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I find this thread intriguing because I've had this internal conflict about pursuing a residency since I first applied to pharmacy school. I'm currently a PY2 in the PharmD/MBA program working 2 hospital jobs (1 small critical access hospital and the other a large academic teaching hospital affiliated with my college of pharmacy). Having picked the brains of every pharmacist that I've worked with, I still can't decide if a residency is "worth it." For what it's worth, I am a pessimist, and I've known that my college of pharmacy has been pumping out bull**** since the day I stepped foot on campus. So perhaps my opinion is biased about academia (applied first go around, didn't get in, yet my class has inherited 5 people that failed the year that I was denied and I'm doing fantastic in school as I'm arguably one of the busiest most involved students in my class, they push residencies like no other, they speak of all the possibilities your future beholds yet forget to mention most grads get stuck in the path that they take, etc etc)
Most of the staff pharmacists seem to think that a residency alienates the workforce. From my observations I agree with this statement. I see little if any difference between the clinical pharmacists at my academic institution vs the pharmacists at my critical access hospital. Non of the small hospital pharmacists are residency trained, yet their experience more than overcomes it. The ironic thing is, everyone seems to gun for the large academic institution jobs because they think it's the greatest thing since sliced bread. I think that is farther from the truth. The pay difference between the smaller hospital and the academic center is greater than the difference between retail "hospital," meaning, the smaller hospital pays a **** ton more than the larger institution. In addition, the pharmacy hours at the smaller hospital are 9-5 through the week, and 9-2PM on weekends, 1 weekend per month, and you don't have to put up with the "clinical segregation" that exists at the larger hospital. People are fighting tooth and nail to get into the residency programs at my larger hospital because the programs are arguably some of the best in the country, however you work a minimum of 80 hours/week, and once you graduate, you are looking at a job that doesn't necessarily pay too well (if you stay in house, which not many do)...and, not that the atmosphere is toxic, it's just the expectations and competition among pharmacists is so high because of it's reputation, it's just not they type of job that I see myself taking because I can't be "me."
My dilemma lies only upon what the outlook looks like in May 2016. I keep telling myself that if I have an institutional job offer at a non profit (I have 200K in debt so I will doing IBR with 10 year loan forgiveness), I would be stupid not to take it. Having said that, I don't want to get stuck in retail, so if I have to do a residency to end up in an institutional setting, I have no choice but to follow through with it. But...I discovered that you can do IBR repayment while in the residency program, so if that's the case, that changes things considerably. Financials aren't everything but this is what I'm looking at:
Staff Position: ~$100K/year
After Taxes: $72,000/year or $6,000/month
IBR Monthly Payment: $950
Take Home: $5,050 X 12 = $60,600 X 2 = $121,200 take home after taxes and loans working as a staff pharmacist right out of school
Residency Position: ~$40K/year (I'm assuming this, I have no idea what residencies pay these days)
After Taxes: $33,944/year or $2,828/month
IBR Monthly Payment: Starts at $285/month Finishes at $971/month 30 years later, so let's be conservative and say $350/month while in residency
Take Home: $2,478 X 12 = $29,736 X 2 = $59,472 take home after taxes and loans working as a resident (slave)
121,200 - 59,472 = ~$61,728 is an estimated difference in the "usable" dollars I would lose out on if I elected to do 2 years of residency
Unfortunately, this doesn't quantify personal satisfaction, social life, family time, etc etc as many of the residents I've talked to (residency specific) really don't appear to be happy due to the amount of time they spend working and what they are missing out on in life. To me, this is the biggest reason I don't want to do a residency. I've shoveled **** for the past 10 years just to get to where I'm at. I don't want to wait until I'm 30 to start reaping the rewards of my hard work. If I did do a residency, I feel like I would be able to overcome that $60K difference in the long run (I hope, with 3,000 new residents/year, that may not be possible, but I'm confident in my abilities), it's just I've alienated so many people already since pharmacy school began. I'm taking 25 credit hours, working 2 jobs which consumes every weekend per month except 1 which I then spend studying for block exams. I essentially have no life, and I'm ready to change that once I graduate. I feel like doing a residency will just further isolate myself from the rest of the world, and eventually I'll be consumed by my work because that's all I know.
The only other fear I have is being stuck in a staff position that I don't like if I don't do a residency and simply take a staff position. I can see already that this is institution specific. The staffers at my larger hospital look like they HATE their life. Working 7 Christmas' in a row, all you do is right click to verify orders, stamp your name on every cart fill item/ Pyxis stock out. On the flip side, at the smaller hospital, they truly think they have a unicorn job (because they do). These "staff" pharmacists do everything that needs to be accomplished by a pharmacy department between 3 full time pharmacists. This means that they stay engaged in a variety of tasks, from order entry, to checking, to clinically intervening, to dosing. They don't do a lot of one thing, they do a tiny bit of everything, and they all love what they do and they all have amazing lives outside of work (vacations every 3 months, nice cars, nice homes, kids in private schools, yada yada). That's the kind of life I personally want, so I'm trying everything I can to set myself up for a position like that.
