This needs to be said- all of you who did a Residency were scammed

[NateRobinson]

Pharmacy Residency is the biggest scam in pharmacy school history. Why, you ask?

1. 8 years of pharmacy school total. Why not just go to medical school and become a doctor? ESPECIALLY considering getting in requires good grades and a high SAT score to begin with.

2. Graduating as a 24 year old and going into retail right away after 6 years of pharmacy school will automatically give you AT LEAST $115,000 per year STARTING at the big chains.

3. What do you really do once you get that almighty PGY-1 and PGY-2 added to you resume? Guess what kids? If you do another 2 years of residency, now you *MIGHT* be able to prescribe warfarin to some patients if the doctor gives you a standing order at the coumadin clinic!!!! Oh wait, Eliquis, Pradaxa and Xarelto came out now? Goodbye coumadin clinic!

4. Student Loan debt? Yes. Starts right after you graduate. Do you want to make $115,000 per year upon graduation or make about $38,000 per year as a resident while you're chasing that ALMIGHTY PGY-2?

I don't get it. I really, really don't. The funny part is deep down inside, you guys know that I'm right. You probably tried retail at one point in your lives, were scolded for being slow as hell, or not able to multitask, or move around fast enough. Maybe you thought helping patients or ringing out some front store stuff at the pharmacy was BENEATH YOU. When I was a PHARMACY MANAGER, I would help my techs at pickup all the time. Ring out whatever they wanted to buy. Stop being so god damn cocky. That's what drives everything- academia has fed you from day 1 that you're "Too GOOD" to just do retail, that you're too smart for that, that you should do a residency! And your feeble little minds believed it, and you actually did it.

I hate that kids in their 2nd year are being fed this bull**** garbage from day 1 in their pharmacy classes. Told that retail is evil and that its this, its that. MONEY drives everything in life, ladies and gentlemen. Do you really want to make $38,000 a year for 2 years as resident, and then top out at about $120,000 per year? Don't be fooled by the prospect of having an office or a conference room or whatever. At the end of the day, you're nothing. You're nobodies. What power do you have? You can't prescribe. All you do is make recommendations. I have the same exact power as you. No doctor will say "OH, HE HAS A PGY2, let me listen to him OVER THAT BASTARD PHARMD"!

It's complete bull****. Kids, the pharmacy world was, and always WILL BE dispensing. That's what we do. We dispense and we COUNSEL. Flu Shots are a welcome addition. I'm all for expanding our roles in the retail pharmacy world. But all of this residency bull**** is killing me. It's hurting our kids that are in pharmacy school right now. They are being lied to.

The only way I can see you going into residency is if you're rich, you do not want to become a doctor, but you want to spend 2 years of your life being a preceptors little bitch, sucking up like a little dog, and memorizing USELESS FACTS ABOUT DRUGS THAT YOU CAN JUST LOOK UP IN 5 seconds. Guess what? Doctors nowadays have this magic device called an iPad mini that they can slide into their lab coat, tap on a small little icon called an "app", type in the name of the drug they want information on, and have it all load up on their screen in a matter of 15 seconds.

When I had acute care, my preceptor would sit in the corner during the doctor's rounds and have us sit next to him. If the doctor's had a question, he would raise his hand like a god damn little dog all excited wagging his tail hoping they would call on him, so that he would answer their question and so that he would feel useful. 9 times out of 10, they would either not have a question, or they would ask it, but immediately look at their iphone or whatever, while my preceptor sat there pumping his arm into the air like "OOOOH OOOH PICK ME OH MIGHTY DOCTOR!!! I KNOW THE ANSWER!""

I can go on and on, but I'm going to stop here. Just thinking about my last sentence and how my preceptor used to sit in the corner of the room every morning just made me laugh out loud, and then shake my head at how god damn embarrassing that was. They all probably looked at him and us like "what are they doing here?"

STICK. TO. DISPENSING. GET. YOUR. MONEY.

---

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[rph3664]

Do you want to tell us what you really think?

When I was in school in the early 1990s, it was all about "pharmaceutical care" and TPTB tried to sell us all on the Pharm.D. degree, which was 2 years in addition to our 5-year B.Sc.Pharm. Maybe 10 people in my class did it, and most of them regretted it.

 

[NateRobinson]

Cool story bro. Really great information!

Sent from my LG-V521 using Tapatalk

I'm trying to save all the 3rd, 4th and maybe even 5th year students from the scam. If they're getting job offers from CVS/Walgreens for $115,000 PLUS per year, then take it and RUN.

Kids, do not fall for it. You're smarter than this. THE PEOPLE WHO ADVOCATE RESIDENCY ARE THE PEOPLE WHO RUN THE PROGRAM, ARE THE PEOPLE WHO ARE TAKING YOUR MONEY FOR TUITION. Have you ever thought of it in those terms? They don't give a **** about you or your career.

 

[NateRobinson]

Do you want to tell us what you really think?

When I was in school in the early 1990s, it was all about "pharmaceutical care" and TPTB tried to sell us all on the Pharm.D. degree, which was 2 years in addition to our 5-year B.Sc.Pharm. Maybe 10 people in my class did it, and most of them regretted it.

Exactly. Those 10 people spent all that money on the additional 2 years, and it got them what, exactly? My old Boss (pharmacy supervisor for CVS) had a regular pharmacy degree, not a PharmD. I would say 20% of my current pharmacists in my district do not have a PharmD. Residency is a scam.

 

[Michael_Scott]

I'm trying to save all the 3rd, 4th and maybe even 5th year students from the scam. If they're getting job offers from CVS/Walgreens for $115,000 PLUS per year, then take it and RUN.

Kids, do not fall for it. You're smarter than this. THE PEOPLE WHO ADVOCATE RESIDENCY ARE THE PEOPLE WHO RUN THE PROGRAM, ARE THE PEOPLE WHO ARE TAKING YOUR MONEY FOR TUITION. Have you ever thought of it in those terms? They don't give a **** about you or your career.

WTF!!!!!!! that is terrible ....once you go retail you never go back.....hospital pharmacy is soooo much better... residency may significantly help a person get a hospital job.

 

[lcow2004]

Retail has changed a lot over the years so it might not be the same anymore

 

[lcow2004]

Pharmacy Residency is the biggest scam in pharmacy school history. Why, you ask?

1. 8 years of pharmacy school total. Why not just go to medical school and become a doctor? ESPECIALLY considering getting in requires good grades and a high SAT score to begin with.

