ASHP 2020 Initiative

Discussion in 'Pharmacy' started by gwarm01, Sep 7, 2016.

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  1. gwarm01

    gwarm01 7+ Year Member

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    Well folks, it's 2016 and we are staring down 2020. What do you feel about ASHP's 2020 initiative requiring all new hospital pharmacists to possess a PharmD and PGY1 residency?

    This is an idea that I've heard here and there. I've heard administrators suggesting it would be a requirement, some also considering a board certification as a bare minimum. What have you heard in your practice?

    Personally, I've worked in a few healthcare systems with different philosophies. Some have been very adamant about this, despite having senior members of staff with BSPharm that are the most knowledgeable. Others have tried to enforce this requirement while lacking the sort of prestige that would draw these types of candidates.

    What do you think? Have you seen a push through administration to enforce this goal? Or just a push for residency trained pharmacists because, hey, why not? Plenty of fish in the sea.
     
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  3. Apotheker2015

    Apotheker2015 2+ Year Member

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    I am in retail but most of my friends are either done with their PGY-1 or starting a PGY-2. According to them and from what I see on job postings is that a PGY-1 is required at most hospitals in the metro area (~3 million people). You can break into a hospital position if you knock on the back door and take an overnight position. Once you get >75 miles outside of the metro area, having a PGY-1 is more of a preference as I have seen plenty of people land clinical pharmacist positions which involve rounding with the medical team on a daily basis.

    I don't know how feasible it is to have all hospitals in all geographical areas to agree to require a PGY-1, especially if you are not offering a higher salary for having additional training. That's the part that just never makes sense to me. Physicians get more training = more money. Nurses get more training = more money. Pharmacists do it and they actually get less pay than most AND that's not even taking into account say the additional 70k you did not make while you were in your PGY-1 & PGY-2 making 50K/year. Maybe we're too chicken to demand more?
     
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  4. lord999

    lord999 Moderator Emeritus 10+ Year Member

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    The same way that the BCNP requirement works in nuclear medicine, when it suits the corporation and/or USG. DoE NRC basically told APhA to form BPS to deal with the legal construction of a BCNP specialty, and yes, BCNP is a legal distinction than normal RPh work as not just an RPh may supervise a medical isotope reactor or radioisotope compounding practice.

    Due to the growth of the need for Mo (Tc-99), NRC allowed for non-trained pharmacists to compound under the supervision of BCNP's. This later became, the BCNP was the PIC and everyone else were just standard pharmacists with the option for training.

    There is no legal distinction drawn between clinical pharmacy and standard pharmacy. There are actually distinctions drawn between different categories of license for RN's (dialysis, NP/CNS, etc.) than certifications (CCRN), which the license categories do have a true difference. For medicine, it's a little less clear (except for Path/Rad and those few with specific legal implications), but if practicing outside an ABMS specialty, you're still held to account to that specialty. Pharmacy has never defined that there is a practice standard of care difference between their line pharmacists and residency-trained or board-certified pharmacists (except the aforementioned BCNP where that's a government imposition).

    So, yeah, when there's plenty of applicants, sure, only residents/BC-possession staff get hired in the hospital, because doing a residency commits you to the Stockholm Syndrome of you're definitely put in your time to learn hospital. Gotta find someway to keep that university position available to the dedicated.

    What I'll be curious it is whether ASHP will take their own medicine for DoP's or Chiefs. I honestly think background training in accounting and regulatory go a longer way than a residency. I still would prefer hiring a MBA over a admin trained pharmacy resident as of right now, and the current VA credential policy gives preference to MBA/MPA/MHA candidates with FACHE certification still.

    So, basically, yeah, if someone has background credentials that are a signal that you're dedicated to institutional pharmacy, sure, I'll take that into consideration. Wouldn't you? But, it's not exclusive like a union card to me, I'll happily take a BSPharm, BCPS or a 20-year civil service or a retired USPHS officer irrespective of their other qualifications against than a fresh resident with the PharmD/residency/BCPS (my HR will probably say I have to hire the USPHS officer then the 20 year civil service first, but that's a different story).

