Careers

Career advancement opportunities – Residency or fellowship?

Over the last decade, the profession of pharmacy and the capabilities of a pharmacist has advanced immensely with respect to broader clinical responsibilities and logistical needs in the Pharma industry. We previously lived in a time where a bachelor’s degree in pharmacy sufficed for a career in pharmacy practice. Since 2003; however, the Doctor of Pharmacy (PharmD) degree has superseded previous qualifications to become a licensed pharmacist and has provided pharmacists more holistic roles as a healthcare provider. To dive deeper, the role of a pharmacist now extends from the initial introduction of a chemical molecule for drug therapy all the way to managing a patient’s regimen post dispensing. Based on the competitiveness and saturation of the workforce, in addition to employment projections showing decreased future demand for retail pharmacists (as previously mentioned in our Pharmacist market saturation and career outlook blog here), it is presumed by many that a PharmD will simply be a stepping stone within the realm of pharmacy practice. Therefore, the well-rounded ability needed for our future pharmacists will strongly build through residencies and fellowship.

What are some opportunities to differentiate yourself as a newly graduate? Let’s take a look at the following main categories of post-graduate training programs:

Residencies:

  • Focus primarily on direct patient care
  • Within a clinical, hospital, or community setting
  • Collaborate with pharmacists, nurses, and other healthcare professionals
  • Duration: 1 year each – Postgraduate Year One and Two (PGY1 and PGY2)
    • PGY1 – General medicine
    • PGY2 – Specialized therapeutics
      • Specific areas of focus include: Ambulatory care, cardiology, critical care, geriatric, pediatric, oncology, pain management, and more. For a more complete list of options, be sure to check out American Society of Health-System Pharmacists’ (ASHP) website.
    • Interestingly enough, the perception of a PGY3 residency has been viewed negatively by many pharmacists. Based on a distributed survey, residents, preceptors, coordinators, and other pharmacists believe that PGY3 training offers limited benefits in professional development.
  • Career after completion: Hospital or clinical pharmacist

While clinical and hospital settings are more predominate, many also choose to pursue community-based residency programs. This path allows residents to remain within the community setting while taking on critical education and training to provide increased care and improve patient outcomes.

Another popular residency of interest is managed care. Managed care residencies heavily focus on evidence-based clinical decision-making and comparative research, medication therapy management, clinical drug evaluation, formulary management, quality assurance, and drug utilization review. A pharmacist within these roles is responsible for performing any analysis, for example, drug utilization data to identify trends and then implement new strategies to improve patient outcomes. Additionally these roles may also require on-going knowledge of all heath plan pharmacy benefits. Beyond the logistical aspects of analyses, clinical knowledge is key for a successful career in managed care. Managed care pharmacists are also part of multidisciplinary teams during rounds in which they serve as the primary drug information resource, provide pharmaceutical interventions, facilitate prior authorizations, and develop educational materials for patients and providers.

What’s the likelihood of matching?

Below is a graphical representation of the match statistics between 2013-2020. Figure 1 illustrates the amount of applicants participating in the match, positions offered, matches/positions filled, unmatched applicants, and unfilled positions. Based on the trend, it’s easy to interpret that residency is playing an expanding role as more programs are being introduced each year. While this appears to be beneficial, it’s also important to address the increasing applicant pool, making it a challenging to gain acceptance in the program of your choice.

A close up of a map

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Figure 1. Complete match statistics between 2013-2020.

Fellowships:

  • More research and data-based
  • Within the pharmaceutical industry, academia, nontraditional pharmacy or healthcare setting
  • Collaborate with professionals, both in and out of healthcare
  • Duration: Ranges between 1-3 years depending on the program
  • Career after completion: Pharmaceutical industry or academia

It is very clear that these two main options provide two distinct pathways. The direction you wish to pursue will strictly depend on your interests. If you thoroughly enjoyed classes that focused on therapeutics, pharmacology, and kinetics throughout pharmacy school then a residency may be the best option for you. Conversely, if you were more engaged on the economics, research, and administrative science side of pharmacy, then a fellowship would be better suited for you. Whether you wish to enhance your clinical knowledge or look for professional advancement, a residency or fellowship will provide a firm foundation and present you with many unique career opportunities down the road.

What can you do now and what are some additional resources to find out more?