2. Graduating as a 24 year old and going into retail right away after 6 years of pharmacy school will automatically give you AT LEAST $115,000 per year STARTING at the big chains.

3. What do you really do once you get that almighty PGY-1 and PGY-2 added to you resume? Guess what kids? If you do another 2 years of residency, now you *MIGHT* be able to prescribe warfarin to some patients if the doctor gives you a standing order at the coumadin clinic!!!! Oh wait, Eliquis, Pradaxa and Xarelto came out now? Goodbye coumadin clinic!

4. Student Loan debt? Yes. Starts right after you graduate. Do you want to make $115,000 per year upon graduation or make about $38,000 per year as a resident while you're chasing that ALMIGHTY PGY-2?

I don't get it. I really, really don't. The funny part is deep down inside, you guys know that I'm right. You probably tried retail at one point in your lives, were scolded for being slow as hell, or not able to multitask, or move around fast enough. Maybe you thought helping patients or ringing out some front store stuff at the pharmacy was BENEATH YOU. When I was a PHARMACY MANAGER, I would help my techs at pickup all the time. Ring out whatever they wanted to buy. Stop being so god damn cocky. That's what drives everything- academia has fed you from day 1 that you're "Too GOOD" to just do retail, that you're too smart for that, that you should do a residency! And your feeble little minds believed it, and you actually did it.

I hate that kids in their 2nd year are being fed this bull**** garbage from day 1 in their pharmacy classes. Told that retail is evil and that its this, its that. MONEY drives everything in life, ladies and gentlemen. Do you really want to make $38,000 a year for 2 years as resident, and then top out at about $120,000 per year? Don't be fooled by the prospect of having an office or a conference room or whatever. At the end of the day, you're nothing. You're nobodies. What power do you have? You can't prescribe. All you do is make recommendations. I have the same exact power as you. No doctor will say "OH, HE HAS A PGY2, let me listen to him OVER THAT BASTARD PHARMD"!

It's complete bull****. Kids, the pharmacy world was, and always WILL BE dispensing. That's what we do. We dispense and we COUNSEL. Flu Shots are a welcome addition. I'm all for expanding our roles in the retail pharmacy world. But all of this residency bull**** is killing me. It's hurting our kids that are in pharmacy school right now. They are being lied to.

The only way I can see you going into residency is if you're rich, you do not want to become a doctor, but you want to spend 2 years of your life being a preceptors little bitch, sucking up like a little dog, and memorizing USELESS FACTS ABOUT DRUGS THAT YOU CAN JUST LOOK UP IN 5 seconds. Guess what? Doctors nowadays have this magic device called an iPad mini that they can slide into their lab coat, tap on a small little icon called an "app", type in the name of the drug they want information on, and have it all load up on their screen in a matter of 15 seconds.

When I had acute care, my preceptor would sit in the corner during the doctor's rounds and have us sit next to him. If the doctor's had a question, he would raise his hand like a god damn little dog all excited wagging his tail hoping they would call on him, so that he would answer their question and so that he would feel useful. 9 times out of 10, they would either not have a question, or they would ask it, but immediately look at their iphone or whatever, while my preceptor sat there pumping his arm into the air like "OOOOH OOOH PICK ME OH MIGHTY DOCTOR!!! I KNOW THE ANSWER!""

I can go on and on, but I'm going to stop here. Just thinking about my last sentence and how my preceptor used to sit in the corner of the room every morning just made me laugh out loud, and then shake my head at how god damn embarrassing that was. They all probably looked at him and us like "what are they doing here?"

STICK. TO. DISPENSING. GET. YOUR. MONEY.

Did you not match for residency?

 

[Momus]

Cool story bro. Really great information!

Sent from my LG-V521 using Tapatalk

Did you get the tablet for free? I got the $240 LG gpad for $20 total lol. I am gonna root it when I have some free time later.

 

[ldiot]

I agree with the OP but still dislike him. Plus all these wannabe doctors means a little less competition in retail.

 

[confettiflyer]

Can someone give me a tl;dr, I got through about a paragraph and realized it continued past that.


Sent from my iPhone using SDN mobile app

 

[gwarm01]

Can someone give me a tl;dr, I got through about a paragraph and realized it continued past that.


Sent from my iPhone using SDN mobile app

I made it to "PHARMACY MANAGER." It sounds like somebody had a bad day at CVS.

 

[Mad Jack]

Can someone give me a tl;dr, I got through about a paragraph and realized it continued past that.


Sent from my iPhone using SDN mobile app

I WORK RETAIL AND SO SHOULD YOU, BECAUSE I'M A MANAGER AND NOT GROVELING BEHIND SOME PHYSICIAN ALL DAY, RAWR.

That was the gist of it.

 

[rxdawg21]

That has to be the most uneducated post I have seen. I didn't do a residency and think residencies are ridiculous, but it is the new reality if you want to work hospital and clinical. I am at the VA and many pharmacists in ambulatory care etc prescribe for multiple disease states. Also at the VA you definitely max out at >120k even as a plain staff, with clinical pharmacists making more (at least at my VA). I did a few years in retail (plus 6 years (started at 18 and took 6 years to get PharmD).

Bottom line- If you are working at a chain retail store and think your salaries and current worklife (which usually sucks btw) is safe you are taking a major gamble (I am talking about people with >10 years left on their careers). Reimbursements continue to drop with little to no sign of a reversal happening and new pharmacy graduates are chomping at the bit to get on the hamster wheel of life and pay off those student loans while buying themselves new toys that further enslave them to the job. I would be genuinely afraid to bank my career on cvs/wags/ etc. Also I took a 25k pay cut (I'm making back a few k every year in higher pay raises) to not work weekends and get off at the latest 530 during the week with WAY less stress and boy has it been worth it.

 

[ldiot]

@rxdawg21

So to practice pharmacy at the top of your licence you must work for the government... where your compensation is taken forcefully in taxes. That's the problem... clinical pharmacy simply doesn't produce revenue. Until that happens nobody will see the explosive growth that has been predicted. Don't get me wrong pharmacists are underutilized and are fully capable... and I wish there were more positions like yours in the private sector. But the solution to the problem is not more education in the form of residency but rather progress on the front of reimbursement. Residency doesn't create jobs, it's just become an obstacle to get into a practice setting that has existed for decades (hospital). Obviously your case is an exception but if we want to create new jobs clinical pharmacists must be able to bring in revenue. Even in hospitals the justification for having a clinical pharmacist is purely cost savings... they don't bring in a dime.

