Emma Foreman: My Working Life as a a Consultant Oncology Pharmacist

 

What did you want to be when you were at school/growing up? 

A librarian!! I loved the idea of arranging books into categories and alphabetical order and stamping them out for people to borrow – I was already showing pharmacist tendencies, I just didn’t know it then. 

 

Why did you change your mind?

We had a chapter in my GCSE chemistry book called ‘Chemicals in the medicine cabinet’, which was all about drug design and pharmacology and I found it really interesting.

A school trip to Glaxo Wellcome, where a pharmacist spoke to us about how salbutamol was based on the adrenaline molecule, finished the job.

 

Can you describe your work in 1 sentence?

Helping cancer patients get the most from their medicines.

 

What qualities do you think you need to do your job well?

Compassion, communication, clinical knowledge, quick thinking, judgement, prioritisation, attention to detail and the ability to stay calm when things don’t go to plan.

 

How has your career diverged from the traditional community or hospital pharmacy route?

I chose the hospital pharmacy route, but have always looked for interesting opportunities along the way. – I did a Voluntary Service Overseas (VSO) placement in Ghana early in my career which sparked a passion for global health, and I am currently trying to combine the two in work with the Commonwealth Pharmacy Association and collaborations with international oncology pharmacy groups. I have also worked in a travel clinic, and the Camp Bestival medical tent – pharmacy is never boring!

 

What are the main 3 factors that make you frustrated at work?

When bureaucracy gets in the way of innovation, or people aren’t willing to try new things. I also get frustrated with the lack of investment in pharmacy services – as a profession we have so much to offer, but are often limited in our capacity through a lack of staffing or facilities.

 

Would you recommend your career to a young person? 

Yes, a career in pharmacy can take you in so many directions. I enjoy the constant innovation of new medicines and the multidisciplinary nature of the work we do. I enjoy working with patients, and get great satisfaction when I feel I have managed to help someone.

I love that you can get involved with clinical work, research, drug development, teaching, global health, genomics – wherever medicines are involved there will always be an opportunity for a pharmacist! I am always learning and my role is constantly evolving.

 

What have been your biggest career disappointments?

Back in the 90s I was a resident pharmacist at Northwick Park Hospital in London and applied for a C grade post (equivalent to a band 7 now) in the production team and I didn’t get it. I was so upset, but that disappointment spurred me on to apply for VSO and that was a life-changing experience.

Later, when I was Lead Cancer Pharmacist at the Royal Sussex Hospital, I nominated myself for a position on the British Oncology Pharmacy Association (BOPA) executive committee and didn’t get that. Again, I was really disappointed, but I got more involved in BOPA activities and the next year I was appointed.

Recently I applied for a global health doctoral fellowship. I didn’t get that either, but I sought feedback from the panel and am working on improving my proposal to apply for the next cohort. No-one’s career path is a straight line – you never know what is around the corner!

 

What was your best career move?

Doing VSO – it has completely changed my perspective on healthcare (and life!). Living and working in a resource-limited setting teaches you to be resourceful and creative with what you have. I also loved the Ghanaian culture and lifestyle, which is very friendly, relaxed and welcoming – qualities which are really important when you work in a busy stressful environment.

 

What 3 factors make you skip into work? 

My favourite part of the week is our Friday morning consultant-led renal and melanoma clinic attended by the full multidisciplinary team of doctors, research nurses, clinical nurse specialists and me.

I see on-treatment patients to assess any symptoms or side effects, review their supportive medicines and prescribe and adjust their cancer treatments. I enjoy having the support of the whole team when I come across something I am unfamiliar with, and I also enjoy being the person that the team comes to with medicines-related queries. It’s a real team effort and I think the patients really benefit from the multidisciplinary approach. 

 

What’s the best advice you’ve ever got from a patient or work colleague ?

