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Most in-demand specialty?

Discussion in 'Pharmacy Residencies and Fellowships' started by DaveRX, Jul 7, 2008.

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  1. DaveRX

    DaveRX Junior Member

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    I am interested in doing a specialty residency but I wanted to know which one is in demand. My areas of interest are Infectious Disease, Oncology, and Cardiology specifically but I am willing to look into other areas if there will be more job opportunities.
  2. ItsOverZyvox

    ItsOverZyvox Retired

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    Thanks to Antimicrobial stewardship article in IDSA guideline, one of the most sought after pharmacists are the ones with PGY1 residency and an ID Fellowship. You can name your price right now.
  3. janeno

    janeno Senior Member

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    Excuse my ignorance, but how safe is infectious disease specialty? What is the chance of catching something from the patient?
  4. Priapism321

    Priapism321 Bursting with enthusiasm

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    I am always much more worried about giving the patients something I am carrying in me/on me than the other way around...
  5. ItsOverZyvox

    ItsOverZyvox Retired

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    Slightly higher than catching cardiovascular disease from heart patients.
  6. ItsOverZyvox

    ItsOverZyvox Retired

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    Brush your teeth you foo..
  7. DaveRX

    DaveRX Junior Member

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    Why a fellowship and not an ID residency? or would either suffice? I'm interested in ID but not so much in research.
  8. ItsOverZyvox

    ItsOverZyvox Retired

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    ID fellowship doesn't mean research... well if you can find first year ID residency, then go for it.
  9. janeno

    janeno Senior Member

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    What about oncology or cardiology? Is there a demand for specialized pharmacists in these areas?
  10. ItsOverZyvox

    ItsOverZyvox Retired

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    Oncology..some. Cardiology? What does a cardio-pharmacist do? Invasive Cath procedures?
  11. janeno

    janeno Senior Member

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    what about critical care? there are tons of residencies for this specialty.
  12. ItsOverZyvox

    ItsOverZyvox Retired

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    boring.
  13. janeno

    janeno Senior Member

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    what do you mean boring?
  14. njac

    njac Senior Member

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    I've heard that, but recently someone was telling me that there is a glut of ID pharmacists. They also said the same of critical care... Think they're trying to talk me out of something?
  15. ItsOverZyvox

    ItsOverZyvox Retired

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    glut of ID pharmacists? Is that right? I've been trying to hire an ID pharmacist for the past 6 months. In an easy to hire area. I couldn't even convince on ID pharmacist to move from a podunk little town.

    I don't know about critical care. They're useless to me and I have no need for them at all.
  16. ItsOverZyvox

    ItsOverZyvox Retired

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    Offering M-F no weekend no staffing position with all holidays off. Opportunity to travel, present, and teach. $115,000 per year.

    Can't find no one..
  17. njac

    njac Senior Member

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    where?

    teaching hospital?
  18. ItsOverZyvox

    ItsOverZyvox Retired

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    No where near you are. And yes....

    Heck..at the rate I'm going, by the time you're done with residency and ID fellowship, it may still be open.
  19. njac

    njac Senior Member

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    I have zero interest in staying where I am.

    And figuring a 1 year PGY1 and a 1 year PGY2 specialty (vs fellowship) you've only got 3 years!
  20. ItsOverZyvox

    ItsOverZyvox Retired

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    PGY2 ID will do....
  21. ItsOverZyvox

    ItsOverZyvox Retired

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    Then we'll teach you Abx Stewardship. And it won't take one year.
  22. ItsOverZyvox

    ItsOverZyvox Retired

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    You know what will be impressive? You already have access to this stuff through your purchaser....start quoting cost per day for ABX therapy to you peers and dierctor and pharmacists...

    "hmmm Levaquin 750mg IV costs $9 per day...but PO costs over $16...."

    "why are we using Zyvox 600mg IV at $155 per day when we can give Vancomycin for $6 per 1 gram?"

    "why are we using Cancidas at $114 per 50mg when patient has Candida Albican.... where we can use Fluconazole 400mg IV for less than $15 per day?"

    "why are we using Invanz at $50 per dose when we can use Ceftriaxone 1 gram which costs $3 per dose and flagyl 500mg IV q6h...which costs like nothing?"
  23. Priapism321

    Priapism321 Bursting with enthusiasm

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    Or:

    "Why are we using anidulafungin when the patient has dose-dependent fluconazole sensitive glabrata?"

    "Why are you writing for linezolid when the patient has a VRE UTI, how about ampicillin, which you know concentrates to like 3000 mcg/ml in urine?"
  24. ItsOverZyvox

    ItsOverZyvox Retired

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    "Why can't we try tobramycin injection for inhalation instead of TOBI?

    "Why are we giving xopenex at $2.80 per dose when albuterol costs 10 cents per dose.....they have identical active ingredient..and same ADR profile."

    Why are we giving Merrem 2 grams q8h at $188 per day when we can give Zosyn 4.5 grams q6h for $80 per day to treat pseudomonas?

    :smuggrin:
  25. Priapism321

    Priapism321 Bursting with enthusiasm

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    Why not make it a 4.5 gram bolus followed by 13.5 grams continuous per 24 hours? Only a few people per week required pip/tazo at my previous institution; even less meropenem.
  26. ItsOverZyvox

    ItsOverZyvox Retired

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    Because it's an ICU patient with all the lines tied up.
  27. Priapism321

    Priapism321 Bursting with enthusiasm

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    Excellent point. What about 3.375 grams q8h given as four hour infusions? Just trying to help your bottom line here.
  28. njac

    njac Senior Member

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    my last rotation had an ID pharmacist with no order entry duties and a M-F 9-5 job. And still, everyone in the place was on Zosyn and they wondered why there was such a godawful C.Diff problem there.