 

[gwarm01]

I agree with some of what you are saying, but your presentation is terrible. You come off like you have a chip on your shoulder.

I agree that the whole clinical push in school is over the top. Every student gets the idea that they are going to be this super clinical specialist that does... ???? all day. Whatever it is, it doesn't involve order verification or dispensing.

I have dealt with plenty of students who speak down, even if subtlety, at pharmacists who are "just staffing" at the hospital, as if order verification, medication preparation and delivery aren't some of the most crucial operations in the hospital. Meanwhile those same students will be begging to get this "just staffing" job after they finish residency. Hopefully they then realize just how clinical every pharmacist can and should be, even if they aren't pushing a computer around on rounds.

I have only ever worked in the hospital setting because I prefer that environment, the type of work, and the lifestyle it affords me. It doesn't hurt that I got in without doing a residency so I didn't have that opportunity cost to deal with. I still respect retail pharmacists and want them to succeed, because I am under no delusion that my pay isn't going to be proportional to the going retail rate. However, I will never regret making a marginally lower salary because I work banking hours, no weekends or holidays, get about 5 weeks of vacation per year, and yes, I have an office. I even have a white board and draw funny pictures when I'm bored. It's worth the 10k/year to not deal with the stress.

 

[lord999]

That has to be the most uneducated post I have seen. I didn't do a residency and think residencies are ridiculous, but it is the new reality if you want to work hospital and clinical. I am at the VA and many pharmacists in ambulatory care etc prescribe for multiple disease states. Also at the VA you definitely max out at >120k even as a plain staff, with clinical pharmacists making more (at least at my VA). I did a few years in retail (plus 6 years (started at 18 and took 6 years to get PharmD).

Bottom line- If you are working at a chain retail store and think your salaries and current worklife (which usually sucks btw) is safe you are taking a major gamble (I am talking about people with >10 years left on their careers). Reimbursements continue to drop with little to no sign of a reversal happening and new pharmacy graduates are chomping at the bit to get on the hamster wheel of life and pay off those student loans while buying themselves new toys that further enslave them to the job. I would be genuinely afraid to bank my career on cvs/wags/ etc. Also I took a 25k pay cut (I'm making back a few k every year in higher pay raises) to not work weekends and get off at the latest 530 during the week with WAY less stress and boy has it been worth it.

But to the extent that lasts under PCMH, we'll see. Pharmacy has always done a fairly bad job of representing themselves even in the VA. Do you know this ambulatory care pharmacist job came to be? This disease state management aspect was originally given to nurses, but the ones they gave it to, botched it enough times that a pharmacist was installed as their supervisor for med changes. The role grew from there to what it is today (much like how most VA BCMA Coordinators are becoming pharmacists where they were originally nurses due to professional incompetence on the nurse's part with technology).

I generally agree with the OP's statement, but agree even more with gwarm01 that the argument is a straw-man. There are a couple of relevant exceptions during the old days (fellowship if someone is trying to enter industry, "supervised hours" when trying for BCNP), but I've found that most preceptors who are my generation (which is not old) have lived to regret it. What I find deeply offensive, is that despite their own issues with the faith, they continue to push this onto unsuspecting students who do not know any better as a way to self-justify their own choices.

The happiest pharmacists I have met were ones that enjoyed or at least made peace with being a pharmacist in the dispensing role. Whether that be a retail pharmacist in a chain or independent, a basement hospital pharmacist, one in home-infusion or nuclear practice, those who did understand what this profession is really about make it out ok. There's some extra services that one can offer on a case example (drug dosing, disease state management), but overall, the majority of the work is still dispensing.

And when budgets are cut in the VA as they are wont to do, the clinical pharmacy specialists are pulled from clinic and will staff. This happens every 10-15 years or so, and it happens to every pharmacist. When you've gone through a bad time in government (or a bad chief tenure), come back and let me know if government's a good career choice. Nobody and nowhere is perfect.

The top of the license practice has always been to do what no one else can, which is to oversee the dispensing process. A pharmacist who can handle an outpatient 500 fill/shift (not day) store is practicing at the top of their license to the point that there has always been an argument for piece differential pay to reward a pharmacist willing to work under that time-pressure. Hospitals have largely made up the pay difference, but there is a reason why outpatient pharmacy has always been a better pay area.

 

[BenJammin]

Not matching for a residency was one of the best things to ever happen to me. I got hired out of school as a clinical pharmacist, I'm one of the most respected pharmacists with the internal med docs, and all of the pharmacists who work below me are the ones who laughed at me not matching wondering why I didn't chase three letters and a number at 1/4th of normal salary.

Keep laughing at me not getting a residency. That's how I know I did it right!

 

[mustang sally]

Meh, it's all just a game that we play. If you want to do retail, go retail. If you want to do other jobs, you probably need a residency. It's just the way it is.

Plus it's not shocking that some people may be better suited to retail, hospital, academia or whatever else, as everyone has different strengths and weaknesses. As long as you are happy with your choice that's all that really matters. Personally, I get a little tired of these pissing contests amongst pharmacists.

 

[rxdawg21]

@rxdawg21

So to practice pharmacy at the top of your licence you must work for the government... where your compensation is taken forcefully in taxes. That's the problem... clinical pharmacy simply doesn't produce revenue. Until that happens nobody will see the explosive growth that has been predicted. Don't get me wrong pharmacists are underutilized and are fully capable... and I wish there were more positions like yours in the private sector. But the solution to the problem is not more education in the form of residency but rather progress on the front of reimbursement. Residency doesn't create jobs, it's just become an obstacle to get into a practice setting that has existed for decades (hospital). Obviously your case is an exception but if we want to create new jobs clinical pharmacists must be able to bring in revenue. Even in hospitals the justification for having a clinical pharmacist is purely cost savings... they don't bring in a dime.

You are correct in the current model mainly benefits government through either the VA or through a hybrid academia/clinical role. ( I don't know about clinical pharmacists and hospitals however) The biggest problem I see with the VA am care model taking off is we are literally doing the job of a NP or a PA, they already have that right in the private sector and I don't see them relinquishing it to us (even tho at my VA at least the PharmDs are definitely better and have superior drug knowledge, but my sample size is definitely limited). The whole push towards clinical pharmacy in the am care setting and even most specialties can be performed by a PA/NP, of course there are exceptions to this rule.

