Residency Programs: Are They in Your Future?

There are many reasons why people get excited about attending the American Society of HealthSystem Pharmacists (ASHP) Midyear Clinical Meeting every December. Whether it is an opportunity to visit Las Vegas, hear the opening general speaker (former president Bill Clinton this year), expand your professional network, learn about new information from the many exhibitors, or just enhance your knowledge base, lots of things happen at this meeting. One growing focus of the conference is the residency showcase—a place where pharmacy students can engage with residency programs and determine ones to which they want to apply.

According to the most recent ASHP Commission on Credentialing numbers,¹ there were almost 2 pharmacy students applying for every residency position available. The demand for residencies grows each year, but is it really necessary? The American College of Clinical Pharmacy developed a position statement that stated that by 2020, everyone who wants to practice pharmacy in a direct patient care role should complete a residency.² While some professional organizations have adopted a similar resolution, not all are in support.

Expecting further training suggests that the pharmacy curriculum in existence today does not prepare pharmacists fully for the current demands of the job. Others suggest that the overwhelming majority of residencies are in the hospital setting, but the majority of pharmacy students start employment in community pharmacies. Finally, the profession recently changed the degree to 4 years. When is it enough education?

My support of residency training comes through both my personal journey and from teaching many residents over the years. My residency experience changed my professional views on what a pharmacist can do, and I have observed how it has created numerous opportunities for me, I have watched many residents develop a professional maturity that would not have come easily through other avenues. Residents learn how to confidently communicate with different types of health care professionals. They develop an ability to make sound decisions quickly in regard to patient care, and they demonstrate how to balance numerous responsibilities while meeting all pressing deadlines. These are skill sets that a manager wants in any employee—and why a residency creates future opportunities.

Because of the recognition of employment uncertainty and a need to distinguish their credentials, the number of students wanting to do a residency will continue to increase. The real issue becomes, how can we stimulate growth of residency positions in hospitals to keep up with the demand? There are numerous hospitals, many of which are non-teaching institutions that have not established a residency program. However, there are academic medical centers that have either not started a residency program yet or are not even close to the capacity they can handle.

There are many benefits to an institution for establishing residency training. At the University of North Carolina Hospitals, for example, I have observed that our staff really embrace the residents. This includes our pharmacy technicians and pharmacists who have not completed a residency. They really enjoy teaching the residents how to resolve issues that arise in daily practice. The pharmacists also feel safe asking residents questions about pharmacotherapy issues. This cooperation has allowed our program to be embraced by the entire department, not just the preceptors.

Residents coming in each year and challenging conventional practice, have helped transform us to a department that strives for continual improvement and embraces best practices from all over the country. Many of our residents have been hired, and while I do not believe that a residency’s primary purpose is creating an employment channel, it can be a positive benefit from training residents.

A final benefit of residency training is that Medicare pass-through reimbursement can be an unexpected revenue stream. Depending on your Medicare payer mix and how your organization calculates the pass-through reimbursement, much, if not all, of the resident’s expense can be recovered.

So, the real question is why have you not maximized residency education at your site? I believe that almost every reason postulated can be overcome.

Take the plunge and join the ever-exciting residency showcase at the ASHP Midyear Clinical Meeting. I can promise you, it will be an experience that will be continually rewarding

Stephen F. Eckel, PharmD, MHA, BCPS, FASHP, FAPhA, is the assistant director of pharmacy and residency program director of UNC Hospitals, and director of graduate studies in the Division of Pharmacy Practice and Experiential Education at the University of North Carolina Eshelman School of Pharmacy. He was elected the chair of the Acute Care Practice Forum and board member for the North Carolina Associ-ation of Pharmacists. He served for many years in the American Society of Health-System Pharmacists (ASHP) House of Delegates.

References

1. www.ashp.org/DocLibrary/Accreditation/COC-Update-2012-NRPC.aspx.

2. www.accp.com/docs/positions/positionStatements/paper013.pdf.