PREPARING TO COMPETE FOR A PHARMACY RESIDENCY

in Get the Residency
DOI:
https://doi.org/10.37573/9781585287161.001
Free access

Many factors have contributed to the escalating level of competition for securing a pharmacy residency in the United States. These include an increasing number of students graduating from more pharmacy programs, declining job opportunities for new graduates in some regions, and interest in further training to be competitive for patient-focused or other specialized positions as part of an evolving profession. The gap between the number of residency positions available and the number of positions needed to train all interested and qualified graduates is increasing every year. Thus, it is critical for you to prepare well for the residency interview process to maximize the probability of impressing residency program directors (RPDs), receive a high ranking, and ultimately match with your desired residency program. Although some students decide that they will pursue residency training before they begin pharmacy school, others do not make that determination until the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting (MCM) in their last year of school. Regardless of the year you decide to apply for a residency, there is plenty you can do to prepare yourself for this process. Although the focus of this book is on the interview and application process, in this first chapter, we will provide some guidance on how to prepare throughout your pharmacy school experience.

A RESIDENCY IS DEFINITELY FOR ME (P1–P2 YEAR)

If you decided that you wanted to seek a residency early on in your pharmacy education, during your first professional (P1), second professional (P2) year, or earlier, you already have a head start on the majority of applicants. Not surprisingly, the core steps to developing your candidacy begin with grades. However, many other attributes, such as leadership, teamwork, and publishing, increase your chances at being successful in obtaining a residency (see Table 1-1).

TABLE 1-1.

Plan of Attack: What to Do and When to Do It

1st Year

2nd Year

3rd Year

4th Year

First Semester

First Semester

First Semester

First Semester

Focus on academics

Focus on academics

Focus on academics

Work hard during your APPEs

Explore various organizations

Join one or two organizations (if not done in P1 year)

Seek leadership position(s) in your core organization(s)

JUNE

Start writing your personal statement/letter of intent

Find out your faculty research interests

Seek research or project opportunity (if not done P1 year)

Seek research or project opportunity (if not done P2 year)

AUGUST–SEPTEMBER

Update/finalize your CV (and portfolio if applicable)

Start developing and organizing your CV (and portfolio if applicable)

After finals, update your CV (and portfolio if applicable)

After finals, update your CV (and portfolio if applicable)

SEPTEMBER–OCTOBER

Contact RPDs, and ask for letters of recommendation from preceptors, employers, mentors, etc.

Save money for travel to interviews

Save money for travel to interviews

Continue to talk with upperclassmen about APPEs;

Begin making a list of qualities important to you, and find programs you may be interested in applying to;

Save money for travel to interviews

Buy a business suit (if not already in wardrobe);

Apply to the ASHP resident matching program (if applicable);

DECEMBER

Attend ASHP MCM and maybe PPS;

Finalize the list of programs you will be applying to;

Submit application materials to each program

1st Year

2nd Year

3rd Year

4th Year

Second Semester

Second Semester

Second Semester

Second Semester

Focus on academics

Focus on academics

Focus on academics

JANUARY

Secure interviews

Consider joining one or two organizations

Maintain involvement in one or two organizations

Maintain involvement in one or two organizations

FEBRUARY

Interview

Start talking to faculty to get research experience (either in the summer or in your second year)

Seek research opportunity (if not done first semester)

After you find out your APPE schedule, contact preceptors for the months of December, January, February, and March regarding the possibility of attending MCM and interviewing for positions

MARCH–APRIL

List your sites for the Match; Match Day; Phase II; Post-match

Run for an officer position/head of a committee (this occurs near the end of the semester)

Run for an officer position/head of a committee (this occurs near the end of the semester)

Change APPE schedule if preceptor is not accommodating

Celebrate your success

After finals, update your CV (and portfolio if applicable)

After finals, update your CV (and portfolio if applicable)

Save money for travel to residency/fellowship interviews

Study for your licensure exam and prepare to take law exam in the state you will be completing the residency

Save money for travel to residency/fellowship interviews

Talk to upper classmen about APPEs;

Consider elective courses in your areas of interest

After finals, update your CV (and portfolio if applicable)

 Celebrate your success

APPE = advanced pharmacy practice experience; CV = curriculum vitae; MCM = Midyear Clinical Meeting; P1 = first professional; P2 = second professional; PPS = Personnel Placement Service; RPDs = residency program directors.

