PGY1 residencies not enough anymore?

[MatCauthon]

I recently went to pharmacy career expo in California. I talked to all of the hospital recruiters. Apparently most of the recruiters aren't considering hiring PGY1 residents anymore. The hospitals are getting enough PGY2 residents applying that they don't usually won't consider PGY1 residents unless they did their residency at the same institution they are applying for.

I was discussing clinical jobs with a recruiter at a popular hospital and she was even saying that they were primarily considering people that went beyond the PGY2 residency and did a fellowship.

What the heck is the point of all this extra education? Does this really benefit the pharmacy profession if recruiters keep using these things to exclude potential applicants? 3 years of post-graduate pharmacy education is equivalent to some physician residencies, but I doubt we will ever get compensated for all this extra-schooling.

PGY1 residencies are already getting cut-throat to obtain and I can't imagine how hard it is to get a PGY2 residency. One recruiter said they had 250 applicants for 2 PGY1 residency spots. This is getting ridiculous. Many of the brightest people in my class didn't even get one interview for a residency.

Thoughts?

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[type b pharmD]

I recently went to pharmacy career expo in California. I talked to all of the hospital recruiters. Apparently most of the recruiters aren't considering hiring PGY1 residents anymore. The hospitals are getting enough PGY2 residents applying that they don't usually won't consider PGY1 residents unless they did their residency at the same institution they are applying for.

I was discussing clinical jobs with a recruiter at a popular hospital and she was even saying that they were primarily considering people that went beyond the PGY2 residency and did a fellowship.

What the heck is the point of all this extra education? Does this really benefit the pharmacy profession if recruiters keep using these things to exclude potential applicants? 3 years of post-graduate pharmacy education is equivalent to some physician residencies, but I doubt we will ever get compensated for all this extra-schooling.

PGY1 residencies are already getting cut-throat to obtain and I can't imagine how hard it is to get a PGY2 residency. One recruiter said they had 250 applicants for 2 PGY1 residency spots. This is getting ridiculous. Many of the brightest people in my class didn't even get one interview for a residency.

Thoughts?

california is a competitive market. you have tons of schools that are turning out the brightest students in pharmacy school in some cases, and a large academic medicine presence in most of the big cities. and on top of that, everyone wants to work in california. I'd say this sounds pretty reasonable given the supply and demand . Rural midwest hospitals are not requiring residency a lot of times, so there you have it

 

[cycloketocaine]

california is a competitive market. you have tons of schools that are turning out the brightest students in pharmacy school in some cases, and a large academic medicine presence in most of the big cities. and on top of that, everyone wants to work in california. I'd say this sounds pretty reasonable given the supply and demand . Rural midwest hospitals are not requiring residency a lot of times, so there you have it

I agree, location is everything.

 

[PumpkinSmasher]

I agree, location is everything.

Yep! And there is going to be more and more pharmacy students and more and more residents. The market will drive a credentialing bonanza!

 

[janeno]

Increase in number of schools and supply of more pharmacists drives this market. I can foresee the situation getting only worse. Three and a half years ago when I started pharmacy school, getting into residency was very easy and you had a guaranteed job afterwards. These year I see more pgy1 residents deciding to pursue pgy2 to set themselves apart from all of pgy1s. Soon there will be pgy2 residents who are not able to find jobs especially in their areas of specialization.

Although I am a proponent of pharmacy residencies, I am starting to wonder whether attending a medical school would have been a better choice. Pharmacy residencies are becoming more stressful and demanding. Most of them don't require overnight call but pharmacy residents have way more projects than any medical resident. As a medical resident, you need to complete three years of residency, and most of them usually have a job offer by the end of it. Plus, at the end, a physician is the one who manages all of the patient care, accepts/rejects recommendations by pharmacists, and receives reimbursement for their services.

As I am going through the residency interview process, I am very thankful for interviews that I got but I am becoming very disappointed with the current situation. The residency programs are extremely intense and exhausting compared to what they used to be three years ago. These programs still have tons of applicants because many students want to work in a hospital or cannot find retail jobs. Many current pgy1s don't know whether they will have job offers at the end of residencies, and some are opting for pgy2 residencies just to stay in the desired location.

