When he arrived in England 13 years ago from Afghanistan, Masih Kunduzi could speak no English. Now he is running a branch of Day Lewis. The Young Pharmacist of the Year talks to Neil Trainis

 

It is a long way from Afghanistan to England but Masih Kunduzi has well and truly arrived.
The young pharmacist’s formative years were spent in a country that has long been ravaged by war. He describes Afghanistan’s healthcare system as “non-existent.”

With its own struggles, it is tempting to think England’s healthcare system was not much of an eye-opener for him. He disagrees.

“It’s quite a personal thing. I came from a country where healthcare was really bad. I had a lot of love for chemistry, biology and physics and I wanted to apply that understanding so I could help people,” he says as he ponders why he chose to become a pharmacist.

“In Afghanistan healthcare was non-existent. There were no regulations, no health, no security, patients were not at the centre of their own healthcare. So many things there contrasted with here in the UK.

“It spurred me on. It’s all about what I can give back to people. When I came here I was 12 and without any English. My English is not perfect now. It’s better but not perfect.”

Masih’s English is excellent. He is quietly spoken and exudes an inner confidence and assuredness that puts you at ease when you talk to him. A quality that might come in handy when he speaks to patients, one might think.

He came to the UK in 2005 when he was 12 and, by his own admission, spoke not a word of English, but in the space of 13 years he finished his exams, completed a degree at the University of East Anglia, did his pre-registration at a branch of Day Lewis in Colchester and now manages one of their shops in Bury St Edmunds. It has been quite a journey.

Yet it was at the Colchester branch where Masih really made an impression. Soon after finishing his pre-reg stint there, he was contacted by one of the bosses at Day Lewis who, impressed with his attitude, offered him a position as pharmacy manager.

“As soon as I finished my pre-reg, he offered me a job. He said it wouldn’t be easy managing people. And it’s not easy. As well as the work, I’ve had to develop my personality skills to manage people too,” Masih says.

Composed and self-assured, the young pre-reg student took on a wide range of activities including briefing the pharmacy team on a monthly basis with information he took in from his trips to local pharmaceutical committee training events.

As the Pharmacy Business roving judge Richard Brown observed in his assessment of Masih’s awards application last year, “as the meetings progressed his own leadership style developed.”

In many ways he was destined to be a pharmacy manager – he assertively says he would like “to be managing more pharmacies at Day Lewis” in years to come – largely because of his propensity to take the initiative.

During his pre-reg he carried out an audit which saw him deliver written information to 20 patients on their blood pressure medication followed by a review of their understanding.

Masih’s audit found that most people did not take in the right information which reinforced how important it is to deliver information in a way people can understand.

He also carried out a clinical audit in which he examined the prevalence of hypoglycaemia or low blood glucose when using sulphonylurea medicines to treat type 2 diabetes.

Of the 20 people he assessed, 16 who experienced hypoglycaemia assumed it was part of the medicine’s side-effects and two patients whose problem was severe were switched to the oral anti-diabetic drug alogliptin.

As fears grow that community pharmacy is slowly being usurped by what the profession itself has termed the Amazonisation of medicines supply, anxieties intensified by Amazon’s recent foray into healthcare with its purchase of internet pharmacy PillPack, Masih says pharmacists’ breadth of clinical knowledge is not being used.

“One of the things that stood out when I qualified is we have a lot of clinical knowledge that is not being utilised. We work in the pharmacy, we handle a lot of prescriptions but we’re not at the centre of the patient care-plan.

“We can lose that knowledge over time if it is not used regularly. We can speak to patients directly, dealing with their health issues, minor ailments, providing clinical healthcare. We can revolutionise healthcare.

“The danger is that it is heading towards Amazon. I have my own concerns. But the tiny interactions we can have with patients, such as asthma, you can pick up on so many things that they can improve on. Simple advice can save GPs’ time. GPs don’t have the time.

“Amazon can’t give that advice. One session of mine where I spent 10 minutes with a patient on their inhaler technique can save the NHS money. And it improved their breathing. Online pharmacy can’t do that.

“A lot of medicines can lead to admissions to hospital. We monitor them. Once we found an anti-diabetes medicine caused hyperglycaemia in a patient. It’s about patient care and that’s very powerful. With diabetes, it has to be individualised care.”

Few exams in any discipline can prepare students for what they will encounter in real life scenarios and that has certainly been a complaint of the pre-registration assessment, especially the June sitting.

More than 500 students complained the June 2017 exam “was not a true nor accurate reflection of real practice and many went on to say the assessment was not reflective of the practice of newly qualified pharmacists,” according to the British Pharmaceutical Students’ Association.

Masih does not look for excuses. He suggests the exam’s questions were geared more towards hospital pharmacy but he took what he learned from that and weaved it into his knowledge of community pharmacy.

“In my personal view, the mock exam was different from the actual paper we sat. That was reflective of what we do in pharmacy. The paper didn’t give me any bother but other people had problems.

“It was a good a good reflection of pharmacy but within community pharmacy you don’t come across the questions as much as in hospital pharmacy. But I’ve incorporated what I learned into my community pharmacy experience and updated my knowledge.”

Characteristically self-effacing, Masih adds: “I’m still lacking. I’m not fully informed but I regularly read up on pharmacy magazines and other sources to update my knowledge.”

He has settled into life at Day Lewis. Indeed, life in England. But there is a strong sense that he is not content to sit on what he has achieved.

“I want to be more involved clinically. Where I work now, it is very deprived. I’d like to come up with my own service. My big area is asthma, COPD.

“I want to be managing more pharmacies at Day Lewis.”

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