WVUPharm2007

imagine sisyphus happy
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I think it's just an independent pharmacy trying to get cheap, low hanging fruit. I can't blame them. Put a ridiculously low salary out there and see if anyone bites.
 

Swishers

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Apr 18, 2011
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Maybe it's a typo. Instead, they're looking to pay $38/hr for an awesome pharmacy TECHNICIAN.
 

Momus

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Maybe it's a typo. Instead, they're looking to pay $38/hr for an awesome pharmacy TECHNICIAN.
I know a pharmacy tech making 35ish/hr. There is always outliers. Same with pharmacist hrly rate.
 

rph3664

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Jul 5, 2010
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I know a pharmacy tech making 35ish/hr. There is always outliers. Same with pharmacist hrly rate.
Wow. Where is that? I could possibly see a salary like that in Alaska or Hawaii, where living expenses are also high.

As for the OP, there have been threads here about this company before. It sounds to me like a crunchy-granola kind of place. There is a pharmacy school in Madison, so the area was always saturated anyway.

http://communitypharmacy.coop/
 

lord999

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10 years ago, dental
Is roughly the equivalent to a job as a dental hygienist (which only requires an associates degree)- Median 2015 wage for dental hygienist is $71,500/year.
A decade ago, dental hygienists and physical therapists in most MSA's easily made more than pharmacists did. (I'm surprised at how low the median is for RDH, minimum in my city is $90-$95k). It's just the matter that their salaries did not grow as much as ours did (PT even fell). I actually think that we're going the way of PT in terms of oversaturation and salary retreat.
 

Momus

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We are in 0 growth in salary for the next unforeseeable future. We will get inflation raises only. The party is over. Supply > Demand. Glad, I milked it as much as I can.

But let me just put this in here...
 

lord999

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Oh yes, I think salaries will drop, but probably not that low. I don't believe it will be merely no growth, I believe strongly in that it will be negative (and the feds have already started that with the retention pay elimination on all 0660s in VA). Pharmacy had that happen to them in the late 1960s and early 1970s when chains destroyed the majority of the Rexall and hospitals increasingly let nurses mix. See the Whitney lectures, but the early days of ASHP were literally to justify the operational pharmacist as an alternative to nurse compounding IV's.

What I think really is going to happen is that you just keep getting a bastard deal and then becoming virtually unemployable when you're 55-60. Not everyone is going to have that sort of experience, but I do think a sizable minority (akin to the disenfranchised engineer and dot-com bust programmer) will have some tough times. I can't see any way where the chains don't have a harder time once everyone realizes how much in debt CVS and CRW are. And I can't see any way that the small-time hospitals will be able to weather the continuing CMS cuts like small town pharmacies disappeared from a death of many thousands of PBM cuts.

I'm seeing a lot of applications from unemployed 55-65 pharmacists, so I am probably biased, but being old sure isn't golden anymore.
 

stoichiometrist

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Skyrocketing pharmacy school tuition and student loan burdens are already doing most of the work in reducing our take home pay.
 
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rph3664

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What I think really is going to happen is that you just keep getting a bastard deal and then becoming virtually unemployable when you're 55-60. Not everyone is going to have that sort of experience, but I do think a sizable minority (akin to the disenfranchised engineer and dot-com bust programmer) will have some tough times. I can't see any way where the chains don't have a harder time once everyone realizes how much in debt CVS and CRW are. And I can't see any way that the small-time hospitals will be able to weather the continuing CMS cuts like small town pharmacies disappeared from a death of many thousands of PBM cuts.

I'm seeing a lot of applications from unemployed 55-65 pharmacists, so I am probably biased, but being old sure isn't golden anymore.
The B.Sc.Pharm. degree identifies them as being an "older" pharmacist who hasn't done a residency, which precludes hospital employment, and not a few of them are having to quit retail jobs they've had, often for decades, because they just don't have the stamina to keep up with metrics. On top of it, being older means they have more life experience and can't be dinked around the way a younger person can.

Just yesterday, I was at a gas station and the cashier was a tech I worked with after I graduated over 20 years ago. She was surprised that I was no longer working as a pharmacist, but she did understand. She also told me that another tech we worked with also works at that station. They're probably paid more, and experience less stress than they did as pharmacy techs. :(

My 53-year-old BFF is job hunting again; he has an offer for a contract job at a state mental health facility for $45/hr.
 

lord999

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The B.Sc.Pharm. degree identifies them as being an "older" pharmacist who hasn't done a residency, which precludes hospital employment, and not a few of them are having to quit retail jobs they've had, often for decades, because they just don't have the stamina to keep up with metrics. On top of it, being older means they have more life experience and can't be dinked around the way a younger person can.

My 53-year-old BFF is job hunting again; he has an offer for a contract job at a state mental health facility for $45/hr.
Something I am fairly proud of is that civil service does not discriminate against BSPharm holders for operational positions (for clinical positions, if the BSPharm has a BC something, they will be treated the same as the PharmD and Residency combo if they have practice). It makes no difference in promotion, period, once someone is career tenured (TIG and suitability take higher precedence). It's explicitly forbidden to discuss background education and baseline qualifications for GS-14 and GS-15 promotions as those can only be screen-out factors (for initial appointments, they're completely in bounds).

On top of it, being older means they have more life experience and can't be dinked around the way a younger person can.
At least in our case, it has always been such that you could migrate to other forms of work (and some arguably with a better work-life balance) without taking an extreme hit to quality of living circumstances. Our dental, medical, and surgical colleagues don't get that sort of tradeoff opportunity if they find medicine isn't for them. But, I don't think the straight pharmacist will get the luxury of having a career to retirement without fighting hard for it anymore if they are students or new grads now. I'm right now debating on the academic sense whether my generation (1995-2005) will have that either. It really depends on how CMS is going to restructure its payment scheme and the financial health of now the big two. Any one of those factors changes, it'll be profession changing. And if you knew how it was going to turn out, you can place bets on it such that you shouldn't be working anymore (as in, not even the experts convincingly know what will happen).

