It has started... PGY3's in newest AJHP

[KidPharmD]

The newest issue of AJHP just arrived at my house. First article I noticed starts on pg 1199 (vol 71)

"The future of specialized pharmacy residencies: Time for postgraduate year 3 subspeciality training."

It has been a rumor for a while now, and it looks like it is happening.

I haven't been able to do anything but skim, but it looks like the authors are advocating a 3rd year residency/fellowship for the most specialized training.

Examples they give include: Endocrinology, Pediatric Hem/Onc (currently a PGY2 residency), Geriatrics, Nephrology, Hospice/Palliative Care, and Advanced Clinical Administrative Leadership.

I really thought required PGY1's would come first, but this looks like I might be wrong.

This definitely doesn't read like an ASHP opinion paper, so its probably a while off (at least for accredited residencies). I am very glad I am going to be out before people start thinking about implementing this.

Any thoughts? Anyone read this yet?

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[BMBiology]

3 years of residency = 60 k x 3 = 120 k = 1 year pharmacist salary. Why wouldn't they?

 

[rxglasshalffull]

60k a yr? where is that? when i was doing my rotations in new jersey in 2012-2013, residents were paid 38k to 40k a year.

 

[trailerpark]

Who wouldn't want to train pharmacists for a third of their salary. I really think anyone who's going to do 3 years of pharmacy residency should just go to medical school! Reminds me of nurses going for their phD in nursing and introducing themselves as doctors to patients.

 

[fauxden]

wow.... that's insane

 

[npage148]

I wonder how much higher a pgy3's horse is gonna be. You'll probably get a step ladder to carry around upon completion

Also I don't think mandatory pgy1 will be possible just due to the shear number of students the system would require

 

[gtpederson]

Congratulations on completing your PGY-3!
Oh, you wanted a job? Well, we don't have any actual "paid" positions in your specialty, but I could put a good word in for this 0.4 FTE outpatient position that just opened up!

 

[BMBiology]

60k a yr? where is that? when i was doing my rotations in new jersey in 2012-2013, residents were paid 38k to 40k a year.

and they don't get any benefits...maybe just health insurance?

This whole pharmacy thing is becoming more and more of a scam every year. They accept 2.7 gpa students, charge them 50 k a year in tuition, tell them how great clinical pharmacy is and then tell them to do 3 years of residency. Sounds like a pump and dump scheme to me.

 

[rxglasshalffull]

and they don't get any benefits...maybe just health insurance?

This whole pharmacy thing is becoming more and more of a scam every year. They accept 2.7 gpa students, charge them 50 k a year in tuition, tell them how great clinical pharmacy is and then tell them to do 3 years of residency. Sounds like a pump and dump scheme to me.

its so a scam....and i dont know if the residents in NJ get any benefits, definitely health insurance though. they work their asses off. monday thru fri like 10 - 12 hours day, then staff every other weekend at the hospital. no thank you, when am i going to have time to go to the beach, gym, yoga or hang out with friends?

 

[PharmDstudent]

3 years of residency = 60 k x 3 = 120 k = 1 year pharmacist salary. Why wouldn't they?

your math is bad or i'm tired. i can't decide which one it is...

 

[Wheresmyaricept]

your math is bad or i'm tired. i can't decide which one it is...

That's why some people need to do PGY3 because they can't do normal things like basic math.

 

[awval999]

Totally expected. At our hospital we currently have 2 PGY1 RPh residents, 5 APPE students and 1 CPhT student. We NEED these students to complete our daily workload. We're a ~400 bed hospital. It's such a scam imo. There are plans to a PGY2 in critical care and a PGY2 in ambulatory. Much easier to add a resident than a new FTE.

 

[VCU07]

there is absolutely no point to this. if compensation increases dramatically then maybe it can be justified, but then again, why not just go to med school.

 

[gwarm01]

This is getting ridiculous. It would make sense if there were actual specialties that one could train in, but as it stands these people are struggling to find hospital staffing jobs. The academy needs to stop pretending like we are physicians. It's one thing to spend years in residency and come out as a surgeon or radiologist, another thing entirely to come out as a pharmacist with some special knowledge but no job to benefit from that knowledge. To add insult to injury, you spend all of this time and effort and aren't even rewarded with a high paying specialty. If you are lucky you will get a marginally higher starting rate based on that residency.

