Pharmacy School Dean: A Day in the Life

With so many career options available to pharmacists after graduation, the "Day in the Life" series is meant to provide you with insights into what it's like to be a pharmacist in various areas so that you can pursue what's right for you!

Questions #1-13 cover topics related to a day in the life of a School of Pharmacy Dean.

1. Tell us a bit about your background (school, training, etc…)

• BS Pharmacy (89’) and PharmD (90’) – St. Louis College of Pharmacy (now the University of Health Sciences and Pharmacy in St. Louis)
• General Clinical Residency (now called PGY1) – University of Kentucky
• Critical Care Specialty Residency (now called PGY2) – University of Kentucky
• Neuroscience Research Fellowship – University of Kentucky

2. How long have you been the Dean of SIUe School of Pharmacy?

• Interim Dean 2018-2019
• Dean 2019 - present

3. What are some of the best and worst things about holding the position of Dean?

Best:

• Being able to support a program and its people which I helped establish in 2004.
• Student success in its many forms - similar to my past roles as department chair and Associate Dean.  Our program was developed with a student-centered focus and I believe that it should remain that way.
• Designing the new health science building from the ground up. We have always been in temporary space and beginning with the fall 2025 term, will have a permanent home on campus that will expand the resources for research while providing a state-of-the-art educational facility.

Worst:

• Responsibility to make difficult and/or unpopular decisions even when they are necessary.  Examples include:
  • The details related to the pandemic response including requiring the COVID-19 vaccine were difficult. Regardless of whether I believed in the science or whether I supported the vaccine personally, I had to mandate the vaccine for all students and create a system for medical or religious exemptions in order to guarantee the delivery of the educational requirements of our program (i.e., experiential education).
  • Budget cuts: A perfect storm has occurred that has resulted in revenue declines for the School of Pharmacy. Since the SIUE School of Pharmacy opened to students in 2005, there has been a greater than 50% increase in the number of schools and colleges of pharmacy and many of the existing programs increased their class sizes over the same time period.  This resulted in the number of pharmacy graduates exceeding the market demand and as the job market slowed both regionally and nationally, interest in pharmacy as a career waned.  This fact was compounded by a decline in the number of high school graduates. When this fed back into the slowing market, it resulted in reduced student enrollments in pharmacy programs across the nation and SIUE was not immune. The good news is that the job market has improved, and our enrollments are starting to improve. Unfortunately, the decline in high school graduates is still expected to worsen in the Midwest and continues to negatively impact the university. As a school of pharmacy within a much larger university, the budgetary impacts are much broader than just our own enrollment. SOP budget cuts have largely been covered through a reduction in the number of faculty and have followed retirements and resignations. If the enrollments continue to trend upward and the revenue/expense picture improves, I anticipate that the lost positions will be reinstated.

4. What are the main barriers to entry? (PGY1 or PGY2, fellowships, 3-4 years experience, etc…)

For PGY1, the main barrier has changed dramatically. Previously, the demand for residency positions far exceeded the number available and the slow job market exacerbated this fact as it put more graduates in pursuit. Recently, with the decline in the number of pharmacy graduates and with the improving job market, there are more residency positions than there are candidates interested in pursuit of a residency, so things have sort of flipped.

For PGY2, positions remain very competitive. PGY2 residencies are funded differently from PGY1 residencies so the number and types of institutions that can offer and/or sustain a PGY2 is much lower.

For Fellowships, you need to look at the different types of fellowships but all look for candidates with experience (residency, fellowship, or work-related) and/or a demonstrated interest. The most popular are industry-sponsored fellowships which span the various sectors of the pharmaceutical industry and are funded by the pharmaceutical company. Another type of fellowship is more research-intensive and is often based within an academic institution. This is what I completed, and the entire salary/benefits package was funded internally through grant funding. ACCP has published guidelines that guide what they might look like (https://www.accp.com/resandfel/guidelines.aspxor), but in general, fellowships are not standardized in the same way as an ASHP-accredited PGY1 or PGY2 residency. The remaining fellowships tend to be very specialized and include areas such as regulatory affairs at the FDA or association fellowships with ASHP that can be leadership or healthcare policy-focused. There are too many to describe all in detail.

5. What was your career path prior to becoming a Dean?

After completing my fellowship, I accepted a tenure-track faculty position in the Department of Pharmacy Practice at the UIC College of Pharmacy with the intent of continuing my clinical research focus. While at UIC, I pivoted and pursued laboratory training to augment the clinical research focus. After three years, I moved to the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy. Because my grant activity was now primarily bench-focused, I was housed within the Department of Pharmaceutical Sciences even though my appointment was in Pharmacy Practice. This gave me an unusual breadth of research experience and I was externally funded with both types of research while at UAMS. In 2004, I moved to SIUE as the inaugural department chair for pharmacy practice. I hired all of the original faculty in the department and oversaw the development of new clinical sites for faculty, the experiential program, the capstone program (now called ImPACT program), and subsequently residency program development.  The title of Director of Clinical Programs was added to my title as chair because of the added focus on external healthcare partners in each of the aforementioned areas.  In 2012, I moved to the Associate Dean for Student Affairs position and this was retitled to Associated Dean for Professional and Student Affairs as the role took on some academic affairs duties, we transitioned to PharmCAS and we grew out of the conditional entry program for admissions. In 2018, I was asked to serve as the interim Dean; in 2019, I was appointed to the CEO Dean role.

