ACCP has written a position statement a few years back that promotes mandatory residency training for all pharmacists involved in direct patient care. After reviewing the paper, consider these questions:
Do you agree with the tone of the article in that residency training should be mandatory for all pharmacists involved in direct patient care?
What is considered direct patient care? Should it apply to all community and hospital pharmacists?
What should the expectations be for a new graduate from a doctor of pharmacy program? Should they be ready to practice as independent clinical pharmacists (eliminating need for mandatory residency training)?
If residency programs were required for you to be a community pharmacist or a staff pharmacist in a hospital, would you have still chosen to come to pharmacy school?
65 comments:
I do not agree that residency programs should be mandatory for all graduating pharmacists. There are too many factors that need to be incorporated when making this decision. It stated there are currently around 8,000 graduating pharmacists per year, meaning there will need to be 8,000 residency opportunities available. Not to mention there will need to be 8,000 preceptors willing to teach accordingly without having residency program standards fall due to having to accommodate more people. If the amounts of residency opportunities are limited, this allows preceptors to drill knowledge into each student. This won’t allow for residents to fall through the cracks, ultimately compromising the standards. This also imposes an economical barrier for a lot of additional education that most graduating pharmacists won’t even use. Direct patient care is a huge part of both community and clinical pharmacists, and approximately 90% of pharmacists go into community pharmacy after graduation. While I think pharmaceutical care is important in all aspects of pharmacy and critical skills must be learned, I think they can be obtained in the four years of earning the PharmD degree. I do believe however that those who choose to go into advanced clinical practice should be required to get more training in order to specialize and participate in direct patient care. These clinical skills will be needed for certain jobs, but in very few. If residency programs were required for community or staff pharmacists, I still would have come to pharmacy school. This is because I have the desire to seek the additional knowledge and education an advanced pharmacist would need, regardless where I end up working.
Ashley Sobol P1
In brief another money making scheme...who`s going to fund this and gradute school is already expensive and rising how is one to get along in life with loans on your back is this still the Ameriacn way ? no one learns from the past.
Insurance should fund 100 % since they will be the primary beneficary money wise and they are the ones who should employee the gradutes
CLT Preceptor
I do not agree with mandatory residency training. I think if your planning on being a community pharmacist then residency training is overkill. We are well trained in our 4th year of school in different scopes of pharmacy and this is enough to get us ready for practice. if you plan to specialize or work in direct patient care then it is a good idea to have residency training, but should not be required since everyone has varing degrees of experience in pharmacy.
I believe residency programs are a good idea and I myself am interested in a residency program. However I believe if they do become mandatory, more residency programs need to be approved and available to the massive amount of graduating student pharmacists that would be entering the residency pool.
I believe doing residency is a very good idea, but it should be kept as optional. Part of the statement implies that those pharmacists who involved in direct patient care must go through residency is basically another way to say EVERY pharmacists have to do residency training. For me, involving direct patient care also includes counseling, consultation or education patients which are most of future pharmacists want to do. As one of the student spoke in class, the attitude is also an important part. There is a very big different between “I want to do that” and “I have to do that.” It basically would change how they practice. I’m sure most of us before choosing our ultimate path had to go through a decision making process. And I’m sure you probably heard this sentence many time: “Choose whichever job you like to rather than following a situation or an order.”
Also, after the presentation about residency during orientation week, there are not many spots for students after they graduate. Base on that fact alone, I doubt this statement would soon be able to succeed.
I feel like a required residency for all pharmacy graduates would lower the quality not only of the residency, but also for the education that students get while in school. Pharmacists should graduate from their pharmacy school ready to practice, that is a responsibility of the school-to prepare their students for their career.
Sarah Paiement
Doctor of Pharmacy Candidate
Wingate University Class of 2015
Mandatory residency would be difficult to accomplish due to the already limited number of residencies available. It would take time and effort to find qualified new residency sites. It would be easy increase the number of available residencies and have a large portion of them being sub-par, unhelpful, and even hurtful to the development of the resident. If there was a way to ensure the expansion of available residency opportunities in a manner that maintains a high quality level of the residencies then it would be a good idea. If it does become required then we would be seen by other health care professionals as more equal. We would also be able to make a stronger push to widen our scope of practice and receive payment for going through a residency and for the addition things we will be allowed to do. As long as the quality of residencies stays high as the number is expanded to accommodate all graduating pharmacy students then the idea would be in the best interest of the profession.
Kai Jones
WUSOP class of 2015
I do not think residencies should be required for all pharmacists. Pharmacists do not always do work involving direct patient care. For those pharmacists they would not need much clinical knowledge in their practice and a residency may be a waste of time for them as opposed to starting their careers right after pharmacy school. The article states that Pharmacists involved in direct patient care should be required to have a residency. For pharmacy positions not involving this care a residency or residencies as we know them would not be as beneficial. Community pharmacies are starting to become more involved with direct patient care such as giving vaccinations and offering MTM services. These added positions may be benefited by pharmacists that have had residencies but there may be value in having more specific residencies created relating to those kinds of duties rather than more comprehensive residencies.
