about everything in the workplace. The ten weeks I spent in Sheridan have been the most educational and beneficial time during my college career.

Initially, I became acclimated to my surroundings in the pharmacy and at the prison in general. Along with two dental COSTEPs, I went through four days of training and familiarization with the institution. Once in the pharmacy, I first filled prescriptions in order to learn the formulary and the location of medications. After a few days, I logged onto the computer system, read through charts, and entered new prescriptions. This allowed me the opportunity to review treatment plans and make interventions when necessary.

Another area where I was able to play a large role was in the Isoniazid (INH) Clinic for prophylaxis of active tuberculosis. My preceptor, LT Chris Bina, explained how to schedule and order labs, initiate therapy, monitor for side effects, monitor compliance, and counsel new patients on INH treatment. He allowed me to take over many of the duties related to the INH clinic for the summer. With its hands-on approach, the INH clinic taught me much more about tuberculosis and isoniazid than was ever discussed in class.

During my summer, I was able to help with two drug utilization evaluations; one on Warfarin and the other on HMG CoA Reductase Inhibitors. LT Bina and I went through the Warfarin DUE together, then I was allowed to pursue the HMG CoA DUE on my own. The information we compiled was distributed to the Continuous Quality Improvement Committee and follow-up education for the medical staff was provided when deemed necessary. Hopefully, the information on the cholesterol-lowering drugs can soon be utilized in the initiation of a Lipid Clinic at FCI Sheridan.

Finally, running pill line was the most unique part of working in the prison system. This was when I issued controlled substances and psychotropic medications to the inmates dose by dose. There was nothing comparable in other settings where I have worked. Although nervous the first time I was the one opposite the inmate, I actually found it exciting to administer medications. Everything I learned while at Sheridan was something new and different from previous jobs and this made work enjoyable. Experiencing two body alarms, a week long lock-down, pill line in the housing units, Psych Clinic, and the death of an inmate never left a dull moment.

While at FCI Sheridan, not only did I learn more related to my future degree, but also about different career options, the Bureau of Prisons, and the Public Health Service. This summer has made me seriously consider a future with the Bureau of Prisons, and I will recommend a JR COSTEP rotation to anyone. It was a wonderful opportunity to learn more about my career, see different areas of the country, and have an enjoyable yet educational summer.

ENS Martina Ringen, FCI Phoenix, Fhoeix, AZ

"Don't pick up hitchhikers"...curve to the right, turn ID card if the front desk controller does not recognize my face...wait. One, two, three, four more doors to be unlocked before me and locked behind...wait in line with escort for keys...walk through a couple more securely locked doorways. And welcome to another day in prison. I love it here!

Phoenix, Arizona has been my home this summer during my BOP Pharmacy COSTEP assignment. My daytime residence is FCI Phoenix-a men's medium to high security prison. I have found lodging in the guest room of some new friends; a family I found through the local branch of my church. Afternoons and evenings I can workout, shop, sleep, or whatever suits my fancy. My fancy has recently included a beautiful day trip to Sedona. There are actually some trees in Arizona! Tubing down the Salt River ate up another day off of work. Now down to the real reason I am

I have been thoroughly challenged at this institute by my fellow pharmacists. My preceptor CDR Andrew Litavecz has years of experience to make me think about long term pharmacy practice. The staff pharmacist LTJG Tom MacLean, a recent graduate, still has MOA's, DI's, and all related facts buzzing around in his head. So at any moment I might be thrown the curve ball "What's the mechanism of action of this drug?" as he holds up a newly filled prescription bottle.

This team of pharmacists has given me a rather well rounded perspective on pharmacy. I do enjoy my pharmacist duties and daily interaction with the inmates. I am glad to be here long enough to know many inmates by name: those who come daily to take psychotropic medications under our supervision. In addition, I do spend considerable time working on QA reports, DUE research, and looking up all the drug answers that I cannot remember.

I also appreciate being able to know the whole medical team here reasonably well, partly due to our daily medical staff meetings. Those relationships make it much easier to call the prescribers with my questions and concerns about prescriptions.

One particular summer bonus that I would like to highlight is the IHS Pharmacy Training Program which I attended in Phoenix for four days. During this seminar I learned invaluable physical assessment techniques and reviewed case studies with experienced pharmacists. Most memorable was role playing angry or otherwise 'problem' patients. In small groups we took turns acting as patient and pharmacist to practice managing difficult situations and barriers to successful counseling. That week of training would be of benefit to everyone. If possible, I hope to attend that program every few years to renew what I learned.

When the end of summer has come and for the last time I walk out of these locked doors, I will be sad to leave this team, the inmates' familiar faces, and the challenges I have faced. However, I will also be thankful for my experience and hopeful for opportunities in the future.

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