6. Did you ever think you would be where you are now? At what point in your pharmacy career did you shift towards more of a leadership/executive path?

First, I never thought of myself as ever becoming a faculty member. I was just happy to graduate pharmacy school as half of my entering pharmacy class out of high school did not. The decision to pursue my PharmD was somewhat naïve. I knew that this new degree to our program would only require a few extra summer courses, an extra semester of therapeutics, and two more terms of experiential education above the BS Pharmacy degree, but I did not really understand what the “new” patient care focus was all about. I had already been working in a hospital pharmacy and wasn’t sure what the PharmD was going to offer in terms of added opportunity as all of the pharmacists that worked with me had patient care in mind. My plan was to become a nuclear pharmacist and did two rotations (APPEs in today’s terms) for my BS Pharm degree. It wasn’t until I did my first rotation in an ICU when I could see the impact of the pharmacist bedside, that I decided to put a renewed focus on learning how to apply this new knowledge. My preceptor for this rotation encouraged me to pursue a residency and then she left StLCOP. She had returned home and to the University of Kentucky College of Pharmacy. I followed in her footsteps and worked with her for the next three years in the residency/fellowship. During my residency, I decided that a faculty role was something that I was interested in pursuing. Years later, after my promotion to Associate Professor and the earning of tenure at UAMS, I began to become more involved in the administrative aspects of the department and the college. I rewrote policies, developed new operating papers, explored the varied nuances of why we were doing things the way we did, served as secretary to the faculty, and began to mentor other faculty members. This combination of activities formed my desire to formalize a pursuit for greater leadership opportunities, not because of pay, but because I could better use my influence to improve the space(s) where I worked.

7. What are your responsibilities/tasks during a typical workday?

Currently, my time is spent primarily in meetings and/or working on related activities to these meetings. Some relate to duties at the university level where I am co-chairing the self-study process for university accreditation by the Higher Learning Commission (HLC) and serving on committees related to strategic position alignment to better align existing resources across campus. Within the school, I meet regularly with both department chairs, the assistant and associate Deans, and the various directors.  With the Director of Business Affairs, we manage the budget and each of the positions mentioned in the School has duties that impact the budget (positively or negatively).  My primary role is to ensure that we collectively have the physical and financial resources for the School to carry out its Mission. Of course, we are also finishing out the construction of the new health sciences building so I spend a lot of additional time reviewing lists of equipment, furniture, and supplies in preparation for moving into our new space this summer.

8. What are some of the challenges you face working as the Dean of a School of Pharmacy?

Enrollment and finances are the two biggest challenges that virtually every Dean of a school of pharmacy faces.

9. How can current students or pharmacists best prepare for a career trajectory similar to yours?

It all begins with experience and a willingness to observe, learn, and reflect. There is not a quick start tutorial to becoming a Dean and certainly not a degree or certificate program that prepares you fully. It took me 30 years from the time I graduated college until I was appointed the Dean, and it was not a journey that I ever imagined. Mentors, colleagues, and experiences (both positive and negative) helped guide my path, but all along I gravitated toward things that interested me. I am simply fortunate to have had interests that intersect or overlap well with being a Dean.

10. What are some of the most gratifying experiences/opportunities you have had so far in this position?

I love seeing the new faces in an incoming class and then watching them cross the stage as graduates and alumni; many of whom have gone on to develop great careers and have impacts within their communities. I also take great pride in watching a young program mature and with it, a lot of tremendous faculty and staff who are leaving their imprint on this program and its participants.

11. What is the biggest impact you think you have on students and faculty?

It is largely unseen, but the provision of resources is my number one priority.  Whether it be through the development of new scholarships, new facilities, new programs, or figuring out how to keep offering professional development opportunities when finances are tight, this is my role.

12. You have an active home and family life, how do you manage to balance all of your responsibilities?

I am not sure that I have always been able to balance it all. There have been times in my career when my focus was primarily on work and not at home. I did what I thought I needed to do at the time. It worked out well for promotion, tenure, and to becoming a sought-out content expert professionally. Unfortunately, it took a life-threatening condition at the age of 37 for me to rethink my approach to life. I still desired to be successful, but my approach changed dramatically. I shifted to working on things that were more self-rewarding, both personally and professionally. This is when I decided to become a department chair and to focus on the development of others; this is also when my formal leadership journey began. You can be successful without being happy, but why not be both?

13. What is one piece of life advice you wish you could share with everyone?

Attitude is a choice. Even in the most demanding of situations, you can choose how you respond to it. I still remind myself of this fact regularly when I find myself challenged.

The following question is meant to be fun and provide some insight into the culture and personality of these professionals!

1. What is one book you would recommend to a friend?

The Last Lecture by Randy Pausch. He is quoted as saying "We cannot change the cards we are dealt, just how we play the hand."  In a way, it goes back to my answer to question 13.

Thank you to Dr. Luer for taking the time to share his experience as a Pharmacy School Dean.

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