PHR 522: Advance Pharmacy Practice Experiences (APPE)

North South University

Department of Pharmaceutical Sciences

INTERNSHIP MANUAL
FOR
BPHARM PROFESSIONAL

Version-1
Updated July, 2020

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 UNDERTAKING

I, S/o ,

I.D. No. is an Intern Pharmacist of Department of

Pharmaceutical Sciences, North South University undertake that, I abide by all the
Rules and Instructions mentioned in this internship manual as written and framed
by Department of Pharmaceuticals Sciences, NSU as amended from time to time.
I shall be responsible for any actions from the authorities, if I fail to oblige
the mentioned rules and instructions in this internship manual.

Date: SIGNATURE OF THE INTERN

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 Introduction

This Internship Manual of the Department of Pharmaceutical Sciences, North South University
(NSU) has been designed to educate and train the students in the detection and management of drug-
related problems and to assist the students in applying the acquired knowledge in the promotion
of rational drug therapy. The internship is prepared to provide academically supervised clinical
experiences which will give the interns a better knowledge of the most current and appropriate
methods of collecting and applying clinical information concerning the therapeutic and toxic effects
of drugs. The clinical practice experience for both NSU Model Pharmacy and Hospital Pharmacy in
different learning experience than dictated courses. There will be numerous opportunities to gain an
appreciation and understanding of the concept of pharmaceutical care as well as share in the
ultimate responsibility for patient care outcomes. The department of Pharmaceuticals Sciences at NSU
provides an experiential learning environment which will assist our interns to become confident,
caring and ethical pharmacy practitioners with the ability to think critically and apply their
knowledge and skills in the best interest of their patients, regarding individualized
pharmacotherapy planning, intervention and outcome evaluation. The clinical experiences
imparted on interns by well qualified and experienced preceptors will help them to enter their
choice of clinical specialty, to continue successfully in their lifelong learning and practice and to
meet their responsibilities as a health care practitioner to patients and the society.

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 Objective of Internship

1. To provide patient care in cooperation with patients, prescribers, and other members of an
interprofessional health care team based upon sound therapeutic principles and evidence-
based data, taking into account relevant legal, ethical, social cultural, economic, and
professional issues, emerging technologies, and evolving biomedical, pharmaceutical,
social or behavioral or administrative, and clinical sciences that may impact therapeutic
outcomes.
2. To manage and use resources of the health care system, in cooperation with patients,
prescribers, other health care providers, and administrative and supportive personnel, to
promote health; to provide, assess, and coordinate safe, accurate, and time-sensitive
medication distribution; and to improve therapeutic outcomes of medication use.
3. To promote health improvement, wellness, and disease prevention in co-operation with
patients, communities, at-risk population, and other members of an interprofessional team
of health care providers.
4. To demonstrate skills in monitoring of the National Health Programmes and schemes,
oriented to provide preventive and promotive health care services to the community.
5. To develop leadership qualities to function effectively as a member of the health care team
organized to deliver the health and family welfare services in existing socio-economic,
political and cultural environment.
6. To communicate effectively with patients and the community.

Intern’s Daily Activities

Each intern will be assigned a preceptor and thus to a specific medical team and he is
expected to become an active member within the team. During the student interns are
required to actively participate in patient care as outlined below:
 Internship in NSU model Pharmacy:
I. Maintain NSU Model Pharmacy activity's log book for enter and exit in
Pharmacy daily
II. Temperature and humidity monitoring (room& refrigerator)
III. Costly and high alert item count (insulin, vaccine, ketamine etc.)
IV. Supervise the cleanliness of pharmacy
V. Manual sorting of antibiotic prescription
VI. Raise product requisition
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 VII. GRN if deemed appropriate by the Pharmacist.
VIII. Bill settlement if deemed appropriate by the Pharmacist.
IX. Dispensing medication according to prescription
X. Counseling patient if deemed appropriate by the Pharmacist.
XI. Inventory management (monthly)
XII. Documentation (daily sale update, and purchase details of different companies)
XIII. Expired product return to supplier or destroy

