Postgraduate Training—Or Not?

JANUARY 01, 2006
James C. McAllister III, MS, FASHP

It is that time again! The American Society of Health-System Pharmacists Midyear Clinical Meeting signaled the beginning of resident recruitment. I suspect that more than 1000 recent graduates will be evaluating alternatives for continuing their education through organized general practice and/or specialty residencies. Hundreds of hospitals and scores of colleges of pharmacy began the recruitment phase at the Residency Showcase and Personnel Placement, and the excitement at the meeting was palpable. I also was impressed this year by what appeared to be a substantial increase in community pharmacy and ambulatory care residency programs for which residents were being recruited.

I am an avid supporter of residencies, and I strongly encourage UNC students to consider a residency as a prelude to establishing their own practice. I sometimes describe a residency as an organized way to consolidate years of pharmacy practice experience into 1 year (or 2 if one follows a general practice residency with a specialty residency). I am sure that many residents feel as if they virtually live at their hospital during their program and that they will vouch for my description.

Pharmacy practice and performance expectations by patients, physicians, and other providers are evolving rapidly in many organizations, including ambulatory care environments. Admittedly, this evolution is in various stages and is changing at a different pace among provider organizations. Residency training is one solution to prepare young practitioners to assume clinical or practice management responsibilities with a minimum of on-thejob training. In other words, the experience may help "jump-start" an individual's career and allow him or her to begin at a higher practice level.

I prefer to hire new practitioners with residency experience. Yet, with the limited number of residents seeking jobs, it is challenging to find the level of expertise in a practitioner that I want. On the other hand, residency experience is not necessarily essential for all pharmacists to practice in some acute care and ambulatory care environments. In fact, some colleagues suggest that schools of pharmacy are insensitive to what the market requires in terms of pharmacist skills and that we "overtrain" new graduates.

Given the above and the diversity of practice expectations across the country, we have a true conundrum. It seems to me that schools of pharmacy and the practicing pharmacist community both have incentives to collaborate on preparing pharmacists (and perhaps even retooling graduates) for contemporary pharmacy practice. Instead of divisive debates on whether new graduates are overtrained or whether pharmacy practice lags behind in some environments, should we not work together to align ourselves from both educational and practice perspectives, and then agree on a strategy for the future?

Collaboration in preparing professional students for the workforce doubtless will improve. In the meantime, however, postgraduate training programs remain a worthwhile investment for young pharmacists to make, and employers will compete aggressively for their skills.PT

Mr. McAllister is director of pharmacy at University of North Carolina (UNC) Hospitals and Clinics and associate dean for clinical affairs at UNC School of Pharmacy, Chapel Hill.