I think a mandatory residency would be a good idea for anyone in a specialty or hospital setting. For a community setting having a residency should not be required. However, we had talked about how patients and other healthcare professionals would potentially view us differently if we have a residency. On the flip side of that, what if people started viewing us as the most over educated professional again.
I see a benefit for pharmacist wanting to be in the clinical setting to do residency training. I do not think that it should be mandatory but perhaps determined through an assesment to see if that pharmacist is capable of bypassing a residency. Depending on the experience level of an individual who is a new graduate in that field it may not be needed, but for another graduate even of the same class it may be needed in order for them to perform at their full potential. If it were required of me to do a residency I would still have chosen this field simply because this is what I want to do, after this long in school one or two more year is not going to kill me.
My opinion on mandatory residency training is split. I can see the benefits from doing a residency, and it out weighs my reasons for not doing a residency. I've worked with pharmacists fresh out of school, and I was horrified that they were in charge of patients healthcare. Therefore, residencies could have benefited these below par pharmacists. Also, pharmacists that have completed residencies can stand their ground and defend their doctoral degree against any opposition that may look down on the pharmacist's role. Now, some people may be in a situation where a residency after school is not viable; so requiring a residency is a bit much and may turn potential pharmacists away. I am older than mos,t and if I want to start a family when I graduate, a residency may cause an issue. Would I have still picked being a pharmacist as a career? yes.
Ryan Tucker, P1
I believe a mandatory residency for all pharmacists is unnecessary. Pharmacists that want to specialize should definitely consider a residency and without a doubt not having that residency experience will not qualify them as much as a pharmacist with that residency experience. But to require that all pharmacists need to have a residency creates all sorts of problems such as funding, opportunities, preceptor availability, etc. A pharmacist at CVS does not need a year of residency to be qualified, hence making that pharmacist continue his or her education further than the four years of pharmacy school is unclear to me.
Kyle Crisco, P1
Class of 2015
I do not agree that residency programs should be mandatory for all graduating pharmacists. I think that if a sufficient amount of residency positions are created to accommodate all graduating pharmacists, the quality of the residencies may become compromised. This will lower the standard for pharmacists that are truly interested in clinical pharmacists and becoming CPPs. I believe the P4 year rotations fully prepare pharmacists to enter retail positions.
In my opinion, as long as the limited amount of residencies continues to drive pharmacy students to excel and be competitive, the quality of clinical pharmacists will increase.
I agree with many of the posts that residencies should not be mandatory. Especially if one is targeting to go into community practice, they should not be made to do a residency. One person in the class discussion mentioned that many have prior experience that amounts to many years in the community setting. Then why should they be imposed with another year or two of residency training?
Similarly in the clinical setting, I believe that residencies are advisable for those in specialty programs since this would enable concentration in that area.
I also agree with one of the preceptors that said it is 'a money making scheme.' It seems that bureaucracy is taking over education as well where leading organization are finding methods to make students compelled to pay fees to be able to enter into a program.
I do not think that residency programs should be required for all students coming out of pharmacy school. However, it should ABSOLUTELY be necessary for students who wish to specialize and practice in a hospital. It was said in class that we should come out of pharmacy school with the skill set to perform any pharmacy job we wish to have. But do you think in four years you will have the skills to design a treatment program for a new liver transplant patient with complications such as a collapsing hepatic artery, elevated enzymes, and a severe reaction to warfarin in the first week on the organ transplant team? I don't think I will be. And if I do, I'm not sure I would be confident enough to put someones life on the line that early in my career. Chances are a person would not even be given an opportunity to work with a specialized team unless you have additional training. I think the question is not should residencies be mandatory or not, it should be what aspects of the profession should residencies be mandatory for.
Question for our mentors. Has anyone who is currently working as a retail pharmacist completed a residency? If so, did you feel that the extra year of experience proved to be worth it even though you are working in retail? Also, is it your professional experience that all new pharmacists graduate school with all the knowledge they require to work in a retail position? A lot of the comments against mandatory residency revolve around the concept that four years is plenty of time to produce graduates who know enough to begin to practice and a residency should only be for people pursuing a hospital or clinical position.
Courtney Black
P1
I do not believe that all pharmacists should have to do a residency. I do not think they should because we are already going to school for an additional 4 years and we are going to learn a lot during those 4 years. Now if you try and specialize in an certain area of pharmacy then I do believe you should do a residency because it is involved in a special type of pharmaceuticals. There are always exceptions to everything and this is no different. I do think that if you are truly just trying to do a community based pharmacy then a residency is not needed, however if you are trying to do a specialty area of study then I think it is needed.
I tend to agree that in some clinical settings such as acute care, burn units, cardiac care units, internal medicine, pediatrics, and other such specialties, it just makes sense to have residencies. As a student, I was amazed how much the rest of the medical team looked to the pharmacists to get all the medication right. One time on a pediatric rotation the attending physician asked me to write the order and protocol on giving a patient iron dextran and Cerebyx (fosphenytoin). They literally gave me the doctor's order sheet to use. Iron dextran can cause anaphylaxis, and too much phenytoin is deadly. I thankfully got it right, but it instilled in me the belief that I would need more comprehensive traning to be competent in that setting.