 Internship in Hospital
 OPD (Out Patient Department)
I. Raise product requisition
II. GRN
III. Bill settlement
IV. Inventory counts monthly
V. Expired product return to supplier or destroy
VI. Narcotic product purchase
VII. New product launch
VIII. Drug recall
 Inpatient Pharmacy
I. Temperature & humidity monitoring (refrigerator& room)
II. Unit dose dispensing
III. Narcotic drug dispensing
IV. Inventory management
V. Documentation
 Clinical
 Ward Pharmacy
I. Prescription review & indenting
II. High alert drug monitoring
III. Restricted drug monitoring
IV. Patient counseling
V. ADR reporting to Quality dept.
 Oncology Pharmacy
I. Prescription review
II. Chemo drug admixing
III. Patient counseling
 Clinical Pharmacologist
I. Training to staff of medical service
II. New Drug monitoring
III. ADR reporting to DGDA
IV. Preparing Drug guideline
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Responsibilities of the Supervisor
1. At the beginning of the rotation, the rotation topics should be reviewed shortly with
the students, introduce the students to the hospital preceptor and NSU Model
pharmacy with students about expectations and standards of evaluation.
2. Familiarize precisely with the internship manual’s contents, rules and
instructions about rotations and student's evaluation.
3. Determine student’s competency based on his/her work profile and through
discussions and experience with the preceptor and students.
4. Communicate effectively with the students, hospital preceptor and with the
department of pharmacy both written and verbally in a regular basis.
5. Strive to encourage the student’s interests in all hospital aspects particularly clinical
participation.
6. Respect confidentiality of student’s academic records.
7. Respect the dignity of each student individually and all students collectively in all
academic contexts.
8. Should review the progress of the students with the hospital preceptor in a timely
manner and share the results with the students.
9. Follow up the progress of the students with the hospital preceptor and internship
year supervisor.
10. Be available at reasonable times for teaching and evaluation of the students.
Responsibilities of the Hospital Preceptor
1. At the beginning of the rotation, communicate with students about expectations of
internship and standards of evaluation. (discuss about the medications available in
the hospital and Pharmacotherapeutic approach for such rotation).
2. Orient the students about the laws and regulations of the Hospital and Discipline
and Ethics of the professional practice.
3. Delegate to students, his/her defined duties, with appropriate supervision and
direction, but never use students as substitution for regular staff.
4. Familiarize precisely with the internship manual’s contents, rules and instructions
about rotations and student evaluations.
5. Encourage the students to read, search, and communicates with others in all hospital

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 aspects and clinical training.
6. Maintain proper attendance of students to make it sure that students observe
punctuality of time (daily attendance, medical team rounds, OPD, and any other
clinical activities).
7. Determine student’s competency based on his/her daily log profile and through a
frequent discussion with students and help their concerns.
8. Respect confidentiality of student’s internship information.
9. Be available at reasonable times for teaching and evaluation of the students.
10. Communicate with the rotation supervisor or internship supervisor directly or
through the coordinators for the progress of student’s internship or any
circumstances.

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Course Description

The APE intern experience is made up of mandatory 16 weeks of training, in which 8 weeks
of the internship at NSU Model Pharmacy and 8 weeks are Hospital Pharmacy. The first day
of each internship will be used to provide orientation and details about the contents with the
students, supervisors and preceptors. The last day of the internship will be used for written
examination and evaluation by the student.
The interns should behave and think like a pharmacist during all the rotation and utilizing
his/her pharmaceutical and clinical knowledge and sense in all internship regarding

1. Pharmaceutics
2. Clinical pharmacology and toxicology
3. Principles of pharmacy profession
4. Medicinal chemistry
5. Pharmaceutical calculation
6. Principles of pharmacogenetics
7. Medical statistics and epidemiology
8. Pharmaceutical care
9. Pharmacy Management
10. Pharmacoeconomics
11. Evidence-Based Pharmacy