Study, Study, Study

Based on published literature and years of collective personal experiences, grades do matter.1–4 The notion that “a C equals a PharmD” does not translate to the successful quest of securing a residency. Although grade point averages (GPAs) are not the sole criteria for securing a residency, they are often used as an initial filter in deciding who to consider for interviews. Depending on the residency program, some RPDs may want a minimum GPA of 3.0,5 while other programs may have a higher cut-off depending on the number of applicants for that cycle. Recent data showed that the average applicant had approximately a 3.5 GPA.6 During the first year, your focus should be on academics, particularly in the first semester. For many of you, this may be the first time away from home and the first time taking such a heavy science load. Some of you may struggle with the academic rigors of pharmacy school. Although you can recover from an unfortunate beginning, there are ways to settle into the demands of pharmacy school and lay solid academic groundwork for the upcoming years of education and your profession.

From unpublished and published data, the minimum grade point average (GPA) needed to be competitive may range between 3.0–3.7 and may become higher as the competition continues to get more intense. Additionally, some RPDs look specifically at clinical or therapeutic courses to see how you perform.5;7

The first semester in particular can be distracting. You are constantly bombarded with different organization events, rushing a professional fraternity, making new friends, and possibly exploring a new city. Make time to have fun, but not at the expense of your schoolwork. Make sure you know how much time you have to devote to classes to be successful. Make learning, and not necessarily achieving the highest grade (although this is important as well), a priority.

Watch your part-time hours; there will be plenty of time to work over the next 40 to 50 years.

Paying for a graduate education is stressful for many pharmacy students. However, if at all possible, hold off on getting a part-time job (or if you have one, decrease the number of hours you work). This is especially important if you know you require more time to grasp concepts. You will have plenty of opportunities to work (pretty much the rest of your life), and this time should be devoted to your studies to ensure you will get through the program. If you have a part-time job, it will almost definitely impact your grades and have little impact on making you a better residency applicant. Let us repeat, your grades are more important than your part-time job. Plus, consider the economic consequences of poor performance in a course. Falling a year behind due to failing a course not only costs you an additional year of tuition and fees, but also one year of a pharmacist’s salary. Does a $400 paycheck every two weeks make up for it? Spend carefully so that you do not have to work, if possible. For those who must work, consider a job in a work-study program (where you may have more time to study), in a research laboratory, or in a pharmacy. It is never too early to begin thinking about forming positive relationships with supervisors, preceptors, mentors, and future colleagues. However, it is imperative that you allocate enough time to maintain a competitive GPA. Being able to academically ace your first year will give you some latitude if your grades suffer when pursuing the complementary skills of holding officer positions during your P2 and third professional (P3) years.

Your grades are more important than your part-time job.

Get Involved in Professional Organizations

In your first year, from the moment you set foot onto campus, you will be inundated with opportunities to volunteer for a health fair, listen to guest speakers, and become involved in professional student organizations. Pick the events and organizations you attend mindfully. Take the first semester to explore what the various organizations have to offer. In pharmacy school, you will be exposed to well over a dozen professional groups. You will not have time to be a member of each and every organization. However, in your first semester, explore what the organizations are about. Go to the free lunches or dinners (you may be able to avoid purchasing a meal the entire first month of your pharmacy education), ask questions, volunteer for a health fair or two, but take your time to decide what organization fits your interests the best. Talk to the leaders and members in the organization to gauge how much time is devoted to the group. This will help you decide which organization (and leadership role) will best suit you in the upcoming years.

