Fellowships and Residencies delay the inevitable

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Though I'm amused that the amount of federal taxes I am withholding exceeds my former residency salary, hahaha.

But rest assured I'm no bright-eyed/bushy-tailed kool-aid drinking cheerleader of pharmacy idealism...it's my goal every day to instill a sense of reality to my students and residents I precept/train.
You are the type of person who may save the profession. Sorry for misjudging you...old people tend to do that...keep up the good work!
 
Have any of you ever thought about this; how your professional liability insurance is based on your scope of practice. The thing that many of you fear, linking your name to an actual order, IS under your scope of practice and protected. However, are things like participating when a patient is coding covered by your professional liability insurance? How about something as simple as taking a blood pressure? Have any of you ever checked? It may be fun playing the role of junior-doctor, that the schools have set you up for with these residencies, but if the marketplace doesn't say that is within your scope of practice, you may be hung out to dry.
 
I miss the old emoticons. I'd be using the beating the dead horse one right about now... 🤣
 
Have any of you ever thought about this; how your professional liability insurance is based on your scope of practice. The thing that many of you fear, linking your name to an actual order, IS under your scope of practice and protected. However, are things like participating when a patient is coding covered by your professional liability insurance? How about something as simple as taking a blood pressure? Have any of you ever checked? It may be fun playing the role of junior-doctor, that the schools have set you up for with these residencies, but if the marketplace doesn't say that is within your scope of practice, you may be hung out to dry.

http://www.dartmouthlawjournal.org/uploads/GARDIPEE.pdf
 
I miss the old emoticons. I'd be using the beating the dead horse one right about now... 🤣
Now, now...for you, the horse called "rationalization" is very much alive; regardless, i'm tired of beating the drum, so good luck and get back to me in 5 years...maybe you'll be seating folks ate the Cheesecake Factory...you can help out if a patron has a "cafe coronary"...LOL!!!!!
 
Now, now...for you, the horse called "rationalization" is very much alive; regardless, i'm tired of beating the drum, so good luck and get back to me in 5 years...maybe you'll be seating folks ate the Cheesecake Factory...you can help out if a patron has a "cafe coronary"...LOL!!!!!

I love Cheesecake Factory! 🙂
 
Well the answer is that...it doesn't matter whether it's scope of practice or not, you're gonna get sued regardless. Now the question of whether your insurance will back you up or not depends on how it's all worded. Devil's in the details. It'll also depend on how the courts interpret everything. In that article, it cites a Georgia (or Alabama?) case where pharmacists were only considered "learned intermediaries" and not actual practitioners, therefore not liable.

In cases of taking BP, responding to codes, etc... it depends on the siutation. If a code fails and a pharmacist is vicariously implicated vs. directly (like giving the wrong med), then I do believe it's still within the professional scope as determined by an insurance company (it's still the provisioning of medicine).

Basically it's complicated, situation and company dependent, and plantiff/court dependent. I'm too busy to look at my coverage fine print (my role is managerial + traditional staffing + consultative such that I still fall under "learned intermediary") but my gut tells me it's written in such a way that an enterprising corporate lawyer can throw you under the bus no matter what the situation is.
 
Stupid question, but did you have liability insurance as a resident?
 
Well the answer is that...it doesn't matter whether it's scope of practice or not, you're gonna get sued regardless. Now the question of whether your insurance will back you up or not depends on how it's all worded. Devil's in the details. It'll also depend on how the courts interpret everything. In that article, it cites a Georgia (or Alabama?) case where pharmacists were only considered "learned intermediaries" and not actual practitioners, therefore not liable.

In cases of taking BP, responding to codes, etc... it depends on the siutation. If a code fails and a pharmacist is vicariously implicated vs. directly (like giving the wrong med), then I do believe it's still within the professional scope as determined by an insurance company (it's still the provisioning of medicine).

