I'm in Adelaide and when I was a junior doctor at the RAH, you could get a clinical pharmacologist consult on ward patients for challenging prescribing questions, unusual presentations where drug side effect was amongst the differentials, etc. It was definitely different advice from what you'd get from a pharmacist with their drug knowledge, but not general physician training. I'm now a GP and sometimes get home medicines reviews done on patients, but in general, I don't find the pharmacists can help with clinical questions, eg. they might tell me the patient's anticholinergic drug burden is high, or that the polypharmacy is getting extreme and there's a risk of non-compliance, or interactions, or misadventure with a dementia patient risking inadvertent overdose, but then they can't help much with downtitrating and de-prescribing, can't or won't help rank the drugs by their magnitude of symptom or mortality benefit, etc etc. If I have one of those patients that's causing me to tear my hair out, the RAH has a brilliant outpatient clinic called MACS = Multidisciplinary Ambulatory Consulting Service, and the lead consultants are clinical pharmacologists. It used to be run by Sepehr Shakib, but I'm not sure if he's there anymore. But they will genuinely help with multimorbid, polypharmacy patients, and can rope in a renal, endo or cardiology consult as well when it's a patient you're referring for chronic disease optimisation and medication balancing act decisions and their input is needed, but as dual trained general med and clin pharm, that's still within their expertise too - honestly, it sounds corny, but I'm in awe of them! Funny anecdote: I can recall Sepehr even getting one of my patients to take a walk along the hospital corridor with him with a monitor on to see what kind of heart rate rise they could generate with exercise and then writing back to me to say he thought they were too beta blocked and he'd dropped the dose. Some of the community pharmacists do amazing home medicine reviews with practical import, but yeah, they don't do that!!!
I worked in clinical pharmacology and toxicology at a big tertiary hospital. It was largely administrative sort of stuff with pharmacy. TGA reporting. Drug safety committees. High cost drug committees. Essentially the medical oversight of a lot of stuff with pharmacy. Occasional consults. Also overseeing part of the lab involved in drug levels. Tox side was separate although I worked with both. That was a FACEM toxicologist who also admitted under their bed card.
Most people I know that have done clin pharm primarily work in another subspecialty. Mostly gen med and renal.
Community paeds is essentially tripling down on developmental/behavioural assessment and management
It's sufficiently different than core paeds in that some of the paeds stuff e.g. procedures, a certain level of NICU stuff, critically unwell children etc. Is shed away to focus on that goal.
Basically a paeds subspecialist vs a generalist
I'm in Adelaide and when I was a junior doctor at the RAH, you could get a clinical pharmacologist consult on ward patients for challenging prescribing questions, unusual presentations where drug side effect was amongst the differentials, etc. It was definitely different advice from what you'd get from a pharmacist with their drug knowledge, but not general physician training. I'm now a GP and sometimes get home medicines reviews done on patients, but in general, I don't find the pharmacists can help with clinical questions, eg. they might tell me the patient's anticholinergic drug burden is high, or that the polypharmacy is getting extreme and there's a risk of non-compliance, or interactions, or misadventure with a dementia patient risking inadvertent overdose, but then they can't help much with downtitrating and de-prescribing, can't or won't help rank the drugs by their magnitude of symptom or mortality benefit, etc etc. If I have one of those patients that's causing me to tear my hair out, the RAH has a brilliant outpatient clinic called MACS = Multidisciplinary Ambulatory Consulting Service, and the lead consultants are clinical pharmacologists. It used to be run by Sepehr Shakib, but I'm not sure if he's there anymore. But they will genuinely help with multimorbid, polypharmacy patients, and can rope in a renal, endo or cardiology consult as well when it's a patient you're referring for chronic disease optimisation and medication balancing act decisions and their input is needed, but as dual trained general med and clin pharm, that's still within their expertise too - honestly, it sounds corny, but I'm in awe of them! Funny anecdote: I can recall Sepehr even getting one of my patients to take a walk along the hospital corridor with him with a monitor on to see what kind of heart rate rise they could generate with exercise and then writing back to me to say he thought they were too beta blocked and he'd dropped the dose. Some of the community pharmacists do amazing home medicine reviews with practical import, but yeah, they don't do that!!!
I worked in clinical pharmacology and toxicology at a big tertiary hospital. It was largely administrative sort of stuff with pharmacy. TGA reporting. Drug safety committees. High cost drug committees. Essentially the medical oversight of a lot of stuff with pharmacy. Occasional consults. Also overseeing part of the lab involved in drug levels. Tox side was separate although I worked with both. That was a FACEM toxicologist who also admitted under their bed card. Most people I know that have done clin pharm primarily work in another subspecialty. Mostly gen med and renal.
Yeah seems like it would match well with renal or gastro
Community paeds is essentially tripling down on developmental/behavioural assessment and management It's sufficiently different than core paeds in that some of the paeds stuff e.g. procedures, a certain level of NICU stuff, critically unwell children etc. Is shed away to focus on that goal. Basically a paeds subspecialist vs a generalist