Why choose pharmacy residency over other career options?

[Timbo]

I guess this question is for residency trained pharmacists. Why did you choose pharmacy school + residency when your salary would've been over twice as high and taken about the same amount of time had you gone to med school? Or you could done PA for a third of the time investment and nearly similar salary? Would you have decided differently if you could go back? If you were a working pharmacist with no residency and no loans remaining, would you rather do residency or get a PA degree?

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[projektreverb]

It’s not really apples to apples though. There’s a higher barrier to entry if I’m going from PharmD to PA then PharmD to Residency.

 

[Pharmacy is a Scam]

I guess this question is for residency trained pharmacists. Why did you choose pharmacy school + residency when your salary would've been over twice as high and taken about the same amount of time had you gone to med school? Or you could done PA for a third of the time investment and nearly similar salary? Would you have decided differently if you could go back? If you were a working pharmacist with no residency and no loans remaining, would you rather do residency or get a PA degree?

Because I wanted to help people, make good money, not deal with blood guts and gore and not be in school until I’m 35.

 

[lord999]

Considering your other posts, are you truly asking for a sincere response?

Did a fellowship plus grad school rather than a residency, and pharmacy was an undergraduate degree. I do not think your numbers are correct for either midlevel practitioners or even physicians. Pharmacists were paid more for less at all points in my career against midlevel except nurse anesthetists due to a CPT anomaly. As for physicians, well, I hope the market works out better as they must put up far higher sacrifices in time, money, opportunity, and sanity to get where they are today (I still think pediatrics and primary care are undervalued by the CPT system compared with their value proposition). Pharmacy commitments are limited, and it is a blessing to me, because I have no problem walking away from it when it suits me, and a curse to you as you will not take the risks for anything better.

I would rather suffer medical school than go for a PA or APRN. It's not a money concern as you are fixated on but an occupational one for me. I prefer the quietness of the hood over general practice any day.

I would not have minded going MD in a Lab Medicine or Radiology role, but I am fine with how life worked out. My LizzyM was Category 1 competitive (and while my grades are old, I still think I could score around 41Q again on the MCAT or its modern equivalent), and I could have taken the MSTP route (was offered conversion in grad school). I liked PhRMA money too much back then to go. I regret only the choice between two good things, but not taking that path.

Knowing what I know now, I "should" have gone MS Quantitative Finance, PhD Mathematics and joined a HFT algorithm shop. But again, it worked out fine. I got more than what I put in. I still think that my programming experience was worth less than I valued it in the past.

 

[Timbo]

Considering your other posts, are you truly asking for a sincere response?

Did a fellowship plus grad school rather than a residency, and pharmacy was an undergraduate degree. I do not think your numbers are correct for either midlevel practitioners or even physicians. Pharmacists were paid more for less at all points in my career against midlevel except nurse anesthetists due to a CPT anomaly. As for physicians, well, I hope the market works out better as they must put up far higher sacrifices in time, money, opportunity, and sanity to get where they are today (I still think pediatrics and primary care are undervalued by the CPT system compared with their value proposition). Pharmacy commitments are limited, and it is a blessing to me, because I have no problem walking away from it when it suits me, and a curse to you as you will not take the risks for anything better.

I would rather suffer medical school than go for a PA or APRN. It's not a money concern as you are fixated on but an occupational one for me. I prefer the quietness of the hood over general practice any day.

I would not have minded going MD in a Lab Medicine or Radiology role, but I am fine with how life worked out. My LizzyM was Category 1 competitive (and while my grades are old, I still think I could score around 41Q again on the MCAT or its modern equivalent), and I could have taken the MSTP route (was offered conversion in grad school). I liked PhRMA money too much back then to go. I regret only the choice between two good things, but not taking that path.

Knowing what I know now, I "should" have gone MS Quantitative Finance, PhD Mathematics and joined a HFT algorithm shop. But again, it worked out fine. I got more than what I put in. I still think that my programming experience was worth less than I valued it in the past.

