I always wanted to be a clinical pharmacist, but now...

[Somatic]

I went to pharmacy school because I wanted to be a clinical pharmacist but now that I am about to graduate, I think I might go retail mostly because of the way the job market is. I have worked retail for several years and don't mind it. I also applied to residencies and withdrew from the match (but may still participate in the scramble). I would appreciate any advice on whether my thought process is logical on why I should just go retail rather than do a residency.

My biggest reason for not doing a residency is that I fear I might have a hard time finding a job with just completing a PGY1. Also, clinical pharmacists are not recognized or reimbursed by insurance companies so if the hospital has budget cuts, they may cut clinical pharmacists since they don't generate profit for the institution.

On the other hand, I know there are threats to retail such as cuts on reimbursement from insurance companies and automation. I recently watched a video on this thing that's like red box but for prescriptions. I fear something like that may become widespread in the next several years.

I would appreciate any insight on retail pharmacy vs clinical pharmacy. Is one better than the other? Does one have a more secure future than the other?

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[dingerx]

I went to pharmacy school because I wanted to be a clinical pharmacist but now that I am about to graduate, I think I might go retail mostly because of the way the job market is. I have worked retail for several years and don't mind it. I also applied to residencies and withdrew from the match (but may still participate in the scramble). I would appreciate any advice on whether my thought process is logical on why I should just go retail rather than do a residency.

My biggest reason for not doing a residency is that I fear I might have a hard time finding a job with just completing a PGY1. Also, clinical pharmacists are not recognized or reimbursed by insurance companies so if the hospital has budget cuts, they may cut clinical pharmacists since they don't generate profit for the institution.

On the other hand, I know there are threats to retail such as cuts on reimbursement from insurance companies and automation. I recently watched a video on this thing that's like red box but for prescriptions. I fear something like that may become widespread in the next several years.

I would appreciate any insight on retail pharmacy vs clinical pharmacy. Is one better than the other? Does one have a more secure future than the other?

This is my perspective. Get as far away from "traditional" pharmacy as possible. Retail will get worse because of profit requirements and clinical programs are not expanding fast enough or at all. Do what makes you happy, pay off your bills (no BMW right now) and save some cash. I went back to school part time and am working full time and really enjoying it. Oh, the final piece of info is I really don't know much. This is just my opinion. Nobody knows what to do. If they did, they'd be rich, retired and did I say rich?

 

[aboveliquidice]

I went to pharmacy school because I wanted to be a clinical pharmacist but now that I am about to graduate, I think I might go retail mostly because of the way the job market is. I have worked retail for several years and don't mind it. I also applied to residencies and withdrew from the match (but may still participate in the scramble). I would appreciate any advice on whether my thought process is logical on why I should just go retail rather than do a residency.

My biggest reason for not doing a residency is that I fear I might have a hard time finding a job with just completing a PGY1. Also, clinical pharmacists are not recognized or reimbursed by insurance companies so if the hospital has budget cuts, they may cut clinical pharmacists since they don't generate profit for the institution.

On the other hand, I know there are threats to retail such as cuts on reimbursement from insurance companies and automation. I recently watched a video on this thing that's like red box but for prescriptions. I fear something like that may become widespread in the next several years.

I would appreciate any insight on retail pharmacy vs clinical pharmacy. Is one better than the other? Does one have a more secure future than the other?

Clinical pharmacy, as a term, should be a banned term. It encompasses so many different jobs that have very little to do with each other. At my institution, we have 10 (maybe a few more) clinical pharmacists. They are all specialists. These include MICU/SICU, ID/HIV, transplant, nephrology, geriatrics, anticoag, nuclear, oncology, warrior training and pain. The only major specialty we are missing (and I think this will be fixed in the coming years) is psych.

None of these pharmacists "man the line" or fill prescriptions in the traditional sense. They round with the internal medicine teams, precept residents and students, conduct primary research, and generally drive the decision making process of pharmacy.

If that sounds like something you want to do, then residency is for you. That being said, there is nothing wrong with being a line pharmacist. I know for me, filling xxx scripts per day wasn't desirable.

 

[Farcus]

Clinical pharmacy, as a term, should be a banned term. It encompasses so many different jobs that have very little to do with each other. At my institution, we have 10 (maybe a few more) clinical pharmacists. They are all specialists. These include MICU/SICU, ID/HIV, transplant, nephrology, geriatrics, anticoag, nuclear, oncology, warrior training and pain. The only major specialty we are missing (and I think this will be fixed in the coming years) is psych.

