(Resolved and Ongoing): Transitioning PharmD to MD

[Kalaphin]

Hi there, recent member of SDN. I recently graduated and got my PharmD this May, and had originally wanted to do clinical pharmacy and tried to match for ASHP 2020. Didn't get it, but was still set on applying to pharmacy residency the following year. I talked to my preceptors who helped me write my LORs and asked them for help for next year's pharmacy residency programs early so that I could put in the work / get advice / increase my chances of getting matched for the following cycle.

Even more recently, however, a friend of mine recommended that if I like clincal so much I should look into becoming a physician, and as I started doing the research and looking into why I wanted to do clincal pharmacy so much I realized that what I really wanted to do was just be clinical in general.

Now I am at the point that I am definitely going to apply for med school next cycle, but I also don't want to drop my plans for applying to residency. If I get into residency this year, my last day as a resident will match up with my timeline of my first day as a medical student. And I don't want to miss the opportunity to learn more and gain more clinical skills that I know a PGY-1 could offer me.

This is all in my head right now and I don't know how to talk to my preceptors about this. I developed very strong relationships with two preceptors in particular and I don't want to destroy that relationship with them. I found my love for clinical BECAUSE I had those rotations, but at the same time, if I pursue med school, will they see me as the student who left pharmacy? I also wonder: am I being too greedy, pursuing a residency while applying for med school? Will my preceptors resent me for taking their time and taking a spot in a program that another student would have benefited from and stayed in?

I'm wondering if there are any other PharmD MDs that ran into the same issue, and I'm wondering, what you did and what happened? Any advice would be greatly appreciated.

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[FrkyBgStok]

Not a pharmacist but what is residency like? I know that there would have been almost no time to apply and interview for multiple med schools throughout my first year of residency. and what is it that draws you away from clinical pharmacy and into clinical medicine, because there is a whole lot of BS associated with clinical medicine that drains on your actual clinical time. I image it is similar in pharmacy so you may be leaving one thing for the same thing in another.

and personally, it does seem crappy to pursue a residency (from what I understand they are generally hard to get) taking a spot away from someone dying to do clinical if you have absolutely no interest in staying. and sure there is going to be learning in that year, but the benefit that you will have for medical school was long tapped out in pharmacy school. I sure as hell don't remember many mechanisms of action, and those that I do, it is out of my own curiosity and definitely not out of necessity. And I remember zilch about pharmacodynamics and pharmacokinetics. I am not trying to be a pharmacist as well.

 

[Kalaphin]

Not a pharmacist but what is residency like? I know that there would have been almost no time to apply and interview for multiple med schools throughout my first year of residency. and what is it that draws you away from clinical pharmacy and into clinical medicine, because there is a whole lot of BS associated with clinical medicine that drains on your actual clinical time. I image it is similar in pharmacy so you may be leaving one thing for the same thing in another.

and personally, it does seem crappy to pursue a residency (from what I understand they are generally hard to get) taking a spot away from someone dying to do clinical if you have absolutely no interest in staying. and sure there is going to be learning in that year, but the benefit that you will have for medical school was long tapped out in pharmacy school. I sure as hell don't remember many mechanisms of action, and those that I do, it is out of my own curiosity and definitely not out of necessity. And I remember zilch about pharmacodynamics and pharmacokinetics. I am not trying to be a pharmacist as well.

FrkyBgStok. You have a good point. I anticipate with COVID that our interviews will be mostly Zoom meetings rather than face to face, but if for some reason we are able to curb the pandemic, then yes, that would be a problem juggling interviews and residency work.

I personally don't think that there is a distinction between clinical pharmacy and clinical medicine. It's all health and science to me. And I think ignoring one or the other does a disservice to the patient. Sure you can have two people who specialize, but I'd like to approach the patient with both pharmacy knowledge and medical knowledge, and my pharmD has already prepared me for the former. I want clnical to keep building those skills. I'm not coming in with the attiude of leaving one practice for another. I'm coming in with the mindset that I will be adding on to what I already know about medicine and patient health.

