Rural health-care services get boost from pharmacy students

Community connections and a wide scope of practice in Alberta make an appealing mix for career opportunities.

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Alma Steyn (left), who owns a pharmacy in Canmore, Alta., speaks with recent U of A graduate Preston Eshenko, who now works as a pharmacist in Banff. Eshenko is following in Steyn's footsteps as a volunteer helping to train pharmacy students in rural placements. (Photo: John Ulan)

For rural communities, health care can be difficult to access.

Throw in part-time clinic hours, an Alberta winter or a global pandemic, and those accessibility challenges only become more apparent.

But many services that once required an appointment with a family doctor can now be provided by an Alberta pharmacist — including some prescriptions, referrals, disease screenings, provision of health advice, precision medicine and vaccinations. And pharmacists, along with the students they train, are prepared to serve rural communities.

“Every year I work in a small town, I love it more and more,” said Alma Steyn, owner of Gourlay’s Clinic Pharmacy Canmore. “That connection you get with people — the patients and the other health-care professionals we work with — is unbelievable.”

Alma Steyn administers an injection to a patient at the pharmacy she owns in Banff, Alta. (Photo: John Ulan)
Pharmacy owner Alma Steyn vaccinates a patient — one of the wide range of services available at local pharmacies across Alberta. “Pharmacists are filling a much bigger role than we ever have before,” she says. (Photo: John Ulan)

In rural pharmacies like Gourlay’s across the province, University of Alberta pharmacy students are training in a complex work placement and discovering the benefits of practising in a smaller community.

“Some of the products that I’m compounding here, I've never seen anywhere else,” said Olivia Stephen, a fourth-year pharmacy student completing her final placement with Steyn at Gourlay’s Canmore. “For example, we have different compounds and medications that we make for emergency pain management for the ski hills.”

Stephen also assists in meeting the needs of tourists, like getting travellers the medications they need but forgot at home or helping with acute illnesses that pop up on vacation. And she consults directly with physicians — usually from the doctor’s office next door — to develop personalized care plans.

“The best thing about rural communities is getting to know patients and the patients getting to know you,” said Stephen. “It makes helping them a lot easier.”

Pharmacy student Olivia Stephen sits on a park bench with the Calgary skyline in the background. (Photo: John Ulan)
Fourth-year pharmacy student Olivia Stephen says she plans to return to a rural area once she graduates this spring. (Photo: John Ulan)

Return to rural areas after graduation

Over their four-year degree, U of A pharmacy students complete 1,600 hours of hands-on training in pharmacies and hospitals, with 10 to 20 per cent of those hours spent in rural placements. Of those students who have found jobs on graduation, 30 per cent choose to return to work in rural areas.

“The number one thing for me is the seamless care and the ease of communication in rural settings,” said Preston Eshenko, a recent graduate of the U of A pharmacy program. Eshenko completed three of his placements in rural communities during his degree, and on graduation started work as a full-time pharmacist at Gourlay’s Pharmacy Banff, sister branch to Gourlay’s Canmore. He also works a few shifts per month at Banff Mineral Springs Hospital, which he said is common among most pharmacists in town.

“It benefits the patients because we know what went on during the different levels of care,” said Eshenko. “It's much easier to find information and communicate between areas of the system when you also work at the hospital and know all the nurses, emergency room staff and acute care team.”

The number one thing for me is the seamless care and the ease of communication in rural settings. It benefits the patients because we know what went on during the different levels of care.

Preston Eshenko

Pharmacy graduate Preston Eshenko laughs with a customer at Gourlay's Pharmacy Banff where he works as a pharmacist. (Photo: John Ulan)
(Photo: John Ulan)

In Canmore, Steyn said the doctors just pop into the pharmacy to discuss patient needs, and vice versa. “It's not over the phone and not over fax. It's just a human connection.”

Steyn is one of more than 1,000 volunteer preceptors who give their time to train U of A pharmacy students. She said the training experience has just as much benefit for her and for her patients as it does for the students. Eshenko, who has signed up to be a preceptor and is waiting to take on his first student, agrees.

“I had very good preceptors throughout school, and I wanted to pass that on,” said Steyn. “But students know what's going on. So it’s a great way to stay updated on current practice and get fresh ideas.”

During his own student placements, Eshenko said he always tried to bring a fresh perspective to his team.

“So I'm looking forward to learning from my students and staying up-to-date on the most recent progressions in health care — because it’s always changing — and being able to change my practice for the better because of their input.”

Filling a gap in care

Pharmacy students training in small communities and their subsequent interest in returning to rural areas to practise after graduation is important not just to the practice of pharmacy, but to the health-care system as a whole.

Pharmacies have been one of the only health-care providers that have stayed open to the public and accessible throughout the pandemic, and they are steadily taking on more responsibilities that have traditionally been fulfilled at family practice offices, drop-in clinics or urgent care centres. Alberta pharmacists have the largest scope of practice in Canada, including taking on some kinds of general health consultations, referrals to other health-care services and prescribing medication. They are also the largest single provider of the COVID-19 vaccine and flu shot in the province.

“Pharmacists are filling a much bigger role than we ever have before,” said Steyn.

“If your patients know you, like they do in a small town, they’re more likely to trust you and open up to you about changes in their health or life,” said Stephen, who plans to work in a rural area once she graduates this spring. “And that makes for better patient care and better health outcomes.”