Clinical Pharmacy

[thaliagoo]

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Hi, I am in the process of applying to pharmacy school and am also trying to decide what I wanna do for the rest of my life I've worked at a pharmacy but am not sure I want to dispense drugs for the rest of my life. I'm rather interested in clinical pharmacy, but have a few questions about it.
1- Clinical pharmacists have to do residencies but make less money than their community pharmacy counterparts. Is this true and why?
2- I've heard of pharmacists who make over 200k at hospitals and at drug companies. What is their job and how much qualifications are needed to obtain these types of jobs?

I'm also looking at dual degree programs like PharmD/MBA or PharmD/MPH in just trying to get myself to be more competitive in the job market. I would really like to be done in 4 years, though that might not seem possible. If anyone is pursuing a dual degree and want to tell me their reasons/experiences, that would be great!

Thanks in advance.

 

[dgroulx]

I recently went to a job fair and all clinical positions required a residency. It is competitive. The job requires some extra training beyond your 4 years of pharmacy school. Retail pays more because most people would rather do something else. They suck you in with the large salary.

Having a dual degree takes a year more of school. You may as well do a residency for a year to increase your education, unless you are truly interested in the business end of pharmacy.

 

[kwizard]

1- Clinical pharmacists have to do residencies but make less money than their community pharmacy counterparts. Is this true and why?
2- I've heard of pharmacists who make over 200k at hospitals and at drug companies. What is their job and how much qualifications are needed to obtain these types of jobs?

Thanks in advance.

The salaries for pharmacist range dramatically with the region you live in, but yes retail tends to make more b/c of the work conditions like the previous post mentioned and the retail/community setting is where the shortage of pharmacist is most severe at so the retail is where the supply most outweighs the demand. However when you talk about comparing salaries b/w retail vs hospital vs long term care, you have to consider the benefits and how many hours are you actually working for that annual salary. For instance if you are making 100k/yr and are salaried only to work 40hrs/wk but really end up working 50-60hr/wk due to administrative stuff then your hourly rate really isn't what they have on your paycheck.

Depending on what lifestyle you desire, benefits is also an impt issue. Typically hospitals offer a larger range of benefits (i.e. better healthcare coverage, tuition reimbursement, childcare assistance). Benefits in long term care/home infusion tend to be closer to retail so you really have to read in compare/contrast which best suits your needs. Retirement benefits tend to vary as well but I'd still pick hospital and/or federal system over retail.

Pharmacists that make 200k/yr are few and far between unless you fall into any of the following categories: indepent owner of community pharmacy, medical science liaison (MSL) in industry, Dean of School of Pharmacy, acaedmic researhc who is really killing in funding for research (very rare) or just really work in an area where pharmacist are really short and you are working 60-70hrs/wk.

The indepent owner of a community pharmacy speaks for itself and really can't be compared to anything else as it depends on the store. Dean of the school of pharmacy is unique as well as it may take an entire career to get to being a Dean and a lot of moving around and you still may not get 200k (160k-180k/yr may be more realistic).

A MSL in industry is probably the most realistic goal to obtain in 5-10 yrs unless you want to work nearly 2 FT jobs in an underserved area. MSL qualifications are typically those that have done residency/fellowship training and have practiced for typically 3-5 yrs (including residency yrs) and have developed an expertise in one area (i.e. cardiology, CNS drugs, respiratory, etc). There avg start off salary can range anywhere from 90-120k/yr w/ the avg sign on bonus of 18-20k. This varies alot depending on company. Basic duties are review some of clinical trials and the industry level, helping publish literature about drugs, side effect monitoring, and helping coordinate (w/ drug reps) meeting and/or seminars talks about various drugs/disease states.
After a while depending on how well you do you may get to the 200k? The academic person who spends 20 yrs in academia really killing in research w/ funding/grantsmanship is most likely to get to 200k earlier than other whenever they decide to leave academia for industry.

Even Pharmacy Directors tend to do approx ~120-130 depending on area.