I agree, it is pretty crappy, just wanted to confirm if other people thought this way. I don't know how much pharmacology is taught in medical school, but it seems from my rotations that it is very sparse. Can you elaborate about how med students are taught to choose drug therapies with the limited time they give you in medical school? And what would you say are the things medical school taught you that were the most important, seeing as there are some courses you think are BS?

 

[penicillinman]

Not exactly in your position, but I’m a PharmD in MS1. I practiced as a clinical pharmacist for 10 yrs prior to returning back to school. In short, if you are planning to go to medschool, skip the pgy1. There’s lots that goes into building a good app, and a good mcat score being one of the most important. Pick up a prn gig (it will likely end up paying you as much as you would earn in your pgy1) and you will have time to study for your mcat, as well as put in some extracurriculars. Shoot me a pm if you have any more qns about the process.

 

[FrkyBgStok]

Can you elaborate about how med students are taught to choose drug therapies with the limited time they give you in medical school? And what would you say are the things medical school taught you that were the most important, seeing as there are some courses you think are BS?

basically, we look at the meds we use and know those. I am in peds emergency medicine, so I know my handful of meds pretty well. kid comes in with nausea, ondansetron. I know the mechanism of action, I know the side effects, I know the concerns. oh he can't get zofran. lemme call pharmacy. antibiotics: lets use cephalosporins for example. I know cefazolin, ceftriaxone, cefepime, I know about ceftaz and couple more, and then their general oral counterparts (cephalexin, cefdinir) and know what they cover and what they don't. looking to cover something else that I am not that familiar with, lemme call ID or pharmacy. you have pain that isn't controlled by tylenol and ibuprofen but you want to avoid an opioid? I have toradol and that's it.

so I know a good chunk of those meds, but I can't tell you anything about the other cephalosporins because I don't prescribe them. I have never prescribed an oral antifungal for anything other than tinea capitis or thrush without ID first making the call. I am not trying to say that pharm courses are BS, but most just aren't needed for what I do. and an infectious disease doctor is going to have the lock on antibiotics, but they won't have any idea which medication is best for seizure prophylaxis. all of that is taught in residency and fellowship, not really in medical school. so you will have a leg up in pharmacology, but if you, as a pharmacist, were rotating in my peds ED, and recommended a different antiemetic that works better in this given situation, I am still going to call my own pharmacist because I have never prescribed it. or I am going to say, "nah lets do zofran."

 

[Dr Tapatio]

Hi there, recent member of SDN. I recently graduated and got my PharmD this May, and had originally wanted to do clinical pharmacy and tried to match for ASHP 2020. Didn't get it, but was still set on applying to pharmacy residency the following year. I talked to my preceptors who helped me write my LORs and asked them for help for next year's pharmacy residency programs early so that I could put in the work / get advice / increase my chances of getting matched for the following cycle.

Even more recently, however, a friend of mine recommended that if I like clincal so much I should look into becoming a physician, and as I started doing the research and looking into why I wanted to do clincal pharmacy so much I realized that what I really wanted to do was just be clinical in general.

Now I am at the point that I am definitely going to apply for med school next cycle, but I also don't want to drop my plans for applying to residency. If I get into residency this year, my last day as a resident will match up with my timeline of my first day as a medical student. And I don't want to miss the opportunity to learn more and gain more clinical skills that I know a PGY-1 could offer me.

This is all in my head right now and I don't know how to talk to my preceptors about this. I developed very strong relationships with two preceptors in particular and I don't want to destroy that relationship with them. I found my love for clinical BECAUSE I had those rotations, but at the same time, if I pursue med school, will they see me as the student who left pharmacy? I also wonder: am I being too greedy, pursuing a residency while applying for med school? Will my preceptors resent me for taking their time and taking a spot in a program that another student would have benefited from and stayed in?

I'm wondering if there are any other PharmD MDs that ran into the same issue, and I'm wondering, what you did and what happened? Any advice would be greatly appreciated.

You need to give your profession a chance. I imagine you have student loans from it too. Why in the world would you add 4 years of medical school and medical residency when you can start earning money? The grass isn't always greener

As for your preceptors, nobody has met them. Will some people resent you? Sure. Will some people understand? Sure.

