Who Wants to Specialize?

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Will you specialize?

  • You bet!

    Votes: 90 71.4%
  • Nah, just the residency

    Votes: 14 11.1%
  • Residencies are optional for a reason

    Votes: 10 7.9%
  • Retail for the win!

    Votes: 12 9.5%

  • Total voters
    126

pharm B

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  1. Pharmacist
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Who here is thinking about pursuing a residency after pharmacy school? Anyone wanting to pursue being certified in a specialty?

The Board of Pharmaceutical Specialties site has a description of each of the current specialties available.

http://www.bpsweb.org/

It's at least another year not making mad money, but I think it's worth it.
 
I'm So for it, I was thinking of getting the BCOP because I enjoyed working in the Cancer Center at UMB and feel there's so much to explore in Oncology 👍
 
I bet most of us now will say residency or specialized, but but by the time we graduate i'm sure we all will just go straight to retail. I will go retail =]
 
I'm retail all the way. Gonna get my MBA, hopefully open a bunch of stores... I could specialize as it would be interesting, but that's not where my heart is.
 
I would like to open up a pharmacy as well. I don't see a better way to distinguish my pharmacy than doing a specialty (pharmacotherapy). Anyone else see MTM as the future for pharmacists?
 
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To hell with being a glorified McDonald's employee if I don't absolutely have to be.

I asked if someone would like fries with that for a couple years while I was a teenager. If I can help I'd like to never see a drive-through again from the inside.
 
Critical care, emergency care, or psychiatric pharmacy 🙂 if I get a job where I work now, I am thinking critical care or hem/onc.
 
I thought your heart was in racing. :meanie:

That's what I'll be doing on the weekends. What a better tax write off than to sponsor my own car :meanie:

I would like to open up a pharmacy as well. I don't see a better way to distinguish my pharmacy than doing a specialty (pharmacotherapy). Anyone else see MTM as the future for pharmacists?


MTMs are the future.
 
Critical care, emergency care, or psychiatric pharmacy 🙂 if I get a job where I work now, I am thinking critical care or hem/onc.


I'm thinking critical care too - I even scheduled shadowing in ER pharmacy at SF general hospital also known as the "crazies" over the spring break when everyone will be relaxing, just to get a taste of what critical care is like.

Critical care programs also seem to be instituted at really good schools - Stanford, John Hopkins, so that definitely has an appeal to me as well since I want to do residency at a good school.

As for optionality of residencies mentioned by someone: one of our professors said that in a few years pharm residencies will be required just like for medicine. They are already esentially required if you want to work at certain positions straight out of school and don't have years of work experience behind your back.
 
Yep! Nuke. Heres hoping a few more years of 1am-7am will land me a management job post graduation. The schedule is brutal during pharm school, but it is well worth it in the end.
 
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I'm retail all the way. Gonna get my MBA, hopefully open a bunch of stores... I could specialize as it would be interesting, but that's not where my heart is.


Good luck with that. Not to burst your bubble or sound like a fortune teller, but retail is not sustainable and with any luck pharmacy will dump dispensing and transition to direct patient care.
If your love is for business, consider skipping the clinical degree.
 
I'm thinking critical care too - I even scheduled shadowing in ER pharmacy at SF general hospital also known as the "crazies" over the spring break when everyone will be relaxing, just to get a taste of what critical care is like.

Critical care programs also seem to be instituted at really good schools - Stanford, John Hopkins, so that definitely has an appeal to me as well since I want to do residency at a good school.

As for optionality of residencies mentioned by someone: one of our professors said that in a few years pharm residencies will be required just like for medicine. They are already esentially required if you want to work at certain positions straight out of school and don't have years of work experience behind your back.

I love the craziness! I see what the critical care pharmacists do here and I just love the fast-paced, stress filled excitement of saving lives. Hopefully, I can get into critical care in the hospital I am at now but at our other location 🙂 UofA is starting up an Emergency Medicine pharmacy residency at their medical center- I am sure it will be accredited soon and that might be something I shoot for if I don't land a clinical job right out of school or after a PGY1 Pharmaceutical Practice residency. Like I have said before, I am really really hoping to become a lifer where I am now 🙂 :xf:
 
I am really really hoping to become a lifer where I am now 🙂 :xf:
Me too. Starting with 4-6 weeks of vacation is nice. Personally I hope to never apply for another job again in my life. It's possible!!
 
Me too. Starting with 4-6 weeks of vacation is nice. Personally I hope to never apply for another job again in my life. It's possible!!