Our industry hasn't become the IT industry yet where that definitely is the case, but being older tends to grant a reputation one way or another which is usually negative if unemployed involuntarily. A pharmacist with a strong reputation for either negative matters or even colorless is not worth hiring as there is not a growth opportunity with them, and they don't have other factors like past loyalty to recommend them. (On the other hand, I think the civil service is a bit too loyal to employees that are loyal despite being non-functional.) I always find it entertaining when people keep saying that IT is the countersolution when I keep seeing grey-haired programmers apply for even entry level VA positions but have previous applications where the hiring officer noted that they were jerks in the interview when they came in the 1980s.

Ageism is alive and well, but I really would take after some of the older chain members (old timer) and the (semi?)retired DoP It's Z where you work where you can while you can, you do what you can to save, pay your obligations and incur none involuntarily (I consider children an obligation but hopefully a voluntary one). Career lifespans are lower than what anyone wants to realistically think, and that while the work is available and you're willing, you should do what you can with what you have while avoiding burnout. Today's not easy, but this profession is nowhere near as apocalyptic as it was in the late 1970s/early 1980s where not only were there no jobs, but licensing was extremely difficult to do the unavailability of getting enough hours. This is not me saying "man up and quit whining" but saying that we have quite a bit lower to go on this roller coaster before we get another calm period. But the old pharmacists are what we know as survivors' bias, if they are old and still work in pharmacy as an FTE, they are the exception and not the rule, especially if their careers cross the 25 year mark.
 
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Apotheker2015

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Something I am fairly proud of is that civil service does not discriminate against BSPharm holders for operational positions (for clinical positions, if the BSPharm has a BC something, they will be treated the same as the PharmD and Residency combo if they have practice). It makes no difference in promotion, period, once someone is career tenured (TIG and suitability take higher precedence). It's explicitly forbidden to discuss background education and baseline qualifications for GS-14 and GS-15 promotions as those can only be screen-out factors (for initial appointments, they're completely in bounds).



At least in our case, it has always been such that you could migrate to other forms of work (and some arguably with a better work-life balance) without taking an extreme hit to quality of living circumstances. Our dental, medical, and surgical colleagues don't get that sort of tradeoff opportunity if they find medicine isn't for them. But, I don't think the straight pharmacist will get the luxury of having a career to retirement without fighting hard for it anymore if they are students or new grads now. I'm right now debating on the academic sense whether my generation (1995-2005) will have that either. It really depends on how CMS is going to restructure its payment scheme and the financial health of now the big two. Any one of those factors changes, it'll be profession changing. And if you knew how it was going to turn out, you can place bets on it such that you shouldn't be working anymore (as in, not even the experts convincingly know what will happen).

Our industry hasn't become the IT industry yet where that definitely is the case, but being older tends to grant a reputation one way or another which is usually negative if unemployed involuntarily. A pharmacist with a strong reputation for either negative matters or even colorless is not worth hiring as there is not a growth opportunity with them, and they don't have other factors like past loyalty to recommend them. (On the other hand, I think the civil service is a bit too loyal to employees that are loyal despite being non-functional.) I always find it entertaining when people keep saying that IT is the countersolution when I keep seeing grey-haired programmers apply for even entry level VA positions but have previous applications where the hiring officer noted that they were jerks in the interview when they came in the 1980s.

Ageism is alive and well, but I really would take after some of the older chain members (old timer) and the (semi?)retired DoP It's Z where you work where you can while you can, you do what you can to save, pay your obligations and incur none involuntarily (I consider children an obligation but hopefully a voluntary one). Career lifespans are lower than what anyone wants to realistically think, and that while the work is available and you're willing, you should do what you can with what you have while avoiding burnout. Today's not easy, but this profession is nowhere near as apocalyptic as it was in the late 1970s/early 1980s where not only were there no jobs, but licensing was extremely difficult to do the unavailability of getting enough hours. This is not me saying "man up and quit whining" but saying that we have quite a bit lower to go on this roller coaster before we get another calm period. But the old pharmacists are what we know as survivors' bias, if they are old and still work in pharmacy as an FTE, they are the exception and not the rule, especially if their careers cross the 25 year mark.
You brought up very interesting points. I also think that older pharmacists eventually become unemployable because they simply do not keep up with new drugs and treatment guidelines. Those are the ones who choose to do mindless CEs and who flip channels the second a commercial for a drug comes on. In the case of retail pharmacists, I would say a big part of the problem is that they remain staff pharmacists for 25 years. Most refuse to take on other responsibilities. They're just clocking in and out. Their counseling is limited to reading the directions to the patient off the label. A good friend of mine, god bless him, has been a retail pharmacist for at least 20 years and a preceptor for at least 10 years. Just recently I asked him his thoughts on Truvada and if he had a lot patients on it. He had no idea what I was talking about. he actually thought that he was dispensing Truvada as monotherapy to treat HIV. Huh??? I know that when I have an old timer, my ears go up the moment they're counseling someone. Hmmm... I suppose I do that with new grads, as well. And well, I am a new grad for all purposes.

My point is that, they clock in and out and that's all they deign to do. Of course, you're going to become unemployable at some point. Whereas if you take on the challenge to become a manager, and maybe eventually oversee several stores and keep on taking responsibilities, you'll be employable for as long as you want to be.

That's my two humble cents.
 
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Momus

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You brought up very interesting points. I also think that older pharmacists eventually become unemployable because they simply do not keep up with new drugs and treatment guidelines. Those are the ones who choose to do mindless CEs and who flip channels the second a commercial for a drug comes on. In the case of retail pharmacists, I would say a big part of the problem is that they remain staff pharmacists for 25 years. Most refuse to take on other responsibilities. They're just clocking in and out. Their counseling is limited to reading the directions to the patient off the label. A good friend of mine, god bless him, has been a retail pharmacist for at least 20 years and a preceptor for at least 10 years. Just recently I asked him his thoughts on Truvada and if he had a lot patients on it. He had no idea what I was talking about. he actually thought that he was dispensing Truvada as monotherapy to treat HIV. Huh??? I know that when I have an old timer, my ears go up the moment they're counseling someone. Hmmm... I suppose I do that with new grads, as well. And well, I am a new grad for all purposes.

My point is that, they clock in and out and that's all they deign to do. Of course, you're going to become unemployable at some point. Whereas if you take on the challenge to become a manager, and maybe eventually oversee several stores and keep on taking responsibilities, you'll be employable for as long as you want to be.

