Number of Hours Worked

[Sosumi]

We just had our residency forum last night. I'm still unsure whether I should or shouldn't do one. The speaker was the director of residency accreditation, and one of my classmates said she heard her say they're pushing to mandating all new PharmD graduates complete a residency starting in 2015. I know they're switching over to PGY1 and PGY2 for everyone and pushing for specialized training in year 2 meaning that I'm going to have to do a second year of residency training if I want to do ICU, oncology, or pharmacy informatics which are the fields I'm looking into.

Everything sounded fine until we heard the residency panelists speak. They were saying that they spent around 60-80 hours a week working! Especially the Johns Hopkins residents. One of them who was a recent graduate from our school (and named Honesty) said that she was burnt out and leaving the program at a smaller institution early. Is this typical of residency training? Do most residents spend that much time working their 1st and 2nd years?

---

Members don't see this ad.

 

[dgroulx]

I was talking with a UF student who completed their residency about 9 months ago. He said that he worked 12 hour days. Another interesting thing was that he applied for a specialty residency and got accepted his first year and bypassed having to do the general residency. He's now a critial care pharmacist.

I asked how many people applied for the residency that he got and he said 7 others applied for the specialty residency. So, maybe when there isn't a lot of competition and you're a good candidate you can skip that first year.

 

[kwizard]

I was talking with a UF student who completed their residency about 9 months ago. He said that he worked 12 hour days. Another interesting thing was that he applied for a specialty residency and got accepted his first year and bypassed having to do the general residency. He's now a critial care pharmacist.

I asked how many people applied for the residency that he got and he said 7 others applied for the specialty residency. So, maybe when there isn't a lot of competition and you're a good candidate you can skip that first year.

Good point!!! However, ASHP is really "cracking down" on doing specialties straight out of school (i.e. bypassing the pharmacy practice). So this option will be less likely when new standards go into effect starting 1/07. While this can be perceived as good or bad, the business side of the argument will always mandate that you have to complete a PGY1 before doing a PGY2. If you have people doing PGY2s straight out of school then ASHP and can't strongly advocate for federal funding of residency programs b/c the non-pharmacists out there can say that you can get from point A (graduating school) to point B (clinical pharmacist job) w/o residency training or w/o the typical 2 yrs of training that may be required for that position in the near future. This is the argument that threatend federal funding for residency training and although ASHP won the argument for pharmacy practice training (PGY1) they are still trying to re-establish federal funding for PGY2 programs. Secondly when new standards come into place in 1/07 all programs will be required to go through the match and while their will be some "specialties" that may consider themselves PGY1 they still must cover the same core concepts mandated for PGY1 system (examples: Pharmacy practice w/ emphasis in ambulatory care or maybe pharmacy practice w/ emphasis in psych, etc). So more than likely the reality of having to do 2yrs of post-doc training is quickly becoming the reality as the clinical pharmacist structure (i.e. clin pharm I, clin pharm II, clin pharm specialist) becomes more common in various hospitals. How fast all of this occurs is anyones guess and will depend on your area. Exceptions to the rule...always an issue in any profession and the ultimate equalizer is who you know and demand outweighing supply so if you know the right people and/or demand outweighs the supply you may be able to save some time (just unlikely if you are in a major metropolitan area). Especially w/ critical care and oncology they really tend to stress the application of PGY1 knowledge and application of it during PGY2 to facillitate further growth.

Residency hours...varies w/ the program. The average is probabaly 50-60hrs/wk. Programs like the ones at Hopkins and Univ of KY are notorious for being brutal and requiring close to 80hrs/wk. The programs in the VA, Kaiser, and most community teaching hospitals are typically a little less stressful being toward the 50hrs/wk avg. However critical care tends to be intense. Informatics on the other hand may be done w/ just pharmacy practice (or possibly no residency training depending on your computer savy).

Various ways to determine typical work hrs is to email and/or ask former/current residents or speak w/ them verbally during the various forums and/or Midyear meeting. Another option would be to read up on the program if they have a website. Biggest "red-flags" are if they require you to sign a contract denying you the right to work anywhere outside of the hospital pharmacy for moonlighting activities or only allowing you to do so w/ permission from pharmacy director or clinical coordinator (yes some programs actually do this). I believe the programs at UK and Hopkins simply forbid any moonlighting activities via contract. Second set of "red-flags" would be staffing component. Ideally if you have 3 residents then that should mean only staffing every 3 rd wknd (typical in most VAs, some VAs don't even have a staffing component (component is fullfilled via longitudonal clinic duties) or they pay you real pharmacist pay for those hours). Other red flags: when you work the wknd do you get days off during the week? If not that means 14-21 days straight. Will you be required to work evenings? How many? Will you get the day shift off? If not then that means a 16hr shift plus having to come back in the next day at 7 or 8am? Ooh, Ooh, my favorite: Are there any on-call hrs or would you be expected to cover for a manager on-call or for someone calling out?