Well considering that by the time I graduate, they will have invested $20,000 in me through tuition reimbursement :laugh::laugh: That might be a small incentive to take me, not to mention already being knowledgeable of workflow, the software, and the nuances of how things are done, etc. 🙂
 
Good luck with that. Not to burst your bubble or sound like a fortune teller, but retail is not sustainable and with any luck pharmacy will dump dispensing and transition to direct patient care.
If your love is for business, consider skipping the clinical degree.

Retail is sustainable, I have worked for a local chain which has combined direct patient care with normal dispensing and is doing VERY well.

I've been in the retail business almost a decade now so I can see that we are definitely heading towards a crunch. The main problem is a lot of the people who are running retail pharmacies have no business experience or training whatsover which is why they are running into problems.

And my love is not for business. Do you really think I would bust my ass for six years and then do another 4 in pharm school just because I love business? Please.
 
Retail is sustainable, I have worked for a local chain which has combined direct patient care with normal dispensing and is doing VERY well.

I've been in the retail business almost a decade now so I can see that we are definitely heading towards a crunch. The main problem is a lot of the people who are running retail pharmacies have no business experience or training whatsover which is why they are running into problems.

And my love is not for business. Do you really think I would bust my ass for six years and then do another 4 in pharm school just because I love business? Please.

yeah phathead , good idea opening the retail pharmacies. I think that will end up making you real rich someday as long as you factor in things like mail order and long term care (ie getting into it yourself) Retail is probably going to change in the future, but it's nothing that a good businessperson cant keep up with.

I want to start a nuclear pharmacy but I think the fact that it is going to go cyclotron only in the next 10-20 years will prevent me from ever raising the startup capital.
 
yeah phathead , good idea opening the retail pharmacies. I think that will end up making you real rich someday as long as you factor in things like mail order and long term care (ie getting into it yourself) Retail is probably going to change in the future, but it's nothing that a good businessperson cant keep up with.

I'm not looking to get rich. Obviously I wouldn't just start up a bunch of stores, I have a plan to buy a collection of stores first or at least united them under a common banner.

I don't mock you guys when you say you want to go into obscure narrow fields, why should I catch flak for wanting to do something different?
 
I'm not looking to get rich. Obviously I wouldn't just start up a bunch of stores, I have a plan to buy a collection of stores first or at least united them under a common banner.

I don't mock you guys when you say you want to go into obscure narrow fields, why should I catch flak for wanting to do something different?

I'll buy some stock in your company, phathead 😍 😀
 
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I'm not looking to get rich. Obviously I wouldn't just start up a bunch of stores, I have a plan to buy a collection of stores first or at least united them under a common banner.

I don't mock you guys when you say you want to go into obscure narrow fields, why should I catch flak for wanting to do something different?

wasnt being sarcastic. and dude, you're definitely going to get rich owning multiple stores
 
I want to do geriatrics and LTC, but I wouldn't mind doing retail at least part time. I think it's funny how retail is bashed so much, but the majority of pharmacists end up in retail. I don't mind it, but I'm going to try and stay with Publix if I can help it... it seems like heaven to me compared to some stories posted on here.
 
I'm retail all the way. Gonna get my MBA, hopefully open a bunch of stores... I could specialize as it would be interesting, but that's not where my heart is.

Retail is sustainable, I have worked for a local chain which has combined direct patient care with normal dispensing and is doing VERY well.

I've been in the retail business almost a decade now so I can see that we are definitely heading towards a crunch. The main problem is a lot of the people who are running retail pharmacies have no business experience or training whatsover which is why they are running into problems.

And my love is not for business. Do you really think I would bust my ass for six years and then do another 4 in pharm school just because I love business? Please.

So defensive! Pretty sure there are lots of intelligent people involved in retail pharmacy. My point is, retail promotes pharmacists as salesmen rather than patient care providers by the very nature of the setting. Furthermore, it is impossible to provide completely ethical medical care when your income is based off of a product and not a service. This is why MDs cannot own lab facilities.

Learn some more about the issue (reimbursement, automation of dispensing, mail order) and maybe you'll understand where I'm coming from. Best of luck to you, regardless.
 
I am interested in specializing in solid organ transplant or pediatric oncology. I think that solid organ is really my calling though. It is such an interesting area. My only concern is the availability of residency positions and jobs after. Ideally I would like to stay in the south, and I am afraid that may be difficult with solid organ.
 
So defensive! Pretty sure there are lots of intelligent people involved in retail pharmacy. My point is, retail promotes pharmacists as salesmen rather than patient care providers by the very nature of the setting. Furthermore, it is impossible to provide completely ethical medical care when your income is based off of a product and not a service. This is why MDs cannot own lab facilities.

