General Trend: Pharmacists are rejecting PGY2 residencies and even PGY1

[steveysmith54]

Also less students are applying to schools... Hmm, I wonder why.

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[JustFillIt]

I started rejecting students in 2020…. Just doing my part. I used to take 3/year

As far as I’m concerned anyone who is applying For pharmacy school 2020 and beyond simply lacks common brain function and I honestly don’t want to be around them.

I have developed some sort of a disdain and/or suspicion for folks that are in pharmacy school now.

 

[steveysmith54]

I think it’s a matter of demand and job availability for pgy2 trained rph. I’ve seen plenty of them having to take graveyard positions doing central pharmacy staffing gigs… the second issue is why can’t pgy1 sites adequately train the pharmacists or the future job site to train the pgy1 Rph?

 

[letsquitpharm]

I wonder what kind of "advanced training" and "competitive edge" of PGY-1 and PGY-2 can give pharmacy graduates...We are in a tight labor market, and I have a friend 6 months out of 1-year industry fellowship relocating to Boston in May, after netting a 145k/yr +20% bonus + 50k relocation + 20k sign-on, while my cs classmates are so busy switching to more lucrative jobs one after another and/or getting overemployed with job 2s/job 3s. Yes, that's right, we are talking about taking two to three full-time remote tech jobs, getting paid as much as 500k/yr in total comp.

I think residency programs need to wake up. It's pay up or shut up. COL has skyrocketed, and who the hell, with a normal brain function, want to slave themselves for not one but two prime years to just "increase job competitiveness" for an uncertain gig after the end of program? I honestly have a hard time thinking about that...

 

[BenJammin]

Not only do we not hire residency trained pharmacists but it's disqualifying as far as we're concerned. You spent that year being trained to look at things a certain way and I have to spend a year to undo some of that and get you to view things in the way we do it. I'd rather hire a new grad who can start fresh than have to tear down something already built up.

 

[gwarm01]

I managed to get an inpatient position as a new grad with no residency. I started the same day as someone who had a PGY2 and we were working the same shifts, doing the same thing.

Two years of residency and congratulations, you are still a pharmacist.

 

[Chrish]

Those who have done residencies or involved into residency administration will defend it as mean of concentrated intense learning boot camp. Those who don’t fall into these categories will think it’s a scam for hospitals to gain cheap labor.

 

[steveysmith54]

I managed to get an inpatient position as a new grad with no residency. I started the same day as someone who had a PGY2 and we were working the same shifts, doing the same thing.

Two years of residency and congratulations, you are still a pharmacist.

Personally I'd rather do DO/MD and 3 years of family medicine residency rather than Pharm.D. and 2 years of residency.

 

[JustFillIt]

Not only do we not hire residency trained pharmacists but it's disqualifying as far as we're concerned. You spent that year being trained to look at things a certain way and I have to spend a year to undo some of that and get you to view things in the way we do it. I'd rather hire a new grad who can start fresh than have to tear down something already built up.

This just makes too much sense….

 

[VA77]

The line it is drawn
The curse it is cast
The slow one now
Will later be fast
As the present now
Will later be past
The order is rapidly fadin'
And the first one now
Will later be last
For the times they are a-changin'

 

[alpha12]

Those who have done residencies or involved into residency administration will defend it as mean of concentrated intense learning boot camp. Those who don’t fall into these categories will think it’s a scam for hospitals to gain cheap labor.

I fall in the latter category.

 

[sadface]

Yes, as a resident you work harder for less money. And pharmacy and medical residents deserve to be paid more. But residents also learn more than individuals who go straight into staffing in the short term, and many hospitals don’t have adequate orientation to teach everything before working independently. The number of fourth years at the end of their appes that can’t dose vanco and warfarin is awfully high to give a blanket statement that residency isn’t worth it. It’s not for everyone and it’s not required, although many hospital jobs prefer it. Wonder how many threads I can find with this same discussion 😉.