Basically making 200k/yr as a pharmacist is pretty rare unless you own your own pharmacy. Even if you want to go into management the MBA alone may not get you what you want immidiately b/c everybody want to see experience and qualifications. So if you do the PharmD/MBA then consider doing a residency in pharmacy management. There are even some programs that you can do residency training and get the Masters in Pharmacy Management or MBA during the residency program (typically at no extra cost). Three programs I know of off the top of my head are the Ohio State Program (produced a lot of pharmacy directors) and the program at Hopkins. UK also has a program, but I don't know if they have incorporate the MBA into the program, but you could get the MHA (Masters in Health Administration) or MBA at UK as they offer both.

MPH...well this would benefit you the most if you were going to go into the public sector FDA/VA/CDC/WHO/IHS. The pay increase you would receive for MPH will vary but they still will want to see some pharmacy residency training (at least 1 yr). Salaries here tend to be a little lower (<90k/yr initially) but you can make more in long run if you move up adminstratively (100-120k/yr) but the benefits (vacation, sick leave, retirement, scheduling, child care) tend to be far better in federal sector than in any other pathway of pharmacy (it even tends to be better than academia b/c you can potentially make more quicker in federal sector and stil engage in scholarly academic stuff like in academia).

I hope this answers at least some of your questions and good luck.

 

[ButlerPharm.D.]

I agree with kwizard, just because you have an MBA it doesn't mean you are more competitive. When you think about it, would an employer rather hire someone who is a new graduate with a PharmD/MBA or a guy who has been working for a few years but who also happens to have an MBA?? In a field such a management experience is quite important.

 

[sdn1977]

I agree with Kwizard & Butler. Lets get the money issue off the table first...$200,000 is rare, but doable as a retail pharmacist - not as a hospital pharmacist. The reason is retail folks are happy to pay you overtime (I'm in a state which mandates overtime) and hospitals shrink from that (they'd rather do without a pharmacist than pay overtime). Although I'm in an area of the country with a high pay scale, the overtime required for $200K would burn you out pretty quick. Administrators make very little more than staff or clinical pharmacists - here their pay is about $130K (salaried - no overtime).

Drug companies vary - reps income stinks! You are paid an hourly then commission - you gotta be a good sales person. If you are fortunate to climb the ranks thru a drug company, $200K might be realizabe - ie VP of pharmaceutical affairs, but this takes years.

As for deciding upon a residency...well...clinical pharmacy has changed in the years I've worked. Early in my career, there were few of us, but now - all pharmacists are required to take on previous skills which were only "clinical". Hospitals around me employ very few "clinical" only pharmacists. The work is spread throughout the staff. In retail, the most recent Medicare D regulations speak to clinical management by retail pharmacists, so IMO....all pharmacists must have clinical management skills. Actually, this is a pet peeve of mine...those of us who were promoting clinical involvement in the 70's began an "isolationist" approach within the profession unwittingly just by trying to "sell" hospital administrators on the ability of the pharmacist to become more involved in a patient's drug therapy. So...many years later...folks decide if they want to be clinical or not, when the original goal was to have all pharmacists take a clinical approach to the practice of pharmacy, no matter their practice setting. If I were to advise anyone...if your school is strong on clinical skills during your 4 years (some are known for this, others not so much), then don't worry about a residency - your school experience will speak for itself. If that is not the case, do the residency. If you are in a state that has a lot of "clinical" positions - you can ask around....do a residency. IMO, a residency will never hurt you, but sometimes, a fellowship may benefit you more than a residency.

 

[kwizard]

I agree with Kwizard & Butler. If I were to advise anyone...if your school is strong on clinical skills during your 4 years (some are known for this, others not so much), then don't worry about a residency - your school experience will speak for itself. If that is not the case, do the residency. If you are in a state that has a lot of "clinical" positions - you can ask around....do a residency. IMO, a residency will never hurt you, but sometimes, a fellowship may benefit you more than a residency.

Sdn1977 makes some very goodpoints and provides a very well stated historical perspecting regarding the evolution of clinical pharmacy. However, I would like to add just a few additional comments. Differences b/w residency and fellowship vary a bit, but general consensus is that fellowship training is primarily for people to gain research experience (whether they have previous residency training and/or PhD background) so typically the desired endpoint is different (clinical vs research). However there are some fellowships that you can do straight out of pharmacy school (typically in outcomes research in the industry or for managed care sector). If you were to do a MBA or MHA then these programs may also require for you to do more practice based fellowships or internships to gain "real-world experience" in order to graduate (prior to graduate you'd do an internship vs after graduation you'd do a fellowship).

