Q&A with a Pediatric Pharmacotherapy PGY-2 Pharmacy Resident

Danielle McDonald, PharmD, is a PGY-2 pediatric pharmacotherapy resident at Rutgers, the State University of New Jersey in Piscataway. She completed her PGY-1 training at Atlantic Health System in Morristown, New Jersey, and she holds a PharmD degree from the Ernest Mario School of Pharmacy at Rutgers in Piscataway. Her professional interests include pediatric infectious diseases, medication safety, and teaching. She hopes to obtain a clinical position in pediatrics at an academic medical center upon completion of her residency. She sat down to answer some questions about her residency.

Question: Why did you decide to pursue a PGY-1 and PGY-2 pharmacy residency?

Answer: In my last year of pharmacy school, I completed the KNIGHT ScholaRx program at Saint Barnabas Medical Center in Livingston, New Jersey. This program consisted of a diversified block of advanced pharmacy practice experiences, longitudinal assignments, and a clinical research project. For the first time in my training, I was exposed to hospital pharmacy and many clinical practice areas, including pediatrics. My preceptors and experiences at this institution motivated me to pursue residency training in order to strengthen my clinical knowledge in a challenging yet supportive environment.

During my PGY-1 residency training, I explored many of my interest areas with an open mind and the support of amazing preceptors. Within the first few months of residency, I solidified my love for pediatric clinical pharmacy. I worked with an interdisciplinary team in the pediatric intensive care unit, completed research in the pediatric emergency department, and participated in pediatric-focused teaching opportunities at local schools of pharmacy. For me, pursuing a PGY-2 in pediatrics was an easy and exciting decision to advance my career and prepare me to work as a pediatric clinical pharmacist.

Q: What is the structure of your residency program?

A: My PGY-2 residency program is uniquely structured with opportunities to practice in 5 different medical centers. At least 1 pediatric faculty member from Ernest Mario School of Pharmacy is affiliated with each of the medical centers. My preceptors and their established practices guide my residency training in different subspecialty areas. I also take part in various teaching opportunities at the school of pharmacy’s professional courses and electives. Additionally, I had the opportunity to pursue a per diem staffing position in a pediatric satellite pharmacy within 1 of the medical centers.

Rotation opportunities include general pediatrics, pediatric intensive care, neonatal intensive care, pediatric hematology/oncology, infectious diseases, neurology, emergency medicine, and ambulatory care. I am lucky to have a lot of flexibility with my rotation schedule and research projects so that I can cater my training to my subspecialty interests.

Additional responsibilities of my residency program include presentations on local, state, and national levels. For instance, I present patient case seminars at the end of each practice site block, a poster presentation at the American Society of Health-System Pharmacists Midyear Clinical Meeting, and a platform presentation at the Pediatric Pharmacy Advocacy Group (PPAG) meeting.

Q: What are your day-to-day tasks?

A: My day-to-day tasks vary with my rotation schedule on a month-to-month basis. Generally, I round with a multidisciplinary teaching team on the service I am on for that particular month. I typically arrive at the hospital early in the morning to review patients prior to rounding so that I am prepared with any interventions I would like to discuss. After rounds, I may lead topic discussions with students, follow-up on patient care from the morning, or work on research or presentations.

Q: What are the benefits of completing a PGY-2 residency? What about the disadvantages?

A: For me, each of my residencies have truly been a gift. I feel lucky every day that I get to come to work to do what I love with the support and encouragement of so many wonderful people that I respect and admire. Yes, I work hard, but that works pays off 10-fold, and I have accelerated my career in a relatively short window of time.

During my PGY-2, I have been able to focus on my specific interests, and each day I become more confident in my skills and independence. Residency programs are designed to make residents succeed, to give them a competitive edge in the job market, well-equipped to handle any challenges. I have been able to pursue research, teaching opportunities, and other scholarly activities, most of which are already pre-built into my program. Beyond the structure of the program, I have the network and resources to accomplish additional goals I have set for myself within the residency year.

In regards to disadvantages, you definitely take a pay cut, and you are working many more hours than you normally would in most full-time positions. I wouldn’t say a PGY-2 residency is for everyone, but, if you are motivated and passionate about a specific area of pharmacy, the benefits more than outweigh any potential disadvantages.

Q: How did you decide your PGY-2 program was the right fit for you?

A: I knew I wanted to find a program that would provide me with many teaching opportunities and the ability to explore my subspecialty interests. I also wanted to be exposed to multiple institutions in order to gain broader knowledge of variances in clinical practice. The pediatric pharmacotherapy residency program at Rutgers University met everything on my residency “wish list” and more!

Best of all, at the very heart of the program are amazing preceptors and an incredible program director. Fortunately, I previously worked with many of these preceptors, whom I admired greatly as a student and PGY-1 resident. Once you narrow down programs based on the offered opportunities, selecting the right fit often comes down to the people. The people with whom you will work, the ones who are going to teach, shape, and guide your post-graduate education, are, in my opinion, the most important aspect of a residency program. Knowing that, it was very clear to me that my PGY-2 program was the perfect fit.

Q: What opportunities does a PGY-2 pediatric pharmacotherapy resident have after completion of the program?

A: There are many opportunities for a PGY-2 pediatric pharmacotherapy resident after completion of the program. From my personal exposure, most PGY-2 graduates go into clinical positions in their specialty areas at academic medical centers, but the options are really endless. You can stay general within pediatrics or pediatric critical care, pursue a subspecialty area, enter academia, etc. The best thing about a career in pharmacy is that you can always evolve your interests and involvement. You are trained, especially through residency, to succeed in the face of challenges and to be a life-long learner. These qualities enable you to pursue any career within or even outside of your formal training.

Q: What advice do you have for students looking to pursue a residency in pediatrics?

A: Keep an open mind during PGY-1 and get exposed to as many specialty areas as possible before solidifying your decision about PGY-2 training. You may be surprised by what you love. Even your least favorite course in school could become your passion in clinical practice. If you decide on pediatrics, still keep your involvement broad. Pediatrics encompasses patients as young as neonates and up to 21 years or older, and emerging subspecialties blend different areas of training. It is important to get a strong general foundation before delving into PGY-2 specifics.

With that in mind, there are many pediatric-focused opportunities you can pursue during your time as a student or PGY-1 to strengthen your knowledge outside of general rotations. One of the best ways to get involved and inspired is by becoming a member of a national organization, such as PPAG. Through this membership, you can attend national conferences, actively participate in special interest groups, and present research to experts in your field of interest. These connections will help you network and learn more about advances in pediatric pharmacy around the world. Interacting with other clinical pharmacists at these meetings always reinvigorates by passion for pharmacy and the pursuit of excellence.

Overall, pediatrics is an exciting field with many opportunities for pharmacists to optimize patient care. Completing a residency in pediatrics is 1 of the best ways to prepare you to provide that care and to successfully achieve your career goals.