Which RX Job?

[aznjeff07]

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A little background on myself. I chose pharmacy a few months before high school graduation; my friend told me his sister was going to be one making $100/hr(lie) and have Dr.(semi lie) in front of her name. My family was financially unstable so I did not have the luxury of time to go to med school nor the money. I then enrolled in school and finished the whole process with about 95k in loans; I had almost full scholarship my 2 pre-pharm years and about 1/5 by 4 years of pharm school.

I applied for some IHS residencies but due to a paperwork fiasco, that affected a lot of people, I had a very short period of time to secure a job. I settled on Walmart and have been happy for the most part, but I still dislike retail. I now have a years experience and an opportunity to get into clinical pharmacy; the only aspect of pharmacy I find somewhat enjoyable.

And now here I am. I have 2 formal offers and one eh situation. I'm struggling with what I should do and unfortunately the 2 formal offers want an answer by Friday (in about 16 hours).

1. Rural Hospital - 2.5 hours from where I want to be
Staffing - 2 staff pharmacist and 1 manager that can fill in if he wants
Hours - Everyone is done by 530pm with every 3rd weekend on and random on call

Upside - They are trying to get a true clinical pharmacist position set up in the hospital and are giving me the opportunity to set it up and be at least 1/2 of it, 5k sign on bonus with possible relocation allowance and salary is negotiable (already competitive), I foresee at least 1/2 clinical pharmacist job functions in about a year, average census is only about 25 pts 🙂

Downside - I will have no social life out in the boonies, I will have no formal training (almost every aspect will be self taught) since the other staff pharmacist has been there only one month and her past hx is all retail, a new pharmacy director is coming in and he could have lied about wanting to continue to try to set up a clinical pharmacist, this position is no guarantee that I will get a clinical position I want in the city at a later date.

2. Manager Care - In the city about 15 minute from ideal location
Staffing - tons
Hours - Overnight with Sun being the only weekend day

Upside - Performance based bonuses, good location, some exposure to clinical pharmacy in terms of drug familiarity, possible chance for clinical position in the future, I get to keep my social life and be close to family, I will get plenty of training.

Downside - I will basically be an input pharmacist with little clinical aspect, if I were to get onto the clinical team the timeline the manager gave me was around 5 years...., overnight shift - can be good and bad, I will be constantly be under pressure to crank the orders out since they keep metrics for bonuses, I can get cut if they lose contracts.

3. New branch of a long-term care facility - in the city about 15 minutes from ideal location
Staffing - 2 staff and one manager
Hours - normal day shift with every other Sat and on call

Upside - City life, normal hours and social life intact, I will get to help set up this location from the ground up and put it on my CV, it will be at least 1/4 clinical with room for growth, salary and benefits negotiable, room for much advancement.

Downside - They are still trying to set everything up so even the manager doesn't have a formal contract. This means I can not be offered one and a verbal contract has not been extended. The facility is set to open on July 1 so I don't understand the hold up. They will also only have minimal staffing with quite a few prescriptions so I'll be constantly busy until they have enough growth to hire someone else.


So I'm just looking for input. I'd like to hold out for option 3 but it's no guarantee (if they make an offer I am the frontrunner so far) because they can't seem to get everything in order. The other 2 positions have a bunch of other applicants so they won't hold the job so I'm stressing with no idea what to decide.

I know career one is best career wise, but it only give me a better chance at a position I'd apply for later. And even that proposition is not very comforting since I'm sure I'll be up against formally resident trained pharmacists.

I know this is my choice to make and I should do what's best for me, but I am truly at a loss. Input would be appreciated.

I am not married and my relationship status is complicated since I'm sure people will ask.

 

[BMBiology]

Great job graduating with just 95 k.

I say accept the managed care position while you wait for the LTCF position.

If you did a residency, I would have recommended the hospital position. You will be competing against residency trained and experienced pharmacists when you want to relocate to the city. Pretty competitive.

The managed care, evening position sounds like it is just a dispensing role? Doesn't sound like an important role so they can just get rid of you if they loss a big contract. I would also confirm with the company's policy as to when you can transfer to another department. Five years sounds a bit excessive. If a manager from another department likes you, they can't stop you from transferring to another department but you will be working night shift so there's not much opportunity for you to socialize and meet other pharmacists.

The LTCF position doesn't sound too stable but it sounds like you have an opportunity to move up and it seems to fit you better than the other two positions.

Another option is to stay at Walmart while you keep on waiting for the LTCF position. At least it offers stability.

 

[vistaril]

You left out the most important thing- what kind of bank you making at each of these?

Also, you keep talking clinical clinical clinical....but where do you have any experience or training for such a role? Seems to me that, without a residency, you would have probably been more qualified to slide into a pseudoclinical role if you had gone straight from pharm school to one. Spending a few years at WalMart sure didnt develop any clinical skills I wouldnt think....

 

[BMBiology]

You can always take a 2 week "vacation" at Walmart so you can work at the LTCF. If it fits you well, then just dump your Walmart job.

 

[aznjeff07]

Great job graduating with just 95 k.

I say accept the managed care position while you wait for the LTCF position.

If you did a residency, I would have recommended the hospital position. You will be competing against residency trained and experienced pharmacists when you want to relocate to the city. Pretty competitive.

