One year post-graduation in hospital debating residency

[TheUglyBarnacle]

Hello all, I am seeking career advice as the 2018 residency application start looms.

I am a 2018 graduate now working full time in a hospital. I applied to 15 higher-end residency programs, got 4 interviews (and 2 in Phase II) but did not match. After scrambling to find a job post-graduation I got a relatively quick job offer at a small hospital and started working in July 2018. Now I am debating going back for a residency position.

I work split time inpatient and in the ER, which the ER is a brand new position they created and the position I was hired for (they wanted a bright and motivated new grad). I have lots of opportunities here such as student precepting and additional projects to pick up all the time, as well as creating an ER pharmacist position largely from scratch.

However, I can't help but feel I want to go back and apply to a residency. The number one reason is that I do not want to live in the place that I live now. It isn't bad, but I am a big-city person who is antsy to leave. I also want to be able to switch jobs quickly and have a clinically-minded career with ample opportunity down the road. With the currently saturated hospital market, more hospitals are seeking only residency trained applicants. My concern is that down the road not being residency trained will limit my opportunity for not being "serious" about the profession enough.

Obviously this decision comes with downsides. I know a job is not guaranteed after residency. I know residency is difficult. I know I may not even get one if I apply. Thankfully student loans are not a concern for me. But even after landing a quality job I want to do a residency. The question is: is this a good idea? What are your thoughts?

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[Sabril]

i would do a residency. if student loan is not a concern to you, you are already ahead of the crowd by at least 5 years. even if residency turns out to be a waste of one or two years, then you are still ahead of at least 3 years (financially at least, and resume wise). then you still have time to worry about finding a job after that (maybe not the kind of clinical job that you want right away)
i wish i had the same option that you did (i actually did but was way too dumb and lazy at the time). residency would be the one single "mistake" at this point in time that i regret not making

 

[PharmDBro2017]

Working 1-2 years is equivalent of doing residency.

I would stay where you're at for 3 years and soak up knowledge/learn as much as you can, get board certified after 3 years, and re-evaluate. You can find a new job to work after that if you still aren't happy. The opportunity to build a ER pharmacist position from scratch is one I've never heard of for a new grad... sounds pretty cool.

 

[BidingMyTime]

The opportunity to build a ER pharmacist position from scratch is one I've never heard of for a new grad... sounds pretty cool.

This. That sounds like a great job. Where are you at OP? If you decide to leave, you should post here first, so we can all get first dibs on your job.

"Residency trained" pharmacists are a dime a dozen. Being able to say you started an ER pharmacist position in a hospital that never had one before, now that is unique. I wouldn't leave your current job for a residency, unless you really can't stand the small town living and you get a residency in your preferred area to live.

 

[DOOM N GLOOM]

Working 1-2 years is equivalent of doing residency.

I disagree. Residency gives you a much broader exposure to different specialty areas so it’s the “far but shallow” principle that applies to someone that did residency versus “narrow but deep” experience that you get by just working in a job.

As a ED pharmacist, for example, you won’t get exposure to IM, ID, Oncology, etc. but you do get very good at ED since that is obviously what you do everyday. So you may have an “advantage” from an experience standpoint if both you and a resident were applying to an external ED position, but the resident can see the larger picture and can connect the dots in ways that you can’t, so they ultimately have more “potential.” Depending on the philosophy of the hiring manager they may choose to go with the resident for the potential and that is what I see most of the time. Of course, it goes without saying that if you specialized in ED then the only types of jobs you would be competitive for down the line are ED jobs, so something like ID would be completely out of the question. But if you had an ID rotation as a resident, you can still use that as a talking point 10 years down the line, which may still count for something.

So as a non-residency trained pharmacist the only way to have a resume that can “substitute” for residency is if you have worked in 5 different departments before, which is highly unlikely to have happened and if it does will take you 10-15 years to obtain. This is why people say residency= 3-5 years of experience but quite frankly I think even that estimate is an understatement because you can’t buy perspective.

Now, specific to OP’s situation, based on the description of the role I would say stay put for at least 2 years, because you have a unique role and plenty of responsibilities that will grow you professionally. If this was a staffing position in a hospital I would say do residency but it sounds like you have opportunities to do things at your current institution that you won’t be able to do at hospitals elsewhere (i.e. cross-train). After 2 years, I would apply for residency if your long term plan was to move to a saturated area for the reasons that you mentioned. But 2 years is the perfect balance of “being competent your role” and “not being too old to do residency”.

 

[PharmDBro2017]

Ah the uppity resident has arrived I see.

I was talking about on paper, someone who has worked for a few years in a hospital I would hire over a PGY1 (unless they interviewed terribly). Also, OP will get ID exposure doing ED stuff... the pharmacist will often be the first one asked about coverage. ID is very important for the ER.

edit: Also, the place that you do a residency is very important. I have met both sides of the coin, some of most intelligent pharmacists (who blow my mind with their abilities) and equally some of the most idiotic pharmacists (who made me think they stole someones identity), both who have been residency trained. Just because you completed a PGY1/2 does not mean you know anything more than the average pharmacist. More often than not, I bet I would still hire the person with 2-3 years of staff hospital experience and still fresh out of school, rather than a PGY1. And someone with 2-3 years ED pharmacist experience... that is a very good CV padding opportunity.