If you find yourself answering yes to too many of these answers than so long social life and hello ~70hrs/wk (if not more) at your practice site.

Just know what questions to ask and talk to previous/current residents to get a good idea of what is right for you. Good luck.

 

[Sosumi]

Thanks for the advice

Hopkins residents do have to take on-call staffing which sounds like a pain in the butt. There are 18 residents and so many satellite pharmacies since they're such a large hospital. I'm not a big fan of Hopkins (I have friends who work as students there and get worked to death for not so hot pay -- just the privilege of putting it on their resume).

I just spoke to a PGY2 who was teaching us the diabetes cases today. She's finishing her primary care specialty at UMMS and says she spends about 80 hours during crunch time finishing her projects -- which kind of projects do they give you during residency? She says she didn't want to do one at Hopkins since they're so competitive there and not very encouraging. The good thing is hearing residents actually finding clinical jobs after residency. She is going to be faculty at PCP and work at the VA hospital there.

 

[kwizard]

Thanks for the advice

Hopkins residents do have to take on-call staffing which sounds like a pain in the butt. There are 18 residents and so many satellite pharmacies since they're such a large hospital. I'm not a big fan of Hopkins (I have friends who work as students there and get worked to death for not so hot pay -- just the privilege of putting it on their resume).

I just spoke to a PGY2 who was teaching us the diabetes cases today. She's finishing her primary care specialty at UMMS and says she spends about 80 hours during crunch time finishing her projects -- which kind of projects do they give you during residency? She says she didn't want to do one at Hopkins since they're so competitive there and not very encouraging. The good thing is hearing residents actually finding clinical jobs after residency. She is going to be faculty at PCP and work at the VA hospital there.

I'd agree w/ you in regards to the intensity at Hopkins. Projects during residency training...well it depends and can vary from drug regimen reviews, developing a criteria for use for a new agent, developing new administrative protocols (i.e. monitoring protocols, increased monitoring for various agents (i.e. metabolic disorders for atypical antipsychotics or insulin drip protocols in critical care, med reconcilation, etc), or just general stuff that the preceptor doesn't have time to do and passes on to the resident. All of this in addition to your residency project which of course has to be done to complete your training. Residency projects typically involve pharmacist in in some clinic setting or inpt showing improved outcomes or gathering data retrospectively to show something unique. Retrospective projects are the most common simply b/c the residency is only 1 yr and prospective trials are hard to get past the IRB in ample enough time to gain approval, recruit amount of patients, gather data, analyze data and complete manuscript. All of that in 1 yr well really 9 months give regional residency conferences are in May and your first month is typically orientation. Retrospective reviews are just easier as you can typically do an expedited/exempt review to get it past IRB quicker and then gather data and be done w/ ample time.

FYI...I guess you are looking at residency training for the 07-08. Finding a clinical job after residency training can be a difficult task depending on the availability that yr. Networking is always helpful, but if you desire to stay in the Baltimore metro area, but best of wishes to you as things are ever changing. Union Memorial also has a residency program and so does Sinai, but honestly I am not that familiar w/ either program. I think Sinai makes you sign a contract about not working outside of the program, but I think Sinai is supposed to be pretty strong in critical care as may be the case w/ Union. The VAs in DC and in Balt both have residencies. VA in Baltimore is probably a little more established clinically given relationship w/ Univ of MD?? The VA in Philly is also re-starting their residency as well. Christiana Health Care system in Delaware may be another option if you're willing to commute. Again, good luck. Eastern States Residency conference (http://www.easternstates.org/) is 5/11-5/13 at the Marriot in the Inner Harbor so it may be worthwhile to check out if you have the time to get an idea on potential topics and what other residents are doing.

 

[tupac_don]

We just had our residency forum last night. I'm still unsure whether I should or shouldn't do one. The speaker was the director of residency accreditation, and one of my classmates said she heard her say they're pushing to mandating all new PharmD graduates complete a residency starting in 2015. I know they're switching over to PGY1 and PGY2 for everyone and pushing for specialized training in year 2 meaning that I'm going to have to do a second year of residency training if I want to do ICU, oncology, or pharmacy informatics which are the fields I'm looking into.

Everything sounded fine until we heard the residency panelists speak. They were saying that they spent around 60-80 hours a week working! Especially the Johns Hopkins residents. One of them who was a recent graduate from our school (and named Honesty) said that she was burnt out and leaving the program at a smaller institution early. Is this typical of residency training? Do most residents spend that much time working their 1st and 2nd years?

Try 80+ for medical residents