It's Okay If You Don't Know It All: News Flash...You're Not Supposed To!

Walking into the hospital on my first day of clinicals as a pharmacy extern, I felt a mix of excitement and dread. Mostly dread. There were rows of medications. Ones I could see and ones securely stashed away. It was a moment I had been anticipating throughout my years of studying pharmacy. But as I stood there in my clinical couture, reality hit me—this wasn’t just an academic exercise anymore.

This was real life, with real patients depending on the knowledge I’d spent years cramming into my brain. And let me tell you, I felt woefully unprepared.

Later that week, we gathered for our weekly seminar briefing with our lecturers, all of us fresh-faced externs eager (and nervous) to share our experiences. It wasn’t long before one of my classmates spoke up, recounting how a nurse had approached her on the floor, asking what a particular drug was used for.

"What's the mechanism of action?" the nurse had asked casually.

"And are there any major side effects I should watch out for?"

My classmate paused during her story and let out a nervous laugh. “I froze,” she admitted. “She said let me tell you I had no clue.”

Heads nodded all around the room. Every single one of us could relate. During my first week, I had been asked a similar question about a drug I’d never even heard of before. As I stumbled through my response, I thought to myself, How is it possible that I’ve studied for this long and still don’t know anything?

The truth is, no matter how hard you study in school, the transition to clinical and hospital practice is daunting. You step into a world filled with hundreds of drugs, many of which you’ve never encountered in your textbooks with the strangest names. Even the drugs you do recognize suddenly feel foreign when presented in a real-world context because you studied in black-and-white. Facts first.  And the professionals around you—pharmacists, nurses, and doctors—seem to have a wealth of knowledge that feels lightyears away from where you are now.

In moments like those, it’s easy to feel like you’ll never catch up. That’s how I feel quite often. But here’s what I’ve learned: no one expects you to know everything right away. Your lecturers, your preceptors, and even the seasoned professionals in the hospital all understand what it’s like to be in your shoes. Every single one of them started out as a novice, too.

During our seminar, one of our lecturers shared a story that really stuck with me. She told us about her first year as a practicing pharmacist when a physician asked her for a drug recommendation for a condition she’d never treated before. She didn’t know the answer. She said she really wanted to answer the question but every time she opened her mouth to say something nothing came out. Eventually, she collected herself and instead of falling into a full blown panic, she said, “Give me a moment to look that up.” That humility—and the effort she put into finding the right answer—earned her the respect of the healthcare team.

The takeaway? No one knows everything, not even the most experienced pharmacist. There’s simply too much information out there, and medicine is constantly evolving. It’s okay not to know all the answers right away. What’s not okay is failing to learn from those moments.

As a pharmacy extern or intern, your job isn’t to have all the knowledge stored in your brain. Your job is to learn. Read every day. Take notes on the drugs you see in practice. Ask questions—even if they feel “dumb.” Trust me, the professionals around you would rather see you ask for clarification than make a mistake because you were afraid to speak up.

And most importantly, be kind to yourself. This is a journey, not a race. When you’re overwhelmed by how much you don’t know, take a moment to reflect on how far you’ve already come. Remember when you didn’t even know how to read a prescription? Or when the concept of pharmacokinetics felt like a foreign language? You’ve conquered those hurdles, and you’ll conquer this one, too.

By the end of that seminar, I realized something important: feeling daunted isn’t a sign of failure. It’s a sign that you care deeply about your future profession. And that’s a good thing. It means you’re willing to put in the work to grow, even when it feels hard.

So, to all the pharmacy externs and interns out there feeling overwhelmed by the sea of new drugs and clinical situations: you’re not alone. We’re all figuring it out one step at a time. Keep reading, keep asking, keep growing—and trust that, with time and practice, you’ll become the confident professional you’re striving to be.

You’ve got this.