Sorry to rant, but I think it is a racket. The only real specialized pharmacist positions we have at my hospital are for oncology, and I don't think they get paid some astronomically higher rate than anyone else. We have a mix of residency and non-residency trained pharmacists and we all share the same responsibilities and are being trained for the same clinical duties. I feel sorry for anyone who would put themselves through three years of residency without some clear promise of an amazing, exclusive career at the end of it.

 

[Gombrich12]

So now people will be training for possibly 4 yrs undergrad + 4 yrs pharm school and 3 yrs of residency to be a pharmacist, for a total of 11 years? Yea, I don't see anyone who is particularly bright choosing this path. This might be the best way to scare prepharmacy students away, tell them you have to do a 3 year residency like a doctor and get paid at a 1/3 the rate.

 

[moisturize]

That means after I complete my PGY3, I get paid at a 15 year veteran level right (1 pgy = 3 years of experience)?

 

[pharm B]

This is getting ridiculous. It would make sense if there were actual specialties that one could train in, but as it stands these people are struggling to find hospital staffing jobs. The academy needs to stop pretending like we are physicians. It's one thing to spend years in residency and come out as a surgeon or radiologist, another thing entirely to come out as a pharmacist with some special knowledge but no job to benefit from that knowledge. To add insult to injury, you spend all of this time and effort and aren't even rewarded with a high paying specialty. If you are lucky you will get a marginally higher starting rate based on that residency.

Sorry to rant, but I think it is a racket. The only real specialized pharmacist positions we have at my hospital are for oncology, and I don't think they get paid some astronomically higher rate than anyone else. We have a mix of residency and non-residency trained pharmacists and we all share the same responsibilities and are being trained for the same clinical duties. I feel sorry for anyone who would put themselves through three years of residency without some clear promise of an amazing, exclusive career at the end of it.

I wasn't aware (until recently) that some organizations do have different pay scales for staff pharmacists and "clinical" pharmacists. The VA has regular RPhs at one level and "clinical pharmacy specialists" a pay grade above. Of course, the VA also gives its pharmacists a pretty wide scope of practice.

Do you think there will be more of these academic clinical pie in the sky jobs if we attain provider recognition?

 

[Ackj]

Who's honestly going to sign up for a PGY3?

A desperate unemployed PGY2. Your loans have been ballooning for the past 2 years thanks to minuscule IBR payments, and now you owe a big fat sum.

 

[Momus]

There are always serial education addicts for the sake of "learning". Like those people who have a BA in history, Master in history, and then Ph.D for history. Finish at 30 yo and make 35k in the library. Just don't be one of them idiots.

 

[pharm B]

There are always serial education addicts for the sake of "learning". Like those people who have a BA in history, Master in history, and then Ph.D for history. Finish at 30 yo and make 35k in the library. Just don't be one of them idiots.

Yeah, one of those idiots that's deeply and personally invested in something they love and have made into their life's work. We should all definitely get an applied clinical degree and just make big money.

 

[BMBiology]

Yeah, one of those idiots that's deeply and personally invested in something they love and have made into their life's work. We should all definitely get an applied clinical degree and just make big money.

That's fine and all but do it with your own money, not tax payers' money.

 

[pharm B]

That's fine and all but do it with your own money, not tax payers' money.

Does a history prof (or author, or History Channel talking head) qualify for PSLF? Or is he pretty much just going to pay back the taxpayers, with some nice interest? If it's the second, what's the problem?

 

[BMBiology]

Does a history prof (or author, or History Channel talking head) qualify for PSLF? Or is he pretty much just going to pay back the taxpayers, with some nice interest? If it's the second, what's the problem?

most likely he would die with his debt. And yes, he would qualify for PSLF if he works for a non-profit organization or university.

Learn into your 50s on your own dime. Better yet, pick up a book at the library. It is free. It is a disservice to put someone in a debt he can't repay, just like this 3 year residency crap.

 

[Momus]

Yeah, one of those idiots that's deeply and personally invested in something they love and have made into their life's work. We should all definitely get an applied clinical degree and just make big money.

