Postgraduate Training—Or Not?

It is that time again! The AmericanSociety of Health-System PharmacistsMidyear Clinical Meeting signaledthe beginning of resident recruitment.I suspect that more than 1000recent graduates will be evaluatingalternatives for continuing their educationthrough organized general practiceand/or specialty residencies. Hundredsof hospitals and scores of colleges ofpharmacy began the recruitment phaseat the Residency Showcase and PersonnelPlacement, and the excitementat the meeting was palpable. I also wasimpressed this year by what appearedto be a substantial increase in communitypharmacy and ambulatory care residencyprograms for which residentswere being recruited.

I am an avid supporter of residencies,and I strongly encourage UNC studentsto consider a residency as a prelude toestablishing their own practice. I sometimesdescribe a residency as an organizedway to consolidate years of pharmacypractice experience into 1 year(or 2 if one follows a general practiceresidency with a specialty residency). Iam sure that many residents feel as ifthey virtually live at their hospital duringtheir program and that they willvouch for my description.

Pharmacy practice and performanceexpectations by patients, physicians,and other providers are evolving rapidlyin many organizations, including ambulatorycare environments. Admittedly,this evolution is in various stages and ischanging at a different pace amongprovider organizations. Residency trainingis one solution to prepare youngpractitioners to assume clinical or practicemanagement responsibilitieswith aminimum of on-thejobtraining. In otherwords, the experiencemay help "jump-start"an individual's careerand allow him or herto begin at a higherpractice level.

I prefer to hire newpractitioners with residencyexperience. Yet,with the limited numberof residents seekingjobs, it is challengingto find the level ofexpertise in a practitionerthat I want. Onthe other hand, residencyexperience isnot necessarily essentialfor all pharmaciststo practice in someacute care and ambulatorycare environments.In fact, somecolleagues suggestthat schools of pharmacyare insensitive towhat the marketrequires in terms ofpharmacist skills and that we "overtrain"new graduates.

Given the above and the diversityof practice expectations across thecountry, we have a true conundrum. Itseems to me that schools of pharmacyand the practicing pharmacist communityboth have incentives to collaborateon preparing pharmacists (and perhapseven retooling graduates) for contemporarypharmacy practice. Instead ofdivisive debates on whether new graduatesare overtrained or whether pharmacypractice lags behind in someenvironments, should we not worktogether to align ourselves from botheducational and practice perspectives,and then agree on a strategy for thefuture?

Collaboration in preparing professionalstudents for the workforcedoubtless will improve. In the meantime,however, postgraduate trainingprograms remain a worthwhile investmentfor young pharmacists to make,and employers will compete aggressivelyfor their skills.^PT

Mr. McAllister is director of pharmacyat University of North Carolina (UNC)Hospitals and Clinics and associatedean for clinical affairs at UNCSchool of Pharmacy, Chapel Hill.