That's my two humble cents.
You need peons to run the business. The business will be only as good as your ground peons. All pharmacies need ground slaves. I'll be happy to be one making more money than people 2 ranks above me for 0 responsibility. If you are incompetent, you will be let go no matter who you are. I clock in and out and get about same pay as DM every year. You see those bosses that have been in the same rank for years. They are most likely incompetent. It's Peter principle. When the board/merger chooses to trim the fat, the middlemen, your DM/VP will be the first one out the door. Trust me, without those middle managers, the pharmacies will run just fine for quite a while. Can you say the same for your techs or rphs?
 

Apotheker2015

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You need peons to run the business. The business will be only as good as your ground peons. All pharmacies need ground slaves. I'll be happy to be one making more money than people 2 ranks above me for 0 responsibility. If you are incompetent, you will be let go no matter who you are. I clock in and out and get about same pay as DM every year. You see those bosses that have been in the same rank for years. They are most likely incompetent. It's Peter principle. When the board/merger chooses to trim the fat, the middlemen, your DM/VP will be the first one out the door. Trust me, without those middle managers, the pharmacies will run just fine for quite a while. Can you say the same for your techs or rphs?
Your point is valid. I am in no way attempting to delineate a general rule or theory on long term employment outlook for pharmacists who choose to clock in and out. To each their own... Whoever is contempt with being a peon, should then be a peon. :)

The key point, though, is to be good at whatever you do. That goes for managers, technicians, pharmacists who choose to clock in and out. I guess we can agree on that.
 

Sine Cura

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I will be amazed if I get 10 years out of this. As for choosing to just clock in and out, can hardly blame people for shutting down mentally at the end of the day after playing PDMP detective and Medicaid patient whisperer all day long
 

Apotheker2015

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I will be amazed if I get 10 years out of this. As for choosing to just clock in and out, can hardly blame people for shutting down mentally at the end of the day after playing PDMP detective and Medicaid patient whisperer all day long
Of course! *Medicaid patient whisperer. I should add that to my linkedin profile.
 
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lord999

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I want to ask you something else. I've been researching lots of other healthcare careers over the last few weeks, and several of the guys I went to undergrad with are either in dental school now or have recently graduated from dental school within the last year or so. I was catching up with a few of them the other day, and they were talking about how much money dentists/dental specialists make and how good the job market is (at least here in mid-sized cities in the southeast -- things may be different in big cities), presumably because there are so few dental schools out there. For example, GA has one dental school, AL has one dental school, FL has only 3 dental schools, PA only has 3 -- even CA only has 6. These guys I know talked about how they were so proud of the fact that, even though lots and lots of people want to become dentists these days, the ADA and related organizations are very resistant to the notion of opening up more dental schools. Now here is the catch -- there's no doubt that a new dental school would make lots of money regardless of where it opens, but for whatever reason, new dental school openings aren't happening.

So my question is, what is so radically different about the leadership organizations in the pharmacy profession (as compared to those in dentistry, medicine, etc.) that they're opposed to making the accreditation/approval criteria for opening a new school more stringent? If the accrediting organizations in dentistry and medicine aren't so easily swayed by the prospect of making lots of money by accrediting more and more schools, then why are the pharmacy organizations susceptible to it? Is the rumor true that with chains like CVS and Walgreens being the biggest donors to the APhA, the APhA (and related organizations) are therefore obligated to make decisions (I.e., flood the job market) that will benefit those donors?

Also, something else I'm curious about is, whenever someone cites a foreboding piece of evidence that has predictive value regarding the job market (e.g., the overall 10-year ADI trend, the many articles that discuss the massive oversupply of pharmacists that is expected to result in 20%+ unemployment by 2018, etc.), representatives from the APhA always have some sort of excuse for why the study/article has no legitimacy or value (e.g., see the Chapman thread). Do you think these people are simply blinded by their own hubris and honestly can't see that there isn't going to be some huge explosion in demand for pharmacists over the next few years due to "emerging roles," or are they just lying to protect their and the APhA's own interests?
Short Answer:
Whether or not they (the profession) took Flexner (https://en.wikipedia.org/wiki/Flexner_Report) seriously and satisfied enough demand while retaining quality. Medicine went a little too far with their supply shortage, dentistry arguably has grown organically along with DPM and veterinary and while it may not be perfect, it is reasonable, nursing is completely at the opposite end of the spectrum. (And yes, there is a tasteless joke that is made about the circumstances, but that'd get my post banned. :O).

Long Answer:
Look, professional education is not cheap for either you or the state. For dentistry at present and pharmacy in the old days, there was an extremely high capital investment per student due to the laboratory training requirements. Ask any dental student about finances, and they'll stress just as much if not more about their professional equipment costs than tuition. For pharmacists prior to the late 1990s, you actually had at least two major compounding laboratories (extemperous and sterile), one laboratory class in pharmacology where you made sure the rabbit died, one laboratory class in medicinal instrumental analysis where you were trained on USP or Remington validation techniques. If you were very "lucky", you had a class in medical botany or pharmacognosy. I know the numbers for a couple of pharmacy schools, Minnesota when I was a graduate student spent $16k per pharmacy student per year in addition to tuition (so 480 students across 4 years meant that it's a $7.6M taxpayer burden), and it still was the second highest tuition in the country after UCSF. You have to thank the generous taxpayers in your state for subsidizing your education (and even for really red states, there is still a substantial amount of state support for professional education).

If you think pharmacy was bad about the support needs, dentistry is far, far more structurally intensive than pharmacy. Medicine actually even more so, to the point that no medical school can do it alone and this includes private schools, they depend on handouts from CMS DGME and to a lesser extent IME for keeping afloat alongside some hospital. Veterinary was always the most expensive (equine and exotics) and depends on DoA funding to stay afloat. This is partly the reason for why the schools are not as distributed. Without state support, the school has to pass on the costs to the student. This is easily possible in nursing because there is not a large structural requirement. It was not easily possible in pharmacy until recently. The oldest private schools, USP, Drake, Creighton, are all really special cases where they had enough research, intellectual property (USP's IP royalties and corporate stock ownership make it such that it is a pharmaceutical corporation that just so happens to run a pharmacy school), and endowments to offset the tuition enough that charging the equivalent of $60k/year now was possible. But that all changed with the curriculum reforms.