None of these pharmacists "man the line" or fill prescriptions in the traditional sense. They round with the internal medicine teams, precept residents and students, conduct primary research, and generally drive the decision making process of pharmacy.

If that sounds like something you want to do, then residency is for you. That being said, there is nothing wrong with being a line pharmacist. I know for me, filling xxx scripts per day wasn't desirable.

You made your institution sound like heaven for what it is.

 

[PharmDstudent]

I wanted to do "clinical" pharmacy before I got into pharmacy school, too, but then I realized that it was what all of my aggravating professors did AND it required a year or more of a reduced salary plus other hoops that I had no interest in jumping through.
Now I'm an overnight retail pharmacist, and I work PRN at a small hospital. It's all good!

There are so many types of pharmacy that I think you could muse on it for awhile before forcing yourself to do one or the other.

 

[Pharmacy Kid]

At my institution, we have 10 (maybe a few more) clinical pharmacists. They are all specialists. These include MICU/SICU, ID/HIV, transplant, nephrology, geriatrics, anticoag, nuclear, oncology, warrior training and pain. TQUOTE]

I plan to do a PGY-1 and PGY-2 in warrior training.

 

[gtpederson]

At my institution, we have 10 (maybe a few more) clinical pharmacists. They are all specialists. These include MICU/SICU, ID/HIV, transplant, nephrology, geriatrics, anticoag, nuclear, oncology, warrior training and pain. TQUOTE]

I plan to do a PGY-1 and PGY-2 in warrior training.

This is your spatula. There are many like it, but this one is yours. Without it, you are nothing. Without you, it is nothing.

 

[Pharmacy Kid]

This is your spatula. There are many like it, but this one is yours. Without it, you are nothing. Without you, it is nothing.

"How much can you know about yourself, if you've never been in a fight?"

 

[297point1]

I recently watched a video on this thing that's like red box but for prescriptions. I fear something like that may become widespread in the next several years.

I saw something like that when I went through pharmacy school. The technology to do this has been available for 20 years; unless state laws change, it will always be the 'future of pharmacy', and never the present.

There are many bigger threats to retail pharmacy than a red box.

 

[297point1]

"How much can you know about yourself, if you've never been in a fight?"

This is my spatula, this is my gun.
This is for counting, this is for fun.

 

[WhiteSnows]

I thought about residency for the first year but I realize the same thing as you did. So I decide to do a Ph.D in pharmaceutics after Pharmacy. This is a long term investment so I would not mind. I am also young and motivated in any way, plus I do not plan to get married soon.

 

[Somatic]

I saw something like that when I went through pharmacy school. The technology to do this has been available for 20 years; unless state laws change, it will always be the 'future of pharmacy', and never the present.

There are many bigger threats to retail pharmacy than a red box.

What are the threats to retail pharmacy in your opinion? Do you think going the clinical route is any more secure?

 

[mmdw]

I have always been interested in pharmacy, but thought of retail pharmacy as boring. I recently heard about clinical pharmacy and thought it was really interesting. However, after reading these forums, and speaking to my friend in pharmacy school, it seems like everyone is terrified there won't be any jobs when they graduate. Is this how it is projected to be even when I would potentially graduate in 2016 or 2017?

 

[homeslice]

I have always been interested in pharmacy, but thought of retail pharmacy as boring. I recently heard about clinical pharmacy and thought it was really interesting. However, after reading these forums, and speaking to my friend in pharmacy school, it seems like everyone is terrified there won't be any jobs when they graduate. Is this how it is projected to be even when I would potentially graduate in 2016 or 2017?

By that time there will be negative jobs. You'll have to pay the nearest pharmacy to be unemployed.

Based on these boards, at least.

 

[297point1]

What are the threats to retail pharmacy in your opinion? Do you think going the clinical route is any more secure?

These threats have been discussed ad nauseum on this site- look for posts from folks in the trenches.

The clinical route is no more secure, but it does open up a wealth of opportunities that won't be available to you if you stick to a retail track.

 

[goodmusic00]

So, why would people interested in clinical pharmacy?
Considering nowadays, being a clinical pharmacist typically needs BA/BS + 4 yr Pharm school +1 or 2 PGY =9-10 yrs
which is almost same as Medical school.

