How to Be a Successful Pharmacy Resident
Editor's Note: I'm very excited to introduce Dev Chatterji, PharmD, BCPS. He's a clinical pharmacy specialist in Infectious Disease and Internal Medicine and he's a former Residency Program Director.
In fact, he has the special distinction of being MY former Residency Program Director (which makes him both incredibly patient and able to live through times of severe frustration and emotional distress).
Dr. Chatterji, has mentored dozens (if not hundreds) of students and residents over the years. And he's found certain character traits in both that lead to success. In today's post he's going to share those insights with you. So that you can apply the lessons he's learned in his many, many years of experience (he's pretty old ;) ). No matter where you are in pharmacy school, residency, or practice, you will find something useful in this post. Enjoy!
What Makes a Successful Pharmacy Resident?
Perspective from a Residency Program Director (RPD)
“What qualities you are looking for in a resident to be successful in your program?”
Anyone who has ever had the pleasure of being an RPD has likely been asked that exact question in some form or another.
It’s one of my favorite questions to get asked by aspiring pharmacy residents…NOT!!
I say this because it’s a very difficult question to answer. If you asked 5 RPDs or 5 preceptors what an ideal candidate is you'd get different answers from all of them. Even within the same institution.
Furthermore, the whole idea of ‘successful residency’ is somewhat arbitrary. It lays in the eyes of the beholder...
And what about the resident's idea of success. What an RPD may consider a successful resident could be very different from what the actual resident thinks.
A resident may go through their PGY1 thinking they got what they wanted out of their training (like Brandon did). While their preceptors may think that the resident was kind of 'blah' (like Brandon was).
Put another way, my definition of "success" may be very different than yours.
So before I delve into traits and characteristics that I believe make a successful resident, keep in mind that these are only thoughts and opinions from one individual’s perspective.
The Essential Character Traits of a Successful Pharmacy Resident
1. Ownership and Sense of Responsibility
First let's talk about ownership. Your residency year is a unique time in your training where you are exposed to a variety of disease states and clinical situations.
As a resident you must take it upon YOURSELF to acquire the knowledge and skills to effectively practice in the various environments you will be exposed to (ambulatory care, internal medicine, critical care, ID, oncology, transplant, etc...).
You should NOT expect to be instructed step-by-step on how to work up a patient. Likewise, don't expect to be given key articles or guidelines to read. A successful resident is self-aware and reflective. They recognize their gaps, try to improve them, and only then turn to a preceptor for guidance and reinforcement.
Now let's talk about sense of responsibility. One thing that new pharmacy residents struggle with is transitioning from "student" to "pharmacist." Since residents are still under the umbrella of being a trainee, the first few months of residency are not all that different from their P4 year. So new residents often don't really feel like a licensed pharmacist...and they lack a sense of all the responsibilities that come with that license.
I will admit that much of this stems from the residency program itself not always giving new residents full autonomy. Part of the beauty of residency training is that you are sort of in a ‘protected’ environment that allows you to acquire and practice certain skills.
But there's a down side to this. Since you aren't always given full responsibility, it's hard to develop a strong sense of responsibility. You'll never learn to ride a bike if you don't take the training wheels off.
My advice to incoming residents is to first remember that you are no longer in school. Nor are you on rotations. This is a job!
If you go in with the mentality that there is a checkbox of things your preceptor has asked you to do (work up patients, look up ‘xyz’ drug information questions, attend rounds, do a case presentation, etc...) and you are just completing these tasks to ‘complete the assignment’, then you are not really understanding the point of residency training and will not be a successful resident.
I know what you're thinking. How do semi-vague concepts like "ownership" and "responsibility" apply to practice? I'm glad you asked.
I think the overall goal of PGY1 residency training is to teach residents a ‘skill set’ - AN APPROACH TO PRACTICE in any given pharmacy environment.
If you look at ASHP’s Residency Learning System (RLS) and view the goals/objectives of residency training, you will notice that they are very broad. This is intentional. It allows the objectives to be applied to any type of residency setting (hospital based, clinic or outpatient based, managed care, etc...).
Therefore, the basic skills you obtain (how to approach a patient, what to look for and monitor from a pharmacy perspective, prospective medication review, etc...) can be replicated in any practice setting.
I’ve reinforced to residents over and over again to not forget their basic pharmacy foundation skills. These need to be taken with you to each rotation. For example, during your rotation with the Bone Marrow Transplant Service, your patients still need to have their med rec done.
Many residents will freeze during what they consider to be a complex and intimidating setting (such as Critical Care, Transplant, and Oncology). They forget to apply general medicine/pharmacy skills they've already picked up from other rotations.