Do you know what Remington's is used for? Can you deal with the instrumental analysis to determine quality of a synthesized med? Can you use an industrial tablet machine wet process? Can you make digoxin from digitalis? Yeah, most of that knowledge is completely useless in the modern sense, and so curricular reforms changed to eliminate most of the more outrageous matters. A fad also caught on where clinical pharmacy was the wave of the future starting with a guy in UCSF named Francke and continuing from the 1970s through the present (yes, if you read Whitney lectures from about 1978 or so until today, notice how they all remarkably say the same tired future of pharmacy practice where the major changes have been making pharmacists far more efficient about their work than before). I'm not saying that this should be taught again to the undergraduates, but I do think that the lessening of the cost to train made it possible for private pharmacy schools to operate and pass on the entire costs of training to students. Yes, these curricular reforms were absolutely necessary as a pharmacist buys their products not makes them or has to verify the actual quality of the drug analytically anymore, but it had a side effect of lowering the bar to entry.

This doesn't happen in medicine because of the necessity of getting CMS and NIH to fund part of the school, and that is still based on an ancient law defining hospital construction and provider estimation called Hill-Burton and the CMS Acts. It doesn't happen in Dentistry as often because the capital requirements are probably an order of magnitude higher than pharmacy's to open. It certainly doesn't happen in veterinary (in fact, there is some fears that there will be less student places in the future).

The other part of the story said above is that both pharmacy's nominal (actual dollar amount) and parity adjusted (in relation to other careers) has rapidly increased. Considering the salaries, it's possible to make good on even a fairly large loan. How far, who cares from an academic standpoint? We already have the tuition money if it's a private school. For a public school, this will come back to haunt you later.

What is really funny to me is that LB (the Chapman dean) probably sat in the same room as the Minnesota SAPh grad students all did, heard either Linda Strand or Peter Morley lecture on this very subject (I believe this history of professionalism is the very first class in the very first semester of training to understand how pharmacy dug this hole for themselves and how other professions dug themselves out), and Lucinda Maine hearing it from Albert Wertheimer. They all know the game and actually could have done things to avoid this fate. They are completely aware in their part of contributing to the pre-Flexner sort of situation. That's fine, I'm sure it's lucrative for them. But, they all know what and where the hypocrisy of doing this is considering the actual future of the profession. I'm not going to answer LB directly because I understand enough why he would do this and I don't think it's a bad idea for him, but it's really disappointing that this modern generation of Minnesotan SAPh leadership will deservedly get a lot of the blame for going along with the trend knowing what will happen, because how does this story end any differently? We know the story, is this really our fate?

By the way, I want to stress this thoroughly. Dentists, physicians, and podiatrists are paid on piecework in most cases. Yes, their salaries are higher, but they do actually have to work for it. Now, a major trade secret in dentistry that few outside of the profession talk about is that rural dentists and small city dentists in General Practice in general make more money due to the CPT multipliers for the tradeoff that they live outside of a metropolis. That's the other part of the secret sauce that makes dentistry viable. Dentists not only have to be productive in personal ways (you can tell who a lazy/inept dentist is fairly quickly from practice fiscal audits), but have financially viable ways of practicing in remote areas. Pharmacists can hide themselves in the crowd in an institutional setting. That's why I like the retail metrics system and staffing models from a productivity standpoint. Yes, you can juke the numbers (in fact, everyone should be taught how to "optimize" KPI's since it makes your life, the DM's, and the corporation's life easier), but that's much harder in hospitals.

Medicine did take it too far in the other direction in terms of being too short, and NP's really changed the dynamics of the work situation (for the better). That's not my story to tell, read Social Transformation of American Medicine for the better story (or not depending on the final comments).

If you really want to solve pharmacy, the conclusion that most of us had come to is that if you have that sort of angst, you leave it. There's a couple of ways, using that intelligence to become a capitalist and get rents on capital, changing to another profession where people care a bit more about their self-interest, etc. I'm neither intelligent or driven enough to leave it, so I'll always be here (plus, I do like the work and for what I do if I practiced pharmacy normally, there's no other profession that can sensibly take that work away from me).

Learned Answer:
We are the healthcare profession equivalent of Purgatory, suffering the consequences for our sins, never achieving the promised land (medicine), nor descending into the inferno (nurses), but always hopeful that there's a better deal than what we have and knowing that there is a reason for our suffering even if we don't know precisely what. You're in a profession that's neither terrible enough that only the strong survive, passionate enough that it can reinvent itself, intelligent enough to prove itself unique except for the tasks that everyone else loathes (drug preparation and dispensing), or courageous enough to take the risk of doing things for the right reasons even if they risk professional judgment. Pharmacy is a profession that has never been a full profession, and the work circumstances are such that they are good enough for you to stay and not terrible enough to move on. Scale that up, and that's why the future of pharmacy is and will be always the same as its present, concerned for an individual and comfortable livelihood with limited on-the-job responsibility and almost none outside the job. Anyone who does not really find solace in that never satisfied always looking will move on. The moment you understand that these limitations are as much your professional peers as well as yourself, you can start making peace with not only the direction, but the progression of the problems in pharmacy and that life is too short to worry about something that is a structural problem.

And if you want to know why I'm a civil servant and not a full academician, I really do want to make a difference if only minor. But that difference is not for the profession, it is really for how the system works. Academicians are blind to the way the profession has worked (the pedagogy criticism is that PharmD training is now about training about the idealized and thoroughly fictitious practice of clinical pharmacy than how to be a pharmacist for CVS or VA or Omnicare which are actual jobs). What you observe, trust me, you know the trends that you can see and understand. You do not need to trust a paper when seeing your new grad colleagues get shafted on a 40-hour workweek involuntarily should give you all that you need to know about pharmacist's relative bargaining position in this age. Now predicting the future, I can give you as many wrong predictions that you're willing to pay me for, but my own is what is driving me to take a short-term immediate view on work now and in the near-term future (work while I can, while I have the ability to in the circumstances that are advantageous to me).
 
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Apotheker2015

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Jun 9, 2015
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Short Answer:
Whether or not they (the profession) took Flexner (https://en.wikipedia.org/wiki/Flexner_Report) seriously and satisfied enough demand while retaining quality. Medicine went a little too far with their supply shortage, dentistry arguably has grown organically along with DPM and veterinary and while it may not be perfect, it is reasonable, nursing is completely at the opposite end of the spectrum. (And yes, there is a tasteless joke that is made about the circumstances, but that'd get my post banned. :O).