Unless your mind is set to going to community practice/retail I would do a residency. The argument against residency training is that you could cover the same amonut of ground in knowledge at your own pace on your own. This is debatable and partly true depending on how much of a "go-getter" you are, but pharmacy in hospitals/managed care/federal systems is becoming a "letters game" (i.e. how many letters are behind your name (i.e. board certification). So depending on the area on the number of jobs available you will typically see jobs requiring residency training and/or board certification for clinical jobs. Note that they also have to state that a considerable amount of experience may replace board certification or residency training. While this is true on paper it rarely occurs in reality. Contradicting myself again you do still see that person straight out of school with a clinical job and no residency training (it is just less likely).

The job typically goes to the person w/ the credentials and for better or worse residency training is the way to go to stay competitive. Then once you get residency training and want to excel in the clinical arena then go for board certification. I don't completely agree w/ all of the "newer" theories within pharmacy, but that is the way things are becoming. The requirements for management experience are different which is why I'd pursue managerial residencies for the experience and connections. Even still unless you have the inside connect or train under someone w/ a lot of connections you may still be faced w/ having to take a clinical job and move your way up the latter.

 

[thaliagoo]

Thanks for all the replies-- they were very helpful. I will do further research on this topic but this gives me a great place to start.

The main two things I'm looking for in a career is
1- to do something I'll enjoy. I think I can definitely enjoy a career as a clinical pharmacist and work in experimental drug setting or something similar to that.
2- to not have an extremely stressful/overwhelming career. This is one of the reasons I shyed away from research. Don't get me wrong-- my research mentor is wonderful, and I am in awe of her. I don't think I have the physical or mental capacities to handle her lifestyle, though.

I have several questions on some of you guy's posts, if you don't mind answering them.
kwizard- "...but really end up working 50-60hr/wk due to administrative stuff then your hourly rate really isn't what they have on your paycheck"
Are you implying that hospital pharmacists end up working 50-60hr/wk?

About MSL, I searched those job posts on the net and the career itself seems interesting. It seems more demanding than the work of a community pharmacist, but it might be something I'll enjoy. I noticed one thing though, it seems that for a lot of them, you work at home instead of in an office. This seems odd to me, for some reason. Is this typical of MSL or just the jobs I looked at?

Owning my own pharmacy is not really something I'm considering (although I might change my mind). Is there an advantage of getting an MBA if I don't plan on doing the independent pharmacy business? Does an MBA look good for other positions?

Thanks for the detailed reply, it cleared a lot of issues for me. I've always intended on getting a residency and am even more sure now with your posts. What you mentioned relating to the public sector sounds appealing... I will definitely do more research on PharmD/MPH options.

sdn1977 You mentioned the S-word... sales. Sales is out of the question for me (I've had bad experiences with salemen). Are a lot of the pharmaceutical companies more interested in sales? (Do you really need a PharmD to do sales?)

 

[Glycerin]

Hi, I am in the process of applying to pharmacy school and am also trying to decide what I wanna do for the rest of my life I've worked at a pharmacy but am not sure I want to dispense drugs for the rest of my life. I'm rather interested in clinical pharmacy, but have a few questions about it.
1- Clinical pharmacists have to do residencies but make less money than their community pharmacy counterparts. Is this true and why?
2- I've heard of pharmacists who make over 200k at hospitals and at drug companies. What is their job and how much qualifications are needed to obtain these types of jobs?

I'm also looking at dual degree programs like PharmD/MBA or PharmD/MPH in just trying to get myself to be more competitive in the job market. I would really like to be done in 4 years, though that might not seem possible. If anyone is pursuing a dual degree and want to tell me their reasons/experiences, that would be great!

Thanks in advance.

Have you checked out Pfizer's guide to pharmacy? There are SEVERAL different subareas of pharmacy.

 

[kwizard]

Thanks for all the replies-- they were very helpful. I will do further research on this topic but this gives me a great place to start.

kwizard- "...but really end up working 50-60hr/wk due to administrative stuff then your hourly rate really isn't what they have on your paycheck"
Are you implying that hospital pharmacists end up working 50-60hr/wk?