What is being missed here is that whether we are in community, hospital, long-term care, or in nuclear pharmacy, additional training is ALWAYS needed after graduation. In nuclear for example, a pharmacist must have 200 hours of didactic training as well as 500 hours of experiential training in order to practice. That's quite alot of information to assimilate. So in essence, ALL pharmacist jobs require some form of additional training, whether is it named "residency" or not.
Chris deHoll, PharmD
Authorized Nuclear Pharmacist
Cardinal Health Nuclear Pharmacy
Asheville, NC
Also, just to comment on Ashley Sobol's entry, I hope that we as preceptors don't "drill knowledge into each student." If that has been your experience, I am sorry. A preceptor is to promote an atmosphere of thinking and learning, permitting the student to grow at their own ability. Preceptors should help students question their own knowledge base in order to create deeper learning and satisfaction.
It is my hope that preceptors can be seen as a big brother or sister who is their to help, not to belittle.
I do not believe that pharmacy students should be required to complete a residency. Not all pharmacists will need the experience from residencies to perform their job adequately. If someone wants to practice in a specific field then they should have to complete a residency but if you are going into community practice then I do not see the need for a residency. After graduating from Wingate I feel like I should have the skills needed to practice in the community setting. As practicing pharmacists we are required to participate in continuing education so we will still be improving and gaining more experience throughout our careers. I know personally that I if I had to complete a two-year residency to graduate then I would have been less likely to attend pharmacy school. At the end of the day there are pros and cons in completing a residency but I think that it should be the individuals’ decision to participate, not something that is forced upon them.
Although it certainly is a good idea and would help any graduate prepare for a prospective career more thoroughly, residency training should not be required of all graduates. If a newly declared Pharm. D. feels confident in their choice of practice setting and can demonstrate skills than perhaps that individual is suited to take up a role immediately after school. For those who feel they need more experience, residencies are always an option and I definitely recommend them. However, we shouldn't question whether a graduate knows the trade or not, so ultimately the decision of how competent a pharmacist is lies with that pharmacist. We also have to be aware of the setting in which they plan to practice, as certain factors can play a role. There are often checks and balances present in the workplace to ensure a pharmacist is conducting practice appropriately (i.e. managerial positions, technicians, other pharmacists). A pharmacist is not always the authority, and the collaborate effort of staff members along with pharmacists ensures that even a pharmacist has someone to verify their own work with or consult if need be. Pharmacists always need to be knowledgeable and skilled, but this doesn't necessarily mean that they are the ones in charge in all cases or that they don't have someone to consult with. After schooling and even after a residency, practicing pharmacy is a learning opportunity.
I think that residency should be optional, because it creates another hurdle in getting out into the working world. As we all know we will have a massive debt and by being forced to do a residency will increase that debt. Only those people who want to pursue a higher more specialized field in pharmacy should seek a residency. I will be doing a residency because I know that it will allow me to work in both hospitals and at the CVS if need be, but I think that it should not be forced on us. I would have still come to pharmacy school if I had to get a residency, but only if it was given to us. Also there are not be enough residency programs for all of the pharmacy students that are graduating.
John K. -P1
I tend to agree with everyone else that has commented on this blog. Residencies should be a personal choice. There are definitely some areas of pharmacy that would need additional training, but I don't believe retail is one of these areas. Considering most graduates will end up in this type of setting it seems ridiculous that a residency would be required. Not to mention the fact that there aren't near enough programs to accommodate all of the graduates each year. If you wish to do a residency then you should have no problem doing that, but it seems unrealistic to make this a requirement for everyone.
Bess Urie, P1
In my opinion, I do not believe that residency training should be mandatory for graduating pharmacist. One of the benefits of the residency is to make yourself more competitive. If every graduating pharmacist is going into a residency program after graduation, then you are no longer set apart from the other graduates. I do however think that the programs are a good idea for those who aren’t going into the retail setting. If you are going into a more clinical setting, the extra knowledge you receive from the program can be invaluable but it should be your choice on whether you want to do it or not.
Jessica Farris P1
Class of 2015
Even though I am interested in a residency program and I believe it is a great idea to gain more experience before practicing on your own right after graduation, I do not think it would be a good idea for residency programs to become mandatory. There are not enough preceptors for the amount of graduates each year. Even as it is now, it is very competitive to get the residency practice site that you want, thus, with even more graduates having to go through a residency program, it will be even more difficult to acquire a site that interests you and will benefit your future career. Thus, it may be likely that a student would be required to do a residency in a site she will never use in her future if these residencies are made mandatory. I believe that if a student wishes to enter the community pharmacy setting upon graduation, a residency should not be required since the 4 years of pharmacy school should adequately prepare all students for this type of setting. However, in any other profession that chooses to specialize, more training and experience should be required, thus, those students wishing to engage in a more specialized scope of practice should be required to have one or even two years of additional training in the form of a residency program.
Charleen Gnisci, P1
To address Courtney's question, and perhaps touch on some of the other comments...