During the end of the first semester or start of the second semester of your P1 year, commit to an organization. Joining an organization and holding an officer position is a highly desirable quality for an RPD. This will show the RPD that you have leadership skills, the ability to work in groups to accomplish tasks, and time management skills. Remember, do not join every organization. Outside of the prestigious, invitation-only societies (eg, Rho Chi, Phi Lambda Sigma), limit yourself to joining two other organizations. RPDs also want to see that you can remain focused. Joining one or two organizations and being an active member (eg, holding an officer position, attending events) will develop the aforementioned skills that will assist you in successfully completing a residency. If you run for an office in an organization, be sure you are diligent in your work. This will give you the opportunity to develop a rapport with your faculty advisor(s) and potentially secure that critical glowing letter of recommendation (also sometimes referred to as a letter of reference or letter of support).

Even though we encourage waiting a semester before joining an organization, an exception may be with pharmacy fraternities, which typically have students “rush” during the first semester of pharmacy school.

Get Involved in Research With a Faculty Member

In your P2 year, you will most likely have a good sense of how much time you need to devote to your studies. During this year, you can consider taking on a leadership role in an organization, working with a faculty member on a research project or publication, increasing your hours at a part-time job, or volunteering in a unique pharmacy setting.

Consider working with a mentor on research. Research can take on many forms and does not always mean working in a laboratory. You may be able to assist faculty in a clinical trial or in a social, behavioral, or pharmacy administration pharmacoeconomic study. In class, listen to what your professors are excited about, which is most likely what they are researching. Don’t approach a professor just to put a “research project” on your curriculum vitae (CV); find a mentor you would like to emulate in your career and whose research you have genuine interest in. For example, if you received a Bachelor of Science in Psychology, find a faculty member that practices in psychiatry. If you have a passion for computers and informatics, perhaps one of your professors is doing cutting-edge research in that area. Faculty members are excited about sharing what they do with students and can often find a way to incorporate you into research projects. Most faculty members are in education because they have a passion for teaching, research, and service. As a student, you can contribute and assist faculty members by completing literature searches, developing and administering surveys, assisting in interventional research with patients, and working in a laboratory setting. The possibilities are endless. Often, a professor may have a stipend for you or offer the position as part of a research grant or work-study program, or you may receive elective course credit, which will serve a dual purpose for you.

Pharmacy practice or clinical faculty usually have clinical sites where they provide direct patient care. These faculty primarily teach in your therapeutics courses.

Research projects can result in a poster presentation at a national meeting or in a publication. Presenting research at a state or national conference is a wonderful opportunity to network with people from across the country. Additionally, some residency programs may only interview or rank applicants that have some type of publication on their CV. As such, you can approach a faculty member and ask about writing a review on the use of a medication for a different indication (eg, serotonin norepinephrine reuptake inhibitors for attention-deficit hyperactivity disorder), health insurance coverage and special populations (eg, Affordable Care Act and pediatrics), or how blockchain technology can be leveraged in healthcare.8–10 If you have your own research idea, consider working with some classmates on something you find novel and important. The author once had a couple of students approach him to provide feedback and insight on a survey they had developed on their own to conduct a small project. The author was happy to read over the protocol, provide constructive criticism, and connect the students with people who would assist in completing the project. Having an original and creative idea helps you stand out from your classmates.

Keep in mind, however, that becoming involved in research projects can be time-consuming. This may be time you would have otherwise spent socializing with friends and family or being involved in a professional organization. This time should not be taken away from your academic studies. Again, working intimately with a faculty member on research will allow the professor to get to know you and your abilities personally. If you do a great job, you may secure your second letter of recommendation. Also, here is something you seldom hear: Most of us are genuinely interested in seeing you succeed, and nothing gives us more pleasure in our career than seeing a student develop over three to four years and become successful in our profession. Seek us out!

You may find that some of the professors who come across as intimidating in the classroom are actually approachable and encouraging when you seek them out one-on-one.

Start Developing and Organizing Your Curriculum Vitae

Every activity, officer position, and scholarly endeavor you attain should be placed on your CV. We recommend you update your CV every semester, if not every month. Some students use a notebook (or tool like Google Docs) to record completed events and activities to assist them in the future when developing their CV. By staying up to date with your CV, you will have less stress when the time comes to submit your residency applications. It is very difficult to develop your CV when you are trying to remember everything you did over the past two to three years. Therefore, try to update it once every semester, possibly the weekend right after your finals are finished. Be on the lookout for CV writing workshops at your school or at professional meetings as well as following guidance provided in this book.

