Pharmacy Failed a Class in Pharmacy School, Remediated with an A, but Rethinking Pharmacy - What should I do?

[BC_89]

Hello! I would greatly appreciate any advice here.

I failed one of my P1 classes last year due to medical reasons and was a little immature. I had a good start in pharmacy school (with As and Bs) my 1st semester, but my grades fell dramatically my 2nd semester. I was lucky in that my school allowed me to remediate, and was told by one of my professors that if I want to do residency, I would need to start getting mostly As in my classes. I did a research project and took some graduate coursework during my year off, and remediated that same class with an A. With all that has happened, my GPA is now just slightly above a 3.0.

I went into pharmacy school after doing extensive research on the field: being involved in a pre-pharmacy club, doing research, and working in a pharmacy setting. I still really like learning and am passionate about the field. I knew of the job market saturation prior to enrolling, but thought that if I worked hard enough, my future might be secure.

With the job market saturation and the dent in my academic record, would it be recommend I drop school to work as a technician or stick it out? Does anyone know of a person either in their class or school that was in similar situation as me, but ended up succeeding?

I come from a low-income background where my education was mostly funded by financial aid and scholarships. I was lucky enough to graduate college with just a few thousand dollars in loans. However, the dent in my record provides me with a higher financial burden, and I'm not sure if it is financially plausible enough anymore to risk not be able to practice.

Thank you for taking the time to read this thread!

With knowledge of the job saturation and a drop in an academic record (but still in the program), did you have the main goal to do residency and avoid retail?

I do apologize for not being specific.

Honestly, I was aiming for a niche position and wanted to do a hospital residency because I like how there are more opportunities to learn, gain new skills, and make improvements in the pharmacy setting.

I don't really mind retail. I had experiences in both settings and find them both rewarding (and sometimes not so rewarding) in different ways. I like how in the hospital setting, we get to monitor labs, give drug recommendations, make IVs, TPNs, and unit dose. There's still a lot I don't know about pharmacy practice... but so far I like both. Though I don't really like prior authorizations and other administrative work, I do like the patient interaction you get in the retail setting.

But with job market saturation, even if I'm not able to do hospital, I still wanted a residency so that I could have more opportunities to network and get my skills recognized at conferences. I was told that it's important to network because it's hard to know how much health care is going to change. Though... I don't know how much of this is true.

Similar question is what do you define as successful? Full time employment? Working inpatient? Geographically landing your career in an ideal prominent location? As for finding yourself in a financial burden that will depend on your estimated overall debt by graduation. Keep in mind many graduates are struggling to pay off their debt.

What I meant by success is simply getting a full-time job and being able to practice. I don't mind working hard, but my biggest fear is not being able to work or pay off my loans. I would preferably like to do inpatient and don't mind if the location is less than ideal. I know that even people with stellar grades that did residency might have to relocate. And some with residency might not be able to find their desired job...

I am not sure what you mean by dropping school and working as a technician. Are you implying to take another break from school and work as a technician or do you wish to be done with school altogether? If you turn away from pharmacy, what is your back-up? Do you still wish to pursue a healthcare profession and if so do you have the pre-requisites?

Hmmm... hard to say. I was thinking about dropping out of school to work as a pharmacy technician and be done with school all together. I think I'd want to find some way to get my pharmacy loans forgiven as well... If I end up dropping, I don't believe I would want to re-enroll because that would be money and time lost from taking the first year classes.

As for prerequisites, I have a B.S. in Pharmacology, but might need to take some additional classes depending on the school and field. I knew since high school that I wanted to do something in the health professions, but didn't know what - a couple of the doctors and nurses I talked to when volunteering told me that pharmacology was what they struggled with most in school.

However, I'm not sure about pursuing another healthcare profession at this moment. I did consider nursing at one point, but decided not to because I had always been a little squeamish. I might consider nursing again, seeing how I'm pretty much desensitized by now (maybe a CRNA or ACNP).

I would consider what the other professional programs might think of your transcript showing that you (at one point) could not keep up with the rigors of grad school. I do not want to assume but the situation sounds like your ultimate goal is residency no matter what. If this is the mindset, you need to understand that their is a possibility that you may not reach your career goal.

Definitely a point to consider, thank you! Will health professional schools would look at a pharmacy school transcript when selecting candidates, especially if it's not grades for their prerequisite requirements? Do you think it is something I should bring up if I were to apply to another school? If anything, I think this experience made me a better person. I was able to develop better coping mechanisms that will help me stay focused despite external circumstances, learn how to take better care of my health, and learn more about how to learn more effectively. I think it also made me much more empathetic towards others.