The managed care, evening position sounds like it is just a dispensing role? Doesn't sound like an important role so they can just get rid of you if they loss a big contract. I would also confirm with the company's policy as to when you can transfer to another department. Five years sounds a bit excessive. If a manager from another department likes you, they can't stop you from transferring to another department but you will be working night shift so there's not much opportunity for you to socialize and meet other pharmacists.

The LTCF position doesn't sound too stable but it sounds like you have an opportunity to move up and it seems to fit you better than the other two positions.

Another option is to stay at Walmart while you keep on waiting for the LTCF position. At least it offers stability.

Eh, 95k is disgraceful in my case. Most of my friends graduated with under 50k with minimal or no scholarships. I figured I'd enjoy student life a tiny bit and needed living expenses with little outside support. It's the interest that's killing me. All unsubsidized so 20k in interest so far....

Back to the point.

The managed care does cut people when they lose contracts; a friend confirmed this. I would not however be directly related to dispensing since they do not dispense overnight. I would be almost solely data input and some other minor functions.

The long-term care facility would be stable in my opinion. It is a pretty big company with a few branches in the U.S. I just don't want to accept the managed care position and then crap out...I can give a polite FU when leaving retail, but it's not in my nature to burn bridges. Managed care isn't scheduled to start until July 1, so I'd be quitting before I actually start if the long-term gets their shiet together. Long-term is scheduling to start training the last week of june, but they have yet to secure a building lease....

 

[aznjeff07]

You left out the most important thing- what kind of bank you making at each of these?

Also, you keep talking clinical clinical clinical....but where do you have any experience or training for such a role? Seems to me that, without a residency, you would have probably been more qualified to slide into a pseudoclinical role if you had gone straight from pharm school to one. Spending a few years at WalMart sure didnt develop any clinical skills I wouldnt think....

Salary is all give or take 7k. Hospital is 98k, managed 105, long term would be around 100. Only managed care isn't negotiable.

 

[BMBiology]

Also, you keep talking clinical clinical clinical....but where do you have any experience or training for such a role? Seems to me that, without a residency, you would have probably been more qualified to slide into a pseudoclinical role if you had gone straight from pharm school to one. Spending a few years at WalMart sure didnt develop any clinical skills I wouldnt think....

I also agree with this. A lot of people keep on talking about "clinical" but often it is just a dispensing role. Also, are you really prepared to do "clinical" work without anyone guiding you?

 

[aznjeff07]

You can always take a 2 week "vacation" at Walmart so you can work at the LTCF. If it fits you well, then just dump your Walmart job.

Lol funny story. I gave a weeks notice to my district manager since I have to move out by the end of May and he just told me that today was my last day if i didn't give him more notice. I don't understand how a non-pharmacist is even a DM let alone thinks he has leverage when I have 2-3 offers on the table.

 

[BMBiology]

Lol funny story. I gave a weeks notice to my district manager since I have to move out by the end of May and he just told me that today was my last day if i didn't give him more notice. I don't understand how a non-pharmacist is even a DM let alone thinks he has leverage when I have 2-3 offers on the table.

That's retail. They don't really need you because they can easily find someone to take your shift. They figure you are not going to do a good job anyways so might as well get rid of you.

So others know: if you work in retails, don't hand them your resignation unless you are prepared to leave immediately.

 

[aznjeff07]

I also agree with this. A lot of people keep on talking about "clinical" but often it is just a dispensing role. Also, are you really prepared to do "clinical" work without anyone guiding you?

It would initially be dispensing until I get familiar with all the drugs - est 6 months. Then I'd be in a satellite on the floor with the Dr's and inputting when I have a chance. This is if they haven't just been straight up lying to me.

The no formal training or guidance is worrisome...but I've seen it done at a local hospital by one person at a much larger facility (I know that doesn't mean I will succeed but it does give me hope). It wouldn't be as hardcore clinical as most would think since the census is so low at the rural hospital. I think I could handle it. Main worry for here is will I be competitive with 2 years of informal clinical experience versus a pgy1 let alone a pgy2+ pharmacist in the city?

 

[miac]

what job did you decide?

 

[BenJammin]

I graduated with less than $50K and my current student debt load is $9,000. Feels good.

 

[BenJammin]

By the way, "clinical" is so overrated. Unless you know more than the docs in regards to guidelines and antibiotic spectrum then you are useless to the healthcare team that rounds. That's why I'm considering a move to retail.

 

[owlegrad]

By the way, "clinical" is so overrated. Unless you know more than the docs in regards to guidelines and antibiotic spectrum then you are useless to the healthcare team that rounds. That's why I'm considering a move to retail.

You are right, I don't know why docs even let other healthcare people round with them.

 

[BenJammin]

You are right, I don't know why docs even let other healthcare people round with them.

I sense the sarcasm but my point is still valid. What's the point of a residency is we just become the fail safe to a doctor's misguided choice of therapy? You don't need one for that and you certainly don't need a residency for the clinical job I have. Take someone like me who is in clinical pharmacy without a residency and someone who just got into one, string them along for a year, and you'll get the same clinician.

 

[Hello2000]

I sense the sarcasm but my point is still valid. What's the point of a residency is we just become the fail safe to a doctor's misguided choice of therapy? You don't need one for that and you certainly don't need a residency for the clinical job I have. Take someone like me who is in clinical pharmacy without a residency and someone who just got into one, string them along for a year, and you'll get the same clinician.

Yes a lot of p'cists who want a more clinical role actually mean that they would like to carry out complex surgery on a daily basis.