ASHP 2020 Initiative

[confettiflyer]

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.

I blocked him and ignored, stop quoting him. You're part of the problem.


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[confettiflyer]

In that case, you are "literally" correct.

Stop replying, you're part of the problem.


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[deleted820760]

Stop replying, you're part of the problem.


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I wish @owlegrad would ban him already. It should have happened months ago.

 

[gwarm01]

I blocked him and ignored, stop quoting him. You're part of the problem.


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What can I say, I have a sickness that makes me need to know what everyone is saying. But now.. now I am free. If we can just get others to join us and stop quoting him these threads won't be so hard to follow.

 

[owlegrad]

I wish @owlegrad would ban him already. It should have happened months ago.

Oh my goodness there's no winning with you people! I STILL get complaints about banning SHC and she was 10x the troll this guy will ever be.

Besides I legitimately find him funny. What's the harm in a little troll-baiting? The site can get so dull without a few harmless trolls here and there. In truth I really do regret banning shc just because with her around it was never dull.

And of course I do fully support the use of ignore for people who find his inputs distracting, annoying, or otherwise loathsome.

 

[owlegrad]

Stop replying, you're part of the problem.


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No cross posting/dup posting or it is you I will ban! MWHAHAHAHA

 

[deleted820760]

Oh my goodness there's no winning with you people!

You people!

 

[deleted820760]

No cross posting/dup posting or it is you I will ban! MWHAHAHAHA

It's not his fault if people don't listen the first time. Lol.

 

[owlegrad]

Twist: it was me all along. MHAhaha

 

[radio frequency]

Blocking for good.

So tired of having to read these never ending strings of arguments with someone who will likely never find satisfaction in anything in life but only more complaints.

 

[deleted820760]

Blocking for good.

So tired of having to read these never ending strings of arguments with someone who will likely never find satisfaction in anything in life but only more complaints.

I think I blocked him in the first few months I joined SDN, but then certain conversations weren't making sense. I didn't know what people were responding to. I unblocked him just so I wouldn't be confused.

 

[Winged Scapula]

To the user who asked that we require proof of attendance at pharmacy school from a certain user, I'll remind that user that those of you who are not verified pharmacists, could also be accused of misleading users about your identity. You cannot be demanding such proof and subsequent banning of an individual if you are not willing to undergo the same scrutiny.

If you find another user objectionable, put them on Ignore as others have done. SDN is not going to be asking for enrollment transcripts or other proof of user identity.

 

[Dalteparin]

Oh my goodness there's no winning with you people! I STILL get complaints about banning SHC and she was 10x the troll this guy will ever be.

Besides I legitimately find him funny. What's the harm in a little troll-baiting? The site can get so dull without a few harmless trolls here and there. In truth I really do regret banning shc just because with her around it was never dull.

And of course I do fully support the use of ignore for people who find his inputs distracting, annoying, or otherwise loathsome.

Respectfully, I disagree. SHC was actually amusing, and I think (hope?) that once she got out in the real world she'd have been less of a princess. PAtoWhatever contributes nothing to this forum. They hijack every single thread they post in, so much so that even those of us who have them on Ignore (which I do) still have to read their posts to find out what people are talking about. This forum has been very useful to me over the years, but seeing this person's behavior tolerated and even encouraged by someone who should be shutting it down is very disheartening and makes me want to avoid the forum. I agree that we shouldn't ask for proof of enrollment, but expecting members to be respectful of people who are trying to help them and not turn every thread into a discussion about them is more than reasonable. Just my $0.02.


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[lord999]

Respectfully, I disagree. SHC was actually amusing, and I think (hope?) that once she got out in the real world she'd have been less of a princess. PAtoWhatever contributes nothing to this forum. They hijack every single thread they post in, so much so that even those of us who have them on Ignore (which I do) still have to read their posts to find out what people are talking about. This forum has been very useful to me over the years, but seeing this person's behavior tolerated and even encouraged by someone who should be shutting it down is very disheartening and makes me want to avoid the forum. I agree that we shouldn't ask for proof of enrollment, but expecting members to be respectful of people who are trying to help them and not turn every thread into a discussion about them is more than reasonable. Just my $0.02.