I do find it interesting that less places are matching though, although I wonder how many brand new residency spots were opened? It seems many employers don’t value a pgy2/have a specialized staffing model to make doing a pgy2 worth it unless that’s the only clinical area someone wants to work in.

 

[mustang sally]

I don't have a problem with residencies per se, but I dislike how it draws a line between pharmacists (ie. those who are residency-trained vs those who are not).

 

[BenJammin]

You can almost smell the panic from the posters who for one reason or another are desperate to justify their one or two year residency experience.

 

[confettiflyer]

You can almost smell the panic from the posters who for one reason or another are desperate to justify their one or two year residency experience.

It’s like schools, though. It only matters for your next step. I’m like ten years past residency, it’s just a distant baseline at this point.

Let’s call it what it is, it’s compressed and lower paid work experience, and a handy way to do a 1 year trial run on someone. Most hospitals have a 90-120 day probation period, after which, it is exceedingly difficult to fire someone without cause… it’s easier to sprint and fake your way across 90 days vs. 365.

Like that 90 Day Fiancé show on TLC.

 

[samven582]

ASHP will disagree with you

 

[Chrish]

Personally I am not against the concept of one year residency. If I were going hospital route, I would definitely feel more comfortable in my day to day role after at least few months of training if not a whole year. Getting comfortable with everyday staffing, making IV, Tpns, evaluating clinical trials etc. would take time for someone without prior experience.

Two years on the other hand definitely sounds overboard.

 

[WVUPharm2007]

ASHP will disagree with you

Are people still trying to claim that several years of actually being a staff pharmacist isn't as good preparation for being a staff pharmacist as a year of residency?

That **** used to crack me up when I was doing hospital.

Whatever, y'all do you. I'll chill out here doing my thing at CVS graveyard shift.

 

[steveysmith54]

Are people still trying to claim that several years of actually being a staff pharmacist isn't as good preparation for being a staff pharmacist as a year of residency?

That **** used to crack me up when I was doing hospital.

Whatever, y'all do you. I'll chill out here doing my thing at CVS graveyard shift.

Sounds like they went a step further. Despite not being able to fill PGY2 spots, they are requiring PGY1 completion to apply to PGY2. Why can't an experienced clinical RPh without a PGY1 residency apply for a PGY2 residency if his/her heart desires? Let the programs decide who they want to accept and train for PGY2. Pretty stupid if you ask me. Lets DEFUND and BAN ASHP NOW!!!! I want residency equity.

 

[samven582]

Sounds like they went a step further. Despite not being able to fill PGY2 spots, they are requiring PGY1 competition to apply to PGY2. Why can't an experienced clinical RPh without a PGY1 residency apply for a PGY2 residency if his/her heart desires? Let the programs decide who they want to accept and train for PGY2. Pretty stupid if you ask me. Lets DEFUND and BAN ASHP NOW!!!! I want residency equity.

I just got an email today from them bragging about how they have 60K members

 

[sadface]

You can almost smell the panic from the posters who for one reason or another are desperate to justify their one or two year residency experience.

I think I’m the only person who posted something vaguely positive about doing a hospital residency, so feel free to quote what gave you that impression and I can rephrase it. I definitely feel no regret nor is my intention to justify my choice to an online forum (or I wouldn’t have posted in a thread where people who largely have not done residencies are pointing out their shortcomings, similarly “justifying” their choice I suppose). I did a pgy1 residency because it met my career goals, I wanted to, and I would not have been considered for my current position without it. I elected not to do a second year partially for the reasons people have pointed out here. I routinely tell my students it’s not required but to consider one if it aligns with their career goals.
I 100% agree that getting work experience can replace doing a residency — but I hear far more often that employers in my area won’t consider someone without one, than I do places looking down on it. So I wanted to offer some of the potential benefits to this discussion. Also I don’t think the value is significant enough to justify outpatient residencies, but maybe someone who works outpatient can comment more on that.