Learn some more about the issue (reimbursement, automation of dispensing, mail order) and maybe you'll understand where I'm coming from. Best of luck to you, regardless.

You think I don't know what I'm getting into?

Our reimbursement rates have dropped to atrocious levels. Two of our contracts were changed to pay is AWP + 4% this past year, and the AWP used is based off of the costs paid by mail order pharmacies, which are invariably lower for whatever reason, meaning we are either filling at cost or slightly above it. Or how about how some insurances, I'm looking at you Medicaid, will only pay one dispensing fee on a drug per month. Have to have two courses of amoxicillin a month? Well we just lost our fee, lovely.

Considering the average cost of a prescription, before the cost of drug is calculated, is around $10, and yes you are hemorrhaging money left and right. Automation of dispensing, in the terms of robots, have helped immensely. The upfront costs of our robots, per store, is about $250,000 per year, but if you factor in depreciation costs over the ten years we have had some of them it only really amounts to $18,000 per store. So really, you're getting another tech in a way for only $18,000 a year.

Mail order is something which is a pain in our side, but it can be mitigated. First, their separate system of receiving drugs and supplies for a lower cost has to change. There's no reason they should be able to pay 10 bucks less for the same box of One Touch strips that I buy. Second, THEY push a product and not a service, not us.

Retail pharmacists are not salesman. They do not sit there and push particular products all day long. Walgreens, CVS, Walmart, yes they have given the perception that pharmacy is a production based industry when it is in fact a service based industry. Retail is not about throwing 30 tablets in a vial and cramming as many people into a store as possible to make the most amount of money possible.

Independents are filling in the niche voided by the big box pharmacies, that is they are providing true services. MTMs are the future of the retail profession, along with in-store clinics, vaccination programs, respiratory management, etc etc. It is perfectly ethical and I would argue that retail pharmacist can do more for a patient on a large scale than a clinical pharmacist does.

Retail pharmacists can see their patients several times a week, offer advice when needed and even catch an evolution of a condition and offer new methods of treatment. Clinical and hospital pharmacists may save lives, but retail pharmacists improve the quality of life.

Thus, I am well versed in the economics of pharmacy. You don't need to tell me to research more, because I've been there. Perhaps you need to venture out and see some of the more innovative retail pharmacies out there so you can see what we can truly offer.

That and I have a bit of a plan in the works with my former boss to help ensure small towns in rural areas are able to keep their pharmacies, thus not forcing people to have to drive to a Walmart and such. Small towns losing pharmacies, and by an extension ready access to a pharmacist, is one of the biggest problems pharmacies are facing at the moment and I would love to have a hand in remedying that.
 
I am interested in specializing in solid organ transplant or pediatric oncology. I think that solid organ is really my calling though. It is such an interesting area. My only concern is the availability of residency positions and jobs after. Ideally I would like to stay in the south, and I am afraid that may be difficult with solid organ.

I preferably want to stay south of the mason dixon line myself. LOL I don't think it will be hard for us because there are big cities and small rural areas down here, plus a lot of older people want to retire down south where it is warm. I'm not too picky either... I'd be content anywhere in central/northern Florida, Georgia, the Carolinas, maybe Tennessee but I grew up on the ocean so that might be hard for me.
 
I preferably want to stay south of the mason dixon line myself. LOL I don't think it will be hard for us because there are big cities and small rural areas down here, plus a lot of older people want to retire down south where it is warm. I'm not too picky either... I'd be content anywhere in central/northern Florida, Georgia, the Carolinas, maybe Tennessee but I grew up on the ocean so that might be hard for me.
I am not worried about getting a job in retail or even in a hospital in the south. So many areas are under served and are begging for pharmacists. My concern is being able to find a position in solid organ transplant in the south. There just aren't that many transplant units down here. Hopefully it will work out. I so want to stay in the south. I can't imagine living anywhere else!
 
You think I don't know what I'm getting into?

Independents are filling in the niche voided by the big box pharmacies, that is they are providing true services. MTMs are the future of the retail profession, along with in-store clinics, vaccination programs, respiratory management, etc etc. It is perfectly ethical and I would argue that retail pharmacist can do more for a patient on a large scale than a clinical pharmacist does.

Thus, I am well versed in the economics of pharmacy. You don’t need to tell me to research more, because I’ve been there. Perhaps you need to venture out and see some of the more innovative retail pharmacies out there so you can see what we can truly offer.

Just a few things...

If I insinuated you didn't know the issue, I apologize.

