I am one of those few who got a clinical position without a residency. I was able to do so because I had a medical background and 5 years of patient-care experience prior to entering pharmacy school.
Becoming a clinical pharmacist right out of school is difficult though. Physicians come to me every day and ask me to decide on an antibiotic for them, recommend a pain management program, determine pediatric dosing, etc. The bad part is they never come and ask me the easy questions, it is always for a patient who is allergic to 5 classes of antibiotics, or refuses to take certain narcotic pain relievers, and has no insurance so they can't afford any brand name meds.
We have a pharmacy resident at my hospital and I see what she is experiencing. I think I am getting far more practical experience (in my specialty area) than she is. She spends much of her day working on projects, doing presentations, going to meeting, etc. What I do envy about her is that she will get to rotate through all the specialty areas around the hospital, and she isn't under the pressure I am in making a split-second decision.
After her one year residency she can get a clinical job in any general pharmacy area, I am pretty much limited to my specialty for now. I would probably need about three years to be able to expand out into a general clinical position.
Either way you go about it, deciding to become a clinical pharmacist is definitely a challenging road. Make sure you plan to study long after your graduation date.