 

[RXDOC1986]

I think I’m the only person who posted something vaguely positive about doing a hospital residency, so feel free to quote what gave you that impression and I can rephrase it. I definitely feel no regret nor is my intention to justify my choice to an online forum (or I wouldn’t have posted in a thread where people who largely have not done residencies are pointing out their shortcomings, similarly “justifying” their choice I suppose). I did a pgy1 residency because it met my career goals, I wanted to, and I would not have been considered for my current position without it. I elected not to do a second year partially for the reasons people have pointed out here. I routinely tell my students it’s not required but to consider one if it aligns with their career goals.
I 100% agree that getting work experience can replace doing a residency — but I hear far more often that employers in my area won’t consider someone without one, than I do places looking down on it. So I wanted to offer some of the potential benefits to this discussion. Also I don’t think the value is significant enough to justify outpatient residencies, but maybe someone who works outpatient can comment more on that.

I got my Pharm.D. long before it was required or offered in most states (1986). I did it because I wanted to validate my education at a different level. Then I did a residency in Nutritional Support loooong before it was fashionable to do so(1987). I did it because I was fascinated with Nutrition, TPNs and enteral feeds. Because I wanted to learn more with my BCNSP. I agree that now days, new graduates are forced into PGY1 to be able to gain employment and escape retail. There is even an "Advanced" Community Practice Residency for future Retail Pharmacist! In the past, as a preceptor, I always enjoyed having residents, admired their commitment and sacrifice. Now it is more like a requirement to have it, with employers and hospitals taking advantage of PGY1s.

 

[sadface]

I got my Pharm.D. long before it was required or offered in most states (1986). I did it because I wanted to validate my education at a different level. Then I did a residency in Nutritional Support loooong before it was fashionable to do so(1987). I did it because I was fascinated with Nutrition, TPNs and enteral feeds. Because I wanted to learn more with my BCNSP. I agree that now days, new graduates are forced into PGY1 to be able to gain employment and escape retail. There is even an "Advanced" Community Practice Residency for future Retail Pharmacist! In the past, as a preceptor, I always enjoyed having residents, admired their commitment and sacrifice. Now it is more like a requirement to have it, with employers and hospitals taking advantage of PGY1s.

Your point is well taken. Despite it being an expectation in my area I was still excited to get more practical experience and gleaned a lot of information from some really smart people I got to work with, and got some opportunities that staffing pharmacists don’t always get to do. I know I personally was a much more prepared pharmacist after. So my motivations still might have been more similar to yours. And my residency didn’t have as predatory of staffing requirements as some which may be impacting my experience compared to others.

 

[KidPharmD]

You can almost smell the panic from the posters who for one reason or another are desperate to justify their one or two year residency experience.

I am not sure why. I don't feel the need to justify my 2 years of residency here. They were both essential to me getting where I am today and an irreplaceable learning experience. It wasn't a perfect experience but I honestly believe that still. I also believe that is what we are giving our current residents. The pay sucked. The processed sucked and has only gotten worse. ASHP needs to do a lot to make it better (and the federal government) including requiring stipends to be adjusted to the average cost of housing near the site. All that being said, I absolutely understand why graduates are choosing not to do a residency right now.

Are people still trying to claim that several years of actually being a staff pharmacist isn't as good preparation for being a staff pharmacist as a year of residency?

That **** used to crack me up when I was doing hospital.

Whatever, y'all do you. I'll chill out here doing my thing at CVS graveyard shift.

I don't think anyone is claiming that. The context of the screenshot was the removal of the previous exemptions that used to be available to allow people with experience but no PGY1's to apply to be a PGY2. I think most places that want PGY1s for "staff pharmacists" usually already have or are moving toward a hybrid model or are kidding themselves on how clinical their staff pharmacists are (or are just looking for something to differentiate candidates).

However, in my smaller world - no amount of staffing at an adult hospital will prepare you for staffing here as much as a pediatric PGY1 does. And no amount of staffing (pediatric or not) would prepare someone for being one of our specialists as much as a pgy2 does.

 

[BC_89]

...Despite not being able to fill PGY2 spots, they are requiring PGY1 completion to apply to PGY2. Why can't an experienced clinical RPh without a PGY1 residency apply for a PGY2 residency if his/her heart desires? Let the programs decide who they want to accept and train for PGY2...