About MSL, I searched those job posts on the net and the career itself seems interesting. It seems more demanding than the work of a community pharmacist, but it might be something I'll enjoy. I noticed one thing though, it seems that for a lot of them, you work at home instead of in an office. This seems odd to me, for some reason. Is this typical of MSL or just the jobs I looked at?

The aforementioned "pfizer guide" is a good place to start (slightly a bit embelished) as you wouldn't to be completely objective about the "ups and downs" of your position w/ your name/place of employment attached.

MBA or MHA are most advantageous if you are looking to move up within administration w/i a business and/or major hospital setting. Most independent pharmacy owners don't have any auxillary business degress as community pharmacy is more dependent on your ability to manage a pharmacy and using common sense about balancing the budget. The complications w/ insurance companies are complicated, but typically something the pharmacy owner figures how to work with. MBA and/or MHAs are typically for those who wish to run a "big business" (i.e. big used to imply several employees w/ obligations to several different services).

MSL...most MSL positions tend to have you set up a home office. Why?...b/c you are often traveling so much the idea of an office at a central location defeats the purpose and most of the offices are at the central location of the drug company (i.e. New Jersey) so it wouldn't be advantageous to set up offices all around the country b/c you have MSLs all over the country. Being a MSL is rewarding if you like evaluating the literature and discussing how it applies to clinical practice and don't mind the occasional compromise of trying to evaluated how your product may be better than others. You are not pushing the product like a drug rep but are more trying to evaluate the pro's and con's of the product based on the literature and developing relationships w/ prescribers in your area and educating them. Typically if the drug reps in your area do well then you get a portion of the bonus that comes to your region b/c you are also often responsible for educating the drug reps.

Drug reps/salesman...Nope no PharmD needed here. I am not even sure if you need a degree. Most have degrees in sales as that is really the emphasis, but like SDN1977 said, it is cut throat and may potentially compromise your integrity and/or ethics.

Clinical pharmacists in hospitals...well it depends on the pharmacy. Some phamacies tend to to use the aforementioned clinical staff model where most of the clinical-staff pharmacists due most of the therapeutic drug monitorings (TDM) w/ antibiotics, antiseizure meds, etc. In this case the "purely clinical" pharmacist would use there time developing protocols for TDM, do TPN writing (depending on facility) and do inpatient and/or outpt anticoagulation. Other miscellaneous responsibilities would be for P&T committee meetings (drug regimen reviews (if you don't have students or residents to pass that on to) or other various policies (i.e. USP 797)).

If you don't have a clinical staff model then the pharmacists simply staff (i.e. process orders) and the clinical people p/u the TDM in addition to other duties. In more progressive facilities like in the VA system the difference b/w clinical and non-clinical is more clear cut as the clinical staff typically run clinics w/ prescribing authority.

All of which have have their pro's and con's that you would have to weigh on an individual basis. How many hours you work as a clinical pharmacist depends on the facility and your efficiency. The avg is ~50hrs/wk. Avg salary is typically 85-110k/yr (depening on area). If you are primarily staffing range is typically 80-95k/yr. These are just estimates are really subjective to my own opinion so please take w/ a "grain of salt" and are based on potential salaries coming straight out of school. On the avg, residency training gets you maybe an additional 2-5k/yr in salary vs someone who has been out of school the same amount of time w/o such training. But this really depends on what type of job you are applying for so it may be better stated that the kind of jobs that the person w/ residency training is applying would be different then the type of job a person w/o residency training would apply for as they would typically list in requirements what they are looking for (i.e. residency training, board certification, etc).

 

[dgroulx]

I talked with a couple of hospitals who are hiring pharmacists out of school. For a clinical position, I must do a residency first. For a staff pharmacist position, I can get hired right out of school. You may want to talk with some pharmacists at hospitals in your area and see what their jobs entail.

 

[sdn1977]

Thaliagoo...no a Pharm.D. is not required for sales, but I've never met anyone who has climbed the industry ladder to a management position who has not done a stint in sales, unless they have come from academia in which they have paid a different price altogether. IMO, most drug sales folks do have degrees with a preference for a science degree, but not normally a graduate degree (BS, BA usually).