Plus, the tuition for pharm school is also about the same as medical school, roughly around 150k to 200k for four years.

So, considering that pharmacy field is so uncertain now, and you have to be very competitive to be able to get in residency.
Which means, you have to study just as hard as medical students if not more.
And yet, when you are working as a clinical pharmacist, you don't get the respect, the salary, of what a physician will get. Also, it is harder to get a job at a location where you like to live too. (with that amount of hard work, long training, debt, is it worth it?)

So, nowadays, is it still worth it to go to clinical pharmacy?

 

[rxstudent13]

Go with what makes you happy, not by what people tell you to do. I met two retail pharmacists who did a residency and they hated it. They did not enjoy getting up at the crack of dawn, rounding with physicians, and working long hours. Do it if you know you're going to love it. Retail pharmacy can be fun. It just depends on how you approach. If you don't like either, there's still Am Care and Managed Care, but those jobs are very rare.

 

[spacecowgirl]

So, why would people interested in clinical pharmacy?
Considering nowadays, being a clinical pharmacist typically needs BA/BS + 4 yr Pharm school +1 or 2 PGY =9-10 yrs
which is almost same as Medical school.

Plus, the tuition for pharm school is also about the same as medical school, roughly around 150k to 200k for four years.

So, considering that pharmacy field is so uncertain now, and you have to be very competitive to be able to get in residency.
Which means, you have to study just as hard as medical students if not more.
And yet, when you are working as a clinical pharmacist, you don't get the respect, the salary, of what a physician will get. Also, it is harder to get a job at a location where you like to live too. (with that amount of hard work, long training, debt, is it worth it?)

So, nowadays, is it still worth it to go to clinical pharmacy?

Well, if you don't want to be a physician and you want to be a pharmacist, I guess that would help make your decision.

Maybe it's because I came from a completely different social sciences, humanities background vs. a science background, but I don't understand this "why be a pharmacist when you can be a doctor" thing that is going around SDN. They are completely different careers with some pre-reqs in common. Being a pharmcist is not an ego-substitute for being a physician. Go the pharmacy route because you want to be a pharmacist. Not that hard to understand.

 

[Praziquantel86]

Well, if you don't want to be a physician and you want to be a pharmacist, I guess that would help make your decision.

Maybe it's because I came from a completely different social sciences, numanities background vs. a science background, but I don't understand this "why be a pharmacist when you can be a doctor" thing that is going around SDN. They are completely different careers with some pre-reqs in common. Being a pharmcist is not an ego-substitute for being a physician. Go the pharmacy route because you want to be a pharmacist. Not that hard to understand.

This. I don't understand the conglomeration of healthcare that goes on in people's heads. You want to be a physician, be a physician. Like pharmacy? Be a pharmacist. Enjoy nursing? Go be a nurse. They are distinct jobs with a common theme.

I think it comes from the pre-health advisors, just because I can't think of any other place that it could come from. Very frustrating.

 

[All4MyDaughter]

Well, if you don't want to be a physician and you want to be a pharmacist, I guess that would help make your decision.

Maybe it's because I came from a completely different social sciences, numanities background vs. a science background, but I don't understand this "why be a pharmacist when you can be a doctor" thing that is going around SDN. They are completely different careers with some pre-reqs in common. Being a pharmcist is not an ego-substitute for being a physician. Go the pharmacy route because you want to be a pharmacist. Not that hard to understand.

Yeah, physicians do rectal exams and pap smears and cut people open and have to look at pee and poop and other nasty things. I don't like blood or butts. I wanted to be a pharmacist, not a physician.

 

[PharmD RPh]

I would love to sit at home all day and play halo on xbox. It requires very little education outside of reading the game's manual. Tuition is about $60 (cost of the game) and you can start your job right away. However after reading online that no one was willing to pay me to do this, I decided to look at different career options that were in need and actually paid me. The horrible outlook on being a halo player as an occupation steered me away from it. Now I'm a pharmacist.

 

[owlegrad]

This. I don't understand the conglomeration of healthcare that goes on in people's heads. You want to be a physician, be a physician. Like pharmacy? Be a pharmacist. Enjoy nursing? Go be a nurse. They are distinct jobs with a common theme.

I think it comes from the pre-health advisors, just because I can't think of any other place that it could come from. Very frustrating.

Interesting thought. I always assumed that it came from people being uneducated about what exactly the roles of various health care providers are exactly. Do you think mechanics are often asked why they didn't become electricians?

