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 NIH Jr COSTEPS.

Summer 2003

ENS Monica A. Coulombe
University: University of Rhode Island
Duty Station: National Institute of Drug Abuse

For my JR COSTEP assignment I traveled to Baltimore, Maryland to work at the National Institute on Drug Abuse, National Institutes of Health. Here I worked closely with my preceptor CAPT Brooks, and CDR Na. The mission of NIDA is to conduct studies and publish scientific papers. Here at the pharmacy we compound the drugs that are needed to give the subjects who are partaking in these clinical trials. We are also responsible for compounding the drugs needed for the non-clinical trials, on a daily basis, being performed by the various scientists. The non-clinical studies are performed on tissues or animals in the facility.

The pharmacy performs the drug audits in all the laboratories in the facility. As the new intern, I am responsible for scheduling, and performing the audits along with the other student we have at our facility.

Quality Control is also a responsibility of mine. First, CAPT Brooks made sure that I understood the difference between Quality Control and Quality Assurance. At our level, we are responsible for Quality Control. This ensures that all meds are being stored properly, that there is proper handling of meds while compounding, and aseptic technique is being performed when necessary. I perform the following tasks: checking the temperatures in the refrigerators, plating the IV and compounding areas (for environmental debris), calibrating the balances and checking expiration dates of medication located throughout the pharmacy.

My main responsibility throughout the summer is to maintain one a current clinical trial in our institute. I am in charge of dispensing and preparing the medications on a daily basis to the nursing staff; which includes the daily paperwork; also, preparing the components for compounding and lastly compounding the drugs for the trials. It is a single-blinded trial that runs for 35 weeks per study subject.

As I enter my fifth year as a Pharm.D. Candidate at University of Rhode Island, I have expanded my pharmacy practice knowledge to include a very unique aspect of the clinical side. Without working in an institute such as this, I would not have an opportunity to compound like I do here. It is quite different from the community aspect that we pharmacy students are most accustomed. Overall, as I complete my first three weeks it has been a pleasurable experience, and I look forward to what the rest of my assignment will be.

Summer 1997

Sheri Hoyler
University: University of Texas

Of all of the summers I've spent, I believe the summer of 1997 will be remembered as the one that offered more opportunity than I could have ever imagined. The COSTEP experience provided me the chance to meet some wonderful people and do some exciting things.

I came to my internship at the National Institutes of Health, in Bethesda, Maryland, with expectations that were far exceeded by my preceptor, Dr. Steve Piscitelli. Steve, who specializes in pharmacokinetic research, has such a dynamic career and is so successful at what he does that I could not have asked for a more thorough introduction to a career in clinical research. The opportunities provided to me this summer included: sitting in on Pharmacy Professional Advisory Committee meetings with the Chief Pharmacy Officer of the PHS (not to mention the Acting Surgeon General of the United States); going to meetings of the Institution Review Board for the National Institutes of Allergy and Infectious Diseases; attending clinical rounds with prominent figures, such as Dr. Anthony Fauci; and I got to go to the press release by the federally appointed task force on treatment recommendations for HIV infection.

Aside from all of this, I was given several very educational projects. I developed a drug interaction chart for antiretroviral drugs, wrote a class review of the quinolones and a brief monograph on azithromycin, researched information on Indinavir's safety and efficacy, was exposed to literature on gender differences in metabolism, and was given the unique opportunity to publish in the &it American Journal of Hospital Pharmacy &it (for which Dr. Piscitelli is a contributing editor).

As if all this was not exciting enough, my weekends were spent visiting family and friends in Virginia, Delaware, Pennsylvania, and New York. I spent the 4th of July on the lawn of our nation's capitol, and later spent the day on Capitol Hill with Bob Steeves from the Food and Drug Administration. Appealing to the historian in me was a trip to an 18th century apothecary in Old Town Alexandria. The Food Drug and Law Institute provided me, and all the area COSTEPs, with the unique opportunity to attend a week long seminar in Washington, D.C. Then, toward the end of the summer, under the guide of wonderful hosts, Steve and Penny Dittert, fellow COSTEPs and I toured a federal prison in Beckley, West Virginia. While we were there we stopped off for a white water ride down the New River, an awesome experience! The friendships I developed, through weekly socials in Georgetown, Old Town Alexandria, and Bethesda, I'm sure will be lasting. And, I could never offer enough gratitude for such a wonderful roommate, Colleen Davies. For a full summer, I think this one just about topped it!

ENS Kerri Jones
University: University of Nebraska Medical Center

I was assigned to work with Charles E. Daniels, Ph.D., Chief, Pharmacy Department, Clinical Center, National Institutes of Health. The title of my assignment was "Pharmacy Special Projects."

I attended management meetings, institutional review board (IRB) hearings, rounded with the department's clinical pharmacy specialties (in the areas of Mental Health, Infectious Diseases/HIV, pediatrics, Bone Marrow Transplant, Oncology/Hematology, Ambulatory Care, & Endocrinology), participated in an anticoagulation clinic, and assisted in the department's preparation for JCAHO accreditation visit this fall.