    By the way, the line they (faculty) sold us in pharmacy school would be that the PharmD's would have jobs and the BSPharm's would be unemployed in the cold if they didn't convert by 2010 (2001 was the final entry year for a BSPharm). Nope, didn't happen, you don't throw away good employees for academic reasons. Only universities can do that!
     
  5. awval999

    awval999 New Member 10+ Year Member

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    The misconception is that hospitals won't hire a non-PGY-1 graduate.

    The fact is, they don't have to hire a non-PGY-1 graduate.

    Take my community hospital for example. We graduate 2 PGY-1s every year. Hell, the DOP wants to increase to 4. Why wouldn't we just hire our favorite PGY-1 for the one opening we may have once a year. We already know him/her. They know the computer system. We've had them on a year long interview. So we just wait until they graduate, it's not rocket science.

    And every other community hospital in our system has their own 2 PGY-1s. So of course we look after our own. The system absorbs every [good] PGY-1 graduate every year.

    And guess who usually gets our PGY-1s. Our favorite APPE students.

    It's almost like employers hire who they already know. Mind blown.
     
  6. gwarm01

    gwarm01 7+ Year Member

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    Thanks for the well reasoned post. I especially appreciate this part. I've worked with many pharmacists, usually those who are younger, on their first job, and freely drinking the Kool-Aid, who are thoroughly convinced that there is something about a PGY1 that you can never replicate. They would consider the 20 year vet to be intrinsically inferior to a new pharmacist with a PGY1 in a way that can absolutely never be rectified. It's really puzzling, especially when you see these same pharmacists ignore their own faults and shortcomings.

    I think it's safe to say there are people in every field that wear blinders and live in the clouds, it just frightens me when leadership in the field tries to make that the official direction.
     
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  7. Niosh

    Niosh 7+ Year Member

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    My hospital has no official preference. We just filled an open position which we had four applicants. One was residency trained, the rest were not. In the hierarchy of who we offered the position to first went to the one with the most related experience. The residency trained was third I think (maybe second), above the new grad with no residency.

    There still aren't even enough seats for PGY1 for the number of applicants. I don't think ASHP has a reasonable goal. Wasn't it the same for 2015 too anyway?
     
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  8. Dred Pirate

    Dred Pirate 2+ Year Member

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    The idea that a PGY-1 is required is ridiculous. If a hospital wants to, go ahead, but this is all about propping up their own agenda. My hospital has hired a mix of PGY-1, PGY-2, no pgy with experience, and new grads right out of school - and guess what - the underlying credentials have had ZERO correlation to how successful they pharmacists have been.
     
  9. msweph

    msweph 2+ Year Member

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    Some of those BS Pharm guys are damn impressive. The **** they know off the top of their heads from experience are great.

    I learned so much sitting next to a 60 year old pharmacist that did tox, management, clinical rounding, staffing LTC, home infusion- it was amazing how all those experiences were applicable to a clinical pharmacist job at the most random times.
     
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  10. confettiflyer

    confettiflyer Did you just say something? 10+ Year Member

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    It's the de facto requirement now in the SF Bay Area, I'd say 90% of new hires/new grads are going to be of the PGY-1 grad type, with the other 10% going to top tier/top school candidates with impressive rotation performance. Lateral or promotional moves by grandfathered BSPharm's/PharmD's with experience +/- BPS certification is not generally affected by the new grad market.

    Majority of my health system is BPS certified (mostly BCPS, a few in crit care, nutrition, anticoag, etc...), that's pharmacists of all stripes (20+ year tenured BSPharms, older PharmD's without residency, new grads), if they're not certified, they're working on it. Since it's paid for + extra annual compensation, it's a nice feather in the cap.

    I've also been told I live in an overcompensated, oversaturated, and overcredentialed bubble. I can only live in one place at a time, so I don't really care.
     
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  11. gwarm01

    gwarm01 7+ Year Member

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    I've seen it. Despite what people may think, completing a residency doesn't imbue you with some sort of secret knowledge that is otherwise unobtainable. I don't think anyone believes a new graduate will come into the job as capable or more than a residency trained pharmacist, but after six months on the job things could be different. I've worked with PGY2 trained pharmacists who couldn't hold a candle to a smart PharmD with a year of experience under their belt. When you judge based on credentials rather than the individual you end up making a lot of assumptions that may not be accurate.
     
