For my STEP Signature Project, I traveled to Cagliari and Rome, Italy with a group from The College of Pharmacy. In Italy we visited both educational and cultural sites throughout Italy and were able to interact with various academic faculty and medical professionals.

Through these experiences, I was able to experience a part of the Italian healthcare system and learn how Italian pharmacies are different from those in the United States. Overall the experiences in Italy changed how I viewed our own healthcare system in the United States. Before visiting Italy I assumed that the United States was far ahead of other nations in terms of technology and automation in Pharmacy. However, I learned that they have much of the same technology we have and, in some cases, even more. This taught me that I shouldn’t make assumptions about what resources another country has until actually having the facts.

During our time in Cagliari we visited three pharmacy locations. We visited an oncology hospital pharmacy, general hospital pharmacy, and community pharmacy. The two hospital pharmacies that we visited were very similar to those we have in the United States. They had much of the same automation, access to drugs, and overall procedures that I have experienced are generally in the average hospital in the United States. In addition, the oncology pharmacist received the same if not more education and training than our pharmacists in the United States. The main difference that I saw between hospital pharmacies in the United States and equivalent pharmacies in Italy was Italy was in general lacking the appropriate amount of personnel and staffing that is standard in the United States. For example, due to budget cuts there was currently just one pharmacist working in the oncology pharmacy. He said he had been working upwards of 80 hours per week since there was not another pharmacist on staff. This is in stark contrast of the United States where there are more than enough pharmacists present and many work a standard work week of 40 hours. For example, the James cancer hospital hires around 120 pharmacists for our oncology pharmacy here at Ohio State. The week we had visited they had just hired another pharmacist to share the workload and the pharmacist that had been working 80 hours said he would now be working closer to 40-60 hours per week.

The biggest difference between pharmacy in Italy and pharmacy in the United States was present in the community pharmacy that we visited. The community pharmacy was almost unrecognizable from the large chain retail pharmacies that are common throughout the United States. In the United States the pharmacies we know are convenience or super markets with pharmacies conveniently located inside. These big chain pharmacies like Walmart, Kroger, Walgreens, and CVS just to name a few are focused not only on running a pharmacy, but also their regular store business, which makes up a large part of their profits. This is not the case in Italy where there aren’t any large chain pharmacies. Most community pharmacies are locally owned. This means that they stay fairly small. This does not mean however that they don’t have advanced technology. The community pharmacy we visited has an entire compounding center along with automated filling machines two things you see in a pharmacy in the United States. While their community pharmacies did have a small selection of items available for purchase without a prescription, they were mostly centered around heath supplies, toiletries, etc. This is very different from the United States where most pharmacies will sell you both grocery items as well as your prescriptions. These community pharmacies also appeared to be staffed more adequately compared to the hospital pharmacy we visited.

Overall the pharmacies were nothing like I had envisioned. There were some aspects such as the community pharmacy’s ability to compound personalized medications that could be of great use if implemented in the United States. This showed me how I should never assume that just because something I am used to seems like it is the best system, it doesn’t mean that someone hasn’t thought of something that works even better. It also showed me how to be thankful for the resources we do have right here at home. We are very privileged to live in a society where we are at the forefront of healthcare innovation. While we have our own problems to deal with, our overall access to resources including professional staff is something that shouldn’t be overlooked. Being able to have a good amount of staff available to meet the needs of patients is important. If a hospital is understaffed it can lead to fatigue and mistakes by the medical staff that can have negative impacts of patients. This is something that was very prevalent in Italy, which made me thankful of what we have in the United States.

These things that I learned while in Italy will likely have an impact on how I think in the future as I work towards becoming a doctor. It is possible that in my future career I will be expected to deal with various policy decisions. The experiences I had in Italy will likely affect how I will approach these future decisions. I will be more likely to do more research about how others have handled the same situation to see if there might be a better way of doing things. In addition, I hopefully won’t take for granted the resources including staffing resources that are available to me in my future career. I hope that I will be able to utilize these experiences I have had and knowledge I have gained through this trip to be a better doctor that is able to serve his patients more effectively.