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This is advice for incoming or prospective students who want to work in clinical/hospital pharmacy. Some may disagree or have caveats to what I write, and I welcome their perspectives or disagreements in this thread, and will include their perspectives in this post as I see them. I will say this right now: if you're going to work in hospital, you will have to have at least a one-year residency after you graduate. The time when you could get away without a residency has passed for you.
Some background: This is coming from the perspective of someone who attended one of the top 10 pharmacy schools in the country, maintained a 3.4 GPA, was extensively involved and held multiple leadership positions in 6 different professional societies and organizations, presented original research at national conferences, received multiple awards for community health service, and had already defended a master’s thesis and published several articles in peer-reviewed scientific journals before entering pharmacy school. I did not receive a residency in either phase of the residency match this year, and have spent the last 4 months unsuccessfully looking for pharmacist positions near where my spouse currently lives. I would be lying if I said I didn't feel incredibly disillusioned and betrayed by the whole experience. If I had to do it over again knowing what I know now, I would not have applied to pharmacy school (for my own reasons; don't interpret this as me trying to deter you from pharmacy). But I want to make sure the same thing doesn't happen to someone who is in the place I was 4-5 years ago.
1.) The school you go to doesn’t matter.
EDIT: ClearBlueSkies (see below) disagrees and has some caveats to this point. Since this person has experience reviewing residency applications, I would give more weight to their perspectives on this point.
If it’s accredited, you’ll most likely get the same basic education at any other program, so it’s better to pick based on what’s going to put you in the least amount of debt after graduation. You might have more opportunities for interesting experiences during your schooling and you might get more financial support for attending professional conferences, etc., but if what you’re really hoping for is a job, then pharmacy is too big of a profession to care about your connections or where you went to school. The name of the college on your degree is more a testament to who you were BEFORE you got accepted than who you will be when you graduate with your PharmD. I lost residency positions to, and completed rotations with, students who went to schools like Palm Beach Atlantic and Sullivan University. Not exactly institutions that are well-known or well-connected as far as pharmacy goes, but the students at those colleges are just as intelligent, ambitious, and qualified as they are at UNC or Kentucky, so don't be distressed if you have to go to what you consider a "fallback school". We all have to pass the exact same licensing exam. If you get into pharmacy school, and get good grades while you're there, you've probably done 70% of the work you need to be considered for residencies and fellowships.
2.) Outside of your GPA, the most important thing is work experience
If you were not planning on doing an internship during pharmacy school, I would reconsider. If you have been accepted, start looking for internships within a 2 hour drive from your college; consider working weekend shifts if you find one that’s closer to the edge of that radius. Residency programs place a lot of weight on experience because residents are doing the job of licensed pharmacists, and they want to know that you can do the job. Direct experience goes a long way to assuring them of that. You don’t have to work long hours, averaging 10 hours a week is plenty in school, but they need to see you’ve put in the hours in an operational setting, because they need someone who understands the workflow of hospital pharmacy. Students without that experience are riskier bets or may take longer to train, and so they are getting less out of their investment, and are less likely to consider them for residency.
Sometimes internships are very hard to come by, so you have to be willing to do some traveling if you can't find one close by.
3.) Community service doesn’t matter
EDIT: ClearBlueSkies (see below) disagrees with my conclusions about the weight of community service in residency applications. Since this person has experience reviewing residency applications, I would give more weight to their perspectives on this point.
If you’re going to do community service, do it because you find intrinsic value and believe it’s important. Don’t do it because you think it will give you any sort of advantage for jobs, residencies, or fellowships, because it won’t. Your institution cares that you do the absolute bare minimum necessary to make them look good on paper. Beyond that, the only people to whom your service will matter are the people you help. So if you’re not heavily involved in community service, don’t feel like you need to force yourself to go above and beyond because it will look good on a CV – there are more effective uses of your time if your goal is to look good on paper. You’ll be just fine just doing the minimum your program requires. But I will reiterate, if you think it’s important, do more than they expect for the sake of the people you help, not for an illusory competitive advantage.