Basically it's complicated, situation and company dependent, and plantiff/court dependent. I'm too busy to look at my coverage fine print (my role is managerial + traditional staffing + consultative such that I still fall under "learned intermediary") but my gut tells me it's written in such a way that an enterprising corporate lawyer can throw you under the bus no matter what the situation is.
OMG!! "Learned intermediaries"!!! That's it!!! That's what we are!!! I cannot thank you enough, confettiflyer. LEARNED INTERMEDIARIES!!!! That is perfect. I said before, our profession is neither fish nor fowl...we are "learned intermediaries"!!!
 
OMG!! "Learned intermediaries"!!! That's it!!! That's what we are!!! I cannot thank you enough, confettiflyer. LEARNED INTERMEDIARIES!!!! That is perfect. I said before, our profession is neither fish nor fowl...we are "learned intermediaries"!!!

Haha, I like that phrase too (though not as excited as you seem to be?) but there's discussion in that Dartmouth paper about whether this could be turned on its head going forward with expansion of roles.

At the end of the day we practice under physician protocols, so in theory we are no different from a medical assistant calling in prescriptions on behalf of a physician. The expansion of independent practice will occur completely on the NP side because it is much cheaper to do so.

So...neither fish nor fowl, but we are the instead cows. Happy to roam the fields, but when it starts raining, we promptly go into the barn. I like it that way.
 
Haha, I like that phrase too (though not as excited as you seem to be?) but there's discussion in that Dartmouth paper about whether this could be turned on its head going forward with expansion of roles.

At the end of the day we practice under physician protocols, so in theory we are no different from a medical assistant calling in prescriptions on behalf of a physician. The expansion of independent practice will occur completely on the NP side because it is much cheaper to do so.

So...neither fish nor fowl, but we are the instead cows. Happy to roam the fields, but when it starts raining, we promptly go into the barn. I like it that way.
you are a very, very intelligent person! i am a cross between a curmudgeon, comedian and misanthrope...i'm 60 and i don't believe in the "nobility" of the human race...i'm courteous, but i don;t suffer fools gladly...no time to waste...you have insight, wit and logic...the world is a better place with a person like you...best of luck with your profession and life...your employer is fortunate to have you...from a fellow "learned intermediary", LOL!!
 
you are a very, very intelligent person! i am a cross between a curmudgeon, comedian and misanthrope...i'm 60 and i don't believe in the "nobility" of the human race...i'm courteous, but i don;t suffer fools gladly...no time to waste...you have insight, wit and logic...the world is a better place with a person like you...best of luck with your profession and life...your employer is fortunate to have you...from a fellow "learned intermediary", LOL!!

Haha, thank you sir, I'll drink to that.
 
And forget that dream "role" they told you about in school. It doesn't exist. Hell, they told us the same stuff back in 1976.
Eh? My dream role certainly does exist, and that's exactly what I have been doing for the last few years. Not what I thought my dream job would be back when I was a student (when I got closely acquainted with that role, I changed my mind about what I wanted to be when I grow up), but it was rather funny when I realized that what I get paid to do and what I like to do in my spare time are exactly the same things - except with different type of content. But same exact skills, processes, etc. 🙂 And if not for the fellowship, I would not have gotten where I am at all - or it would have taken me 5+ years longer to get here. Why waste time?
 
Eh? My dream role certainly does exist, and that's exactly what I have been doing for the last few years. Not what I thought my dream job would be back when I was a student (when I got closely acquainted with that role, I changed my mind about what I wanted to be when I grow up), but it was rather funny when I realized that what I get paid to do and what I like to do in my spare time are exactly the same things - except with different type of content. But same exact skills, processes, etc. 🙂 And if not for the fellowship, I would not have gotten where I am at all - or it would have taken me 5+ years longer to get here. Why waste time?
Well, good for you. But, what exactly is the role you occupy? Can it be done by a less costly occupation or can it be replaced by technology? Does it have staying power; that is, in crunch time, when your employer is looking to decrease costs, is your role essential to operations? Lastly, how much did all of this cost YOU to attain (and please include opportunity costs, which is the money you could have been earning if you would have skipped the residency/fellowship and just got a job).
 