 

[gwarm01]

I disagree. Residency gives you a much broader exposure to different specialty areas so it’s the “far but shallow” principle that applies to someone that did residency versus “narrow but deep” experience that you get by just working in a job.

I once saw a PGY1 hired into an oncology spot that was originally going to be a promotion for a staff pharmacist who had been helping out and filling in the role for well over a year. Very sad to see the 1 month oncology rotation made them more valuable than the person who has been doing the job for over a year.

For anyone interested, the residency trained pharmacist bailed after a year and the staff pharmacist hates the job after being passed over once again.

 

[MatCauthon]

experience plus BCPS is going to trump residency in many hospitals-- especially if you have some project experience.

 

[Rockinacoustic]

What "Big-City" do you want to work in? You can have 5+ years hospital experience but there are handful of PGY-1 and PGY-2 trained grads with 5+ years experience as well seeking jobs in big cities.

 

[Corytrade]

I wouldn't do it if I were you. Continue to build experience for a few more years in the job you have, it is a job even a resident wouldn't get without a PGY-2 possibly. Starting a clinic/pharmacist position trumps a residency by far in my opinion.

 

[DOOM N GLOOM]

Ah the uppity resident has arrived I see.

I was talking about on paper, someone who has worked for a few years in a hospital I would hire over a PGY1 (unless they interviewed terribly). Also, OP will get ID exposure doing ED stuff... the pharmacist will often be the first one asked about coverage. ID is very important for the ER.

edit: Also, the place that you do a residency is very important. I have met both sides of the coin, some of most intelligent pharmacists (who blow my mind with their abilities) and equally some of the most idiotic pharmacists (who made me think they stole someones identity), both who have been residency trained. Just because you completed a PGY1/2 does not mean you know anything more than the average pharmacist. More often than not, I bet I would still hire the person with 2-3 years of staff hospital experience and still fresh out of school, rather than a PGY1. And someone with 2-3 years ED pharmacist experience... that is a very good CV padding opportunity.

That’s all theoretical and theory does not equal reality. Don’t get me wrong, I agree with many of the finer points than you’ve made and I’m sure you have a small camp that supports your line of thinking but in reality the perception of someone who has done a residency is worth a lot more than what they actually did/learned during the experience (i.e. credentials matter). There’s also some hiring bias in that directors of pharmacy who are most likely residency trained will hire residency-trained pharmacists vs. directors of pharmacy who are not— if you find one of those, then good for you! That is definitely the minority though.

But the point is, things don’t always work they way you tee them up to be— you would think, for example, that a clinician like a pharmacist or doctor to be the best type of sales rep because they can speak to the safety & efficacy of the product and it’s clinical trials etc., but in reality pharma hires hot, blonde, braindead chicks who probably didn’t even graduate college to be their sales reps because... you know why.

 

[PharmDBro2017]

That’s all theoretical and theory does not equal reality. Don’t get me wrong, I agree with many of the finer points than you’ve made and I’m sure you have a small camp that supports your line of thinking but in reality the perception of someone who has done a residency is worth a lot more than what they actually did/learned during the experience (i.e. credentials matter). There’s also some hiring bias in that directors of pharmacy who are most likely residency trained will hire residency-trained pharmacists vs. directors of pharmacy who are not— if you find one of those, then good for you! That is definitely the minority though.

But the point is, things don’t always work they way you tee them up to be— you would think, for example, that a clinician like a pharmacist or doctor to be the best type of sales rep because they can speak to the safety & efficacy of the product and it’s clinical trials etc., but in reality pharma hires hot, blonde, braindead chicks who probably didn’t even graduate college to be their sales reps because... you know why.

What is theory?

I think it depends which area of the country you live. The majority of directors I have met are not residency trained, you? Definitely hiring bias going on.

 

[lord999]

What is theory?

I think it depends which area of the country you live. The majority of directors I have met are not residency trained, you? Definitely hiring bias going on.

I agree. The exception is always academia which is a paperchase anyway. To the OP, getting genuine experience and testing is by far the better way to go as many say here. I get completely what you mean about that this is not your kind of town (I spent much of the early part of my career in DC, and I hate big cities), but the job you have is going to be a singular experience. That does not mean keep looking, but don't downgrade. We have quite a number of pharmacists who would love to switch places with you.

 

[projektreverb]

I’m going to echo what many have said here. Honestly, it sounds like the job you got is better than what any residency could provide you with. Take it, make the best of it, and when the time/opportunity comes, take that position at a hospital in the big city.

 

[gwarm01]

I’m going to echo what many have said here. Honestly, it sounds like the job you got is better than what any residency could provide you with. Take it, make the best of it, and when the time/opportunity comes, take that position at a hospital in the big city.

This is what I was thinking. You have a job that many PGY1 pharmacists will never have. Take advantage of it and it could be a stepping stone to greener pastures later in your career.