This.

If (for one reason or another) someone with X amount of clinical experience decides to apply to a PGY2, they should do as was done (up until last year I believe?) and fill out the exemption application and let the site(s) use their agency to do as they wish with them.

We had someone on here some time last year state their unforeseen circumstance when this happened. I want to say they had a few years experience working as a clinical pharmacist with no PGY-1 and was not grandfathered into applying for an oncology PGY-2 when the change suddenly happened (I'll need to dig and see what the details were on that).

Still baffles me, especially when more and more jobs demand X amount of years [+] PGY-1 as a minimal requirement or else you're screened out...

***Edit: Found it ***

Cancellation of PGY1 Pharmacy Residency Exemption Program

Hello - Is anyone else frustrated about ASHP's removal of the PGY1 Pharmacy Residency Exemption Program? I want to file a petition in efforts of reinstating this program. To access petition, please click here: https://chng.it/wrg44LX7sx ASHP used to have a PGY1 Pharmacy Residency Exemption...

forums.studentdoctor.net

 

[VA77]

Yeah I'm going to echo BC89 above. Pharmacy was my second career with a BS is CS and almost 20 years in IT in multiple positions at hospital and colleges. I wanted to try to get into informatics but I always ran into the residency roadblock. Residency is a pay to play sick game where you 'give' two years of labor on top of the money and time already invested in school. Residency has turned into a limited privilege for a few because even if you did want to take a decreased salary there just aren't enough spots for all the candidates especially niche fields.

 

[KidPharmD]

This.

If (for one reason or another) someone with X amount of clinical experience decides to apply to a PGY2, they should do as was done (up until last year I believe?) and fill out the exemption application and let the site(s) use their agency to do do as they wish with them.

We had someone on here some time last year state their unforeseen circumstance when this happened. I want to say they had a few years experience working as a clinical pharmacist with no PGY-1 and was not grandfathered into applying for an oncology PGY-2 when the change suddenly happened (I'll need to dig and see what the details were on that).

Still baffles me, especially when more and more jobs demand X amount of years [+] PGY-1 as a minimal requirement or else you're screened out...

***Edit: Found it ***

Cancellation of PGY1 Pharmacy Residency Exemption Program

Hello - Is anyone else frustrated about ASHP's removal of the PGY1 Pharmacy Residency Exemption Program? I want to file a petition in efforts of reinstating this program. To access petition, please click here: https://chng.it/wrg44LX7sx ASHP used to have a PGY1 Pharmacy Residency Exemption...

forums.studentdoctor.net

I talked to someone at ASHP after this happened. They weren't directly involved in the exemption process or the decision, but they did share some of the scuttlebutt with me. Essentially ASHP was denying most of the applications because many people who applied didn't really qualify. Also, many of those that did get approved didn't match anywhere. While I think it was a process that many didn't like, I also think that it was a process that many did not feel was worth the effort they had to put into it to maintain.

 

[JustFillIt]

I talked to someone at ASHP after this happened. They weren't directly involved in the exemption process or the decision, but they did share some of the scuttlebutt with me. Essentially ASHP was denying most of the applications because many people who applied didn't really qualify. Also, many of those that did get approved didn't match anywhere. While I think it was a process that many didn't like, I also think that it was a process that many did not feel was worth the effort they had to put into it to maintain.

Just curious - why did they feel the applicant “did not really qualify”?

Was it a quality of student issue?

 

[KidPharmD]

Just curious - why did they feel the applicant “did not really qualify”?

Was it a quality of student issue?

This program wasn't geared toward students. It was geared toward pharmacists who had enough experience to be "equivalent" to a PGY1 and thus would be allowed to apply to a PGY2 without a PGY1. Here is the information sheet:https://www.ashp.org/-/media/assets...s/docs/pgy1-residency-exemption-criteria.ashx

My understanding was they got lots of applications from people who didn't have actual clinical experience (including academics and research) but they applied anyway. For example, people who thought that because 5 years in a basement pharmacy got them past HR for not having a pgy1 it would get them past ASHP.