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  12. stark3

    stark3 5+ Year Member

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    Wow I want to meet this new grad. Can't hold a candle to ?? Sounds like they walk on water. I don't usually talk about my co-workers this way.
     
  13. gwarm01

    gwarm01 7+ Year Member

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    The funny thing about being a new graduate is that you are capable of growing and learning with time and experience.

    Why don't you calm down about my anonymous assessment of a former coworker? It's not like I gave out their SSN. Heaven forbid I express myself with a little personality.
     
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  14. PharmD500

    PharmD500 SDN Gold Donor Gold Donor

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    What do you guys think about this?

    • Bachelor of Pharmacy for the people who want to do retail.
    • PharmD for people who want to work in other settings, including hospital staffing and clinical. However, the P4 rotations would have to be higher quality and be consistent across the board at all the schools. No easy rotations!
    • No BCPS, but instead, have a Naplex that is way more difficult and does what it is supposed to do, which is to test competence. All pharmacists should technically be specialists in pharmacotherapy. I mean isn't that what pharmacy education is for?
    • No PGY-1 in pharmacy practice, since it's pointless if 4th year rotations are of good quality.
    • Post-graduate residency should be for people wanting to specialize in things like Transplant, Critical Care, Pediatrics, Oncology, Infectious diseases. It should take the place of our current PGY-1 residencies.
    • Shut down some of these pharmacy schools, especially the bad ones, and only graduate the number of pharmacists needed.
     
  15. awval999

    awval999 New Member 10+ Year Member

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    The NAPLEX should be as rigorous as the BCPS. It should be like the Bar exam for law students. ~50% passing rate. Obviously high tier schools would earn higher pass rates and the newer schools probably lower.

    I agree. Post-graduate residency in specialized areas. None of this PGY-1 glorified rotation non-sense. Oh I'm sorry, glorified rotation nonsense + weekend staffing + one research project.
     
  16. steveysmith54

    steveysmith54 Member 10+ Year Member

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    pretty remarkable that an association who wants to do nothing about and claims to have no have no control over pharmacists saturation wants to get involved in telling others how run hospital pharmacies.

    Someone who went to a legit school, had legit rotations, and also worked as intern (imagine that) can work in a hospital... There is nothing magical about hospital work.

    As far creating different degrees or requirements for hospital VS outpatient, I disagree. Again, pharmacists are trained to be experts in all aspects of drug distribution. I have worked hospital, outpatient, LTC, and consulting in my career. If certain schools are not preparing their students to work at a hospital, that should be addressed and corrected.
     
  17. farmadiazepine

    farmadiazepine 5+ Year Member

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    ASHP is a joke, so sure, by 2020 it'll be a requirement right.

    No.

    Until they do something good for the profession, and that means first resolving the problem of oversupply of pharmacists to help keep our wages high, then I have no respect for them.

    I was talking to a friend of mine who is now a GI fellow, and he was telling me programs limit the number of GI fellows every year. The number of GI fellows coming out and starting to work equals the number that retire and stop practicing.

    Pharmacy programs all fu*ked up. The price of gas goes up, the price of food, the price of housing, the price of drugs, while reimbursements go down and pharmacist salaries don't grow.
     
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  18. PharFromNormal

    PharFromNormal 2+ Year Member

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    The thing is all of this truly hinges on licenses not education. When anyone talks about who should or shouldn't practice pharmacy based on their education level they need to remember that at the end of the day unless you're in a state where you have a license to do something different than someone else, you COULD be hired and put into any pharmacist role. Now sure organizations and certain leaders have their own filters on "I'll only hire so and so" but this is much looser than having a license to actually do the work required. Having a regulatory definition on some of these softer subjective things is much harder in practice to actually do.
     
  19. croquemonsieur

    croquemonsieur 7+ Year Member

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    This comes from an ACCP position paper, not ASHP.

    Edit: Guess ASHP is on the same nutty bandwagon. My bad.
     
  20. gwarm01

    gwarm01 7+ Year Member

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    Hospital practice requires a PGY3 MINIMUM imo.
     
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  21. Rockinacoustic

    Rockinacoustic 7+ Year Member

    We have moved to a staffing model where all pharmacists working on the floors will require a PGY-1 or equivalent experience + board certification. So yes, new grads by 2020 will need a PGY-1 to work in a non-distributive role in our system.