4.) Extracurriculars like advocacy, involvement, and leadership count for something, but not as much as you’ll be led to believe
Again, GPA and work experience are the most important. That is what will keep you above whatever cutoff residencies and fellowships put in place for applications. But if you make that cutoff, you and the 50-100 other applicants you’re competing against are still like a bunch of baby ducks that can’t be told apart from each other. The positions you hold and the organizations you’re involved in play some role in helping sort you out a little, but the people it helps the most are the ones at your pharmacy program so they can co-opt your initiative for advertising themselves. Don’t try to overload on leadership, you’re already juggling so many things to stay competitive, and the more you’re involved, the more diminishing the returns will be, even sliding into negative territory if it cuts into your work or study time. You'll find out where that balance lies for you in school. Just know that you don't have to push yourself.
5.) Publications only matter if it’s related to pharmacy
If you came from another related background, like chemistry or biology, and have at least third authorship on a peer-reviewed article, you might as well have not published anything at all. If you’re able to do pharmacy research while you're in school, take advantage. It’s just one more thing that will help you stand out against all the other baby ducks.
6.) Don’t get a pet. Hold off on children if you can.
If you already have a pet or a child, that’s a different matter. But professional school already going to be so insanely busy, it’s a terrible time to take on the responsibility of caring for a living thing that depends entirely on you for its well-being. If you can hold off on having kids, I would, but children are different from pets. You’ll eventually find a good time to add a pet, but there is NEVER a good time to have babies. You will always, always, always have to make time for children. But if having children is really important to you, and it happens in pharmacy school, then that’s when it happens, just make sure your significant other understands they’ll probably need to take on most of the childcare for the next 4 years unless you also have family nearby that’s willing to help.
7.) You don’t have to go to the professional meetings to get a residency
The ASHP Midyear Clinical Meeting is the best place to learn about programs in a confined space of time, but it’s not required, and it will cost you at least $500 per event for the opportunity when you factor in travel, lodging, and food, so if you plan on going, save it for the last year of your program. If you go to ASHP Midyear any time other than the last year of your program, don’t go to the residency showcase until the last hour of each grouping, it’ll reflect poorly on you when interviews roll around. If you’re presenting a poster, that’s different, and hopefully your college will help with the cost of attending the conference (just don’t count on a lot of help, maybe enough to dent the cost of registering. That's how it is even at some of the bigger programs).
8.) Applying to residency is EXPENSIVE, and if you don’t get a position, there are no refunds.
I spent over $1,000 participating in the residency match algorithm, not including the money I spent in travel. I applied to 25 different programs, and received only 2 interviews. 35% of new graduates who apply to residencies and participate in the match will not get a position, and do not get any of that money back - it's a sunken cost. Participants who will not be new graduates have even lower odds (under 50%). Know the odds, and understand you might be trying to put yourself in a box in which you don’t fit.
9.) No one will tell you why they didn’t hire you or why you didn’t get a residency
I will be very blunt: You are not a priority - you or the other 99 students who applied to the exact same program but didn’t get in. Residency directors simply do not have the time, and won’t take the time, to tell every one of you what was lacking, even if you ask - they don't owe it to you. The most you can hope for is, “There were so many qualified applicants and we had a hard time choosing.” That, of course, isn't the truth, but answering truthfully would take up more time than it’s worth for them to answer you. When it comes to finding ways to improve yourself, you’d better hope you’re really self-aware, or you have supportive college faculty.
10.)If you were one of those who said you’d never do retail, Murphy's Law is always in play.
EDIT: Chalupa_Batman86 (see below) makes an important caveat that I did not originally include - retail is not an easy fallback option, either. In most areas of the job market, pharmacy is over-saturated, and the guarantee of a pharmacist position when you graduate no longer exists.