Long Answer:
Look, professional education is not cheap for either you or the state. For dentistry at present and pharmacy in the old days, there was an extremely high capital investment per student due to the laboratory training requirements. Ask any dental student about finances, and they'll stress just as much if not more about their professional equipment costs than tuition. For pharmacists prior to the late 1990s, you actually had at least two major compounding laboratories (extemperous and sterile), one laboratory class in pharmacology where you made sure the rabbit died, one laboratory class in medicinal instrumental analysis where you were trained on USP or Remington validation techniques. If you were very "lucky", you had a class in medical botany or pharmacognosy. I know the numbers for a couple of pharmacy schools, Minnesota when I was a graduate student spent $16k per pharmacy student per year in addition to tuition (so 480 students across 4 years meant that it's a $7.6M taxpayer burden), and it still was the second highest tuition in the country after UCSF. You have to thank the generous taxpayers in your state for subsidizing your education (and even for really red states, there is still a substantial amount of state support for professional education).

If you think pharmacy was bad about the support needs, dentistry is far, far more structurally intensive than pharmacy. Medicine actually even more so, to the point that no medical school can do it alone and this includes private schools, they depend on handouts from CMS DGME and to a lesser extent IME for keeping afloat alongside some hospital. Veterinary was always the most expensive (equine and exotics) and depends on DoA funding to stay afloat. This is partly the reason for why the schools are not as distributed. Without state support, the school has to pass on the costs to the student. This is easily possible in nursing because there is not a large structural requirement. It was not easily possible in pharmacy until recently. The oldest private schools, USP, Drake, Creighton, are all really special cases where they had enough research, intellectual property (USP's IP royalties and corporate stock ownership make it such that it is a pharmaceutical corporation that just so happens to run a pharmacy school), and endowments to offset the tuition enough that charging the equivalent of $60k/year now was possible. But that all changed with the curriculum reforms.

Do you know what Remington's is used for? Can you deal with the instrumental analysis to determine quality of a synthesized med? Can you use an industrial tablet machine wet process? Can you make digoxin from digitalis? Yeah, most of that knowledge is completely useless in the modern sense, and so curricular reforms changed to eliminate most of the more outrageous matters. A fad also caught on where clinical pharmacy was the wave of the future starting with a guy in UCSF named Francke and continuing from the 1970s through the present (yes, if you read Whitney lectures from about 1978 or so until today, notice how they all remarkably say the same tired future of pharmacy practice where the major changes have been making pharmacists far more efficient about their work than before). I'm not saying that this should be taught again to the undergraduates, but I do think that the lessening of the cost to train made it possible for private pharmacy schools to operate and pass on the entire costs of training to students. Yes, these curricular reforms were absolutely necessary as a pharmacist buys their products not makes them or has to verify the actual quality of the drug analytically anymore, but it had a side effect of lowering the bar to entry.

This doesn't happen in medicine because of the necessity of getting CMS and NIH to fund part of the school, and that is still based on an ancient law defining hospital construction and provider estimation called Hill-Burton and the CMS Acts. It doesn't happen in Dentistry as often because the capital requirements are probably an order of magnitude higher than pharmacy's to open. It certainly doesn't happen in veterinary (in fact, there is some fears that there will be less student places in the future).

The other part of the story said above is that both pharmacy's nominal (actual dollar amount) and parity adjusted (in relation to other careers) has rapidly increased. Considering the salaries, it's possible to make good on even a fairly large loan. How far, who cares from an academic standpoint? We already have the tuition money if it's a private school. For a public school, this will come back to haunt you later.

What is really funny to me is that LB (the Chapman dean) probably sat in the same room as the Minnesota SAPh grad students all did, heard either Linda Strand or Peter Morley lecture on this very subject (I believe this history of professionalism is the very first class in the very first semester of training to understand how pharmacy dug this hole for themselves and how other professions dug themselves out), and Lucinda Maine hearing it from Albert Wertheimer. They all know the game and actually could have done things to avoid this fate. They are completely aware in their part of contributing to the pre-Flexner sort of situation. That's fine, I'm sure it's lucrative for them. But, they all know what and where the hypocrisy of doing this is considering the actual future of the profession. I'm not going to answer LB directly because I understand enough why he would do this and I don't think it's a bad idea for him, but it's really disappointing that this modern generation of Minnesotan SAPh leadership will deservedly get a lot of the blame for going along with the trend knowing what will happen, because how does this story end any differently? We know the story, is this really our fate?

By the way, I want to stress this thoroughly. Dentists, physicians, and podiatrists are paid on piecework in most cases. Yes, their salaries are higher, but they do actually have to work for it. Now, a major trade secret in dentistry that few outside of the profession talk about is that rural dentists and small city dentists in General Practice in general make more money due to the CPT multipliers for the tradeoff that they live outside of a metropolis. That's the other part of the secret sauce that makes dentistry viable. Dentists not only have to be productive in personal ways (you can tell who a lazy/inept dentist is fairly quickly from practice fiscal audits), but have financially viable ways of practicing in remote areas. Pharmacists can hide themselves in the crowd in an institutional setting. That's why I like the retail metrics system and staffing models from a productivity standpoint. Yes, you can juke the numbers (in fact, everyone should be taught how to "optimize" KPI's since it makes your life, the DM's, and the corporation's life easier), but that's much harder in hospitals.

Medicine did take it too far in the other direction in terms of being too short, and NP's really changed the dynamics of the work situation (for the better). That's not my story to tell, read Social Transformation of American Medicine for the better story (or not depending on the final comments).

If you really want to solve pharmacy, the conclusion that most of us had come to is that if you have that sort of angst, you leave it. There's a couple of ways, using that intelligence to become a capitalist and get rents on capital, changing to another profession where people care a bit more about their self-interest, etc. I'm neither intelligent or driven enough to leave it, so I'll always be here (plus, I do like the work and for what I do if I practiced pharmacy normally, there's no other profession that can sensibly take that work away from me).