Clean Up Your Social Network

If you have a presence on social networking sites like Facebook, Instagram, or Twitter, start cleaning them up! Better yet, be thoughtful about what you post on social networking sites, since you can only do so much to clean something up once it’s out there. For example, even if you go back and delete some provocative things you tweeted, the U.S. Library of Congress is digitally archiving everything ever written on Twitter, so you can never get rid of certain things. What you post may affect you, as RPDs or hiring personnel may go to these sites to see who you are and what you do.11 Even if you keep privacy settings as secure as possible, elements, such as your primary profile picture, may still be seen. Considering that social networking sites like Facebook have been fined by the U.S. government over concerns about privacy, the implications of what you post may not be fully understood. Also, you may be “social friends” with a student who may gossip about your extracurricular activities to professors (Believe us, it happens!). Every year, students across the country are likely failing to secure residency interviews because they have developed a negative reputation during pharmacy school. Pharmacy is a small world and sometimes information is relayed regarding your habits.

On the flip side, social media can also help you. Posting pictures of pharmacy-related events you have done may not win you any “cool” points, but it may solidify your attitude toward the profession in the eyes of an RPD. A more targeted approach to cultivating their professional network being used by pharmacy students is via LinkedIn. You can provide hashtags to events you developed/hosted, presentations you have done, or published works. Students have also been highlighted by their pharmacy program or a professional organization for specific awards. You may add a link to these when needed. Most pharmacy organizations and many in the pharmacy world maintain a presence on LinkedIn for connectivity and as a tool for maintaining current awareness in the field. In one instance, one of the authors helped a hiring manager for a less conventional job opportunity (eg, digital health company) by connecting them with the prospect’s LinkedIn account profile. The hiring manager used their profile rather than the prospect’s CV or resume to make a preliminary judgment. After an initial screening on a professional-focused social networking platform, a request for a CV or resume might follow. An increasing trend is to provide your LinkedIn account hyperlink below your email on your CV.

One approach experts recommend is to put everything you post on social media to the “boss test” first. If your boss at work saw what you wrote, a picture you posted, or something you “liked,” would it create a problem for you?

Recognize that some pharmacy students gossip, and this can affect your candidacy. Also, be aware that your picture may be taken and “tagged” without you even knowing it, so be careful of how you conduct yourself, and be cognizant about monitoring your online presence.

Try to capitalize on the professional networking opportunities that social media offers. One pharmacy student hosted a #scriptyourfuture chat on Twitter and #SYFChallenge on Facebook about medication adherence that was so popular it became a trending topic and helped increase awareness on the subject. Another pharmacy student was immortalized in a book about using social media to drive positive social change.

Explore Your Passions

By your P3 year, you are probably beginning to realize where your passions lie. You do not necessarily have to have them set in stone, but your exposure to introductory pharmacy practice experiences (IPPEs), professional organizations, and therapeutic/clinical course work or research may spark an interest in a particular field of pharmacy. It is a great idea to begin to network with faculty or preceptors who have sparked this interest. For example, a student that knows she wants to work in pediatrics may contact the pediatric pharmacist where she is assigned for an IPPE or the faculty member who practices in pediatrics to shadow and discuss postgraduate training and job opportunities. This is a great way to network and learn more about the field. Consider taking electives in areas you are interested in (eg, women’s health) to supplement your learning and to connect with faculty. Be prepared in advance for these courses and engage with your professors. The smaller class size of electives allows your faculty to get to know you better, which may prove useful during your residency application process (again, another potential person to write a letter of recommendation for you).