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As observed on another thread and as a previous mod, I know that there is little that can be done, but I agree that like ten years ago, we have a member who is very disruptive. If we can have a general agreement among us that we should not respond, then ignoring won't be a problem. However, there is still major thread derailment even with ignore which is very irritating.

I agree with @Dalteparin that there is a difference between a troll and someone being intentionally disruptive.

 

[confettiflyer]

No cross posting/dup posting or it is you I will ban! MWHAHAHAHA

lol I forgot you're a mod, the app strips out everything except username. This app is also why I take weeks to view PM's


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[BidingMyTime]

Stop replying, you're part of the problem.

I wish @owlegrad would ban him already. It should have happened months ago.

I completely disagree. PAToPharm is currently the most entertaining part of our board, now that Sparda is too busy working and dating to post more often. PA2Pharm is like a soap-opera, and I'm genuinely curious to see how his 3rd go at a professional school works out. I'm still upset that the SHC saga was prematurely cancelled, and I never got to find out if she found her rich sugar daddy dentist or whatever, and how long her marriage lasted before she got kicked out for a newer trophy wife.

 

[Z-Qualizer]

I completely disagree. PAToPharm is currently the most entertaining part of our board, now that Sparda is too busy working and dating to post more often. PA2Pharm is like a soap-opera, and I'm genuinely curious to see how his 3rd go at a professional school works out. I'm still upset that the SHC saga was prematurely cancelled, and I never got to find out if she found her rich sugar daddy dentist or whatever, and how long her marriage lasted before she got kicked out for a newer trophy wife.

This.

I also keep hoping that @PAtoPharm will start his own thread where people can follow his journey(s). I'm really excited to see which field(s) he pursues after PA/AA (again).

 

[PAtoPharm]

This.

I also keep hoping that @PAtoPharm will start his own thread where people can follow his journey(s). I'm really excited to see which field(s) he pursues after PA/AA (again).

Ha, so you've already come to the conclusion that I'll fail out of AA/PA school, regardless of which type of program I end up matriculating at. I can understand the psychological defense mechanism at play here: if someone with my kind of background had the nerve to quit pharmacy school when they should've simply felt immensely grateful to be in ANY professional school, even if it's pharmacy, then there's no way that the egos here can process the notion of me leaving this dead-end field (find me a message board for physicians, PAs, or NPs where there is an actual demographic group of members who are actively talking about leaving the profession entirely) to pursue something with better prospects than what pharmacy offers. It's almost like there's a collective mentality of "if I'm stuck in what this profession has become, then there's no way that someone like PAtoPharm should have the opportunity to move onto something better."

I'll ask you this, Z-Qualizer. Other than the fact that I already unsuccessfully attempted two professional programs (despite the fact that I absolutely left the second one on my own terms --because duh), why are you so convinced that I won't be able to pass a general PA program, especially after I made all A's in the basic medical science courses that are taught to both AA and PA students (anatomy, physiology, etc.)?

At least I'll have a reason to be motivated in PA school. After reading posts from people here who say they worked as interns, had good GPAs, and served as presidents of student orgs and STILL couldn't find jobs as pharmacists, it's a wonder anyone pursues this field anymore.

 

[BenJammin]

Anyway, back on topic. Residencies are ruining this profession. It really is the perfect scam. It won't surprise me to see PGY 2 being required for a staff position. Clinical specialists are far and few between due to the lack of quality contribution they bring to the medical team.

You gotta love it if you're an employer. Convince new grads that their pharmacy education was inadequate and needs to be augmented with two years of residency. Those two years will save the hospital $160,000 per pharmacist and will keep the staff lean. If you have a 5 man rotation like we do that's nearly a 5 million dollar cost reduction over 6 years. It's genius, really.

 

[deleted820760]

Anyway, back on topic. Residencies are ruining this profession. It really is the perfect scam. It won't surprise me to see PGY 2 being required for a staff position. Clinical specialists are far and few between due to the lack of quality contribution they bring to the medical team.

You gotta love it if you're an employer. Convince new grads that their pharmacy education was inadequate and needs to be augmented with two years of residency. Those two years will save the hospital $160,000 per pharmacist and will keep the staff lean. If you have a 5 man rotation like we do that's nearly a 5 million dollar cost reduction over 6 years. It's genius, really.