You gotta start putting everything in perspective

 

[Kalaphin]

You need to give your profession a chance. I imagine you have student loans from it too. Why in the world would you add 4 years of medical school and medical residency when you can start earning money? The grass isn't always greener

As for your preceptors, nobody has met them. Will some people resent you? Sure. Will some people understand? Sure.

You gotta start putting everything in perspective

I did, I don't like where the profession is going. I don't have student loans. Because sometimes it's not about the money. Sometimes it's about getting a good education and helping people the best way you possibly can. Again, I'm not in it for the greener pasture. I'm in it to better myself and help a community that may need me in a "different field". If I was, I would just stay in my field as is. But I know that just having money isn't going to make me happy in the long run.

I understand that, and I've reconciled my feelings. Thank you for your opinions.

 

[Dr Tapatio]

I did, I don't like where the profession is going. I don't have student loans. Because sometimes it's not about the money. Sometimes it's about getting a good education and helping people the best way you possibly can. Again, I'm not in it for the greener pasture. I'm in it to better myself and help a community that may need me in a "different field". If I was, I would just stay in my field as is. But I know that just having money isn't going to make me happy in the long run.

I understand that, and I've reconciled my feelings. Thank you for your opinions.

Well, if you feel this strongly, then good luck in your journey. You're certainly not the first MD PharmD, so it's definitely a viable path. I think you should re-think residency in pharm and decide on medicine if that's really what you want. I understand having a backup is good, but I can't see it going that well with your preceptors unless they have a really good relationship with you where they'll support you regardless

 

[Kalaphin]

Ok guys, thanks for all the feedback and input. I've come to the decision to not pursue the residency while applying for med school because it would 1. take the spot away from someon else 2.be an enormous investment of time and energy which could be used better to build a stronger med school application. Thank you everyone for all for your advice, despite being a little defensive, I like receving critical feedback and listening to other people's perspectives besides my own.

With regards to telling my preceptor, I've resolved to tell them. It doesn't sit well with me that I can't trust myself to handle what they have to say. If it's good or bad, it's a lesson learned in what to do or not to do. Obviously I'll be sad if they become disappointed because I really respected them and their opinions and wanted to keep the relationship going long into my life. However I realize, it's not the end of the world, and I'd rather be honest than lie about something I am (at this point) pretty invested in to someone I have a lot of respect for.

Bless ya'll. Hope you are all safe. I'll keep you updated once I talk to my preceptor so you can know how it turned out.

 

[Kalaphin]

Hey, guys. Finally got the chance to talk to my preceptor about going to med school. The verdict - she was super supportive and understanding. Told me she also considered medical school if she didn't get into residency. She wants to me to keep her updated, and it looks like my fears were unfounded! Unless anyone objects, I'll keep letting you know how it goes through my journey! Bless y'all for all your advice! I'll keep you posted and keep this thread open to help anyone else who is going through the same thing I am. Advice from other PharmD MDs also welcome! Bless y'all and stay safe.

 

[Hannah1451]

Ok guys, thanks for all the feedback and input. I've come to the decision to not pursue the residency while applying for med school because it would 1. take the spot away from someon else 2.be an enormous investment of time and energy which could be used better to build a stronger med school application. Thank you everyone for all for your advice, despite being a little defensive, I like receving critical feedback and listening to other people's perspectives besides my own.

With regards to telling my preceptor, I've resolved to tell them. It doesn't sit well with me that I can't trust myself to handle what they have to say. If it's good or bad, it's a lesson learned in what to do or not to do. Obviously I'll be sad if they become disappointed because I really respected them and their opinions and wanted to keep the relationship going long into my life. However I realize, it's not the end of the world, and I'd rather be honest than lie about something I am (at this point) pretty invested in to someone I have a lot of respect for.

Bless ya'll. Hope you are all safe. I'll keep you updated once I talk to my preceptor so you can know how it turned out.

thinking about PharmD to MD too!! I am a new grad