I've been a member since 2007 and came to give back as a Rph.

[Marzapan]

Well, I don't call the Kaiser Managed Care programs, like the Modesto/Stockton and South Sac residencies real managed care because it's mostly amb care with a few things thrown in. Just look at their previous residents, it's either you become a DEC or you just end up doing plain amb care. So what was the point if you just got into amb care, might as well, just did a regular amb care residency. The VA has their own system, so none of what you learn in that residency is transferable to a regular health plan or PBM work, it's just not the same.

An accredited managed care residency is required to have an amb care component, along with drug reviews and a few other things thrown in, it's clinical and you have to be a good clinician to be good at it. Don't get me wrong, my clinical skills are pretty poor now but I had to work it during residency...haha.. but I get why you say the more clinical it is, the less managed care it is, cause Kaiser messes it up, calling their residencies managed care when it should really be called amb care management or drug use management residency.

Yeah there are a lot of "fake" managed care programs who brand themselves that way (I'm guessing to attract more interest from students). I recall picking up fliers for the Kaiser "managed care" residencies back in the day and the curriculum was 100% the same as any other Kaiser residency, going as far as having inpatient rotations as possible "elective" rotations. I asked the current residents what part of their residency is "managed care" and how it is different from any other Kaiser residency and it was clear from their response that they had no concept of the field.

Closest thing Kaiser has to "managed care" is probably their PGY-2 drug info residency, but doing drug reviews is just scratching the surface and a highly overrated skill in managed care. Though I'm not exactly surprised because the concept of "managed care" to most is working a P&T, PA or an MTM job (all of which are saturated).

I'm curious where you trained too. My personal guess is Centene or Optum.

---

Members don't see this ad.

 

[sunshao]

I did a managed care residency as well and have a job in the managed care world. I agree that if your managed care, your less clinical and more business. I have given up most of my clinical knowledge outside of knowing how to look up dosing/literature reviews for client questions/working with the claims system. I would never survive in a amb care rotation. Even our "clinical programs" are nothing that requires in depth knowledge that isn't provided in pharmacy school. The most important thing is can u save the healthcare system money and control costs of the pharmacy benefit. In our world, all that really matters is if u did an AMCP managed care residency and u know how our healthcare system works.

 

[moolman]

I did a managed care residency as well and have a job in the managed care world. I agree that if your managed care, your less clinical and more business. I have given up most of my clinical knowledge outside of knowing how to look up dosing/literature reviews for client questions/working with the claims system. I would never survive in a amb care rotation. Even our "clinical programs" are nothing that requires in depth knowledge that isn't provided in pharmacy school. The most important thing is can u save the healthcare system money and control costs of the pharmacy benefit. In our world, all that really matters is if u did an AMCP managed care residency and u know how our healthcare system works.

You're probably not in CA hence you say your clinical programs isn't very clinical. But I agree, you don't need the knowledge of an amb care rph and you won't get that experience. My whole team is at least board certified for CP so they keep up a bit, as much as they can. We don't do things to save money and control costs, it's just a bonus and I'm not a bleeding heart where I claim that I'm doing it for the people...haha....

 

[researchpharma]

It’s amazing how easy it is to make over $35/hr apparently. It’s a wonder more people don’t do it considering how easy it is.

This is only super obvious to me because I work in research, but CRCs, CRAs, CTMs, only need a bachelors degree and end up making good pay with experience. We are extremely busy with huge demand for COVID-19 vaccine research and there is a shortage of CRAs right now (possibly further exacerbated by it being a traveling often by plane kind of job.)

 

[mentos]

This is only super obvious to me because I work in research, but CRCs, CRAs, CTMs, only need a bachelors degree and end up making good pay with experience. We are extremely busy with huge demand for COVID-19 vaccine research and there is a shortage of CRAs right now (possibly further exacerbated by it being a traveling often by plane kind of job.)

Can you tell us what those abbreviations mean?

 

[researchpharma]

Can you tell us what those abbreviations mean?

Clinical Research Coordinator, Clincal Research Associate, Clinical Trial Manager

 

[Chrish]

Is there any hope left? I mean less and less people going and saturation finally somewhat reversing 10 years down the road?

 

[mentos]

Is there any hope left? I mean less and less people going and saturation finally somewhat reversing 10 years down the road?

Unless there's some radical change in the healthcare or capitalism system in this country, in ten years there will be less pharmacist jobs due to automation, mergers, pharmacies closing, decreased reimbursements, increased tech duties etc. Most working pharmacists right now still have 20+ years until retirement, they are not quitting voluntarily.

 

[Marzapan]

Is there any hope left? I mean less and less people going and saturation finally somewhat reversing 10 years down the road?

There is no hope. Saturation is not going to reverse in 10 years. Yes, there are fewer candidates applying to programs now, but schools are responding by accepting anyone and everyone so it doesnt matter if you have 50,000 applicants or 20,000 applicants when all you need is to fill 15,000 seats each year.

Then, when schools DO start closing down, their classes must be grandfathered/there must be a teach-out plan so you won't see the impact of school closures until 5 years from when they actually close. A transfer program for schools closing down (such as CHSU this year) is actually a terrible idea because students at these diploma mills should have no business being pharmacists in the first place and were likely rejected from other schools to begin with, so what does it say about the "standards" of the programs that will take "transfers?" Better to let a dead corpse rot.

Finally, even if every pharmacy school today closed down today, there are still tens of thousands of unemployed or underemployed pharmacists in the market for the 0 jobs that are available. Many of these pharmacists, because they can find jobs or get more hours, are doing things like board certifications or extra degrees to be "competitive" for the job market. So the 15,000 new grads each year are going to have to go through a credentialling arms race AFTER graduation in order to have a chance at getting a job.

Given above, I'll attempt to do some basic math. If we assume # of applicants each year are going to exceed the # of seats available (because this is a dynamic not static relationship and schools will lower standards in response to decreased applicants), then there will still be 15,000 new grads each year for the indefinite future. If we assume that pharmacy schools are going through a survival of the fittest competition, then let's assume that there will be a net negative of 2 schools, or 200 less students, per year, not realized until year 5. This gives the following numbers:

Year	# schools	total class size	# of actual graduates
2021	138	14,800	15,000
2022	136	14,600	15,000
2023	134	14,400	15,000
2024	132	14,200	15,000
2025	130	14,000	14,800
2026	128	13,800	14,600
2027	126	13,600	14,400
2028	124	13,400	14,200
2029	122	13,200	14,000
2030	120	13,000	13,800
2031	118	12,800	13,600
...	...	...	...
2075	30	4,000	4,800
2076	28	3,800	4,600
2077	26	3,600	4,400
2078	24	3,400	4,200
2079	22	3,200	4,000
2080	20	3,000	3,800

As you can see, even IF 2 schools close down each year starting today, there will still be 3,800 new grads being pumped out 60 years from now for the most definite negative job growth by then. This in the context of the over 540,000 new grads that would be churned out in that time horizon. I suppose the market could accommodate for this since the average job for a "full time" pharmacist will be a $20/hr, 8 hr/week MTM pharmacist.