Well, good for you. But, what exactly is the role you occupy? Can it be done by a less costly occupation or can it be replaced by technology? Does it have staying power; that is, in crunch time, when your employer is looking to decrease costs, is your role essential to operations? Lastly, how much did all of this cost YOU to attain (and please include opportunity costs, which is the money you could have been earning if you would have skipped the residency/fellowship and just got a job).

Actually, if I could do it all again, I wouldn't need to go through pharmacy school or a fellowship. I would just get an MS and go straight into pharma. Although, having a doctorate under your belt (either a PhD or PharmD) can certainly reflect on how fast you move up in this industry.

The fellowship is one of the best routes FOR PharmD students to go into pharma. I conducted a survey with a few co-fellows during my fellowship and we found that PharmD's in industry with a fellowship tended to get promoted faster than those without. This is also true for salary. How's that for opportunity costs? =)
 
Actually, if I could do it all again, I wouldn't need to go through pharmacy school or a fellowship. I would just get an MS and go straight into pharma. Although, having a doctorate under your belt (either a PhD or PharmD) can certainly reflect on how fast you move up in this industry.

The fellowship is one of the best routes FOR PharmD students to go into pharma. I conducted a survey with a few co-fellows during my fellowship and we found that PharmD's in industry with a fellowship tended to get promoted faster than those without. This is also true for salary. How's that for opportunity costs? =)
Working for Big-Pharma is the ideal end point for a residency/fellowship. But you said it all when you said you didn't need pharmacy at all. A doctorate is one thing. A Pham D is the base degree in pharmacy; not even close to a doctorate. You would have to show me the figures on salary compensating for the cost of schooling and the lost wages from not working those years. Just guessing, I think a salary would have to be double (for folks with the fellowship) to make sense. But you picked the right venue. Best of luck!
 
It's all good and you have accomplished quite a lot; but none of those accomplishments are RECOGNIZED in the marketplace!!! You are not a provider; your scope of practice is limited. No one will PAY you for your services. You may serve a complimentary role, show your considerable skills, have the docs or the RN or the patient throw you a bone and give you a warm feeling inside from assisting. But, as a profession, not as individual, anecdotal accounts of how "you are making a difference", there is no recognition. An no matter how you try to dress the profession up with residencies or fellowships or whatever, there is no role for you. The AMA sees to it that you have no role by limiting your scope of practice. The digital revolution and the economic pressures in the current healthcare environment will finish the job. In today's workplace, pharmacists are an overeducated, over-paid profession with no role for the 95% of you. It makes me sad to say that, because you are the best this profession has ever seen, but you are all heading down the rabbit hole by doubling-down with residencies and fellowships. Get on Coursera and explore some complimentary skills that could make you all very valuable to the marketplace. I'm not a "crank" or a "troll". The changes to the
profession are coming and very fast. Five years or less for some very big, downhill, changes.

Last year, I had a lengthy discussion with a residency director about the importance of provider status for pharmacists. Recently, California recognized its pharmacists as health care providers. Does this mean pharmacist in California are getting paid for their MTM services? Is this the beginning to us getting paid as providers?

No company wants to pay for MTM pharmacist services (unless forced to do so by law). If this is the case, what's the point of gaining provider status for pharmacists if the marketplace won't pay us anyways? Perhaps pharmacists gaining provider status is a step in the right direction in terms of getting paid as providers in the future.
 
Last year, I had a lengthy discussion with a residency director about the importance of provider status for pharmacists. Recently, California recognized its pharmacists as health care providers. Does this mean pharmacist in California are getting paid for their MTM services? Is this the beginning to us getting paid as providers?

