APPE in Mexico Fosters Personal and Professional Growth

Published on 11 May 2018

Each year at St. Louis College of Pharmacy, advanced pharmacy practice experiences (APPEs) give students hands-on learning opportunities in a variety of practice settings locally and around the world. During their final (P4) year of professional study, students complete eight, five-week rotations that immerse them in their roles as pharmacists.

This winter, APPEs took P4 students Paul Bossung and Dane Fickes to Monterrey, Nuevo Leon, Mexico. During their rotation, the students lived and worked in Monterrey while shadowing local pharmacists and students. The experience gave Bossung and Fickes the opportunity to develop professionally and personally and expanded their worldview as they learned about the differences between the health care systems in the United States and Mexico.

During their time in Monterrey, Bossung and Fickes worked in both private and public hospitals, and they witnessed stark contrasts in levels of resources and care available to different patient populations.

“It’s amazing being able to help someone from a different country,” said Bossung. “You see a different side of health care and get to see first-hand the differences in treatment between public and private facilities with varying degrees of resources. These experiences made me appreciate my experiences in other U.S. hospitals even more.”

The rotation offered the opportunity to treat diverse patient populations, helping Bossung and Fickes become more aware of how they view patients in their role as a heath care providers.

“Having an understanding of the perceptions of health care in other cultures is critical,” said Fickes. “As pharmacists, we need to treat patients individually based on their culture and understand when we counsel and educate them on medications.”

While learning to embrace a new culture and the diverse populations within it, Bossung and Fickes also learned more about the role of the pharmacist in Mexico.

“Pharmacy is different in every part of the world,” said Fickes “Most importantly, every culture views health care and medicine in a different light. The Mexican people are very open to homeopathic medicine and very resistant to modern medicine. Many patients refused narcotic pain pills solely because they had seen the harm the medications had on others.”

For both Bossung and Fickes, the rotation didn’t come without its share of challenges.

Bossung reminisced about the difficulty of figuring out a prescription that was not only written in a doctor’s shorthand but also in Spanish.

“You have to accept that you’re going to have uncomfortable situations when you go on an international rotation and push through,” said Bossung.

Through it all, Bossung and Fickes were immersed in the culture of Monterrey and discovered what life is like in Mexico. The opportunity helped strip away stereotypes and expand their perspectives on diversity.

“Working with people of different cultures and worldviews gives me a greater respect for those individuals and a greater understanding of the basis of their beliefs,” said Fickes.

“The people in Monterrey were unbelievably friendly,” said Bossung. “It wasn’t just the pharmacists and students we met. It was the patients and people we met. Interacting with the residents there and learning about their culture was my favorite part of the experience.”

International experiences like those Fickes and Bossung gained in Mexico prepare students to serve diverse patient populations and see health care through a global lens. During the 2017-18 academic year, 62 students participated in international service and learning programs and projects.

To learn more about international opportunities at St. Louis College of Pharmacy, visit

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