Selecting Your APPEs

Your P3 is an exciting year, particularly as you begin to choose your advanced pharmacy practice experiences (APPEs). Don’t discount the importance of selecting APPEs. Talk with upperclassmen to determine which APPEs were challenging and positive experiences. Don’t shy away from rotations because the preceptor is “hard.” Choose a variety of APPEs in a variety of locations if possible. Having this diversity of rotations allows you to explore career options you may not have considered and reflects your adaptability. If you are considering applying to a residency program in your area, think about selecting a few APPEs at that site to get a first-hand experience to observe what the residents do on a day-to-day basis (and possibly get to know preceptors of the residency program). Residents often serve as preceptors on certain APPEs and may provide insight to the program’s culture. Remember, if you do apply, any person you interact with during your APPE may have an opinion of your application to the program. Consider your APPE as a one- to two-month-long interview, especially if the site has a residency position(s) available.

One thing to consider when scheduling your APPEs is the time necessary to interview for residencies. If you are considering attending the ASHP MCM in December, consider requesting the month off or contacting your assigned preceptor to ensure it will be okay for you to take the time off. Of course, you should offer to make up the missed time on weekends or with special assignments. The majority of your interviews will occur between the end of January and beginning of March. Therefore, as you finalize your APPEs, make sure to email the preceptors as soon as you receive your schedule (even if it is nine months in advance). Your email should convey a professional tone (see Chapter 4: Contacting Residency and Fellowship Programs for general email guidance), describing your anticipated application to residencies and asking for the requisite time off to travel and complete the interviews.

Recognizing that your APPE preceptors should be supportive in encouraging your professional development in this manner, your absence will likely create logistical or even legal challenges for them. Hence, you need to make sure you extend the same professional courtesy by accommodating whatever is necessary to make up for lost time (eg, working 10 to 12 hours a day or weekends) or productivity. If the preceptor for that month is inflexible and unsupportive, you need to follow proper channels to modify your schedule. Ask your administrator of experiential education to switch your APPE, politely outlining the reasons for your request. To make life easier for everyone, we also highly recommend you request the month of February off (if possible) so that you can take the opportunity to prepare for your interviews and not worry about missing too much time. As with many of our suggestions, the key is to try and put yourself in a position to succeed. Don’t forget to remind your preceptor of your earlier request once you begin the APPE, and discuss what you need to do to make up the lost time to achieve that particular rotation’s objectives.

Lastly, consider asking your preceptor in the month of March for the day off when the results of the Match are released (referred to as “Match Day”). The day tends to be emotional (both for those who match and more so for those who do not) and you will most likely be distracted. Also, in the event that you do not match, you can immediately begin to evaluate the programs that will be available for Phase II. The time off will allow you to reach out to your mentors and receive any feedback (eg, programs of interest, changes to your application).

APPEs: Your Final Chance to Shine

The start of your APPE marks the beginning of the last year of your professional program, and you often hit the ground running. How are you going to stand apart from the other two to three students on rotation with you that particular month? More importantly, how will you stand out from the other two to twenty students your preceptor interacts with on a yearly basis?

If you want to distinguish yourself from other students (ie, your competition) in this environment, here are some tips you should follow:

  • Go above and beyond what is asked of you.

  • Show a genuine interest in learning and providing patient care.

  • If you are requested to come in at 6:00 a.m., be there at 5:00 a.m. If you are expected to stay until 6:00 p.m., stay later. Of course, if you are coming in early and leaving late, make sure it is to prepare yourself or to follow up on issues that came up that day.

  • Complete all assignments in a timely manner and to the best of your ability.

  • Accept constructive criticism and ask for ways you can become a better student and, ultimately, a better pharmacist.

  • If you have questions, research the information yourself before asking your preceptor. This shows you have self-initiative and are a self-directed learner.

Your goal is to show that you are willing to perform at the highest level and do more than what is asked. If you have completed your assignments, ask if there is more that you can do. Below is an example of a student-preceptor interaction:

CASE

On the first day of an APPE, I explain to the students what is required of the rotation: when to come in, expected time of completion, assignments (such as drug information questions and patient presentation), and any other miscellaneous activities for that month. Somehow, most students are surprised to see that their grade is a C at their midpoint evaluation. They ask, “Why do I have a C? I have done everything you have asked me to do.” To which I reply, “Exactly. You have done what is asked, which is what I ask every student to do, which is average, which is C work. To earn a grade of a B or an A, you have to do more work than what is required; hence, above average or excellent. When you enter the real world, there will be requirements that everyone will be expected to complete. If you complete them, you will be average because everyone will have completed them. To stand out, you will have to do more than what is asked.”