It appears that many students have the perception that community practice is EASY, and therefore, additional training would be a waste of time. This is quite the opposite of reality. My experience, both as a preceptor and as a pharmacist, is that new grads are NOT equipped to handle the realities of life as a community pharmacist. P4 rotations should teach you the basics, and some of them do, but for the most part, community rotations can't possibly prepare you for the responsibility (and subsequent liability) of community care. All of the technician experience in the world does not prepare you to be a pharmacist (it, in fact, prepares you to be a better technician) - don't be fooled into thinking that it does. A community practice residency would allow that independent practitioner (because that's what you are as a community pharmacist... nobody provides a diagnosis for you, nobody confirms that the product you selected for use is correct, let alone will work) to acquire the knowledge necessary to build a clinically-driven, patient-centered practice. That's the piece that's missing from the new grad repertoire - you may have lots of knowledge and a decent skill set, but you don't really know how to TAKE CARE of people. That's what a residency would provide.
Those of us that practice in the community (but did not complete residencies) are faced with the giant task of acquiring this knowledge/ability on our own. I have my reasons for not completing a residency, but most of them concern geography. I'm pretty sure there's not a community practice residency anywhere near Charlotte (which is both unfortunate and surprising). Whether you work at CVS or at your own independent practice, you have a professional obligation to serve your patients. Acquiring knowledge and skills doesn't end when the graduation song plays.
Practicing with purpose is different from punching a clock and counting by fives. Nowhere should a pharmacist practice more purposefully than in the community. The inherent level of trust bestowed upon a community pharmacist at any given point in the day can be overwhelming - but having the tools and training to perform those trustworthy functions is what a residency would give you. I wish more people would consider community practice residencies - I think those that did could really lead the way in terms of protecting the profession and teaching patients the value added by a community pharmacist.
________________________________
Erica Harms, Pharm.D., R.Ph.
Executive Pharmacist | Target Pharmacy
eharms@carolina.rr.com
I do not agree with mandatory residency requirements for pharmacy graduates. I believe that residencies would be beneficial for those students that plan to practice in a clinical setting, specifically those that want to specialize in a certain area. However, the majority of pharmacy graduates plan to go into community practice and I believe that the 4th year rotations of Pharmacy school give students sufficient training to prepare them to do so.
Sonja Keranovic P1
I believe that residency training provides pharmacists with valuable experience, but should not be mandatory. Student pharmacists receive much experience during rotations in their P4 year. In addition, if residency programs are made involuntary, pharmacists will be forced to look for other ways to stand apart from other pharmacists. Also, many loans require payback upon graduation of pharmacy school and this is certainly hard to achieve upon a residency salary. I may choose to complete a residency after graduation in order to gain more knowledge and familiarize myself in a specific field of pharmacy, however this should not be required of all pharmacy students.
Barbara Santevecchi,P1
My main concern with saying that residencies aren't necessary for some practice fields is that I will begin my pharmacy career and be unprepared for certain situations. I want a dynamic career and to be able to change to a possibly more specialized clinical setting one day. I would consider a residency because I want to be a top candidate for any career move I make. That being said, until providing patient care becomes more prominent than dispensing as a pharmacist's role, mandatory residencies cannot be expected. When pharmacists are level with physicians, they can get extra education like physicians.
Morgan Bourne, P1
Dr. Harms made a great point regarding residencies in community pharmacy and the lack of availability, but benefit of completing one. My sister is a community pharmacist and she would agree 100% with Dr. Harms's statements about new community pharmacists needing training beyond the experiential and didactic training received in the four years of the Pharm D program before practicing community pharmacy.
The majority of residencies are thought of in the clinical setting, which would be an advantageous training addition to a Pharm D, but the majority of pharmacists practice in community settings where there are relatively few residencies available compared to the number of future community pharmacists. I am of the opinion that completing a residency would be an advantage, both in enhancing the pharmacist's knowledge and experience and on the pharmacist's CV, but I do not think residencies should be mandatory until the number of graduating pharmacists and the number of available (high-quality) residencies are equivalent. Perhaps in the future we will see a trend in community pharmacies developing residency programs.
Barclay Driscoll P1
I do not think it should be mandatory for pharmacists to do residencies. First off I would like to give a little background on my pharmacy experience so you can understand where I am coming from. I graduated WUSOP in 2010 after several years of community experience as a tech and an intern. I moved to northern Wisconsin and was a PIC for Wal-Mart for about 9 months. I stumbled upon a hospital position. It is basically a clinical position and after my first 3 months I am a member of the antibiotic stewardship team. With that said, clearly it is not necessary to have a residency to get a clinical position. However, this is not the case in MOST hospitals. It is simply because of the size of area and hospital here. Our clinical coordinator is our only pharmacist here with a residency (out of 19).
As far as making residencies mandatory for those providing direct patient care- this needs to be defined farther. All pharmacists are in a way providing direct care as the medications go directly to the patient, but not all affect what the patient is getting. Retail pharmacists get the most hands on time with the patient but less involvement with what they are taking. I do not see an opportunity for residencies within retail. Training definitely needs to be beefed up in retail but a year is unnecessary. A few months training with focus on management and daily problems would suffice.