Yes I am looking into what my options are currently.

From what I've read, physicians make anywhere between 200 to 500k and PAs about 100k currently. How much would a pharmacist with 2 years of residency make nowadays? My current salary is $120k but that could easily drop to under 100k if my hours get slashed from 40 to 32. If I had done residency would my salary compare to that of an MD? Would my net worth compare to that of a PA if we take into account the time and money investment?

 

[lord999]

Yes I am looking into what my options are currently.

From what I've read, physicians make anywhere between 200 to 500k and PAs about 100k currently. How much would a pharmacist with 2 years of residency make nowadays? My current salary is $120k but that could easily drop to under 100k if my hours get slashed from 40 to 32. If I had done residency would my salary compare to that of an MD? Would my net worth compare to that of a PA if we take into account the time and money investment?

Is that all?

Well, it's pretty "simple" then if that's the calculus. Get into medical school, score within the upper 25% to get into IM or better (you can get into IM with worse, but at 25%, it's a virtual lock), do the residency. 8 years temporal and 12 years working (because the expectation for residents is 60 if not 80), and you'll make $225k working at 60 hours if you're not working in the civil service (civil service works for 40 hours and pays between $160k and $180k).

The problem is that your history suggests that you were only average at pharmacy school, which would put you in the bottom quartile of medical school completions, although getting in is going to be challenging.

Let's assume you can afford it financially. Can you afford it temporally and also given that you're basically working for 0 for 8 years after the residency stipend offsets your medical school, would losing 8 productive years at $80k (what you'd make at 32 hours) be worth it?

I don't know, you aren't @Lnsean who had good stats but also went far out of his way to break the cycle to get into medical school. You can ask him, but I doubt it's financially driven as he could have just done the investing gig if that was what he wanted. But you already seem to be in an occupational mismatch, so your dilemma really is, if money is what matters and not the job, is there anything else that I could do for 40 hours that would be worth giving up pharmacy? The answer is no, not even medicine. Why you would give up pharmacy for medicine is completely around the idea that you would enjoy working as a physician more than a pharmacist, because unless you enter dermaholiday or something in the $350k or higher range, the hour differential is not enough on its own to make up for the lost opportunity.

That said, I know of quite a number of pharmacists who made the transition to medicine and were happier people. I also know some who made the transition for monetary reasons who the majority of them are unhappy about it, because they found out that IM's salary versus working conditions were worse than pharmacy (imagine that).

If you cannot stand the idea of being a pharmacist in terms of working conditions, you are not going to enjoy medicine. Medicine is even more burdensome in terms of interference and bureaucracy. The difference is that you control the destiny in a way that we pharmacists only have a passing interest in.

 

[spacecowgirl]

Because I don't want to examine other people's nasty bits. There is no way through any of those careers wherein you can avoid that as part of your training, even if you eventually only look at nasty bits on imaging.

I am interested in medicine and science. I am not interested in managing diabetes, cutting people, feeling lumps, rectal exams, babies, rabies or scabies. It was not a financial decision.

 

[Timbo]

Is that all?

Well, it's pretty "simple" then if that's the calculus. Get into medical school, score within the upper 25% to get into IM or better (you can get into IM with worse, but at 25%, it's a virtual lock), do the residency. 8 years temporal and 12 years working (because the expectation for residents is 60 if not 80), and you'll make $225k working at 60 hours if you're not working in the civil service (civil service works for 40 hours and pays between $160k and $180k).

The problem is that your history suggests that you were only average at pharmacy school, which would put you in the bottom quartile of medical school completions, although getting in is going to be challenging.

Let's assume you can afford it financially. Can you afford it temporally and also given that you're basically working for 0 for 8 years after the residency stipend offsets your medical school, would losing 8 productive years at $80k (what you'd make at 32 hours) be worth it?