I am pretty sure you don't become a pharmacist because you deeply and personally invested in this field. So, what's your point?

 

[owlegrad]

Does a history prof (or author, or History Channel talking head) qualify for PSLF? Or is he pretty much just going to pay back the taxpayers, with some nice interest? If it's the second, what's the problem?

The problem is we know how to live his/her life better than they do!

 

[BMBiology]

The problem is we know how to live his/her life better than they do!

Why should I have to pay for his useless PhD degree?

 

[pharm B]

Why should I have to pay for his useless PhD degree?

Exactly! Why should we even have history classes or people who pursue the subject? I mean, libraries are free, right? Heck, this conversation makes me so mad I paid as much as I did for pharmacy school. I should have bought a copy of RxPrep and just tested out.

 

[pharm B]

Back on the original topic:

PGY-3 residencies make no sense for pharmacy. At that point, you'd be a fool for not having pursued medicine. The people who do these will carve out their own little clinical fiefdoms and claim to know it all, but at the end of the day, they're no better than any other member of the team. They just have an extra dinky certificate taking up room on their wall.

 

[owlegrad]

Why should I have to pay for his useless PhD degree?

Hear here! I mean never-mind that you cannot point out even a single example of a PhD librarian whose degree you paid for, you are right on brother! Government should not be in the business of using MY money to pay for other people's education!

 

[owlegrad]

Back on the original topic:

I swear you are no fun sometimes.

 

[confettiflyer]

Who's honestly going to sign up for a PGY3?

Someone who faces unemployment, that's who.

I don't think anyone will start the whole process if they know this is the route (undergrad + rx school + 3yrs). You'll catch the people midway through the process who realize it may be the new normal.

I mean PGY1 mandatory = clinical inpatient rph in coastal California didn't develop until I was in pharm school. By then I was all-in.

 

[BMBiology]

Hear here! I mean never-mind that you cannot point out even a single example of a PhD librarian whose degree you paid for, you are right on brother! Government should not be in the business of using MY money to pay for other people's education!

I need to know their social security number too? C'mon, use some common sense. Why do you think the default rate is so high?

 

[owlegrad]

I need to know their social security number too? C'mon, use some common sense. Why do you think the default rate is so high?

I would settle for blood type.

What is the default rate anyway? Since student loans cannot be easily defaulted I can't imagine it is very high.

 

[BMBiology]

I would settle for blood type.

What is the default rate anyway? Since student loans cannot be easily defaulted I can't imagine it is very high.

It shouldn't be high because students can get on income based repayment but remember, it only covers certain federal loans (not parent plus loan, etc.) and it doesn't cover private loans:

"For-profit schools had average three-year default rates of 22.7% -- the highest among all the schools. Public schools came next, with an average three-year default rate of 11%. And private, non-profit institutions recorded a 7.5% rate."

http://money.cnn.com/2012/09/28/pf/college/student-loan-defaults/

 

[trailerpark]

So if people with PGY2's are teaching the PGY3 does that mean the PGY3 students are more qualified than their preceptor after they finish?

 

[pharm B]

So if people with PGY2's are teaching the PGY3 does that mean the PGY3 students are more qualified than their preceptor after they finish?

PGY-3 residents will be required to sport Inception eyebrows the entire time.

 

[MatCauthon]

PGY3s? Haha. Academia can convince anyone that they have to do that.

 

[awval999]

So laughable. I got the AJHP today. The greater move is the standard 0-6 and 2+4 moving to a true 4+4. I guess as current practitioners we should be all for these moves as they will HOPEFULLY discourage pre-pharm students and lead to less demand for even more new schools.

 

[gwarm01]

I wasn't aware (until recently) that some organizations do have different pay scales for staff pharmacists and "clinical" pharmacists. The VA has regular RPhs at one level and "clinical pharmacy specialists" a pay grade above. Of course, the VA also gives its pharmacists a pretty wide scope of practice.

Do you think there will be more of these academic clinical pie in the sky jobs if we attain provider recognition?