Do you think pharmacy schools and residencies should have a Certificate of Need each year? For example, if 3 ID pharmacists are retiring or close to retirement, then there should be 3 ID PGY2 residency spots that year. Same with schools. If there's a need for 40 new pharmacists in the upcoming years in a given area, then the schools should only accept about the number of students needed to fill the need in the area. Thoughts?

 

[confettiflyer]

Anyway, back on topic. Residencies are ruining this profession. It really is the perfect scam. It won't surprise me to see PGY 2 being required for a staff position. Clinical specialists are far and few between due to the lack of quality contribution they bring to the medical team.

You gotta love it if you're an employer. Convince new grads that their pharmacy education was inadequate and needs to be augmented with two years of residency. Those two years will save the hospital $160,000 per pharmacist and will keep the staff lean. If you have a 5 man rotation like we do that's nearly a 5 million dollar cost reduction over 6 years. It's genius, really.

But how does this differ from practically every other profession out there? The offloading of fully paid, on-the-job training and expected in-school training has been dumped by everyone else from nurses (the whole RN/BSN thing) to fashion designers (unpaid internships) to winemaking.

Opining the loss of on-the-job training, apprenticeships, and in-house advancement is about as useful as writing your senator to bring back 8-track tapes.

Pharmacy residency as a prerequisite to full inpatient employment is just the manifestation of this "new" reality which really isn't new at all.

The next thing to drop is actual guaranteed FT employment for new PGY-1's....oh, wait, that's been ongoing.


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[confettiflyer]

Do you think pharmacy schools and residencies should have a Certificate of Need each year? For example, if 3 ID pharmacists are retiring or close to retirement, then there should be 3 ID PGY2 residency spots that year. Same with schools. If there's a need for 40 new pharmacists in the upcoming years in a given area, then the schools should only accept about the number of students needed to fill the need in the area. Thoughts?

1) people travel, system breaks
2) who would enforce? it would be illegal market manipulation (antitrust) if tied to approval/accreditation
3) define retirement....full stop, drop to part time, drop to 0 FTE but stay on and silently intend to work a random amount between 0-40hrs depending on your travel plans? I've seen all 3. How do you consolidate a 0.5 FTE need? with a 0.5 FTE residency?


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[deleted820760]

1) people travel, system breaks
2) who would enforce? it would be illegal market manipulation (antitrust) if tied to approval/accreditation
3) define retirement....full stop, drop to part time, drop to 0 FTE but stay on and silently intend to work a random amount between 0-40hrs depending on your travel plans? I've seen all 3. How do you consolidate a 0.5 FTE need? with a 0.5 FTE residency?


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A Certificate of Need is required for other things, so maybe it won't cause the system to break.

The state or federal government would enforce.

No, they won't all require residency. Just the specialties would. You can replace the retired people with regular graduates.

 

[steveysmith54]

Ha, so you've already come to the conclusion that I'll fail out of AA/PA school, regardless of which type of program I end up matriculating at. I can understand the psychological defense mechanism at play here: if someone with my kind of background had the nerve to quit pharmacy school when they should've simply felt immensely grateful to be in ANY professional school, even if it's pharmacy, then there's no way that the egos here can process the notion of me leaving this dead-end field (find me a message board for physicians, PAs, or NPs where there is an actual demographic group of members who are actively talking about leaving the profession entirely) to pursue something with better prospects than what pharmacy offers. It's almost like there's a collective mentality of "if I'm stuck in what this profession has become, then there's no way that someone like PAtoPharm should have the opportunity to move onto something better."

I'll ask you this, Z-Qualizer. Other than the fact that I already unsuccessfully attempted two professional programs (despite the fact that I absolutely left the second one on my own terms --because duh), why are you so convinced that I won't be able to pass a general PA program, especially after I made all A's in the basic medical science courses that are taught to both AA and PA students (anatomy, physiology, etc.)?

At least I'll have a reason to be motivated in PA school. After reading posts from people here who say they worked as interns, had good GPAs, and served as presidents of student orgs and STILL couldn't find jobs as pharmacists, it's a wonder anyone pursues this field anymore.