I think its crap you have to do a residency to get these jobs that have existed and that the hiring officers more then likely don't have a residency, but welcome to the world of too many pharmacist and having to "set yourself apart." The funny thing is I know several non-residency trained pharmacists that are far superior to many residency trained ones I do know.

 

[ldiot]

You are correct in the current model mainly benefits government through either the VA or through a hybrid academia/clinical role. ( I don't know about clinical pharmacists and hospitals however) The biggest problem I see with the VA am care model taking off is we are literally doing the job of a NP or a PA, they already have that right in the private sector and I don't see them relinquishing it to us (even tho at my VA at least the PharmDs are definitely better and have superior drug knowledge, but my sample size is definitely limited). The whole push towards clinical pharmacy in the am care setting and even most specialties can be performed by a PA/NP, of course there are exceptions to this rule.

I think its crap you have to do a residency to get these jobs that have existed and that the hiring officers more then likely don't have a residency, but welcome to the world of too many pharmacist and having to "set yourself apart." The funny thing is I know several non-residency trained pharmacists that are far superior to many residency trained ones I do know.

I agree. Pharmacists need to be functioning as a NP or PA in the private sector in order for us to see the big time growth that we want. Having to do a residency for a hybrid position or staffing position in some hospital is crap. This isn't growing or benefiting the profession in any way at all. There's no reason a pharmacist can't staff a minute clinic or manage chronic disease states in a primary care setting and that's at a bare minimum. Don't get me wrong if I wanted to be a doctor I would have went to med school but at the same time pharmacists are more than capable are are underutilized.

 

[rxdawg21]

But to the extent that lasts under PCMH, we'll see. Pharmacy has always done a fairly bad job of representing themselves even in the VA. Do you know this ambulatory care pharmacist job came to be? This disease state management aspect was originally given to nurses, but the ones they gave it to, botched it enough times that a pharmacist was installed as their supervisor for med changes. The role grew from there to what it is today (much like how most VA BCMA Coordinators are becoming pharmacists where they were originally nurses due to professional incompetence on the nurse's part with technology).

I generally agree with the OP's statement, but agree even more with gwarm01 that the argument is a straw-man. There are a couple of relevant exceptions during the old days (fellowship if someone is trying to enter industry, "supervised hours" when trying for BCNP), but I've found that most preceptors who are my generation (which is not old) have lived to regret it. What I find deeply offensive, is that despite their own issues with the faith, they continue to push this onto unsuspecting students who do not know any better as a way to self-justify their own choices.

The happiest pharmacists I have met were ones that enjoyed or at least made peace with being a pharmacist in the dispensing role. Whether that be a retail pharmacist in a chain or independent, a basement hospital pharmacist, one in home-infusion or nuclear practice, those who did understand what this profession is really about make it out ok. There's some extra services that one can offer on a case example (drug dosing, disease state management), but overall, the majority of the work is still dispensing.

And when budgets are cut in the VA as they are wont to do, the clinical pharmacy specialists are pulled from clinic and will staff. This happens every 10-15 years or so, and it happens to every pharmacist. When you've gone through a bad time in government (or a bad chief tenure), come back and let me know if government's a good career choice. Nobody and nowhere is perfect.

The top of the license practice has always been to do what no one else can, which is to oversee the dispensing process. A pharmacist who can handle an outpatient 500 fill/shift (not day) store is practicing at the top of their license to the point that there has always been an argument for piece differential pay to reward a pharmacist willing to work under that time-pressure. Hospitals have largely made up the pay difference, but there is a reason why outpatient pharmacy has always been a better pay area.

You may be right and I certainly can't pretend to know what goes on at other VA's. However most of the veteran pharmacist's at my VA have been here for about 20 years, and I haven't heard anything negative from them. My VA is expanding due to huge patient volume increases (our pharmacy calls have doubled in a year, as long as everything else). The VA is being utilized more and more by younger vets as well as the baby boomer generation. Sure they can cut back on the VA, if they do that they will have to funnel that money to the private sector, which will balloon scrip counts in my area at least and also the work of the doctors/NP/PA (although that most likely won't benefit pharmacists). The biggest thing I can see hurting my job is the privatizing the VA, I feel that is too big an endeavor for the current government to undergo and would hurt more jobs then just pharmacy. It could happen, but hopefully doesn't in my time span. Even the Non-VA care program has created jobs just dealing with those prescriptions and veterans.

 

[doublehh03]

OP, people make their own decisions. You make yours, live with it. Others want additional training to do what they want to do. Others don't. Don't need to judge.

 

[Momus]

Yea, I think I paid like $40 since I didn't have T-Mobile for my phone plan

I just called to get my charged waived 2 months for $30 each. Told them I don't get good data service. They didn't catch that if they waived the full $30 that's also waiving my $10 installment for the tab lol. Finally canceled the plan 2 weeks ago. I cashed out the card at a bank and pay with my cc for additional 2% back.

 

[Rockinacoustic]

Can someone give me a tl;dr, I got through about a paragraph and realized it continued past that.


Sent from my iPhone using SDN mobile app

Just the ramblings of a soul who got passed over for district manager again.

 

[gwarm01]

Having to do a residency for a hybrid position or staffing position in some hospital is crap. This isn't growing or benefiting the profession in any way at all.

I've always agreed with this position. PharmD + residency made sense when it was training for specialized jobs or the new, clinically focused areas that were supposed to appear. Now we expect new pharmacists to complete all of this extra training for a job that a BSPharm was more than qualified to fill.

Wherever you hear someone say they know non-residency trained pharmacists who are better than those with a PGY1/2, you have to think of course! They graduated and went right to work. The PGY2 spent two years training for a different job, now they are approaching staffing from the wrong angle. Which leads me to another thought: if you spent the time and effort to get a PGY2, why aren't you going out there and finding that job?!

 

[PumpkinSmasher]

I've always agreed with this position. PharmD + residency made sense when it was training for specialized jobs or the new, clinically focused areas that were supposed to appear. Now we expect new pharmacists to complete all of this extra training for a job that a BSPharm was more than qualified to fill.

Wherever you hear someone say they know non-residency trained pharmacists who are better than those with a PGY1/2, you have to think of course! They graduated and went right to work. The PGY2 spent two years training for a different job, now they are approaching staffing from the wrong angle. Which leads me to another thought: if you spent the time and effort to get a PGY2, why aren't you going out there and finding that job?!

