In October 2018, Jill S. Bates, PharmD MS BCOP CPP, was awarded a research grant for her project “Implementation of a Preemptive Approach to Pharmacogenomics in Oncology.” The University of North Carolina School of Medicine and the North Carolina Translational and Clinical Sciences Institute awarded the grant. In an interview in May 2019, she spoke about her research, her career, and the sources of inspiration and motivation for her work.
Please describe your current position and the types of patients you see in clinical practice.
My current position is precision therapeutics pharmacist. In this role, I initiate, maintain, and develop strategic relationships and scientific communications to support the growing University of North Carolina (UNC) precision therapeutics program (PTP). I work collaboratively to create programmatic infrastructure for precision therapeutics. This includes creating tools such as clinical decision support in the electronic health record, increasing internal and external awareness of the UNC PTP, disseminating precision therapeutics education to patients and providers, developing institutional processes and guidelines for clinical implementation of precision therapeutics, and creating metrics for programmatic success. In addition, I develop and plan precision therapeutics–specific advanced training opportunities, actively contribute to the body of knowledge in precision therapeutics by publishing articles on the topic, and design and conduct precision therapeutics research. The focus of my position is working interprofessionally with the UNC Eshelman School of Pharmacy Center for Pharmacogenomics and Individualized Therapy and throughout the UNC Healthcare’s department of pharmacy to utilize precision therapeutics as a foundational and proactive strategy for ensuring patient safety. [Note: In July 2019 Jill assumed the position of pharmacy program manager (pharmacogenomics) for the Department of Veterans Affairs at the Durham VA Medical Center, Durham, NC.]
Please tell us about your research grant award and the potential impact of your research on patient care.
My research grant was awarded by the UNC School of Medicine and the North Carolina Translational and Clinical Sciences Institute for the study of emerging challenges in biomedical research. The study, which focuses on the implementation of pharmacogenomics in oncology, has two specific aims: (1) to evaluate whether leukemia and gastrointestinal oncology pharmacists, nurse practitioners/physician assistants, and oncologists who participate in continuing education programming and training on pharmacogenomics gain knowledge and self-efficacy, and (2) to integrate functionality into the electronic medical record by using discrete reporting and a clinical decision support platform to test implementation of six pharmacogenes relevant to 6-mercaptopurine, fluorouracil, capecitabine, rasburicase, voriconazole, allopurinol, and tacrolimus. The drug-gene pairs being evaluated have high levels of evidence to support their use. Given strong evidence, pharmacogenomics practices should be in place for these drug-gene pairs.
Pharmacogenomics is a proactive patient safety strategy. It hinges on pharmacokinetic mechanisms that affect drug disposition and can be applied to practice in a way similar to that used to adjust a medication for hepatic or renal dysfunction, allowing more data to accurately individualize a patient’s treatment. If there are data that can better individualize a patient’s treatment for a patient, those data should be applied.
How long have you been a member of HOPA, and how have you been involved?
I have been a member of HOPA for 13 years. Over this time I have been involved in multiple committees (related to standards, programming, education, and board certification review), and I served as a HOPA research grant proposal reviewer and a member of the Hematology/Oncology Pharmacy Scope of Practice Task Force.
Who was your mentor, and how did he or she influence your career path?
I have had several wonderful mentors during my career. When I was a graduate student, Dr. John Mitchell (my masters thesis advisor) believed in me, took me onto his lab staff, and personally worked with me so that I could grow academically. During pharmacy school I had the honor of being mentored by Drs. Sandra Durley and Nicholas Popovich. Sandra is a wonderful role model of a woman in leadership. Nick (“Dr P”) created in me a deeper love of teaching and showed me how education can have an impact on the future of our profession.
As a clinician, I have been mentored by Drs. John Armistead, Sharon Murphy Enright, John Valgus, and Lindsey Amerine. I feel very grateful to have had such wonderful mentors—each has influenced my career path in a special way. John Valgus and Lindsey Amerine are coworkers of mine and have provided me with guidance and friendship over the years. Sharon and I worked together on the American Society of Health-System Pharmacists’ women in leadership task force, and whenever we connect, she consistently offers a refreshing and creative perspective on being a woman and having a career. Last, John Armistead has had a profound impact on my growth. He and I have regular telephone calls in which I usually am coming to him with a request for guidance. I asked John to mentor me outside of a formal structure, and he graciously agreed to do so. John has much experience and is a strong leader. In addition, we have many shared interests, including continuous professional development and advancement of the pharmacy profession. I highly regard his advice and perspective and seek them when needed. He has had a tremendous influence on my life. I feel truly grateful to have had such amazing mentors and can certainly say that I stand on the shoulders of giants.
What would you define as keys to your success?
My faith in God has been the primary key to any success I have had. In addition, my desire for connection and prioritization of connecting with others has been invaluable. I naturally like to meet people, to visit with and learn from others. I really do not think that I consciously recognized the value of this until much further on in my career path. Luckily for me, I have always been involved in professional organizations, and because I naturally enjoy people, I fostered many connections, albeit serendipitously. As I have matured into a more experienced clinician, and especially since moving into my pharmacogenomics role, I realize the value of connecting with others to grow as a person and in my practice and my program and to be the best I can be for any trainees that I am responsible for.
There are so many intelligent and awesome people out there—we should strive to surround ourselves with role models who have more experience and insight than we do. In addition, humility, openness to feedback with a growth mindset, and an interest in continuous professional development have been key for me. Though an emphasis on networking may seem a cliché, it is truly one of the most important things you can do to build a personal brand.
What is one of the proudest moments of your career?
My proudest moments are all about people. I love thinking about special patients with whom I have shared special moments, sometimes involving very intimate and vulnerable life circumstances. Or watching the success of residents and students with whom I have provided educational care. I love the year-end residency banquet, which gives a platform for reflecting on a resident’s growth over the course of the PGY2 oncology year. It is so amazing to see these graduates. I also am truly excited and proud of the students I have taught who come to share their “big wins” with me. I love watching these learners succeed and at times getting a little glimpse of a piece of me in their practice. I feel very proud to have influenced these learners and potentially others whom they will influence, as well as our profession as a whole.
Oncology pharmacists can have a profound influence on their patients and trainees. What would you like your patients, trainees, and colleagues to know about you?
I am a working mom. I have two children, Alex (9 years old) and Payton (7 years old), whom I adore. I have interests outside of pharmacy; for example, I am an avid runner and enjoy yoga. I love being outdoors, and I am deeply committed to my faith. I think that all these things are important because they are part of what makes me who I am. I bring all of myself to my career, and I work hard to integrate everything in a harmonious way. All these things have an impact on my growth and ultimately on those I connect with. I care deeply about people and relationships, and I think this is really important when managing yourself.
What advice would you offer to other oncology pharmacists who are either just beginning their career or expanding their role in research?
I would say this: make a commitment to continuous professional development (CPD). In addition to having a good mentor, focusing on CPD is the best way to strategically grow into yourself. It takes practice to understand things that are life-giving and things that are life-sucking for you. Additionally, times change, and life-giving activities are not static; nor are they always the best option. It is well worth the effort it takes to identify areas of your passion and skill. Once you have identified these, stay open, seek feedback, practice essentialism, and work hard.
I like to move in accordance with this quotation from Theodore Roosevelt (it was brought to my attention by Brené Brown, one of my favorite authors): “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”
Lisa Cordes, PharmD BCOP BCACP
Oncology Clinical Pharmacy Specialist and Educator
National Cancer Institute
Kasey Jackson, PharmD BCOP
Clinical Pharmacist Specialist, Hematology/Oncology
Medical University of South Carolina Hollings Cancer Center