How do I move from dispensing to clinical decisions in pharmacy?

Dispensing is real clinical work, even if it does not feel like the decisions you mean. Every time you catch an interaction or check a dose, you are already reasoning clinically. The leap you want is not to a different mind. It is to using more of the one you have. What separates dispensing from advising is mostly confidence and exposure. You know more than you give yourself credit for, but you have not yet practiced offering it out loud. That practice is how the knowledge turns into contribution. Start small and low-stakes. When you spot something worth saying, say it, even if it is just a note to the prescriber suggesting a review. One offered thought a day builds the habit and the standing. You are not below clinical decisions. You are one built habit away from being part of them.