 

[sakigt]

Just stick it out and take BCCCP in a few years

 

[Dred Pirate]

This. That sounds like a great job. Where are you at OP? If you decide to leave, you should post here first, so we can all get first dibs on your job.

"Residency trained" pharmacists are a dime a dozen. Being able to say you started an ER pharmacist position in a hospital that never had one before, now that is unique. I wouldn't leave your current job for a residency, unless you really can't stand the small town living and you get a residency in your preferred area to live.

this x1000 - I was able to do a similar thing and it opened a lot of doors - even got job offers for a couple of jobs I know I wasn't truly qualified for

 

[student089]

One big-city hospital told me they only hire resident-trained pharmacists for day shifts.

 

[TimeZero]

Sounds like you lucked out and are in a much better spot than most new grads/newly minted PGY-1/2 residents. I recommend you look at job posting for the facilities that are located in your desired area. Do they require residency? experience? board certification? all of the above? I've seen both ends of the spectrum. Perhaps reach out to staff and/or management.

The largest facility in my area's pharmacy is run by residents. It is extremely difficult to gain employment without a residency, and if they do hire a non-residency trained pharmacist (no matter the experience/credentials); it is most likely to imprison them in the central pharmacy or on a med-surg floor. I can speak from experience as one of my colleagues spent three years staffing the ICU at a fairly decent sized inner city hospital, he was unhappy with management and put in his notice. The facility described above hired him to staff central and he has been there ever since. He is occasionally talked down to by snot nosed new grads a few months into their residency, but seems resigned at the moment. The only way he finds his way into the ICU at his current site is by completing a non-traditional residency.

My personal opinion is there is no substitute for experience, this is true for most professions. The optional pharmacy residency pathway has created a dichotomy that shouldn't exist. PharmD, xxxx, xxxx, xxxx, xx will never equal MD, but it seems some people just keep trying. Ideally, you should decide sooner rather than later, as at some point there won't be much that you will take away from a PGY-1, intellectually speaking.

 

[rxkrafted]

Yeah I would stay put in that unique scenario you are in. Imagine the risky possible scenarios you could end up in...
You may not even be able to find a job afterwards and will be more difficult the longer the unemployment time. Another scenario is that you may find a job but not be satisfied with the city again.

There is a fresh new residency trained pharmacy waiting for that spot you have once you leave... Just be grateful for what you have and patiently wait to apply to positions in desirable cities you want to live in later on with more experience you build.

 

[ornithoptor]

Agree with above posts, people do residency for hospital jobs. Well, you have a job, and you risk that going back to residency with no jobs when you finish.

That being said, if you are unsatisfied with your current setting, residency will open a few doors or new opportunities for you. Of course, risks will be involved.

5 years ago, I would strongly encourage you to pursue this path. I would now caution you with the choice, perhaps after 3 years in you current role just to compete better with other residents when you all finished the programs.

 

[TheUglyBarnacle]

Hello all,

I greatly appreciate everyone's input and advice to me in my career, it means the world to me.

After a great deal of thought I eventually applied to PGY-1 programs (becuase what did i have to lose in applying?) and matched to an inpatient acute residency in a big and exciting city! I am excited and slightly anxious to move again but am overall happy with my choices. My current position is certainly interesting and I am thankful to have found it, but I was also in need of a new work and life environment. My path isn't for everyone but thus far it seems to be working out well. Thank you all again.

 

[greenteapanacea]

Hello all,

I greatly appreciate everyone's input and advice to me in my career, it means the world to me.

After a great deal of thought I eventually applied to PGY-1 programs (becuase what did i have to lose in applying?) and matched to an inpatient acute residency in a big and exciting city! I am excited and slightly anxious to move again but am overall happy with my choices. My current position is certainly interesting and I am thankful to have found it, but I was also in need of a new work and life environment. My path isn't for everyone but thus far it seems to be working out well. Thank you all again.

Which state is your ED job in?

 

[TheUglyBarnacle]

Ohio, but you'll be hard-pressed to find it as its not listed as a stand-alone position. Plus theres an intern here being groomed quite heavily to replace me anyway.

 

[BidingMyTime]

For anyone interested, the residency trained pharmacist bailed after a year and the staff pharmacist hates the job after being passed over once again.

I question if there weren't other reasons why the staff pharmacist is being passed over. For a known employee with experience in the department to be passed over (twice!,) makes me wonder if management just wasn't happy with his work.

There’s also some hiring bias in that directors of pharmacy who are most likely residency trained will hire residency-trained pharmacists vs. directors of pharmacy who are not— if you find one of those, then good for you! That is definitely the minority though.

It depends. I would say a majority of hospitals have older directors, who never residency trained. With newer directors, I agree they are mostly residency trained. Eventually most directors will be residency trained, for now, from what I've seen, the majority are not.

Ohio, but you'll be hard-pressed to find it as its not listed as a stand-alone position. Plus theres an intern here being groomed quite heavily to replace me anyway.

Sheeeessh! That is why you are supposed to let us know where the position is so we can all apply! Give us a chance against the intern!