However, I stand by my statement. MTM (based off the idea of pharmaceutical care, which was developed by Linda Strand and others were at the U of MN) is NOT retail. And unfortunately, it must be separated from dispensing completely in order to be completely ethical. A pharmacist cannot help a patient decide if they should start or stop a medication when their paycheck banks off of this decision!

The incorporation of MTM into community settings is probable and possible, given that pharmacists providing MTM are not also dispensing. The reason why they should be separated is reimbursement: a dispensing pharmacist is paid for a product while a pharmaceutical care practitioner is paid for a service.

On this note, I believe that pharmacy will have to "give up" the dispensing role eventually in order for pharmacists to be recognized as true patient care providers. It's too murky otherwise.

Take it or leave it, but there's no need to argue. Just giving my viewpoint, and once again, wishing you well.
 
I would love to specialize in Psychiatric Pharmacy. I'm actually interested in psychology altogether...Plan to go to psych school after getting into pharmacy school (or visa versa if life takes me to that route 🙂).
 
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I am not worried about getting a job in retail or even in a hospital in the south. So many areas are under served and are begging for pharmacists. My concern is being able to find a position in solid organ transplant in the south. There just aren't that many transplant units down here. Hopefully it will work out. I so want to stay in the south. I can't imagine living anywhere else!

Network, network, network! Transplant is a small world (smaller than pharmacy, which is already small). Shadow as much as you can, get involved in research pertaining to immunology or cancer, volunteer at sites that serve organ donor patients. Also, PM me if you like...I know a pharmacist in Tennessee who might have some contacts for you. It's never too early to establish mentors.
 
How viable / Why don't more people end up working part time retail & say hospital or another non-retail setting ? This way you get experience in multiple areas and you have more options.

Guess you don't get any/as comprehensive benefits if you're just a part timer?
 
Just a few things...

If I insinuated you didn't know the issue, I apologize.

However, I stand by my statement. MTM (based off the idea of pharmaceutical care, which was developed by Linda Strand and others were at the U of MN) is NOT retail. And unfortunately, it must be separated from dispensing completely in order to be completely ethical. A pharmacist cannot help a patient decide if they should start or stop a medication when their paycheck banks off of this decision!

The incorporation of MTM into community settings is probable and possible, given that pharmacists providing MTM are not also dispensing. The reason why they should be separated is reimbursement: a dispensing pharmacist is paid for a product while a pharmaceutical care practitioner is paid for a service.

On this note, I believe that pharmacy will have to "give up" the dispensing role eventually in order for pharmacists to be recognized as true patient care providers. It's too murky otherwise.

Take it or leave it, but there's no need to argue. Just giving my viewpoint, and once again, wishing you well.

Why can’t a retail pharmacist decide if a patient should start or stop a medication therapy? You’re implying that they are all searching for profits, when they’re not. In fact, in many many cases, there is no financial benefit to us for dispensing a different medication.

Our MTMs are done by pharmacists who do not regularly dispense. They have received additional training and generally MTMs is all though except for emergency fill in needs.

A dispensing pharmacist is not paid for a product. We do not produce it, only release it to the public. It is still a service. That is like saying UPS is in the business of producing packages. They do not produce anything, they provide the service needed to move it back and forth.

And I don’t see how they will have to give up the dispensing role, who else will take it over? Again, I’m not talking about the big box pharmacies. Let them crank out their 1000+ Rxs daily with their drones. I’m talking about an innovative patient oriented independent retail pharmacy. It can be highly successful if run correctly and void of the problems you have mentioned.
 
Why can't a retail pharmacist decide if a patient should start or stop a medication therapy? You're implying that they are all searching for profits, when they're not. In fact, in many many cases, there is no financial benefit to us for dispensing a different medication.

Because more medications=more profit for store=generally good things for people who work there!

Our MTMs are done by pharmacists who do not regularly dispense. They have received additional training and generally MTMs is all though except for emergency fill in needs.

A dispensing pharmacist is not paid for a product. We do not produce it, only release it to the public. It is still a service. That is like saying UPS is in the business of producing packages. They do not produce anything, they provide the service needed to move it back and forth.

But their salary is based off of product. Pay for service means pay based on the number and complexity of drug therapy problems.

And I don't see how they will have to give up the dispensing role, who else will take it over? Again, I'm not talking about the big box pharmacies. Let them crank out their 1000+ Rxs daily with their drones. I'm talking about an innovative patient oriented independent retail pharmacy. It can be highly successful if run correctly and void of the problems you have mentioned.

Look into Canadian hospitals. Pharmacists are actually not involved in dispensing at all! Dispensing is performed by robots and technicians.

Innovative and patient-orientated=ambulatory care, or pharmaceutical care, not retail.