The intern is required to know differential diagnosis related to diseases, though is

advantageous. However, focus on pharmaceutical sciences is encouraged and essential.
RULES AND REGULATIONS FOR INTERNSHIP
Introduction:
Internship is defined as the clinical and hospital training of pharmacy students following
successful passing of the college graduation requirements. This period is a component of the
study of pharmacy and last for fifty 24 weeks, excluding holidays and vacations. Interns are not
considered eligible for the practice of pharmacy unless they successfully pass the internship
training in affiliated or approved teaching hospitals.

Educational Goals:
1. Application of knowledge and fine-tuning of skills during clinical training.
2. Training on independency in decision taking and decent conduct.
3. Application of pharmacy ethics with strong and special adherence to Doctor’s Code of
Conduct in all aspects of practice.
4. To educate the trainee to get used to team work in the field of pharmaceutical sciences, to
make him/her aware of capabilities and limitations and to train him/her to consult with
seniors and experienced colleagues.
5. To develop in the intern, the eagerness to follow up newly emerging issues in the field of
pharmaceutical sciences and to develop skills in reading, searching information in books,
references, periodicals and electronic databases.
6. To develop the intern’s communication skills with his/her colleagues, the pharmacy and
medical team, the patients and their relatives.
 Internship Duration:
The internship is a mandatory 16 weeks period divided into Hospital Pharmacy and
NSU Model pharmacy rotations as follows:
NSU Model Pharmacy Rotations Duration
(8 weeks)
Module-1: Initial Review of Prescription 2 Weeks 
Prescription review differentiate between OTC and prescription drug
and dispensing Ensure 5 drug characteristics (right drug, dose, dosage form,
therapeutic indication, route)
Monitor Therapeutic duplication
Monitor Drug-drug interaction
Monitor Drug-food interaction
Ensure 5 rights (medicine, dose, quantity, container, instruction)
when dispensing
Double check of high alert medication before dispensing
Module-2: The entire information of medicine (name, use, how to take,  
Patient Counselling duration and expected time of improvement, advice to complete the 1 Week 
and Drug information treatment, advice to follow up)
Specific indication for antibiotics and sedative drugs
Counselling about drug-drug interaction and drug-food interaction
Counselling regarding overdose, side effects and adverse drug
reaction
Providing proper information about storage and caution of drug use
Module-3: Checking blood pressure  
Customer service and Glucose test 1 Week 
dealing Good response to the customer over phone
Meet up the demand of customer
Providing necessary information if customers want
Delivery of medicine in necessary condition
Module-4: Product Short list 2 Weeks 
Drug procurement and Raising requisition in pharmaceutical company
inventory management Receiving drugs from companies
GRN
Bill settlement
Costly and high-risk medicine count
Storing and labelling according to drug category
Inventory count (monthly with expiry)
Disposal of damaged and expiry product or return to
pharmaceutical company & Maintain FIFO/FEFO rules
Monitoring temperature and humidity of room and refrigerator
Module-5: Record of purchase orders (date, company, PO number, received 2 Weeks
Financial /Office date)  
Documentation Record of daily sale
Monthly financial report of purchased medicines
Records of antibiotics daily sold (if there is no prescription)

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Start of the Training:
Intern students are allowed to start training after completion of 130 credit. He/she can then
start internship following the coordination with the Chairman of Interns’ Committee or the
Dean for Academic Affairs.

Changes are not allowed following the distribution of the timetable: only strictly in the
situation where there is a replacement and agreement of departments concerned.

Delay in Starting of the Training:

1. The intern students will not be allowed to start training after 6 months from date
his/her graduation requirements were fulfilled.
2. If the duration of delay exceeded 6 months and no longer than one year, he/she shall
be re-examined in all the mandatory internships. If fails, he/she shall be re-examined
after a month, and during that period he/she is advised to come to the hospital on
regular basis to prepare for the second examination, and will not allowed to start
internship before passing the examination.
3. If the duration of his/her delay is more than one year, he/she shall be re-examined in
both mandatory and elective internship. If fails, he/she shall be re-examined one
month late and be advised to come to hospital on regular basis to prepare for the
second examination, and will not allowed starting before passing the examination.