 

[confettiflyer]

Sounds like they went a step further. Despite not being able to fill PGY2 spots, they are requiring PGY1 completion to apply to PGY2. Why can't an experienced clinical RPh without a PGY1 residency apply for a PGY2 residency if his/her heart desires? Let the programs decide who they want to accept and train for PGY2. Pretty stupid if you ask me. Lets DEFUND and BAN ASHP NOW!!!! I want residency equity.

You can just start an unaccredited PGY2 (and PGY1), no one is stopping you.

 

[confettiflyer]

I just got an email today from them bragging about how they have 60K members

lol why are you on their email list

 

[baronzb]

I'm seeing a lot more programs pop up in my area. Partly because it's a good resume booster to the clinical employee on sight, weather a private hospital chain trying to justify their position or a PHS pharmacist trying to get promoted.
I have met several PGY2 people and though they did get an admin position or PHS staff pharmacist, they didn't work in their specialty. I actually recommend against PGY2.

 

[steveysmith54]

You can just start an unaccredited PGY2 (and PGY1), no one is stopping you.

Who said that I haven’t? Interested in applying?

 

[confettiflyer]

Who said that I haven’t? Interested in applying?

You can’t afford me lololol

 

[steveysmith54]

You can’t afford me lololol

But I offer a hybrid Pgy1&pgy2, I call it pgy1.5….7 days on 7 days off….. 100% remote…

 

[workingfarmer]

Instead of residencies board certifications would justify the absence of it when applying to certain jobs....it depends though usually
residencies + board certification > board certification;
residencies = board certification (due to the relevant year required to sit for one)

 

[confettiflyer]

Board certification is a great indicator that someone can jam through 120 CE hours in the final year of a 7 year certification cycle

 

[DrWrong]

Not only do we not hire residency trained pharmacists but it's disqualifying as far as we're concerned. You spent that year being trained to look at things a certain way and I have to spend a year to undo some of that and get you to view things in the way we do it. I'd rather hire a new grad who can start fresh than have to tear down something already built up.

No offense, but this sounds extremely ignorant. Having only worked in large teaching hospitals, I’d much rather have a residency trained pharmacist that is comfortable making evidence based recommendations to the medical team, critically think, function independently, and have experience doing medication use evaluations, among other things taught in residency. Not many students are able to do this out of school.

 

[lane one]

I think there are still specialized positions that really do require PGY2 training. Sure, you can probably get by in the MICU with just experience at a smaller place, but a lung-transplant specialist is going to be nearly impossible. There's just no way to gain to the experience that a PGY2 in that area can get you.

That being said, I think ASHP shutting the door on experienced pharmacists is ridiculous. It may not be worth their time to "maintain the program" but they shouldn't be dictating who can obtain training. If you're qualified and you want to specialize, you should be allowed to do so. My main issue with it is that there is virtually no avenue for a practicing clinical pharmacist to advance in their field. The only avenue is PGY2, even into management. Even if you did a PGY1, completing a PGY2 after 5 years of practice and 2 kids really isn't an option. Other professions can earn a masters degree in the evenings to secure advancement. Terrible for engagement and for the future of the profession in my opinion. Everyone chooses their specialty very early on in their career and doesn't have the ability to pivot towards their interests after a few years of practice. It's a structural problem within clinical pharmacy that I believe ASHP is contributing to with their petty qualifications.

There are HR implications as well. If we move towards a model where PGY2 is the required for any specialist position, and established clinical pharmacists cannot be considered, by definition all promotions/specialist positions are going to 26 yr olds. You can't hire 26 yr olds to the top of the totem pole and push all the old people to the bottom and cite "qualifications" when the old people aren't allow to obtain the qualifications. I'm not sure where the whole thing is headed but as others pointed out, the market might settle it with supply and demand. What happens when a PGY2 is required for a position but obtaining a PGY2 is no longer a good financial decision?