I developed the agenda packet for the P & T meeting. I also developed a program for pharmacist credentialing, along with a plan for implementation and subsequent evaluation of the program. The credentialing proposal will be presented as a student poster at the 1997 ASHP Midyear Clinical Meeting in Atlanta, GA. Finally, Dr. Daniels & I developed an Investigational New Drug Application Flowsheet, which after final revisions will be submitted to a pharmacy journal for possible publication.

I really enjoyed my JRCOSTEP assignment. Dr. Daniels was an excellent preceptor and I learned a lot! My only regret is that my academic schedule only allowed me to accept a 6-week assignment - I wish I could have spent the entire summer at NIH.

Devvrat Patel
University: Howard University
Duty Station:National Institute of Drug Abuse

This summer was unlike any other summer I have had in the past; it was both an educational and informative three months. I had an opportunity to participate in the Junior Commissioned Officer Student Training and Extern Program (JRCOSTEP) at National Institutes of Health (NIH)/National Institute on Drug Abuse (NIDA) in Baltimore, Maryland. This experience greatly enhanced my knowledge in the field of pharmacy, especially as it pertains to research. I was very fortunate to work with Public Health Service (PHS) officers CAPT Anthony Brooks, and LCDR Paul Na. Since starting, both officers answered any questions I had and got me involved in the everyday operations of a research pharmacy. I quickly became aware of the importance of pharmacy in a research setting.

Specifically, I was responsible for compounding and dispensing various investigational medications for both clinical and preclinical research studies carried out at NIDA. Since most of the studies were blinded, it was extremely important to properly handle and document any drugs dispensed. I learned to prepare emergency envelopes for studies in case an adverse reaction occurred in the participants. I also realized the importance of keeping proper documentation for each controlled substance dispensed. Furthermore, since most of the drugs were in powder form, the pharmacy staff taught me different techniques in compounding the drugs into the dosage forms of capsules, solutions, and IV injections. The highlight of my COSTEP duties was to make a poster that was presented at the NIH Poster Day. This poster compared the success rate of completion of studies based on the participants' keeping an initial appointment to begin the study.

Since CAPT Brooks was persistent in challenging me with medical questions, he required me to visit the National Library of Medicine (NLM) to answer these questions. For instance, I had to find out the different pharmacological effects of morphine on dogs, cats, and horses. I also had to use library resources to prepare the posters. This way, I learned to utilize different databases effectively to retrieve journal articles. This experience will be very useful throughout my career for future research projects.

Since CAPT Brooks knew that I was particularly interested in research, he made arrangements for me to work with other researchers who had different backgrounds and experiences. I had an opportunity to work with Dr. Wallace Pickworth, a pharmacologist, who assisted me in preparing another poster on pharmacokinetic properties of nicotine. Preparing and presenting these two posters gave me two different views on the steps necessary to carry out research projects.

By participating in the COSTEP program, I was also able to learn the history and other facts about the PHS. CAPT Brooks and LCDR Na made every effort to inform me of the different aspects and factual information of the PHS. By attending Pharmacy COSTEP meetings and the PHS Orientation, I was able to get insight and the history of PHS, and I was able to learn about the career opportunities available in the PHS after graduation.

This JRCOSTEP experience was unique. It was a worthwhile and beneficial experience for me. Since I am a 3rd year Pharm.D. student at Howard University, Washington, DC, this experience refocused my career goals. I have been exposed to a unique field of pharmacy, and now I have a better understanding of the challenges faced by a research pharmacist. I would strongly recommend other students to apply for the Jr COSTEP program.

ENS Mark W. Sellers
University: University of Maryland, School of Pharmacy
Duty Station: National Institute of Drug Abuse

Introduction

My assignment was with the pharmacy at the National Institute on Drug Abuse (NIDA), Intramural Research Program (IRP). NIDA is a part of the National Institutes of Health (NIH), which conducts and funds research on substance abuse across the country. The location of my assignment was the NIDA facility located at the Johns Hopkins Bayview Medical Center in Baltimore, Maryland. I began my externship on May 22nd and finished on August 18th. It turned out to be a summer of great opportunities as I was exposed to a broad spectrum of pharmacy practice areas. Having just finished my first year of pharmacy school, I gained experience and knowledge that third and fourth year students may never gain. As a result of my JRCOSTEP, I believe I’m much further along starting my second year of school.

Overview of NIDA Pharmacy

The pharmacy at NIDA helps coordinate drug procurement, storage, compounding, and dispensing for a wide variety of both non-clinical and clinical studies conducted within the facility. The pharmacy also maintains and dispenses medications for use on subjects admitted to the inpatient research center. In addition, the pharmacy is the point of contact for questions concerning FDA procedures and for maintaining past and current Investigational New Drug (IND) applications.

