Residency/Fellowship

[toshpharmd]

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I've been reading a lot about the optional residency and fellowship options after pharmacy school. Can someone elaborate on how these additional training years will benefit you as a pharmacist (or is it something to break into industry/academia)?

 

[zelman]

I've been reading a lot about the optional residency and fellowship options after pharmacy school. Can someone elaborate on how these additional training years will benefit you as a pharmacist (or is it something to break into industry/academia)?

It's a scam.

 

[confettiflyer]

Just as a preemptive warning, there are a lot of bitter people on these forums that will call residency/fellowship a scam or unnecessary. Be sure to keep that in mind that while there are legitimate critiques out there, most of the time it's bitterness (at least on these forums).

That said, residency is only useful if it's paired with a high functioning pharmacist. Residencies don't magically make people into upstanding clinicians or even people. If you were a dumb a-hole who interviews well going into residency, you're going to be a dumb a-hole who interviews well after residency.

For me, it opened doors in that it allowed me to train and gain experience without an employer "taking a chance" on me right out of school. No one in their right mind today would hire an oncology pharmacist or a critical care pharmacist right off the bat, but hey, there I was in both of those settings during residency soaking it up and getting training. I got to make mistakes, be stupid, and all the things a first year pharmacist gets to do, but what that turned me into was a decently serviceable pharmacist and my new employer could say to him or herself, "Hey that guy was nice and he looks residency trained, so he got all the stupid 1st year mistakes done already, let's hire him!"

Of note, it's virtually impossible to get an inpatient clinical job in the San Francisco Bay Area without completion of a PGY-1. Virtually, not completely, and we did just hire a non-residency trained pharmacist (one of our in-house interns) to a hard-to-fill position.

Also remember it's job and geography dependent. If you want to be a critical care pharmacist at Ronald Reagan/UCLA in Los Angeles, it's pretty much going to be PGY-2 or equivalent experience.... or bust. If you want to be a general pharmacist at a 25 bed critical access hospital in Clear Lake, CA, and that's your dream job....residency is unnecessary.

I had a clinical job lined up on the east coast and I opted to do a residency on the west coast. Why did I do it? I wanted to be back in California, and residency was my fast track back (I would have stayed on 3-4 years at that first job, taken BCPS, and jumped west after that). My income differential my 1st year practicing after PGY-1 vs. what I would have made at my first job was +$42,000/yr, it's now +$75,000/yr based on estimated hourly rates put forth by SDN members for inpatient jobs in the mid-Atlantic region. My residency paid a bit over $50k/yr at the time (much more now), and so I pegged my break even point at roughly 2.5 years (which was 2.5 years ago, oddly enough)

So it worked for me, financially and personally. It doesn't work for everyone that way.

 

[Lnsean]

it started as a scam but so many people are in on the scam now that you will also need to be in on it too just to be competitive

 

[Dred Pirate]

confetti put it best - there is a role - and it is beneficial - but there are some bitter people out there - I am NOT residency trained (but the only way to get my job now is to be residency trained + 3-5 years experience or have no residency but 10 years residency), but I hire and train residents. Depending on your location and desires - they is a need to do one in order to get a hospital job. If your plan is retail (which is still the majority of RPh's) - Don't waste your time unless it is some sort of uber specialized corporate gig.

Tell us more about what your goals are and location?

 

[toshpharmd]

Just as a preemptive warning, there are a lot of bitter people on these forums that will call residency/fellowship a scam or unnecessary. Be sure to keep that in mind that while there are legitimate critiques out there, most of the time it's bitterness (at least on these forums).

That said, residency is only useful if it's paired with a high functioning pharmacist. Residencies don't magically make people into upstanding clinicians or even people. If you were a dumb a-hole who interviews well going into residency, you're going to be a dumb a-hole who interviews well after residency.

For me, it opened doors in that it allowed me to train and gain experience without an employer "taking a chance" on me right out of school. No one in their right mind today would hire an oncology pharmacist or a critical care pharmacist right off the bat, but hey, there I was in both of those settings during residency soaking it up and getting training. I got to make mistakes, be stupid, and all the things a first year pharmacist gets to do, but what that turned me into was a decently serviceable pharmacist and my new employer could say to him or herself, "Hey that guy was nice and he looks residency trained, so he got all the stupid 1st year mistakes done already, let's hire him!"

