Pharmacy Residency Is Not the End-All-Be-All for Pharmacy Students

If current pharmacy school experiences are anything like mine, there were a few promises, including a great career, a high-paying salary, and a lot of opportunities. Despite this promise, the curriculum largely focused on 2 career outcomes—retail or hospital—with particular focus on residencies. There were some rumblings about “industry” positions, but ultimately, there were not many resources or professors to help understand the full scope of opportunities available to pharmacy professionals.

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The Coveted Top of Pharmacy License Practice

In my final year of pharmacy school, I spent time in my rotations learning as much as I could. For someone who values practical experience over didactic coursework, this was my time to shine. I wanted to do everything available and volunteered to take on projects beyond the expectations for an advanced pharmacy practice experience student. I rounded in intensive care units, participated in pharmacy and therapeutics committees, implemented medication safety protocols for nurses administering hazardous drugs, shadowed prescribing pharmacists, and so much more. Throughout my work, what stuck with me the most was the single-minded focus of many of my preceptors on residency.

The promise of residency was practicing at the top of the pharmacy license: managing drug therapies, facilitating care, and, in some cases, prescribing. That is what many students sought in a position following pharmacy school; they believed residency was the way to get there. But when speaking with residents, I thought it seemed like putting life on hold for a year. The residents always looked worn out and tired after coming off a string of long shifts.

In my rotation at a Veterans Affairs hospital, I had a oneon- one conversation with the director of pharmacy, who informed me that in a few years, she would hire only pharmacists with residency experience, even for outpatient pharmacies within their health system. Although the intention may have been to encourage me to pursue residency, it felt like a looming threat to my career, as I hadn’t been preparing residency applications yet and it was already October.

Furthermore, the implications for all hospital pharmacists needing to be residency trained were, and continue to be, dismal. First, that means that residency training did not yield the promised “top of license” job placements. Residency trained pharmacists would be in typical dispensing roles that many can achieve directly out of school. So, why go through a year of overwork and underpay? Second, this also means that residency training did not result in a higher-paying role. One promise of a clinical pharmacist role is higher compensation potential, but knowing hospital systems, the compensation would not go up—just the requirements for landing the job.

The Best Thing to Happen to Me

The omnidirectional pressure to complete a residency got to me in that final year of pharmacy school. I started the process of collecting my application materials. I dug my heels in and applied to too many programs, interviewed at a few programs out of state, ranked only half of them, and did not match. I tried again in the second round, interviewed a few more times, and opted not to participate in the scramble. Some programs I could not even pretend to want, so I did not include them on my ranking. It did not feel like a good fit, whether it was the culture, the residents looking stressed out, or not being able to envision myself in the program. I followed my intuition, even if that meant an uncertain future.

Ultimately, not matching was the best thing that ever happened to me.

Finding Purpose in Serving Large Populations

After trying to fit a square peg into a round hole (I am the peg; residency is the hole), I expanded my efforts into other areas. At this point, I did not know what I was going to do, and yes, I felt some panic around not knowing. But with a resilience mind-set, I knew there would be some way forward.

Fortunately, I had been medical writing part time while in pharmacy school. One option was to lean in and learn more about medical writing, pharmaceutical marketing agencies, and what I call “industry-adjacent” industries. I define this as organizations and roles with a lower barrier to entry than pharmaceutical manufacturers but still worked with those companies. This includes technology companies, start-ups, data companies, marketing agencies, contract research organizations, consultancies, and other organizations that act as vendors to pharmaceutical manufacturers.

I had a leg up on learning more in this area because I knew professionals in these fields already. I could reach out to them for answers and interview coaching. Without them, I would not have been able to land an industry-adjacent role. After not matching with a residency, I interviewed for a professional education role focused on patient access, and the rest is history. I learned and continue to learn everything I can about patient access, managed care, and most recently, market access. I have held various roles in industry-adjacent companies, all of which have not had a doctor of pharmacy as a requirement.

Despite that, pharmacy education has been central to my success, and I have utilized my pharmacy knowledge in various ways. For example, I have taught others how to manage the health care system and administrative requirements for getting patients treatment. I have built certifications for health care and life science professionals. I have also consulted on how to build supportive patient services programs, thinking outside the box by putting myself in patients’ shoes, and understanding specific patient challenges. I have helped pharmaceutical manufacturers understand the competitive landscape and showcase the benefits of their drugs. Furthermore, I have evaluated clinical evidence of new drugs to propose specific health care coverage to insurers.

In these various functions, I rediscovered my passion for helping patients but on a bigger scale. Instead of helping local populations, I was helping others facilitate access to health care for hundreds or thousands of people. As I continued to evolve my skills, those numbers turned into hundreds of thousands and potentially millions of people.

So my promise: There are plenty of opportunities. They may require a little more effort, research, and networking, but a pharmacy degree is enough, and you are enough.

About the Author

Amanda DeMarzo, PharmD, MBA, is a health care and life sciences consultant who works to improve the current health care system through expanding training and education, emphasizing patient-focused performance, and utilizing data and advanced technology to enhance patience access.