Steven Chen, clinical pharmacist Photographed by Philip Channing

Issue: Spring 2005

The Age of Pharmacy

True to a 100-year tradition of innovation and leadership, USC’s top-rated School of Pharmacy challenges age-old assumptions about the proper sphere of drugs and druggists.

By Diane Krieger

A less persistent practitioner might have given up trying to pay a house call on a patient whose street address didn’t seem to exist. But Steven Chen persevered, circling the Watts neighborhood, scanning house numbers. Finally he rang a door bell for directions. The woman who answered pointed across the street to a boarded-up vacant lot. Slipping through a makeshift opening in the fence, Chen spied an abandoned camper shell in the middle of a field.

“I was worried about you,” he told the gaunt man who lives there. “You missed your last appointment.” The patient, a diabetic who had suffered a stroke, insisted everything was okay, but Chen had doubts. Glancing around the trailer, he saw no refrigerator or any other electrical appliance. “Where’s your insulin?” Chen asked.

The patient led him outside to a rusty, doorless fridge standing in tall weeds. There, stored as instructed (the label read: “keep refrigerated”) lay several weeks’ supply of useless medication. “Obviously the integrity of the insulin was compromised,” Chen says wryly.

Adventures like this aren’t unusual in the life of this USC faculty clinician. Part detective, part primary-care provider, part teacher, he represents the vanguard in a profession as old as the caveman.

Chen is a pharmacist.

If you think pharmacists are just the guys (more on that later) who pour pills into amber jars with child-proof caps, you’re about 50 years behind the times. Much has changed over the past half-century, most notably major advances in the tools and methodologies of drug research, resulting in an explosion of therapies available to alleviate (and sometimes eliminate) the greater part of human illness. With it has come a $300 billion global pharmaceutical industry.

So you can chuck most of the stereotypes you ever swallowed about pharmacists – from Shakespeare’s destitute apothecary, reduced to supplying “a dram of poison” to suicidal Romeo; or the small-town druggist of Frank Capra’s It’s a Wonderful Life, who carelessly slips cyanide into a child’s cold remedy. If poverty and quackery were ever the pharmacist’s lot, they’re a dim memory now. Today’s drug specialists are well-paid and well-respected, clinically trained, ethically and culturally sensitized professionals uniquely qualified to play a critical role in a health system that increasingly treats them as the physician’s partner, not underling.

Armin Kasravi PharmD ’03 now works in the pharmacy of USC/Norris Comprehensive Cancer Center.

“There are pharmacists who practice in 100-percent patient-care environments,” says Chen. He ought to know: He’s one of them. A clinical pharmacist formerly based at Cedars-Sinai Medical Center, Chen now sees patients at three USC-affiliated safety-net clinics for indigent and uninsured Angelenos. For many people on maintenance drugs for chronic conditions – such as hypertension, heart failure, high cholesterol, diabetes or asthma – someone like Chen is a logical primary-care provider. He’s got drug therapy training that is the envy of everyone on the medical team. And he’s fully authorized under protocol to examine patients, perform diagnostic tests, order labs, administer drugs and modify therapy as he sees fit.

Yes, you’re thinking, but he probably gets stuck with all the slam-dunk cases.

Wrong.

“In the clinics where I work,” Chen explains, “the doctors refer to me all the patients they would like to know what to do with”: the guy whose blood pressure isn’t responding to meds, the one with high cholesterol who can’t handle statins, the cardio patient who suffers from frequent fluid overload.

“I’m a detective,” Chen says. “I get to figure out why the patient is failing to respond to a drug regimen. The reason I never get bored is because it’s never the same.”

Chen recalls a hypertension patient who, unbeknownst to his doctors, had stopped taking his diuretics. Though he continued to urinate frequently, the patient’s blood pressure spiked. Stumped, the doctor called in Chen, who quickly connected the dots. Having ascertained that the patient had quit his water pills, Chen understood the return of hypertension. As for the frequent urination, it was easily explained by his new diagnosis: the onset of diabetes.