    With this requirement comes increased pay, but of course this is La La Land California...
     
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  22. CindyN

    CindyN

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    I apologize in advance if this is considered a dumb question. However, I really haven't been able to find an answer elsewhere. I am an American who made the mistake of studying pharmacy abroad. So I am graduating this summer with a BSc Pharmacy instead of PharmD. I didn't know going in that I would really love the clinical field. So now I'm coming back to the states and I'm going to go through the licensure process for foreign grads, but after that I was hoping to do a post grad residency. Is it possible to apply for PGY1 as a B.Pharm and not a PharmD? I have looked into non-traditional PharmD programs that cost upwards of 60 K and take 3 years to complete. So if all else fails that is the plan.
     
  23. PharmDBro2017

    PharmDBro2017

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    Correct me if I'm wrong, but you got an undergraduate degree in pharmacy it sounds like. That doesn't qualify you to do residency, you need a graduate program degree.

    Also, rumor has it $40,000 flat was the residency pay nearby here for PGY-1 2017 applicants. That is an embarassment.
     
  24. pharmrx33

    pharmrx33

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    ~50K here :)
     
  25. gwarm01

    gwarm01 7+ Year Member

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    Foreign graduates who obtain the equivalency are as eligible as US graduates to apply for residencies.
     
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  26. PharmDBro2017

    PharmDBro2017

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    Right. I wasn't sure if that's what op had (the equivalency of pharmd), that was my question.


    Sent from my iPhone using SDN mobile
     
  27. Dred Pirate

    Dred Pirate 2+ Year Member

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    if they are new and have a bs not a pharmd - I doubt that will be considered equivalent - but I could be wrong
     
  28. gwarm01

    gwarm01 7+ Year Member

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    All of my knowledge is second hand and I'm too lazy to actually look it up, but I worked with a foreign pharmacist once who was completing an internship as part of the requirements for the FPGEC or whatever it's called. I think eligibility depends on which country you obtained your degree, but then you have to do a year of internship before you can take the NAPLEX.
     
  29. lord999

    lord999 Moderator Emeritus 10+ Year Member

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    That's pretty much the case in terms of the hours, and to add insult to injury, she will have to take TOEFL and TSE on top of that for most states, and be disqualified from almost all federal positions as a foreign graduate has to get special exception from DC for their application to even be considered outside of VA (the VA has a specific qual standard for FPGEC that no other federal agency has). Yeah, you saved about $100k on the degree for an additional PITA.

    And while licensure makes one technically eligible for residency (yes, we do take BS Pharm's for residents), I found that most had to explain again and again their roles to people.
     
  30. samven582

    samven582 7+ Year Member

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    Unfortunately, it's becoming a reality. At one of the health system I work at here in NY, My director told me that they would be implementing this initiative by 2020.
     
    Last edited: Sep 8, 2017
  31. Dred Pirate

    Dred Pirate 2+ Year Member

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    what sort of grandfather clause are they implementing?
     
  32. gwarm01

    gwarm01 7+ Year Member

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    One more reason why I am actively removing myself from the practice of pharmacy. I can't bring myself to jump through the hoops or deal with the attitudes.
     
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  33. Seriously Serious

    Seriously Serious Pharmacy cringe. Gold Donor 2+ Year Member

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    Staff positions should not require a PGY1...... what a joke
     
  34. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    And labor is officially expected to shoulder the burden of training yet even more. Great job, guys.
     
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  35. msweph

    msweph 2+ Year Member

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    Some staff rph are realllllllllly dumb.

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  36. PharmDBro2017

    PharmDBro2017

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    Thankful I don't live in NY/CA. I don't see it happening in many places, besides those two.


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  37. PharmD500

    PharmD500 SDN Gold Donor Gold Donor

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    True, which is why pharmacy education needs to be better, and the bad schools need to be shut down. They also need to make the NAPLEX much more difficult.

    I've met really dumb PGY1-trained pharmacists. Not all residencies are equal, and not all residency-trained pharmacists are equal. I've even met some regular pharmacists who were better than the residency-trained ones. Maybe if you compare a new grad to a residency-trained pharmacist, the new grad would be worse, but not pharmacists who have clinical experience. In that case, it would just depend on the person.
     