By making residencies mandatory you loose the upper hand that potential employees have over others and also decreases the value of the program. If everyone has to do them, we are all evened out in our potential and the achievers are not separated from those that are just getting by. It is true you do not develop clinical judgments during your 4 years of pharmacy school, even on rotations. Rotations differ tremendously from each other and go by quickly. New grads should not be expected to be ready to practice as independent clinical pharmacists but given opportunities to gain experience either through their employers or by residencies. Employers, if not requiring residencies, are more than capable of training their staff for clinical practice; this is how it has been for years.
Residencies do distinguish achievers from the group and make it a quicker road for those who know they want to work in hospital and specialize. It should be discussed more frequently and more in depth during earlier years of school. I was on the fence about doing a residency before graduating. Residencies do give you an opportunity to develop networking opportunities which help when one is on their own to start protocols or programs within their setting. They also teach you great skills for doing presentations and helping to teach others. Not everyone wants this though, not everyone wants to nor should be a leader.
I think that becoming a BCPS or gaining other certifications is the way to distinguish oneself. A residency gives you a crash course in experience but you can also gain this experience over years. Certifications or BCPS shows you know the information.
Pharmacists are no longer in short supply as we were in previous years. The market is flooded, hence why I moved. In fact, I have seen Wal-Mart in this area cut all of their non-manager pharmacists to 30 hours a week.
If residency programs were required I would still have chosen pharmacy but it would make it much harder to change between areas. If someone did 2 years of residency with a focus on nuclear pharmacy would they be able to change to a retail pharmacist without having to re-do their second year of residency? By making it mandatory to do 2 years in your field you would have to at least repeat your second year.
Darcy Clements, PharmD
Sacred Heart Hospital
Eau Claire, WI
And
Wal-Mart Pharmacy
Menomonie, WI
I dont think that residency programs should be a mandatory requirement for pharmacists. When we get out of school, we should have all the skills required to go out and practice pharmacy. I think that doing a residency should be a personal decision that one makes. You should choose to do a residency beecause you want to make yourself more competative or to allow you to specialize in one particular field. If you want to be a community pharmacaist, it would be silly for you to be required to do one or two years of residency.
I think this decision is totally dependent upon the individual and the scope of practice he/she desires. I don't think it's necessary or practical to require every pharmacy grad to attend a residency program, but if one chooses to complete one, it's perfectly acceptable. Most likely, it's even recommended in a specialized field, but for community pharmacists, I don't feel like it should be mandatory. What ever happened to good old-fashioned on-the-job training anyway? There will be a window of time in every job, regardless of amount of training, where we will have to become comfortable with our roles and duties, and our pharmacy education on its own should make this transition fairly smooth.
Kelly Campbell, P1
I don't think residency programs should be required for all pharmacy graduates. Anytime you make anything mandatory it takes away a lot of quality of the experience. People who wouldn't have chose to participate will not get anything out of it because they aren't doing it on their own. They would be only doing it because it is required, and they have been forced into it. I would still have come to pharmacy school even if they were required simply because I really want to become a pharmacist, but I agree that it is silly to make residency a requirement.
I feel like we are pushed toward to take part in residency program more than ever to get a job we want. In job market, many places will not be available for one without residency training, and employers might be willing to hire pharmacists with extra training and education. This trend probably makes us to feel that we need residency trainings after graduation, but I still believe participating residency should be kept as optional, and it shouldn’t be controlled by any other factors but our own choice.
Yeo-hoon Yoon, P1
I do not agree that graduating pharmacists should be required to undergo a mandatory residency program. I am very curious as to how the number of required residencies would be offered, as the number of graduating pharmacists is continually rising every year, and I simply do not find it feasible for enough residency positions to be available for all of those graduating students. I feel that taking away the competitiveness of residencies, pharmacy students would have to look for even more ways to keep themselves competitive in a line of work that only gets more competitive as the years go by. Required residencies for graduating pharmacy students is simply too much; getting a job upon graduation is competitive enough!
I do not agree that graduating pharmacists should be required to undergo a mandatory residency program. I am very curious as to how the number of required residencies would be offered, as the number of graduating pharmacists is continually rising every year, and I simply do not find it feasible for enough residency positions to be available for all of those graduating students. I feel that taking away the competitiveness of residencies, pharmacy students would have to look for even more ways to keep themselves competitive in a line of work that only gets more competitive as the years go by. Required residencies for graduating pharmacy students is simply too much; getting a job upon graduation is competitive enough!
Pharmacy residency is designed to further your education and allow specialization after pharmacy school. Therefore, it should not be a requirement to practice in a patient care setting. The article says that all pharmacists will be involved in direct patient care where they are monitoring the drug therapies of patients, even community pharmacists. The term independent clinical pharmacist in a community setting has a different meaning than the term in a hospital setting. I believe that new PharmD graduates should be able to practice independently in any community setting monitoring patient therapy and counseling as needed, with no residency whatsoever. On the other hand, clinical pharmacists in a hospital setting are confronted with more advanced, complex issues that could mean life or death for their patients, therefore, these pharmacists should have mandatory training to ensure the safety and quality of care for hospital patients. If residency programs were required though, I would still go to pharmacy school. Eliminating the competition to get a residency would be one less thing for me to worry about in pharmacy school so it would definitely not change my decision to attend pharmacy school.