I don't know, you aren't @Lnsean who had good stats but also went far out of his way to break the cycle to get into medical school. You can ask him, but I doubt it's financially driven as he could have just done the investing gig if that was what he wanted. But you already seem to be in an occupational mismatch, so your dilemma really is, if money is what matters and not the job, is there anything else that I could do for 40 hours that would be worth giving up pharmacy? The answer is no, not even medicine. Why you would give up pharmacy for medicine is completely around the idea that you would enjoy working as a physician more than a pharmacist, because unless you enter dermaholiday or something in the $350k or higher range, the hour differential is not enough on its own to make up for the lost opportunity.

That said, I know of quite a number of pharmacists who made the transition to medicine and were happier people. I also know some who made the transition for monetary reasons who the majority of them are unhappy about it, because they found out that IM's salary versus working conditions were worse than pharmacy (imagine that).

If you cannot stand the idea of being a pharmacist in terms of working conditions, you are not going to enjoy medicine. Medicine is even more burdensome in terms of interference and bureaucracy. The difference is that you control the destiny in a way that we pharmacists only have a passing interest in.

You're right, I'm not really considering med school at this point in my life for the reasons you mentioned. I only brought up medicine because I'm genuinely curious why one would choose pharmacy + residency as opposed to medicine because the latter would result in higher salary, more job stability/opportunities, more room for career growth, and more autonomy as a practitioner despite requiring similar time and money investment. Yes we all know medicine can be brutal, but is it that bad that people are giving up all the pros I just mentioned?

How did you get that I was only average and based on what history? I'll admit I was average during pharmacy school but only by lack of necessity. Everybody who were not aiming for residency during pharmacy school were average or below because there was no reason to overachieve. However my undergrad stats were 3.9 GPA, 94th %tile PCAT, 2 yrs hospital volunteering exp, etc. I have confidence in my academics.

Personally I'm looking at either PA or pharmacy residency or maybe even grad school for anything else that interests me at this point. Obviously residency sounds like the option that makes most financial sense, however I would also like people's input on job market predictions and job satisfaction. It's not that I can't stand being a pharmacist or the working conditions but I've already seen several stores around me close or cut hours. You can't just can't help but think "when are we next?". The job itself is okay albeit getting monotonous.

 

[lane one]

Yes I am looking into what my options are currently.

From what I've read, physicians make anywhere between 200 to 500k and PAs about 100k currently. How much would a pharmacist with 2 years of residency make nowadays? My current salary is $120k but that could easily drop to under 100k if my hours get slashed from 40 to 32. If I had done residency would my salary compare to that of an MD? Would my net worth compare to that of a PA if we take into account the time and money investment?

2 years of residency will probably get you some job security, but I wouldn't expect much pay increase from what you're currently making. You could probably consistently and reliably make your current salary if you chose the right specialty (growing in demand). I've considered it as well but I don't think the ROI is there for me. There's just not much salary growth potential in clinical pharmacy.

 

[Seriously Serious]

Well, it's not the same time investment. Physician residency is a lot longer, and from what I have heard, more demanding. Given that the PharmD compensation is a lot lower than the average physician, I can maneuver into other fields (Industry, Public Health, Business) without taking a massive pay-cut. More importantly (for me), I do not have to worry about bedside manner or looking at disgusting **** all day.

 

[BidingMyTime]

I guess this question is for residency trained pharmacists. Why did you choose pharmacy school + residency when your salary would've been over twice as high and taken about the same amount of time had you gone to med school? Or you could done PA for a third of the time investment and nearly similar salary? Would you have decided differently if you could go back? If you were a working pharmacist with no residency and no loans remaining, would you rather do residency or get a PA degree?