I realize this is a free country and we have freedom of speech, but how about you come back and visit us when you actually graduate from a professional school and get a job. With all due respect, you have nothing to contribute to this pharmacist forum at this time. You're neither a pharmacist, health care professional, or a even a health professional student. There is very little doubt that you can handle professional level courses from an academic point of view, it's your overall decision making in life which gets you in trouble and what caused you to fail out of that AA program. The question still remains is if you have what it takes to get to the finish line in any health professional program. The reality is you still have a giant mountain to climb to even get to the level of an average poster in this forum who earns six figures.

 

[Charcoales]

Don't ban them, this is a forum, if we really didn't like their posts, their threads would simply fall off the front page tbh.

 

[PAtoPharm]

I realize this is a free country and we have freedom of speech, but how about you come back and visit us when you actually graduate from a professional school and get a job. With all due respect, you have nothing to contribute to this pharmacist forum at this time. You're neither a pharmacist, health care professional, or a even a health professional student. There is very little doubt that you can handle professional level courses from an academic point of view, it's your overall decision making in life which gets you in trouble and what caused you to fail out of that AA program. The question still remains is if you have what it takes to get to the finish line in any health professional program. The reality is you still have a giant mountain to climb to even get to the level of an average poster in this forum who earns six figures.

I get it; until I've accomplished something concrete, the talk is meaningless. That's why I actually consider starting pharmacy school to have been the biggest mistake of my life and not starting AA school. The realization hit me a few weeks ago that if I had started PA school when I had started pharmacy school, I would be over 60% of the way done with the program by now. No wonder people are applying in droves to PA schools and not pharmacy schools. I still stand by my point that making the decision to stay in pharmacy school just for the sake of FINALLY finishing SOMETHING would have been an idiotic justification, especially when you consider the current state of the field and where it's heading. The only caveat would've been if I truly had no chance of getting accepted to any other graduate health professions programs. In other words, if I had been leaving pharmacy school with a 2.7 overall GPA (not just for pharmacy school classes but for all classes), I would've agreed that I should finish pharmacy school just to have some sort of professional qualification, but instead, the fact that I left with a 3.6+ overall means that I have at least some options. Like I said before, the fact that someone with my background would risk leaving pharmacy school to pursue something else with no guarantees of getting accepted should be a tell-tale indicator of just how bleak pharmacy's outlook is.

 

[confettiflyer]

Not a fan of banning but for the love of Jesus Jones please stop fcking quoting and replying


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[confettiflyer]

A Certificate of Need is required for other things, so maybe it won't cause the system to break.

The state or federal government would enforce.

No, they won't all require residency. Just the specialties would. You can replace the retired people with regular graduates.

No I was saying people relocate. Say California is full, North Dakota has need, the Californian will go to North Dakota with the school opening and return to CA. Already happening.

Federal govt can't enforce if it's against federal law. You'd have to set up the equiv of a legal, regulated monopoly.


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[BidingMyTime]

I agree with Benjammin that residencies are a scam after a formal college/university education (and one that is used in many industries), but I also agree with ConfettiFlyer that they are here to stay, and that there is no practical way to limit or do away with them. We all must just adjust to the new reality.

 

[gwarm01]

I assume he meant working in IT as a pharmacist, not quitting working or finding a new profession in general

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Yep. I feel way more appreciated working in IT. I don't have to deal with any of the attitude, people aren't constantly measuring credentials. I work a great schedule, have very little stress, and make more than I did as a clinical pharmacist. Plus it opens pathways to promotion through hospital administration, or potentially doubling my salary as a consultant.

I still work as a hospital pharmacist for a PRN side job and I'm happy with that. It's just enough to be fun but not be burnt out, and I don't really care about the politics of a side job.

edit: about quitting working.. that would be the dream. I'm trying to save / invest fairly aggressively with the hopes of retiring in my 50's. I'd like to still be young enough to enjoy life and my hobbies.

 

[wucool33]

Oh my goodness there's no winning with you people! I STILL get complaints about banning SHC and she was 10x the troll this guy will ever be.

Besides I legitimately find him funny. What's the harm in a little troll-baiting? The site can get so dull without a few harmless trolls here and there. In truth I really do regret banning shc just because with her around it was never dull.

