After graduation--Residency....work...MBA....other?

[Flavoring Agent]

Hey everybody!

I'm graduating this May, but I find myself in a predicament. Should I do a residency or not.

I'm still asking myself this question, despite working in a very large hospital for the past five years. I've shadowed every type of pharmacist we have, from the staff pharmacist to the clinical in nutrition support and ID.

I like what every pharmacist can bring to the table in the hospital setting. I really like and appreciate each job function. I'll tell you what I don't like....

-The time/financial commitment to a residency. I've seen residents come and go. A one year residency is not going to cut it in this economy, meaning if I'm going to do one, it needs to be a two year residency. This is a pretty dramatic pay cut, that I will not recuperate after completing one, as our profession does not reward professional advancement. This is particularly concerning, as my parents were both recently laid off and I would like to help relieve them of their financial burden, since I have younger siblings.

-I do not like how limited pharmacist is. We can only make recommendations and no matter how scientifically sound our recs are, it can be scoffed aside by a PGY1 resident. I know this step requires building a relationship with the physicians you work with, but still, I feel like I was sold a dream that is different than reality, now that I am going through rotations at different sites.

-The future of pharmacy. I'm concerned that if I don't do a two-year residency, I won't survive this looming influx of new grads. To make it, we know have to continue to distinguish ourselves.

I have thought about working right after graduation and completing an MBA on the side. I am interested in the administrative side of pharmacy (I know that managers can be really stressed, but there is a void of pharmacy directors nation wide).

I am interested in working for the drug companies...but I don't like sales. A medical science liaison sounds fun, but my fear with working in the industry is that they are susceptible to economic bust and booms and have laid off workers without notice and I don't know if I could transfer from industry to hospital, with the gap of clinical services.


I'm also thinking of working for a few years and save up to go to PA school. I really want to be able to diagnose patients and have some prescriptive authority (I'm pretty sure this from my original desire to go to med school, but I chose not to because of the financial burden). I'm coming out of pharmacy with a very low debt, so this would not be a huge transition. I may enjoy the dual role...but this is a very lateral decision to another mid-level provider that won't net me much financially. I'm thinking this will give me more options....but there is a lot of PA schools popping up recently and state medicaid programs are cutting reimbursement, which is forcing physicians to lay off NPs/PA.

There is no easy choice and no golden ticket anymore. It is hard, balancing the long-run with the short term realties. What are y'all thoughts?

Thank you for letting me vent.

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[xiphoid2010]

Hey everybody!

I'm graduating this May, but I find myself in a predicament. Should I do a residency or not.

I'm still asking myself this question, despite working in a very large hospital for the past five years. I've shadowed every type of pharmacist we have, from the staff pharmacist to the clinical in nutrition support and ID.

I like what every pharmacist can bring to the table in the hospital setting. I really like and appreciate each job function. I'll tell you what I don't like....

-The time/financial commitment to a residency. I've seen residents come and go. A one year residency is not going to cut it in this economy, meaning if I'm going to do one, it needs to be a two year residency. This is a pretty dramatic pay cut, that I will not recuperate after completing one, as our profession does not reward professional advancement. This is particularly concerning, as my parents were both recently laid off and I would like to help relieve them of their financial burden, since I have younger siblings.

-I do not like how limited pharmacist is. We can only make recommendations and no matter how scientifically sound our recs are, it can be scoffed aside by a PGY1 resident. I know this step requires building a relationship with the physicians you work with, but still, I feel like I was sold a dream that is different than reality, now that I am going through rotations at different sites.

-The future of pharmacy. I'm concerned that if I don't do a two-year residency, I won't survive this looming influx of new grads. To make it, we know have to continue to distinguish ourselves.

I have thought about working right after graduation and completing an MBA on the side. I am interested in the administrative side of pharmacy (I know that managers can be really stressed, but there is a void of pharmacy directors nation wide).

