Dr. Grace Mary John: My coursework offered a compelling mix of theory and practical skills, particularly from the second year onwards, when we delved into pharmacology and pharmacotherapy. A key part of this was working with patient clinical "case files," where we analyzed cases for potential drug-related issues and presented our findings to the faculty. These discussions were fundamental in developing critical thinking in pharmacotherapy.

My interest in Infectious Diseases began during my PharmD internship. While on rounds with my cardiothoracic surgeon mentor, Dr. Pai, I asked for a study assignment. Instead of a theoretical task, he directed me to a patient recovering from CABG surgery with a sternal wound infection, suggesting I conduct an audit. This request evolved into a collaborative study with the Microbiology Department focused on surgical site infections. This hands-on experience, investigating the complex interaction between pathogens and antimicrobial treatments, was the moment my specialization in Infectious Diseases truly started.

Dr. Grace Mary John: Board certification is offered through the Board of Pharmacy Specialties (BPS), a U.S.-based organization. Currently, there are 14 different specialties for which you can obtain certification, including:

• Critical Care

• Infectious Diseases (ID)

• Ambulatory Care

• Cardiology

• Oncology

• Nutrition

• Neuropsychiatry

• Pain Management

• Emergency Medicine

• Pharmacotherapy

• Transplant

• Sterile Compounding

• Nuclear Pharmacy

• Pediatrics

Dr. Grace Mary John: Absolutely. Because of the gaps in formal clinical training within pharmacy education, much of my learning came from clinicians who were willing to go beyond traditional boundaries and invest in teaching. I am deeply indebted to Prof. Dr. George Chandy, my institution’s Director and former Director of CMC Vellore, who played a defining role in my professional growth. Although he was initially unfamiliar with the PharmD model, he believed in my potential and appointed me as the hospital’s first clinical pharmacist. He personally mentored me and encouraged several consultants to involve me in their clinical practice, allowing me to gain real-world exposure to patient care and pharmacotherapy decision-making.

Over time, he placed his trust in me to manage medication regimens for his gastroenterology and hepatology patients—an opportunity that marked a major turning point in my career. He also actively supported my development by facilitating multiple national and international training programs, further strengthening my clinical foundation.

In the field of Infectious Diseases, I was fortunate to receive guidance from Dr. Abi Manesh and Dr. Priscilla Rupali at Christian Medical College, Vellore, whose mentorship significantly shaped my clinical thinking and approach. I am also thankful to Dr. Jency Maria Koshy from my institution, who encouraged me early on to pursue specialization in infectious diseases. Another important influence was Dr. Mohamed Hisham, a senior clinical pharmacist who completed his PharmD (PB) in India and later worked at the Cleveland Clinic in the Middle East. His determination to pursue board certification despite the lack of structured training pathways in India was deeply inspiring. Watching him succeed showed me that such goals were achievable within our system and gave me the confidence to pursue a similar journey.

Dr. Grace Mary John: My decision to pursue the Board of Pharmacy Specialties (BPS) Board Certified Infectious Diseases Pharmacist (BCIDP) credential stemmed from a strong desire to deepen my expertise in antimicrobial therapy. This interest first took root during my internship, when I conducted an audit on surgical site infections. That experience exposed me to clinically important pathogens and antibiotic spectra, sparking a deeper curiosity about infectious diseases.

As a clinical pharmacist, I found antibiotic dosing—particularly when guided by creatinine clearance—relatively intuitive, but I was especially drawn to the broader concept of Antimicrobial Stewardship (AMS), a discipline that was notably absent from my formal academic training. Realizing that local exposure alone would be insufficient to develop this expertise, my Director arranged an observership at Tufts Medical Center in Boston in 2017. During this time, I had the opportunity to shadow Dr. Kirthana Beaulac, a BPS Board Certified Infectious Diseases Pharmacist. Through her work, I witnessed firsthand how a well-trained clinical pharmacist could influence antimicrobial selection and optimization using pharmacokinetic and pharmacodynamic (PK/PD) principles. Although many of the clinical discussions during rounds were beyond my understanding at the time, her depth of expertise left a lasting impression and solidified my resolve to pursue BCIDP as a means of strengthening my practice and contributing meaningfully to AMS efforts in India.

There is a widespread misconception that formal residency training is required to either be eligible for or succeed in BPS certification examinations. However, my colleague Dr. Vineeth Jayakumar, the other BPS Board Certified pharmacist at my institution, exemplifies an alternative pathway—having successfully passed the BCPS examination on his first attempt through self-directed preparation. His achievement reinforced my belief that with dedication, structured self-study, and clinical engagement, it is entirely possible to reach this professional milestone even in settings with limited formal training pathways.

Dr. Grace Mary John: One of the greatest challenges I faced was the lack of vertical academic integration. I had to return to the fundamentals of microbiology, pharmacology, and therapeutics and rebuild my knowledge base almost from scratch. Another significant obstacle was the marked difference in antimicrobial resistance patterns between India and Western countries, which made it difficult to directly apply international guidelines to local practice. However, working through these guidelines provided valuable clarity, helping me understand the principles of rational antibiotic selection and the drivers of resistance.

