Is a Kaiser PGY1 a mistake?

[andaheart]

So I'm in a bit of a conundrum. Applied to and interviewed at three PGY1 programs, two hospital based and the other at Kaiser. From the interview and site visit, I think Kaiser would be a very good fit for me, but I'm unsure if it's a good idea to do (what is basically) an Am Care residency. Yes, it's listed as Managed Care, but at its core, you really do a good bit of Am Care work. My ultimate goal (I think!) at this point is to teach, but I'm wondering if Kaiser would exclude me from ever having a hospital clinical site, etc. To me, it just seems like a Kaiser residency would pigeon hole me into a very narrow scope of practice. And lets face it, Am Care pharmacy doesn't exist outside the walls of Kaiser or the VA (this is was PAs, NPs, and MDs are for). Any thoughts? Im wondering if i should just rank the hospital practice sites just to open up more doors...

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[spacecowgirl]

I disagree - there is Amb Care pharmacy out there! I did an amb care/managed care residency and now work at an inpatient hospital, but I also have started an MTM clinic. I wouldn't want to do amb care FT, personally so for me it's a perfect mix. There was definitely a learning curve for working inpatient again (I interned as a hospital) but it's not impossible to transition and there is a lot of amb care knowledge in inpatient pharmacy.

If you feel Kaiser is your best fit, that's what you should do. It's a hard year to spend doing something you don't like. Good luck.

 

[MustLoveDrugs]

Amb care definitely exists outside the VA and Kaiser. It may just not be in the ways you would think. On rotations, I was with a pharmacist who meets with hospital employees and their families with diabetes and asthma. The pharmacist discusses lab findings, inhaler techniques, weight management and then sends a letter to the PCP with recommendations. The patients get a break on prescription costs, and the hospital improves outcomes.

I would encourage you to just think about what you want to do for the next year. Do you want to see patients every single day? Do you want some office time and some patient contact time? Does Kaiser give you the balance you're looking for, or do you want a heavier patient load? No right or wrong answers... Just things to consider. If you really like the Kaiser program and are interested in managed care and ambulatory care, I don't think you're limiting yourself at all. Residency is about more than finding a specialty. You're taught how to think critically about situations, manage your time and get your foot in the door for professional organizations and networking opportunities. I don't think you can go wrong.