I am interested in working for the drug companies...but I don't like sales. A medical science liaison sounds fun, but my fear with working in the industry is that they are susceptible to economic bust and booms and have laid off workers without notice and I don't know if I could transfer from industry to hospital, with the gap of clinical services.


I'm also thinking of working for a few years and save up to go to PA school. I really want to be able to diagnose patients and have some prescriptive authority (I'm pretty sure this from my original desire to go to med school, but I chose not to because of the financial burden). I'm coming out of pharmacy with a very low debt, so this would not be a huge transition. I may enjoy the dual role...but this is a very lateral decision to another mid-level provider that won't net me much financially. I'm thinking this will give me more options....but there is a lot of PA schools popping up recently and state medicaid programs are cutting reimbursement, which is forcing physicians to lay off NPs/PA.

There is no easy choice and no golden ticket anymore. It is hard, balancing the long-run with the short term realties. What are y'all thoughts?

Thank you for letting me vent.

Have you thought about doing a residency and work for the VA? If you go PGY-1 in primary care, or even a well rounded pharmacy practice program, you can land a primary care clinical pharmacist spot. In the VA, clinical pharmacist in primary care has prescriptive authority (within the scope of the disease you manage of course).

There is a lot of openings right now as VA is shifting into the PACT model (don't ask me to explain). My fellow resident just took one in a small town in Texas for $120K a year + $10K sign on bonus.

 

[Tinkerbell22]

Have you thought about doing a residency and work for the VA? If you go PGY-1 in primary care, or even a well rounded pharmacy practice program, you can land a primary care clinical pharmacist spot. In the VA, clinical pharmacist in primary care has prescriptive authority (within the scope of the disease you manage of course).

There is a lot of openings right now as VA is shifting into the PACT model (don't ask me to explain). My fellow resident just took one in a small town in Texas for $120K a year + $10K sign on bonus.

I didn't know this, but that's interesting. All of the VA residencies I've seen on the ASHP and VA websites look really great.

 

[mustang sally]

Have you thought about doing a residency and work for the VA? If you go PGY-1 in primary care, or even a well rounded pharmacy practice program, you can land a primary care clinical pharmacist spot. In the VA, clinical pharmacist in primary care has prescriptive authority (within the scope of the disease you manage of course).

There is a lot of openings right now as VA is shifting into the PACT model (don't ask me to explain). My fellow resident just took one in a small town in Texas for $120K a year + $10K sign on bonus.

That's pretty cool. I always heard it was almost impossible to get a job in the VA! After doing one rotation there, I really liked what I saw.

 

[xiphoid2010]

That's pretty cool. I always heard it was almost impossible to get a job in the VA! After doing one rotation there, I really liked what I saw.

Do a residency in the VA if you want a job. While private sector don't listen to Obama's call for more primary care, VA has to adhere to government policy. As a result, the inpatient side is starved of money, while outpatient primary care openings gets the funding left and right.

Right now, as long as you are willing to move, there are plenty of primary care openings. They are even willing to take a PGY-1 for GS-12 position (clinical specialist), which in other practice areas would typically require PGY-2 or experience. My residency tried to offer me a PC spot, but I'm an inpatient person through and through. Sorry, there are only so many times I can tell stupid non-compliant patients to take their meds before I get mad.

 

[spacecowgirl]

is PACT like ACO or medical home?

 

[Momus]

Looks like your mind is so scattered all over the place... if I give you $5M now, would you be able to make a decision what you really want? Man up...

 

[xiphoid2010]

is PACT like ACO or medical home?

kind of like medical home. All patients are suppose to be assigned to teamlets consisting of a PC physician + support staff. Every 3 teamlets suppose to have 1 clinical pharmacist, aka a clinical pharmacist for every 1200 patients. The reality is, number of pharmacist is nowhere near that number. My medical center would have to double the number of clinical pharmacist to meet that, but we only got approved to fund 1 additional spot this year. This is still way better than the inpatient side, which is constantly short staffed, and four of us residents were critical to keeping things going there.