Most of the staff pharmacists seem to think that a residency alienates the workforce. From my observations I agree with this statement. I see little if any difference between the clinical pharmacists at my academic institution vs the pharmacists at my critical access hospital. Non of the small hospital pharmacists are residency trained, yet their experience more than overcomes it. The ironic thing is, everyone seems to gun for the large academic institution jobs because they think it's the greatest thing since sliced bread. I think that is farther from the truth. The pay difference between the smaller hospital and the academic center is greater than the difference between retail "hospital," meaning, the smaller hospital pays a **** ton more than the larger institution. In addition, the pharmacy hours at the smaller hospital are 9-5 through the week, and 9-2PM on weekends, 1 weekend per month, and you don't have to put up with the "clinical segregation" that exists at the larger hospital. People are fighting tooth and nail to get into the residency programs at my larger hospital because the programs are arguably some of the best in the country, however you work a minimum of 80 hours/week, and once you graduate, you are looking at a job that doesn't necessarily pay too well (if you stay in house, which not many do)...and, not that the atmosphere is toxic, it's just the expectations and competition among pharmacists is so high because of it's reputation, it's just not they type of job that I see myself taking because I can't be "me."
My dilemma lies only upon what the outlook looks like in May 2016. I keep telling myself that if I have an institutional job offer at a non profit (I have 200K in debt so I will doing IBR with 10 year loan forgiveness), I would be stupid not to take it. Having said that, I don't want to get stuck in retail, so if I have to do a residency to end up in an institutional setting, I have no choice but to follow through with it. But...I discovered that you can do IBR repayment while in the residency program, so if that's the case, that changes things considerably. Financials aren't everything but this is what I'm looking at:
Staff Position: ~$100K/year
After Taxes: $72,000/year or $6,000/month
IBR Monthly Payment: $950
Take Home: $5,050 X 12 = $60,600 X 2 = $121,200 take home after taxes and loans working as a staff pharmacist right out of school
Residency Position: ~$40K/year (I'm assuming this, I have no idea what residencies pay these days)
After Taxes: $33,944/year or $2,828/month
IBR Monthly Payment: Starts at $285/month Finishes at $971/month 30 years later, so let's be conservative and say $350/month while in residency
Take Home: $2,478 X 12 = $29,736 X 2 = $59,472 take home after taxes and loans working as a resident (slave)
121,200 - 59,472 = ~$61,728 is an estimated difference in the "usable" dollars I would lose out on if I elected to do 2 years of residency
Unfortunately, this doesn't quantify personal satisfaction, social life, family time, etc etc as many of the residents I've talked to (residency specific) really don't appear to be happy due to the amount of time they spend working and what they are missing out on in life. To me, this is the biggest reason I don't want to do a residency. I've shoveled **** for the past 10 years just to get to where I'm at. I don't want to wait until I'm 30 to start reaping the rewards of my hard work. If I did do a residency, I feel like I would be able to overcome that $60K difference in the long run (I hope, with 3,000 new residents/year, that may not be possible, but I'm confident in my abilities), it's just I've alienated so many people already since pharmacy school began. I'm taking 25 credit hours, working 2 jobs which consumes every weekend per month except 1 which I then spend studying for block exams. I essentially have no life, and I'm ready to change that once I graduate. I feel like doing a residency will just further isolate myself from the rest of the world, and eventually I'll be consumed by my work because that's all I know.
The only other fear I have is being stuck in a staff position that I don't like if I don't do a residency and simply take a staff position. I can see already that this is institution specific. The staffers at my larger hospital look like they HATE their life. Working 7 Christmas' in a row, all you do is right click to verify orders, stamp your name on every cart fill item/ Pyxis stock out. On the flip side, at the smaller hospital, they truly think they have a unicorn job (because they do). These "staff" pharmacists do everything that needs to be accomplished by a pharmacy department between 3 full time pharmacists. This means that they stay engaged in a variety of tasks, from order entry, to checking, to clinically intervening, to dosing. They don't do a lot of one thing, they do a tiny bit of everything, and they all love what they do and they all have amazing lives outside of work (vacations every 3 months, nice cars, nice homes, kids in private schools, yada yada). That's the kind of life I personally want, so I'm trying everything I can to set myself up for a position like that.