Learned Answer:
We are the healthcare profession equivalent of Purgatory, suffering the consequences for our sins, never achieving the promised land (medicine), nor descending into the inferno (nurses), but always hopeful that there's a better deal than what we have and knowing that there is a reason for our suffering even if we don't know precisely what. You're in a profession that's neither terrible enough that only the strong survive, passionate enough that it can reinvent itself, intelligent enough to prove itself unique except for the tasks that everyone else loathes (drug preparation and dispensing), or courageous enough to take the risk of doing things for the right reasons even if they risk professional judgment. Pharmacy is a profession that has never been a full profession, and the work circumstances are such that they are good enough for you to stay and not terrible enough to move on. Scale that up, and that's why the future of pharmacy is and will be always the same as its present, concerned for an individual and comfortable livelihood with limited on-the-job responsibility and almost none outside the job. Anyone who does not really find solace in that never satisfied always looking will move on. The moment you understand that these limitations are as much your professional peers as well as yourself, you can start making peace with not only the direction, but the progression of the problems in pharmacy and that life is too short to worry about something that is a structural problem.

And if you want to know why I'm a civil servant and not a full academician, I really do want to make a difference if only minor. But that difference is not for the profession, it is really for how the system works. Academicians are blind to the way the profession has worked (the pedagogy criticism is that PharmD training is now about training about the idealized and thoroughly fictitious practice of clinical pharmacy than how to be a pharmacist for CVS or VA or Omnicare which are actual jobs). What you observe, trust me, you know the trends that you can see and understand. You do not need to trust a paper when seeing your new grad colleagues get shafted on a 40-hour workweek involuntarily should give you all that you need to know about pharmacist's relative bargaining position in this age. Now predicting the future, I can give you as many wrong predictions that you're willing to pay me for, but my own is what is driving me to take a short-term immediate view on work now and in the near-term future (work while I can, while I have the ability to in the circumstances that are advantageous to me).
Anyone else wanna buy Lord999 a drink or 5? Great post! Very insightful. There is even a reference to Dante's Divine Comedy. Very nice.
 
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rph3664

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A good friend of mine, god bless him, has been a retail pharmacist for at least 20 years and a preceptor for at least 10 years. Just recently I asked him his thoughts on Truvada and if he had a lot patients on it. He had no idea what I was talking about. he actually thought that he was dispensing Truvada as monotherapy to treat HIV.
There are many places where it's very likely that the pharmacist has never seen an RX for Truvada, and if s/he hasn't done much in the way of HIV CE's, s/he may not know what it is. I've certainly heard of it but had to Google it so I would know EXACTLY what it is. Truthfully, I know more about early 1990s HIV therapy than I do about current therapy.
 
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Apotheker2015

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There are many places where it's very likely that the pharmacist has never seen an RX for Truvada, and if s/he hasn't done much in the way of HIV CE's, s/he may not know what it is. I've certainly heard of it but had to Google it so I would know EXACTLY what it is. Truthfully, I know more about early 1990s HIV therapy than I do about current therapy.
I can see that, of course. That's all part of staying current. We all know that the second we grabbed that diploma portions of our knowledge started to slowly become outdated. During my 4th year, I had 3 rotations that happened to in a retail environment. It tried my best to take home most days of the week a package insert of a drug I was not very familiar with. I wouldn't always go through the entire thing. I would skim through the main sections just to be more familiar with them. I still do it every now and then with new drugs. I want patients to trust me whenever I tell them anything about their meds.

I guess I have an issue with handing out medications I do not know. That's something that they drilled in our heads in school. I just won't. But then again, that's just me.
 
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TheBlaah

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I honestly don't know where you're getting 80k from, even in Georgia.

As your feelings of inferiority, that seems more like a personal problem. There will always be people who are smarter, who make more money, who are simply better. While becoming a pharmacist definitely won't help, this is really something you just need to let go.

As for the second half of your post, there's no magical breakpoint in terms of salary for when it becomes worth earning a degree for an individual. It's really about time you stopped being so indecisive though. You've already spent several years in AA school. Switching to another career path at this point would mean wasting another year to pursue uncertain prospects. Also, I'm not certain how you failed AA, but I would hazard a guess that would preclude you from matriculating into medical school, not to mention graduating. In light of this, just consider whether whatever caused your failure would be more prevalent in pharmacy school or dental school.
 
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gwarm01

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I can see that, of course. That's all part of staying current. We all know that the second we grabbed that diploma portions of our knowledge started to slowly become outdated. During my 4th year, I had 3 rotations that happened to in a retail environment. It tried my best to take home most days of the week a package insert of a drug I was not very familiar with. I wouldn't always go through the entire thing. I would skim through the main sections just to be more familiar with them. I still do it every now and then with new drugs. I want patients to trust me whenever I tell them anything about their meds.

I guess I have an issue with handing out medications I do not know. That's something that they drilled in our heads in school. I just won't. But then again, that's just me.
Another issue is that you tend to specialize in your patient population over time. I learned so much more about pediatric critical care on the job than I did in pharmacy school, but I don't know that I've ever seen an HIV patient and certainly would need to do some research if it came up. Luckily you usually have time to research unusual medications and circumstances in a hospital. I bet it's pretty tough working retail where a new drug could come out every single day that someone, somewhere wants to prescribe.
 
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awval999

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Regarding the $80k figure -- from what I have read and been told, that is what hospital pharmacists (including those who have completed residencies) are starting out at in the mid-sized cities outside of Atlanta. In fact, the mention of a $38/hour salary (which is approx. $80k/year) in the thread title is what piqued my interest in this thread in the first place. Just out of curiosity, what kinds of salaries are hospital pharmacists starting out at in your city?

At this point, I really regret not making it through the AA program (which I was only in for 2 semesters, BTW). Now that it has been almost ~9 months since I failed out of that second semester, I feel like I definitely could've passed if I had put in just a little more effort. Technically, I only failed because of 2 significant mistakes that a little more practice would have prevented me from making. I do wish that the school had been in a different area.... to be honest, I just hated living in such a crowded area, and I just didn't like the "feel" (hard to explain) of where I was, and I think I let it get to me. Of course, if I had just sucked it up and done what I needed to do, I would have moved out of the area by now and started full-time clinicals. But now, I realize that I'm on track to condemning myself to suffering through a much more unpleasant fate.