The absence of structured infectious diseases–focused residency programs in India further limited opportunities for formal hands-on training. In addition, the cost of preparing for the examination was substantial. I was fortunate to receive strong support from both my institution and my husband, which made this demanding journey both feasible and rewarding.

There is a common perception that BPS certification is merely a prestigious credential with little practical relevance. In reality, the certification process requires in-depth engagement with evidence-based medicine, contemporary clinical guidelines, and key clinical trials, fostering a thorough and nuanced understanding of one’s specialty. This rigorous preparation strengthens critical thinking and clinical judgment, enabling pharmacists to make well-informed, data-driven recommendations that directly improve patient care. Another misconception is that BPS certification is prohibitively expensive. While the financial commitment—including exam fees and study resources—is considerable in the Indian context, the depth of knowledge gained and the professional opportunities it creates far outweigh the cost.

Dr. Grace Mary John: Learning directly from clinicians was essential. Before taking the exam, I undertook a formal training at CMC Vellore’s ID department, where I was mentored by consultants and participated in rounds and cross consultations. This exposed me to complex cases such as HIV; transplant-related infections like Multi Drug Resistant Organisms (MDROs), Histoplasmosis, Toxoplasmosis etc.; viral diseases like Cytomegalovirus (CMV), BK polyomavirus (BKV), etc.; and other rare pathogens. This experience broadened my perspective beyond antibiotic therapy. I supplemented this with self-study using Infectious Diseases Society of America (IDSA) guidelines and completed the Society of Infectious Diseases Pharmacists (SIDP) course on AMS in Acute Care. As my foundational knowledge strengthened, I relied on the American Society of Health-System Pharmacists (ASHP)/ American College of Clinical Pharmacy (ACCP) board certification preparatory materials. Learning from physicians and specialists during clinical practice also provided practical insights into patient management

Dr. Grace Mary John: The BCIDP credential significantly enhanced my confidence and refined my clinical decision-making. The rigorous preparation process—studying updated guidelines, recent clinical trials, and evidence-based treatment modalities—was transformative. It equipped me with a robust knowledge base, making me feel accomplished even before taking the exam. Passing the certification exam further validated my expertise, enabling me to make evidence-based recommendations with greater authority. After certification, the recognition from colleagues was palpable. My recommendations carried more weight, and I found that colleagues were more willing to send me cross consultations for infectious disease management. My suggestions were no longer just well-reasoned opinions—they were evidence-driven, guideline based, and backed by an internationally respected credential. This newfound confidence has been a cornerstone of my practice as an Infectious Diseases specialist

Dr. Grace Mary John: As the first board-certified pharmacist in India, my BCIDP credential elevated the visibility and credibility of clinical pharmacy within my institution and beyond. Prior to certification, my consultants were already supportive, but the certification formalized my role as a subject-matter expert. Colleagues, both physicians and clinical pharmacists, expressed pride in my achievement, fostering greater acceptance of clinical pharmacists’ roles. Consultations increased, and other departments began to seek clinical pharmacy input more frequently. Our hospital’s Clinical Pharmacist-led AMS program became a national model, particularly valuable in settings lacking infectious diseases physicians. My board certification provided greater credibility to this model, encouraging other institutions to consider similar initiatives. During a subsequent observership in 2022 at the Detroit Medical Center (DMC) and Karmanos Cancer Institute, in Detroit, Michigan, I was able to make clinical suggestions that aligned with those of U.S.-trained ID pharmacists. The contrast from my 2017 visit was profound and humbling. It affirmed how much I had grown—and how much impact structured preparation and certification could have.

Dr. Grace Mary John: Earning the BCIDP credential opened numerous professional avenues for me. Clinically, it strengthened the confidence and trust placed in me, particularly in antimicrobial stewardship and complex patient management. I was appointed as a core member of my institution’s antimicrobial policy–making committee and was given expanded responsibility in clinical decision-making across departments as well as in hospital-level administrative initiatives.

Academically, I was able to establish a more structured approach to training my team in infectious diseases, which motivated several PharmD graduates to pursue board certification themselves. I was also invited to teach infectious disease–focused sessions to MBBS students in my role as Assistant Professor of Pharmacology—an uncommon but encouraging example of true interdisciplinary collaboration.

From a professional standpoint, BCIDP certification led to a significant salary increase and numerous invitations to speak at national and international conferences, where I have presented our Clinical Pharmacist–led antimicrobial stewardship model. Notable engagements include serving as faculty at the Clinical Infectious Disease Society (CIDS) annual conference, a forum largely led by infectious disease physicians, and co-directing the Consortium of Accredited Healthcare Organizations (CAHO) iComply audit for infection prevention and antimicrobial stewardship. Another meaningful milestone was my role as an expert panelist for the Indian Pharmaceutical Association’s Fellowship in Infectious Diseases Pharmacy, a program designed to develop a skilled workforce of ID pharmacists in India.

I also had the honor of serving as a BPS Ambassador for the 2022–2024 term, which allowed me to share my journey and highlight how board certification can transform clinical practice and create impactful opportunities on a global stage. Together, these experiences have significantly expanded the scope, reach, and influence of my professional work.