 

[JustFillIt]

You can't hire 26 yr olds to the top of the totem pole and push all the old people to the bottom

Have you ever worked retail?

 

[owlegrad]

I feel like maybe it isn't crazy that to do something with a "2" in the name you should first do the thing with a "1" in the name. I don't know, maybe that's just crazy talk. Like if someone really wants to do a PGY-2 maybe they should have to do a PGY-1 first?

Maybe the real issue is that there just shouldn't be jobs that require a PGY-2?

 

[BenJammin]

No offense, but this sounds extremely ignorant. Having only worked in large teaching hospitals, I’d much rather have a residency trained pharmacist that is comfortable making evidence based recommendations to the medical team, critically think, function independently, and have experience doing medication use evaluations, among other things taught in residency. Not many students are able to do this out of school.

How many PGY-1 residents are able to do that out of school? The difference is that I get to train them to do it the way our facility does it rather than have to combat a totally different style that may not mesh well with our practice or their future colleagues. You can call it ignorant all you want and I take no offense to it. The results speak for themselves.

 

[mentos]

Why don't residencies pay pharmacists the same as a regular staff pharmacist? I'd like to see how many residency programs there are if the pay was the same.

 

[steveysmith54]

No offense, but this sounds extremely ignorant. Having only worked in large teaching hospitals, I’d much rather have a residency trained pharmacist that is comfortable making evidence based recommendations to the medical team, critically think, function independently, and have experience doing medication use evaluations, among other things taught in residency. Not many students are able to do this out of school.

I think it all depends on what school these students graduated from, their study habits, internship experience, and the quality of their rotations. It’s not like these new grads are coming to work right after completing their classroom education

 

[alpha12]

I feel like maybe it isn't crazy that to do something with a "2" in the name you should first do the thing with a "1" in the name. I don't know, maybe that's just crazy talk. Like if someone really wants to do a PGY-2 maybe they should have to do a PGY-1 first?

Maybe the real issue is that there just shouldn't be jobs that require a PGY-2?

Why stop at 2? Create 3,4,5 and 6 as well

 

[lane one]

Have you ever worked retail?

Yes, although I must admit I don't get your point. Are you implying that they're treating new grads with more respect and granting more pay than their older counterparts?

I feel like maybe it isn't crazy that to do something with a "2" in the name you should first do the thing with a "1" in the name. I don't know, maybe that's just crazy talk. Like if someone really wants to do a PGY-2 maybe they should have to do a PGY-1 first?

Maybe the real issue is that there just shouldn't be jobs that require a PGY-2?

I think the issue is that a lot of people didn't do a PGY1 and are now practicing in a clinical setting. It's only been very recently that PGY1 has become a requirement to work in health system pharmacy. There are lots of PharmDs with years of experience that now have no path forward thanks to ASHP.

To your second point, I don't think you see the need for PGY2 training because you've never heard of the jobs they do. That doesn't mean that they aren't highly specialized, important and in many cases (transplant) required by CMS.

 

[JustFillIt]

Yes, although I must admit I don't get your point. Are you implying that they're treating new grads with more respect and granting more pay than their older counterparts?

If you don’t get my point - maybe you have not worked retail for a long time?

Because what you said is precisely what they did in retail. I suppose my point was - what you said is not entirely unheard of.

 

[lane one]

If you don’t get my point - maybe you have not worked retail for a long time?

Because what you said is precisely what they did in retail. I suppose my point was - what you said is not entirely unheard of.

You didn't answer my question. Are new grads making more than the 10+ year guys/gals?

 

[JustFillIt]

You didn't answer my question. Are new grads making more than the 10+ year guys/gals?

It depends - I think the majority of young are making as much at this point. They are brining them down

 

[confettiflyer]

Why don't residencies pay pharmacists the same as a regular staff pharmacist? I'd like to see how many residency programs there are if the pay was the same.

Why should a hospital ignore supply/demand to make random internet people happy?

If I’ve got dozens and dozens of applications for any job, I’m going to price that wage as low as I can go.

I ain’t no commie.