With this example in mind, realize that even though you may receive a high grade for following an APPE preceptor’s expectations, it does not necessarily mean you will receive a strong letter of recommendation. They might just not want to deal with a difficult student or receive bad preceptor evaluations. Even though this information is directed to your APPEs, keep it in mind for your IPPEs as well.

Consider applying to or participating in APPE-track, preresidency, or advanced clinical experience programs if offered by your institution. These APPE-track programs have a variety of designs and requirements, so you should analyze the specific opportunities carefully before applying, preferably in the beginning of your P3 year. Some programs are a complete year at one institution, while others may be only two rotations at one institution. Also, requirements may include any combination of the following: attending extra seminars, completing a medication-use evaluation, finishing a clinical skills checklist, competing in clinical skills competitions, taking extra electives, completing an additional APPE, and more. Many track programs are focused on preparing students for a highly competitive pharmacy residency and/or future practice in a hospital or institutional setting. Note that such programs typically require significant efforts from the students to acquire a certificate of completion. From personal communications and published data, applicants may have an advantage to secure interviews and match by participating in these programs.12 Keep in mind, many of these APPE-track programs now require a letter(s) of recommendation and/or an interview for selection, so it is important to be aware of these requirements with enough time to prepare your application packet.

DECIDING LATER ABOUT A RESIDENCY

If you are entering your P3 year or have begun your APPEs and realize you want to do a residency, there may be a lot of ground to cover in a limited amount of time.

Here are some things to consider:

  • How are your grades? If they are not a solid B average, it will be difficult to compete. At this point, try to improve your grades by performing very well during the rest of your courses, especially the therapeutic sequences, and stand out in a positive way during your APPEs.

  • Hopefully, you have been involved in organizations during your first two to three years and have excelled in at least one officer position. If not, consider joining an organization if you are still a P3; however, note that it will be extremely difficult to secure an officer position, since the voting usually takes place during the end of the academic year (April–May). Sometimes, there may be an opportunity to run for an officer position if someone resigned. However, if you just joined the organization or were not an active member, it will be difficult to win the election. Despite this, you may still join the organization and be involved in committees within the organization (eg, community outreach) and participate in their events (eg, health screenings). Given all this, remember to join an organization that you like and have a genuine interest in. If you are in your last professional year, it will be nearly impossible to hold office or be involved in the events as you may have APPEs in different cities and spend much of your time completing all your APPE assignments. Also, remember to consider professional organizations in your community, such as your local ASHP chapter. These organizations can provide opportunities to attend free continuing education (CE) dinners and allow you to network with local pharmacists or RPDs. Often, you can volunteer to participate in a committee for such an organization.

CASE

A few years ago, Jamie, a pharmacy student in her P3 year, decided that she was interested in pursuing residency training. Her next step was to go to her faculty for guidance and recommendations. After discussing her interests and goals, Jamie narrowed her list of potential residency programs. Jamie was intrigued by one of the programs and took some unconventional steps to evaluate it. When she discovered that the RPD would be nearby to give a CE presentation, Jamie managed to make time to attend that meeting to observe the lecture—all while following proper channels at her school. The way Jamie executed this plan allowed her a rare, face-to-face, extended opportunity to observe the RPD and see if he was someone she wanted to spend a year learning from. After the presentation, Jamie introduced herself and got to know the RPD. This was one of the most impressive efforts on the part of any student looking for a residency the RPD had ever encountered. Jamie had already separated herself from other applicants before they had even started applying. The logistical effort of getting to the CE meeting just to introduce herself and assess the personality and teaching style of the RPD, and the support of the student’s faculty enabling her to do so, all led to a very favorable impression of this student. Even without this extraordinary meeting with the RPD, Jamie was an excellent applicant. It was clear to the RPD that Jamie would excel in the training program, and he, of course, gave her the chance to prove it.

