Fellowships and Residencies delay the inevitable

[Sans Crainte]

I know I said I was done with this thread, but I can't help myself.

You would honestly hire someone fresh out of pharmacy school with no hospital experience whatsoever over a PGY-1?

Secondly, you have this huge bias against residency trained individuals, and you're not willing to listen. ONE person comes in here and says he and other people that didn't do a residency form better relationships with a healthcare team, and you're jumping up and down with excitement in agreement and state that is proof enough why people shouldn't do a residency. However, multiple people come in here saying how they earned jobs, money, educational experiences, relationships from a residency and you refute every single point.

I already knew when other people chimed in you were going to refute their points because you're attitude towards those with a residency is predictable.

Hey Goldfish!!! Welcome back!! When I was in the 9th grade I had this priest, Father Connelly, for religion class at a catholic high school. He was one rough old dude and we all couldn't stand him; he said these words that stayed with me, "Love me or Hate me, but don't ignore me." I'm pleased not to be igged, as you young kids say!
"You would honestly hire someone fresh out of pharmacy school with no hospital experience whatsoever over a PGY-1?" In a heartbeat!!! But that is from years and years of observation, which you, my young fish, seem to discount. I'm not pulling this out of thin air. For most, the PGY-1 program makes you a worse candidate...you have "paralysis by analysis"...I won't repeat what I have said previously on the subject, read past posts...I would, in fact, give more credit to the person who realized that he or she was very well-prepared by successfully completing his Pharm D degree and passing the board...that says YOU ARE READY...don't you get it??? What did all of that schooling produce, an imbecile? It also shows the person to be a realist, not a theorist. He is confident in his abilitiesw and doesn't need the fluff next to his name.

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[Sans Crainte]

This quote seriously makes me laugh. Someone who pretends to be so smart would say this after one single person. BenJammin may be a super awesome pharmacist, but he's one person. His mileage may vary. Unless he's worked at every hospital and with every resident, his word isn't gospel. His comment won't make me stop pursuing my passion. I doubt it'll make anyone who really wants a residency stop pursuing it (neither will you).

Fishy, no one wants to rain on your parade. But you drank the kool-aid and it was refreshing to hear from someone with a more balanced outlook.

 

[GoldfishPharmD]

What makes his outlook balanced? I think a balanced outlook is someone that can appreciate those that do and don't do a residency. Someone that can see a benefit to both. He came in bashing residency trained individuals. Anyways, balanced outlook or not, he's one person out of many pharmacists. His opinion is not fact and won't make people stop what they're doing.

Oh, thank you for your grandpa stories, and by the way, I'd never say "igged".

 

[GoldfishPharmD]

To be clear though, I have nothing but respect for both sides of the field. I've met a bunch of super smart nonresidency trained pharmacists. They know their stuff and are really great at it. They're very humble people too. I've also met awesome residency trained pharmacists as well. Like I said before, I wish there wasn't this divide or need to tear people down.

I had a rotation in the field I want to go into and my preceptor was amazing, and I looked up to him. He didn't do a residency and was trained on the job in this specialty that now requires 2 years of training for newbies. He was brilliant. If I could have jumped straight into work and been trained on the job, I would have done it, but like I said, those days are LONG gone. Of all the listings I have found, they want either 5 years of experience or a PGY-2. I graduated in May, so I don't have either. I have to keep going, but I'm glad that this way will help me come closer to my goal. Despite what you may think, I'm also loving this experience. I get to jump around and get a taste of everything. Most jobs won't allow that.

I'm not delaying because I'm scared. I delayed because I have a passion, so a lot of the assumptions you make about residents, I find really offensive. Yes, it is true for some, but not for all people that are training.

 

[BenJammin]

Where did this come from?

I'm not getting in an "I have a better relationships with my providers" pissing contest, but I would heartily disagree.

It has to do with personalities, not training.

Exactly. You're not going to gain a personality from a residency.

 

[njac]

Exactly. You're not going to gain a personality from a residency.

And we all know plenty of people without them who didn't do residency.

I don't think you can compare interpersonal skills between those with and without residencies.

 

[Sans Crainte]

What makes his outlook balanced? I think a balanced outlook is someone that can appreciate those that do and don't do a residency. Someone that can see a benefit to both. He came in bashing residency trained individuals. Anyways, balanced outlook or not, he's one person out of many pharmacists. His opinion is not fact and won't make people stop what they're doing.

Oh, thank you for your grandpa stories, and by the way, I'd never say "igged".

you made me laugh with "grandpa"...I don't dislike residencies...I just find it amazing that you kids are the brightest ever in the profession, with years of schooling that doesn't seem to count for anything...and the fact that the profession, if it was truthful with its place in the healthcare environment of today and tomorrow, doesn't scale back the program to three years...the money would be less but the jobs plentiful...the residency is just a sign of desperation to justify the schools going in the wrong direction for the times...they are preparing you guys for the days of retrospective payment...when every charge was covered...those days have been gone for 40 years....

 

[Sans Crainte]

Exactly. You're not going to gain a personality from a residency.

Bravo! Like I said, personality and $4.50 will get you a latte at Starbucks...

 

[Sans Crainte]

And we all know plenty of people without them who didn't do residency.

I don't think you can compare interpersonal skills between those with and without residencies.

Pl

And we all know plenty of people without them who didn't do residency.

I don't think you can compare interpersonal skills between those with and without residencies.

Please! Just get a job and get some reps in the real world and develop your interpersonal skills...not in the alternate universe pandering to your physician masters on rounds..."I make a difference!" PUKE!

 

[Sans Crainte]

To be clear though, I have nothing but respect for both sides of the field. I've met a bunch of super smart nonresidency trained pharmacists. They know their stuff and are really great at it. They're very humble people too. I've also met awesome residency trained pharmacists as well. Like I said before, I wish there wasn't this divide or need to tear people down.