Because pharmacists doing residency, are doing it for job benefits/satisfaction, not salary. Not everything is about money, some people believe it or not, put a higher priority on the actual work they will be doing and/or the work environment they will be working in. When I first graduated from pharmacy school, pharmacists getting residencies could actually expect lower pay at a job requiring a residency, then non-residency trained pharmacists. Still, there were plenty of pharmacists signing up for residencies, because they wanted these "cushy" jobs, even if they were lower paid. It's still true today, non-resident pharmacists are going to make more working in retail, then a residency trained pharmacist working in a hospital (CA doesn't count, since someone always points out that the inverse is true there, but only in that state.)

 

[Timbo]

Because I don't want to examine other people's nasty bits. There is no way through any of those careers wherein you can avoid that as part of your training, even if you eventually only look at nasty bits on imaging.

I am interested in medicine and science. I am not interested in managing diabetes, cutting people, feeling lumps, rectal exams, babies, rabies or scabies. It was not a financial decision.

Well, it's not the same time investment. Physician residency is a lot longer, and from what I have heard, more demanding. Given that the PharmD compensation is a lot lower than the average physician, I can maneuver into other fields (Industry, Public Health, Business) without taking a massive pay-cut. More importantly (for me), I do not have to worry about bedside manner or looking at disgusting **** all day.

Because pharmacists doing residency, are doing it for job benefits/satisfaction, not salary. Not everything is about money, some people believe it or not, put a higher priority on the actual work they will be doing and/or the work environment they will be working in. When I first graduated from pharmacy school, pharmacists getting residencies could actually expect lower pay at a job requiring a residency, then non-residency trained pharmacists. Still, there were plenty of pharmacists signing up for residencies, because they wanted these "cushy" jobs, even if they were lower paid. It's still true today, non-resident pharmacists are going to make more working in retail, then a residency trained pharmacist working in a hospital (CA doesn't count, since someone always points out that the inverse is true there, but only in that state.)

So then it sounds like the most common reason for choosing pharmacy+residency was not for what it offers over other healthcare careers but what it doesn't offer. How safe do you guys feel clinical pharmacists are from being replaced or made less necessary by technology or advances in pharmaceuticals? (eg advances in EHR software) Do you feel they are at a disadvantage for not having diagnostic or procedural skills compared to other healthcare professions? Or do you feel pharmacists' role will continue to grow within healthcare institutions?

 

[confettiflyer]

Higher eventual pay and better working conditions (inpatient and specialist positions), and the ability to relocate into California without initially having my license yet we’re the biggest draws. I turned down an inpatient job to do it.

 

[BidingMyTime]

Do you feel they are at a disadvantage for not having diagnostic or procedural skills compared to other healthcare professions? Or do you feel pharmacists' role will continue to grow within healthcare institutions?

Yes, pharmacists are at a definite disadvantage because they can't do diagnostic or procedural skills. Pharmacists roles are NOT growing in healthcare institutions, and I don't see that happening at this point.

 

[spacecowgirl]

IDK - I don't feel threatened by technology yet. Drugs are getting more, not less, complicated. Imagine if the order entry person were confronted with the alerts we are plus everything else they have to do/click/document.

 

[owlegrad]

IDK - I don't feel threatened by technology yet. Drugs are getting more, not less, complicated. Imagine if the order entry person were confronted with the alerts we are plus everything else they have to do/click/document.

I agree. I would also say that in general pharmacy systems don’t seem to get better at handling alerts or doing anything else for that matter. Virtually every update makes my job harder instead of easier. Eventually computers will replace every human function but I haven’t seen any evidence that it is even close to happening in pharmacy.

 

[Pharmacy is a Scam]

Yes, pharmacists are at a definite disadvantage because they can't do diagnostic or procedural skills. Pharmacists roles are NOT growing in healthcare institutions, and I don't see that happening at this point.