With the increase in health-care complexity have come profound changes in the way pharmacists are trained for the many roles they perform. Much of that is indisputably the legacy of the USC School of Pharmacy, now in the midst of its centennial, which continues a long tradition of leading the way in shaping the future of one of the world’s oldest professions.

Second-year PharmD students Susan Quach and Septima Hong compare notes.

According to the California Board of Pharmacy, Americans go through about 2 billion prescriptions a year – about half of them taken improperly. That misuse costs the economy $15 billion annually; American businesses lose about 20 million workdays from incorrect use of cardiac- and circulatory-disease drugs alone.

An estimated 10 percent of all hospital admissions are due to medication-related problems. And we’re not talking about just the elderly and chronically ill. More than half of all Americans used at least one prescription drug last year; on average, they filled 7.5 prescriptions.

Some of that may be a function of over-medicating. But it also reflects real pharmaceutical advances. According to Chen, in 1989, the year he graduated from USC with his PharmD degree, the medical community frowned on prescribing more than two hypertension drugs to the same patient. Today the standard of care for controlling blood pressure is three or more drugs. “Fifteen years ago we thought you needed three drugs to treat heart failure; today the typical patient receives up to seven or eight meds,” Chen says.

This abundance of new drugs brings never-before imagined complexity to health care. When you factor in the possibility of drug overlap from multiple providers – the family physician, the cardiologist, the gynecologist, the dentist – well, it’s pretty easy to see how the bright promise of sophisticated, individualized drug therapy to treat every conceivable ill comes with some serious risk.

Because of this complexity, the pharmacist is emerging not only as an essential member of the health-care team, but also as the logical gatekeeper for all drug-related patient-care issues. Chen believes we’re just a few years away from carrying magnetized “drug cards” listing all our current and past meds at a swipe. He expects to see a new class of drugs emerge – drugs sold by pharmacists only – to bridge the widening gap between “over-the-counter” remedies and doctors’ prescriptions. In England, he notes, pharmacists are already authorized to sell low-dose statins (cholesterol-reducing agents) directly to patients after a thorough evaluation.

Chen calls pharmacists “the most accessible health-care professionals.” When you think about it, there’s one in every pharmacy: available for consultation without appointment, rain or shine, on the weekend and in the wee hours.

It isn’t only community pharmacists who provide this kind of service. Take USC pharmacologist James David Adams, an expert on native California plants whose current research focuses on new drug design for the treatment of stroke. While hospitals and medical seminars pay handsomely to hear Adams lecture on alternative therapies – a fast growing portion of pharmacy sales – he routinely takes calls from “strangers off the street” at no charge. (LAC+USC Medical Center has a 24-hour helpline staffed by pharmacists that performs a similar free service: call 800-876-4766 or 323-226-7741.)

One such stranger recently drove in from Malibu to see Adams. “She brought me a plate of cookies,” he chuckles – payment the USC scientist gladly accepted. “I think a lot of pharmacy professors do this; it’s a normal function of our job,” he adds.

Post-docs Pedro Inarrea and Qiong Qiong Zhou.

As splendid as that sounds from the consumer’s perspective, it underscores a hurdle that has long held back the natural evolution of the profession. Historically, pharmacists have been paid primarily on the basis of moving product. No matter how much time they spent in patient consultation, their income was pegged to drug sales. A provision in the 2004 Medicare Reform Act is poised to topple this archaic restriction, which makes little sense as public health policy. The new law creates, for the first time, a mechanism whereby health workers – including pharmacists – may receive compensation for “medication therapy management.”

Anticipating the day when pharmacists would move from the supply room to the examining room, pharmacy schools have largely abandoned their trade-school mission. In fact, pharmacy research faculty are almost indistinguishable these days from basic scientists at medical schools and in life-science graduate programs.