And of course I do fully support the use of ignore for people who find his inputs distracting, annoying, or otherwise loathsome.

You banned SHC?!?!?! You MONSTER!!!

 

[owlegrad]

You banned SHC?!?!?! You MONSTER!!!

Uhm....what I meant was, whoever banned her still gets complaints. The identity of the banner is of course privileged information.

 

[Z-Qualizer]

Not a fan of banning but for the love of Jesus Jones please stop fcking quoting and replying
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"Right here, right now, there is no other place I wanna be."

 

[Z-Qualizer]

Ha, so you've already come to the conclusion that I'll fail out of AA/PA school, regardless of which type of program I end up matriculating at...

I never said you'd flunk out. You just seem like a fickle person - nothing wrong with that, if that's who you are. Whether you drop out, flunk out, or even make it through, become a PA/AA, & then decide it's not really for you, I just don't see you sticking with ONE thing for very long. And that's OKAY man, it's your life.

Now will you please start your own thread, so I don't have to derail these nice people's threads???

 

[BidingMyTime]

Now will you please start your own thread, so I don't have to derail these nice people's threads???

Maybe what we need is a permanent stickied thread for PA2Pharm updates & postings. Seems like a win-win situation for everyone.

 

[CYP-0]

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.

I'm a new grad...and not in a residency program. I am going through a recruitment process right now for a clinical position with a coveted schedule that demanded PGY-1 as a requirement. Turns out that the latter is not as absolute as they made it look. No, I didn't do any APPE's there, neither am I acquainted with anyone there.

They use some website/program called "Predictive Index" as part of their 'lawn-mowing' process, which makes a lot of sense. The program is suppose to be able to estimate your likely work ethics or attributes, which they believe has more weight than the credentials you may have. Again, very smart system, I think.

But as far as making PGY-1 universal requirement for hospitals, what about the rural hospitals that sing "no experience required" for their vacancies, let alone a PGY-1? Umm....yeah. I wish ASHP much luck with that. Unless that requirement will be restricted to metro or heavily saturated areas alone.

 

[gwarm01]

I'm a new grad...and not in a residency program. I am going through a recruitment process right now for a clinical position with a coveted schedule that demanded PGY-1 as a requirement. Turns out that the latter is not as absolute as they made it look. No, I didn't do any APPE's there, neither am I acquainted with anyone there.

They use some website/program called "Predictive Index" as part of their 'lawn-mowing' process, which makes a lot of sense. The program is suppose to be able to estimate your likely work ethics or attributes, which they believe has more weight than the credentials you may have. Again, very smart system, I think.

But as far as making PGY-1 universal requirement for hospitals, what about the rural hospitals that sing "no experience required" for their vacancies, let alone a PGY-1? Umm....yeah. I wish ASHP much luck with that. Unless that requirement will be restricted to metro or heavily saturated areas alone.

Maybe in a world where every new graduate must have a residency to practice, but hopefully the maniacs that push this stuff haven't strayed that far from the light just yet. Hopefully some people will remember that there was a time before everything was an electronic, multiple-choice exam, and before you could retake your lowest tests several times, and before everything was adaptive to smooth out your grades. Pharmacists who graduated when pharmacy education wasn't a joke are perfectly capable of practicing without having taken an additional year or two of PGY-tutoring to get them up to speed. Imagine turning down a 10-year experienced clinical pharmacist (and let's even say they have BCPS just to satisfy the credential lust) in favor of someone who just graduated from some joke residency program like this guy is in: PGY1 Residency Programs, accreditation with ASHP, and standards • r/pharmacy

edit: I've never heard of that predictive index you are going through, but it sounds kind of interesting. Most of pharmacy practice is basic enough that you are going to have many qualified candidates for any given position. How can you just narrow it down to the people who aren't going to cause drama, be jerks, or flake out all of the time? I just want someone dependable who can get the job done.