To try to put this all in some perspective for you...can you see the many, many possibilities open the various posters have outlined? If you really like drugs & are interested in being a part of having them have a productive place in our society, pharmacy might be a career for you. You very likely will change where your interests lie many times just during your 4 years of school. You might even change career paths like me! There are so many pharmacists in places we haven't even touched on & some that didn't exist when I got out of school. Don't worry about the money - you will make a lot! Don't worry about the time you have to spend studying or working - you will spend a lot! But...remember, there are ways to manipulate your life & work so you continue a good balance between making money/spending time and having a fulfilling life. IMO - you gotta decide if drugs & their uses are what catch your interest first then the rest will follow. Good luck & have fun!

 

[NCRxgal]

The salaries for pharmacist range dramatically with the region you live in, but yes retail tends to make more b/c of the work conditions like the previous post mentioned and the retail/community setting is where the shortage of pharmacist is most severe at so the retail is where the supply most outweighs the demand. However when you talk about comparing salaries b/w retail vs hospital vs long term care, you have to consider the benefits and how many hours are you actually working for that annual salary. For instance if you are making 100k/yr and are salaried only to work 40hrs/wk but really end up working 50-60hr/wk due to administrative stuff then your hourly rate really isn't what they have on your paycheck.

Depending on what lifestyle you desire, benefits is also an impt issue. Typically hospitals offer a larger range of benefits (i.e. better healthcare coverage, tuition reimbursement, childcare assistance). Benefits in long term care/home infusion tend to be closer to retail so you really have to read in compare/contrast which best suits your needs. Retirement benefits tend to vary as well but I'd still pick hospital and/or federal system over retail.

Pharmacists that make 200k/yr are few and far between unless you fall into any of the following categories: indepent owner of community pharmacy, medical science liaison (MSL) in industry, Dean of School of Pharmacy, acaedmic researhc who is really killing in funding for research (very rare) or just really work in an area where pharmacist are really short and you are working 60-70hrs/wk.

The indepent owner of a community pharmacy speaks for itself and really can't be compared to anything else as it depends on the store. Dean of the school of pharmacy is unique as well as it may take an entire career to get to being a Dean and a lot of moving around and you still may not get 200k (160k-180k/yr may be more realistic).

A MSL in industry is probably the most realistic goal to obtain in 5-10 yrs unless you want to work nearly 2 FT jobs in an underserved area. MSL qualifications are typically those that have done residency/fellowship training and have practiced for typically 3-5 yrs (including residency yrs) and have developed an expertise in one area (i.e. cardiology, CNS drugs, respiratory, etc). There avg start off salary can range anywhere from 90-120k/yr w/ the avg sign on bonus of 18-20k. This varies alot depending on company. Basic duties are review some of clinical trials and the industry level, helping publish literature about drugs, side effect monitoring, and helping coordinate (w/ drug reps) meeting and/or seminars talks about various drugs/disease states.
After a while depending on how well you do you may get to the 200k? The academic person who spends 20 yrs in academia really killing in research w/ funding/grantsmanship is most likely to get to 200k earlier than other whenever they decide to leave academia for industry.

Even Pharmacy Directors tend to do approx ~120-130 depending on area.

Basically making 200k/yr as a pharmacist is pretty rare unless you own your own pharmacy. Even if you want to go into management the MBA alone may not get you what you want immidiately b/c everybody want to see experience and qualifications. So if you do the PharmD/MBA then consider doing a residency in pharmacy management. There are even some programs that you can do residency training and get the Masters in Pharmacy Management or MBA during the residency program (typically at no extra cost). Three programs I know of off the top of my head are the Ohio State Program (produced a lot of pharmacy directors) and the program at Hopkins. UK also has a program, but I don't know if they have incorporate the MBA into the program, but you could get the MHA (Masters in Health Administration) or MBA at UK as they offer both.

MPH...well this would benefit you the most if you were going to go into the public sector FDA/VA/CDC/WHO/IHS. The pay increase you would receive for MPH will vary but they still will want to see some pharmacy residency training (at least 1 yr). Salaries here tend to be a little lower (<90k/yr initially) but you can make more in long run if you move up adminstratively (100-120k/yr) but the benefits (vacation, sick leave, retirement, scheduling, child care) tend to be far better in federal sector than in any other pathway of pharmacy (it even tends to be better than academia b/c you can potentially make more quicker in federal sector and stil engage in scholarly academic stuff like in academia).

I hope this answers at least some of your questions and good luck.

Thank you so much for your input. Your reply was very helpful🙂