Pharmacy Residency or Not?

If you were a manager or director of a hospital pharmacy, what candidate would be the most desirable for your team:

1. A fresh-out-of-school pharmacist who just passed the boards
2. A fresh-out-of-school pharmacist a year ago that just completed a residency
3. A seasoned 5-10 year pharmacist in the same type of pharmacy

This is the question I have been thinking about in the past few months, and a follower here has mentioned I should do a post on it and try to lend some insight without bias.

That's the hard part because I fall into category 3 and you can better believe that I truly believe the seasoned 5-10 year pharmacist has a lot over the other two.  So, can I do this without bias?  At least I have gotten my opinion out of the way.

The pharmacist that just passed the boards is likely to have the most up-to-date knowledge at his/her fingertips... or rather brain.  He or she more than likely has just memorized a plethora of information since we cannot bring Lexi-Comp or any other reference into the boards exam to help us pass.  But is it true that knowing information is very different from applying it in practice?  I remember graduating with that same idea of knowing my stuff but the job I chose helped me quickly forget about 80% of what I learned (retail).  I did not need to know sterile technique.  Gone.  I memory dumped everything about IVs and anything else that I could and focused on classes of drugs commonly used in retail, the side effects, the interactions and giving flu shots.  I obtained my immunization certification and let those that graduated with me that wanted to do a residency to go for it.  Heck, they were making $40K to my 100K.  Seriously.  Easy decision with Sallie Mae knocking on my mailbox monthly for her piece of the pie.  I wanted a bigger pie to have left for ME.

The new grad has the knowledge, but the application is not there yet.  That's my point.

The residency trained pharmacist, on the other hand, has had the knowledge memorized and hopefully had the opportunity to apply that knowledge surrounded by professional pharmacists who helped them to grow both in learning and application.  It really depends on where you did your residency, but yes.  If you did one, kudos to you.  Would I do one now if I could do it all over again?  YES and YES.  Sorry, my opinion that your last rotation of clinicals being equal to a residency is not.  To arrive at a facility for one month and to move on doesn't even get you started on the nuances of the place much less dealing with the different personalities of physicians and nurses.  It doesn't matter if you did the same work as the resident.  He/she will be there for awhile.  It is just different.  Plus, they are sacrificing about 80,000 in pay probably.  Maybe less.  It is just different.

The seasoned pharmacist.  Big sigh.  He/she could be really over it, could be the type that wants to do more (me), or could just really be doing what they love.  The neat thing about experience is that it is priceless.  A pharmacist that has been in the field for over 20 years really has an appreciation for it all.  Yes, they may have moved on past order entry and clinical floor work.  They may be in management at this point, but some remain in a operational/clinical role.  I truly have more appreciation for this category because the truth is I'm heading there faster than I would like.

I have had this blog now for several years, and I remember when I started it I wanted to fall in the ranks with others that griped about retail.  I had a different story for most every HOUR of the day.  Things that you could never imagine were happening around me and it was so very entertaining.

I went through a conversion from retail to home infusion to LTC to hospital.  The last move was made for me because the LTC I worked on sold to another company and lay-offs were happening.  I had to find a place before it was my turn.  I would probably still be there had it not fallen on hard times running customer service, the IV program and maybe even PIC.  Who knows.  Things change all the time just like in every area of life and you have to take the bull by the horns and work with what you have.

The original question:  Pharmacy residency or not?  If you are graduating from pharmacy, please for the love of God do a residency.  There are too many pharmacists now and you have to differentiate yourself.  If you are not or cannot do one, find a niche.  Find something that doesn't have a glass ceiling.  Pass the BCPS exam after three years of experience.

Does the three year rule of working before you can take the BCPS equal one year of residency then?  Perhaps.  I can see how this is a good rule of thumb of knowledge.

Who would you hire of the three and why?

Read this article.  Seriously a good read from the ACCP.

Is It That Bad?

A potential pharmacist student commented on my blog here asking me if pharmacy was really that bad... he said he was reading blogs about the medical profession and all we do is gripe and complain. Got me to thinking this early morning about that question... "Is it that bad?" For me, no way it's not that bad or I would have already gone back to school to do something else. I believe it's human nature to complain some and especially to complain anonymously. Things about pharmacy that I have loved... This is a list probably needed to be completed to tell you guys and gals the GOOD stuff.

1. If you loved science and you loved biology in high school and college then pharmacy could be the career for you. Not only did I have the opportunity to learn about chemicals, etc..., but I learned the various ways they are changed, metabolized, and excreted by the human body. Not only that, but the different ways they can be broken down by DIFFERENT human bodies - some with renal issues, some with hepatic issues, etc... Everyone can be truly different. Drugs can react differently. I found this one single point of pharmacy to be quite fascinating.

2. If you want to graduate in 6-8 years and start out making six figures (potentially) this may be the job for you. I found in 1999 when I graduated that I was making close to six figures, but a lot of the older pharmacists were really ill about the new guys on the block because they knew we were making the exact same pay. It wasn't pay based on performance but LICENSURE. For the new guy, this is great; for the old guy, it can be disheartening to think that little youngin' next to you is bringing home the same bucks. I'm almost 10 years out of pharmacy school now (unbelievable time flies!) and it STILL DOES NOT BOTHER ME. I don't get wrapped up in petty stuff, and I figure if you really want a dollar more per hour, you could have negotiated up front. BE A SHARK when you negotiate - ASK FOR THE IMPOSSIBLE. If you do not ask, you will NOT RECEIVE. Vacation... they say we'll give you 3 weeks. Tell them that you want 4 weeks. Go up on pay by at least 5-10K per year. Why not? They want you and they will negotiate just like if you are selling a house.

3. Options other than retail. When I tell people I'm a "pharmacist," the majority think retail. What is great about pharmacy is that there are MANY MANY options in different jobs. Of course coming out of school, retail is the most lucrative in pay, but over time other positions can be just as tasty. There are the hospital pharmacists (me), the home infusion pharmacists, the nuclear pharmacists, the retail pharmacists, the professors in a pharmacy school, the long-term care pharmacist, the consultant pharmacist, and the specialty pharmacists within other settings. You can do a residency, make yourself a little different than Joe PharmD next to you, and land a Critical Care Specialty Pharmacist position at a big city hospital, make rounds with a physician that actually respects you if you know your shit and drink Starbucks coffee everyday leaving for home at 5pm like the rest with bankers' hours. The CHOICES ARE ENDLESS really.

I've been out of school, like I said, for 10 years almost. I have tried retail, home infusion, long-term care, and hospital. I love little bits of all of them... but I find hospital to be the most comfortable for me.

I would never tell someone to NOT pursue pharmacy. It's a great career for anyone... BUT you will find some complaining out there... even from me.

Blogs have to be funny after all, right?