A global perspective while on APPEs
Sierra Schmiedt, PharmD, is a community pharmacist in Huron and Mitchell, SD, and Tony Tran, PharmD, is a pharmacist with the Indian Health Service in Fort Thompson, SD. Both are 2024 graduates of the South Dakota State University College of Pharmacy and Allied Health Professions.
Sierra Schmiedt, PharmD, wanted to push herself as an individual and experience health care outside of the United States. Tony Tran, PharmD, wanted to build on a favorable study abroad experience as a high school student and visit the country of his heritage. That is how then-South Dakota State University student pharmacists ended up in Vietnam for 5 weeks for their final 2024 APPE rotations.
Getting acclimated
Our first couple of days at the hospital were a huge shock as we both took in the new environment with practices different from back home. We were both amazed at how the health care system provided such care despite limited resources, though we were surprised by how little autonomy pharmacist had in Vietnam, where doctors perform tasks that a pharmacist would normally do, such as counseling patients on their medications.
Despite our initial nervousness, we were welcomed during each of our initial tours of each department within the hospital, as the Work the World Team in Vietnam made sure we were in the correct direction each week. The staff members we had encountered included both of us in various opportunities we would not have experienced in the United States as a pharmacist, and we never felt out of place during our time at the hospital.
A memorable case
One of the memorable cases on this rotation was observing a paracentesis performed on a patient within the patient’s room, which was shared with 11 other patients. A plastic chair was set up for the patient to sit backward on, bracing their arms on the backrest. The physician had sterile materials and prepped for the procedure, while other patients in the room were standing on their beds to get a better view. The physician administered the lidocaine, manually pulled some fluid, then set up tubing to drain the rest. One end of the tubing had an I.V., as the other end was attached to an Aquafina bottle on the floor that began to fill with cooper-colored fluid.
Learning differences between the two countries
The health care system in the United States differs significantly form that of Vietnam. Vietnam is a developing country, thus resources such as medications, testing materials, and treatment options are limited. One key difference we encountered was the rate of antibiotic resistance. With several medications being available to purchase without a prescription, this had led to a huge increase in antibiotic resistance. In Vietnam, one of the first-line antibiotic options is a carbapenem, which would be a last-line option in the United States.
Another difference would be how the United States has a more technological advance system where prescriptions can be sent electronically to pharmacies. In Vietnam, all of the prescriptions are handwritten by the physician, and if there are any discrepancies, the pharmacist has to inform the physician, as the prescription is given back to the patient for them to return back to the physician for the corrected prescription.
A wealth of experiences and memories
Outside of rotations, on evenings and weekends, we would take the advantage of our free time by exploring Vietnam. On weeknights, we would go out for food at local establishments with other students from around the world, and weekends were used for big adventures. We hiked through national parks and explored through the city of Hue. We had also took weekend trips to visit Da Nang, Hanoi, and took a cruise through Ha Long Bay. There was not a weekend when we had nothing planned.
We would highly recommend this rotation to any student seeking an international experience. We were both supported the entire time from the Work the World agency. You will gain a global perspective, life experience, make new friends, and view the world through a different lens.
We both left Vietnam with a wealth of experiences and memories that will stay with us as we continue into our professional careers as pharmacists.