I also don't think that residencies should be mandatory for pharmacy students. They are of course a wonderful option available to those who would like further experience, especially in a specific field, but we should graduate with all the REQUIRED knowledge to be a practicing pharmacist. In fact, I kind of feel that requiring residencies is admitting to the "inadequacies" the AMA talked about in the article we read earlier.
I do not agree that residency programs should be mandatory, however I plan on doing one because I think they are helpful in not only gaining experience but also in learning new skills and making yourself more marketable. I wouldn't want them to be mandatory, because I would like to use my residency as a way to stand out from the crowd as it were. Also there are not enough programs to accomodate the rising number of pharmacy school graduates.
I do not necessarily agree with the article in that future pharmacy students will have to complete a residency in order to enter practice. I feel like there should be an assessment test in which students are required to take upon graduation, assessing whether or not they should have to do a 1 or 2 year additional years in a residency. There are not enough preceptors to teach every single resident if every pharmacy graduate is required to complete a residency before practicing in a community or clinical setting. The idea of it is interesting, however, because it is directed towards showing that pharmacists are more than capable of handling a wide variety of situations and are completely competent within a health care setting. The idea that all pharmacy graduates must complete a residency, however, is a bit too much. Having said that, had I known that I must complete a residency before becoming a practicing pharmacist, I would still have applied to pharmacy school in hopes of becoming a pharmacist in the future.
I do agree with this article in saying that residency training needs to be mandatory if a pharmacist wants to work in a profession dealing with direct patient care. Getting that extra practice and more in depth training allows the pharmacist to become more experienced and more educated and efficient at performing the task in real situations once they are on their own. This training will also help the pharmacist have a greater impact in their patients’ health. I think that residencies should apply to only hospital and clinical settings since the retail/community pharmacists are not actually providing such in depth direct patient care. The community setting really does the more basic patient care with counseling and does not act in the medication choice procedure. Residencies are also important for the newly graduated pharmacists because they are graduating with the basic knowledge of how to be a pharmacist but have little to no experience in the clinical/ hospital management care settings. I can’t really say whether I would have still chosen pharmacy school if residencies were required to be a pharmacist, it would depend on the length of time I would have to spend doing them and how many I would be required to do.
I tend to agree with most of my classmates in the sense that a residency should not be mandatory for all pharmacist. The reason I feel this way is that history shows that pharmacist have done well with the training they have received thus far to give patient adequate care. I don't feel that any additional training will give be much more beneficial. In reality, it is more up depended on the individual in terms the clinical skills they have and additional training will have more of an impact regardless of practice setting.
I do not agree that residency programs should be required for graduating pharmacist as they are not required for many other professionals. I think that it is overkill on the profession because we are already required to have 1500 hours of clinical experience. why should we have to do a residency on top of that pharmacy school is already a huge economical burden on students if more is added then it will be a less attractive field which will not be a good path for the field to move in. Since competition for being accepted is high it allows school to pick from the cream of the crop if it becomes undesirable then less will apply leading to a lower quality of graduates.
I feel that residency programs should be mandatory for all pharmacists who will provide primary, secondary, or tertiary care services. Residency should only be optional for pharmacists not directly involved in patient care. I feel this prerequisite not only helps earn the experience required to provide quality patient care, but also justifies qualification for the roles sought by pharmacists as their scope of practice expands. I recall from the 'scope of practice' discussion that many physicians hold their residency training in high regard and posit that the experience gained during these formative years was invaluable to their careers and set them apart from other practicing professionals. Pharmacists who complete residency programs will share in this benefit and further earn their right to practice alongside physicians.
Many pharmacists and student pharmacists suggest that all of the experience one needs is obtained during the 'practice experiences' and rotations integrated within Pharm.D programs. This may be true now, but as the practice of pharmacy continues to grow and branch, I feel that the need for more experience will arise. Again this applies mainly to pharmacists who will have direct roles in patient care. It is possible that in addition to practice rotations, the P4 year may evolve to include more classes featuring additional or specialized coursework specifically designed for students preparing to engage in patient care. This change would necessitate a shift in the time spent participating in accreditation-required practice experiences and rotations; such demands could be met by mandatory postgraduate residency programs. Alternatively, the P4 year could remain the same, and additional education could take place directly in required residency programs.
If the future of pharmacy was more certain, altering the educational requirements may not be necessary. The future is not clear, however, and one day the supply of pharmacists may indeed outweigh the demand. Early action to increase the expertise of practicing pharmacists helps ensure the profession will continue to thrive and maintain a high level of respect and importance in the health care industry.