At USC, two academic departments – pharmaceutical sciences, and molecular pharmacology and toxicology – house a small army of basic scientists exploring the design, development and delivery of drugs. Researchers like Ian Haworth, an expert in the computer simulation of biomolecular structures. Or Rajindar S. Sohal and Enrique Cadenas, both world authorities on the biochemistry of aging. Or Jean Shih and Kevin Chen, mavericks in the decoding of neurotransmitters (see “MAO’s Revolutionary,” page 27.)

“There isn’t much difference between most of us [in pharmacy] and basic scientists at the Keck School of Medicine or the College of Letters, Arts and Sciences,” says biochemist Sarah Hamm-Alvarez. An expert on the cell biology of the eye, Hamm-Alvarez specializes in “membrane trafficking,” with a particular emphasis on the secretion of tear proteins. What drew her to a pharmacy program, she says, was the desire to see her basic discoveries applied directly to therapeutics. She’s hot on the trail of new drugs to treat Sjörgren’s syndrome, a disease of the lacrimal gland. “I think one thing that distinguishes our faculty as a whole is that we probably know more about drugs than other basic scientists.”

Besides advancing human knowledge, research faculty like Hamm-Alvarez are also preparing hundreds of future pharmacists and scores of master’s and doctoral degree students who feed a growing demand for academics in a plethora of life-science subspecialties.

Meanwhile in the Titus Family Department of Pharmacy, three dozen clinical faculty study the dynamics of the rapidly proliferating arsenal of drugs on the human anatomy. Among them is psychiatric pharmacist Glen Stimmel, a leading expert on anti-depressants and antipsychotic drugs; and pharmacogenomics expert Paul Beringer, an authority on the use of genetic markers to predict a patient’s response to a particular drug.

Two other departments emphasize the increasingly intricate business side of the profession. In 1994, USC’s pharmacy school became the first in the country to offer graduate degrees in pharmacoeconomics. The program prepares pharmaceutical policy specialists now in high demand with drug manufacturers, managed-care organizations, government agencies and academia. The Department of Pharmaceutical Economics and Policy also conducts research on state drug and managed-care policies, FDA policy, patient compliance and the effects of patient consultation.

Pediatric and neonatal pharmacotherapist Irving Steinberg instructs students in a computer lab.

More recently in 2000, USC’s pharmacy school unveiled one of the country’s first regulatory science programs, to address the burgeoning need for experts in navigating the labyrinths of the FDA drug-approval process. Observers say taking a new drug from R&D to retail pharmacy shelves is now a 10-year, $800 million project. An FDA “request for approval” fills hundreds of binders, says neurophysiologist Frances Richmond, a research professor and founding director of the regulatory science program. “You rent a truck or plane to take all that paperwork to Washington,” she says. Not surprising, considering federal regulations now govern every nuance of safety assurance, risk management, standards for labeling, packaging and manufacturing, advertising and distribution.

Some 50 students are currently learning the regulatory ropes at USC in what Richmond unabashedly calls “the best program of its kind in the world.” Most are mid-career professionals, so the course work is structured in non-traditional clusters of evening, weekend and Internet-based sessions, with some cross-over into specialized business and engineering offerings. Students also get real-world practice as interns, including working at USC’s Alfred E. Mann Institute, which specializes in shepherding faculty-developed bioengineering devices and drugs through early-stage FDA approval.

In the fall, the distance-education component went online across the United States and Canada. According to Richmond, new curricula are likely to branch into related areas of food, dietary supplement and environmental regulation.

However, the lion’s share of students still opt for the traditional doctor of pharmacy (PharmD) credential that has been the profession’s gold standard since USC pioneered it in 1950. Right now, there are nearly 800 students in the four-year program, which continues to press the envelope in pharmacy education with a reduced emphasis on classroom learning and intense focus on hands-on pharmacy experiences in remarkably diverse settings.

Pharmacy schools are under pressure to crank out more of everything: more pharmacists, more pharmacological researchers, more drug-expert administrators.