 

[CYP-0]

Maybe in a world where every new graduate must have a residency to practice, but hopefully the maniacs that push this stuff haven't strayed that far from the light just yet. Hopefully some people will remember that there was a time before everything was an electronic, multiple-choice exam, and before you could retake your lowest tests several times, and before everything was adaptive to smooth out your grades. Pharmacists who graduated when pharmacy education wasn't a joke are perfectly capable of practicing without having taken an additional year or two of PGY-tutoring to get them up to speed. Imagine turning down a 10-year experienced clinical pharmacist (and let's even say they have BCPS just to satisfy the credential lust) in favor of someone who just graduated from some joke residency program like this guy is in: PGY1 Residency Programs, accreditation with ASHP, and standards • r/pharmacy

edit: I've never heard of that predictive index you are going through, but it sounds kind of interesting. Most of pharmacy practice is basic enough that you are going to have many qualified candidates for any given position. How can you just narrow it down to the people who aren't going to cause drama, be jerks, or flake out all of the time? I just want someone dependable who can get the job done.

My favorite part from your reddit link was that he or she mentioned that they didn't spend more than 20% of the time in their area of practice. And this is precisely the reason why I think most of these programs have become a grandiose scam, which they utilize to save RPh costs. Like a user mentioned, "genius, really." I would rather spend a whole year accumulating real, on-the job experience, while being paid my worth than to be paid peanuts to run a research project...and showcase my journal club skills, only to end up with a staff position and be re-trained for the job. AND I still won't get paid any extra for being PGY1-trained?

As for the predictive index thing, I never heard of it as well till now; www.predictiveindex.com
I guess that's their own way of narrowing things down to the most potentially dependable person for the job.

 

[confettiflyer]

C'mon, do people still think PGY-1 is about making better trained pharmacists? It's all about cost reduction and offloading traditional on-the-job training onto temporary contract employees.

We can easily.... EASILY hire new grads and train them to clinical unicorn status.

But, why?

It's like buying the giant Costco pack of salsa without trying it. Why would you even do that when the sample lady is standing right there?

Even a big proponent of residency like me understands that.

 

[CYP-0]

C'mon, do people still think PGY-1 is about making better trained pharmacists? It's all about cost reduction and offloading traditional on-the-job training onto temporary contract employees.

We can easily.... EASILY hire new grads and train them to clinical unicorn status.

But, why?

It's like buying the giant Costco pack of salsa without trying it. Why would you even do that when the sample lady is standing right there?

Even a big proponent of residency like me understands that.

Perhaps so. But that ideology only favors institutions that are in attractive geographical locations for employment. They have more negotiating power to retain worthy "salsa samples" per their specifications.

Something along the lines of "ASHP-recommended qualifications of a hospital pharmacist" might be a more acceptable bill. I'm very curious to learn how they plan to enforce PGY-1 as a requirement, if they plan to do so at all.

 

[confettiflyer]

I'm very curious to learn how they plan to enforce PGY-1 as a requirement, if they plan to do so at all.

They legally cannot. I don't know how people got around to thinking they somehow have the ability to do so.

ASHP is a private, non-profit organization that has zero bearing on anything outside of its immediate purview accrediting residencies themselves. There's no requirement anyone be a member, much less listen to or adhere to their vision statements.

Even the residencies themselves don't need to be ASHP accredited. You can open one yourself, flip ASHP the bird, and you will be loved by your hospital administrators. Obviously, the challenges there are private (not being listed on phorcas, graduates not eligible for BPS certs straight away), but it's purely voluntary.

The only entities that can force requirements onto hospitals would be TJC, CMS, or some other governmental body...which would never ever happen because that idea doesn't make any sense.

ASHP calling for residencies being required is like me calling for the requirement that everyone love Donald Trump and hang his photo up in their house. Some people might think that's a fantastic idea, but completely unenforceable, at least under this Constitution/system of government.

 

[Dred Pirate]

They legally cannot. I don't know how people got around to thinking they somehow have the ability to do so.

ASHP is a private, non-profit organization that has zero bearing on anything outside of its immediate purview accrediting residencies themselves. There's no requirement anyone be a member, much less listen to or adhere to their vision statements.

Even the residencies themselves don't need to be ASHP accredited. You can open one yourself, flip ASHP the bird, and you will be loved by your hospital administrators. Obviously, the challenges there are private (not being listed on phorcas, graduates not eligible for BPS certs straight away), but it's purely voluntary.

The only entities that can force requirements onto hospitals would be TJC, CMS, or some other governmental body...which would never ever happen because that idea doesn't make any sense.