Aside from pharmacy school, I have also been considering both medical and dental school, but I have started to lean towards pursuing dental school over the last few months. I actually had an advising appointment with my state dental school last week, and they told me that I should have a decent chance of receiving an interview invitation if I spend two semesters taking at least 15-20 credits per semester of upper-level science courses and score highly on the DAT. However, like you said, there is still a great deal of uncertainty involved with applying to dental school, especially if someone is hellbent on staying in GA, which only has 1 dental school. I know a guy who is in an oral surgery residency program now, but it took him 3 application attempts to get accepted to the state school. I believe he was around 30-31 years old when he finally got accepted. On the other hand, there are at least 2 or 3 relatively new private dental schools that I'd have pretty good chances of receiving interview invitations to, but they're expensive (then again, so is pharmacy school). For someone in my situation, I guess it just depends on how much time someone wants to spend to achieve a particular goal.

In response to your other point -- I understand that there will always be people who are smarter and more successful than me (obviously), but the question is... are all dental residents geniuses with 150+ IQs? Or are some of them on my level (whatever that means)? When I graduated with my biology degree a few years ago, I had a 3.6 GPA, so on paper, wouldn't I have been considered a fairly typical, likely-to-be-successful dental (or even DO school) applicant? And if I had studied hard in dental school and graduated in the top 30% of the class, maybe I wouldn't have gotten accepted to an oral surgery or orthodontics program, but what about residency programs like endodontics, periodontics, etc.? All I'm trying to say is -- yes, many of the dental residents I used to pass on my way to/from AA school are probably smarter than I could ever be, but I bet some of them had to study just as much as I'd have to study if I got accepted to dental school. I just have the feeling that there's no reason I shouldn't be one of them right now. I really don't think I'll be ever to just let it go unless I bite the bullet, apply to every private dental school in the US, and put my money where my mouth is.

Anyways, to keep the thread on topic, I've also noticed that retail pharmacy companies have slashed salaries in various ways over the last year or so as well. For example, I was told that Walmart used to offer a $50 bonus payment to any pharmacist who works on a Sunday, but in April or May (I think), they did away with that policy and now pay pharmacists who work on Sundays what they pay pharmacists who work on any other day of the week. A pharmacist I know who works PRN shifts said that this amounts to an instant $3k-$5k/year paycut for pharmacists who normally work every Sunday of the year. Also, I heard that CVS used to pay a decent shift differential to overnight pharmacists, but it has now been reduced to something like $5/hour for only a few hours per shift. I wonder what kinds of cuts other retail pharmacies (especially the "better to work for" companies like Publix) will make....
PGY-1 graduate starting salary of $104k in NE Ohio.
 

bulldog1123

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Definitely better than $80k; just out of curiosity, though, is that approximately what you expected to be offered out of residency, or were you expecting more?
TheBlaah is from Atlanta, GA (and if I'm not mistaken I think he practices there too) and I am as well and I have to agree with TheBlaah. Not sure where you are pulling 80k from but I have seen and heard much different. Atlanta itself is much more saturated and all the clinical or hospital pharmacists I have spoken to make more then that and salaries are even better is mid level towns outside of Atlanta since they have a little harder time filling depending on how far out you go from Atlanta. Areas like Tifton, Valdosta still even offer signing bonuses for retail.
 

awval999

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No, that is not my salary.

That is the salary that we offered our current resident who we signed on this summer.
 

gwarm01

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When I was working at a large health system in Florida we had a clinical pharmacist making $38/hour. I don't know the circumstances behind that rate, but I do know I was offered $42/hr in 2013 and by the end of 2015 I had friends that started there at $46/hr. Considering how unhappy I was with my pay, I can only imagine how that person felt.
 

rxdawg21

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The only hospital I know of in Georgia paying in the 80k range is/was medical center in Macon and that was for a staff pharmacist. Granted I do not know the salaries of a lot of hospital pharmacists, but find it hard to believe 80k is typical in Georgia.
 

gwarm01

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The only hospital I know of in Georgia paying in the 80k range is/was medical center in Macon and that was for a staff pharmacist. Granted I do not know the salaries of a lot of hospital pharmacists, but find it hard to believe 80k is typical in Georgia.
I've seen some nearly that low. My alma mater releases yearly employment surveys of the graduating class, and I routinely see the low end of hospital salaries being in the mid-80's, and the high end being >$120k. I'd be interested in seeing the breakdown of for-profit vs non-profit, academic vs community hospitals and other factors. My completely baseless view has been that private, for-profit hospitals will pay a higher salary. It seems like the big name, university affiliated, more prestigious hospitals will pay less because people want to work there just for the name. I don't know if that is actually true or if it has just been a few fringe cases I've seen.

Right now it seems like you can get more pay if you are willing to go to a more rural location because they have trouble drawing applicants. With my current job, I moved from a larger metropolitan area to a much smaller and less desirable one and increased my pay by about $5/hr. I work per diem at a smaller hospital about an hour away from here, even more rural, and the pay is about $15/hr more than I make at my full-time job. That's a big boost even for PRN rates.

I wonder if we will ever see a reversal, where the big university hospitals are willing to pay a premium for more qualified and talented candidates? As saturation worsens and low quality students graduate from low quality schools, will these big name hospitals pay top dollar for the best pharmacists? The cynic in me says no, but who can tell.
 

Humble Sloth

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I've seen some nearly that low. My alma mater releases yearly employment surveys of the graduating class, and I routinely see the low end of hospital salaries being in the mid-80's, and the high end being >$120k. I'd be interested in seeing the breakdown of for-profit vs non-profit, academic vs community hospitals and other factors. My completely baseless view has been that private, for-profit hospitals will pay a higher salary. It seems like the big name, university affiliated, more prestigious hospitals will pay less because people want to work there just for the name. I don't know if that is actually true or if it has just been a few fringe cases I've seen.

Right now it seems like you can get more pay if you are willing to go to a more rural location because they have trouble drawing applicants. With my current job, I moved from a larger metropolitan area to a much smaller and less desirable one and increased my pay by about $5/hr. I work per diem at a smaller hospital about an hour away from here, even more rural, and the pay is about $15/hr more than I make at my full-time job. That's a big boost even for PRN rates.

I wonder if we will ever see a reversal, where the big university hospitals are willing to pay a premium for more qualified and talented candidates? As saturation worsens and low quality students graduate from low quality schools, will these big name hospitals pay top dollar for the best pharmacists? The cynic in me says no, but who can tell.