Dr. Grace Mary John: Given India’s diverse healthcare needs and large patient population, there is a compelling need for specialization in several areas. BPS offers a wide array of certification programs, many of which align with India’s pressing healthcare challenges. India continues to face a formidable burden of antimicrobial resistance (AMR), and clinical pharmacists can play a pivotal role in both stewardship and policymaking. Thus, BPS Board Certification in Infectious Diseases Pharmacy remains one of the most active and relevant specialties. Closely following is BPS Board Certification in Critical Care Pharmacy, where pharmacists are increasingly essential in managing complex pharmacokinetics and pharmacodynamics in severely ill patients. Other valuable specialty certification offered by BPS include Pharmacotherapy, Oncology, Geriatrics, Pediatrics, Cardiology, Psychiatry, and Transplant Pharmacy. Emerging roles are also being seen in Ambulatory Care, Emergency Medicine, and Pain Management Pharmacy. With the high patient load in Indian outpatient settings—often ranging from 50 to 100 patients per consultant per day—there is limited time for in-depth counselling or therapeutic decisionmaking. In such scenarios, clinical pharmacists could play a crucial supporting role, particularly in chronic disease management. However, for this model to work effectively, pharmacists must be trained to understand disease pathology, lifestyle modifications, complications, and pharmacotherapy in a holistic context. This is where I believe, Pharmacotherapy and Ambulatory Care Pharmacy certification from BPS can become a game-changer.

Dr. Grace Mary John: I first learned about the SHEA Ambassador Program in 2018 during a discussion with a senior physician from the U.S. Centers for Disease Control and Prevention at a conference in Kerala. I applied for the program in 2019 but was not selected because I did not yet meet the five-year experience requirement. When I reviewed the profiles of previous awardees—who were predominantly senior infectious disease physicians and microbiologists—I also noted that no pharmacist had ever been chosen for this role.

After obtaining my BCIDP certification, I reapplied in 2021 with the goal of representing the growing role of clinical pharmacists in infectious diseases in India. This time, I was selected. Attending the SHEA Spring Conference in Colorado proved to be a transformative experience, as it allowed me to connect with infectious diseases pharmacists from around the world and establish collaborations that strengthened my antimicrobial stewardship efforts. This opportunity underscored the value of global professional networks in advancing clinical pharmacy practice and in addressing the challenge of antimicrobial resistance.

Dr. Grace Mary John: I have had the privilege of working with a group of dedicated clinical pharmacists to drive a community-led movement aimed at redefining the role of clinical pharmacists within India’s healthcare system. This shared vision led to the establishment of the Federation of Clinical Pharmacists in India (FCPI) in 2022. As FCPI’s Co-Founder and Immediate Past President, I have partnered with an energetic and committed team to advance our core mission: to elevate clinical pharmacy through increased visibility, structured professional development, and purposeful mentorship—so that pharmacists can play a more impactful role in patient-centered care.

One of the most defining milestones of this journey was organizing the ID Congress 2023 at my institution in collaboration with FCPI. As the largest in-person infectious diseases conference held in India, it brought together more than 1,000 delegates. What made it truly historic was the academic parity it established—clinical pharmacists, for the first time, stood shoulder-to-shoulder with infectious disease physicians in delivering rigorous, evidence-based scientific sessions. The conference sent a powerful message: clinical pharmacists are not merely supporting clinicians, but are educators, leaders, and drivers of clinical excellence.

Under the FCPI umbrella, we have since launched multiple specialty forums—including Infectious Diseases, Critical Care, Pediatrics and Neonatology, Transplantation, Quality Improvement, and Research—which have evolved into thriving communities of practice. These platforms are designed not only to share expertise, but also to mentor early-career pharmacists as they move from academic training into real-world clinical practice.

At the international level, I have been honored to represent Indian clinical pharmacists through ambassador and committee roles with organizations such as SHEA, BPS, and SIDP. Taken together, I see my leadership journey as one of building bridges—linking grassroots professional growth in India with global standards and best practices. It is about shaping a future where clinical pharmacists are recognized not only as contributors to care, but as architects of change—informing policy, advancing antimicrobial stewardship, and improving patient outcomes across diverse healthcare settings.

Dr. Grace Mary John: Do not let a lack of structure become a barrier to your growth. If residency programs are not available, carve your own learning pathway. Seek mentorship, take up observerships, and immerse yourself in clinical case discussions and international guidelines. The journey to certification is not just about passing an exam—it is a process that shapes your clinical reasoning, your confidence, and your role as a patient care provider. Your environment may not be perfect, but your mindset can be powerful.

 Board certification brings with it a rigorous framework for decision-making, built on evidence-based practice. It challenges you to think holistically, to question assumptions, and to continuously seek better ways to care for your patients. It shifts your approach from reactive to proactive—from routine to reflective. This growth in competence naturally brings with it a growth in confidence, and that confidence becomes your credibility.

Dr. Grace Mary John: It’s a catalyst for transformation—turning competent pharmacists into confident, evidence-based, and globally respected clinicians.