I had a rotation in the field I want to go into and my preceptor was amazing, and I looked up to him. He didn't do a residency and was trained on the job in this specialty that now requires 2 years of training for newbies. He was brilliant. If I could have jumped straight into work and been trained on the job, I would have done it, but like I said, those days are LONG gone. Of all the listings I have found, they want either 5 years of experience or a PGY-2. I graduated in May, so I don't have either. I have to keep going, but I'm glad that this way will help me come closer to my goal. Despite what you may think, I'm also loving this experience. I get to jump around and get a taste of everything. Most jobs won't allow that.

I'm not delaying because I'm scared. I delayed because I have a passion, so a lot of the assumptions you make about residents, I find really offensive. Yes, it is true for some, but not for all people that are training.

Just get a job before they are gone!!!!

 

[confettiflyer]

If someone has a crappy personality and/or suffers from "analysis by paralysis," they'll carry those traits with them into full employment whether they have a residency or not.

When PGY1 grads are outnumbered by non-PGY1 trained pharmacists by 3.5:1 (13,000 new grads, ~2900 residents in 2013), friction like this is bound to happen.

 

[Sans Crainte]

If someone has a crappy personality and/or suffers from "analysis by paralysis," they'll carry those traits with them into full employment whether they have a residency or not.

When PGY1 grads are outnumbered by non-PGY1 trained pharmacists by 3.5:1 (13,000 new grads, ~2900 residents in 2013), friction like this is bound to happen.

That last line says it all. But in my observation, residencies reinforce all of the traits that inhibit job performance...have any of you looked up what "Sans Crainte" means? It means "without fear" and that is the philosophy I try to instill in anyone new in the profession...unless you can put your fears aside, all the fellowships and residencies in the world can't help and you will not enjoy your job...every order and every phone call will send a jolt through you...the only way to become "sans crainte" is to learn that it isn't about you...it is about your customer...the patient, the nurse and the doctor...you are a person with a set of skills that transforms you into a problem-solver....and at the end of the day, your "customers" want two things from you; solutions to problems and good feelings...that's it

 

[Sans Crainte]

If someone has a crappy personality and/or suffers from "analysis by paralysis," they'll carry those traits with them into full employment whether they have a residency or not.

When PGY1 grads are outnumbered by non-PGY1 trained pharmacists by 3.5:1 (13,000 new grads, ~2900 residents in 2013), friction like this is bound to happen.

The growth of residencies has peaked...those with residencies will find themselves reduced to staffing functions over the next five years...

 

[njac]

Pl

Please! Just get a job and get some reps in the real world and develop your interpersonal skills...not in the alternate universe pandering to your physician masters on rounds..."I make a difference!" PUKE!

What is your issue? You don't know me, or my practice.

 

[Sans Crainte]

What is your issue? You don't know me, or my practice.

I have no "issue". I have 37 years of varied experience in the profession and in life. From this lofty perch I have observed a profession that is neither fish nor fowl, trying to find a role. If current grads, who had to be the best of the best to even gain admission to a school of pharmacy, go on through a rigorous course of study to complete a Pharm D degree, pass the board, only to be told by some employer that you are not qualified WITHOUT a residency is absurd beyond belief. And that you guys can go along with this is a higher absurdity. Then, to top it off, the current environment is dominated by lower cost providers, such as PA's and Nurse Practitioners, while pharmacists are overpriced and easily replaceable by technology...like I said, I have no "issue"...all I have is a bit of wisdom to pass on to those who haven't drank the kool-aid...

 

[confettiflyer]

It's not a qualification issue, it's a question of value...go talk to Z in the pharmacy forums, I think he has a better pulse on current hiring practices of most DOP's in California.

If an institution is short-sighted such that it chooses a fresh grad vs. a 1 year experienced pharmacist, all other things being equal (even if one reduces residency to just one year of underpaid work experience), I probably wouldn't want to work there. Luckily for me, that's not my reality, so doors have opened to me that ordinarily aren't.

And for what it's worth, I wouldn't put too much stock into benjammin's posts, I won't say why, you'll just have to take my word for it.

 

[Sans Crainte]

It's not a qualification issue, it's a question of value...go talk to Z in the pharmacy forums, I think he has a better pulse on current hiring practices of most DOP's in California.

If an institution is short-sighted such that it chooses a fresh grad vs. a 1 year experienced pharmacist, all other things being equal (even if one reduces residency to just one year of underpaid work experience), I probably wouldn't want to work there. Luckily for me, that's not my reality, so doors have opened to me that ordinarily aren't.

And for what it's worth, I wouldn't put too much stock into benjammin's posts, I won't say why, you'll just have to take my word for it.

Well, look at what you are saying, at its essence; a person with one year experience is more likely to be the better hire. That may prove out, but it is not a certainty. Also, everything equal, the person who is actually on the job everyday for that year is far ahead of the person who spends that year in a residency, in everything I have observed. Thinking like that also eliminates many good candidates for no reason. One year's experience, although valuable, isn't a deal-breaker. For Pete's sake, I see techs, who had no exposure to anything pharmacy related, who perform their job terrifically after 90 days. After a year, they are lights-out. Some are better and more valuable than pharmacists, even with residencies. So making the "residency" experience the determining factor is any hire is just hubris and actually will weaken the pharmacy depatment.

 

[confettiflyer]

Well, look at what you are saying, at its essence; a person with one year experience is more likely to be the better hire. That may prove out, but it is not a certainty. Also, everything equal, the person who is actually on the job everyday for that year is far ahead of the person who spends that year in a residency, in everything I have observed. Thinking like that also eliminates many good candidates for no reason. One year's experience, although valuable, isn't a deal-breaker. For Pete's sake, I see techs, who had no exposure to anything pharmacy related, who perform their job terrifically after 90 days. After a year, they are lights-out. Some are better and more valuable than pharmacists, even with residencies. So making the "residency" experience the determining factor is any hire is just hubris and actually will weaken the pharmacy depatment.

Really the reality is that PGY1's compete against new grads, that's where the comparison is made, especially with the June timing and job hunt. PGY1 isn't often going to compete against a 1 year in-practice RPh for a few reasons (a 1 year employee at a hospital isn't going to jump to another institution that early-most of the time).