Assignments completed during my tour

  • Poster presentation of "Ecstasy: Rave Reviews?" at the NIH Poster Day and the National Institute on Aging (NIA) Poster Day.
  • Research of the following topics:
    • Morphine effects in dogs vs. cats.
    • Caffeine content of at least 12 different soft drinks and other common beverages.
    • What percentage of heavy drug abusers consume caffeine, smoke cigarettes, and/or consume alcohol?
    • Location of action of nicotine, alcohol, and caffeine in the body.
    • Describe the difference between lactose and dextrose, and why lactose is most often used as filler in pills and capsules.
    • Pharmacy Technician 2-year program at Anne Arundel Community College; what is it about, what are the current wages of a pharmacy technician, and do pharmacy technicians that have passed the Pharmacy Technician Certification Board (PTCB) examination earn higher wages?
    • Use of the apothecary system in pharmacy practice, researched at the National Library of Medicine in Bethesda, MD.
    • Can mosquitoes transmit AIDS, and what is the lifecycle of a mosquito?
  • Consolidated list of medical information websites into one linked document
  • Compounded and dispensed both non-clinical and clinical drugs.
  • Filled prescriptions for subjects in the inpatient research center.
  • Responsible for documentation, preparation, compounding, and dispensing of the Methadone Research Study.
  • Allowed time to give geriatric education talks at area Senior Centers.
  • Updated pharmacy forms.
  • Straightened supply rooms and consolidated supplies.
  • Document destruction in accordance with Department of Health and Human Services guidelines.
  • Responsible for the pharmacy quality assurance program.
  • Prepared placebo capsules.
  • Maintained DC area interns website.
  • Attended staff meetings.
  • Attended the following events:
    • One-day Public Health Service Officer Training Academy at the Parklawn Building in Rockville, MD.
    • Seminar by Dr. Mendelson on MDMA (ecstasy) at Johns Hopkins Bayview Medical Center in Baltimore, MD.
    • NIH Clinical Center Pharmacy introduction in Bethesda, MD.
    • Overview of the Public Health Service at the Parklawn Building in Rockville, MD.
    • One-day tour of St. Elizabeth’s Mental Health Facility in Washington, DC.
    • One-day tour of NIH Clinical Center Pharmacy in Bethesda, MD, which included grand rounds with the National Institute of Allergy and Infectious Diseases (NIAID) clinical team.
    • Tour of the US Pharmacopoeia in Rockville, MD.

Summary

There is no other opportunity for a pharmacy student to be exposed to so many aspects of both the Public Health Service and pharmacy practice than I was able to take part in this past summer. I was fortunate to have a preceptor that was so willing to let me take advantage of as few or as many opportunities as I wanted, as long as I completed assigned tasks on time. There were so many other meetings, seminars, and events in the Washington, D.C. area that I was unable to attend due to time restraints. The other 2 pharmacists I worked with helped me out a great deal and truly enhanced my JRCOSTEP experience. On a final note, I also had some of the best crabs the Chesapeake Bay has to offer. Not just once, but twice!

Preceptors

  • Captain Anthony J. Brooks, PD is a graduate of Howard University School of Pharmacy and is the Chief Pharmacist of the NIDA Pharmacy.
  • Lieutenant Commander Paul J. Na, PD is a graduate of the University of Maryland School of Pharmacy.
  • Catherine Loi, PD is a graduate of the Massachusetts College of Pharmacy.

Marnin Alan Forman
University: Texas A&M University
Duty Station: Vetierinary Resources Program

The Junior Commissioned Officer Student Training and Extern Program (JR COSTEP) is designed to introduce professional students (veterinarian, medical, pharmacists, engineers, etc.) to the opportunities available to them in the United States Public Health Service and allow them to gain professional experience in their chosen fields. The program allows students to experience first hand the Public Health Service Commissioned Corps. The commissioned corps is a uniformed service led by the Surgeon General. JR COSTEP participants are credited for their time if they enter the Public Health Service but are not obligated to serve in the Public Health Service after graduation.

My duty as a COSTEP was at the National Institutes of Health in Bethesda, MD. I worked in the Veterinary Resources Program (VRP) which is an component of the National Center for Research Resources. VRP is one of the largest biomedical research animal care and use programs within the U.S. Department of Health and Human Services. At VRP a majority of my work was with the microbiology diagnostic laboratory. Dr. Theresa Lawrence served as the director of the laboratory and my COSTEP preceptor. My work in the lab involved performing microbiological procedures for diagnostic, health surveillance, and environmental submissions. The diagnostic submissions were received from a wide variety of animals from the National Institutes of Health campuses. The procedures included processing biological specimens, performing biochemical characterizations, and antimicrobial susceptibility testing. I was also responsible for documenting results which are then conveyed to the presenting veterinarian.

Dr. Lawrence also encouraged me to make best use of my time by taking advantage of the numerous opportunities available to me at the National Institutes of Health. I observed and assisted with necropsies performed in the VRP pathology department. I attended weekly pathology slide conferences issued by the Armed Forces Institute of Pathology. I also attended training seminars on biohazard handling and laboratory animal handling and manipulations. Through the COSTEP program I was able to assist in the publication of a biweekly newsletter. Also through the program I was able to tour a number of facilities associated with the Public Health Service.

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