Halting of Training:
1. If, for acceptable reasons, the training is halted for a period no longer than 6
months, he/she shall continue training and the duration of halt shall be rewarded at
the end of the internship period.
2. If, for acceptable reasons, the period of halt exceeded 6 months, but less than one
year, he/she shall repeat the core internship.
3. If the period exceeds one year, he/she shall repeat the whole internship period.
4. In case he/she fails, he/she shall be re-examined in internship. If fails, he/she shall be
re- examined one month later and be advised to come to Model pharmacy/hospital
on regular basis to prepare for the second examination, and will not allowed starting
internship before passing the examination.

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Training Hospitals:
Training of interns is undertaken in affiliated teaching hospitals or in any other hospitals
recognized by the College for training interns.

To ensure adequate training, the ratio of the interns to bed should be 1: 10.

Evaluation Protocols:
1. The intern is evaluated on the basis of his/her punctuality, professional
capabilities, scientific knowledge and his/her relations with patients, students,
colleagues, seniors and the nursing staff.
2. Every internship is of 100 marks in total, in which 50 marks will be based on
hospital and 50 marks will be based on NSU Model Pharmacy.
3. Interpretation of the scores is as per the NSU grading rules:

Disciplinary Actions:
1. Short-comings of an intern in relation to his duties and professionalism shall be

Numerical scores Letter grades Grade points

93 and above A Excellent 4.0
90 to below 93 A– 3.7
87 to below 90 B+ 3.3
83 to below 87 B Good 3.0
80 to below 83 B– 2.7
77 to below 80 C+ 2.3
73 to below 77 C Average 2.0
70 to below 73 C– 1.7
67 to below 70 D+ 1.3
60 to below 67 D Poor 1.0
Below 60 F 0.0

forwarded to the Intern’s Committee with the appropriate recommendations as

perceived by the department. This could either be a written warning, repetition of the
whole or part of the internship.
2. If an intern commits misbehavior in attitude or ethics thus disgracing the
Pharmacist's code of conduct or Islamic regulations, the College Deanship may take
any disciplinary actions as per University regulations.

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Final reports submission and examination
The internship is required to submit training report both NSU model Pharmacy and Hospital
Pharmacy to the Department of Pharmaceuticals sciences at the end of each internship. The
date of the examination shall be arranged and amended by the coordinator for the
best feasible timing.

Final evaluation
To pass-in the internship, an intern should pass each step of the evaluation
separately, including: daily activities, examination and reports. If an intern fails in
any step of the evaluation, he/she will fail in the internship and should repeat the
internship in full. The evaluation shall also consider seriously the professionalism and
code of ethics, and the preceptor/supervisor has the right to fail the intern upon breaking
any one of these codes.

Intern has the right to appeal to the school's discipline committee to review and sort out
any potential conflict and the discipline committee's decision shall be judgmental
and final.

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 INTERNSHIP EVALUATION FORM

Internship: ……………………… Training period: …………………………………

Student's Name...…………………………….…….. . ID: …………………………….
Using the 5-point scale below, please evaluate student's performance
1 0= very poor 20 = poor 30 = fair 40 = good 50 = excellent

Characters Score/50 Comments

Attendance
Professional appearance
Attitudes
Quality of work
Organization and time management

Written communication
Oral communication

Dependability
Punctuality
Initiative, motivation, self-starter
Interviewing and counseling
Patients
Arrange writing for discharge
medications (or Participate)

Care plan
Any additional activity assigned by
the preceptor
Examination by NSU Intern Score/50
committee
Total score out of 100: (Total Score
represent the final
grade)

Name & signature of the supervisor: date:

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