I could see more of these positions existing if it became possible to bill for services or if pharmacist scope of practice was expanded in certain ways. Maybe these advanced practice pharmacist laws could affect this? The problem is that what we do is such a small part of the healthcare equation. A unit that needs several doctors and dozens of nurses can usually be handled just fine with one pharmacist. Most of us are already sharing staffing and clinical duties and getting by just fine. I don't know where these unicorn jobs would even be.

I'm not even going to mention the fact that PGY3 pharmacists would likely feel like they are too good to actually do any work, staffing or clinical, and would be entitled to sit in their office (provided fresh out of school) creating PowerPoint presentations to teach the rest of us lowly pharmacy peasants how it's done.

Okay, that got ranty. I just know a "clinical specialist" who once said he didn't know how to introduce himself to people because they don't know what a clinical specialist is. I guess merely calling yourself a pharmacist isn't good enough.

 

[awval999]

It was hard to even get through the article.

A PGY3 sub-specialty in PEDS heme/onc? I doubt our MAIN CAMPUS even has ONE peds heme/onc pharmacist. How many of these unicorn, wait, double rainbow unicorn jobs are there? 10-15 in the entire country? You will have over-trained RPhs for which there are no jobs. These PGY3 RPhs will be put in the oncology suites and do the traditional order verification/clinical work in which current BPharms do.

It's one thing if there was a thirst for these positions, but there isn't. Hospitals are making cuts and trying to reduce costs. A fancy $150k (including benefits) RPh? Sure, adding a residency isn't expensive and you can have pharmacist extenders at $40k/year, but I just feel bad when they can't get the jobs they trained for, because they don't exist in that high of amount.

 

[tungsten87]

The newest issue of AJHP just arrived at my house. First article I noticed starts on pg 1199 (vol 71)

"The future of specialized pharmacy residencies: Time for postgraduate year 3 subspeciality training."

It has been a rumor for a while now, and it looks like it is happening.

I haven't been able to do anything but skim, but it looks like the authors are advocating a 3rd year residency/fellowship for the most specialized training.

Examples they give include: Endocrinology, Pediatric Hem/Onc (currently a PGY2 residency), Geriatrics, Nephrology, Hospice/Palliative Care, and Advanced Clinical Administrative Leadership.

I really thought required PGY1's would come first, but this looks like I might be wrong.

This definitely doesn't read like an ASHP opinion paper, so its probably a while off (at least for accredited residencies). I am very glad I am going to be out before people start thinking about implementing this.

Any thoughts? Anyone read this yet?

Wow - normally I am (pretty much) all for pharmacy resident training, however, some of these specialties are ALREADY PGY-2 at some institutions? For instance, MSKCC has two pediatric heme/onc PGY-2 slots, there are 1-2 PGY-2 in nephrology, several PGY-2 in geriatrics/palliative care. I think this is kind of ridiculous. Why the hell would anyone have to do two years of residency followed by a third to specialize in geriatrics? Clearly, this profession has much bigger concerns than opening up a third year in residency - lack of jobs, too much supply, etc.

 

[owlegrad]

LOL@"double rainbow unicorn jobs"

 

[Jibby321]

Where is this article?

 

[MatCauthon]

Employer to PGY3: you are overqualified for everything at our hospital. We are worried that you might start thinking you are a doctor. Why don't you try Rite-Aid?

 

[gwarm01]

Here's the link, but you have to be a paying member to actually read it. Anyone want to post the contents for us non-PGY3 having plebeians?
http://www.ajhp.org/content/71/14/1199.full?hw-tma-check=true

 

[Jibby321]

Here's the link, but you have to be a paying member to actually read it. Anyone want to post the contents for us non-PGY3 having plebeians?
http://www.ajhp.org/content/71/14/1199.full?hw-tma-check=true

Damn

 

[Reirrac]

Naw heck no! Whoever wrote that article is out of touch with reality.

 

[pharm B]

lol, I love that they closed with a quote from Shinseki.

 

[metallideth]

lol, I love that they closed with a quote from Shinseki.

lol this

 

[Gombrich12]

Naw heck no! Whoever wrote that article is out of touch with reality.

Even if they carved out some billing niche that was lucrative it wouldn't last for long as NPs, PAs and even MDs encroached. Dispensing and compounding are all we have in exclusion. This is simply rearranging the deck chairs and only will affect a few people at the very margins.