 

[spacecowgirl]

I think this "ante up" movement is crazy. If you have to expand residencies, you're going to run into the same problem as with APPE sites and that is lower quality experiences.

In my ideal world, a bachelor's would be required for pharmacy school (make that D at the end mean something), 2 years didactic, 2 years of rotations. If the point is that residency is needed to make a competent "clinical" pharmacist, the ACPE should be concerned that their accredited schools aren't fulfilling that duty. The point of residency would be for specialization.

 

[FarscapeGirl]

I think this "ante up" movement is crazy. If you have to expand residencies, you're going to run into the same problem as with APPE sites and that is lower quality experiences.

In my ideal world, a bachelor's would be required for pharmacy school (make that D at the end mean something), 2 years didactic, 2 years of rotations. If the point is that residency is needed to make a competent "clinical" pharmacist, the ACPE should be concerned that their accredited schools aren't fulfilling that duty. The point of residency would be for specialization.

What's your opinion on those that desire to work in retail and only retail? I don't know if that would require 2 years of rotations, especially since so many pharmacy students work as interns during their entire pharmacy career. Would you want the rotations expanded to 3 months?

Personally, I have no desire to do a residency, but that's because I have a PhD, and I've been in school now almost 24 years, not counting kindergarden. I may have felt a little differently if I had started pharmacy school earlier. I got a lot of experience and confidence in the PhD program that I probably wouldn't have had if I had gone into pharmacy school right out of undergrad.

Actually, I may feel differently if it were still possible to do a specialty residency without doing the first year, too. I had thought about doing a residency in diabetes, but I think I'm going the Certified Diabetes Educator route instead.

 

[type b pharmD]

What's your opinion on those that desire to work in retail and only retail? I don't know if that would require 2 years of rotations, especially since so many pharmacy students work as interns during their entire pharmacy career. Would you want the rotations expanded to 3 months?

Personally, I have no desire to do a residency, but that's because I have a PhD, and I've been in school now almost 24 years, not counting kindergarden. I may have felt a little differently if I had started pharmacy school earlier. I got a lot of experience and confidence in the PhD program that I probably wouldn't have had if I had gone into pharmacy school right out of undergrad.

Actually, I may feel differently if it were still possible to do a specialty residency without doing the first year, too. I had thought about doing a residency in diabetes, but I think I'm going the Certified Diabetes Educator route instead.

retail and other dispensing positions should have just been allowed to stick with the b pharm

 

[bacillus1]

Actually, I may feel differently if it were still possible to do a specialty residency without doing the first year, too. I had thought about doing a residency in diabetes, but I think I'm going the Certified Diabetes Educator route instead.

There are several PGY1s that "specialize" in diabetes, not sure how employable people are after those programs.

 

[PharmDstudent]

retail and other dispensing positions should have just been allowed to stick with the b pharm

There are enough situations in retail that an advanced clinical degree is warranted. It's not necessary, because you can always ask patients to speak with their doctor, but it's still helpful. I counsel, take blood pressure readings, give flu shots, and make recommendations. So it's helpful to do those things while being backed by autonomy.

 

[FarscapeGirl]

There are several PGY1s that "specialize" in diabetes, not sure how employable people are after those programs.

Something to think about, I guess. Thanks for the info.

Although after grad school, I just don't know how much I have left in me for long hours and low pay... I do think some of these residencies are just ways to get people to work for long hours and low pay.

Speaking of which, what do you all think of community residencies?

 

[PumpkinSmasher]

Increase in number of schools and supply of more pharmacists drives this market. I can foresee the situation getting only worse. Three and a half years ago when I started pharmacy school, getting into residency was very easy and you had a guaranteed job afterwards. These year I see more pgy1 residents deciding to pursue pgy2 to set themselves apart from all of pgy1s. Soon there will be pgy2 residents who are not able to find jobs especially in their areas of specialization.

Although I am a proponent of pharmacy residencies, I am starting to wonder whether attending a medical school would have been a better choice. Pharmacy residencies are becoming more stressful and demanding. Most of them don't require overnight call but pharmacy residents have way more projects than any medical resident. As a medical resident, you need to complete three years of residency, and most of them usually have a job offer by the end of it. Plus, at the end, a physician is the one who manages all of the patient care, accepts/rejects recommendations by pharmacists, and receives reimbursement for their services.