I’ve got some disappointing news for you. Lots of students who graduated in the last 5 years who said they'd never work in retail have had to make what was, for them, a difficult choice 4 to 6 years too late. And by then, they accumulated tens or hundreds of thousands of dollars in student loan debt, and finding a different career is no longer possible. If you’re going into pharmacy, the vast majority of the jobs are in retail, and by the time you graduate, I guarantee hospital pharmacy positions will require a residency, and demand for residencies is outstripping supply by leaps and bounds every year. If you came into pharmacy school thinking you were going to work in hospital, you should prepare yourself right now for the likelihood of taking a job at the first chain that hires you.
11.) Pharmacy is only a small world if you're a big fish, or if you really screwed up.
You will hear a lot of people say pharmacy is a small world. It's repeated to the point of being a cliché. However, it is only true if you do something to make yourself known, for better or for worse. The connections you make in pharmacy school won't go as far as you'll be led to believe. Networking is important, as it is in any profession, but it's not something that's going to save you if you can't find a job in your chosen specialty, especially if you aren't looking for a job that's near the pharmacy school you attended (as I, and many of my fellow nascent graduates are finding out).
12.) Don't let any of this deter you, but please be realistic.
Again, I'm not writing any of this to scare you off, there are lots of good reasons to go into pharmacy, don't judge it on account of my failure. I just don't want any of you to get to the end of 4 or 6 years and find out for yourself that things are not as you were told at the beginning of your didactic training, because pharmacy schools see and present a lot of things through rose-colored glasses. Most pharmacy grads go into retail. The bar for hospital pharmacy gets higher and higher every year, and so someone who was perfectly qualified 10 years ago won't make the cut today. It is not necessarily a reflection on your abilities, they're just measured against an increasingly long ruler. For anyone familiar with the Red Queen Hypothesis, it applies as much to evolution as it does to careers - you have to sprint just to stay in place.
Be prepared to work your butt off in pharmacy school if you plan to pursue a residency or a fellowship, and know all the right things you have to do to get residency if that is your goal. And know that about 6,000 other students are working their butts off to the same end. If you do all the right things, and you get a little luck on your side, or just happen to know the right people, you might just make it in, but make sure you know what your back-up plan is if you fall short, and make sure you're comfortable with that back-up plan before you commit to entering pharmacy school. It's pretty difficult to justify going to another field once you've paid $60,000-$200,000 for that degree and have to start making interest payments on your loans.
Best of luck to you all.
Some background: This is coming from the perspective of someone who attended one of the top 10 pharmacy schools in the country, maintained a 3.4 GPA, was extensively involved and held multiple leadership positions in 6 different professional societies and organizations, presented original research at national conferences, received multiple awards for community health service, and had already defended a master’s thesis and published several articles in peer-reviewed scientific journals before entering pharmacy school. I did not receive a residency in either phase of the residency match this year, and have spent the last 4 months unsuccessfully looking for pharmacist positions near where my spouse currently lives. I would be lying if I said I didn't feel incredibly disillusioned and betrayed by the whole experience. If I had to do it over again knowing what I know now, I would not have applied to pharmacy school (for my own reasons; don't interpret this as me trying to deter you from pharmacy). But I want to make sure the same thing doesn't happen to someone who is in the place I was 4-5 years ago.
1.) The school you go to doesn’t matter.
EDIT: ClearBlueSkies (see below) disagrees and has some caveats to this point. Since this person has experience reviewing residency applications, I would give more weight to their perspectives on this point.
If it’s accredited, you’ll most likely get the same basic education at any other program, so it’s better to pick based on what’s going to put you in the least amount of debt after graduation. You might have more opportunities for interesting experiences during your schooling and you might get more financial support for attending professional conferences, etc., but if what you’re really hoping for is a job, then pharmacy is too big of a profession to care about your connections or where you went to school. The name of the college on your degree is more a testament to who you were BEFORE you got accepted than who you will be when you graduate with your PharmD. I lost residency positions to, and completed rotations with, students who went to schools like Palm Beach Atlantic and Sullivan University. Not exactly institutions that are well-known or well-connected as far as pharmacy goes, but the students at those colleges are just as intelligent, ambitious, and qualified as they are at UNC or Kentucky, so don't be distressed if you have to go to what you consider a "fallback school". We all have to pass the exact same licensing exam. If you get into pharmacy school, and get good grades while you're there, you've probably done 70% of the work you need to be considered for residencies and fellowships.