This anecdote reprises the unconventional efforts that one student took in evaluating a program and its RPD. For some, this example may blur the line between persistence and harassment, but the takeaway is that demonstrating creativity and a willingness to use unconventional (but sanctioned) methods to distinguish yourself may enhance your chances.

During the ASHP MCM, program directors sometimes give presentations. Take this opportunity to attend their lecture and see their teaching/delivery style. You don’t have to approach them, but sitting in and listening to them may be a great way to gauge a future preceptor or director.

WHAT ABOUT A TIMELINE FOR ACCELERATED PROGRAMS?

Currently, approximately 20% of pharmacy programs are accelerated three-year programs. Although students are able to complete their pharmacy education in a shorter time span, the recommendations for involvement in professional organizations and research with faculty will need to be modified to accomplish it. Because the pace of the coursework is quicker in an accelerated program, it is critical to focus on your course work in the first semester of the program. However, you may need to seek leadership and research opportunities in the second semester of your P1 year.

A LITTLE BIT ABOUT THE LINGO

Now that you have decided to pursue some type of postgraduate training, you may be confused with all the acronyms and types of residencies. Keep in mind, the main purpose of a residency is to develop your clinical skills to prepare you for a career with direct patient care.

There are two types of residencies: postgraduate year-1 (PGY-1) and postgraduate year-2 (PGY-2).

  • A PGY-1 residency focuses on providing you with experiences in a variety of settings to obtain a general knowledge base. Some may have an emphasis on a particular area (eg, pediatrics, ambulatory care), which allows for more time spent with a specific population; however, the goal is to provide rotations that focus on developing a clinician that can provide “evidence-based, patient-focused medication therapy management with multidisciplinary teams”, in a variety of patient populations.13

  • A PGY-2 is a residency that builds on the foundation of the PGY-1 but focuses on a specialty area such as critical care, oncology, or psychiatry.13

It is not necessary to know what you want to specialize in when you apply for your first residency, but if you happen to know that you would like to practice in pediatrics, you may consider a PGY-1 in a pediatric institution or a PGY-1 that also has a PGY-2 in this specialty. When making decisions such as this, it is important to reach out to upperclassmen, alumni, past preceptors, and faculty to discuss your options. Again, many faculty members would be happy to discuss your career development with you.

Programs with both PGY-1 and PGY-2 residencies may seek applicants who are interested in a two-year commitment at the same site.

One question commonly asked by students is, “Should I consider a non-ASHP accredited residency?” The answer is complicated. Residencies that have obtained ASHP accreditation have gone through a rigorous process to ensure an optimal, auspicious learning environment for the resident in which specific educational outcomes are met. The ASHP accreditation process has specific requirements for qualifications of the RPD, preceptors, and the environment in which the residency will take place. All persons applying to a residency should review the ASHP Accreditation Standards to become familiar with these requirements.14 A nonaccredited program may be in precandidate status, implying it has just started and is applying for ASHP accreditation. Or you may encounter a program that is well established and has decided not to pursue accreditation because they wish to be more flexible with how to structure the program, allowing for more personalization based on the resident’s specific career goals and objectives. On the other hand, lack of accreditation or precandidate status could indicate the program is looking for “cheap labor” by offering a residency, which may not effectively prepare you. As you research the programs you are considering, be sure to discern which philosophy the program is employing as their basis for not seeking accreditation.

As far as PGY-2 programs are concerned, an accredited program can only take students who have completed an ASHP accredited or in accreditation process PGY-1, while nonaccredited PGY-2 programs can take any pharmacy graduate, with or without a PGY-1. Some PGY-2 programs may prefer to remain nonaccredited because they would rather have a larger applicant pool from which to secure a resident, or, as mentioned previously, they feel they have a reputable, competitive program that has a track record for preparing pharmacists for successful careers in patient care. It will be your job to ask the right questions and carefully research these programs. Asking where former residents practice is a great way to gauge how the residency stacks up.