I never advocated for PGY1 being the determining factor, but it makes for an effective screening tool when you have dozens and dozens of applications hitting your doorstep for 1 FTE or even per-diem position. It's like GPA and pharmacy school...when you have thousands of applications and limited resources, it makes for a handy screening tool even though we all know GPA is a piss poor indicator for anything.

On that note, I received budget approval today and my department will be hiring 3 pharmacists..."residency preferred" will most likely be on the description, if anything to give us an out when child prodigy #1 sans residency walks through the door (I'm not holding my breath for him/her).

 

[Sans Crainte]

Really the reality is that PGY1's compete against new grads, that's where the comparison is made, especially with the June timing and job hunt. PGY1 isn't often going to compete against a 1 year in-practice RPh for a few reasons (a 1 year employee at a hospital isn't going to jump to another institution that early-most of the time).

I never advocated for PGY1 being the determining factor, but it makes for an effective screening tool when you have dozens and dozens of applications hitting your doorstep for 1 FTE or even per-diem position. It's like GPA and pharmacy school...when you have thousands of applications and limited resources, it makes for a handy screening tool even though we all know GPA is a piss poor indicator for anything.

On that note, I received budget approval today and my department will be hiring 3 pharmacists..."residency preferred" will most likely be on the description, if anything to give us an out when child prodigy #1 sans residency walks through the door (I'm not holding my breath for him/her).

You are an erudite individual and I respect your opinion. I agree with you that the PGY1 is a good screening tool for hires; it makes me wonder before I would hire a grad with one. It makes me question their courage in the face of real-time decision-making. It also makes me question their ability to reason logically. They are ready when they have degree in hand and pass the registry. Why is another, redundant hurdle necessary? Enough already! We are what we are; "learned intermediaries", not providers. We fill a role that no one wants to accept. The "residency" was added as a way to bolster the inane decision to call the base-degree in pharmacy a "Doctor" of pharmacy. Doctors have residencies, so it went to figure that a "Doctor" of pharmacy would need a residency program to embellish the farce. It is really quite embarrassing that our profession is so pitiful to try this. We are not DOCTORS, no matter how the schools and those with the base pharmacy degree in 2013 would like otherwise. The marketplace will soon correct it all.

 

[Sans Crainte]

FOR ANYONE NEW TO THIS THREAD, SEE RESPONSE #221...its distills it all down for you...the truth in a few sentences...there is no dancing around it with this and that...see #221

 

[GoldfishPharmD]

FOR ANYONE NEW TO THIS THREAD, SEE RESPONSE #221...its distills it all down for you...the truth in a few sentences...there is no dancing around it with this and that...see #221

You think too highly of your own OPINIONS....

 

[confettiflyer]

You are an erudite individual and I respect your opinion. I agree with you that the PGY1 is a good screening tool for hires; it makes me wonder before I would hire a grad with one. It makes me question their courage in the face of real-time decision-making. It also makes me question their ability to reason logically. They are ready when they have degree in hand and pass the registry. Why is another, redundant hurdle necessary? Enough already! We are what we are; "learned intermediaries", not providers. We fill a role that no one wants to accept. The "residency" was added as a way to bolster the inane decision to call the base-degree in pharmacy a "Doctor" of pharmacy. Doctors have residencies, so it went to figure that a "Doctor" of pharmacy would need a residency program to embellish the farce. It is really quite embarrassing that our profession is so pitiful to try this. We are not DOCTORS, no matter how the schools and those with the base pharmacy degree in 2013 would like otherwise. The marketplace will soon correct it all.

I respect your opinion as well...but opinions are opinions, my existence is rooted in the fact that I am in an overcrowded marketplace of newly minted pharmacists with not enough jobs to go around. I don't buy the academic BS of residencies either, but I'm a pragmatist, and when I can go from being 1 pharmacist in a pool of 13,000 to a pool of 3,000, it made economic sense given the labor market I'm in. There's enough buy-in from enough DOP's that opinions like yours don't impact the calculations we make (more on that in a minute).

Trust me, letting go of a slightly-over-six-figure job right out of Rx school was painful.

I applied to same logic and calculation when I finished undergrad and was deciding on what to do then. I could have been 1 of the millions of newly minted B.S/B.A students unprepared for anything except serving that $4.50 latte at Starbucks, or I could have invested time/$$ to become 1 in 13,000.

My gut tells me my PharmD colleagues think with the cold calculus of ROI and employment prospects when thinking about residency, NOT because we have pie in the sky, ivory tower based aspirations to be MD-lite. If you encounter subpar pharmacists after PGY1, that's a product of their institution's deficiency in training coupled with that person's aptitude. Again, it's no different from the same person working at a subpar institution as a staff member suddenly showing up at your doorstep, you'd think, "what an idiot" just the same.

Fact is, most of us would have foregone a PGY1 if a job showed up in the area we want (e.g. hospital)...this is supported by the #'s, there were unmatched residencies ten years ago when such jobs were plentiful.

Again, for most (not all) it's the calculus of fulfilling the bottom part of Maslow's hierarchy and not the top.

 

[confettiflyer]

Addendum to the calculus of us newbies on the ground:

Assuming I get my license in August as a new grad and face 3-4 months of unemployment until I find something (conventional wisdom: don't bother applying for jobs without a license, not with all these licensed yahoos running around), that means a) I wouldn't have income for June 2013-June 2014 FY until ~December 2013, b) my total intake for FY 2013-2014 would be just over ~$70,000 gross pay (assuming annual gross salary of $120k).

Consider then a resident who starts on July 1, 2013 with no license and earns ~$45,000 a year. The actual income gap is $25,000 (assuming the resident doesn't moonlight, many of us do) with the added benefit of not going through 5 months at zero income. Not everyone in Gen Y can just move back home.

Massaging the #'s? Maybe. But I do think it's a realistic situation and thus part of the cold calculus I'm harping on about.

 

[Sans Crainte]

I respect your opinion as well...but opinions are opinions, my existence is rooted in the fact that I am in an overcrowded marketplace of newly minted pharmacists with not enough jobs to go around. I don't buy the academic BS of residencies either, but I'm a pragmatist, and when I can go from being 1 pharmacist in a pool of 13,000 to a pool of 3,000, it made economic sense given the labor market I'm in. There's enough buy-in from enough DOP's that opinions like yours don't impact the calculations we make (more on that in a minute).