2.) Outside of your GPA, the most important thing is work experience
If you were not planning on doing an internship during pharmacy school, I would reconsider. If you have been accepted, start looking for internships within a 2 hour drive from your college; consider working weekend shifts if you find one that’s closer to the edge of that radius. Residency programs place a lot of weight on experience because residents are doing the job of licensed pharmacists, and they want to know that you can do the job. Direct experience goes a long way to assuring them of that. You don’t have to work long hours, averaging 10 hours a week is plenty in school, but they need to see you’ve put in the hours in an operational setting, because they need someone who understands the workflow of hospital pharmacy. Students without that experience are riskier bets or may take longer to train, and so they are getting less out of their investment, and are less likely to consider them for residency.
Sometimes internships are very hard to come by, so you have to be willing to do some traveling if you can't find one close by.
3.) Community service doesn’t matter
EDIT: ClearBlueSkies (see below) disagrees with my conclusions about the weight of community service in residency applications. Since this person has experience reviewing residency applications, I would give more weight to their perspectives on this point.
If you’re going to do community service, do it because you find intrinsic value and believe it’s important. Don’t do it because you think it will give you any sort of advantage for jobs, residencies, or fellowships, because it won’t. Your institution cares that you do the absolute bare minimum necessary to make them look good on paper. Beyond that, the only people to whom your service will matter are the people you help. So if you’re not heavily involved in community service, don’t feel like you need to force yourself to go above and beyond because it will look good on a CV – there are more effective uses of your time if your goal is to look good on paper. You’ll be just fine just doing the minimum your program requires. But I will reiterate, if you think it’s important, do more than they expect for the sake of the people you help, not for an illusory competitive advantage.
4.) Extracurriculars like advocacy, involvement, and leadership count for something, but not as much as you’ll be led to believe
Again, GPA and work experience are the most important. That is what will keep you above whatever cutoff residencies and fellowships put in place for applications. But if you make that cutoff, you and the 50-100 other applicants you’re competing against are still like a bunch of baby ducks that can’t be told apart from each other. The positions you hold and the organizations you’re involved in play some role in helping sort you out a little, but the people it helps the most are the ones at your pharmacy program so they can co-opt your initiative for advertising themselves. Don’t try to overload on leadership, you’re already juggling so many things to stay competitive, and the more you’re involved, the more diminishing the returns will be, even sliding into negative territory if it cuts into your work or study time. You'll find out where that balance lies for you in school. Just know that you don't have to push yourself.
5.) Publications only matter if it’s related to pharmacy
If you came from another related background, like chemistry or biology, and have at least third authorship on a peer-reviewed article, you might as well have not published anything at all. If you’re able to do pharmacy research while you're in school, take advantage. It’s just one more thing that will help you stand out against all the other baby ducks.
6.) Don’t get a pet. Hold off on children if you can.
If you already have a pet or a child, that’s a different matter. But professional school already going to be so insanely busy, it’s a terrible time to take on the responsibility of caring for a living thing that depends entirely on you for its well-being. If you can hold off on having kids, I would, but children are different from pets. You’ll eventually find a good time to add a pet, but there is NEVER a good time to have babies. You will always, always, always have to make time for children. But if having children is really important to you, and it happens in pharmacy school, then that’s when it happens, just make sure your significant other understands they’ll probably need to take on most of the childcare for the next 4 years unless you also have family nearby that’s willing to help.
7.) You don’t have to go to the professional meetings to get a residency
The ASHP Midyear Clinical Meeting is the best place to learn about programs in a confined space of time, but it’s not required, and it will cost you at least $500 per event for the opportunity when you factor in travel, lodging, and food, so if you plan on going, save it for the last year of your program. If you go to ASHP Midyear any time other than the last year of your program, don’t go to the residency showcase until the last hour of each grouping, it’ll reflect poorly on you when interviews roll around. If you’re presenting a poster, that’s different, and hopefully your college will help with the cost of attending the conference (just don’t count on a lot of help, maybe enough to dent the cost of registering. That's how it is even at some of the bigger programs).