No company wants to pay for MTM pharmacist services (unless forced to do so by law). If this is the case, what's the point of gaining provider status for pharmacists if the marketplace won't pay us anyways? Perhaps pharmacists gaining provider status is a step in the right direction in terms of getting paid as providers in the future.
The question is, what services that the pharmacist provides would be valued in the marketplace; what can you do that is unique, valuable and fills an unmet need? How would you bill for such a service and how would you provide evidence of the cost-effectiveness from a provider who is as costly as a pharmacist? Would the service you provide even offset your salary? Could that service be done as well by a less costly provider?
Over a 10 year period I spearheaded efforts at cognitive reimbursement for pharmacists in the retail setting. I networked with many experts. One of the best strategies that I heard was that of a pharmacist who went to an insurer offering disease-state management for pediatric asthma. He told the insurer that he would manage the therapy of 100 of the costliest patients for one year for free. At the end of the year, the insurer would compare the costs of care with the previous year. The pharmacist would then ask for 10% of the savings. In that way, the insurer risked nothing and had evidence that the intervention had value. The pharmacist then signed a contract with the insurer to manage the patients on a capitated basis. On reflection, the insurers in today's marketplace would give the role to a Nurse Practitioner or Respiratory Therapist, at a much less cost than a pharmacist. Our role is what it has always been. The environment has doomed any excursions into other areas.
 
One point Sans makes that I do agree with is the differential in salaries between pharmacists and nurse practitioners/physician assistants. At least in the hospital setting this gap is narrowing. One of the best things we can do for our profession is to continue to support our mid-level brothers and sisters. As their salaries increase it not only protects our salaries but makes our contributions to the hospital seem "more affordable." Until then, even if we are granted provider statuses across the country, we are too expensive comparatively. However, it may be too late because I already see the explosion in PA schools and the coming salary crunches for that profession.
 
One point Sans makes that I do agree with is the differential in salaries between pharmacists and nurse practitioners/physician assistants. At least in the hospital setting this gap is narrowing. One of the best things we can do for our profession is to continue to support our mid-level brothers and sisters. As their salaries increase it not only protects our salaries but makes our contributions to the hospital seem "more affordable." Until then, even if we are granted provider statuses across the country, we are too expensive comparatively. However, it may be too late because I already see the explosion in PA schools and the coming salary crunches for that profession.
The gap will narrow by pharmacist salaries coming down; not pulling up NP's or PA's. The "explosion" has been in the number of pharmacy schools. The advantage that NP's and PA's have over pharmacists is that THEY ARE PROVIDERS. We are "learned intermediaries", with no defined role up on the floors. Our role is defined within the department; but no one wants to accept that, since you all went to school for so long and did residencies and fellowships that promised so much more.
 
One point Sans makes that I do agree with is the differential in salaries between pharmacists and nurse practitioners/physician assistants. At least in the hospital setting this gap is narrowing. One of the best things we can do for our profession is to continue to support our mid-level brothers and sisters. As their salaries increase it not only protects our salaries but makes our contributions to the hospital seem "more affordable." Until then, even if we are granted provider statuses across the country, we are too expensive comparatively. However, it may be too late because I already see the explosion in PA schools and the coming salary crunches for that profession.
The gap will narrow by pharmacist salaries coming down; not pulling up NP's or PA's. The "explosion" has been in the number of pharmacy schools. The advantage that NP's and PA's have over pharmacists is that THEY ARE PROVIDERS. We are "learned intermediaries", with no defined role up on the floors. Our role is defined within the department; but no one wants to accept that, since you all went to school for so long and did residencies and fellowships that promised so much more.
 
My biggest problem with residencies is that they do not teach you how to handle practitioners. I don't have a residency but all of the docs and mid levels LOVE me because I save their ass and I know how to communicate with them. I'll give you a great example. We just started a residency program so I'm asking this resident in the latter part of the year about the lovenox dosing on a patient and get her thoughts on it. She says "I need to tell Dr Johnson that his dose is 3 fold above what it should be because the guidelines..." and I stop her. Why are you bringing up the guidelines? The DO/MD knows the guidelines, the PA knows the guidelines, and the NP knows the guidelines. What value are you if all you can do it repeat information that they already know?

This person has a PGY-1 on their resume and is more qualified than me? Hahaha! Get real.
 
My biggest problem with residencies is that they do not teach you how to handle practitioners. I don't have a residency but all of the docs and mid levels LOVE me because I save their ass and I know how to communicate with them. I'll give you a great example. We just started a residency program so I'm asking this resident in the latter part of the year about the lovenox dosing on a patient and get her thoughts on it. She says "I need to tell Dr Johnson that his dose is 3 fold above what it should be because the guidelines..." and I stop her. Why are you bringing up the guidelines? The DO/MD knows the guidelines, the PA knows the guidelines, and the NP knows the guidelines. What value are you if all you can do it repeat information that they already know?