ASHP calling for residencies being required is like me calling for the requirement that everyone love Donald Trump and hang his photo up in their house. Some people might think that's a fantastic idea, but completely unenforceable, at least under this Constitution/system of government.

the closest ASHP could come to requiring it is that they could say if you want to host an accredited residency - all of your RPh's must be residency trained - this may even be a stretch, but they could easily require it of all of your preceptors

 

[deleted820760]

Unless the resident ends up staying on after residency, it seems like the hospital is losing money from having them. I wonder why so many hospitals have pharmacy residents or even students. It doesn't seem like a good deal at all. It takes up time and resources for no good reason. At least with regular employees, you invest the time to train them and they usually stay longer than a year.

What am I missing? And don't say the residency project benefits the hospital, because the projects are usually nothing of great value imo.

 

[PAtoPharm]

Unless the resident ends up staying on after residency, it seems like the hospital is losing money from having them. I wonder why so many hospitals have pharmacy residents or even students. It doesn't seem like a good deal at all. It takes up time and resources for no good reason. At least with regular employees, you invest the time to train them and they usually stay longer than a year.

What am I missing? And don't say the residency project benefits the hospital, because the projects are usually nothing of great value imo.

At the local hospital here that has a residency program, the DOP flat-out told me that one of the benefits (from the hospital's perspective) of bringing in new residents every year is that they basically use them as cheap labor instead of hiring new pharmacists on a "regular basis." In fact, the hospital with the residency program hasn't hired a single pharmacist in over 4 years. This fact was first relayed to me by a user on this forum, and at the time, I didn't believe it (this was also when I had whatever transient mental illness caused me to ignore any negative realities presented to me about pharmacy). So for many hospitals, it's basically an issue of cost savings over hiring an "official" pharmacist.

 

[gwarm01]

What am I missing? And don't say the residency project benefits the hospital, because the projects are usually nothing of great value imo.

Reduced cost weekend staffing?

 

[lord999]

Reduced cost weekend staffing?

Exploitable (at work and after work with projects) labor and a year-long interview as well as the obvious weekend staffing. It's "educational."

 

[deleted820760]

Exploitable (at work and after work with projects) labor and a year-long interview as well as the obvious weekend staffing. It's "educational."

Does the benefit outweigh the costs? You seem like the perfect person to ask. By the time you've invested all the time and energy into training them so they can work somewhat independently, the year is over.

How much money would you say it costs to have and train a resident, and how much money would you say they save the hospital? Take into consideration all the staff helping with training, journal clubs, and projects. Besides, there needs to be a residency coordinator, and they need to get paid, too. It just doesn't seem worth it unless the resident stays on after residency.

 

[lord999]

Does the benefit outweigh the costs? You seem like the perfect person to ask. By the time you've invested all the time and energy into training them so they can work somewhat independently, the year is over.

How much money would you say it costs to have and train a resident, and how much money would you say they save the hospital? Take into consideration all the staff helping with training, journal clubs, and projects. Besides, there needs to be a residency coordinator, and they need to get paid, too. It just doesn't seem worth it unless the resident stays on after residency.

Actually, there is an internal report for CPPO (Clinical Pharmacy Practice Office) that a VA public version was made and a private one was sent to the Office of Academic Affiliations (OAA). So, in the VA, the individual medical centers DO NOT fund residencies, that is done through the Central Office, and OAA was the responsible organization. Also, they fund all clinical postgraduate training (so physicians, dentists, nurses, podiatrist, clinical psych, etc.) as we are separate from the CMS DGME process. I should look at updating it when I have some spare cycles.

The methods were measuring something called cost per prescription using an internal costing approach that the government uses for managerial cost accounting, a system today called the Decision Support System but at one point was called Automated Medical Information System. This system is used to set the budget for each pharmacy, the number of personnel allocated to each pharmacy, and the level of extra infrastructure support that is given to the network for pharmacy matters. As medications are the second largest line item behind personnel VA wide, this has always driven the importance of the business.

Until about 5 years ago, you have to understand that pharmacists would be paid a retention bonus of somewhere between $5k and 10k in most areas of the country (but surprisingly not CA, IL, and NY because they are always easy to hire stations). So, there's kind of a cost offset of that annually that gets figured into post General Schedule compensation. I say this because I have a feeling that you were once one of us.