Not being able to keep up with the rigors of pharmacy school at one point in my life is also my biggest fear about the quality of my application for residency. I know that heath professionals can be very risk averse. Entering pharmacy school, we swore an oath to "First, do no harm." Also, the cost of attendance...

We were given advice during orientation that mistakes can happen, and when it does, it's important to fix it quickly and learn from it; but one mistake at work can really ruin a patient's life.

I think my biggest question is how much would it set the quality of my application back, and whether or not there is still an opportunity for someone to consider me if I were to improve from this point forward.

If you have hopes of getting a niche position in pharmacy, you need to re-evaluate your career goals. My program has had many students repeat school and still land a job but very few of them were able to get a residency.

Glad to know that it was possible! Do you mind sharing, if you know, what other qualities they had that made them competitive despite having to repeat school?

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[KidPharmD]

If pharmacy is what you want to do then I don't think you have ruined your chances.
First, I don't think you ever say what year your are now. If just above a 3.0 is the highest your GPA is going to get then that does put you at a bit of a disadvantage. If you still have some grades to add to that that could pull it up then I think you could be okay. People with a 3.0 still get residencies. It depends a lot on the rest of your application.

Before deciding how much that F will mean, I would take a look at your official transcript and see how obvious it is. If your remediation class replaced the F (the F doesn't actually appear on the transcript) then that is one thing. If the F is there but not included in your GPA then that is slightly more problematic.

There is also a good chance that proving that you have learned from your failure will be a thing you can leverage if you can get interviews. By the time you are doing residency interviews P1 year is a long time ago and people are less interested in it. I will say that while we looked at the GPA of each candidate, I didn't review a single transcript and I don't think anyone else on our selection committee did either. I do know people that had to repeat coursework and still got residencies but not recently (I just don't know anyone who repeated anytime recently).

That is very encouraging. Thank you for taking the time to share!

I just finished my second P1 year after failing a class last year, so incoming P2. At my institution, a "D" is a failing grade and is very obvious. I waited a year before being able to take the class again. I'm attending a 4 year program, so if I were to continue, it will take me 5 years to finish. They also average the grades in the courses students have to repeat (both the D and the A will appear on the transcript - equalizing to a 2.0 - C grade).

I didn't know that 3.0s can still get residencies... If you don't mind me probing, what types of qualities and experiences did these people have to make up for the poor grades?

 

[BC_89]

Will health professional schools look at a pharmacy school transcript when selecting candidates, especially if it's not grades for their prerequisite requirements?

The pharmacy courses will be looked at. However, the main focus is always going to be the prerequisite undergrad courses (you will find many of our family admins and faculty from other professions attesting this to many students). It's good to know though that undergrad and grad school GPAs are kept different and many applications separate them as well.

Something to strongly keep in mind: A lot of pharmacy school programs still consider the first and second year as undergraduate work on a transcript so I would get with your program and see what the official transcripts would say. For example, I enrolled in a pharmacy program many years ago but had to leave after the first semester (military life at its finest). Some years after converting over to active duty and leaving from the military, I enrolled in another program (3 year accelerated) and found out that my previous pharmacy school had all of my courses listed as "undergraduate" work despite getting an acceptance at the time with a bachelors degree. Remember, many students only do 2 years of pre-reqs and never earned a bachelors when going for a PharmD so many programs allow such students to "earn" that bachelors during school after completing the introductory years in pharmacy.

Do you mind sharing, if you know, what other qualities they had that made them competitive despite having to repeat school?

Many worked part time as interns as well as participated in research projects and poster board presentations. Others networked within the job sites they were interning at and found a connection somewhere down the line (prn / per diem / full / so on and so forth). A few others focused on specific pharmacy settings such as working for the IHS or VA sites in rural areas that many overlooked. Just keep an open mind and don't be picky when specific job opportunities open up down the road.

 

[lord999]

So, I am going to be both negative and positive.

Negative:
If you are planning on a residency in an academic setting, particularly an Academic Health Center, it is unlikely. There are just too many good applications for the high-end for yours to be reasonably competitive.

You will not get the benefit of the doubt if you fail again. This lack of a safety net (since you already used yours) is an additional stressor, and first year is the easier year.

Positive
Academic Health Center residencies constitute <15% of the residencies. The other 85% are a mix of government, private sector, etc. I can tell you for the government ones, the smaller sites are not competitive even now. This is far less a percentage than a decade ago. In OR for example, there is one residency that I know is a good one that has not matched simply because of its location and its focus on Nursing Home. The competitive residency in OR has notoriously problematic preceptors and has had bad classes.

If you are motivated not to fail again, I still think you will do ok as long as you get some connections (as in, go to your state ASHP meeting and actually chat with the RPD's and try to get hospital tech/intern employment). Although I am from Research, I highly DO NOT recommend doing research for just another credential, you are FAR better off finding more work. Only do research if it's self-satisfying, you actually find enough poster and abstract work working in your hospital to write something up if you are relatively observant.

