Stepping away from didactic learning into real-world experience is an essential part of a future pharmacist’s education. Starting in the spring of their third year, and continuing through their fourth and final year, Doctor of Pharmacy (PharmD) students at the University of Tennessee Health Science Center College of Pharmacy begin their Advanced Pharmacy Practice Experiences (APPE). These hands-on rotations, constituting nearly 30% of their curriculum, place students in top health care facilities across Tennessee, where they collaborate with seasoned pharmacist preceptors in hospitals and community pharmacies. This pivotal phase not only bridges academic learning with practical application but also shapes future pharmacists as they learn to improve patient care across the country.
Imagine, however, expanding your pharmacy knowledge beyond borders, delving into global health care practices, understanding a mosaic of patient needs, and transforming your approach to care. The college’s International APPE program opens this world to select students, offering opportunities to complete clinical rotations in international settings and serve culturally varied populations.
Research published in the American Journal of Pharmacy Education indicates that participants in international APPEs demonstrate notable improvements in global health skills, including cultural awareness, communication, problem-solving, and adaptability. As shown by PharmD students at UT Health Science Center who have participated in the International APPE program, these experiences are truly transformative, allowing them not only to explore new cultures and countries but also to deepen their understanding of patient care.
Global Perspectives on Pharmacy Practice: Cultural Insights and Traditional Medicines
Kimberly Kinget, PharmD ’25, a first-generation Thai American, decided to visit her ancestral homeland for her international APPE, gaining valuable insight into how culture impacts patient care. “I am a more effective pharmacist because of my experience in Thailand,” she says. “By experiencing pharmacy practice in a different context than what I learned in America, it broadened my perspective on socioeconomic factors, therapeutic outcomes, and naturopathic methods that are often overlooked in the U.S. health care system.” This immersive journey not only enriched Dr. Kinget’s understanding of global health but also made her more empathetic and insightful with every patient she encounters, recognizing that their backgrounds significantly influence their health care needs, she says.
Adrienne Kue, PharmD ’25, credits her international APPE in Hiroshima, Japan, with gaining insight into the vibrant differences in pharmacy practice across countries. “I was struck by the distinct differences in drug distribution and compounding practices compared to those in the United States,” Dr. Kue says. “One of our final experiences was a visit to a Kampo pharmacy, where we explored the practice of traditional Japanese herbal medicine. Unlike in the U.S., where herbal remedies are typically over the counter, Kampo is integrated into formal health care in Japan. We learned about the scientific basis of Kampo and even had the opportunity to prepare our formulations for personal consumption. It was an incredibly unique experience.”
Exploring Cultural and Professional Growth through the International APPE
During international APPEs, pharmacy students gain invaluable lessons that shape their professional growth and cultural competence. For Amber Toler, PharmD ’25, who also visited Thailand for her international APPE, a key takeaway was the importance of cultural humility in patient care. Being immersed in a different health care system and working alongside students from Thailand, Japan, and Indonesia provided her with direct insight into how cultural beliefs, traditions, and societal structures profoundly impact health behaviors and acceptance of treatment.
“This experience challenged me to step outside of my comfort zone and consider how pharmacy practice must be adapted to respect and accommodate different cultural norms,” Dr. Toler says. “It reinforced the importance of being open-minded, asking thoughtful questions, and never assuming that one approach fits all.”
Originally from Puerto Rico, Johnsean Ramos Torres, PharmD ’25, saw an international APPE in Dublin, Ireland, as an opportunity to deepen his understanding of pharmacy practice in different patient populations and improve his skills, with a plan to return to his home and practice ambulatory care or psychiatric pharmacy. “I cannot stress enough how grateful I am for the opportunity to experience pharmacy practice abroad,” Dr. Ramos Torres says. He emphasizes that these experiences are instrumental in his growth as a pharmacist dedicated to lifelong learning.
“One lesson this experience taught me and something I wouldn’t have learned during a standard APPE is the importance of adaptability in clinical practice across different health care systems. Practicing in a country with a different formulary, treatment guidelines, and health care structure forced me to step outside of my usual clinical framework and think critically about how to approach patient care when resources or medications are limited or managed differently. It taught me that being a strong clinician isn’t just about following protocols; it’s about understanding the ‘why’ behind treatment decisions and being open to alternative, yet evidence-based, approaches that may be more practical or culturally appropriate in different settings,” he says.
Global Perspectives and Personal Development in Pharmacy Practice
The different health care model of Barcelona, Spain, with universal coverage, strong community pharmacy networks, and a deeply ingrained role of pharmacists in public health initiatives, allowed Kayla Frick, PharmD ’25, to reflect on how different health care styles allocate resources, engage patients, and utilize the expertise of pharmacists.
“I observed how pharmacists navigate health care delivery in a universal health system, often with limited resources compared to some U.S. institutions. I saw firsthand how they adapted their clinical interventions, communication styles, and patient education strategies to align with cultural norms and system constraints,” Dr. Frick says. “The rotation reinforced my belief that pharmacists are essential contributors to global health outcomes, not just through medication management, but as public health advocates, educators, and innovators, regardless of practice variations between countries.”
“Exposure to international pharmacy practice reinforced the value of flexible, globally informed approaches to pharmacy practice and care,” says Hannah Suber, PharmD ’25, who visited Toronto, Canada, for her international APPE. The program afforded Dr. Suber the chance to enhance soft skills such as leadership and collaboration. “This experience equipped me to become a more effective pharmacist by strengthening my leadership skills through active involvement in academic initiatives and serving as an educator to international pharmacy students.”
Besides the experience of navigating a new culture, trying new approaches to patient care, and visiting Niagara Falls, Dr. Suber also took the opportunity to serve as a judge during the 2025 Health Occupation Students of America (HOSA) Canada Conference. “I learned to guide and collaborate with teams, adapt to new environments, and lead with confidence in unfamiliar settings,” she says.
Discover More About the International APPE Program
The International APPE program serves as a gateway for pharmacy students to embark on transformative journeys that shape both their professional and personal lives. These global experiences develop vital skills such as cultural humility, adaptability, and leadership, preparing future pharmacists to provide compassionate, innovative, and culturally sensitive care. As students navigate varied health care environments worldwide, they become not only skilled clinicians but also empathetic, globally minded health care providers ready to make a meaningful difference.
Students participating in the International APPE program are eligible to receive a scholarship from the Seldon D. Feurt Memorial Fund, which was established to honor former Dean Feurt for his impactful contributions to the college and the pharmacy profession in Tennessee.
Students interested in the International APPE program at the college can conduct their international APPEs at varied locations, including Maha Sarakham, Thailand; Dublin, Ireland; Toronto, Canada; Barcelona, Spain; Uppsala, Sweden; and Hiroshima, Japan. Typically, these APPEs are taken in the final semester of the student’s fourth year.
For more information, visit the International APPE program website.