I imagine a lot of them are not willing to relocate. Many of my students think they are going to get some clinical specialist job in my cit and state they do not want to move. I try to talk some sense into them but some people just have to figure it out on their own....

They all want to live in popular metro areas with high saturaton.

 

[rxdawg21]

I've always agreed with this position. PharmD + residency made sense when it was training for specialized jobs or the new, clinically focused areas that were supposed to appear. Now we expect new pharmacists to complete all of this extra training for a job that a BSPharm was more than qualified to fill.

Wherever you hear someone say they know non-residency trained pharmacists who are better than those with a PGY1/2, you have to think of course! They graduated and went right to work. The PGY2 spent two years training for a different job, now they are approaching staffing from the wrong angle. Which leads me to another thought: if you spent the time and effort to get a PGY2, why aren't you going out there and finding that job?!

And just because you did a residency doesn't mean you are more intelligent. Plenty of less intelligent (based on grades and aptitude) people in my class got residencies due to being personable and interviewing well. Anyone can make themselves look good on paper just by being aggressive and getting positions (again they are personable so popular) in organizations and doing a poster and some community service.

 

[Old Timer]

Meh, it's all just a game that we play. If you want to do retail, go retail. If you want to do other jobs, you probably need a residency. It's just the way it is.

Plus it's not shocking that some people may be better suited to retail, hospital, academia or whatever else, as everyone has different strengths and weaknesses. As long as you are happy with your choice that's all that really matters. Personally, I get a little tired of these pissing contests amongst pharmacists.

This is the only right answer. What works for you works for you and what works for me works for me....... Value is a subjective thing.

 

[konkan]

Not matching for a residency was one of the best things to ever happen to me. I got hired out of school as a clinical pharmacist, I'm one of the most respected pharmacists with the internal med docs, and all of the pharmacists who work below me are the ones who laughed at me not matching wondering why I didn't chase three letters and a number at 1/4th of normal salary.

Keep laughing at me not getting a residency. That's how I know I did it right!

I hear you. Im in similar situation. Got hired as hybrid pharmacist right after the school. Then after 5 years I got promoted to afternoon pharmacist in charge who does clinical job (no rounding) on weekdays and staff on weekends.
Overall I feel like i did the right thing and I like what I do. But...Recently I heard of a hospital where one day they took ALL clinical pharmacists that don't have residency and put them in the basement. Just like that. My coworker's friend with 25 or so years of clinical experience was one of them.
Unfortunately at the moment we have a culture in hospital pharmacy world where residency is starting to take over actual experience. I don't care if it's fair or not, what's troubling that it is promoting pharmacists with fancy letters next to their names over people with, in my opinion, superior productivity and experience. But we'll see where it's gonna go.

 

[Topcat15]

WTF!!!!!!! that is terrible ....once you go retail you never go back.....hospital pharmacy is soooo much better... residency may significantly help a person get a hospital job.

That's, like, your opinion, man. I would rank my enjoyment of jobs I have had as: 1) academia (the actual teaching/research aspect); 2) amb care clinic; 3) retail; 4) hospital clinical pharmacist.

Hospitals literally smell like **** all the time, are full of people acutely dying and patients who are the absolute dregs of society, and are primarily staffed by incredibly rude doctors and nurses who treat pharmacy like dirt. It's the most depressing setting I've ever worked in and I literally feel sick to my stomach when I'm there. I'd take retail over a decentralized pharmacist position without hesitation. Disclaimer: I work in grocery store retail with a great manager and amazing co-workers, so I've got it really good in that aspect. But it goes to show that your co-workers and managers go a long way toward making a job great, regardless of the setting. I'm glad I didn't close my mind to retail based on the feedback of professors who haven't worked a real job in 30 years.

 

[rxdawg21]

I do have to say there is a lot more drama and politics in hospital compared to retail. I enjoy retail honestly, however I enjoy banker hours a lot more, and I don't really like dealing with the clientele that visits Wal-mart (or even WAGS AND CVS). However clientele at other retail places aren't that bad, but again they aren't the majority of the jobs.

Moral of the story is not working weekends and getting off at a normal hour every day is what makes my clock tick, to each their own though.

 

[Topcat15]

I do have to say there is a lot more drama and politics in hospital compared to retail. I enjoy retail honestly, however I enjoy banker hours a lot more, and I don't really like dealing with the clientele that visits Wal-mart (or even WAGS AND CVS). However clientele at other retail places aren't that bad, but again they aren't the majority of the jobs.

Moral of the story is not working weekends and getting off at a normal hour every day is what makes my clock tick, to each their own though.

This is the dream.

The schedule is also another reason I don't like hospital. Those things are open 24 hours a day, and they want pharmacists to be there for rounds that begin at 7 in the morning! Madness.

 

[rxdawg21]

This is the dream.

The schedule is also another reason I don't like hospital. Those things are open 24 hours a day, and they want pharmacists to be there for rounds that begin at 7 in the morning! Madness.

Most hospitals will have designated night shifts etc. I work at a VA that luckily has another VA cover our night hours, having said that we still have evening shift pharmacists and the vast majority of us work normal hours getting off 430 or 530 depending on our shift that week. All clinicals here have a straight 8-430 schedule.

 

[gwarm01]

But...Recently I heard of a hospital where one day they took ALL clinical pharmacists that don't have residency and put them in the basement. Just like that.

That just twists my stomach. I can imagine the type of administration that would make this sort of decision too. Probably a director with a PGY2 in administration that has never worked in a central pharmacy or in a clinical service a day in their life (not counting their supervised days in residency of course). Probably very proud of the decision too. I just hope the new replacements can page the older crew when they get in over their heads. Man, that would be a walk out moment for me.

I have friends that work in a hospital that is mandating board certification for all clinical people. They're even playing with the idea of requiring board certification for all pharmacists, even central staffers.

 

[lord999]

You may be right and I certainly can't pretend to know what goes on at other VA's.

Then I know that you truly work for VA. If you've seen one VA, you've seen one VA. As much as we tout that we are a system, each VA has its own quirky practices. That's the admission of wisdom.

My VA is expanding due to huge patient volume increases (our pharmacy calls have doubled in a year, as long as everything else). The VA is being utilized more and more by younger vets as well as the baby boomer generation. Sure they can cut back on the VA, if they do that they will have to funnel that money to the private sector, which will balloon scrip counts in my area at least and also the work of the doctors/NP/PA (although that most likely won't benefit pharmacists). The biggest thing I can see hurting my job is the privatizing the VA, I feel that is too big an endeavor for the current government to undergo and would hurt more jobs then just pharmacy. It could happen, but hopefully doesn't in my time span. Even the Non-VA care program has created jobs just dealing with those prescriptions and veterans.