Trust me, letting go of a slightly-over-six-figure job right out of Rx school was painful.

I applied to same logic and calculation when I finished undergrad and was deciding on what to do then. I could have been 1 of the millions of newly minted B.S/B.A students unprepared for anything except serving that $4.50 latte at Starbucks, or I could have invested time/$$ to become 1 in 13,000.

My gut tells me my PharmD colleagues think with the cold calculus of ROI and employment prospects when thinking about residency, NOT because we have pie in the sky, ivory tower based aspirations to be MD-lite. If you encounter subpar pharmacists after PGY1, that's a product of their institution's deficiency in training coupled with that person's aptitude. Again, it's no different from the same person working at a subpar institution as a staff member suddenly showing up at your doorstep, you'd think, "what an idiot" just the same.

Fact is, most of us would have foregone a PGY1 if a job showed up in the area we want (e.g. hospital)...this is supported by the #'s, there were unmatched residencies ten years ago when such jobs were plentiful.

Again, for most (not all) it's the calculus of fulfilling the bottom part of Maslow's hierarchy and not the top.

What I wrote on #221 is tempered steel. I have nothing else better.

 

[Sans Crainte]

You think too highly of your own OPINIONS....

Fishy!! You seem to be attracted to grandpa's stories...you need to hang out with people your age...they're more fun...but as for #221....it is tempered-steel truth...

 

[Sans Crainte]

I respect your opinion as well...but opinions are opinions, my existence is rooted in the fact that I am in an overcrowded marketplace of newly minted pharmacists with not enough jobs to go around. I don't buy the academic BS of residencies either, but I'm a pragmatist, and when I can go from being 1 pharmacist in a pool of 13,000 to a pool of 3,000, it made economic sense given the labor market I'm in. There's enough buy-in from enough DOP's that opinions like yours don't impact the calculations we make (more on that in a minute).

Trust me, letting go of a slightly-over-six-figure job right out of Rx school was painful.

I applied to same logic and calculation when I finished undergrad and was deciding on what to do then. I could have been 1 of the millions of newly minted B.S/B.A students unprepared for anything except serving that $4.50 latte at Starbucks, or I could have invested time/$$ to become 1 in 13,000.

My gut tells me my PharmD colleagues think with the cold calculus of ROI and employment prospects when thinking about residency, NOT because we have pie in the sky, ivory tower based aspirations to be MD-lite. If you encounter subpar pharmacists after PGY1, that's a product of their institution's deficiency in training coupled with that person's aptitude. Again, it's no different from the same person working at a subpar institution as a staff member suddenly showing up at your doorstep, you'd think, "what an idiot" just the same.

Fact is, most of us would have foregone a PGY1 if a job showed up in the area we want (e.g. hospital)...this is supported by the #'s, there were unmatched residencies ten years ago when such jobs were plentiful.

Again, for most (not all) it's the calculus of fulfilling the bottom part of Maslow's hierarchy and not the top.

But the other thing about my opinion; you may disagree with it, but you can't disagree with the years and the experiences behind it.

 

[confettiflyer]

I'm boots on the ground, you're on the top floor of the skyscraper, I think we're viewing residency through different lenses. It's simply a means to an end that would otherwise be unattainable in most competitive markets.

Now go answer my zombie question.

 

[Sans Crainte]

I'm boots on the ground, you're on the top floor of the skyscraper, I think we're viewing residency through different lenses. It's simply a means to an end that would otherwise be unattainable in most competitive markets.

Now go answer my zombie question.

Zombie question? If by top floor you mean I have the experience of age and you are just beginning, I guess I occupy a higher floor in the building. But you know the funny thing, I can remember back to my days in pharmacy school, 1971 to 1976, and I remember having the same skepticism about our "promised role", from the academics, to the real role I had in experiential training. Was I hopeful the academics were right? Yes, but I wasn't stupid about it. I was especially skeptical of the entire academic process after my first six months on the job where I learned more than in my previous 5 years in school. Add that young awareness to 37 years of varied experience, in life and in pharmacy, and I have become a very good barometer of most things pharmacy. It is all very mathematical when you consider it: years in school + experiential training on rotations + Pharm D degree + Board registry = pharmacist Wasn't that the idea? Where in the world did the "residency" come into things? Read post #221 for the answer.

 

[Sans Crainte]

Do any of you feel any uneasiness over the state of pharmacy in 2013 and going forward? Do you feel any uneasiness about spending all these years in a rigorous program, earning a Pharm D degree, passing the state board and having an employer question your readiness? Worse, why, after all of the above, do some of you lack confidence in your abilities so much that you have convinced yourself that YOU need a residency before you feel comfortable working as a pharmacist? "Oh, the residency offers me so much more than all that went before!" That's pitiful. Something is very, very wrong.

 

[Sans Crainte]

"...The Omnibus Budget Reconciliation Act of 1990 (OBRA) placed pharmacists as learned intermediaries between doctors and patients. It required pharmacists to provide special directions and precautions, as well as information on storage and refills, and it asked them to keep patient profiles. Pharmacists could question doctors prescribing drugs and even refuse to fill the prescriptions..." That's who we are and what we do.

 

[nguyenulm]

This foo be trollin

 

[Sans Crainte]

This foo be trollin

Too old to be "trolllin"...try again...

 

[Aylar]

I'm a P2, and I read way too much of this thread during finals weeks. Sans makes a lot of good points about where the profession is heading, and the obstacles we have, but this line about residencies making you less prepared is ridiculous. I can understand the frustration because I think a lot of people see it as unnecessary, and if people could get the job they wanted (even just staffing) I think they would forgo a residency.

I think it's funny no one has mentioned that residents are basically free labor in programs that are being reimbursed. All of their clinical interventions, might be hard to justify but it's definitely easy when you're having someone do it for free Sans. If you just pay them for staffing at a regular rate that you need anyway if the residency program is reimbursed by CMS it literally costs next to nothing, and you can hire that pharmacist after they're finished and don't have to pay for any additional training if they start staffing. People want to live close to home or avoid retail, and I think confettiflyer is right that doing the residency is the easiest most sensible path to get there.

