Unique Pharmacy Technician Career Ladder Meets the Needs of a Growing Profession

The practice of pharmacy has undergone significant transformation in recent decades, marked by increasing complexity, technological innovation, and expanded care-delivery models. The integration of automation and artificial intelligence (AI) has significantly enhanced the efficiency and effectiveness of pharmacy technicians, and the overall operations of pharmacies. However, these advancements also present challenges, including the need for continuous monitoring, regular maintenance, and management of downtime, all of which can impact the smooth functioning of pharmacy operations. The COVID-19 pandemic imposed significant hardships on staffing and retention, furthering the need to evaluate and enhance the technician career.

Pharmacy technician career development, challenges, and compensation have been a focus over the past 5 years. Technician salaries vary significantly by region and facility, fueling competition across the US. One point of reference for hourly pay is illustrated in Table 1.¹

Many institutions establish pharmacy technician career ladders to support professional growth, with structures that vary in scope and opportunity. Such ladders may be organized according to pharmacy specialty areas or advanced credentialing requirements. A common model is a 3-tier system, which progresses from beginner to advanced and ultimately to specialty-level roles. Some ladders incorporate a training component before the first tier and may extend to encompass supervisory or leadership pathways. These opportunities have leveraged institutions to retain skilled employees and entice applicants to the organization. Some examples of career ladders (Table 2)² show areas of alignment and distinctions that differ from the model implemented at Mayo Clinic Pharmacy (Table 3).

Efforts in pharmacy technician career development date back over 2 decades, during which advancement opportunities were notably scarce. Primarily, this was isolated to roles in specialty workspaces, or technicians were required to apply for different pharmacy positions with limited opportunities. Our experience showed this structure yielded minimal employee satisfaction and constrained opportunities for professional advancement. Table 4 illustrates the various pathways of interest that pharmacy technicians have now pursued.

By 2018, the pharmacy department had intensified its emphasis on technician training and introduced a program that provided hands-on experience in both entry-level and advanced roles through structured training and education opportunities. This initiative enabled leadership to critically assess the current career ladder and to solicit staff feedback on opportunities for advancement. Findings revealed a significant gap in advancement opportunities, characterized by unequal representation within the Mayo Clinic technician workforce. Specifically, pharmacy technicians working in specific specialty areas had greater access to tier advancement due to a perceived higher skill set, greater flexibility in training for more complex tasks, and increased visibility or alignment with previously defined criteria. Restricted participation in advancement-enabling roles contributed to the perception of inequity among pharmacy technicians with comparable skills and qualifications who were not afforded the same opportunities.

Efforts to enhance the career ladder were suspended in early 2020 due to the COVID-19 pandemic. The Mayo Clinic experienced a surge in employees leaving the profession for various reasons, including the pandemic’s impact, salaries, overall dissatisfaction, and a lack of growth opportunities. The team charged with reviewing and providing proposed changes had regular meetings, collected feedback, and designed a career ladder that offers expanded opportunities for staff. Furthermore, it was crucial to ensure the proposed ladder balanced meaningful contributions to employee satisfaction with financial sustainability. A strategic evaluation was initiated to capture the current state, gather employee feedback, and direct communication and implementation utilizing a structured improvement framework (Table 5). The framework aligned with the DMAIC principles (Define, Measure, Analyze, Improve, Control), a data-driven quality improvement methodology commonly used in Six Sigma to guide process improvement and operational excellence, ensuring a deliberate and sustainable rollout. A “Go Live Plan” was initiated in late 2022, targeting the Midwest region, including Mayo Clinic’s primary campus in Rochester, Minnesota, and affiliated Mayo Clinic Health System locations. This allowed the team to pilot the revised ladder within the largest technician workforce before considering broader implementation across other Mayo Clinic sites. The ladder was structured into 5 tiers, with increased compensation provided at tiers 3, 4, and 5.

