University of Iowa, Maho Omoto (6th year, Department of Pharmacy, Faculty of Pharmacy *at the time)

I participated in a four-week practicum at the University of Iowa Hospitals & Clinics in the United States, where I had the valuable opportunity to experience firsthand a healthcare system and the role of pharmacists that differ from those in Japan. In the first week, I learned about the American healthcare system and the general operations of pharmacies through observing a community pharmacy. For the remaining three weeks, I participated in the specialized duties of a pharmacist for one week each at the acute care hospital, anticoagulation clinic, and psychiatry clinic of the University of Iowa Hospitals & Clinics.

Pharmacists in the United States are active in a wide range of settings, from community pharmacies to acute care hospitals, and I realized that their roles often differ from those of pharmacists in Japan. In community pharmacies, many patients use OTC drugs and supplements due to the high cost of medical care, and pharmacists provide consultations. Additionally, pharmacists are certified to administer vaccinations, and pharmacy students also gained experience with vaccinations during their practicum. In acute care hospitals, pharmacists actively participate in team-based care, making rounds with physicians to support patients' pharmacotherapy. It was also impressive that there is a system in place allowing pharmacists to focus on more specialized tasks, thanks to the presence of pharmacy technicians who assist them. Furthermore, while pharmacists in Japan handle a wide range of duties, pharmacists in the US specialize in specific fields. For example, in the anticoagulation clinic, pharmacists perform PT-INR measurements and adjust warfarin dosages, supporting patients in self-management. In the psychiatry clinic, they used an electronic system called PDMP to manage high-risk drugs such as opioids and worked to prevent their abuse.

Although the practicum in English had its difficulties, I was able to have a fulfilling experience thanks to the kind support of the professors and students at the University of Iowa. In my personal time, I enjoyed watching football, apple picking, having a Japanese food party, and traveling to Chicago with the Iowa students, and the four weeks flew by in what felt like an instant. The experience of a hospital practicum in the United States through this program is an invaluable asset to me, and I strongly encourage my junior colleagues to take on this challenge.