Fellowships 101: Q&A with a Residency and Fellowship Director

Residencies are typically the first postgraduate experience pharmacy students ponder after pharmacy school. However, there is a wide array of postgraduate opportunities for pharmacy graduates, and little attention is given to some of these other educational opportunities. One such opportunity is the fellowship.

We interview Tracy Sprunger, PharmD, the director of residency and fellowship programs and preceptor development at Butler University College of Pharmacy and Health Sciences, in Indianapolis, Indiana, to help us discern the differences and similarities between fellowships and residencies, and to learn about different types of fellowships available for new pharmacists.

Q: First off, let’s begin with the following: what is a pharmacy fellowship?

A: The American Society of Health-System Pharmacy defines a fellowship as “A directed, highly individualized, postgraduate program designed to prepare the participant to become an independent researcher.”1

When I describe fellowships to students, I generally say there are 2 different types of fellowships:

1. Traditional fellowship: this is an academic fellowship more focused on research—up to 80% research and 20% clinical experience.

2. Industry fellowship: this is an opportunity, typically within the pharmaceutical industry, which allows the fellow to gain experience in various departments within a pharmaceutical company—like drug information, health economics, and pharmacovigilance. Fellowships are not accredited. However, a few fellowships have completed a formal peer review process through the American College of Clinical Pharmacy (ACCP).2

Q: What is the difference between a fellowship and a residency?

A: It depends on the type of fellowship. Residencies are typically heavy on clinical and patient care experiences (typically 80% clinically based experiences). Academic fellowships, on the other hand, tend to focus more on research in a specific clinical area like infectious diseases, nutrition, and cardiology. Pharmaceutical industry fellowships may not be as focused on research, but incorporate different aspects of clinical research or drug development within the pharmaceutical industry. PGY-1 residencies focus on pharmacotherapeutic skills for a broad patient population, whereas PGY-2 residencies and academic fellowships are more specialized.

Q: Can you complete both a residency and a fellowship?

A: Yes. Often residencies are required before a fellowship. Most fellowships are 1 to 2 years. For academic fellowships, most, if not all, require PGY-1 and PGY-2 training, then a yearlong fellowship. Generally, industry fellowships are offered straight out of pharmacy school, while others may require a PGY-1 residency. There are no standards.

Q: When did fellowships begin in pharmacy?

A: Residencies have been around for 60-plus years. Fellowships, on the other hand, have not been around quite as long as residencies and only began attracting a great deal of attention around the mid-1980s when it came to defining them and attempting to set standards. The good news is that there are now more than 100 fellowship opportunities for pharmacists, and they vary widely. If you’ve seen 1 fellowship program, you’ve seen 1 fellowship program!

Q: ACCP has a database of residencies, along with some fellowships. Is there 1 place where pharmacy students or pharmacists can search all fellowships?

A: I’m not aware of 1 centralized location for all currently available fellowships. The ACCP incorporates some fellowship opportunities in its database of residency, fellowship, and post graduate opportunities.3 Some fellowship programs are represented at Midyear and may offer interviews in the Personnel Placement Service. Also, most industry fellowships are posted as opportunities at the pharmaceutical companies involved, the schools involved, or both, and they may require searching each program individually for specific program and application information.4, 5

Q: When choosing between a PGY-2 residency and a fellowship, what should an early-career pharmacist consider?

A: It depends on what position you are ultimately seeking and the training you need to secure that particular position. If you want to be a faculty member who does a lot of research, you need an academic fellowship. A second year of residency might be good option, particularly if you want to specialize. Everyone I know who has completed a fellowship has typically completed 2 years of residency first.

Q: The majority of fellowships appear to either be clinical- or research-based in academia and in the pharmaceutical industry. Are there others?

A: The academic- or research-focused fellowships are typically clinical specialties. The industry fellowships tend to be more focused on different functions within the industry for drug development and support—such as drug information, pharmacoeconomics, outcomes research, clinical research, etc.

Q: Most fellowships aren’t accredited by an organization, unlike most residencies. How can a pharmacist ensure they are getting a quality experience through a fellowship?

A: As I previously mentioned, the ACCP has peer reviewed a few fellowship programs. If pharmaceoeconomics/outcomes research is your passion, the International Society for Pharmacoeconomics and Outcomes Research, for example, has set fellowship standards with ACCP. Other professional associations, from time to time, also offer fellowships. The best advice I can offer when comparing programs is to find people who went through the program previously and find out what they did after the fellowship or residency. Ask them what they learned from the experience. Ask them, if they could do it over again, would they? Ask a lot of questions. It’s free to ask questions!

Q: What have previous fellows you have known gone on to do with their careers, post fellowship?

A: Drug industry work and academia, mainly. The majority go into academia.

Q: What advice do you have, in general, for pharmacists who want to complete a fellowship?

A: Do your research and homework. Fellowships are a little more challenging than residences because they aren’t in 1 central location. Shadow or do a rotation experience in industry if industry is what you’re curious about. Do research as a pharmacy student if research is your passion. Gain and seek experiences to learn in areas that you care about. Get teaching experience. Of course, be sure to maximize your Advanced Pharmacy Practice Experience rotational experiences, as well. Networking is important. Doing your homework is important, too. Fellowships, like residencies, are competitive—so start early, do your due diligence, and make sure you put your best foot forward when seeking out a fellowship and any postgraduate opportunity.

Erin Albert, MBA, PharmD, JD is an associate professor/director at Butler University COPHS, as well as a writer and entrepreneur. For more on her work, log on to erinalbert.com.

References

1. American Society of Hospital Pharmacists. Definitions of pharmacy residencies and fellowships. Am J Hosp Pharm. 1987;44(5):1142-1144. ASHP website. www.ashp.org/DocLibrary/BestPractices/EducEndDefs.aspx. Accessed November 24, 2014.

2. American College of Clinical Pharmacy. Peer review of fellowships. ACCP website. www.accp.com/resandfel/peerReview.aspx. Accessed December 1, 2014.

3. American College of Clinical Pharmacy. Directory of residencies, fellowships, and graduate programs. ACCP website. www.accp.com/resandfel/. Accessed December 1, 2014.

4. Larochelle PA, Giang DK, Silva MA, et al. Post-pharmD industry fellowship opportunities and proposed guidelines for uniformity. Am J Pharm Educ. 2009;73(1):20. National Center for Biotechnology Information website. www.ncbi.nlm.nih.gov/pmc/articles/PMC2690870/. Accessed December 1, 2014.

5. Bookstaver PB, Rudisill-Caulder CN, Smith KM, Quidley AD. Roadmap to Postgraduate Training in Pharmacy. New York, NY: McGraw-Hill Medical; 2013.