Advice for Staying Up to Date with the Literature
Morgan Belling, PharmD
PGY-2 Oncology Pharmacy Resident
Brandi Anders, PharmD BCOP
Hematology/Oncology Clinical Pharmacist
Wake Forest Baptist Health
Perhaps one of the most important skills you learn during residency is how to effectively teach yourself. This is especially important when you consider how rapidly the field of hematology/oncology pharmacy changes, with new drugs constantly being approved by the U.S. Food and Drug Administration, novel classes of agents being evaluated in the drug development pipeline, and the results of clinical trials being published. Knowing the data, learning how to interpret that information, and applying it to your patient population are essential skills of the clinical pharmacist.
So what advice would two young practitioners offer to students and residents pursuing a career in hematology/oncology pharmacy that would help them stay up to date on the literature? A good place to start is to ask your preceptors and mentors how they continually educate themselves. These seasoned practitioners have devised methods over the years to ensure that they are informed about the most recent events in their areas of practice, and each preceptor undoubtedly has different methods and resources to achieve this. They have established a good system for focusing on the key concepts, while also weeding out unnecessary ancillary information. Learn from your preceptors, and then tailor their advice to best suit your needs.
Preceptors are helpful in pointing you in the right direction in terms of resources you should utilize. For example, you can sign up to receive e-mails about the table of contents from the most recent issues of high-impact journals such as the New England Journal of Medicine and the American Society of Clinical Oncology’s Journal of Clinical Oncology. Create a free account on these journals’ websites and specify which alerts you’d like to receive (for example, with the New England Journal of Medicine, you can sign up for specialty updates in Hematology/Oncology and Infectious Disease).
Another good website to receive updates from is Clinical Care Options (sign up for oncology-related news at www.clinicaloptions.com). From solid tumor to hematological malignancies to supportive care, this resource provides a nice overview of a variety of topics in oncology. Additionally, PracticeUpdate Oncology (www.practiceupdate.com/explore) highlights news from several journals, with links to these highlighted trials. This website also has useful webinars and interviews with leading practitioners who offer insight into results from recent clinical trials and potential implications for clinical practice.
If you are looking for a valuable resource for hematology and bone marrow transplantation, sign up for e-mail alerts from Blood, which has a great series of review articles—“How I Treat”—that are written by prominent practitioners in that area. From recommendations for treating relapsed multiple myeloma to comparing tyrosine kinase inhibitors in chronic myeloid leukemia to discussing respiratory viral infections in transplant, these articles are useful reviews that incorporate both evidence-based medicine and considerations for clinical practice when there are limited data available to guide you.
In addition to the e-table of contents and alerts from these journals, listservs also are a great resource for keeping yourself in the loop! The HOPA listserv and HOPA Central feature discussions about issues in clinical practice, such as strategies for mediating drug shortages and use of biosimilars among different institutions. There are different communities on the HOPA Central website you can join to be involved in more focused discussions. HOPA Central also has a direct link to HOPA News, which offers a wealth of important practice-related information. It’s a good idea to join listservs from organizations that focus on specialties that you’re particularly interested in. For example, the American Society for Blood and Marrow Transplantation features a pharmacy listserv similar to that of HOPA: pharmacists can submit questions and request feedback from members of several different institutions, share ideas, and discuss prominent issues.
With all of the information currently available and constant changes in the hematology/oncology pharmacy world, keeping on top of the most important concepts can seem overwhelming. That’s why it’s essential to have a good system for saving and organizing this information so that you can refer back to it. We recommend creating folders broadly based on different disease states to keep yourself organized. For example, have a file for “hematological malignancies”, then separate that into subfolders for acute myeloid leukemia, acute lymphoid leukemia, chronic myeloid leukemia, chronic lymphoid leukemia, etc. Within your transplant folder, you might create folders on different preparative regimens, the role of transplant in multiple myeloma or Hodgkin lymphoma, and graft versus host disease (GVHD), with important trials saved in each of these subfolders. Whenever your preceptors e-mail you pertinent articles, they may highlight key concepts in the body of the e-mail that you should be aware of and pay attention to, such as how the trials impacted practice, considerations about the patient populations, and limitations of the trials. It’s a good idea to save this correspondence, too, whether by saving it in a Word document or forwarding it to another e-mail address.
(Unless you continue to practice at the same institution after you complete residency, you’ll likely lose access to your work e-mail account, and saving articles and e-mails as you go is much easier than trying to save everything toward the end of residency.)
In addition to saving primary literature and review articles, we recommend you ask preceptors and co-residents to send you electronic versions of the presentations they have developed. (Think Oncology Forum presentations, for example.) These can be useful resources, especially because they contain citations of landmark trials that you can go back to and study. Keep your system of organization as simple as possible so you can easily locate articles when you need them. Remember, part of your role as a pharmacist is educating other members of the healthcare team, and the faster you can pull the articles you need and share them, the better! Building a thorough reference library for yourself should be an essential goal of your residency training.
Finally, in keeping with the specific, measurable goals you establish for yourself throughout your training, it’s very important to consistently set aside a specific amount of time each week (at least 1–2 hours) to solely focus on reading oncology-related literature. This should be in addition to all of the reading you do to prepare for topic discussions and presentations. As one of our mentors advised us, the single most important task you can do to advance your knowledge as a practitioner in oncology is read, read, read! With all of the other responsibilities of residency and pharmacy training, devoting time to reading can easily get pushed to the end of your to-do list, and that’s why we strongly encourage you to protect your reading time. Otherwise, the articles quickly pile up, and you may end up missing important information. Even reading one clinical trial or review article in-depth, or reading the abstracts of a few published trials each week, goes a long way to advancing your knowledge. By following all of these steps, you’ll have a solid framework for educating yourself throughout your career!