A decade ago, America had 65 pharmacy schools. Today, it’s got about 90, and soon will reach 100, says Gilbert Burckart, chair of the Titus Family Department of Pharmacy.

For half a century there were only two pharmacy schools in California – one at UC San Francisco, the other at USC. The University of the Pacific opened its pharmacy program in 1955. But since 1996, three new programs have popped up in Southern California alone – at UC San Diego, Loma Linda and Western University.

Pharmacy and regulatory science student David Sedrak

Still, USC stands in a class by itself, with the luxury to choose the best candidates to fill each slot. People like David Sedrak, a dual-degree student in the PharmD and regulatory science programs who was admitted in 2002 with a bachelor’s in psychobiology from UCLA.

USC’s acceptance rate for PharmD program applicants is about 1 out of 10. Nearly all already have a bachelor of science degree – in stark contrast with what goes on around the country. At some schools, for example, students with little or no science background can enter the pharmacy program as juniors and graduate in six years.

“I notice a huge difference between those students and USC students,” says Burckart, an expert on drugs used in organ transplantation. Besides the solid science background, there’s two years added maturity, greater professionalism, clearer career goals and a lower drop-out rate. “It’s much easier for USC graduates to step into a professional setting,” he says.

Once considered a big pharmacy school, USC is dwarfed in comparison with giants like the Philadelphia College of Pharmacy, which now enrolls 350 students a year. (USC enrolls around 180.) To keep up with demand, faculty at PCP triple-teach their lecture courses, leaving little time for clinical or small-group mentoring – a trend Burckart deplores.

“We need to get out of the lecture hall and get students into situations where they interact with faculty and volunteer faculty,” he says. “We need more experiential learning and more time in small groups to talk about professional issues.”

Information technology is playing a part in this vision. At the University of Florida, the pharmacy program recently soared to 300 students per class, thanks in part to distance education. USC launched its own distance-ed component last fall, in the master’s of regulatory science program. Burckart hopes to see the trend migrate to the PharmD program.

“I’m in favor of any mechanism that presents an alternative to turning our students into stenographers,” he says.

Students must already possess a solid basic-science foundation before entering USC’s PharmD program – prerequisites include organic chemistry and biochemistry, microbiology and molecular biology, mammalian physiology and physics, calculus and statistics, to name a few. This rigorous science background allows USC’s unconventional curriculum to stress experiential learning from the get-go. “We require a lot,” says Michael Wincor, an associate professor of clinical pharmacy, “so [our students] can get right into the therapeutic arena – such as administering flu shots and finger sticks (for cholesterol profiling) during eight weeks of mostly community and hospital rotations in the first year.”

Pharmacy technicians carry out many of the mechanical tasks once relegated to the pharmacist.

By the second year, student-pharmacists are knee-deep in “therapeutics” modules, another USC innovation. One by one this series of courses thematically presents everything there is to know about 11 clusters of disease states and organ systems. In externships, they’ll learn how to prepare sterile IVs while getting their feet wet in the first of many clinical settings, like a hospital, community pharmacy or HMO.

“Our clinical-from-day-one approach is unique,” says Wincor. So are electives: Unlike the cookie-cutter training found at most pharmacy programs, USC’s curriculum leaves room for students to stake out areas of pharmaceutical specialization. Dozens of electives span everything from managing sleep disorders (Wincor’s own sub-specialty) to homeopathic remedies, the dynamics of substance abuse or psychiatric pharmacy practice. By the fourth year, the program is experiential: Each student rotates through six clerkships at sites across California and beyond, working under some 400 volunteer “preceptors” – veteran pharmacists who agree to coach fourth-year student pharmacists in their workplace.

“Most of the advanced rotations take place in a hospital settings,” says Kathleen Besinque PharmD ’82, MS ’88, an associate professor and director of the school’s experiential programs. “Students might be rounding with medical teams, or managing antibiotic therapy or nutritional support therapy.”