I can't speak for the employment statistics, but overtrained pharmacists not getting positions is a thing right now. For example, Pediatric ER as my colleague has is a job that isn't a shortage due to its specificity. @KidPharmD probably did the training but also had to either network, be willing to relocate, or otherwise work his/her way in if just graduated and trained. I actually suspect that happened anyway.

No one cares about conferences outside a self-referential clique. If self-validation professionally is what is desired, then mid-level practitioner is definitely not a good choice for you as you always will be the assistant. Within pharmacy, it's a phase that many go thorough until they are about 15 years in practice and then figure out the echo chamber.

The qualities for a low GPA successful residency candidate from my standpoint viewing national data are:
1. They showed up. Many residencies are still noncompetitive. There isn't yet a hiring differential from coming from certain residencies.

2. They were willing to be flexible and compromise. Geographically, accepting worse environmental circumstances (which actually can be a good thing), accepting problem people (there's a residency in Portland, OR that is non-competitive as the RPD is notoriously mercurial).

3. They were willing to scramble and be accepting. They were willing to work on diminished expectations and problem points, they worked to improve.

 

[KidPharmD]

That is very encouraging. Thank you for taking the time to share!

I just finished my second P1 year after failing a class last year, so incoming P2. At my institution, a "D" is a failing grade and is very obvious. I waited a year before being able to take the class again. I'm attending a 4 year program, so if I were to continue, it will take me 5 years to finish. They also average the grades in the courses students have to repeat (both the D and the A will appear on the transcript - equalizing to a 2.0 - C grade).

I didn't know that 3.0s can still get residencies... If you don't mind me probing, what types of qualities and experiences did these people have to make up for the poor grades?

OK, If you are an incoming P2, you probably still have a lot of time to bring that GPA up. First, work hard at that. The GPA residencies see will be the one at the end of the first half of your P4 year. If that GPA is high enough, then I doubt many residencies will even bother examining your transcript and even those that do will probably not disqualify you for a single D.

My general advice
-Any internship is better than no internship. Something relevant is better than something random, but I didn't work in a hospital during pharmacy school.
-Find mentors. The best ones are ones who are connected to what you want to do. Want to do peds? Get in touch with your peds professor. Want to do VA? Find one of the VA professors to connect with. LOR's can be very influential on getting a residency.
-Keep a professional journal. Write down the stories where you learned something, where you had a clinical win, where you lead a group. One of the big problems is that people don't have good answers to interview questions, but if you have written them down then you can just review your journal when it comes time to apply. (I still do this.)

 

[lord999]

In that case, would you recommend moonlighting during residency so that pharmacists can leave residency off their applications to some jobs without having a gap in employment?

I thought organizations like ACCP and ASHP host conferences to share updates the pharmacy profession and provide networking opportunities. Even nursing has organizations like Sigma Theta Tau, ANA, etc. But I think I may be misinformed. Are conferences really only for self-promotion?

No, I ask that you get a position now. Start working on those connections. Too many of you just go to class without any practical training. I actually do NOT recommend you have outside employment during residency, you're not working hard enough in one if that is the case.

Well, yes at the senior level. At your level, it does have networking opportunities BUT NOT at the national versions. The state versions is where that really gets together. If you are going for a residency and are not cozy with your state's version of ASHP or ACCP, I ask why. But why I wrote that is that you wanted professional validation at conferences. It doesn't work that way unless you are in Research (and there are better venues than pharmacy for that).

Also, you do not have a good working view of the DoD or VA. The DoD's pharmacists are officers before pharmacists. The VA's prescribing authority is widely trumpeted, but it is also extremely protocol driven (that it's something that we all agreed on as "of-course" things to do). You need more work experience as an intern to give you an idea of how this works. As far as getting a recommend from a VA faculty, absolutely it helps. DoD has its own peculiarities for recruitment, it's now more competitive than it used to be, but whether you are going to be O-4 locked or O-6 is largely up to factors at recruitment and the sort of work you do.

 

[KidPharmD]

Thank you so much for your advice! I will do just that!

Would a 3.6+ GPA be considered competitive enough by the time of application P4 year?

And if you don't mind sharing, did you work retail during pharmacy? I heard from a pharmacist, while I was attending an alumni panel 5 years ago, that it's harder to switch from outpatient to inpatient than it is the other way. I'm not sure how much that is true now.

3.6 is very competitive and will be above anyone's screening criteria. 3.5 is generally accepted as the line that improves your chances of residency. I did a bit of specialty and a bit of retail. I would say that inpatient to outpatient would be the easier transition but the opposite isn't insurmountable.