So the 20 year pharmacists, might have just missed the Derwinski era in VA, where they really DID try to fee basis everything. That worked...except that it broke the budget. The dirty secret about Best Care Anywhere was that was Plan B not Plan A. Plan A was we tried to Fee Basis everything out, and it blew up in our face exactly as you described. That is why PBM VHACO was given such expansive power, and where the start of the mail orders (CMOP's) started. That entire CMOP division does not officially exist as a true appropriation in any VA budget, it is a fee-for-service arrangement that each station has with the CMOP for efficiency. Prior to the CMOP, imagine in the tiny space that you were doing trying to do all those refills...we really had a hard time retaining pharmacists in that era due to that and the really low wages (I mean 60-70% of the retail standard which that did not end until well after I joined).

If those pharmacists worked prior to the CMOP era, I'd believe them. If they didn't, then they've already avoided the worst era of being a VA pharmacist. (I doubt it though, for the Class IA and IB stations, there are only between 110-150 ambulatory staff pharmacists that date from earlier than the Derwinski timeframe, so before 1992).

Right now, with the current Fee Basis (Choice) push, that bill for service is even higher now. After Deerfield and Woonsocket got screwed over by VA in the 1990s, this time around, they refused to work with us directly and just through an intermediary PBM would would assume the non-payment risk. The budget for that is more than treble our current costs. The cynical way to put this is that VA pharmacists are cheaper per dispense even given clinical pharmacy than the private sector right now. But, if our purchasing ability or our cost per dispense ability even falls (as it did in the 1990s), dispensing and hospital operations prioritize over clinical every time.

History in the government goes in cycles, we are now swinging back to a fee-basis friendly era, broke as all hell, and the more corrupt and incompetent place that I'm familiar with and used to than the Best Care Anywhere. I know the place for what it is really, so my job is and always will be to defend the veterans FROM the VA's bureaucratic stupidity most of the time as well as provide care that I'd want on myself. The younger and less experienced will need to learn that lesson sooner than later if they are going to keep their ethics intact. Or, they can join the "it's a paycheck" crowd and become the classical government worker in the negative sense. It's really up to the individual. I choose the former as I'd like to think I still have a conscience, and I did have some motivation to help people irrespective of the formal ethical duty.

But, remember, the way that residencies are justified through the VA budget and the front-office is the following:
1. It does not come from the station budget (it comes from the VHACO education) where if you understand how government works, budgeting is a zero-sum game.
2. You get staffing benefits such that none of your pharmacists work weekends.
3. (I view this as the most important) It serves as a year-long interview for someone we might want to hire. Due to the relative difficulty of firing anyone around here, there is a lot of effort put into making the hires the right ones.

What I'm saying is that the the exigency might get you reassigned. But, I kind of like this era as I know I am going to get rid of a bunch of non-dedicated freeloaders. Your 20-year plus veterans are a point of survivor bias, they actually made it that long. Have you looked at your NEW PERSON (File 200) to see how many pharmacists have come through the door and left since that time? The dead tell no tales.

That being said, I'm a career lifer, and so will you (maybe), but it's important to enjoy the moments that you have a good practice career and know that it's worth fighting for. You'd be surprised at how the bureaucracy (including supervision) try to screw that up.

One other issue, you are working at a VA that probably has the optimal number of pharmacy personnel to constitute a single division. I think the magic number is 30 pharmacist FTE's when above that, the service starts becoming impersonal and unmanageable. Knowing what I know now, I would definitely practice in such a pharmacy to begin with and probably never leave. There is no advantage (and you actually learn many sadder stories) to working at a large station or VISN level.

 

[WVUPharm2007]

I've been saying this **** for years on here. Its just a scheme to shift the cost of training onto the labor force. Its simply agreeing to work at 1/3 the salary. Indentured servitude by another name. Just coat that **** in faux prestige and Pavlov's P4s lap it up. Used to be, you just went to the hospital and started working. I did it.

 

[rxdawg21]

Then I know that you truly work for VA. If you've seen one VA, you've seen one VA. As much as we tout that we are a system, each VA has its own quirky practices. That's the admission of wisdom.



So the 20 year pharmacists, might have just missed the Derwinski era in VA, where they really DID try to fee basis everything. That worked...except that it broke the budget. The dirty secret about Best Care Anywhere was that was Plan B not Plan A. Plan A was we tried to Fee Basis everything out, and it blew up in our face exactly as you described. That is why PBM VHACO was given such expansive power, and where the start of the mail orders (CMOP's) started. That entire CMOP division does not officially exist as a true appropriation in any VA budget, it is a fee-for-service arrangement that each station has with the CMOP for efficiency. Prior to the CMOP, imagine in the tiny space that you were doing trying to do all those refills...we really had a hard time retaining pharmacists in that era due to that and the really low wages (I mean 60-70% of the retail standard which that did not end until well after I joined).

If those pharmacists worked prior to the CMOP era, I'd believe them. If they didn't, then they've already avoided the worst era of being a VA pharmacist. (I doubt it though, for the Class IA and IB stations, there are only between 110-150 ambulatory staff pharmacists that date from earlier than the Derwinski timeframe, so before 1992).

Right now, with the current Fee Basis (Choice) push, that bill for service is even higher now. After Deerfield and Woonsocket got screwed over by VA in the 1990s, this time around, they refused to work with us directly and just through an intermediary PBM would would assume the non-payment risk. The budget for that is more than treble our current costs. The cynical way to put this is that VA pharmacists are cheaper per dispense even given clinical pharmacy than the private sector right now. But, if our purchasing ability or our cost per dispense ability even falls (as it did in the 1990s), dispensing and hospital operations prioritize over clinical every time.

History in the government goes in cycles, we are now swinging back to a fee-basis friendly era, broke as all hell, and the more corrupt and incompetent place that I'm familiar with and used to than the Best Care Anywhere. I know the place for what it is really, so my job is and always will be to defend the veterans FROM the VA's bureaucratic stupidity most of the time as well as provide care that I'd want on myself. The younger and less experienced will need to learn that lesson sooner than later if they are going to keep their ethics intact. Or, they can join the "it's a paycheck" crowd and become the classical government worker in the negative sense. It's really up to the individual. I choose the former as I'd like to think I still have a conscience, and I did have some motivation to help people irrespective of the formal ethical duty.

