Personally, I would recommend fellowship and here is my somewhat very opinionated WHY on that
The Good: The growth and opportunity potential is endless given the ability to network and develop real skills that are in short supply. Especially with research skills you can more easily transition into a high paying, cushy, director position. You will have better quality of life. Pharma companies invest heavily in their fellows. You will likely learn a lot more transferable skills that can take you into a wide variety of clinical, research, commercial, and business settings. Your job opportunities after fellowship are incredible. Unlike after a PGY1 residency in which you are set up for not nearly as many opportunities. And there are plenty of new residents that go back into staffing or overnight positions. My personal opinion but that is TERRIBLE.
The Bad: It's 1-2 years of doing stupid work sometimes. You're not guaranteed good pay (that is very company specific). However, the range I have seen in fellowships easily outclasses what residencies typically pay. Depending on your boss, you can have a very good time, or a really crappy time. I've heard amazing stories and horror stories. You may have to move as most companies are on the east or west coasts. Unless you get a field job which is very difficult to get for a fresh graduate. It's a much smaller world in pharma (could be good or bad I guess). There are a lot more company politics at play in pharma than there is within a hospital or retail setting. There is a perception of being money hungry.
So here's the deal: If you care more about patients and taking care of others vs yourself and your family, go clinical (I'm sorry but there is some truth in that statement or I would never make it). Inpatient never closes so somebody has to staff the weekend. If your end outcome is to reap the benefits of seeing improved lives directly on a 1:1 level, go clinical. If you want to see improved outcomes at a population level, good quality of life, good job opportunities in a variety of settings, and positive financial growth over time (substantial pay raises, bonuses, stock options), go fellowship and pharma.
The challenge: Pharma knows it has good perks. It is very difficult to get into pharma but whenever you have the opportunity to start sooner (and are interested in that route) find a way to get in. My biggest regret is going the route that I did and not taking the approach to pharma sooner. After 1 year in a VERY nice residency, I can honestly say I would be willing to give up pharmacy to go into business (may not be what I actually do but is an option).
Edit: In may or may not be clear but I have a somewhat jaded and skewed view of pharmacy due to my experiences. Others may present differing opinions but what I will say is that only you can recognize your value. Are you working in a position that challenges you to grow and take on additional responsibility? Are you being adequately compensated for that responsibility? What are others with your current experience doing and how did they get there?
To OP: My message to you is to know your value and to always try and avoid doing a job that undervalues you or abuses your time.