Many of the preceptors – including Besinque’s husband Gary (PharmD ’82), a pharmacist at Kaiser Permanente – are USC alumni. That’s hardly a surprise, given that half of all Southern California pharmacists are Trojans.

All PharmD students will do at least one rotation in medicine, community pharmacy and psychiatry. Fourth-year students can also do two electives in a variety of specialties and patient-care settings. One option is a clerkship at one of the privately funded safety-net clinics that serve some 600,000 low-income and indigent people a year.

Kathleen Johnson, clinical pharmacist

“USC is on the cutting edge of pharmacy education by involving students, residents and faculty in these clinics,” says Kathleen Johnson, an associate professor in both pharmaceutical economics and the Titus Family Department of Pharmacy. “The clinics give our students an opportunity to see a different health-care setting,” adds Johnson, who co-directs USC’s community pharmacy program. “This is not Beverly Hills!”

In addition to the private clinics operating on Skid Row and in South Central and the Crenshaw district, Johnson says a new partnership with Queenscare Foundation will put USC pharmacy students to work next year in nonprofit clinics around Hollywood, Echo Park and central Los Angeles.

People generally assume a hospital pharmacy is that shop near the elevator well-stocked in pain relievers, magazines, flowers and get-well cards.

But at the heart of any medical center lies a hidden world where teams of pharmacists operate an incredible factory of customized care. Hospital pharmacies dole out the daily dosages of pills, capsules, injections and IV fluids administered to every patient in every ward of every hospital in America. They literally keep hundreds of thousands of people alive every day. Think about that a minute, and remember, prescriptions and dosage levels change as the patient’s condition changes. Patients themselves change too, as new ones are admitted, old ones released. Keeping track of who gets how much of what and how often in a facility with many hundreds of beds is a critical health organizational task. Most hospitals also operate satellite pharmacies staffed by drug specialists with expertise in, say, pediatrics or oncology. Satellite pharmacists typically work closely with multidisciplinary teams of attending physicians and surgeons, nurses, physical therapists, psychiatrists and other specialists.

“This is fairly common,” says Besinque, an expert in women’s health, referring to today’s team approach to hospital patient care. She recalls working as a pharmacist in a psychiatric hospital: “Everybody on the team had some input,” she says.

It might surprise “ER” fans to learn that in hospital settings, physicians frequently defer to pharmacists in managing specialized drugs. In cancer wards, for example, oncologists rely heavily on pharmacists to review chemotherapy orders, check patients’ lab chemistry and weigh in on whether it’s safe to proceed with therapy. Increasingly doctors are taking themselves out of the drug decision-making loop, writing on the patient’s chart, for example: “Anti-coagulant per pharmacist.”

The same goes for antibiotics, intravenous feeding, kidney dialysis, immunosupressants and anti-rejection drugs. (Who better than a pharmacist to manage medication for a living organ awaiting transplantation?)

Though patients may not yet realize it, doctors are increasingly aware of their limitations. It used to be that doctors could keep up with new therapies just by reading the major medical journals and attending a few continuing education seminars. That’s not possible anymore.

Fourth-year students like An Khang Tran (left) and Nhi Tran spend the whole year in clinical rotations.

Increasingly, it takes a pharmacist’s know-how to keep up with the furious pace of pharmaceutical innovation while staying on top of all the existing drugs for a condition; to sort through the literature and assess the accuracy of manufactures’ claims; and to choose the best drug for an individual patient.

Most physicians “don’t have the time to evaluate every study published about a given drug relevant to their practice,” says Chen, the patient-care specialist. “It’s going to get worse as more are approved each year and existing drugs receive new indications.”

One concern is that some doctors will choose the drug they’re most comfortable with – the one they’ve used before or trained on. That isn’t necessarily the best drug for a particular patient. The problem is compounded by the industry practice of drug “detailing” (direct marketing to physicians) and direct-to-consumer advertising.

