5 Questions to Ask Yourself Before Pursuing a Pharmacy Residency

DECEMBER 01, 2016
Pharmacy residencies are a hot topic among many pharmacy students today. Many students believe that completing a residency is necessary to avoid getting “stuck” in retail. In other instances, students may apply for residencies because they see many of their friends and peers doing so, or because their school and faculty heavily emphasize the importance of them.
 
But the reality is simple. First, there are not enough residency positions to meet the demand for those that wish to complete one. Every year approximately 14000 students graduate with a pharmacy degree, yet there are only around 4300 residency positions available. This year, of the 6814 applicants who enrolled in ASHP’s Residency Match, 2861 (42%) were not matched for a position. Second, many students apply for pharmacy residencies without understanding their benefits, disadvantages, and whether pursuing a residency is the best option to meet their career goals.
 
This article presents 5 key questions every pharmacy student or pharmacist should consider before pursuing a pharmacy residency.
 
1.  What are my career goals and expectations?
While in pharmacy school, it’s never too early to start thinking about your career goals. This involves considering the different areas of pharmacy, the pros and cons of each, and where you could see yourself working.
 
For some this may be specializing in one specific area of pharmacy such as pediatrics, oncology, or psychiatry. For others, this may mean working set hours to spend more time with family or simply wanting to make as much money as possible. There’s no right or wrong answer, but it’s important you be honest and realistic with yourself while expanding past “I want to help people.”
 
If you don’t know what your career goals are, then consider researching different avenues of pharmacy. This involves doing your own independent research, talking with faculty, and finding a pharmacy mentor. Additionally, both IPPE and APPE rotations, as well as independent work experience, provide students a great opportunity to experience different areas of pharmacy to better understand career opportunities that are available.
 
Knowing your career goals is critical to answer question number 2.
 
2.  How will a residency help me accomplish my career goals?
This is without a doubt the number one question that students need to consider before completing a residency.
 
Whenever a student approaches me to talk about residencies, the first question I ask is why they’re considering a residency in the first place. Specifically, what do they think a residency will provide them and how will that help them reach their career goals. Unfortunately, students oftentimes haven’t thought that far ahead.
 
It’s important to keep in mind that a residency isn’t an absolute requirement to work somewhere other than retail. While it’s true that approximately 60% of pharmacy students go into retail pharmacy upon graduation, other opportunities do exist.
 
From my graduating class, a number of individuals work in diverse areas without a residency, including hospitals, managed care, drug information, home infusion, and specialty pharmacies. To some extent, it may be harder to get a clinical position without a residency, but through hard work and networking it is certainly not an impossibility.
 
Additionally completing advanced degrees post-pharmacy school graduation, such as a Master of Business Administration (MBA) or Master of Public Health (MPH), can potentially open additional career opportunities.
 
Finally, try thinking about what would happen if you didn’t pursue a residency. How would this affect meeting your career goals?
 
3. What sacrifices am I willing to make to complete a residency?
Both PGY-1 and PGY-2 pharmacy residency programs require a significant time commitment. Hours will vary by program, but many pharmacy residents average 50-60 hour weeks; some may work even longer. Add in commute times and weekend staffing, and you’re looking at a packed schedule. Having completed a residency, I can attest that it can feel draining at times and it’s sometimes a struggle to prevent the negative effects from spilling over into your personal life.
 
Moreover, completing a pharmacy residency involves a major financial loss. The average resident salary is around $45,000, well less than half of the national average pharmacist salary of $120,000. Completing a residency for one year means you are would be losing out on $75,000 and for 2 years $150,000. This doesn’t account for the student loan interest that will accumulate during this time.
 
Students sometimes think that they’ll be in for a major pay day after completing a residency, but this isn’t usually the case. In reality, even after completing a residency, it’s likely you will be looking at a salary that is 10-20% lower than what retail offers without a residency. From a pure return on investment outlook, completing a pharmacy residency is not a good financial decision.
 
Ultimately, whether you decide a residency is right for you should not be based solely on finances. But for those with significant student loans, it should at least be given some consideration.
 
4. Am I willing to potentially relocate?
When looking for residency programs that are the best fit for meeting your professional goals, it’s not uncommon to realize that many of these programs may be spread across the county. For example, there are only a small number of managed care residency programs available in the United States, which limits your choice of where to apply. Additionally, you may want to only apply to certain PGY-1 programs based on their offerings and how you feel they can help you obtain a PGY-2 residency.
 
The thought of relocating may not be a concern for some; in fact, many students will say that this actually presents an exciting opportunity to get a fresh start in a new area after spending many years of pharmacy school or living at home.
 
On the other hand, having to relocate can be a major barrier for others. Moving to a new area can be costly, stressful, and have an impact on relationships with friends and family. It’s easy to say that the move will only be for one or 2  years, however residencies can often lead to job offers or provide connections that can lead to more permanent opportunities in that area.
 
Certainly, there’s no right or wrong answer right. For me, I only applied to 3 programs in the New Jersey/New York region because although I knew I wanted to complete a managed care residency, it wasn’t worth moving away from family.
 
5. What type of residency of best for me?
For students that want to practice in one specific area of pharmacy, PGY-2 residencies are available in a number of specialties including cardiology, critical care, geriatric, infectious disease, oncology, and psychiatry. For these individuals it’s important to pick a PGY-1 program you believe offers the ability to be competitive for these PGY-2 programs.
 
Alternatively, many residents may decide to forgo a PGY-2 opportunity and instead look for a clinical position after the PGY-1 residency. Finally, for those interested in pursuing managed care, residency programs are available.
 
As previously mentioned, I would caution students to strongly consider the long-term impact of where any one type of residency program will lead them. For example, the benefit of completing a community residency or one focused on Medication Therapy Management (MTM), is questionable because jobs can easily be found in these areas without a residency.
 
I would also encourage students not to immediately dismiss residency programs that are not ASHP-accredited. This means that the program has not met ASHP’s lengthy standards and requirements. In general, there are 3 reasons this may be the case:

1. They were accredited in the past but then lost it; this is a red flag
2. They are a new program and are planning to go through the accreditation process
3. The program simply chooses not to be.
 
If applying to a non-accredited program, it’s important you ask about their accreditation status during the interview process. For individuals that wish to pursue a PGY-2 or immediately get board certified with their BCPS, a non-accredited program may not be the best option.
 
For those who have already completed a residency, or are currently in the process of completing one, what questions do you wish you had considered before your residency began? Tweet them to me @toshea125.

Timothy O'Shea, PharmD
Timothy O'Shea, PharmD
Timothy O'Shea, PharmD, is a Clinical Pharmacist working at a large health insurance plan on the east coast. Additionally he works per diem at a retail pharmacy chain. He graduated from MCPHS University - Boston in 2015 and subsequently completed a PGY-1 Managed Care Pharmacy Residency. His professional interests include pharmacy legislation and managed care pharmacy. He can be followed on Twitter at @toshea125.
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