PharmD, considering residency or NP

[kendrick lamar]

i've had a bit of a rough ride during pharmacy school (0-6 programs, no job experience even though I tried ridic hard to find, not very good faculty relationships) and am not really sure ultimately if this is really the field I want to be in in the long run. Although short term, I've considered really trying to find any job that I can, but I'm considering some various routes in the long-term that I'm wondering if anybody has insight of.

1. Residency
As far as pharmacy goes, I've considered re-applying to residency programs for next year as this year I didn't have strong recommendation letters and a solid idea/experience during the process. I've completed both my internal medicine rotation and am care rotation after the application process and both my preceptors were pretty satisfied with me and believe I should pursue a residency in the future. I am looking into programs that have both acute/am care, my interests are diabetes, HepC/HIV, general internal medicine, public health (social/health disparities, epidemiology) and toxicology. My question is what type of jobs residents are able to get these days? I would love to have something that is both inpatient/outpatient and have seen some programs that have outpatient adolescent clinics, Hep C/HIV clinics and diabetes clinics (which are my top 3 interests). I don't know how widely available those options are, so insight/suggestions are appreciated.

2. Nurse practitioner
I have considered going the MD route, although realistically that would take a lot, lots of time to think through if I really want to do that, so I've also considered the NP route as well. yes, I know the pay may probably not be as well as what I'd get with a pharmD degree, but I have volunteered as a first responder for two-three years and I do think that type of clinical responsibility is what I actually enjoy more so than pharmacy practice. I have not heard of many people going from PharmD to NP and was wondering if anybody here has done that? If so, any insights would be appreciated.

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[Digsbe]

If you are thinking of going NP I would probably go PA instead. An NP degree requires you to have a BSN first, a PA degree requires more of a science degree with most of the med/pharm school pre-reqs also being pre-reqs for PA school.

 

[MackandBlues]

NP? that means you need to be a nurse first before going to NP school. So that will probably mean a bachelors in nursing then NP school. you can probalby get credit for your science classes for the BSN but still. So yea, better go MD/DO or PA

 

[Dred Pirate]

ironically in your position it may take as nearly as long to get a NP as an MD - pa would be two more years. But personally, give your pharmD a chance to pay itself off - you ask what type of jobs a resident gets? The same job I have (sans residency) - go try to get a job first and see if you like it, at least start to pay off student debt (assuming you have some as 95% of new grads do)

 

[gwarm01]

ironically in your position it may take as nearly as long to get a NP as an MD - pa would be two more years. But personally, give your pharmD a chance to pay itself off - you ask what type of jobs a resident gets? The same job I have (sans residency) - go try to get a job first and see if you like it, at least start to pay off student debt (assuming you have some as 95% of new grads do)

I second this. Too often I am seeing PGY1 candidates who are struggling to find a job staffing at a hospital due to fewer openings and more graduates. It's hard to recommend a residency at this point because we can't tell what the job market will be like next year. I managed to land a nice hospital job with no residency, and am very grateful, although I do sometimes wonder if my lack of residency might haunt me 10 years down the road if employment expectations change.

 

[kendrick lamar]

I only thought of NP because I know a girl who did kinesiology BS before doing NP, I don't know if the BSN is truly a requirement though it is the more sought out route. I haven't really considered PA route yet because it's something i would need to look into although being a PA after PharmD to earn a more clinical route seems like it would be more pragmatic than doing an NP. Otherwise, yea, I've considered medicine, but mostly MD. I am not sure about osteopathic studies.

 

[kendrick lamar]

I second this. Too often I am seeing PGY1 candidates who are struggling to find a job staffing at a hospital due to fewer openings and more graduates. It's hard to recommend a residency at this point because we can't tell what the job market will be like next year. I managed to land a nice hospital job with no residency, and am very grateful, although I do sometimes wonder if my lack of residency might haunt me 10 years down the road if employment expectations change.

is it a staff job or clinical?

 

[gwarm01]

is it a staff job or clinical?