Take the Vioxx recall. Chen says he saw that coming soon after the manufacturer’s principle safety study appeared in 2000. From this data, “it was clear that people on rofecoxib (Vioxx’s generic name) experienced four-fold higher risk of heart attacks than those on naproxen,” he says – a difference that was never satisfactorily explained.

Clear to a pharmacist perhaps, but not so clear to millions of patients who asked for it by name and urged their doctors to prescribe it.

While drug companies are not without financial ties to universities, pharmacy schools are usually careful to erect a thick wall between sponsors and scholars. To avoid brand-preferences, they stick to generic names.

Nor is corporate support allowed to influence scholarly opinion. For example, “our department doesn’t tell me who is sponsoring a lecture,” says Chen, who frequently gives educational talks to groups of physicians and pharmacists. “That helps, because I’m not biased when speaking about a certain product.” The relationship between physicians and pharmacists is increasingly one of collaboration. “We’re providing value-added services. We’re helping [doctors] treat patients more effectively and reach treatment goals,” says Chen.

He offers this analogy from aviation: If you think of patient care as commercial air travel, the doctor would be the pilot and the pharmacist, the navigator. To fly without one of each in the cockpit seems foolhardy.

“Gentlemen, did you ever wonder about the minority of your profession, the female five percent of pharmacy?” asked Janice Kennedy Weller ’49 in a 1955 article for the school’s alumni newsletter, Pharm-SC. It was the 50th anniversary edition, an occasion to sit back and take stock.

To its credit, USC’s pharmacy program had enrolled two women in 1905, its inaugural year; and female faces are sprinkled throughout the school’s early faculty photos. Still, real change didn’t come until the 1970s, when women’s enrollment suddenly vaulted to 35 percent, and biochemist Jean Shih joined the faculty as pharmacy’s first female tenure-track hire.

USC pharmacy’s headquarters since 1974.

Today, women are no longer the exception; they’re the base. Seventy-five percent of Trojan pharmacy students are female. Their complexion has also changed: nearly two-thirds of USC’s newly minted PharmDs are Asian; fewer than a quarter are white.

Some in the profession attribute the steep rise in women pharmacists to improved work conditions. Writing in 1955, the late USC pharmacy dean Alvah Hall described a profession that had radically changed in his own lifetime: “Forty years ago the pharmacist worked an average of 60 hours a week for about $40. Sundays and holidays were the same as any work day.... He was the man versed in the use of the many crude drugs and chemicals used therapeutically.... Quinine, citrate of magnesia, cascara and mineral oil were popular drugs used then.”

While most PharmD graduates (about 70 percent) still wear a lab coat in a Rite Aid or Sav-On, the work they do and the skills they need to do it have undergone profound transformation. Jobs are abundant. Pay is excellent, starting around $90,000; the work, important and stimulating. The workplace is comfortable; the hours, flexible – making it highly compatible with raising a family.

Indeed, community pharmacy has never been more appealing, according to third-year student David Sedrak, who is president of the USC chapter of the powerful National Community Pharmacy Association. Sedrak has developed a seminar series on starting up and running one’s own pharmacy. The program brings independent pharmacy owners to campus to discuss the unique patient-care opportunities they enjoy.

USC’s pharmacy school has been on the front line of educational reform for most of its 100-year history. And plenty of reform was needed.

When the school opened in 1905, the admission requirement was a middle-school education and 16 candles on your birthday cake. Here as elsewhere, a pharmacy degree was conferred after two years of coursework and four years of practical experience. It served commonly as a springboard for later studies in medicine.

Entrance requirements at USC steadily increased, so that by 1923 one needed a high school diploma; in 1950, USC introduced the nation’s first two-four curriculum, requiring two years of pre-pharmacy college-level education before embarking on the four-year PharmD degree.

By then, it was becoming clear that the health professions were sailing into a hurricane. The post-war period had brought a breathtaking array of new drugs, from antibiotics and anticoagulants to polio and smallpox vaccines. Pharmacy education would have to retool.