This person has a PGY-1 on their resume and is more qualified than me? Hahaha! Get real.

My program has taught me a lot about how to communicate with practitioners. I don't go telling them "the guidelines say this" etc. but I've been amazed by the fact that some of them I've come across DON'T know the guidelines. I've had them ask me what guidelines they could find particular information in. I've had them tell me something is from a guideline when it was from a review article or a case study and not actual guidelines.

Last I checked, a focus of residencies is supposed to be how to form collaborative relationships with others. I'm sure not all of them get it right, but I don't think it's fair for you to say that they don't based on the experience of your residency program at your hospital.
 
My biggest problem with residencies is that they do not teach you how to handle practitioners. I don't have a residency but all of the docs and mid levels LOVE me because I save their ass and I know how to communicate with them. I'll give you a great example. We just started a residency program so I'm asking this resident in the latter part of the year about the lovenox dosing on a patient and get her thoughts on it. She says "I need to tell Dr Johnson that his dose is 3 fold above what it should be because the guidelines..." and I stop her. Why are you bringing up the guidelines? The DO/MD knows the guidelines, the PA knows the guidelines, and the NP knows the guidelines. What value are you if all you can do it repeat information that they already know?

This person has a PGY-1 on their resume and is more qualified than me? Hahaha! Get real.

Sounds like a problem with your institution's residency program. Maybe you should try to fix that.
 
My program has taught me a lot about how to communicate with practitioners. I don't go telling them "the guidelines say this" etc. but I've been amazed by the fact that some of them I've come across DON'T know the guidelines. I've had them ask me what guidelines they could find particular information in. I've had them tell me something is from a guideline when it was from a review article or a case study and not actual guidelines.

Last I checked, a focus of residencies is supposed to be how to form collaborative relationships with others. I'm sure not all of them get it right, but I don't think it's fair for you to say that they don't based on the experience of your residency program at your hospital.
My program has taught me a lot about how to communicate with practitioners. I don't go telling them "the guidelines say this" etc. but I've been amazed by the fact that some of them I've come across DON'T know the guidelines. I've had them ask me what guidelines they could find particular information in. I've had them tell me something is from a guideline when it was from a review article or a case study and not actual guidelines.

Last I checked, a focus of residencies is supposed to be how to form collaborative relationships with others. I'm sure not all of them get it right, but I don't think it's fair for you to say that they don't based on the experience of your residency program at your hospital.
That is where technology will come in and correct the problem before it occurs; guidelines = cookbook = algorithm = improved care When you rely on individuals, no matter how talented, to communicate to practitioners you run the risk of mistakes occurring. That is why, for the majority, residency or not, the clock is ticking...
 
My program has taught me a lot about how to communicate with practitioners. I don't go telling them "the guidelines say this" etc. but I've been amazed by the fact that some of them I've come across DON'T know the guidelines. I've had them ask me what guidelines they could find particular information in. I've had them tell me something is from a guideline when it was from a review article or a case study and not actual guidelines.

Last I checked, a focus of residencies is supposed to be how to form collaborative relationships with others. I'm sure not all of them get it right, but I don't think it's fair for you to say that they don't based on the experience of your residency program at your hospital.
Communication skills develop over time. No matter the residency, you don't come out polished. It also depends on your character traits.
 
My biggest problem with residencies is that they do not teach you how to handle practitioners. I don't have a residency but all of the docs and mid levels LOVE me because I save their ass and I know how to communicate with them. I'll give you a great example. We just started a residency program so I'm asking this resident in the latter part of the year about the lovenox dosing on a patient and get her thoughts on it. She says "I need to tell Dr Johnson that his dose is 3 fold above what it should be because the guidelines..." and I stop her. Why are you bringing up the guidelines? The DO/MD knows the guidelines, the PA knows the guidelines, and the NP knows the guidelines. What value are you if all you can do it repeat information that they already know?