  • Take a moment to fill out the APhA Career Pathway Evaluation Program for Pharmacy Professionals survey. This quiz will aim to assess your goals, values, strengths, likes, and dislikes.
  • Maximize your potential and showcase your academic achievements while demonstrating your leadership qualities outside of the classroom.
  • Check out the ASHP and ACCP directories to get a better idea of the many residency and fellowship opportunities out there and which institute may best suit you.

Whatever you wish to do is ultimately your decision. All we recommend from our end is to be the best version of yourself and manifest all your skills in an effort provide to the pharmacy profession.

Good luck!

Sam Tamjidi

RxPharmacist Team

References:

  1. Dang, Y. H., To-Lui, K. P. (2020). Pharmacist perceptions of and views on postgraduate year 3 training. American Journal of Health-System Pharmacy, 77(18), 1488-1496. doi:10.1093/ajhp/zxaa198
  2. Doctor of Pharmacy. (n.d.). Retrieved September 19, 2020, from https://en.wikipedia.org/wiki/Doctor_of_Pharmacy
  3. Goode, J. R., Owen, J. A., Bennett, M. S., & Burns, A. L. (2019). A marathon, not a sprint: Growth and evolution of community-based pharmacy residency education and training. Journal of the American College of Clinical Pharmacy, 2(4), 402-413. doi:10.1002/jac5.1140
  4. Postgraduate Education Frequently Asked Questions: Residencies and Research Fellowships. (n.d.). Retrieved September 17, 2020, from https://www.pharmacist.com/sites/default/files/files/10-417postgraduate.pdf
  5. Tips on Applying for a Residency or Fellowship. Academy of Managed Care Pharmacy. (n.d.). Retrieved September 19, 2020, from https://www.amcp.org/resource-center/group-resources/residents-fellows/tips-on-applying-residency-fellowship

Pharmacist market saturation and career outlook – An overview

One of the main obstacles that recent PharmD graduates face is the challenge of finding a job right out of school. Whether it is due to saturation or a lack of experience, the dynamic field of pharmacy appears to raise concern for many, and statistics appear to support this concern. According to the U.S. Bureau of Labor Statistics (BLS), which is responsible for publishing employment trends and projections, there is an estimated 3% decline in pharmacist employment between 2019 and 2029. While the career outlook of a pharmacist may vary by industry, it is quite evident that most of this decline comes from chain and independent pharmacies (Table 1).

Table 1. Employment projections for pharmacists in a retail versus non-retail setting.

Table 1 above accounts for 81% (or 259,000 of 321,700) of jobs that pharmacists have held in 2019, while the remaining 19% come from other industries that have a positive effect on the pharmaceutical workforce. A more detailed look at employment projections can be found here.

What can we take home from observing these statistics? The demand for pharmacists who work in non-retail settings, such as hospitals and ambulatory care facilities, is set to increase over the next decade as the number of jobs are expected to grow. Alternatively, all retail positions, which make up over half of all pharmacy jobs, is projected to take a significant hit and decline over the next 10 years. Why might this be the case? This branch of pharmacy is expected to expand the role of pharmacy technicians and transition to greater use of mail order and online pharmacies. For example, marketed as “a better, simpler pharmacy”, Amazon has expanded pharmacy by introducing their PillPack and in September 2020, launched its online pharmacy in India. This online service is free and allows patients to receive free delivery on their prescriptions and over-the-counter medications monthly, reducing the need to sort their meds, wait in line, or chase refills.

How could you respond and move forward?

  • Build connections: Use platforms such as LinkedIn to expand your social network and connect and communicate with those in the same profession. Reach out to your school’s alumni network as you already have a shared connection of your alma mater to start off the conversation.
  • Be comfortable with being uncomfortable: Often you may find more opportunities outside of your city or state of preference. While this may seem unfavorable to begin with, coming out of you comfort zone will always pay off.
  • Be innovative and embrace change: Demonstrate your passion for excelling the pharmacy profession and show your willingness to flourish. Opportunities will come by with the right mindset.

As always, best of luck!

Sam Tamjidi

RxPharmacist Team

References: Pharmacists: Occupational Outlook Handbook. (n.d.). Retrieved September 09, 2020, from https://www.bls.gov/ooh/healthcare/pharmacists.htm

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