No one saw that more clearly than former dean John Biles. Under orders from USC President Norman Topping to re-evaluate the goals of pharmacy education, Biles came to the conclusion in 1967 that the pharmacist-as-small-businessman would have to give way to the drug-specialist-as-patient-care provider.

Biles, now an emeritus professor, remembers calling one of his former students out of the blue in the early 1970s and asking what he had done that day.

“I filled 63 prescriptions,” the man had replied.

Biles was outraged. With machines to do the compounding once done by hand, and drugstore assistants to do the dispensing and sales-clerking, he believed pharmacists should concentrate on the services that they and, increasingly, they alone could provide: assessing drug needs, answering drug-related questions, describing side effects and, when necessary, waving a red flag.

“No longer should the pharmacist as a practitioner emphasize mechanical skills,” Biles told reporters in Washington, when it had become clear that drug companies were appropriating that role on a mass scale. “The filling of prescriptions should be delegated to auxiliary personnel. Functioning as a drug specialist, the pharmacist should relieve the physician and nurse of their duties regarding drug therapy.”

A leading member of a national commission studying the future of pharmacy, Biles was in the spotlight in the early 1970s. Under his leadership, USC became the first pharmacy school in the nation to require clinical rotations through general medicine, neurology and neurosurgery, pediatrics, human behavior and drug abuse, obstetrics and gynecology, dermatology and surgery. The changeover had the full support of USC’s medical faculty.

Vestiges of pharmacy’s trade-school roots remain: A bachelor’s degree is still not required for admission into American PharmD programs. Professional groups are pushing to close this loophole. At USC, the issue is almost moot: 97 percent of last year’s entering class were college graduates.

And still the search for pharmacy’s proper identity goes on.

Pharmacy education should be continually modified, Biles had written in the mid-1970s, until “practitioners can participate as full-fledged members of the health team in the delivery of optimum health care services.”

Pharmacy dean Timothy M. Chan

Though most of the names and faces have changed since then, the philosophy still rings true. For the past 10 years dean Timothy Chan, founding chair of the molecular pharmacology and toxicology department, has scanned the horizon for the next big thing.

On his watch, which ends in June when he returns to teaching and research, Chan has seen the school achieve top-10 status as measured by NIH grants among pharmacy schools; seen faculty research grants double; seen philanthropy more than triple.

On his watch, the school has moved ahead with new programs, such as the interdisciplinary master’s in regulatory science and the world’s first dual PharmD-JD degree. It established the Laboratory for Analytical Research and Services in Complementary Therapeutics, the first venture of its kind at any pharmacy school in the nation; and the Proteomic Core Facility, a high-tech laboratory supporting protein identification for faculty research.

And more changes are afoot, as the school eyes a curriculum overhaul to, as Chan puts it, “pioneer the transformation of the pharmacist’s role from a traditional product orientation to a pharmaceutical patient care perspective.

In his commencement remarks to the pharmacy graduates of 2001, USC dean emeritus John Biles offered the following prophesy: “The practice and delivery of medical care will radically change in the future,” he said. “And you must change also to benefit mankind and your patients.”

Biles was referring to the “paradigm shift” represented in the historic completion of the sequencing and analysis of the entire human genome earlier in the year.

“With training, you will become a clinical pharmacogenomicists – a specialty which will begin to flourish in five years,” he told the students. “You will have the ability to identify and characterize a candidate’s genes, correlate clinical outcomes and drug effects, and develop and utilize genetics test for prediction of drug response, drug selection and dosing based on genotype and gene expression.”

Today pharmacogenomics is indeed a required course for all second-year students in the PharmD program – another USC first. The textbook they use, just published last fall, has a chapter by Burckart.

Biles continued: “Cures for cancer that are free from side effects, predictive diagnosis and prevention of other diseases, … individualized treatment of depression and the elimination of fatal genetic diseases will be discovered. These prizes are so big that the delivery of medical care will be revolutionized.”

Again.