Clinical pharmacy is more or less a subset of academia. I was infuriated when I found out most of the clinical pharmacists in the area are paid either completely or 50% by the school. There are literally VOLUNTEER pharmacists begging for "clinical" work. That's ****ing false advertising on the school's part when they go off and say, "Look at all the things you can do!" There's definitely a place for them, and it's a shame that's the case but the schools are selling a bill of false goods. I spoke with someone at another school who said ALL of their ambulatory care preceptors are paid solely by the school.

I'm surprised that what you said below hasn't happened yet.

Here's a suggestion that might seem radical, but in light of modest projections of 20% of you not having jobs after graduation for the foreseeable future,is not radical at all. The colleges want you guys to extend your "training" period with residencies and fellowships because they don't want you to find out that there are no jobs. Especially the "clinical" dream jobs or jobs in academia. You guys need to organize on every campus (easy with Twitter, Facebook and social media) and form "Occupy Schools of Pharmacy" and have your own version of an "Arab Spring".

Mostly because I said the exact same thing to a group of my classmates more or less, and they looked at me like I'm crazy. It's probably because 1) Younger pharmacy students genuinely don't believe it 2) They're drinking the kool-aid the faculty are serving about their volunteer jobs that pharmacy is changing or 3) they just say "whelp I'll be better than 20% of my classmates, and besides I'm better off than a business major."

 

[Sans Crainte]

I'm a P2, and I read way too much of this thread during finals weeks. Sans makes a lot of good points about where the profession is heading, and the obstacles we have, but this line about residencies making you less prepared is ridiculous. I can understand the frustration because I think a lot of people see it as unnecessary, and if people could get the job they wanted (even just staffing) I think they would forgo a residency.

I think it's funny no one has mentioned that residents are basically free labor in programs that are being reimbursed. All of their clinical interventions, might be hard to justify but it's definitely easy when you're having someone do it for free Sans. If you just pay them for staffing at a regular rate that you need anyway if the residency program is reimbursed by CMS it literally costs next to nothing, and you can hire that pharmacist after they're finished and don't have to pay for any additional training if they start staffing. People want to live close to home or avoid retail, and I think confettiflyer is right that doing the residency is the easiest most sensible path to get there.

Clinical pharmacy is more or less a subset of academia. I was infuriated when I found out most of the clinical pharmacists in the area are paid either completely or 50% by the school. There are literally VOLUNTEER pharmacists begging for "clinical" work. That's ******* false advertising on the school's part when they go off and say, "Look at all the things you can do!" There's definitely a place for them, and it's a shame that's the case but the schools are selling a bill of false goods. I spoke with someone at another school who said ALL of their ambulatory care preceptors are paid solely by the school.

I'm surprised that what you said below hasn't happened yet.



Mostly because I said the exact same thing to a group of my classmates more or less, and they looked at me like I'm crazy. It's probably because 1) Younger pharmacy students genuinely don't believe it 2) They're drinking the kool-aid the faculty are serving about their volunteer jobs that pharmacy is changing or 3) they just say "whelp I'll be better than 20% of my classmates, and besides I'm better off than a business major."

Wow! Aylar, if I was able, I would hire you on the spot! You get my highest rating as a pharmacist and as a person...you will be an asset to any organization. You have insight into the real issues here. The schools owe you kids for selling a false dream...it has been false since I graduated in 1976 and it has gotten worse. I still say a residency does not give the grad better experience than just being in the job, AT FULL SALARY. It is a collusion between the schools and the employers, nothing more. Aylar, you give me hope for the profession...get out there and lead the sheep!

 

[aznoles]

Actually, my advice is solid and that is why it upsets you so. I started the thread to spur discussion. I have not seen anyone on here validly refute my claims. Some have made constructive comments and I have recognized them. Others have had a very defensive response. Like yourself. If the "truth" makes your react in such a way as to call me an "embarrassment to the profession", it is you who have issues. If the accomplishments of my career are an embarrassment, then the rest of you should hope to attain that level of "embarrassment".

I am a teacher at a pharmacy school. In reading these posts I agree with several points. I do think we teach a lot of material to the 5-10%. I once had a student who informed me that all he was interested in was what was on the Walmart $4 list of medications, the rest was just noise to him. I now think I understand where he was coming from. I think we teach a lot of content and then test students with black and white situations. I do believe that students are apprehensive about gray situations and most situations will actually have gray circumstances that need to be addressed in the care of that patient. I also think that technology, cost containment, and automation are real concerns to the practice of pharmacy. I agree and encourage any student to get some cross training in other areas, i.e. an MPH, MBA, etc, Two questions I have are as a pharmacy educator what is it that we should be teaching if we are overeducating our students? and what should be contained in current curriculums to best train student pharmacists for the current and future job market?

 

[Sans Crainte]

I am a teacher at a pharmacy school. In reading these posts I agree with several points. I do think we teach a lot of material to the 5-10%. I once had a student who informed me that all he was interested in was what was on the Walmart $4 list of medications, the rest was just noise to him. I now think I understand where he was coming from. I think we teach a lot of content and then test students with black and white situations. I do believe that students are apprehensive about gray situations and most situations will actually have gray circumstances that need to be addressed in the care of that patient. I also think that technology, cost containment, and automation are real concerns to the practice of pharmacy. I agree and encourage any student to get some cross training in other areas, i.e. an MPH, MBA, etc, Two questions I have are as a pharmacy educator what is it that we should be teaching if we are overeducating our students? and what should be contained in current curriculums to best train student pharmacists for the current and future job market?