One of the most useful pieces of advice I ever had was to apply “The Sun headline test” when weighing up an ethical dilemma. You imagine The Sun (or other tabloid newspaper) headline for each potential course of action and pick the one that is the least eyebrow raising.

Working with cancer patients also reminds me to always “seize the day” and enjoy my work while still maintaining a home-life balance.

 

If you could go back in time and give one piece of career advice to your younger self, what would it be?

You are going to achieve more that you can even imagine, don’t be afraid to push yourself forwards, you are better than you think you are!

 

If there was one thing you could change about your role or the physical or policy environment you work in, what would it be and why?

I would love for there to be enough staff so that more pharmacists in my team could get out into clinics and enjoy working in a multidisciplinary, patient-facing environment. Too many are stuck behind computers most of the day.

Recruitment and retention can be difficult when everyone is working above their capacity – I think it is really important that people get the chance to develop, extend their roles and use their creativity.

 

What do you hope will be your legacy to your profession and colleagues?

I hope that I have inspired some students and junior pharmacists to choose oncology as a specialty, and that I have gone some way to demonstrate the value of consultant pharmacist roles in oncology and to support and raise the profile of oncology pharmacy worldwide.

 

If you could be health secretary for the day what would you do?

Ringfence some funding for the development of pharmacy services within the NHS – we have so much potential within the workforce, if we only had the time and resources to deliver it.

 

What advance in medical/pharmaceutical technology would have the greatest impact in your field?

The development of new cell therapies and immunotherapies has revolutionised the treatment of certain cancers, and use of genomics and biomarkers to identify patients who will respond to particular treatments is going to make a big difference to some patient groups.

Sadly, however, little progress has been made on treatment for some tumour types. It is really important that we invest in research and innovation to develop and optimise treatments for patients with these cancers. 

 

What do you do to relax/de-stress?

I love canoeing and kayaking. You don’t have any time to worry about work when you are throwing yourself down some rapids in a tiny plastic boat! I also like lazy river trips with the family and a picnic when I’m feeling less adventurous.

I am learning to play the bass guitar. I go to mini-trampoline Bounce classes and I like hula hooping. As I live by the sea, a run or walk along the seafront is a wonderful thing when you need to clear your mind!

 

Who has been your biggest inspiration?

I have been very lucky to have worked with some good chief pharmacists who have encouraged and/or pushed me to achieve more – I’m going to name check John Quinn, now chief operating officer at Great Ormond Street in London, and Jatinder Harchowal MBE at the Royal Marsden here.

John really challenged me to become a leader in my field, and Jat has always known what to say to keep me motivated and focussed even when things have been difficult. 

 

What is your guiltiest pleasure?

I like to think that I am quite cool when it comes to music – I like indie and alternative music, a bit of goth and post punk – but give me a cheesy 80s or 90s disco and I will be right there on the dancefloor busting some moves! Anyone who has been to the BOPA conference in recent years will have seen this in action…

 

Your most treasured possession and why?

I have a 14ft pink canoe! I love it because I have lots of fun memories of canoeing with friends and family, and I can jump in it and go canoeing off up the river whenever I want to de-stress.

It’s also a bit old and battered (like me), but it’s actually really nice to paddle – nicer than a lot of the new ones!

 

Biography:

Emma graduated from Aston University with a BSc(Hons) in Pharmacy in 1995 and completed her pre-registration training at Northwick Park Hospital, registering as a pharmacist in 1996. She began her career as a rotational pharmacist at the Queen Elizabeth Hospital in Birmingham, the first of many hospital pharmacy roles. In her career, she has worked everywhere from a small mission hospital in Ghana to a large London teaching hospital. 

She qualified as an independent prescriber in 2010 and completed an MSc in clinical oncology at Birmingham University in 2011 and currently works as a consultant pharmacist at The Royal Marsden in London. She is vice chair of the British Oncology Pharmacy Association (BOPA), having just finished a four-year stint as chair/co-chair, and a founder member of the UK and Ireland Global Cancer Research Network.