But, remember, the way that residencies are justified through the VA budget and the front-office is the following:
1. It does not come from the station budget (it comes from the VHACO education) where if you understand how government works, budgeting is a zero-sum game.
2. You get staffing benefits such that none of your pharmacists work weekends.
3. (I view this as the most important) It serves as a year-long interview for someone we might want to hire. Due to the relative difficulty of firing anyone around here, there is a lot of effort put into making the hires the right ones.

What I'm saying is that the the exigency might get you reassigned. But, I kind of like this era as I know I am going to get rid of a bunch of non-dedicated freeloaders. Your 20-year plus veterans are a point of survivor bias, they actually made it that long. Have you looked at your NEW PERSON (File 200) to see how many pharmacists have come through the door and left since that time? The dead tell no tales.

That being said, I'm a career lifer, and so will you (maybe), but it's important to enjoy the moments that you have a good practice career and know that it's worth fighting for. You'd be surprised at how the bureaucracy (including supervision) try to screw that up.

One other issue, you are working at a VA that probably has the optimal number of pharmacy personnel to constitute a single division. I think the magic number is 30 pharmacist FTE's when above that, the service starts becoming impersonal and unmanageable. Knowing what I know now, I would definitely practice in such a pharmacy to begin with and probably never leave. There is no advantage (and you actually learn many sadder stories) to working at a large station or VISN level.

I appreciate your insight and you are spot on about my VA size. I don't plan on leaving this VA god-willing as it's in a convenient enough location to family and major cities and the town itself is not bad. I believe the pharmacist's that have been here the longest started at the VA in mid to late 90's so just after the era you spoke of. They also talked about making 50-60k starting off, which was way less then retail. Hopefully all works out for me and I get through the bad times.

 

[gwarm01]

I've been saying this **** for years on here. Its just a scheme to shift the cost of training onto the labor force. Its simply agreeing to work at 1/3 the salary. Indentured servitude by another name. Just coat that **** in faux prestige and Pavlov's P4s lap it up. Used to be, you just went to the hospital and started working. I did it.

This is my exact opinion. I don't fault people for pursuing residency because it has become a baseline requirement to get a hospital job in many parts of the country. I have a lot of respect for people who can say they did it because that's what they had to do to get the job they wanted. It's the people who drink the koolaid that really get to me. The ones that are happy to foot the bill for basic job training and wear it like a badge of honor.

Someone with an RPH trained the PharmD that replaced them, who trained the PGY1 that replaced them, who trained the PGY2 that replaced them. I just wonder how long this cycle will continue? Will you work towards a PGY3 just to get a job that pays <100k/year with less authority than a PA or NP? I would be singing such a different tune if residency was a requirement for a truly differentiated job. Doctors do years of residency and come out as a surgeon, or a neurologist, or an anesthesiologist. We do years of residency and come out as a pharmacist who might have a better shot at a very small pool of poorly funded jobs. Most of us just get the same job we would have had otherwise.

Hell, the greatest thing that clinical pharmacy has going on right now might just be the CMS requirement that transplant programs have a dedicated pharmacist. That is the sort of rule that really justifies this advanced training.

 

[M0df]

For the sake of transparency Nate, are you Rx Supervisor/Emerging leader now? Are you in the process of 'interviewing' P4 interns for their future CVS jobs?

 

[ChalupaBatman86]

Hey PGY3'S specializing in Psych - would you treat this outburst with Haldol or Risperdal?

 

[alprazolamborghini]

This is my exact opinion. I don't fault people for pursuing residency because it has become a baseline requirement to get a hospital job in many parts of the country. I have a lot of respect for people who can say they did it because that's what they had to do to get the job they wanted. It's the people who drink the koolaid that really get to me. The ones that are happy to foot the bill for basic job training and wear it like a badge of honor.

Someone with an RPH trained the PharmD that replaced them, who trained the PGY1 that replaced them, who trained the PGY2 that replaced them. I just wonder how long this cycle will continue? Will you work towards a PGY3 just to get a job that pays <100k/year with less authority than a PA or NP? I would be singing such a different tune if residency was a requirement for a truly differentiated job. Doctors do years of residency and come out as a surgeon, or a neurologist, or an anesthesiologist. We do years of residency and come out as a pharmacist who might have a better shot at a very small pool of poorly funded jobs. Most of us just get the same job we would have had otherwise.

Hell, the greatest thing that clinical pharmacy has going on right now might just be the CMS requirement that transplant programs have a dedicated pharmacist. That is the sort of rule that really justifies this advanced training.

you are on point. The whole residency thing in pharmacy is to make yourself more competitive than others to get to the same job. I don't blame ppl who are going for residency. It is just the reality that we have to face right now since it is getting god damn competitive to land on hospital jobs. The truth is that we are still doctor's bitch no matter what. You can do PGY infinity training and still will be treated same with same salary. Yes, VA and other government jobs may have expanded role of pharmacist, but that is about it. Most of hospitals/doctors/ other professionals just consider pharmacist as supplemental tool. Also there is no money to make from hospital's standpoint with pharmacists' PGY training. I doubt this model of pharmacist's role would change any time soon. Well, i just gotta blame this freaking job market.

 

[Michael_Scott]

That's, like, your opinion, man. I would rank my enjoyment of jobs I have had as: 1) academia (the actual teaching/research aspect); 2) amb care clinic; 3) retail; 4) hospital clinical pharmacist.

Hospitals literally smell like **** all the time, are full of people acutely dying and patients who are the absolute dregs of society, and are primarily staffed by incredibly rude doctors and nurses who treat pharmacy like dirt. It's the most depressing setting I've ever worked in and I literally feel sick to my stomach when I'm there. I'd take retail over a decentralized pharmacist position without hesitation. Disclaimer: I work in grocery store retail with a great manager and amazing co-workers, so I've got it really good in that aspect. But it goes to show that your co-workers and managers go a long way toward making a job great, regardless of the setting. I'm glad I didn't close my mind to retail based on the feedback of professors who haven't worked a real job in 30 years.

mr monocle cat...i humbly disagree....I have had the dreadful experience ! ....you likely do not live in a competitive/busy market because retail is the worst in busy markets especially if you are a PIC...hospital jobs are so simple and don't have that crazy pressure...yea you have nurses, doctors disrespecting you but what profession does not face that ?

 

[gwarm01]

Hey PGY3'S specializing in Psych - would you treat this outburst with Haldol or Risperdal?