Your heart is in the right place by wanting to do right by your students. There is not a thing wrong with what you are teaching the students; they all possess an unrivaled level of knowledge of all things pharmacy. Too much, in fact, for many because they are too analytically inclined, to the point of paralysis. Also, many are so fearful of attaching their name to an order that they no longer want to work the bench, which is a shame because most of the good that a pharmacist can do is from a spot inside the department and not up rounding. With all of the knowledge they possess, they should be confident, but many are not. The residency offers the fearful an out, more than it offers anything of value.
As for what the schools should be teaching; an entire year on problem-solving and customer relations. The most important skill is the ability to be faced with a problem, for which you don't know the answer right off, and figure a way to solve it in a reasonable period of time. The patient often can't wait for an exhaustive study of this and that. Basic problem-solving skills are essential and often overlooked. A pharmacy professor from the University of Memphis, Quentin Srnka, had a marketing class in which he said, your customers want two things from you; solutions to problems and good feelings. I have made a very good career from those words. Who is your customer? The patient, of course, but also the nurse, also the doctor, your pharmacy staff-mates who depend on you and probably many others that you never realize. So knowing how to deal with people, help them with their problems and leave them with a good feeling is essential, but lacking in most grads. Grads need to be timely in their decisions; they don't have the luxury to perform exhaustive searches.
As far as the future, the schools went in the wrong direction. The basic pharmacy curriculum should be shortened to at most 3 years, and maybe 2 years. Of course salaries will come down, but they are gong to tumble over the next 10 years on their own. The grads today, who are in debt up to their eye-teeth, need the schools to collaborate with one another and help pay down the student loans these kids have incurred. The schools need 90% of future grads to have the basics and to be able to provide cost-effective services. Maybe 10 % of the grads could continue on the current path, but I may be too optimistic in that regard. Pharmacy went in the wrong direction.

 

[Aylar]

Thanks Sans. The schools aren't the only ones to blame though. I think everyone in the profession is at fault for not taking an active role in being better advocates for the profession. Why has the AMA been able to block the creation of medical schools for so long? Pharmacists have done a terrible job at organizing politically. If they hadn't maybe these diploma mills would have never been accredited or ASHP could have black balled pharmacists who agreed to be preceptors/faculty for them. Maybe less people would have not taken the jobs solely out of principal if it wouldn't have been for them being educated to chase dream jobs that don't exist outside of colleges funding them.

They constantly tell us now that we need to be better political advocates in school. They even made it a graduation requirement that we go to the capitol during legislative day for our state. You know who doesn't go though? The faculty who work at the college. Thanks for leading by example guys. Why is it that pharmacists now are just content to ride the wave until it crashes? Why doesn't anyone want to do anything besides bitch, moan and tell the students "**** you I got mine, you're going to be **** out of luck." I mean, I guess you're trying to give advice Sans, but effectively all I'm hearing from you is "yeah, the school ****ed up, it's going to be rough. Find a back up plan youngsters."

I think some of the best advice you could give to students is to be more realistic about chasing the unicorn jobs. Explain that the 5 ambulatory care faculty members are paid by the school to do volunteer work. The growth of volunteer pharmacy is very closely tied to the growth of schools.

 

[Sans Crainte]

Thanks Sans. The schools aren't the only ones to blame though. I think everyone in the profession is at fault for not taking an active role in being better advocates for the profession. Why has the AMA been able to block the creation of medical schools for so long? Pharmacists have done a terrible job at organizing politically. If they hadn't maybe these diploma mills would have never been accredited or ASHP could have black balled pharmacists who agreed to be preceptors/faculty for them. Maybe less people would have not taken the jobs solely out of principal if it wouldn't have been for them being educated to chase dream jobs that don't exist outside of colleges funding them.

They constantly tell us now that we need to be better political advocates in school. They even made it a graduation requirement that we go to the capitol during legislative day for our state. You know who doesn't go though? The faculty who work at the college. Thanks for leading by example guys. Why is it that pharmacists now are just content to ride the wave until it crashes? Why doesn't anyone want to do anything besides bitch, moan and tell the students "**** you I got mine, you're going to be **** out of luck." I mean, I guess you're trying to give advice Sans, but effectively all I'm hearing from you is "yeah, the school ****** up, it's going to be rough. Find a back up plan youngsters."

I think some of the best advice you could give to students is to be more realistic about chasing the unicorn jobs. Explain that the 5 ambulatory care faculty members are paid by the school to do volunteer work. The growth of volunteer pharmacy is very closely tied to the growth of schools.

Well, the problem is money talks and BS walks...the AMA has money and therefore influence...the pharmacy organizations, do not...but you students are not powerless...with social media you have the most powerful organizing tools in history...get on Twitter and Facebook and ORGANIZE!!! The pharmacy schools need to recognize that you guys are in debt, a debt that many will have difficulty ever climbing out of and there is 20% unemployment starring new grads in the face and lower lifetime wages...you guys deserve refunds from the schools to lower your debt...
I gave quite a bit of advice beyond blaming the schools; but they are the number one culprit. But, to be quite honest, you guys should have made a better choice from the beginning. I talk every smart kid who says they want to go into pharmacy, out of the idea. It is a profession of the past, not the future. So listen to my advice and don't double-down by doing a residency...use you time and resources to find a field that complements what you have learned already.

 

[Its Z]

Your assumption on hiring is the first statement that you have made that shows your immaturity. Attaching PGY-1 does not in any way shape or form mean that person is the better hire. Paradoxically, I would argue that the person who forgoes the PGY-1 is the more discerning, insightful and logical person; and therefore the better hire, long-term. Your assumption is a major error in judgement. I hope that you consider what I have said.

Mmmmm... No.

 

[Sans Crainte]

Mmmmm... No.

Mmmmm...Yes.

 

[Aylar]

Well, the problem is money talks and BS walks...the AMA has money and therefore influence...the pharmacy organizations, do not...but you students are not powerless.

This is inane. You're not responding to me. Why is no blame put on people who've been in the profession? The AMA doesn't get funding outside of physicians. I know students can do things, but why do we have to be the leaders.

I gave quite a bit of advice beyond blaming the schools; but they are the number one culprit. But, to be quite honest, you guys should have made a better choice from the beginning. I talk every smart kid who says they want to go into pharmacy, out of the idea. It is a profession of the past, not the future. So listen to my advice and don't double-down by doing a residency...use you time and resources to find a field that complements what you have learned already.