Resident oversight costs from the VA Central Office perspective:
Based on costs and positions for a I-B facility (that you would not have otherwise):
1 GS-13 rank pharmacist as the Clinical Coordinator and Master RPD and oversight per 10 residents - $160,000

OR

0.2 FTE commitment per subsidiary RPD (this is an OAA policy) - $25k-$35k

ALBCC (Account Level Budgeter Cost Center) Cost Per FTE (basically the cost of lights, water, property consumption and destruction, and consumption of services per FTE): $7k to $13k

Salary and other allowances - $65k (This is calculated from a salary of $45k with benefits)

So, per resident, we get at worst:
$35k support for the trainer
$13k for the supplies consumption (just being on the VA campus)
$65k for the salary

A resident generally costs OAA in the order of $113k per resident on average overall.

Benefits:
(These numbers were done in advance of the changes to credentialing, so don't reflect today's numbers.)

DSS productivity per pharmacist resident: 0.7 FTE contribution observed (that is because the residents actually work and that the VA pharmacist productivity is rather low. Work for us and you'll figure out why). That was surprising, but it also holds across the board. Residents work hard and are expected to work hard.

OLC/HR - Cost to process a pharmacist involuntary termination: >$600k (if you're wondering why we put pharmacists on permanent administrative leave to the minimum retirement age, if the cost of doing that is less than $600k, then usually Regional Counsel tells us to just put them in some dumb job and immediately retire them at age.) There have been less than 10 internal trained residents given involuntary termination or terminal administrative leave and the cases were for theft and not misbehavior (and the difference is misbehavior is anything nonprofessional rather than something your license would be yanked for directly).

Positive and Influential Voice With Academia (No numbers): It is part of OAA's mission to have reasonable relationships with the Academic Health Centers and running this as a loss leader (which really it is not) if they get access to better quality personnel.

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It boils down to the matter that residents actually subsidize their own training. They actually contribute more than their actual resident stipend into the productivity such that we would rather underpay a resident salary and benefits than pay out a 0.7 FTE. That, and we usually got decent people as residents that we could track them for a year and hire the ones we want. Also, we do weed out those who cannot acclimate to the culture or who are on paper stellar but working with them is a chore.

My own experience with residents is that at its most cynical, I can rearrange my staffing for them to cover undesirable areas and shifts, I can offload short-term projects in the name of "education" on to them, and if I don't like them, I can make them disappear immediately if I'm not willing to wait out the year with them. Weirdly enough, I'm actually the opposite of that when I have to act as an RPD, but I also will not voluntarily take residents under any circumstances short of being ordered to. I still don't believe in it philosophically, and I do not believe in clinical pharmacy being a self-supporting function. It divides the department into operational and clinical lines without major management interference and it decreases continuity. I also consider informatics and pharmacoeconomics/managed care residents to be substandard to other methods. The academic or NIH fellowships for informatics always gives superior personnel, and industry fellowships alone or paired with an in-program masters to produce excellent working knowledge pharmacists.

So, I don't believe in residency, but institutionally, you always get more work out of a resident in the name of education than if you paid them straight time and basically worked a reduced schedule for the educational moments. The final contention I have is that with the exception of nuclear, there is no practice that is restricted to a pharmacist with a residency or not. The residency has never clearly trained anyone to the point where they are decisively always going to better than a lay practitioner, there just is not enough specialized knowledge in our work to differentiate (there are specific spot cases like oncology, neonatology, and nutrition that learn toward that specialization, but not insurmountable that you cannot assign a good pharmacist there with a clean conscience).

But, that doesn't stop a club and clique from forming, so I see the day when only those who go through residency get hospital jobs. That's fine, I'll be retired by then. (Still though, the informatics residents have been so substandard, I make it a point to say that I am better trained than residents in informatics.)

 

[Dred Pirate]

What am I missing? And don't say the residency project benefits the hospital, because the projects are usually nothing of great value imo.

the majority likely are not - I went to SERC and 90% were a joke, although ours locally actually have justified some significant cost savings - something that a seasoned Rph could do, but would cost us a lot more time.