Something to keep in mind: if you complete an accredited residency, you will be able to apply for board certification soon after (zero to one year), whereas if you do a nonaccredited residency, you will not be eligible to apply for board examination for at least three to four years.

Board of Pharmacy Specialties provides a licensure examination that adds recognition to your degree and specialty (http://bpsweb.org).

The main purpose of a fellowship is to develop your research skills and prepare you for a career as an independent investigator.15 There are mainly two types of fellowship categories recognized: traditional and industry.16

  • Traditional fellowships are usually two years, primarily focus on research, include preparation for teaching, and are typically associated with a pharmacy program. The majority of traditional fellowships only take students who have completed one to two years of residency.

  • Industry fellowships are usually one year (some two-year programs exist) and focus somewhat on research but more so on providing knowledge of the daily logistical operations of the company. The majority of industry fellowships offer positions to students who have recently graduated (ie, completing a residency is not a requirement).

Although residencies are accredited by ASHP, fellowship programs can seek review by the American College of Clinical Pharmacy (ACCP) Fellowship Review Committee.17 Because traditional and industry fellowships have radically different focuses, it should be easy to determine which one fits your interests and career goals.

Finally, as you prepare and look for residencies or fellowships, it is very important to use sound judgment in talking with your classmates about which programs you are applying to. If you find a “hidden gem,” be careful who you communicate this to. A hidden gem is a residency program you find that people are not aware of due to location, size, or recent establishment. You may have stumbled across a program during an Internet search or at a small booth tucked in a corner during the ASHP MCM. Whatever the case, nothing is worse than finding a program, telling your friends who are also looking for programs about it (perhaps even with the same interests that you have), and ultimately having 10 more people apply to the program.

CASE

I had a student who was looking for a PGY-1. During the ASHP MCM she found a newly established program that provided all the elements she wanted, including teaching opportunities, rotations in oncology and neurology, and location in a large city. In her excitement, she told her roommates who were also attending the ASHP MCM. This resulted in two of them finding the program as well and applying to the same program (even though one of them was not even interested in oncology/neurology but was happy that it was in a big city). The end result was disastrous. One of her roommates ended up matching with that program and she, despite interviewing there as well, was left unmatched. The moral of the story is to be careful what you share!

PHARMACY ONLINE RESIDENCY CENTRALIZED APPLICATION SERVICE

Today, candidates seeking ASHP-accredited (precandidate and full) residencies can submit their residency applications using the Pharmacy Online Residency Centralized Application Service (PhORCAS). This is an ASHP web-based tool that streamlines the application process for applicants, residency programs, and individuals writing reference letters. This allows candidates to submit one application that can be disseminated to multiple ASHP-accredited pharmacy residency programs and allows for an easier application process. You can visit the ASHP website about PhORCAS and read Chapter 3: Navigating PhORCAS for additional information.

SUMMARY

The earlier you start preparing for your residency application, the more competitive you will be. As you can see, there are many ways to make yourself a viable and competitive applicant. Just as you prepared yourself in undergraduate school to gain acceptance into a pharmacy program (perhaps you even prepared yourself during high school to go to your undergraduate school of choice), you will have to take similar steps to secure postgraduate training. In the subsequent chapters, this book will focus on the application and interview process in the order the authors believe will provide you with the most direct guidance. However, you may need to review specific chapters as you encounter various situations. If you secured interviews and want to formally prepare, review Chapter 6: Applying and Getting Ready for a Pharmacy Residency Interview. If you are working on your CV (as recommended) during your first year, review Chapter 2: Developing Your Curriculum Vitae and Personal Statement/Letter of Intent. Use this book as your guide in preparing yourself to secure that residency position.

KEY LESSONS

  • Grades do matter.

  • Reassess your need for a part-time job because your time to study or be involved in professional organizations will be limited.

  • Get involved with organizations and research projects.

  • Start organizing your curriculum vitae early and update it regularly.

  • Clean up your social networking sites, such as Instagram, Facebook, or Twitter.

  • Plan for your rotations and maximize their value and contacts.

REFERENCES

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