Should You Skip a Pharmacy Residency?

Should You Skip a Pharmacy Residency?

Editor's Note: Please give a warm tl;dr pharmacy welcome to Alex Barker, PharmD. Alex is a residency-trained clinical pharmacist who has been writing and making podcasts about the pharmacy profession for years. In fact, if I'm being honest, he's one of the reasons Sam and I had the confidence to "pull the trigger" and launch tl;dr pharmacy last year (thanks for that, Alex!). So needless to say, we're super pumped for him to share some wisdom with you all. 

Alex's most recent project is The Happy PharmD, where he helps pharmacists (and aspiring pharmacists) find happiness through entrepreneurship, side hustles, and non-traditional careers. It's an excellent resource and I highly encourage you to check it out.

I'll let Alex take it from here...


In between the struggle of weekly exams during pharmacy school, another pharmacy student has probably asked you, “Are you going to do a residency?

You probably are too tired from exam fatigue to even think about your career prospects. Surviving a pharmacy exam is enough of a challenge.

You probably have been told that if you want to do anything worthwhile with your degree, you need to have a residency under your career belt. You also may have been told that it’s the only way—or the best way—to get the kind of job that you want.

You’ve probably read all the blog posts and been on Student Doctor Network enough to know that the job market in pharmacy is competitive. There are fewer jobs than there were a few years ago, the salary curve is flattening and the debt load you will have is astronomical.

A residency potentially is a great career move for pharmacists. It can lead you in the direction you want to go. But, that doesn’t mean that it is the right choice for every student.

Once upon a time, I was participating in an interview for a residency candidate in my residency program and I very clearly remember this candidate’s careless attitude. Not only did he appear non-committal during the interview, but he also was two hours late.

Obviously, he didn’t match with our program—and he didn’t match with any others as far as I know.

I am of the opinion that not every pharmacy student needs to do a residency, so here are three good reasons why you might want to skip it:


1. You feel like you’re “supposed to.”

Your first two years of pharmacy school are possibly the worst. You spend most of your time looking at the science behind things, memorizing mechanism action and structures of compounds that you will forget within a week.

Shortly after that, you start learning useful information about medicines, how to use them and how to practice pharmacy.

In your fourth year, you begin to learn more about what an actual pharmacist does during your rotations.

These are generalizations, of course, but during the 3-4 years that you are in school, you also are being “informed” about your career opportunities as a pharmacist.

And the majority of what you probably are being told is pointing you in the direction of a pharmacy residency.

The first thing you learn about residency is that you should do it because it is one of the best ways to give yourself a competitive advantage.

"Now, repeat after me: 'A residency is the only way to find happiness and meaning in this dark and pointless world.'"

"Now, repeat after me: 'A residency is the only way to find happiness and meaning in this dark and pointless world.'"

Pharmacy practice professors likely are the ones telling you this and they have a bias because they probably did a residency themselves. Nowadays, there are very few new pharmacy professors who did not do a residency.

What I am suggesting is that most pharmacy students are indoctrinated to believe that in order to have a successful pharmacy career, they also must have a residency or a fellowship.

I’m not trying to say that a residency is a bad career move. I had a residency and it got me the job that I have.

The problem I see with the idea that pharmacists need a residency is that it puts unnecessary pressure on students.


2.  You aren’t beginning with the end in mind.

One of my favorite books is "The 7 Habits of Highly Effective People" by Stephen Covey.

The first habit in this book states that any person who wants to lead an intentional life with a purpose must begin with the end in mind. You need to know where you are heading in life.

This is probably one of the greatest problems with students who come in for a residency interview. Very few pharmacy students know exactly where they want to go.

And who can blame them?

With the lack of meaningful information on the job opportunities before them, many feel forced into choosing a residency program in order to get a job in any sector other than retail.

The best thing that you can do for your career is to shadow pharmacists and imagine yourself doing exactly what that pharmacist is doing. Watch them work, see what they do and picture yourself doing that for the next 15-20 years.

An article on CNN Money states that Millennials will change jobs four times by the time they are 32 years old. The article further suggests that younger generations are on track to surpass four job changes by the time they turn 32.

We know that this applies to pharmacists, too. The problem is that it is hard to predict the future. People really have no idea where their careers are going to lead them. But you can predict a general direction for your career by identifying the kind of work you enjoy.

A word of warning: If you meet a pharmacist, see what they do on a day-to-day basis and don’t love it, please do not believe that you can find a similar job and be happy.

I’ve spoken to multiple clinical pharmacists in ambulatory care, inpatient medicine, ERs, ICUs and community practice settings—and just because you get a residency does not guarantee that you will love the job that you have.

I’ve also spoken with PGY2s and fellowship recipients who have found themselves miserable with their day jobs.

A residency does not guarantee you a happy and satisfying career.

Before applying for a residency, make sure you have a clear idea of where you want to go; only then you can figure out if a residency will be beneficial for you. If a residency is truly necessary for you to achieve your goals, go for it—but only after you have given it some serious thought!


3. You don’t have the time or money.

Actual image of the residency showcase at the midyear conference. 

Actual image of the residency showcase at the midyear conference. 

The residency application process is not easy. Not only must you do things such as spend money to go to midyear conference, apply to multiple residency programs, travel to interviews and pay for hotels and food, but you also must spend almost every year of pharmacy school building your resume and your network.

This takes a considerable amount of time. Not only are you spending 40 hours a week studying and going to class, but you probably also have a part-time job.

On top of that, you need to think about how to set yourself up for success as a resident because you are competing with other students who have research backgrounds, wonderful GPAs, presentations, and publications.

You need to think about how to make yourself stand out above everyone else. To do that, you must spend considerable amounts of your free time building up your career.

The intangible cost of the time you will spend on this is insurmountable. But if you just want to think about monetary expenses, let’s say you interview at four places. Let’s also assume that they are within your state, so you would not have to buy a plane ticket.

If you spend $100 on gas and food and another $100 on a hotel for one night, it is going to cost you $800 just to complete four interviews.

That’s not even including the $150 fee for matching. Let’s say you bought a ticket to the ASHP Midyear Conference for $315 (assuming you are a member), spent $500 airfare to get there, and another $500 to stay at a hotel during the conference—plus another couple hundred bucks on food and fun while you are there.

You could easily be looking at a nearly $3,000 investment just to apply. If you aren’t 100 percent sold on residency, don’t do it!

Instead, I encourage you to spend your time in pharmacy school identifying a job that you know you will love. When you figure out what job that is, reverse engineer your career. Find out what other pharmacists in that position did to get where they are today; then, follow a similar path.

Specifically, find people who got where they are today without doing a residency. I know of a pharmacist who does infectious disease at a smaller hospital and he didn’t have any residency training—he was self-taught.

It is possible to do something you love while still pursuing a career in pharmacy, even if it is a non-traditional career.

Yes, a residency makes you look like a good candidate and it makes you appear qualified—but it doesn’t guarantee anything.

To truly have a satisfying career doesn’t necessarily require spending two or three years in residency training. Residency certainly can be a valuable use of your time, but only if it ends in a job that is truly satisfying to you.

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