 

[Tinkerbell22]

Hypothetically, if someone did a PGY1 residency in managed care at one VA, would it be possible or likely to get a PGY2 residency in something like geriatrics or psychiatry at another VA? Or is it better to do a PGY1 pharmacy practice residency at the same site that has the PGY2 residency they're interested in? Just wondering...

 

[pharm B]

Hey everybody!

I'm graduating this May, but I find myself in a predicament. Should I do a residency or not.

I'm still asking myself this question, despite working in a very large hospital for the past five years. I've shadowed every type of pharmacist we have, from the staff pharmacist to the clinical in nutrition support and ID.

I like what every pharmacist can bring to the table in the hospital setting. I really like and appreciate each job function. I'll tell you what I don't like....


-I do not like how limited pharmacist is. We can only make recommendations and no matter how scientifically sound our recs are, it can be scoffed aside by a PGY1 resident. I know this step requires building a relationship with the physicians you work with, but still, I feel like I was sold a dream that is different than reality, now that I am going through rotations at different sites.

I don't believe this to be true across the board. If you have the knowledge, you have the knowledge. The PGY-1 resident might say something that you know to be false, and you might scoff at him or her just as easily. It's less about scoffing, and more about working.

-The future of pharmacy. I'm concerned that if I don't do a two-year residency, I won't survive this looming influx of new grads. To make it, we know have to continue to distinguish ourselves.

I have thought about working right after graduation and completing an MBA on the side. I am interested in the administrative side of pharmacy (I know that managers can be really stressed, but there is a void of pharmacy directors nation wide).

I'd consider an MBA if my company did tuition assistance. Why not? That, or an MHA. The biggest thing to consider is what you'd get on the other side of it. Say you invest about 30 grand for the MBA. Would you use it, or be paid more for having it? I'd only pursue it if at least one of those is true. Of course, you sound like you're still pretty undecided about your career path.

I am interested in working for the drug companies...but I don't like sales. A medical science liaison sounds fun, but my fear with working in the industry is that they are susceptible to economic bust and booms and have laid off workers without notice and I don't know if I could transfer from industry to hospital, with the gap of clinical services.


I'm also thinking of working for a few years and save up to go to PA school. I really want to be able to diagnose patients and have some prescriptive authority (I'm pretty sure this from my original desire to go to med school, but I chose not to because of the financial burden). I'm coming out of pharmacy with a very low debt, so this would not be a huge transition. I may enjoy the dual role...but this is a very lateral decision to another mid-level provider that won't net me much financially. I'm thinking this will give me more options....but there is a lot of PA schools popping up recently and state medicaid programs are cutting reimbursement, which is forcing physicians to lay off NPs/PA.

There is no easy choice and no golden ticket anymore. It is hard, balancing the long-run with the short term realties. What are y'all thoughts?

Thank you for letting me vent.

Did you ask these questions P1, P2, P3, or P4 year? Heck of a time to be standing on the other side of the door saying "now what?"

 

[PharmaTope]

if you can get the job, take the job!

 

[xiphoid2010]

Hypothetically, if someone did a PGY1 residency in managed care at one VA, would it be possible or likely to get a PGY2 residency in something like geriatrics or psychiatry at another VA? Or is it better to do a PGY1 pharmacy practice residency at the same site that has the PGY2 residency they're interested in? Just wondering...

Sure. Having a pgy-1 at a VA would give you a leg up when applying for Pgy2. But I would also rank VAs with pgy2 higher to begin with. 1. They tend to be larger and so you will see and learn more the first year, 2. You have the option to early commit, saving you all that extra interviewing trips, 3. Save you the money of having to move again.

 

[pharm B]

Early commit really has me worried with respect to choice of PGY-1 site. I was looking at a few PGY-2 positions out of curiosity, and it looked like the site (a major hospital) had 1 slot for each PGY-2, and when you looked at their PGY-1 residents, they had almost all chosen an early commit at the same site for PGY-2.