I'll have to page the on call resident..

you are on point. The whole residency thing in pharmacy is to make yourself more competitive than others to get to the same job. I don't blame ppl who are going for residency. It is just the reality that we have to face right now since it is getting god damn competitive to land on hospital jobs. The truth is that we are still doctor's bitch no matter what. You can do PGY infinity training and still will be treated same with same salary. Yes, VA and other government jobs may have expanded role of pharmacist, but that is about it. Most of hospitals/doctors/ other professionals just consider pharmacist as supplemental tool. Also there is no money to make from hospital's standpoint with pharmacists' PGY training. I doubt this model of pharmacist's role would change any time soon. Well, i just gotta blame this freaking job market.

Which is why I weep for poor pharmacy students and count my lucky stars that I was able to get the jobs I've had without a residency.

 

[UMRX]

I'm not one to post on this forum, but this warrants a response. I graduated pharmacy school and completed a PGY-1 residency at a large VA. I loved the one on one interactions with patients, and developed awesome relationships with the doctors. I planned on staying after being offered a clinical pharmacy specialist position but...

(Let me insert here, I was never treated like a puppy dog or stuck in a corner like your preceptor. Also, I would have had my own office. With my own chair. Where I would have sat twiddling my thumbs hoping someone *might consult me for a warfarin dose. Really? I mean, really?)

Then, life happened and my husband's job required us to move to a different state. While waiting to get licensed in that state, no hospital would even talk to me until I was licensed. Well, bills and student loans don't wait, so I did something I never thought I would do. I applied to a major retail pharmacy. Ok, so after replying with my life story, I'm finally getting to my point.

My residency makes me an exceptional retail pharmacist. I'm definitely not trying to sound arrogant, but after working with new grads and interns, there is definitely a learning curve when you finish pharmacy school. Yeah, you graduated and passed the NAPLEX but can you actually apply that knowledge and use it to help people (and not hurt someone)? I do not regret doing a residency because I use what I learned almost every day, and I have the option to get back into a clinical position when I so choose. To sum it up, my residency made me a knowledgeable and confident pharmacist regardless of my title and work place. What's so wrong with that? The pay cut? That was my decision. Not yours. And, in case you're wondering...no, I don't think everyone should do a residency. This is just my personal experience I'm sharing.

Also as PHARMACY MANAGER, I work right beside my techs and there is no task "beneath me." I have worked with a few pharmacists that have that "I'm too good for..." complex and guess what, not a single one did a residency. Argument invalid.

My pharmacy school did push for students to do residencies. Why wouldn't they? I mean, it's nice to have options, right? There are tons of opportunities other than just retail. I just don't get the argument. I get some people don't want to do one, but don't judge someone for wanting to. It's their individual decision.

Also, I have patients not customers, and I refuse to just DISPENSE DISPENSE DISPENSE. Take a vaca from retail hell. You need it.

It's pharmacists like you that really set the profession back.

 

[confettiflyer]

I WORK RETAIL AND SO SHOULD YOU, BECAUSE I'M A MANAGER AND NOT GROVELING BEHIND SOME PHYSICIAN ALL DAY, RAWR.

That was the gist of it.

Thanks that was awesome, haha.


Sent from my iPhone using SDN mobile app

 

[HouTX]

sounds like Nate finally became a CVS supervisor. i agree with some of his points but not the delivery.

i had the pleasure of being a preceptor to a grad intern that didn't match. she didn't want to be there so it made it that more difficult

 

[wagrxm2000]

I'm not one to post on this forum, but this warrants a response. I graduated pharmacy school and completed a PGY-1 residency at a large VA. I loved the one on one interactions with patients, and developed awesome relationships with the doctors. I planned on staying after being offered a clinical pharmacy specialist position but...

(Let me insert here, I was never treated like a puppy dog or stuck in a corner like your preceptor. Also, I would have had my own office. With my own chair. Where I would have sat twiddling my thumbs hoping someone *might consult me for a warfarin dose. Really? I mean, really?)

Then, life happened and my husband's job required us to move to a different state. While waiting to get licensed in that state, no hospital would even talk to me until I was licensed. Well, bills and student loans don't wait, so I did something I never thought I would do. I applied to a major retail pharmacy. Ok, so after replying with my life story, I'm finally getting to my point.

My residency makes me an exceptional retail pharmacist. I'm definitely not trying to sound arrogant, but after working with new grads and interns, there is definitely a learning curve when you finish pharmacy school. Yeah, you graduated and passed the NAPLEX but can you actually apply that knowledge and use it to help people (and not hurt someone)? I do not regret doing a residency because I use what I learned almost every day, and I have the option to get back into a clinical position when I so choose. To sum it up, my residency made me a knowledgeable and confident pharmacist regardless of my title and work place. What's so wrong with that? The pay cut? That was my decision. Not yours. And, in case you're wondering...no, I don't think everyone should do a residency. This is just my personal experience I'm sharing.

Also as PHARMACY MANAGER, I work right beside my techs and there is no task "beneath me." I have worked with a few pharmacists that have that "I'm too good for..." complex and guess what, not a single one did a residency. Argument invalid.

My pharmacy school did push for students to do residencies. Why wouldn't they? I mean, it's nice to have options, right? There are tons of opportunities other than just retail. I just don't get the argument. I get some people don't want to do one, but don't judge someone for wanting to. It's their individual decision.

Also, I have patients not customers, and I refuse to just DISPENSE DISPENSE DISPENSE. Take a vaca from retail hell. You need it.

It's pharmacists like you that really set the profession back.

I'd lean more towards you would have been a good retail pharmacists either way then say a residency helped. If you show me ten pharmacists and one did a residency, I would never be able to pick them out.

On the other hand, if you did an internship at either a hospital or chain for 6 years, you will stand out guaranteed.

 

[dnp321]

lol ppl that did residency after pharm school are the ones getting butthurt hahahahaha

 

[gwarm01]

lol ppl that did residency after pharm school are the ones getting butthurt hahahahaha

No one is butthurt. Mainly just confused at the idea of "you weren't good enough for CVS so you had to do a residency!" when hospital jobs are far more competitive with better work environments and benefits while CVS is often considered the pharmacy employer of last resort.

 

[Eichhoernchen]

Honestly my main motivation for not doing a residency was the student debt waiting to be paid off and whether I would have enough for living expenses. I know a lot of my friends who went that route had help from family and/or no loans.