Going Back to Get Ahead: Transitioning from Pharmacist to Pharmacy Resident

Graduating from pharmacy school is significant milestone for pharmacists, as it marks their long-awaited transition from student to professional and the beginning of their career. While many of us are tempted to jump headfirst into the workforce, completing a post-graduate residency has become increasingly necessary for pharmacists who wish to work in direct patient care areas. In fact, ASHP and ACCP have proposed that all pharmacists working in direct patient care roles be residency trained by 2020.^1,2 Additionally, the opportunity to spend a year learning from senior clinical pharmacists may prove invaluable, and could facilitate the development of clinical skills better than work experience alone.

I recently contemplated whether residency was the right decision for me. One year after I accepted a staff position at a large academic medical center, I began to consider going back to complete a pharmacy residency. Despite the financial challenges and time commitment of a one year residency, I eventually decided this was the best fit for me. My residency, while not without its challenges, has added tremendously to my professional development and has created opportunities that would otherwise be unavailable to me.

Financial Challenges

My most challenging obstacle prior to starting my residency was figuring out what to do with my student loans. Accepting a residency position meant cutting my salary in half, and student loans were my largest monthly expense. Fortunately, there were a few options I was able to take advantage of to help lessen the financial impact of my loans during residency.

For example, many loan providers offer income-based payment plans that may reduce your monthly payments. Additionally, most loan providers offer forbearance options that allow you to stop making payments on your loans for a specified amount of time. Different providers have their own requirements however, so it is essential to contact your loan provider to find out if you qualify. There are also a few government-sponsored loan forgiveness options, including programs that provide total loan forgiveness for qualifying loans after a predetermined number of payments.

Time Management

During my residency, the only thing more valuable to me than money was time. In my previous position, I had little-to-no work responsibilities outside of my scheduled shift, so the largest adjustment to my residency was learning how to manage my time more effectively.

However, this ultimately helped me to become a better communicator. I began keeping my email organized with folders and subfolders so I could access valuable information quickly and respond in a timely manner, allowing me to identify scheduling changes or project updates in real time and avoid being blind-sided with an unexpected meeting or deadline. Staying organized can also help you to more easily recognize when you have free time and schedule non-work related activities.

Changing Roles

As a staff pharmacist at the same institution at which I completed my residency, I already knew most of my preceptors. My new relationships with these preceptors proved challenging at times, as my transition from a peer to a mentee meant that I was now constantly being evaluated on my performance by my former colleagues.

Your preceptors want to maximize your experience by praising you when you’re doing well while also giving you meaningful feedback on areas in which they believe you can improve. Taking advantage of this is critical to your success as a resident and future pharmacist. What worked well for me was learning how to be an active listener. I would suggest writing everything down while your preceptor is giving you feedback and try to identify patterns or trends in what they are saying. This process may feel difficult at times, but it will help drive your growth and development.

Traditional vs Nontraditional

Pharmacists considering residency training have many options. Rising expectations for pharmacists to complete residency training have led to the creation and expansion of “non-traditional” residencies. These programs extend the traditional one year PGY1 program into 2 or 3 years. Advantages to this include a less substantial salary decrease and lower time commitment. While accredited nontraditional programs are required to follow the same regulations and standards that govern all residency programs, they expand the advanced training opportunities of a residency to employees of an institution’s pharmacy department who otherwise would not be able to complete a traditional program.³ Although the national residency directory does not list non-traditional programs separately, there are at least 11 non-traditional residency programs in the United States.⁴

Conclusion

Residency can be a transformative experience both personally and professionally. The growing demand for pharmacists to be residency trained is a reflection of the expanding role of pharmacists as essential health care providers. The difficult decision to pursue residency is only the first of many, but it will likely prove well worth the effort. I graduated this summer and know this was the right decision for me; with this advanced training, I now have the opportunity to work in a more patient-care centered role, and I feel much more confident in my abilities as a pharmacist. The journey through residency may be challenging, but through proper preparation, commitment to time management, and maintaining an open mind, your growth as a pharmacist will be well within reach.

Jonathan St. Onge graduated from the University of Connecticut School of Pharmacy and works as a clinical pharmacist at Yale New Haven Hospital. He started his career as a staff pharmacist primarily working in the central pharmacy. After completion of his residency training, he moved into a multi-specialty clinical pharmacist role with special interests in intensive care and emergency medicine.

References

• American Society of Health-System Pharmacists. ASHP long-range vision for the pharmacy work force in hospitals and health systems. Am J Health-Syst Pharm. 2007; 64:1320-30.
• Accreditation Council for Pharmacy Education. Accreditation standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree. www.acpe-accredit.org/pdf/ACPE_Revised_PharmD_Standards_Adopted_Jan152006.pdf (accessed 2017 May 8).
• Strawder et al. Accreditation of nontraditional pharmacy residency programs. Am J Health-Syst Pharm. 2014; 71:276-77.
• Vong et al. Implementation of a nontraditional postgraduate year 1 pharmacy residency program. Am J Health-Syst Pharm. 2013; 70:2019-28.