Of note, it's virtually impossible to get an inpatient clinical job in the San Francisco Bay Area without completion of a PGY-1. Virtually, not completely, and we did just hire a non-residency trained pharmacist (one of our in-house interns) to a hard-to-fill position.

Also remember it's job and geography dependent. If you want to be a critical care pharmacist at Ronald Reagan/UCLA in Los Angeles, it's pretty much going to be PGY-2 or equivalent experience.... or bust. If you want to be a general pharmacist at a 25 bed critical access hospital in Clear Lake, CA, and that's your dream job....residency is unnecessary.

I had a clinical job lined up on the east coast and I opted to do a residency on the west coast. Why did I do it? I wanted to be back in California, and residency was my fast track back (I would have stayed on 3-4 years at that first job, taken BCPS, and jumped west after that). My income differential my 1st year practicing after PGY-1 vs. what I would have made at my first job was +$42,000/yr, it's now +$75,000/yr based on estimated hourly rates put forth by SDN members for inpatient jobs in the mid-Atlantic region. My residency paid a bit over $50k/yr at the time (much more now), and so I pegged my break even point at roughly 2.5 years (which was 2.5 years ago, oddly enough)

So it worked for me, financially and personally. It doesn't work for everyone that way.

Besides retail, anything else would require a residency/fellowship?

 

[Dred Pirate]

Besides retail, anything else would require a residency/fellowship?

not exactly - we have hired new grads into staff positions, as have other near by hospitals. A lot just depends on what you want to do - and where you want to do it.

 

[toshpharmd]

Depends a lot on timing/need - I got into a hospital as a new grad. We have hired residency trained, new grads, and straight retiail pharmacist for staff position - but we prefer residency or experience greatly

If you don't mind, can you share the region your talking about.

 

[zelman]

Didn't you get BCPS and a MS degree in an attempt to get out of retail?

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Yup. But the smart move would have been to work in a hospital throughout school.

 

[toshpharmd]

Yup. But the smart move would have been to work in a hospital throughout school.

Are hospitals usually hiring pharmacy students in their 1st & 2nd years? And what kind of work would you do working there?

 

[zelman]

Are hospitals usually hiring pharmacy students in their 1st & 2nd years? And what kind of work would you do working there?

Yes. And it doesn't matter. It's just a foot in the door. But it would be refilling dispensing cabinets and making IVs mostly.

 

[confettiflyer]

Yes. And it doesn't matter. It's just a foot in the door. But it would be refilling dispensing cabinets and making IVs mostly.

I once spent 6 hours manually cutting metoprolol tablets in half.


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[owlegrad]

I once spent 6 hours manually cutting metoprolol tablets in half.


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We have a machine to do that, which for some reason very few of the techs like to use. Personally I love it!

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[lord999]

For one specialized matter, it is a must:
1. Nuclear (although good luck finding a job) but you're more or less at full pay while in "training". The "must" comes from the legal mandated hours for the RSO and the qualification hours to take the BCNP.

For two other matters, to not have one or a postgraduate degree is so rare, I've never heard of anyone getting a job past 2000 with just basic qualifications.
2. Fellowship or MBA Day School for industry
3. Laboratory head/PI for industry

Everything else, I agree it's what you make it (and I still think it's a scam as most residencies suck as one of these factors is gone), but there's a couple of other pieces of the puzzle.
1. You have to do the work
2. You have to be a place where actual work happens (so too light or too narrow a practice focus tends to not work)
3. (Downplayed, but is actually a decisive factor) You have to have people willing to train you and willing to risk and accept your bad practice until you get better.

Item #3 is what I'd look for in a postgraduate program, but so many residencies now turn it into a hierarchy hazing experience that education is only an afterthought.

If you're willing to do the work, a residency is just a paper credential, you'll do just fine. For those who don't want to do the work , the credential is the necessity.

 

[confettiflyer]

We have a machine to do that, which for some reason very few of the techs like to use. Personally I love it!

Sent from my SAMSUNG-SM-G920A using SDN mobile

Haha, apparently spending 6 x $15/hr = $90 on an intern was a better value proposition than using a machine.

I also occasionally ran up a stat med...beat that, robot army!


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[owlegrad]

Haha, apparently spending 6 x $15/hr = $90 on an intern was a better value proposition than using a machine.