Big university hospitals don't have to pay a premium to get talent. With the massive surplus of pharmacists being minted they can even lower salaries and the competition will remain. I see salaries for retail averaging around 80k in 2020 and hospital pharmacists around 55k. More and more hospitals are having techs check other techs work with the same accuracy as a pharmacist. Make as much money as you can now before peak saturation.
 

gwarm01

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Big university hospitals don't have to pay a premium to get talent. With the massive surplus of pharmacists being minted they can even lower salaries and the competition will remain. I see salaries for retail averaging around 80k in 2020 and hospital pharmacists around 55k. More and more hospitals are having techs check other techs work with the same accuracy as a pharmacist. Make as much money as you can now before peak saturation.
My plan is to squeeze as much cash out of the IT consulting sector as I can before it all goes to hell. Then I sell all assets and move to a cheap U.S. island territory, only to be killed by some sort of natural disaster. It seems like a safer choice than continuing pharmacy.
 

rxdawg21

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Wow, that's low. I was offered 105K in 2011 as a new grad before shift diff.


Edit: in NE Ohio
My understanding is salaries have stagnated or declined some since 2012ish. Personally in retail I knew a DM tell me how they lowered their offers to new grads by 5-10k from 12 to 13.
 

gwarm01

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Just curious, what hospitals in GA are offering >$120k to start? As stated above, several of the mid-sized cities in GA are paying in the $80k-$85k range (unless I'm being lied to by pharmacists I know IRL), including Macon, Columbus, Albany, and Savannah. According to the online residency directory, the hospital in Columbus that has residencies is pushing critical care and ambulatory care PGY-2 residencies now. I'm not sure if they're requiring that a pharmacist complete a PGY-2 residency in order to get hired, but a pharmacist who used to work in Columbus told me that they recently started requiring PGY-1 residency completion. But if they are requiring a PGY-2 these days to get hired as an entry-level hospital pharmacist... that's 6 years total (4 years of Pharm.D. school + PGY-2) to make an $85k salary. WTF? Why are so many pharmacy students competing for these jobs & residency slots? Is it because they actually want these jobs, or are they just desperate to avoid/escape retail?
I can't speak for Georgia since I went to school in Arkansas. Here is a link to their 2016 salary survey: http://pharmcollege.uams.edu/files/2016/08/UAMS-Salary-Survey-2016.pdf

Pay range for hospital jobs (not including residency): 90,000 - 127,920.

In my experience it is typically the hospitals in smaller towns that offer higher salaries because nobody wants to live there.

$127,920/year will let you live like a king. Compare that to salaries in the low 90's in the Miami area with a much higher cost of living. Of course, you always have to balance the quality of life provided by the region you choose to live.
 

bulldog1123

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To me, I think it seems like a case of what people refer to as "diminishing returns"; to state it another way, it's not that I think $85k is a low income on its own -- it just doesn't seem like a worthwhile return for 6 years of school and residency. I've always been the kind of person who likes to make profession-to-profession comparisons (obviously), and when the local newspaper runs a story discussing how graduates of the local technical school's 3-semester dental hygiene program are making close to $80k+ bonuses and benefits in their first jobs, it just makes it hard to feel excited about making the same or marginally more money after going $200k+ in debt (not even considering the $65k of debt I have from the AA school life mistake) and spending 5-6 years in school/residency. Also, the comparison can be made based on the investment of time as well -- I.e., if someone is going to spend 6 years in school/residency to become a hospital pharmacist making $90k, what other professions could they achieve entry to if they are willing to spend that much time in school (and so this is where the comparisons to dental and medical school come in). I'm surprised more people don't have this perspective.
PAtoPharm, I am really confused in what you are trying to achieve here. Its well documented here that after you failed out of AA school you are looking for a different path to pursue which is expected and understandable. You started to consider Pharmacy hence you name. But the weakening job markets disillusioned you so you have set you sights on dental school. Again, I applaud you for wanting to overcome your stumble in AA school and set on a strong career path. But you've beaten the proverbial dead horse to the grave. You bring up the lowest salary ranges for Pharmacy yet now that you've set your sights on dental school you use their top salaries for positions like orthodontics and oral surgery as examples of why their market is strong and its a better path. You can't have it both ways. If you want to approach it that way, why not bring up the salary of nuclear pharmacists or compounding, both of whom I have seen make upper 100k in GA and in states up north, breaking 200k (and this is from personal relationships, not from the grape vine). Again, I don't disagree with you that dental's outlook is better then pharmacy, but why do you keep coming back to mention that when its clear you've starting to lay the foundation for your journey to dental school? We get it, you have loans for AA school and taking out additional loans for pharmacy is not worth it.You say its hard for you to be excited for a 85k job after 200k in loans + 6 years invested. But havent you already began working on dental school, so why are you even focused on Pharmacy anymore? Its time to move on and focus on dental if that is your ambition. Best of luck to you and hopefully you don't look at this as a personal attack as that is not my intention.

*EDIT* If you are still considering pharmacy, then by all means ask away. As being a P1 in GA, your questions have been insightful to me as well. But repeatedly asking the same question in different formats isn't going to change the market from how it is right now.
 

gwarm01

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When making your profession-to-profession comparisons you should always consider the intangibles. I did four years of pharmacy school at a relatively inexpensive state school, have $140k in loans which is high but manageable. Without a residency I was able to get a job in my preferred field of pediatrics, put in a few years of bad shifts and willingness to volunteer which gave me a lot of experience, and now I'm in a comfortable, more administrative role making >100k, work standard office hours, no holidays or weekends, no on call. I bring in an extra $20k by working one weekend a month at a second hospital. It's not perfect and the job market is abysmal, but I still maintain that the right person with the right attitude and ambition can be successful in this field.
 
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bulldog1123

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When making your profession-to-profession comparisons you should always consider the intangibles. I did four years of pharmacy school at a relatively inexpensive state school, have $140k in loans which is high but manageable. Without a residency I was able to get a job in my preferred field of pediatrics, put in a few years of bad shifts and willingness to volunteer which gave me a lot of experience, and now I'm in a comfortable, more administrative role making >100k, work standard office hours, no holidays or weekends, no on call. I bring in an extra $20k by working one weekend a month at a second hospital. It's not perfect and the job market is abysmal, but I still maintain that the right person with the right attitude and ambition can be successful in this field.
and you sir give me the confidence that if I have the determination and drive, this profession can give me what I am looking for. Nothing will be handed to me.