When Joshua Lenchus, DO, RPh, FACP, FHM, discussed his love for chemistry with his high school guidance counselors, they told him it could take him in one of two directions: teaching or a career in pharmacy.
Intrigued by the latter option, he decided to become a volunteer in the pharmacy department at a local hospital. Soon after, he became a full-time pharmacy technician and eventually enrolled in pharmacy school at the University of Florida.
“I always knew I wanted to be a physician, and everybody needs a bachelor’s degree in something,” Dr. Lenchus says. “I thought, ‘What better way to do it than to get a bachelor’s degree in pharmacy and then move into medicine?’ ”
After college, he worked as a retail pharmacist, then moved to the institutional setting, creating the position of clinical pharmacist at Wellington (Fla.) Regional Medical Center. Three years later, he entered medical school and ultimately pursued a career as an academic hospitalist.
Dr. Lenchus now serves as associate professor of clinical medicine at the University of Miami’s (UM) Miller School of Medicine, associate program director of Jackson Memorial Hospital’s (JMH) internal medicine residency training program, and associate director of the UM-JMH Center for Patient Safety, which trains about 1,000 medical students, residents, and interns each year.
“Pharmacy has provided an invaluable background for becoming a physician,” says Dr. Lenchus, who was appointed a member of Team Hospitalist in May. “Many physicians order a medication and have no idea what the other half of the equation entails. My experience gave me a solid footing from which I could springboard.”
Q: You spend considerable time mentoring the next generation of physicians. What’s the best advice you can give them?
A: Physicians have these altruistic notions about wanting to help people, but you really have to do what you love. There’s another hospital a mile and a half away from my house, whereas Jackson is 35 miles away and it takes me an hour in transit time each way. But I couldn’t do what I’m doing now at any other facility. I stay because I love what I’m doing.
Q: Why is the UM-JMH Center for Patient Safety so beneficial?
A: The greatest benefit is the ability to be exposed to and tackle real-life scenarios in a risk-free environment. We use life-size mannequins to re-create scenarios that medical personnel will see during their training. We try to re-create the chaos that will ensue.
Q: So it’s similar to a pilot using a flight simulator.
A: Exactly. When a plane crashes and the NTSB goes to see what happened, they perform what we in medicine call a root-cause analysis. They’re not blaming an individual; they want to see what they can change on a system level to prevent an error like that from happening again. We culminate our training with a debriefing that we approach the same way, so nobody walks away thinking they failed.
Q: How effective can simulation-based education be?
A: There will be some limitations because the technology simply cannot account for every aspect of a human. But there’s a wealth of data that supports this as a pretty good surrogate. The technology provides for an incredible amount of experience and exposure without any potential harm to a patient, and it provides [trainees] an opportunity to do things they otherwise would have to wait to do until a clinical scenario demanded it.