A Month Well-Spent

This past Thursday was the last day of my ICU clinical pharmacy rotation.  That means I am more than halfway through my academic year: five done and four to go.  Out of the five rotations I have done, though, this was by far the most educational, interesting, and potentially life-altering.  My previous rotations, even the best of them, played themselves out to the end which usually came at a point where I was ready to move on to the next one, even if the experience was very positive.  However, this rotation left me wanting more.  Other pharmacy schools use six-week rotations (instead of the four weeks at UW) and this is one month where I wish I had those two extra weeks.  The things I did, and the things my preceptors did as part of their regular day, were the things I can see myself doing, and enjoying doing, for years to come.  As an example, in school I would read things because they would be on the test and because they were a little interesting sometimes.  But in this last month (and the one previous, to some extent) I read those same types of things because I felt a drive to learn more.  When I came across something I didn't know or remember from school, I was actually excited to figure it out; find research papers, look up fundamental concepts (microbiology, biochemistry, etc.) to cement what I found, learn about any related issues, and (when the prompt came in the form of a "drug information" question from a pharmacist or doctor) tell other providers a little about something new or interesting I learned.  Clinical Pharmacy keeps me constantly thinking, by expanding and finding the newest changes regarding my knowledge, and ultimately using that knowledge to either support the medical team or directly improve a patient's stay in the hospital.

My recent post about clinical pharmacy ("My Career Revelation") was sort of left hanging.  As I eluded to, not having this revelation until January means that I have missed the cutoff for residencies.  A Pharmacy Practice Residency is a one-year program for pharmacists (almost exclusively new graduates) to gain experience in clinical pharmacy.  As with most professions, those doing the hiring are looking for candidates with experience.  This is especially important in pharmacy where, as a new graduate, you are often put in positions where you have little immediate support in making decisions quickly (e.g. working the night shift as the only pharmacist in the hospital when a decision must be made or a question answered that couldn't wait until morning).  Because of that (and probably some other factors), a pharmacy manager would find more difficulty in someone fresh out of school over someone with experience.  So by doing a residency, you have an intensive year as a paid (though at a lower rate), licensed pharmacist, but who has extra guidance and support during the time you further develop and become more comfortable with clinical skills.  A year of residency training is supposedly viewed as approximately equivalent to three years of regular work experience when it comes to hiring.  Beyond that first year, you can also do a second-year residency in a specific discipline (e.g. critical care) to even further hone and become more comfortable with your skills and knowledge.  Thus, residencies are beneficial to a new pharmacist by giving them more knowledge and confidence before being thrown into the deep end, as well as by providing them with a way to get the experience that is almost always needed to be considered for a job.

Applying for residencies is even more complicated than applying to college.  There are applications for each individual site but they all go through a central agency.  Once a site decides they are interested in you as a candidate, you are brought in for an interview.  You may interview at a few to a dozen different sites, and at the end of that process, you rank your preferences.  Each residency director does the same: ranks their preferences of which candidates they would most like to extend an offer to.  Once all those rankings and choices are submitted, a computer does some sort of algorithm that "matches" sites to candidates.  As you would expect, that process is pretty long which is why thinking about applying in January is far too late when the process started in September. 

So what do I do?  The first things I heard were that candidates are not considered for a clinical position without a residency under their belt.  I heard this from the school as well as managers at hospitals I've rotated at.  That being said, more of the young (more recently graduated and hired) pharmacists I've met hadn't done a residency than had.  I thought that a residency was a make-or-break part of your job application, when in fact, someone who hasn't done a residency but is a fast learner and relates well to other people could have a leg up on someone with a residency but who lacks interpersonal skills or a drive to succeed.  My plan, as of now, is to look for a job in a hospital that will hire me without a residency.  That may not, and likely won't be the clinical job I'm looking for.  As an entry-level pharmacist, it will likely be a weekend or evening job working hours that people with more tenure don't want to work.  But if I can find a door to get a foot into, it would be an opportunity to get on-the-job experience that may lead into that clinical position I want in the end.  And if it doesn't, it would be a way of making an income as well as keeping myself current on clinical topics (vs. spending nine months in a QFC counting pills and losing knowledge to a lack of its use) until next year's residency cycle begins and I can apply at that time.  That sounds like I have it pretty well figured out, right?  Fundamentally, I think I do, but what I need to figure out now it is who to talk to, where and how to apply, and where to put my name out so I will have somewhere to work come summer.  Graduation seemed so far away even a month ago, but now that I'm figuring out where I'd like to end up and how close June 14^th actually is, I'm realizing I have a lot to do in the upcoming months.