    My favorite part was that everyone, no matter the infection, age or renal function, was started on Vanco 1g Q12H. And then everyone was shocked when the trough pre 4th dose was 4 or 40. They also very rarely used any continuous infusion abx - and again, started vanco at 2g/24h and zosyn at 9g/24h. Regardless of infection and previous level (vanco).
  29. ItsOverZyvox

    ItsOverZyvox Retired

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    Because, 4 hour infusion ties up the line also. And I anecdotally believe that continuous infusion of beta lactam type abx can cause gram negative resistance... Read Nicolau's article from June of 2007...
  30. ItsOverZyvox

    ItsOverZyvox Retired

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    C-Diff ? Hand washing!!! But quinolones are more likely to cause C-Diff than Pip Tazo... then again, anything can cuse C-Diff.

    BTW...your ID pharmacist wasn't doing the job... Zosyn is ok as long as it's appropriate..but everyone being on it probably isn't appropriate.
  31. CYP3A4

    CYP3A4 P450

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    Well, since we are on the the topic of ID residencies, I want to know something. I have 6 years of clinical hospital microbiology background (Micro was my undergrad degree and has gotten me through pharmacy school without having to work for the lousy money techs make).

    Now, if I do an ID rotation during my fourth year AND spend a large portion of my PGY1 year in ID along with my extensive micro background, will I have the same chance of snagging a ID pharmacist job as someone who did just an ID PGY2?

    I don't mean to sound like another lazy pharmacy student who doesn't like the idea of doing a PGY2, but given my circumstances I think I have an edge most pharmacists wouldn't.

    Thought? Opinions?
  32. ItsOverZyvox

    ItsOverZyvox Retired

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    That will depend on you. Most microbiologists I've worked with were clueless to ID pharmacotherapy. I will hire a person without the residency if they know what they're doing.
  33. momoftwosons

    momoftwosons

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    I am new to the pharmacy talks and would like to know what ID means (please excuse my ignorance).

    ***Does it mean Infectious Disease?
  34. njac

    njac Senior Member

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    Infectious Disease.
  35. CYP3A4

    CYP3A4 P450

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    yes, but did those microbiologists go to pharmacy school? You are right though, i guess it will depend on me.
  36. njac

    njac Senior Member

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    from what I've seen from the 4th year ID rotation I don't think it would be enough to consider oneself an ID specialist. You may be awesome, but I would think a specialty would still be advantageous.

    We have excellent ID professors and still didn't touch on several major subjects in our therapeutics class.
  37. ItsOverZyvox

    ItsOverZyvox Retired

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    Well, Infectious Disease involves microbiology-microbes, disease state, antimicrobials, treatment guidelines, and pharmacoeconomics. So understanding the microbes and diagnostic tests is important..but it's a small component to ID practice.
  38. Robotjim

    Robotjim

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    Can someone please describe to me what a clinical pharmacist's duties are...The only Pharmacist that I have shadowed was a retail pharmacist..

    Whats all in a day's work as a ID pharmacist ? I like pharmacy but I would like to be more involved with patient care and have more patient contact in my career. I have recently been made aware that many pharmacists complete residencies and decide to work in clinical settings...This is obviously quite appealing to me and I would love to learn more... Thanks in advance for your help.
  39. ProAthleteMD

    ProAthleteMD

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    BUMP! :D

    I'd like to know the answer to this question too.

    Also, if I decide on the PharmD route, I'd be interested in doing a pediatric residency and an ID fellowship. I know it's far away but would that cut down on my job opportunities? Would I only be able to work at a children's hospital? Say if an adult hospital needed an ID Pharmacist, would I be able to apply?

  40. njac

    njac Senior Member

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    I do not believe there are any residencies or fellowships in pediatric infectious disease pharmacy - so you would not be limited to children's hospitals. You might have the pediatric background from the peds program but you would have to know (and probably see more of) adults for your ID fellowship.
  41. ProAthleteMD

    ProAthleteMD

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    Yeah, that's what I was thinking but I figured I'd ask just to make sure. I guess I'll just stick w/ the peds residency then (if I get a PharmD). Thanks. :thumbup:
  42. JetRockette

    JetRockette New Member

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    This is just from my own personal experience. When I was searching for jobs, the best areas to live always had a huge demand for oncology and crit care. Not to say that other specialties aren't in demand. Most of my friends that are doing residencies are going for ID, but that's just the handful of people I know that are doing residencies. Anything you go for will still put you WAY AHEAD of the competition so congratulations!
  43. VCU2011

    VCU2011

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    Are PGY2 residencies super competitive or not in very high demand? I was looking on ASHP's website at which health systems have the different residencies and they were pretty few and far between. I was using Internal Medicine just as a guideline, but there were only 16 spots in the Country! That being the case, it seems to me that it has to be either very very competitive, or not in very high demand. Can someone help me out with this?
  44. bigpharmD

    bigpharmD

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    Not all are accredited through ASHP. Also look on the ACCP website, talk to preceptors, and go to midyear (if you interested in PGY2). I would say internal medicine is not a high demand specialty area. This is probably because it is really not speciallizing. Many jobs for internal medicine pharmacists can be filled with a good PGY1 resident.
  45. janeno

    janeno Senior Member

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    So which jobs would need then PGY2 residency besides infectious disease as discussed above. From what I have seen on the ASHP residency directory, most abundant residencies are critical care, oncology, ID, and ambulatory care. So are these the only ones that are worthwhile to pursue PGY2 in?

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