Yep. “Clinical pharmacy” is a dead-end career path. All it is is coming up with “novel” value propositions of what a pharmacist can bring to the table using generalizations such as “pharmacists are the drug experts” or surrogate markers such as “medication non-adherence results in poor health outcomes therefore we need pharmacists in setting xyz” without giving any thought to what kind of training a pharmacist actually receives and evolving that skillset to meet market demands (I’m talking about during pharmacy school, not completing multiple years of residency to become a “specialist”). In other words, no matter how much makeup you put on a piece of poop, it’s still a piece of poop. And unless we change the ingredients altogether, pharmacy will forever be what it is.

 

[BenJammin]

I'm currently in the process of seeing how we can replace clinical pharmacists with technicians. Residency training might make someone a good "clinician" but it doesn't always translate into perfect people skills. If pharmacists want to prevent physicians and midlevels from stealing dispensing from them, they'll need to figure out how to sell themselves when you take away the computer screen in front of them.

 

[Seriously Serious]

So then it sounds like the most common reason for choosing pharmacy+residency was not for what it offers over other healthcare careers but what it doesn't offer. (1) How safe do you guys feel clinical pharmacists are from being replaced or made less necessary by technology or advances in pharmaceuticals? (eg advances in EHR software) (2) Do you feel they are at a disadvantage for not having diagnostic or procedural skills compared to other healthcare professions? (3) Or do you feel pharmacists' role will continue to grow within healthcare institutions?

(1) I welcome it, where other responsibilities are replaced, newer ones take its place. Technology/automation threatens more than just pharmacy, it threatens literally every profession. Some are more threatened now more than others, but technology will eventually replace every job (maybe not in our lifetime).

(2) I mean, you could make that argument. I don't know about you, but I do not go to a nurse to get a diagnosis (even though some can diagnose).

(3) I believe it will grow (it has to for survival), but that comes with trust.

 

[lane one]

I agree. I would also say that in general pharmacy systems don’t seem to get better at handling alerts or doing anything else for that matter. Virtually every update makes my job harder instead of easier. Eventually computers will replace every human function but I haven’t seen any evidence that it is even close to happening in pharmacy.

100% agree. Yet every time I try to argue this point with someone not in the field they start into the whole "But it's going to happen with AI. AI is going to change everything so fast you won't even see it coming". We still have techs making IVs and hand delivering medications for crying out loud. I get that it's possible, but there's still plenty of low hanging fruit to automate in the meantime. I think the more likely scenario is that technology will gradually allow you to be more efficient in your role, making it possible to fill the same amount with less people.

 

[spacecowgirl]

And let's not forget that AI is not scalable for smaller institutions. Unless it's a lot cheaper than a tech (who can do many things besides compound an IV) it won't be realistic. Or we'll see small hospitals die more than they are which is a damn shame.

 

[lord999]

I'm currently in the process of seeing how we can replace clinical pharmacists with technicians. Residency training might make someone a good "clinician" but it doesn't always translate into perfect people skills. If pharmacists want to prevent physicians and midlevels from stealing dispensing from them, they'll need to figure out how to sell themselves when you take away the computer screen in front of them.

I'll be curious if the training costs outweigh the cost savings depending on turnover. I'm pretty sure there is a happy medium somewhere, I have seen anticoagulation clinics convert over to technicians successfully (and I'm a major advocate for med rec to be a mostly tech function).

 

[spacecowgirl]

Tell me more?

Me?

 

[BenJammin]

Tell me more?

I'll be curious if the training costs outweigh the cost savings depending on turnover. I'm pretty sure there is a happy medium somewhere, I have seen anticoagulation clinics convert over to technicians successfully (and I'm a major advocate for med rec to be a mostly tech function).

Last year I met two pharmacy owners who were doing community pharmacy in a totally different way. One was embedding pharmacists into physician clinics for med recs/counseling/promotion of pharmacy services and the other one was doing the same thing but utilizing physician billing for compensation of CMRs. I'm trying to figure out how we can do those same services but with technicians. Let the pharmacist do the behind the scenes stuff but have the face of the pharmacy service be a technician who can get the job done.