It seemed like a no-brainer to want to go to a site where you would later apply for their PGY-2, but early commit seems to be hurting the chances of PGY-1's at other sites getting into a PGY-2 at a different location.

 

[xiphoid2010]

Early commit really has me worried with respect to choice of PGY-1 site. I was looking at a few PGY-2 positions out of curiosity, and it looked like the site (a major hospital) had 1 slot for each PGY-2, and when you looked at their PGY-1 residents, they had almost all chosen an early commit at the same site for PGY-2.

It seemed like a no-brainer to want to go to a site where you would later apply for their PGY-2, but early commit seems to be hurting the chances of PGY-1's at other sites getting into a PGY-2 at a different location.

Yeah, it can happen. Looking at the match results, about a quarter of the spots were filled early. Then it was down to 397 applicants for 370 spots going into the matching.

So over all, PGY-2 matching doesn't appear to be as cut-throat as PGY-1... yet.

 

[gotdrugs]

Early commit really has me worried with respect to choice of PGY-1 site. I was looking at a few PGY-2 positions out of curiosity, and it looked like the site (a major hospital) had 1 slot for each PGY-2, and when you looked at their PGY-1 residents, they had almost all chosen an early commit at the same site for PGY-2.

It seemed like a no-brainer to want to go to a site where you would later apply for their PGY-2, but early commit seems to be hurting the chances of PGY-1's at other sites getting into a PGY-2 at a different location.

It's still much, much better overall than what it was prior to specialy residencies going through the Match.

 

[gotdrugs]

Yeah, it can happen. Looking at the match results, about a quarter of the spots were filled early. Then it was down to 397 applicants for 370 spots going into the matching.

So over all, PGY-2 matching doesn't appear to be as cut-throat as PGY-1... yet.

Depends a lot too on the speciality. Some are much more competitive than others.

 

[kyang89]

I'm entering my P1 year yet, so I'm not too aware of how matching works, or what I need to do during my first few years to prep myself for attaining one. With regards to attaining a PGY-1 in the first place, what's the best way to make yourself competitive, aside from a decent pharmD GPA? So far, I've got about 2 years of tech experience in retail chains, and a summer internship at a pharmaceutical company for industry. Also, how likely is it to even attain a PGY-1 residency? Are there many opportunities?

 

[pharm B]

I'm entering my P1 year yet, so I'm not too aware of how matching works, or what I need to do during my first few years to prep myself for attaining one. With regards to attaining a PGY-1 in the first place, what's the best way to make yourself competitive, aside from a decent pharmD GPA? So far, I've got about 2 years of tech experience in retail chains, and a summer internship at a pharmaceutical company for industry. Also, how likely is it to even attain a PGY-1 residency? Are there many opportunities?

My hope is that being an active student with a decent GPA will help you. Having heavy positions (pres of a group, head of a committee for 2 years, or similar) being one definition of "active." Everyone's already a "member."

I'm learning that your summer internships can be a big deal, too. I'm really enjoying the experience, and learning a lot. Pharmacy's a relatively small world. If you make a good impression, your preceptor might help you out in the future with a good letter of recommendation. The person who never gets an internship has to rely on their IPPE sites for a similar recommendation.

 

[pfaction]

The person who never gets an internship has to rely on their IPPE sites for a similar recommendation.

IPPE <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< APPE.

Being able to coordinate all of your learnings > being able to say "I know this before walking in!"

 

[pharm B]

IPPE <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< APPE.

Being able to coordinate all of your learnings > being able to say "I know this before walking in!"

You're right. Didn't even think about APPE.

 

[Flavoring Agent]

Thanks for some of the feedback guys. I really think I could get a job at the hospital I'm at now....but is that what I really want? I know I am a very strong candidate for a residency (not trying to brag) but will that help my career....I'm still trying to answer that for myself.

The VA does sound nice....

If I had 5 million, I'd put half in investments and the other half in a startup company. Nothing like being your own boss, lol!