Overcoming Failure as a Recent Pharmacy Graduate

As a student pharmacist, I encountered very few setbacks and thrived more than I could have dreamed of when I started school. I was a member of Rho Chi Pharmacy Honors Society, president of my school’s chapter of Phi Lambda Sigma, and involved in college committees. Going into my fourth year of pharmacy school, I decided to pursue residency. I was fortunate to match with my first-ranked program in Utah. Following match day, the program director reached out to me and my co-residents to welcome us and share North American Pharmacist Licensure Examination (NAPLEX) and Multistate Pharmacy Jurisprudence Examination (MPJE) preparation advice. Within the welcome material was a warning: “The Utah MPJE is notoriously difficult. Start studying as soon as possible.” While I knew to heed this warning, I would soon find out just how important it was.

My life between match day and starting residency was quite hectic. I was managing my final rotations, preparing for graduation, and gearing up for a cross-country relocation. With all the excitement, I was aware that I needed to spend every moment I could preparing for my board exams. Though success came relatively easy to me as a student pharmacist, the magnitude of the NAPLEX and MPJE was not lost on me. I had to take them seriously; they were the only things standing between me and my future career as a clinical pharmacist. I attempted to prepare for the boards systematically. As I moved across the country, I would complete practice exams in the car. I would unpack a box of belongings, read a chapter of a review book, complete the corresponding quiz material, and repeat. I wanted to be confident while taking my board exams when test day arrived.

Finally, after a stressful month of preparation, it was time for my MPJE. It was not too long after starting the exam when I started questioning every answer selection. My confidence plummeted more and more as I progressed through the test. I left the testing site filled with anxiety and fear of failure yet wouldn’t know official results for several days. I did my best to put on a brave face because my first day of residency was the following week.

On our first day of residency orientation, we were once again reminded that the Utah MPJE is quite difficult. We were also informed that many residents need to retake the MPJE and to schedule the first attempt early enough to give buffer room for a retake if needed. If we were not licensed by a specific deadline, there was the stark possibility of being dismissed from the residency program; I was paralyzed by fear hearing this. Surely that can’t happen to people like me, who were involved, top of their class, and prepared, right?

These exams do not determine what kind of pharmacist or resident you will be. Only you do.

The unfortunate truth is that it can happen to anyone, including myself. Later that week, I checked to see if my MPJE result was posted. I was speechless and scared when I saw that I had failed. The timing could not have been worse, as the next week was the start of my clinical training, and my study time would be limited. After failing the MPJE exam, I was not permitted to retest for 30 days. While this provided extra time to prepare, it also initiated a monthlong spiral. I went into each day of my residency training until I could retest, thinking, “What if I don’t pass in time and get dismissed?” and “Will this impact my success as a resident or ability to early commit to a PGY-2 program?”

Fortunately, my co-residents and residency program director were my biggest supporters. They rallied around me and provided new study materials, words of encouragement, and the confidence that one setback would not define me. I channeled this positivity into my preparation to hopefully have a different outcome the second time around. As the test date arrived again, I felt more confident walking into the exam. However, with the adaptive nature of the MPJE, I still left feeling just as anxious as the first time. I would again have to wait several days before knowing my fate.

I started my first residency rotation in the meantime and did what I could to not think about it. Fast forward a week and I checked to see if my result was posted. I was elated when I found out I had passed. All of the stress and evening studying sessions had now paid off and I could move forward with residency knowing I was here to stay. As someone who had experienced minimal failure prior to this, I never expected this to be part of my story. However, it is, and I truly believe I’m better for it. I can now write and encourage all future pharmacy graduates that while the MPJE and NAPLEX can be scary, failing is not final and it does not define you. This experience taught me no one is immune to failing board exams, and they must be taken seriously.

After I failed, I spent so much time questioning if I belonged in residency, if I would make a bad resident, and if I wouldn’t be able to early commit. If I could go back and tell myself that it would all be OK, I would. I would express this same sentiment to every up-and-coming pharmacy graduate who is anxious about their licensing exams, too, and especially if they fail, that more than likely, it will be OK. Despite my initial setback, I’ve been able to grow into a successful resident. I have succeeded in my rotations, created lasting relationships with co-residents and preceptors, early committed to a PGY-2 program, and grown so much.

Licensing exams are hard and truly anyone can fail. Furthermore, the possible consequences of these exams, such as being dismissed from residency, make them downright terrifying. But all pharmacy graduates should be equipped with the tools needed for success. If you do fail, it does not define you. My failure did not define me. These exams do not determine what kind of pharmacist or resident you will be. Only you do.