As I am going through the residency interview process, I am very thankful for interviews that I got but I am becoming very disappointed with the current situation. The residency programs are extremely intense and exhausting compared to what they used to be three years ago. These programs still have tons of applicants because many students want to work in a hospital or cannot find retail jobs. Many current pgy1s don't know whether they will have job offers at the end of residencies, and some are opting for pgy2 residencies just to stay in the desired location.

Great post! I am also a proponent of residencies but I keep wondering with all these residents being trained every year and more and more coming, will hospitals have positions for these people?

 

[FarscapeGirl]

Great post! I am also a proponent of residencies but I keep wondering with all these residents being trained every year and more and more coming, will hospitals have positions for these people?

It seems somewhat this has happened in academia. It used to be just one post-doctorate position would allow you to then become faculty. Now, there's a glut of post-docs, so people do multiple ones before even thinking of becoming faculty, unless they're geniuses (which are few and far between).

This is probably the reason for now so many PGY2 residencies, and wasn't there something about PGY3 residencies posted awhile back? Now, if someone is specializing in, say, oncology pharmacy, I think they need a second year. But PGY3 is just insane.

I think I'm becoming more and more a proponent of a PharmD, then a PGY1 if you want to do hospital pharmacy, and a PGY2 if you want to specialize. I think most should have a Bachelor's before pharm school unless they are switching from another career. But I have a feeling as I learn more, my opinions will probably change.

 

[PumpkinSmasher]

Something to think about, I guess. Thanks for the info.

Although after grad school, I just don't know how much I have left in me for long hours and low pay... I do think some of these residencies are just ways to get people to work for long hours and low pay.

Speaking of which, what do you all think of community residencies?

It is no secret, resideny programs will tell you straight up. Residents are an asset to the dept and institution. They take on projects and pilot services while covering weekend/holiday shifts and occasionally an emergency shift. They increase pharmacies' exposure throughout the hospital: management meetings, rounds, and just on the floors. The resident is getting the opportunity to train with seasoned pharmacists, see a variety of settings all in one year, and learn some valuable skills to take with them in the future and hopefully increase their marketability.

Both sides are getting something out of it. Of course, I would love to be trained on the job for full pay but that is not common model for clinical pharmacists in today's market.

 

[FarscapeGirl]

retail and other dispensing positions should have just been allowed to stick with the b pharm

Maybe, but I see issues with that, too. People change their minds about what kind of pharmacy they go into once they're in school.

Plus, there are so many more drugs now, it's getting harder and harder to fit all that training in four years.

Then there's the issue of confidence. We sometimes call doctors and prescribers and tell them that what they've prescribed may not be the best. That's probably easier for most to do with a doctorate degree themselves and at 26 yo + instead of with a bachelor's and 22 yo +.

 

[tungsten87]

I'd be interested to see the relationship between quality of residency program (I understand this cannot easily be quantified) and ability to find a job post PGY1.

 

[spacecowgirl]

What's your opinion on those that desire to work in retail and only retail? I don't know if that would require 2 years of rotations, especially since so many pharmacy students work as interns during their entire pharmacy career. Would you want the rotations expanded to 3 months

Like you said, though, you probably don't know what you want to do before starting rotations. I changed my mind completely. To me, the PharmD should prepare you to go into any setting.

retail and other dispensing positions should have just been allowed to stick with the b pharm

I sort of agree with this, but again, like Farscape said, that would lock a person into a track they might not want to be in by P3 year.

Speaking of which, what do you all think of community residencies?

I think they are one of the few things that will move community pharmacy beyond just dispensing.

It is no secret, resideny programs will tell you straight up. Residents are an asset to the dept and institution. They take on projects and pilot services while covering weekend/holiday shifts and occasionally an emergency shift.

Both parties definitely get something out of it, but don't underestimate the amount of work it takes to precept well. So it's not all about cheap labor (not saying you said that, just the thought in general)

Then there's the issue of confidence. We sometimes call doctors and prescribers and tell them that what they've prescribed may not be the best. That's probably easier for most to do with a doctorate degree themselves and at 26 yo + instead of with a bachelor's and 22 yo +.

Why I think a BA/BS is good to have before admission, it just gives you that much more experience, age, maturity, etc. I had young classmates that were whip-smart, but lacking in maturity and confidence. Not to mention life experience.

