December 17, 2021
In this alum spotlight, we chat with alumni Imad Treish, Pharm.D., Chief Strategy Officer at King Hussein Cancer Center in Amman, Jordan. Treish completed his Doctor of Pharmacy degree with the UNC Eshelman School of Pharmacy in 1999, and a residency in Hematology/Oncology at UNC Hospitals in 2000. Today, he works to better pharmacy practice and has helped establish the first international pharmacy residency program accredited by the American Society of Health-System Pharmacists (ASHP). Get to know Treish:
Q: What does a typical workday look like for you?
A: I recently (in August) accepted the Chief Strategy Officer position at the King Hussein Cancer Center (KHCC) in Jordan. I had the privilege to join KHCC in November 2002 as the founding chairman for the department of pharmacy. I served in the position for 7 years during which I created a world-class department of pharmacy modeled to a large extent after UNC Hospital’s Pharmacy Department. Then in 2009, I was tapped to take on the Chief Operating Officer in the Center. During that period, we successfully built, commissioned, and operated a major expansion (84,000 SQM, 180 beds, ambulatory care center). I left KHCC in 2018 and worked with various investment funds in the region to plan and build healthcare projects in various parts of the world including India, Pakistan Kenya, Nigeria, Armenia, Jordan, and Palestine. I’m now back at KHCC leading strategic affairs with the mandate to expand our state-of-the-art cancer services to more patients in Jordan and surrounding countries through various expansion projects and partnerships with local and regional players.
Q: Describe the most exciting or rewarding aspect of your role?
A: Seeing strategies that we carefully planned come to fruition is an amazing feeling, especially strategies that are underpinned by complicated projects. Another exciting part of my current role is leading further expansion in the center including the pediatric cancer center or our satellite facility in in the city of Aqaba, in the south of Jordan.. Exploring potential partnerships with local and international organizations is another amazing component of what I do. But the most exciting part of my day is visiting patient care areas whether inpatient or outpatient and interacting with our staffs and patients. Feeling the genuine appreciation in the eyes and words of staffs and patients, reinforces my conviction that we are doing good.
Q: What is the most challenging aspect of your role?
A: When I started in 2002, I had so many challenges: lack of trained hospital pharmacists in Jordan, severe shortages of medicines, spiraling costs of new cancer drugs, working in a foreign country that I’ve never been to, a medical environment that did not accept the role of pharmacy, etc.
We improvised to meet drugs shortages by directly importing drugs from US and Europe, but sometimes we ended up compounding many sterile drugs like sodium phosphate injection which is ironic because Jordan is a major exporter of phosphates mining products. I still remember that 10-year-old girl on palliative care services for whom I compounded morphine syrup so that she can go home because there was not a pediatric-friendly formulation. We created the region’s first center for drug policy and evaluation that implemented pharmacoeconomic evaluation for new cancer drugs based on local metrics to ensure that only cost-effective drugs would be added to the formulary. I also still remember that angry call from a senior physician at KHCC who was told that he cannot prescribe a restricted medicine by one of my junior pharmacists following the implementation of Pharmacy and Therapeutics Committee restrictions policy! So many good stories.
I was fortunate to have great mentors at UNC who advised me on how to build the pharmacy program at KHCC and had great help from the pharmacy leadership at the National Institutes of Health. Most importantly, I had the trust and support of the senior leadership at KHCC to enable me to take pharmacy practice to new levels not experienced in Jordan before.
Q: Can you talk about the importance of aiding practice advancement outside of the US?
A: International pharmacy practice particularly in low and middle-income countries lags to varying degrees behind the US. In many places, pharmacy schools are still graduating pharmacists without the necessary clinical skills to advance the practice of pharmacy. This is particularly important because whether we like it or not, in most of those countries, pharmacists help patients by often prescribing and dispensing medications as many patients may not have ready access to doctors.
Pharmacists can help their communities improve how they use their medications. Similarly, advanced hospital pharmacy services will improve the quality of care, including things like pharmacists preparing hazardous drugs (chemotherapy) in a sterile and safe environment instead of nurses and doctors preparing those over the sink of the nursing station!
Our clinical pharmacists who round on patients in the various units have become integral components of the multidisciplinary teams that provide care for patients. The number of interventions that our pharmacists perform on daily basis eliminate so many drug errors and improve the drug utilization across the center.
The UNC Eshelman School of Pharmacy, its faculty and students can play an important role in helping many developing countries implement advanced practice models that can demonstrate the value that pharmacists can add to patient care and to healthcare systems in their countries.
Q: How does it feel for the program in Jordan to now be accredited?
A: The ASHP accreditation of the residency program at King Hussein Cancer Center is a testament to excellent pharmaceutical services that we developed at the center over the past 18 years. Although I left the pharmacy department in 2009, I continued supporting the expansion of the role of the pharmacy at KHCC. I am very proud that my colleague and good friend, Dr. Saad Jaddoua, who took the helm of the pharmacy department, continued that journey of excellence to create a very positive image of pharmacy in Jordan and the region. It is a dream that has become a reality!
Q: Can you tell us about the residency program you established?
A: The PGY1 Pharmacy Residency Program at KHCC is a 2-year postgraduate curriculum that follows the ASHP requirements for PGY1 residencies. It offers training opportunities in acute care, ambulatory care, drug information, pharmacoeconomics, research, education/teaching, quality, and pharmacy leadership. The program has graduated two classes with a total of four residents and the plan is to further expand the program following the ASHP Accreditation.
Q: How has your role in Jordan advanced your pharmacy training?
A: When I arrived in Jordan in November of 2002, I was the only pharmacy graduate with a Doctor of Pharmacy degree. Moreover, I was the only one who had structured training in Oncology and a shortly thereafter board certified in oncology pharmacy (BCOP). The experience at UNC gave me the confidence, knowledge and skills to forge a special path for “my” pharmacy department.
Q: What advice would you give to student pharmacists?
A: Take risks and explore diverse career opportunities in and outside of the US and traditional pharmacy roles. Sometimes this means accepting lower pay than what you may get if you were to work in the US as a pharmacist. UNC provided me opportunity to grow not only my pharmaceutical knowledge and skills, but also my leadership skills which allowed me the age of 27 to be leading a pharmacy department and to champion the cause of pharmacy for my colleagues in medical departments many of whom did not believe that we can make such a difference. Nowadays, every clinical service in the center wants their “own” clinical pharmacist!
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