Ryan Neal, P1
Class of 2015
I do not believe that residencies should be mandatory for all pharmacy students. I think it would be to difficult to make it available to all students. There would not be enough sites for everyone. I also think that pharmacy students who were just going into a community pharmacy would not need extra training that is given at a residency. I do believe that residency training would be very helpful for students who were going into a specialized field of pharmacy. I just do not think it should e mandated for all pharmacy students.
Chris Sullivan P1
Thank you Erica for taking the time to answer my question. Your answer provided me with a lot of information to think about and I hope that the rest of my classmates were able to read your response. It definitely helped clear up a few misconceptions I myself have had or have heard from others about what a residency means and what pharmacy school prepares you for.
Courtney Black
WUSOP P1
I don’t think residency should be mandatory for pharmacists. I think that upon obtaining a PharmD degree a pharmacy student is more than competent to administer direct patient care and to fulfill his or her responsibility as a pharmacist. I think pursuing residency should be at the discretion of the pharmacist. Also, it doesn’t seem feasible to implement this particular mandate. The number of graduating pharmacists drastically outnumbers the amount of positions available in residency programs.
I think that over time, residencies will be required for all pharmacists, regardless of whether or not a pharmacist will be working in a community pharmacy or a hospital. If increasing the responsibilities and duties of a pharmacist is the goal, then more education will be necessary to meet the challenge. Managing a patient's drug therapy by assessing a patient, consulting with a patient, and ultimately altering a drug therapy with continued monitoring of a patient's progress is a big challenge and a big change from the way pharmacy has traditionally been practiced. As pharmacy evolves, so should the educational requirements.
I do not agree with the article's statement that residency should be mandatory for all pharmacists practicing direct patient care. Although this may sound ideal for future clinical pharmacists to gain more practice and experience, for community pharmacists, this is seems to be a waste of time and lost of money to be forced to do a residency program that may never be used in their practice for years to come. They defined direct patient care as the pharmacist's role of assessing the patient and contributing in the selection, modification, and monitoring of patient-specific drug therapy. I understand that Medication Therapy Management is pushing its way to everyday pharmacy practice, but this still does not involve direct patient care to the extent of that definition.
Mandatory residency training should not be required to obtain a doctorate of pharmacy. Personally if I knew pharmacy school required a total of six years, this program would not have been my first choice. My goal in undergraduate was to get into pharmacy school after two years and receive the PharmD in a total of six years. Residency programs are helpful in order to obtain less available jobs in the clinical setting, but doesn't help in the community pharmacy setting.
Andrew Helms
I am totally against the idea that residency programs should be required after pharmacy school. There are several reasons why making residency a requirement will not be a good thing. First off, residencies are a tool for making people more competent with one another in getting a job. Someone with a residency will most likely get a job against someone without this extra experience. Requiring residencies will eliminate this competition and actually make pharmacists have to go into even more extra training to gain an advantage in the work force. I also think that there is not enough room to provide every graduate with an appropriate residency program. I think quality of residencies will significantly decrease because they are just another requirement. Students as well as some institutions will not be putting forth maximum effort in these programs. Another reason to not require residencies is that community pharmacists do not need residencies to become competent. I have talked to several people who have pharmacy experience who agree with this notion. It would be a waste of time for a community pharmacists to complete a residency in my opinion. I believe the system we have now is adequate. Currently, a residency is basically required to be hired in a hospital setting. It is difficult to go straight into hospital work right after graduation. So in my opinion, the system we currently have is working. Not everyone needs a residency so it should not be required, especially if that risks quality of the program.
JUSTIN CRUMP
P1
I also do not agree that residency programs should be required by pharmacists upon graduation for a number of reasons. The main reason I feel this way is due to the amount of experiential experience that we gain throughout the four years of pharmacy school, especially our fourth year. Since I want to go into retail pharmacy, I do not believe that residency would help me out at all because I will have the experience that I need. Another reason that I feel like residency should not be required is because if you tack on another year or two before being allowed to work, then why not go to medical school and become a doctor. I know everyone may not agree with me, but the financial incentive of a pharmacist is one of the reasons for attending school as well as future job security. This is just me being honest because money has to be an important factor because it supports a family and allows you to live your life the way you want to live it. That being said, the only instances I could see residency being a requirement would be specialized pharmacy locations that can include nuclear or hospital pharmacists. If a person is to become specialized in a field, then this extra training could help them in the long run.
I have very mixed views about the concept of mandatory residencies. As many people have pointed out making the residencies mandatory makes differentiating ourselves more difficult. The pharmacist who wants to “go the extra mile” would then have to take longer residencies or consider fellowships. Especially considering the lack of exceptional residency sites at the moment compared to the number of graduating pharmacy students this seems to be a poor idea.
I can see that as a profession we may be moving in the direction where for professional respect and to be seen as more competitive with other health care professions we choose to add a required residency (or require a Bachelors etc.). Even doctors, whose training many hold as the standard to other medical professions, have many problems with a residency system that has been established for some time. It would be imprudent to think that we could create a working required residency program without years of planning, design, and staggered implementation.
Finally I feel that if a residency is required it should be a general clinical/pharmaceutical care residency meant to improve our clinical understanding. Several of us have had years of experience in the retail or hospital sectors managing inventory and learning systems that in general are not the part of being a pharmacist that requires the most advanced training.