"Pharmacy is the only health care profession that is reimbursed primarily through sale of a product rather than for provision of patient-specific service."
Denzin NK, Metlin CJ. Incomplete professionalization: the case of pharmacy. Soc Forces 1966;46:375-81.

"The most truthful thing I can say about pharmacy practice is this: it is an occupation psychically bound to the act of providing medications to patients, but which knows that it must find a new reason for being."
Zellmer, 1996
ellmer WA. Searching for the soul of pharmacy. Am J Health-Syst Pharm 1996;53:1911-16.

This study found that only 2% of community chain pharmacists' time was devoted to activities involving disease management. Sleath and Campbell observe that "the profession has a long way to go in its efforts to convince the public (or itself) that the patient rather than the drug product is the social object of the profession."
Sleath B, Campbell W. American pharmacy: a profession in the final stage of dividing? J Soc Admin Pharm 1998;15:225-40.

Just something to think about, everybody.
 
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I have full intentions of specializing. Getting my BCOP or BCNS, and/or doing MTM are all of interest to me. Fortunately, I have a few years to narrow it down. 🙂
 
Look into Canadian hospitals. Pharmacists are actually not involved in dispensing at all! Dispensing is performed by robots and technicians.

Innovative and patient-orientated=ambulatory care, or pharmaceutical care, not retail.

"Pharmacy is the only health care profession that is reimbursed primarily through sale of a product rather than for provision of patient-specific service."
Denzin NK, Metlin CJ. Incomplete professionalization: the case of pharmacy. Soc Forces 1966;46:375-81.

"The most truthful thing I can say about pharmacy practice is this: it is an occupation psychically bound to the act of providing medications to patients, but which knows that it must find a new reason for being."
Zellmer, 1996
ellmer WA. Searching for the soul of pharmacy. Am J Health-Syst Pharm 1996;53:1911-16.

This study found that only 2% of community chain pharmacists' time was devoted to activities involving disease management. Sleath and Campbell observe that "the profession has a long way to go in its efforts to convince the public (or itself) that the patient rather than the drug product is the social object of the profession."
Sleath B, Campbell W. American pharmacy: a profession in the final stage of dividing? J Soc Admin Pharm 1998;15:225-40.

Just something to think about, everybody.

I will agree that pharmacy has a long way to go before realizing its full potential. I will also agree that the public has a misconception about the field and does not recognize it as a service as it truly is.

But by your logic, shouldn't someone like a transplant surgeon be considered to be a salesman as well? In that instance the surgeon in question provides a tangible product, the organ in question, and is reimbursed for those services. How is that different from a pharmacist dispensing medications?

You are, more or less, throwing your retail colleagues under the bus referring to them as salesman/woman and, by extension of other comments, unethical.

There are a lot of services pharmacy COULD provide. I did not say they are, but I said that they could and would move in a direction away from dispensing. Lets face it, you won't make money in a retail pharmacy selling cards and kicking prescriptions out the door. Those days are quickly ending.

The only way they will continue to survive, at least on the independent side of things, is to branch out into unique services. I know of pharmacies which solely focus on diabetes care for their patients. 90% of their patients are diabetics and they, along with an MD and two NPs, readily work on maintaining the quality of life for the patient.

Now in that instance, is the pharmacist a salesman and only looking out for their bottom line?
 
Yeah, me too.

What kind of options for immunology are out there for us? I haven't really asked at all about that.
The BCPS has a sub focus termed "added qualification" in infectious disease. I figure I'll continue my studies of that field throughout pharm school (as I already have studied a ton of it during my upper level undergrad bio courses) and shoot for the certification right after pharm school. I think a teaching hospital would be about the extent of most of our opportunities with the aforementioned + residency. However, I dream of landing a job at the NIH or CDC. The CDC has something like 16 rphs.
 
The BCPS has a sub focus termed "added qualification" in infectious disease. I figure I'll continue my studies of that field throughout pharm school (as I already have studied a ton of it during my upper level undergrad bio courses) and shoot for the certification right after pharm school. I think a teaching hospital would be about the extent of most of our opportunities with the aforementioned + residency. However, I dream of landing a job at the NIH or CDC. The CDC has something like 16 rphs.

The CDC!!! 👍 My cousin works there now in epidemiology, but he is a DVM, MPH. Do you know if they prefer MPH along with the professional degree? It seems like most of them have one.
 
I'm So for it, I was thinking of getting the BCOP because I enjoyed working in the Cancer Center at UMB and feel there's so much to explore in Oncology 👍

Consider me in that BCOP bucket with you.
 
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