"Clinical Pharmacist" title but it really is a staff job. We do have a lot of clinical duties though, so it is sort of a hybrid position. I don't consider my position to be a common one, considering I got this job fresh out of school, moving from a different state with no connections. All I had on my side was a few years of hospital intern experience and a decent interview where I proved to be someone they could work with.

That's why it is tricky to recommend a residency. We have people who have finished their PGY1 now asking us if there are any openings, wanting the same job I got without one. However, regionally I know there is a large preference for PGY1 candidates or equivalent experience for this type of position. I may have managed to just get in before the residency required curtain dropped, but it is hard to say. I am worried that further in my career I might hit a brick wall due to my lack of residency as more and more institutions require paper qualifications in lieu of actual experience.

It is a tough call all things considered. Academically speaking, residency is a great idea. It is more in depth training that can specialize you in a certain field. Unfortunately in practice it may not be worth the investment. The clinical jobs that we dreamed about in school are very few and far between, and until an adequate reimbursement plan is developed many health systems will not spend the money for extraneous pharmacy positions that provide nothing more than potential savings. That leads to the situation I referenced earlier where we have hordes of residency trained pharmacists fighting over hospital staffing positions they could have landed out of school. It's a tough call. I'm hopeful that legislature for advanced practice pharmacists continues to develop over time to truly expand our profession, although I am doubtful. Call me cynical.

 

[BidingMyTime]

I only thought of NP because I know a girl who did kinesiology BS before doing NP, I don't know if the BSN is truly a requirement though it is the more sought out route. I haven't really considered PA route yet because it's something i would need to look into although being a PA after PharmD to earn a more clinical route seems like it would be more pragmatic than doing an NP. Otherwise, yea, I've considered medicine, but mostly MD. I am not sure about osteopathic studies.

Interesting, I was under the impression that a Bachelor's in nursing was an absolute requirement to become a NP. Are you sure your friend didn't obtain a BSN (she probably could have done that in 2 years, if she had the right pre-reqs with her BS.) I agree with the other statements, I would #1 give pharmacy a chance, you've invested so much into it #2 and if you decide you really want to be a prescriber check out PA, it would be a shorter time investment for you, and the theory behind the study would probably line up better with your PharmD, then the theory behind NP.

 

[MackandBlues]

You need to go shadow people in the fields you are considering. That's how you make a better, more informed decision.

 

[BelowTheMean]

Being we are of another health care profession before applying to med school, I would suggest you do look into DO programs. They tend to like pharmD or RNs and take more nontraditional students more than MD schools which traditionally like the fresh 22/23 yo undergrad students.

As far as NP, they have potential to make more than PharmDs. I know my NP friends starting at $57/hr, which is higher than a lot of pharmD starting salaries recently. However, their salaries continue to go up and they will have a more expanded role once government healthcare/obamacare takes full effect. In many states, laws have been passed recently to allow NPs to full self autonomy. This is where I see the US healthcare system heading with midlevel practictioners expanding. I mean, someone has to fill the primary care shortage when most med students dont wanna do it.

Another path is CRNA...hands down highest paid, enjoyable job out of all the nursing jobs. They get paid 163k at my hospital. At my friend's hospital, they get paid well over 200k. Look into this.

 

[kendrick lamar]

There are such things as direct entry MSN/NP programs. I am just doing some research, but of course I'm not going to jump into it tomorrow (this is a decision that I think I will really think about in 2-3 years so I've planned to just get an idea)...I'll be looking for pharmacy jobs for now, maybe to work at least for a bit of course but maybe down the line I would want to do something more clinical; I really had not much of an idea all along if I even wanted to do pharmacy and to be very honest disease pathophysiology is more interesting to me than learning about therapeutics, but I am definitely ready to give it a chance by working for a few years. I've considered MD programs more so than DO because I think some of the institutions I like that offer medical residencies have MD students (again that's something I'd have to research). But I'm not sure if I would want to go through all that schooling for now, lol.