8.) Applying to residency is EXPENSIVE, and if you don’t get a position, there are no refunds.
I spent over $1,000 participating in the residency match algorithm, not including the money I spent in travel. I applied to 25 different programs, and received only 2 interviews. 35% of new graduates who apply to residencies and participate in the match will not get a position, and do not get any of that money back - it's a sunken cost. Participants who will not be new graduates have even lower odds (under 50%). Know the odds, and understand you might be trying to put yourself in a box in which you don’t fit.
9.) No one will tell you why they didn’t hire you or why you didn’t get a residency
I will be very blunt: You are not a priority - you or the other 99 students who applied to the exact same program but didn’t get in. Residency directors simply do not have the time, and won’t take the time, to tell every one of you what was lacking, even if you ask - they don't owe it to you. The most you can hope for is, “There were so many qualified applicants and we had a hard time choosing.” That, of course, isn't the truth, but answering truthfully would take up more time than it’s worth for them to answer you. When it comes to finding ways to improve yourself, you’d better hope you’re really self-aware, or you have supportive college faculty.
10.)If you were one of those who said you’d never do retail, Murphy's Law is always in play.
EDIT: Chalupa_Batman86 (see below) makes an important caveat that I did not originally include - retail is not an easy fallback option, either. In most areas of the job market, pharmacy is over-saturated, and the guarantee of a pharmacist position when you graduate no longer exists.
I’ve got some disappointing news for you. Lots of students who graduated in the last 5 years who said they'd never work in retail have had to make what was, for them, a difficult choice 4 to 6 years too late. And by then, they accumulated tens or hundreds of thousands of dollars in student loan debt, and finding a different career is no longer possible. If you’re going into pharmacy, the vast majority of the jobs are in retail, and by the time you graduate, I guarantee hospital pharmacy positions will require a residency, and demand for residencies is outstripping supply by leaps and bounds every year. If you came into pharmacy school thinking you were going to work in hospital, you should prepare yourself right now for the likelihood of taking a job at the first chain that hires you.
11.) Pharmacy is only a small world if you're a big fish, or if you really screwed up.
You will hear a lot of people say pharmacy is a small world. It's repeated to the point of being a cliché. However, it is only true if you do something to make yourself known, for better or for worse. The connections you make in pharmacy school won't go as far as you'll be led to believe. Networking is important, as it is in any profession, but it's not something that's going to save you if you can't find a job in your chosen specialty, especially if you aren't looking for a job that's near the pharmacy school you attended (as I, and many of my fellow nascent graduates are finding out).
12.) Don't let any of this deter you, but please be realistic.
Again, I'm not writing any of this to scare you off, there are lots of good reasons to go into pharmacy, don't judge it on account of my failure. I just don't want any of you to get to the end of 4 or 6 years and find out for yourself that things are not as you were told at the beginning of your didactic training, because pharmacy schools see and present a lot of things through rose-colored glasses. Most pharmacy grads go into retail. The bar for hospital pharmacy gets higher and higher every year, and so someone who was perfectly qualified 10 years ago won't make the cut today. It is not necessarily a reflection on your abilities, they're just measured against an increasingly long ruler. For anyone familiar with the Red Queen Hypothesis, it applies as much to evolution as it does to careers - you have to sprint just to stay in place.
Be prepared to work your butt off in pharmacy school if you plan to pursue a residency or a fellowship, and know all the right things you have to do to get residency if that is your goal. And know that about 6,000 other students are working their butts off to the same end. If you do all the right things, and you get a little luck on your side, or just happen to know the right people, you might just make it in, but make sure you know what your back-up plan is if you fall short, and make sure you're comfortable with that back-up plan before you commit to entering pharmacy school. It's pretty difficult to justify going to another field once you've paid $60,000-$200,000 for that degree and have to start making interest payments on your loans.
Best of luck to you all.
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