This person has a PGY-1 on their resume and is more qualified than me? Hahaha! Get real.
Once again, the communication skills develop over time; with each encounter. That is how confidence develops. In general, new grads may think they have skills, but it only takes one bad encounter to reveal that there is room to improve. Once again, technology within the software program will be able to eliminate the possibly of error throughout the process, which eliminates most of the need to "correct" the practitioner.
 
Communication skills develop over time. No matter the residency, you don't come out polished. It also depends on your character traits.

I never said you come out polished. I know it takes time, but residencies do help you work on that and begin to establish these relationships. I have the opportunity to round with a team and interject with ideas. In return, they've asked me my opinion on things as well. Outside of a residency, I don't really see where a new grad would have these kind of relationship building opportunities. There are probably a few out there, but it's probably hard to obtain coming straight out of school.
 
I never said you come out polished. I know it takes time, but residencies do help you work on that and begin to establish these relationships. I have the opportunity to round with a team and interject with ideas. In return, they've asked me my opinion on things as well. Outside of a residency, I don't really see where a new grad would have these kind of relationship building opportunities. There are probably a few out there, but it's probably hard to obtain coming straight out of school.
Outside of a residency??? Just getting a job...you'll learning minute by minute...the residency is nothing but an alternate universe...it isn't the job...it delays your preparation for the real job...but, of course for many of you, that is the idea...
 
Outside of a residency??? Just getting a job...you'll learning minute by minute...the residency is nothing but an alternate universe...it isn't the job...it delays your preparation for the real job...but, of course for many of you, that is the idea...

Obviously, I waste time and energy replying to you. You make statements like this, and it makes me realize I'm talking to a wall that isn't going to listen to what I have to say, so I'm officially done with this thread. Good luck to you in your career!
 
Obviously, I waste time and energy replying to you. You make statements like this, and it makes me realize I'm talking to a wall that isn't going to listen to what I have to say, so I'm officially done with this thread. Good luck to you in your career!
You're half-right about wasting time; not on this thread, because it is presenting things that you should consider. But, I'm afraid, you are wasting time (and money) with a residency. I realize a lot of places make having a residency part of the qualification process of getting hired; simple enough, avoid those places and get a job for an organization that has a more rational outlook. Just get a job and soon, before they are gone....
 
Outside of a residency??? Just getting a job...you'll learning minute by minute...the residency is nothing but an alternate universe...it isn't the job...it delays your preparation for the real job...but, of course for many of you, that is the idea...

Yes! This times a million. I'm proud to say that I don't have a residency and I'm as true of a clinical pharmacist as they get. You don't develop relationships with providers like you do actually working which is why non-residency trained pharmacists are much more integrated with the health care team than PGYs.
 
Yes! This times a million. I'm proud to say that I don't have a residency and I'm as true of a clinical pharmacist as they get. You don't develop relationships with providers like you do actually working which is why non-residency trained pharmacists are much more integrated with the health care team than PGYs.
Finally!!! After all of these postings, the truth is spoken!!! BenJammin, you have sunk the arguments for a residency like a three foot putt. Bravo!!
 
Yes! This times a million. I'm proud to say that I don't have a residency and I'm as true of a clinical pharmacist as they get. You don't develop relationships with providers like you do actually working which is why non-residency trained pharmacists are much more integrated with the health care team than PGYs.

Where did this come from?

I'm not getting in an "I have a better relationships with my providers" pissing contest, but I would heartily disagree.

It has to do with personalities, not training.
 
Where did this come from?

I'm not getting in an "I have a better relationships with my providers" pissing contest, but I would heartily disagree.

It has to do with personalities, not training.
It really has to do with real-world, real-time, on-job, experience and the ability to absorb the lessons of each experience. Period. Personality and $4.50 will get you a latte at Starbucks; that's how much it counts in anything.
 
It really has to do with real-world, real-time, on-job, experience and the ability to absorb the lessons of each experience. Period. Personality and $4.50 will get you a latte at Starbucks; that's how much it counts in anything.

And who says that some people don't get this experience from residency?
 