Some conversations lead me to believe people seem to think that every health care worker wants to be a doctor and that we settle for something less when we fail to make it into med school or something. Which I guess is sometimes true, but I doubt it is as common as some people seem to think it is.

 

[ucrx]

Well, if you don't want to be a physician and you want to be a pharmacist, I guess that would help make your decision.

Maybe it's because I came from a completely different social sciences, humanities background vs. a science background, but I don't understand this "why be a pharmacist when you can be a doctor" thing that is going around SDN. They are completely different careers with some pre-reqs in common. Being a pharmcist is not an ego-substitute for being a physician. Go the pharmacy route because you want to be a pharmacist. Not that hard to understand.

100% agree.

I didn't/don't want to be a physician, PA, nurse, dentist, or whatever other health care professional you can come up with. I didn't go to pharmacy school for the money, status, or any other thing that could be given to me by these other degrees/professions. I did it because I find the medication aspect of health care interesting. I don't want to do any of the other crazy things that need to be done in medicine. That doesn't mean I don't have respect for the people doing these things. I think I may have more respect for them because they do things I never want to do.

So if people want to go into pharmacy (whatever aspect of pharmacy)- do it. If you want to do residency/clinical pharmacy, do it. If you want to work in retail, do it.

 

[MatCauthon]

Ok... a lot of ignorance in this thread. Clinical pharmacy is as much a part of community pharmacy as it is hospital/ambulatory pharmacy. Clinical pharmacy is a large-growth area in community pharmacy right now. Ambulatory and community pharmacy are going to continue to morph together. Community/retail pharmacy residencies are the ones that are the most rapidly increasing right now.

Many large chains have started clinical pharmacy divisions and are actively lobbying/advocating to change state laws to benefit their cause. Vaccinations, travel clinics, MTMs, diabetes/HTN/lipid/pain/asthma/COPD management programs are becoming more common in community pharmacy right now. Some of these positions may be more desirable than some of the hospital positions out there.

There is no one straight path to clinical pharmacy anymore.

 

[Thoughtfulsinner]

If you want to do a residency, just go to medical school.

 

[Sparda29]

I would love to sit at home all day and play halo on xbox. It requires very little education outside of reading the game's manual. Tuition is about $60 (cost of the game) and you can start your job right away. However after reading online that no one was willing to pay me to do this, I decided to look at different career options that were in need and actually paid me. The horrible outlook on being a halo player as an occupation steered me away from it. Now I'm a pharmacist.

If you're good enough, you can make a pretty decent living playing video games. I used to play Counter-Strike 6-7 hours a day and going to tournaments. Unfortunately, I didn't catch that one of the people in my clan was cheating (wall hacks/aim bot) and when he got caught, they banned all of us from the league.

 

[rph3664]

I'm one of those people who went to pharmacy school because I wanted to be a pharmacist, not a nurse, a doctor, or anything else.

17 years after graduation, I'm not sure I want to be a pharmacist any more, either. Whether I remain one, at least for now, will be determined in the next few weeks.

 

[ucrx]

If you want to do a residency, just go to medical school.

... but I don't want to be a doctor.

Plus, I can (and will) finish pharmacy school and 2 years of residency when I'm 26. That would be pretty much impossible with med school (4 years pre-med, 4 years med, 3+ years residency/fellowship).... no thanks.

I'm just going to keep saying this every time someone posts that people should just go to med school.

 

[Thoughtfulsinner]

I'm one of those people who went to pharmacy school because I wanted to be a pharmacist, not a nurse, a doctor, or anything else.

17 years after graduation, I'm not sure I want to be a pharmacist any more, either. Whether I remain one, at least for now, will be determined in the next few weeks.

Lots of people feel this way when they realize they don't have much authority to make changes to a patient's therapy. It's nice to think you're being useful, but the reality is the physician does what they want, not what you want.

 

[goodmusic00]

... but I don't want to be a doctor.

Plus, I can (and will) finish pharmacy school and 2 years of residency when I'm 26. That would be pretty much impossible with med school (4 years pre-med, 4 years med, 3+ years residency/fellowship).... no thanks.

I'm just going to keep saying this every time someone posts that people should just go to med school.

But do you see the point that I made, nowadays many students have to get 4 yr undergraduate degree in order to apply to pharm school.

That means, if someone finish high school at 16, he/she can be done med school at 16+4+4+3=27.