I don't want your advice Sans. I want you to be part of the this wild social media movement you're talking about. Start posting on USN&WR's #3 job in the country, being a pharmacist, " this is a bad idea if you're not one already." I want you to get your colleagues to be part of it too. It can't possibly be just the students talking about the job market crumbling. So again if you get to the end of this post, WHERE ARE THE PHARMACISTS TAKING ACTION AND NOT JUST RIDING THE GOD DAMN WAVE UNTIL IT CRASHES?

Why should you boomers expect the "selfish millenials" to pick up the mess you left us with? Why haven't you organized or accomplished any of your goals in expanding the roles of pharmacists beyond being "learned intermediaries." You said you were overeducated in '76, but apparently not because you and your entire generation haven't accomplished anything but a lot of talk about how pharmacy is evolving. The schools went in the wrong direction? That's because YOUR generation let it happen.

But, to be quite honest, you guys should have made a better choice from the beginning. I talk every smart kid who says they want to go into pharmacy, out of the idea. It is a profession of the past, not the future. So listen to my advice and don't double-down by doing a residency...use you time and resources to find a field that complements what you have learned already.

Hindsight is 20/20. And I'm sure just from exchanging with you that these kids were only "smart" if they followed your advice. Like I said the 17 pharmacists who were replaced by new grads nearby didn't want to have to find new jobs, or be forced into retirement. That 20% unemployment statistic affects EVERYONE, why is it currently employed pharmacists are only willing to shovel out "advice" and gloom 'n' doom despite it going to affect them too?

EDIT: too many profanities, I'm really not that angry

 

[BenJammin]

Mmmmm... No.

Uhhhh yeah. Lots of hospitals in rural America won't even look at you if you have a PGY-1 next to your name.

 

[GoldfishPharmD]

Aylar brings up a great point. All you've done, Sans Crainte, is complain, but you haven't stated what you've done as a pharmacists with all these years of experience to help the profession. Also, I like how you disagree with someone that actually does hire pharmacists.

 

[Aylar]

Aylar brings up a great point. All you've done, Sans Crainte, is complain, but you haven't stated what you've done as a pharmacists with all these years of experience to help the profession. Also, I like how you disagree with someone that actually does hire pharmacists.

I think Sans is in a real minority that exists who don't want residency trained staff pharmacists. Directors who didn't do a residency may not see the value in it. My favorite example of this is the BCPS. "Residencies are "SO" intense that it counts for 3 years of practice." You're never going to convince anyone who hasn't done one to believe that. Personally, I think it's something done to prevent new grads from taking it right away. It's just a test that can be studied for and there's some parts of it that even your residency program might not prepare you for. Making people wait 3 years gives them time to forget the stuff they learned in school and become afraid of studying. A good move would to be to make them count for something by making them required for certain positions. Or expand them by doing things like push to be able to take the sit for the same licensing exam as a NP or a PA.

Also, I never said Sans was simply complaining. I said I want him and all the old timers he knows to be a part of this social media movement, and work to maintain and develop the profession instead of watching it burn. His first post makes it sound like he's done more than most by creating a pediatric niche pharmacy, publishing articles for AJHP, he's probably affiliated with several professional organizations. I'm not talking about him, he's out on the net saying start a social media movement. That's a hell of a lot more than most of the other pharmacists his age I know. APhA and ASHP only have 90,000 members COMBINED and there's close to 300,o00 pharmacists and ~50,000 students who are also included in these memberships. That's pathetic.

I'm saying this must be a unified effort. Discussions about where we went wrong aren't that useful, pointing the finger back at boomers, or schools does more to disrupt than to unite. Nearly everyone in the field is aware of the problem, but they think they're doing something when they tell me and other students, "Man it's gonna suck for you. You're screwed. Make yourself more valuable." Why don't they do something and act as if this is going to affect them too instead of just clocking in and out everyday? What can we get them on board so they're not replaced by new grads who are willing to take 10-30% less because they have a mountain of student loans?

 

[Sans Crainte]

Aylar brings up a great point. All you've done, Sans Crainte, is complain, but you haven't stated what you've done as a pharmacists with all these years of experience to help the profession. Also, I like how you disagree with someone that actually does hire pharmacists.

If you can read, look back at some of the posts and you'll see what I've done....I certainly owe none of you millennials a thing...I was the rarest pharmacist of all, I was a pharmacist and at the same time for 20 years I was involved in the labor movement as president of a union inside a hospital system...I have filed grievances (something you have no idea about), I have been to arbitrations (another thing you have no idea about)....I led an 8 day strike that closed down an entire hospital system in 1986...so just shut up about me having "no ideas and complaining"...my rear-end was on the line when I had a family and small children and an entire hospital system trying their hardest to fire me...at one point there were threats on my LIFE....plus, I owned a cutting-edge niche pharmacy practice that was famous across the country and even overseas...my own money used to try to expand the role of pharmacists into cognitive reimbursement (another thing you children know nothing about)...I write these comments because I have experienced pharmacy in every way possible and I am giving you good advice...don't accuse me of being part of the problem...get off your butts and help yourself...the problem with you millenials is we BOOMERS made things too easy for you....go out and dig a ditch for minimum wage for a while and maybe you'll wise-up....the residency is symptom of how you can't work, so you delay it...read what I have posted and get wise or move on...

 

[Sans Crainte]

I think Sans is in a real minority that exists who don't want residency trained staff pharmacists. Directors who didn't do a residency may not see the value in it. My favorite example of this is the BCPS. "Residencies are "SO" intense that it counts for 3 years of practice." You're never going to convince anyone who hasn't done one to believe that. Personally, I think it's something done to prevent new grads from taking it right away. It's just a test that can be studied for and there's some parts of it that even your residency program might not prepare you for. Making people wait 3 years gives them time to forget the stuff they learned in school and become afraid of studying. A good move would to be to make them count for something by making them required for certain positions. Or expand them by doing things like push to be able to take the sit for the same licensing exam as a NP or a PA.