And who says that some people don't get this experience from residency?
The point is, if you just get on with it and get a job, you get real-world, real-time, on-job experience. You are just wasting time, money and effort on a residency. Avoid the places that make a residency a part of the hiring process. If your years of study for your Pharm D and passing the state registry are not proof enough of your preparedness, then that is not the type of place ANYONE should want to work for. All of you new grads are already overqualified for any job at any hospital in the country, from Sloan Kettering to the Mayo Clinic to Mass General. Get a job before they disappear.
 
But I effectively got a $30,000 raise and access to a competitive labor market by entering residency vs taking the hospital offer I had right out of school...and I've bypassed all of the non-residency trained rph's at work directly into a junior management/specialist position.

So on money alone, I'll "break even" in 2 years. I've achieved in 2 years post grad that which would have taken me 5 years at my place of initial offer.

I don't think my story is unique, either...but I do know some PGY-1 grads that are struggling, most of them I'm not surprised about.
 
If your years of study for your Pharm D and passing the state registry are not proof enough of your preparedness, then that is not the type of place ANYONE should want to work for. All of you new grads are already overqualified for any job at any hospital in the country, from Sloan Kettering to the Mayo Clinic to Mass General. Get a job before they disappear.

I agree we are qualified right out of the gate...but sad to say it's an arms race. From the perspective of an employer....if I have an FTE to hire and, for the same price, I can hire a PGY-1 grad who made all his or her first-year mistakes at some other institution vs. a new grad (all other things being equal), I'd be a fool to hire the new grad.
 
But I effectively got a $30,000 raise and access to a competitive labor market by entering residency vs taking the hospital offer I had right out of school...and I've bypassed all of the non-residency trained rph's at work directly into a junior management/specialist position.

So on money alone, I'll "break even" in 2 years. I've achieved in 2 years post grad that which would have taken me 5 years at my place of initial offer.

I don't think my story is unique, either...but I do know some PGY-1 grads that are struggling, most of them I'm not surprised about.
Once again, on an individual basis, a few like yourself may end up in roles that suite your educational experience in pharmacy. For the 95% who won't land in a similar position, the residency is doubling down on a bad bet. However, when crunch time comes for any organization, your position will not be insulated from scrutiny. The residency, and commensurate salary, may make your position stick out like a sore thumb to the accountants.
 
I agree we are qualified right out of the gate...but sad to say it's an arms race. From the perspective of an employer....if I have an FTE to hire and, for the same price, I can hire a PGY-1 grad who made all his or her first-year mistakes at some other institution vs. a new grad (all other things being equal), I'd be a fool to hire the new grad.
Your assumption on hiring is the first statement that you have made that shows your immaturity. Attaching PGY-1 does not in any way shape or form mean that person is the better hire. Paradoxically, I would argue that the person who forgoes the PGY-1 is the more discerning, insightful and logical person; and therefore the better hire, long-term. Your assumption is a major error in judgement. I hope that you consider what I have said.
 
I know I said I was done with this thread, but I can't help myself. 😛

You would honestly hire someone fresh out of pharmacy school with no hospital experience whatsoever over a PGY-1?

Secondly, you have this huge bias against residency trained individuals, and you're not willing to listen. ONE person comes in here and says he and other people that didn't do a residency form better relationships with a healthcare team, and you're jumping up and down with excitement in agreement and state that is proof enough why people shouldn't do a residency. However, multiple people come in here saying how they earned jobs, money, educational experiences, relationships from a residency and you refute every single point.

I already knew when other people chimed in you were going to refute their points because you're attitude towards those with a residency is predictable.
 
Finally!!! After all of these postings, the truth is spoken!!! BenJammin, you have sunk the arguments for a residency like a three foot putt. Bravo!!

This quote seriously makes me laugh. Someone who pretends to be so smart would say this after one single person. BenJammin may be a super awesome pharmacist, but he's one person. His mileage may vary. Unless he's worked at every hospital and with every resident, his word isn't gospel. His comment won't make me stop pursuing my passion. I doubt it'll make anyone who really wants a residency stop pursuing it (neither will you).
 
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