 

[FarscapeGirl]

I think they are one of the few things that will move community pharmacy beyond just dispensing.

So, if you don't mind, can you go into a bit more the benefit of community residencies? I'm curious what the opinions are out there... I don't understand the benefits to them now, but then, I don't know much about them either.

 

[rph3664]

Quite a few new grads are pursuing residencies just so they'll have a steady paycheck. And where does that leave people like me who have many years of experience and a B.Sc.Pharm.?

I do have 2 interviews where they haven't gotten back to me yet, and a possible 3rd later this week.

 

[confettiflyer]

but I think I'm going the Certified Diabetes Educator route instead.

I believe the CDE has a contact hour requirement (1800) in diabetes care? correct me if i'm wrong, for some reason i thought that would be difficult to obtain unless you're seeing patients regularly and managing their disease states (and not staffing or doing anything else).

 

[All4MyDaughter]

I believe the CDE has a contact hour requirement (1800) in diabetes care? correct me if i'm wrong, for some reason i thought that would be difficult to obtain unless you're seeing patients regularly and managing their disease states (and not staffing or doing anything else).

Minimum 2 years experience and 1000 hours DSME with 400 of those hours taking place in the year immediately prior to application.

 

[PumpkinSmasher]

Minimum 2 years experience and 1000 hours DSME with 400 of those hours taking place in the year immediately prior to application.

I was looking into the certification requirements: http://www.ncbde.org/eligibility.cfm . I wonder how a community pharmacy would document hours? Would you document any DUR time spent reviewing a diabetic patient profile, time spent counseling diabetic patients, and any time you called a prescriber regarding diabetic patients specifically?

I will have to talk to some pharms with a CDE and see how they documented hours in their practice setting.

 

[mustang sally]

So, if you don't mind, can you go into a bit more the benefit of community residencies? I'm curious what the opinions are out there... I don't understand the benefits to them now, but then, I don't know much about them either.

In my state there are a lot of independent pharmacies, so PharmDs who have done a community residency usually get on board with an independent to do more "clinical" work (plus dispensing).

I myself am not a huge fan of the idea of community residency, but I think that's probably because I'm not interested in community pharmacy in general.

 

[benjee]

I recently went to pharmacy career expo in California. I talked to all of the hospital recruiters. Apparently most of the recruiters aren't considering hiring PGY1 residents anymore. The hospitals are getting enough PGY2 residents applying that they don't usually won't consider PGY1 residents unless they did their residency at the same institution they are applying for.

I was discussing clinical jobs with a recruiter at a popular hospital and she was even saying that they were primarily considering people that went beyond the PGY2 residency and did a fellowship.

What the heck is the point of all this extra education? Does this really benefit the pharmacy profession if recruiters keep using these things to exclude potential applicants? 3 years of post-graduate pharmacy education is equivalent to some physician residencies, but I doubt we will ever get compensated for all this extra-schooling.

PGY1 residencies are already getting cut-throat to obtain and I can't imagine how hard it is to get a PGY2 residency. One recruiter said they had 250 applicants for 2 PGY1 residency spots. This is getting ridiculous. Many of the brightest people in my class didn't even get one interview for a residency.

Thoughts?

It seems this is getting into another rat race . If recruiters only consider PGY2, then skip them, and look for jobs yourself. In reality, if there is high demand in market, it wouldn't matter if candidates has residency /fellowship or not, they still able to secure a position but if market is saturated, even candidates hold a PHD/pharm D/.. with 10 yrs of residency training/fellowships ( yeah I'm exaggerating), he still be jobless due to overqualified.
people usually have this misconception that residency = job, and this can direct people to wrong direction .

 

[benjee]

Quite a few new grads are pursuing residencies just so they'll have a steady paycheck. And where does that leave people like me who have many years of experience and a B.Sc.Pharm.?

I do have 2 interviews where they haven't gotten back to me yet, and a possible 3rd later this week.

some of them probably own their pharmacies , have lots of autonomy instead of running the rat race like those new grads.
Of course, there are some who are in similar situation as yours, they may practice in rural areas, retired, or change to different careers. or staying in retail chain pharmacies, dealing with micromanagement..etc in order to get a steady income.