By 2022, the team developed a proposed ladder aimed at expanding engagement in the pharmacy profession, strengthening job satisfaction, and supporting retention. Participation in the career ladder includes both internal and external opportunities. External opportunities may involve credentialing or advanced pharmacy leadership education pathways, whereas internal opportunities emphasize educational, research, and quality paths that contribute to departmental advancement and technician development. Supervisors collected data and tracked the professional growth of their assigned technicians. As the technicians progressed and became eligible for the next tier, they were responsible for recording the promotion. Data were collected by the human resources department, which generated a report for the pharmacy department outlining overall progress. The job satisfaction measure was primarily collected through one-on-one interviews, employee emails, staff meetings, and department exit surveys. The human resources and the pharmacy departments collaborated to maintain employee retention data. Following the pandemic, the institution, consistent with national trends, experienced early retirements, reductions in full-time equivalent status, and voluntary resignations. Survey results from other institutions reported average turnover rates of 20% to 30%, with some as high as 41%, citing increased workload, the pandemic, stress, resource shortages, and compensation.³

With resignation rates on the rise, there was a heightened urgency to enhance staff satisfaction and improve retention. By the summer of 2022, leadership secured approval from the human resources and compensation departments to implement the proposed 5-tiered structure (Table 4, Table 6). This revised structure was designed to be inclusive—open to all pharmacy technicians willing to invest in their personal and professional development. The career ladder needed to demonstrate an increased investment in the organization, along with the advancement of employees’ skills and knowledge.

The ladder was designed to align with the organization’s core principles of Practice, Education, Research, Quality, and Leadership. Each pathway incorporated demonstrations of these principles, with increasing depth and complexity as a technician progressed through the tiers. This included an assessment of the difficulty and time commitment associated with the requirements applied in each section. The career ladder was progressively revised to align with these principles, with each tier building on the last and presenting increasingly complex challenges. Additionally, technicians must meet specific educational standards. Eligibility for tiers 3 to 5 necessitates demonstrated work in at least 1 of the 5 categories, and each tier progression requires an additional completed category.

After the revised ladder was launched in November 2022, there was a marked increase in interest among pharmacy technicians. Many quickly embraced the opportunity, gaining the benefits not only from a knowledge and professional development standpoint, but also from a compensation standpoint. Under the previous ladder, employees were limited to a single level of pay grade increase, limiting their financial advancement. The revised ladder offered a 3-level pay-grade increase, thereby fostering a noticeable financial incentive. Prior to 2022, staff members routinely expressed dissatisfaction with their salaries. After the revisions, feedback shifted, with employees commending the efforts to elevate the technician role and enhance pay. There was a noticeable decline in the number of unfavorable salary comments when an employee vacated their position. Documented scenarios in survey forms shifted from pay to different work opportunities. Three employees who have reached the highest tier have commented on the extraordinary work done to enhance the pharmacy technician career and how impressive the promotional pay results have been, which motivated other technicians to take advantage of the opportunity. The leadership team noted enhanced diversity of participation, heightened enthusiasm, and improved staff satisfaction relating to overall compensation. These changes were accompanied by measurable improvements in retention and increased staff engagement regarding future professional opportunities.⁴

Team members continue to actively pursue advancement through the revised ladder, with promotions occurring regularly, often monthly and, at a minimum, quarterly. From 2021 to 2024, turnover rates declined by almost 50%, marking a notable organizational accomplishment. In 2021, there were 110 technician vacancies at Mayo Clinic in Rochester, compared with only 61 in 2024. This resulting enthusiasm has stimulated greater interest in pursuing more challenging career opportunities. As a result, pharmacy leadership is committed to building on this progress by continually evaluating and expanding opportunities that support long-term engagement, development, and retention of pharmacy technicians.

As the pharmacy profession expands and patient needs shift, organizations must be flexible, resilient, and prepared as care strategies evolve. Mayo Clinic continues to leverage automation and artificial intelligence where possible, while also prioritizing overall learning and complex skill-building activities to ensure that competitive opportunities exist. An enhanced career strengthens the assurance that essential skills are attained and uniquely compensated. These structures serve as mechanisms for recruiting and training the highest caliber of talent. As patient care needs evolve, the specialty education and training embedded within a career ladder will be vital to sustaining organizational success.

REFERENCES

1. Occupational employment and wage statistics. U.S. Bureau of Labor Statistics. May 2023. Accessed August 28, 2025. https://www.bls.gov/oes/2023/may/oes292052.htm

2. Deyhim N, Bhakta SB, Varkey AC, et al. Systemization of a pharmacy technician career ladder in a multi-hospital system. Explor Res Clin Soc Pharm. 2021;2:100036. doi:10.1016/j.rcsop.2021.100036

3. Hennessy M. Pharmacy technician shortage is critical. Pharmacy Times. Published November 1, 2022. Accessed August 28, 2025. https://www.pharmacytimes.com/view/pharmacy-technician-shortage-is-critical

4. Advanced pharmacy technician roles. The Pharmacy Technician Society. Accessed August 28, 2025. https://www.pharmtechsociety.org/career/advanced-pharmacy-technician-roles