The Federal Bureau of Prisons (BOP) is the agency of the Department of Justice responsible for incarcerating federal felons. The BOP currently has 100 facilities in 40 states, with several more institutions under construction. The BOP houses inmates from 88 countries who have been incarcerated for every conceivable offense. Inmates are assigned to a particular prison according to their security classification, with prisoners with shorter sentences and lesser offenses placed in Federal Prison Camps, and those with the most severe offenses, longest sentences, and most notoriety incarcerated in U.S. Penitentiaries.

The average patient is a 37-year-old white male sentenced for a drug-related crime. The patient mix is becoming older and sicker because inmates are receiving longer mandatory sentences. About 1% of inmates are HIV seropositive, and 15% are carriers of hepatitis B or C. Liver and kidney damage are common because of self-destructive lifestyles. Several institutions devote substantial resources to treating inmates with mental health needs.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredits every BOP facility. Six are classified as medical referral centers that provide special medical needs such as medical/surgical, long-term care, psychiatric care, medical evaluations, and hospice beds. The remaining facilities have ambulatory care clinics that are usually staffed by 2 physicians, 2 dentists, 6-10 mid-level practitioners (physician assistants and nurse practitioners), technical and administrative aides, and pharmacy staff. These clinics provide outpatient visits, inpatient admissions, follow-up care, physical examinations, vision refraction, laboratory tests, minor surgical services, radiography, consultant visits, dental care, daily sick call, prescription medications, and other services. Specialty care in this setting is provided either by visiting physicians or by transporting inmates to the specialist's practice site.

There are over 150 pharmacist positions in the BOP, many of which are one-man stations. Pharmacists in the BOP are thoroughly involved in pharmaceutical care. Most BOP pharmacists fill medication orders directly from the patient's chart, which provides complete medical information. All pharmacists provide patient counseling and many work with diabetes, hypertension, mental health clinics; monitor the treatment of infectious diseases; go on rounds with physicians; and provide discharge counseling. The pharmacy department is typically located adjacent to the exam rooms. This proximity fosters a genuinely cooperative and interdisciplinary approach to patient care. Pharmacists function as a source of information for their fellow practitioners, they provide education to patients and staff alike, and are intimately involved in continuous quality improvement. Several pharmacists have moved into administrative positions such as Health Service Administrator or Associate Warden.

The BOP Chief Pharmacist is committed to supporting and promoting dynamic roles for the pharmacy practitioner, which include:

• Increasing involvement in drug monitoring and disease management.
• Reducing medication errors through Quality Assurance and Performance Improvement.
• Multi-disciplinary clinical care teams.
• Participating in drug utilization programs.
• Documenting outcomes of care.
• Providing drug information.
• Patient education.
• Formulary management.

Other BOP health initiatives include smoking cessation, proper OTC medication selection through prison commissaries, TB preventive therapy, and HIV medication compliance.

Pharmacists may apply to the BOP either as a civil servant or as a member of the U.S. Public Health Service Commissioned Corps. There are certain hiring restrictions for each personnel system; however, both offer promotion potential and Federal benefits. Please contact the Medical Recruitment Office at 1-800-800-2676 for general information and application procedures.