The skills and clinical knowledge you learned during your Internal Medicine or Ambulatory Care rotation still apply to your ICU patients. This ‘skill set’ that you learn is continuously evolving. The reason you go through different rotations is to practice and apply that skill set with different patient populations.
I'm not saying you should focus on a patient’s anti-hypertensive regimen and attempt to master the JNC-8 guidelines during an Infectious Disease Rotation. This is just a reminder to look at ALL aspects of pharmaceutical care regardless of the setting you are in.
2. Clinical Knowledge
You don’t have to enter residency training as an expert in every therapeutic area. But you do need a strong knowledge foundation that you've honed and developed over 4 years of pharmacy school. Successful pharmacy residents work diligently throughout school and tend to come in knowing the basics. This makes it easier to build upon their foundation with each new residency rotation.
The opposite is also true. If your classroom experience and APPE rotations does not provide you with the clinical basics, it's very difficult to adjust to the fast-paced, high acuity residency training environment.
Put forth your best effort to learn and retain the information in school. Don't learn and dump. Read things that reinforce what you learned in the classroom (Editor's note: I recommend tl;dr pharmacy) so you're not trying to play a losing game of catch up when you start your PGY1.
But you're probably already aware of this. And most likely it's not a surprise that you shouldn't learn and dump. When I say you should try to learn as much as you can during school, you should not be doing this:
Again, touching on the idea of ownership, a resident needs to “know what they don’t know” and proactively work to remedy any knowledge gaps that exist.
3. Pride in the Profession and Understanding Pharmacy’s Role
A successful pharmacy resident displays satisfaction and gratification in being a pharmacist. It's difficult to find success if you don't have pride in what you're doing or if you feel unfulfilled by the work.
Again, if you're trying to complete a checklist of activities instead of embracing the whole concept of pharmaceutical care of the patient, then it's likely you'll be a 'blah' resident instead of a successful one.
You're part of a small group of people that dedicate their professional life to helping others. To improving health. Maybe even saving or prolonging a life. You get to do this every day you go to work. Be proud of the difference you can make in someone else's life.
Going hand in hand with having pride in the profession is having a true understanding of the pharmacist’s role in practice. It's practically impossible to acquire pharmacy-based practice skills if you don’t understand what pharmacy’s role on the healthcare team is.
If you want to improve the quality of care you provide, potentially establish a new service, or enhance pharmacy relations with other healthcare providers, you must first know your role. You contribute a unique skill set to the medical team.
No one has the level of medication training that you bring to the table. Use that to contribute to the overall care of the patient. Look for renal adjustments and drug interactions. Look for unnecessary or duplicate drugs. Because you most likely are the only one that will.
I think it's obvious that good communication skills are required in a successful pharmacy resident, but it's still worth a mention. The healthcare setting is an interesting environment to come into. You're surrounded by different professionals...
Most of whom have advanced training in their area of specialty. Nurses, dieticians, pharmacists, PT/OT, respiratory therapist, and of course let’s not forget the physicians.
This is great in that you have a group of highly trained professionals taking care of people's lives. However, this also means there's a plethora of different personalities. Learning to work with those personalities is a huge barrier to overcome and an essential skill to learn.
The most important part of working in a multi-disciplinary team is being able to communicate effectively. You have to get across your point while at the same time understanding everyone else’s.
One of the unnamed ‘jobs’ you have as a pharmacy resident is being a liaison for the department. A lot programs are relatively new and still building their clinical pharmacy program and the direct patient care pharmacy services they provide.
As a resident, you may be the guinea pig in piloting a new service at your institution. A key component of that is being able to communicate on the behalf of the department to show the importance (and essentialness) of that new pharmacy service.
Having good PR (public relation) skills and being an effective communicator are required to accomplish that. Your ability to effectively work and communicate with diverse personalities and cultures is indispensable to being a successful clinician.
The last essential trait of a successful pharmacy resident is being dependable. Employers gravitate toward employees (remember, this IS a job and you ARE an employee) that demonstrate it.
But what exactly is "dependability?" In essence, someone who is dependable takes responsibility of their assigned task(s) and meets all deadlines with little need for reminders.
A few common sense aspects of dependability include:
- Be on time
- Take responsibility for your errors and find ways to resolve/prevent them from happening again
- If you are unsure about how to respond to a certain situation, seek guidance, but concurrently educate yourself so next time you are in the know
My final bit of advice…. Be balanced! It’s a busy year, but you need to take opportunities for R & R when you can and integrate them into your year.
There are ways to relax and digress without having your residency responsibilities suffer, so find a way to do both! Don't ignore your friends and family. Exercise. Treat yo self.
Trust me, you'll be more successful (and happier) if you do.