Also, I never said Sans was simply complaining. I said I want him and all the old timers he knows to be a part of this social media movement, and work to maintain and develop the profession instead of watching it burn. His first post makes it sound like he's done more than most by creating a pediatric niche pharmacy, publishing articles for AJHP, he's probably affiliated with several professional organizations. I'm not talking about him, he's out on the net saying start a social media movement. That's a hell of a lot more than most of the other pharmacists his age I know. APhA and ASHP only have 90,000 members COMBINED and there's close to 300,o00 pharmacists and ~50,000 students who are also included in these memberships. That's pathetic.

I'm saying this must be a unified effort. Discussions about where we went wrong aren't that useful, pointing the finger back at boomers, or schools does more to disrupt than to unite. Nearly everyone in the field is aware of the problem, but they think they're doing something when they tell me and other students, "Man it's gonna suck for you. You're screwed. Make yourself more valuable." Why don't they do something and act as if this is going to affect them too instead of just clocking in and out everyday? What can we get them on board so they're not replaced by new grads who are willing to take 10-30% less because they have a mountain of student loans?

Here's the equation: Pharm D degree + experiential training + State Board Registry = Pharmacist I don't see "residency" in the equation. Get a job, you'll learn more than having a residency. Also, read post #247 and wake your a-- up. Don't blame boomers for your bad career choice....you should have been smarter....you can organize all you want, the digital revolution with the health care environment is going to eliminate the need for pharmacists (read previous posts)....no amount of money and lobbying can change that...it is like how blacksmiths were no longer needed after Henry Ford started mass producing cars...pharmacy is a redundant profession that is on the way out....so quit blaming anyone for your poor decision...organize against the schools who promised you something that doesn't exist..

 

[Sans Crainte]

Uhhhh yeah. Lots of hospitals in rural America won't even look at you if you have a PGY-1 next to your name.

Those hospitals will be finding out very soon that their budgets are going to be cut to the bone and 50% of their staff is going to be gone...quit wasting time on a residency...get a job at FULL SALARY anywhere you can before the crash comes...the problem is that all of you picture yourself up rounding with physicians and getting a pat on the head for looking up the answer on your Ipad...just get a real job

 

[Sans Crainte]

This is inane. You're not responding to me. Why is no blame put on people who've been in the profession? The AMA doesn't get funding outside of physicians. I know students can do things, but why do we have to be the leaders.



I don't want your advice Sans. I want you to be part of the this wild social media movement you're talking about. Start posting on USN&WR's #3 job in the country, being a pharmacist, " this is a bad idea if you're not one already." I want you to get your colleagues to be part of it too. It can't possibly be just the students talking about the job market crumbling. So again if you get to the end of this post, WHERE ARE THE PHARMACISTS TAKING ACTION AND NOT JUST RIDING THE GOD DAMN WAVE UNTIL IT CRASHES?

Why should you boomers expect the "selfish millenials" to pick up the mess you left us with? Why haven't you organized or accomplished any of your goals in expanding the roles of pharmacists beyond being "learned intermediaries." You said you were overeducated in '76, but apparently not because you and your entire generation haven't accomplished anything but a lot of talk about how pharmacy is evolving. The schools went in the wrong direction? That's because YOUR generation let it happen.



Hindsight is 20/20. And I'm sure just from exchanging with you that these kids were only "smart" if they followed your advice. Like I said the 17 pharmacists who were replaced by new grads nearby didn't want to have to find new jobs, or be forced into retirement. That 20% unemployment statistic affects EVERYONE, why is it currently employed pharmacists are only willing to shovel out "advice" and gloom 'n' doom despite it going to affect them too?

EDIT: too many profanities, I'm really not that angry

You need to wake up.

 

[GoldfishPharmD]

If you can read, look back at some of the posts and you'll see what I've done....I certainly owe none of you millennials a thing...I was the rarest pharmacist of all, I was a pharmacist and at the same time for 20 years I was involved in the labor movement as president of a union inside a hospital system...I have filed grievances (something you have no idea about), I have been to arbitrations (another thing you have no idea about)....I led an 8 day strike that closed down an entire hospital system in 1986...so just shut up about me having "no ideas and complaining"...my rear-end was on the line when I had a family and small children and an entire hospital system trying their hardest to fire me...at one point there were threats on my LIFE....plus, I owned a cutting-edge niche pharmacy practice that was famous across the country and even overseas...my own money used to try to expand the role of pharmacists into cognitive reimbursement (another thing you children know nothing about)...I write these comments because I have experienced pharmacy in every way possible and I am giving you good advice...don't accuse me of being part of the problem...get off your butts and help yourself...the problem with you millenials is we BOOMERS made things too easy for you....go out and dig a ditch for minimum wage for a while and maybe you'll wise-up....the residency is symptom of how you can't work, so you delay it...read what I have posted and get wise or move on...

Good for you. I am helping myself by doing what I want to do and not listening to some random person on the internet. Also, if you can read, I never said you haven't done anything. I simply asked what you've done. You're right, you don't owe me or anyone else any explanations but you're the one that started a whole thread to point fingers at people doing residencies and to tell them to do something else with their life or that they're just doing them because they're too scared to work right out of school. You're demeaning and insulting. Calling people "children". In my eyes, you are a part of the problem. You and people like you make it where there's this divide in the profession when it doesn't have to be that way. Instead of supporting and trying to help with advancing the profession, you knock those that don't think like you.

 

[Sans Crainte]

Good for you. I am helping myself by doing what I want to do and not listening to some random person on the internet. Also, if you can read, I never said you haven't done anything. I simply asked what you've done. You're right, you don't owe me or anyone else any explanations but you're the one that started a whole thread to point fingers at people doing residencies and to tell them to do something else with their life or that they're just doing them because they're too scared to work right out of school. You're demeaning and insulting. Calling people "children". In my eyes, you are a part of the problem. You and people like you make it where there's this divide in the profession when it doesn't have to be that way. Instead of supporting and trying to help with advancing the profession, you knock those that don't think like you.

"Good for you"...save your nonsense for one of your contemporaries...you are a child who has quite a lot to learn, but doesn't want to learn...and cannot make a logical argument...you need quite a lot of work...I'm afraid, though, that your trajectory is already set...I'm instructive, not demeaning...