I also occasionally ran up a stat med...beat that, robot army!


Sent from my iPhone using SDN mobile app

I mean the machine was only like 5k dollars, requires constant attention/maintenance such that parts+labor are probably> than just using a pill splitter, and the output is far from a consistent 1/2 tablet, so you tell me what the better value proposition is. 😛

Even with the near constant need to clean and service the machine (the filters and blades alone need to be replaced every 10k tabs or so), I still prefer that to doing it by hand (obviously I don't literally have to do it by hand myself, I do have a veritable army of technicians who can do it, hopefully you know what I mean). The most annoying part is when you get a 3/4 tablet or you keep getting the "multiple pills in sensor area" error message. Oh, or when you scan the bottle and the machine informs you that the NDC isn't recognized. Thanks Bullseye, very helpful.

Still nothing beats watching the machine reduce a thousand count bottle of metoprolol to 2 thousand half tabs in about the time it takes me check 100 scripts or so. When it works it is a thing of beauty. If only my automated pill packer could handle half tabs, my life would be grand. (I actually hate the automated pill packer with a passion. It is such a great idea but I can almost never get it to output a properly bubbled card. There are nearly always bubbles with multiple pills or empty bubbles. Grrrrrr, Arg.)

 

[gwarm01]

Haha, apparently spending 6 x $15/hr = $90 on an intern was a better value proposition than using a machine.

I also occasionally ran up a stat med...beat that, robot army!


Sent from my iPhone using SDN mobile app

No tube system? You poor thing..

 

[confettiflyer]

No tube system? You poor thing..

We did, but people hoarded tubes.


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[pharmasaurusRex17]

Just as a preemptive warning, there are a lot of bitter people on these forums that will call residency/fellowship a scam or unnecessary. Be sure to keep that in mind that while there are legitimate critiques out there, most of the time it's bitterness (at least on these forums).

That said, residency is only useful if it's paired with a high functioning pharmacist. Residencies don't magically make people into upstanding clinicians or even people. If you were a dumb a-hole who interviews well going into residency, you're going to be a dumb a-hole who interviews well after residency.

For me, it opened doors in that it allowed me to train and gain experience without an employer "taking a chance" on me right out of school. No one in their right mind today would hire an oncology pharmacist or a critical care pharmacist right off the bat, but hey, there I was in both of those settings during residency soaking it up and getting training. I got to make mistakes, be stupid, and all the things a first year pharmacist gets to do, but what that turned me into was a decently serviceable pharmacist and my new employer could say to him or herself, "Hey that guy was nice and he looks residency trained, so he got all the stupid 1st year mistakes done already, let's hire him!"

Of note, it's virtually impossible to get an inpatient clinical job in the San Francisco Bay Area without completion of a PGY-1. Virtually, not completely, and we did just hire a non-residency trained pharmacist (one of our in-house interns) to a hard-to-fill position.

Also remember it's job and geography dependent. If you want to be a critical care pharmacist at Ronald Reagan/UCLA in Los Angeles, it's pretty much going to be PGY-2 or equivalent experience.... or bust. If you want to be a general pharmacist at a 25 bed critical access hospital in Clear Lake, CA, and that's your dream job....residency is unnecessary.

I had a clinical job lined up on the east coast and I opted to do a residency on the west coast. Why did I do it? I wanted to be back in California, and residency was my fast track back (I would have stayed on 3-4 years at that first job, taken BCPS, and jumped west after that). My income differential my 1st year practicing after PGY-1 vs. what I would have made at my first job was +$42,000/yr, it's now +$75,000/yr based on estimated hourly rates put forth by SDN members for inpatient jobs in the mid-Atlantic region. My residency paid a bit over $50k/yr at the time (much more now), and so I pegged my break even point at roughly 2.5 years (which was 2.5 years ago, oddly enough)

So it worked for me, financially and personally. It doesn't work for everyone that way.

Agreed with you. If you intend to move to the west or eastern coast, especially northeast/mid-atlantic and California, .... it is almost impossible to get a pharmacist job inpatient/industry without residency or fellowship. That or you have to have connections into the system.

I had a full time clinical offer in Boston, but I ran back west. Why? Same reason, I wanted to be back on the west coast and residency was my easiest way of doing it without working the retail sector.