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  38. msweph

    msweph 2+ Year Member

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    No I agree. We have some "experience" rph that are awful.

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  39. Seriously Serious

    Seriously Serious Pharmacy cringe. Gold Donor 2+ Year Member

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    We just need to make the NAPLEX more difficult, the rest will follow as pass rates tank.
     
  40. gwarm01

    gwarm01 7+ Year Member

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    We are going to see bottom of the barrel students that were funneled into garbage tier residencies coming into these positions and thinking they are superior to a PharmD with clinical experience that got into pharmacy school when it actually meant something. I've seen a little of this already and it really hurt the department's reputation with nursing and physicians.
     
  41. confettiflyer

    confettiflyer Did you just say something? 10+ Year Member

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    Don't forget students shouldering costs that were once paid for by the state.

    Being a millennial is awesome!


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  42. PAtoPharm

    PAtoPharm

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    So you lambasted me for being a quitter and leaving pharmacy school, and yet you're actively trying to leave pharmacy yourself. That's rich; I'll have to randomly stop by here more often.
     
  43. Abby Atwood

    Abby Atwood

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    I have not completed post graduate training, but I can't justify standing against the requirement. Just because residency can't totally fix a problem pharmacist doesn't mean that it's not valuable. There is always going to be a normal distribution with some amazing new grads and some PGY1 graduates that are real duds. It's not about eliminating the edges of that normal distribution, it's about shifting the mean.

    I expect/hope that pharmacists already practicing in direct patient care settings would be grandfathered in.
     
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  44. PharmD500

    PharmD500 SDN Gold Donor Gold Donor

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    I guess that's where we disagree. I think it's sad that people with doctorate degrees are duds in their field. It's even worse if they've done residency! That means the schools have failed, the licensing exam has failed, and the residency has failed to produce or ensure competent pharmacists. That's more than concerning since these dumb pharmacists can make deadly mistakes. Of course there's going to be variance between individuals in any given field, but general competence should not be too much to ask. All the variance between pharmacists should be above the minimum competency, and that bar needs to be raised way higher than it currently is.

    Getting a doctorate in pharmacy used to mean something! Doing a residency used to mean something! I want that back.

    I would not trust the majority of the pharmacists I have worked with to be involved in my care or the care of my loved ones. This is not just a matter of a few incompetent pharmacists here or there. We're talking about the majority here, and the quality of pharmacists gets worse every year. It's making our profession lose credibility.
     
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  45. gwarm01

    gwarm01 7+ Year Member

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    I warned you not to go to pharmacy school then encouraged you to find something better.

    Congratulations, you are officially the first person I have ever put on an ignore list on any message board ever.

    Someone ban this obvious troll.
     
  46. quickpic007

    quickpic007

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    Good luck getting that back, not going to happen.

    Hah! And how do you help these incompetent pharmacists?
     
  47. Seriously Serious

    Seriously Serious Pharmacy cringe. Gold Donor 2+ Year Member

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    "randomly", hah, you got them jokes.
     
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  48. Jbrl

    Jbrl 2+ Year Member

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    Where's the dislike option when you need it

    In other news, what about the PGY3 proposal? Any headway there for ASHP? :)
     
    Last edited: Sep 10, 2017
  49. PAtoPharm

    PAtoPharm

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    So you don't see the irony in someone acknowledging that they're planning on leaving the pharmacy profession after they (along with others, to be fair) told me (once I had started pharmacy school) that I should stay in pharmacy school, just for the sake of finally starting and sticking to a career plan?
     
  50. owlegrad

    owlegrad Uncontrollable Sarcasm Machine Staff Member SDN Administrator 7+ Year Member

    So you don't see the difference between a successful pharmacist trying to find a better career and a student dropping out of their second professional program to pursue a third?
     
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  51. PAtoPharm

    PAtoPharm

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    Not as big of one as you'd think. My point is, if successful pharmacists (gwarm01 isn't the only one on here) are actively leaving the profession despite having sunk possibly hundreds of thousands of dollars and 6-10 years into pursuing the career and working as pharmacists, then me choosing to leave after investing a relatively minimal amount of time/money is obviously and objectively good decision to make.
     

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