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I remember from my visitation at St. Paul's Hospital that the dispensary was far and away different from the dispensary of any community pharmacy I've been to. What surprised me the most was that the dispensary did not stock the same formulary as do community pharmacies. With introspection, I can discern some reasons why - hospitals are publicly funded so they are bound to use the alternative/equivalent drugs that are the least expensive, and of which the government espouses, and most patients are in hospital for acute care and so generally don't need the same medications on average for chronic conditions as patrons of community pharmacies do. And home care is on the uptick.

Without being privy to all the regulations, I would guess that there are significant differences in hospital pharmacy practice from what I'm used to at work. Are the alternative/equivalent drugs included in a hospital's formulary the same as in PharmaCare? (I was told that they weren't all identical so common drugs for chronic conditions occasionally had to be substituted, or a patient's own supply would have to be brought in). This puzzles me, because though it seems in line with PharmaCare's policies, it can't be the same formulary (I should remember to research this). That makes me wonder, what other hidden differences could there be in hospital and community pharmacy protocol?

A large number of drugs used in St. Paul's are not prepackaged; is it because hospitals need to make IV/IM/SC drugs fresh? Sometimes only a few pharmacists are on staff in the underground pharmacy at any time, and most are needed in the dispensary so do they have a large role in formulation still?

How difficult is it for a retail/hospital pharmacist to make the jump from one to the other?