So, in that case, what is the difference at age?

 

[ucrx]

But do you see the point that I made, nowadays many students have to get 4 yr undergraduate degree in order to apply to pharm school.

That means, if someone finish high school at 16, he/she can be done med school at 16+4+4+3=27.

So, in that case, what is the difference at age?

I get the time isn't a big deal for people who do 4 years of undergrad, but I don't think most people doing residency are doing it to be just like a doctor. We went to pharmacy school to be pharmacists, not doctors. The time really didn't make a big deal to me. If people really want to be doctors, they can go after pharm school.

 

[TemSirolimus]

residency trained pharmacists in inpatient settings are like big burly pitbulls with no teeth.

Armed to the teeth with considerable amount of knowledge but must tip-toe around egotistical providers (mostly older MDs), trying hard not to put a dent on their pride with therapy recommendations.

Diplomacy is a must to thrive as a clipboard pharmacist. That alone is enough to steer me a way from such a career path.

 

[spacecowgirl]

residency trained pharmacists in inpatient settings are like big burly pitbulls with no teeth.

Armed to the teeth with considerable amount of knowledge but must tip-toe around egotistical providers (mostly older MDs), trying hard not to put a dent on their pride with therapy recommendations.

Diplomacy is a must to thrive as a clipboard pharmacist. That alone is enough to steer me a way from such a career path.

BS. Why are there so many misinformed, idiotic posts in this thread? God. There are places like this. There are places that are not like this. Don't make a generalized statement like this.

 

[Its Z]

residency trained pharmacists in inpatient settings are like big burly pitbulls with no teeth.

Armed to the teeth with considerable amount of knowledge but must tip-toe around egotistical providers (mostly older MDs), trying hard not to put a dent on their pride with therapy recommendations.

Diplomacy is a must to thrive as a clipboard pharmacist. That alone is enough to steer me a way from such a career path.

Is that right?

 

[spacecowgirl]

Diplomacy is a must to thrive as a clipboard pharmacist. That alone is enough to steer me a way from such a career path.

Diplomacy is a must for any job.

My sense of worth in my job is not based on who takes my suggestions. I do a lot more than make therapy recommendations. I don't know any of this clipboard pharmacists you speak of, but that's not how the pharmacists in my dept work.

 

[rph3664]

residency trained pharmacists in inpatient settings are like big burly pitbulls with no teeth.

Armed to the teeth with considerable amount of knowledge but must tip-toe around egotistical providers (mostly older MDs), trying hard not to put a dent on their pride with therapy recommendations.

Diplomacy is a must to thrive as a clipboard pharmacist. That alone is enough to steer me a way from such a career path.

The most megalomaniacal doctors I have dealt with are younger women. YMMV, of course.

 

[KARM12]

Diplomacy is a must for any job.

My sense of worth in my job is not based on who takes my suggestions. I do a lot more than make therapy recommendations. I don't know any of this clipboard pharmacists you speak of, but that's not how the pharmacists in my dept work.

Agree. I don't own a clipboard and I don't go around telling prescribers what to do. 90% of the time they are calling me for help and questions.

 

[aboveliquidice]

Agree. I don't own a clipboard and I don't go around telling prescribers what to do. 90% of the time they are calling me for help and questions.

This... Our role on the team is being a resource. All of my attendings thus far (6) have appreciated this. Pulling interns aside and mentioning the dosage adjustment / med indication s/he missed (and impressing the resident), will earn you their appreciation and respect as a member of the team.

 

[Pharmacy Kid]

I own a clipboard, but it's for my workouts.

 

[rph3664]

Lots of people feel this way when they realize they don't have much authority to make changes to a patient's therapy. It's nice to think you're being useful, but the reality is the physician does what they want, not what you want.

And it's our job to evaluate what the physician ordered, and if it's something really unusual or inadvisable, or we've never heard of it before, to talk to them about why they want to do this. Most of them are amenable to changing therapy if it's warranted.

Some of the posts on this board are quite obviously from undergrads, and I'm trying to find a way to say "You don't know what you're talking about" in a tactful manner, KWIM? There is no substitute for actual job experience, and job shadowing and clinical rotations don't count.

 

[TemSirolimus]

hear, hear

Perhaps some other pharmacy departments are run differently from what I have seen so far. My observations were first hand, not anecdotal. Still, a staffing job with some added clinical roles would more than suffice for me.