Jonathan Graham P1
I think that residency programs should not be a mandatory part of school. As of right now there are not enough residencies for all of the pharmacy students now. So if a residency was required then many people would not be able to start their career for a while after they finished school because they would have to wait for a residency to become available. Also with the way that we are doing our fourth year, it is a lot like a residency because that is all that we will be doing in our fourth year. So I do not think that a mandatory residency should be taken into effect because that would just hinder more than help.
I do not think residency programs should be mandatory because i believe that we are getting enough training and education in all these four years that we are capable to go outside and practice. If someone wants to get in detail and be more specific in their concentration, its their personal choice. And also the quality of the services provided by the preceptors will go down. The standards of the program will go down.
I don't think that all graduating pharmacists should have to do a mandatory residency program. I do feel like there should be mandatory residency for clinical pharmacy because there is much more specialization opportunities in the clinical setting. It makes more sense to me for a mandatory residency in direct patient care settings then a retail pharmacy setting where you are in contact with your patients but basically just to dispense the medications and help the patient understand their medications. If residency programs were required for any position as a pharmacists I still would have come to pharmacy school because when I first worked in a pharmacy I really felt excited about finding a field that I loved to learn about.
Nathan Batchelder P1
I think residency programs should remain optional. I feel clinical rotations within the pharmacy school program prep students enough to practice. I have also heard that most jobs don't throw new pharmacists into positions unprepared. Most jobs have orientation or training periods where new hires are paired with an experience mentor for a period of time before they're "Let loose."
Kirsten Ferguson
P1 Wingate
Residency provides more experience and practice for the pharmacist however, i dont think it should be made mandatory. It should be optional to the individuals who want it. I think is a great way to gain experience though so as to be very confident when dealing with patients especially in clinical setting. The problem i see with making residency madatory will be funding and also availalbity.
I think that when you make something a requirement, it takes away from the prestige of it. People who go and do residencies get their reward for doing so by being preferred in the hiring process. Allowing the job market to decide what the standard is will allow the competition of the programs to continue. By making this a standard, residency programs may be created to fit the quantity rather than focus on quality. There would be no point to do a residency if you are doing one only to put it on your CV, rather than to gain the experience. We still need these choices to be able to distinguish one graduate from another.
I really like the idea of having a more specialized formal education instead of a residency. For example, after the first 2 years of graduate school, we could declare whether we were interested in clinical, ambulatory, etc areas of pharmacy, and then our classes would be more catered to our desired area of career. This has proved very effective with the engineering degree, as students declare mechanical, aerospace, biochemical, etc after their first year of general education. I would prefer to see the schools step up to provide students with more practicing knowledge (whether it takes an extra year, even) rather than making residencies mandatory for all pharmacists.
Kim Tooker P1
There are two sides to the argument whether or not residencies should be mandatory. On one hand, residencies are great ways to earn invaluable experience. Many other medical professions require them and they can determine the difference between a good pharmacist and a great pharmacist. On the other hand, residencies are competitive and there may not be sufficient programs after graduation to apply. Nothing is worse than to graduate in your field and not have a job. I personally believe experience is one of the key factors that allows someone to go beyond job performance in the pharmacy field or any other field for that matter. Like the addition of the Pharm.D program, residencies could be an extra step in a career that is really not necessary. There are plenty of great pharmacists who only have their B.S. degrees. There are good arguments and there are bad arguments about mandatory residencies.
I think it is a good idea to have mandatory residency if you are planning to practice on clinical settings and other specialties. I also think there should not be mandatory residency training for community pharmacy practice. Most of pharmacy students already have many years of experience in retail settings therefore it should be given as optional choice .Individuals who like to have more experiences can be part of the residency training. Most of the students would already have debt after 4 years of graduate school and increasing unnecessary debt doesn’t seem to be a good idea. Also, adding few more years of unnecessary training is just waste of time.
Having all those said, if residency programs were required for me to be a community pharmacist or a staff pharmacist in a hospital, I would still be choosing to be pharmacists and serve community.
Direct pharmacy care should be applied to all pharmacy practice settings to have definite outcomes for individual patient and improve quality of life. Every Pharmacists should be willing to practice as independent clinical pharmacists without any exception (eliminating need for mandatory residency training).
I think that residency training should be required, but only for pharmacists who wish to pursue a specialization. When trying to focus on such a specific area, those pharmacists need to spend as much time learning as they do working. In a retail setting, I feel that residency training would just take away from time that that pharmacist can spend really working.
I do not agree that they should be mandatory. Retail pharmacists do not need this added rotation to do their jobs. If we were all required to do another two years of rotations after graduation, I probably would not have chosen to be a pharmacist. That would be a total of 10 years of schooling. There are many other healthcare professional positions that I would have picked with a higher salary than pharmacists for this amount of education. It would change the attitude of many students if they were required to do a residency. Those students would most likely not benefit from their residencies. If you want to do it, great, but that does not mean others who are not interested need to do is as well.
Maggie Kientzel P1
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