Job offer advice

[KansasPharmGirl]

Dear SDN readers,

I'm about to graduate in May and I have a dilemma that has been weighing on me for about a month. I've been offered a position at a rural hospital in the Midwest. I think the job would be fine, it's just not where I want to live. I have another offer at an independent pharmacy in a beautiful mountain town in Colorado. It's my life's dream to live there. I'm just worried that if I take the independent pharmacy job, I will be missing my last chance to ever get hospital experience. And if I take the hospital job, I will be frustrated that I didn't leave here yet. Any advice is appreciated.

Sincerely,

A Kansas Pharm Girl who is dreaming of adventure

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[Lnsean]

suck it up for 1-2 years and take the hospital job.

 

[trailerpark]

You can find adventure anywhere you land.


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[Dalteparin]

Is there a hospital in or within commuting distance of the mountain town? If there is, you could try to get in PRN there in addition to your retail gig.

Honesty, the stuff I've regretted most in my life is the stuff that I did not do, know what I mean? If you don't take this job, a decade from now you might find yourself wondering what if. You don't want that.


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[ldiot]

Which pays more? What the the changes of this indie going out of business? I like retail better but even I would probably go with the hospital job honestly

 

[Rxed 1996]

Whichever pays of your loans quicker. If they're the same, choose what you want.

Don't regret it. You can't have the best of both worlds. If it's your dream, go to Colorado. You never know if you can ever get the same job again. Same if you give up the hospital job and never get the opportunity again.

 

[PharmDBro2017]

Pursue your life dream and go to CO.

You'll live with regret if you don't. Work to live... don't live to work.

 

[Claydoe]

Pursue your life dream and go to CO.

You'll live with regret if you don't. Work to live... don't live to work.

This x1000. You have a chance to make your dream a reality don't pass it up.

 

[gwarm01]

This x1000. You have a chance to make your dream a reality don't pass it up.

Alternative take: one year of hospital experience will make it so much easier to get a hospital job. If that is the field you want to work in, it may be worth the year in the Midwest to get experience then move to Colorado. Live light, get a small apartment and some inexpensive furniture. Then you can just sell or give away everything, move to Colorado and start fresh. The thought of packing up a house and moving it across the country (again) is making me want to slowly sell everything I have.

 

[Dalteparin]

Alternative take: one year of hospital experience will make it so much easier to get a hospital job. If that is the field you want to work in, it may be worth the year in the Midwest to get experience then move to Colorado. Live light, get a small apartment and some inexpensive furniture. Then you can just sell or give away everything, move to Colorado and start fresh. The thought of packing up a house and moving it across the country (again) is making me want to slowly sell everything I have.

If you decide to go with this option, get licensed in Colorado by exam - less money and less hassle than getting licensed by reciprocity.

 

[Ra1nMak3r]

I had the same dilemma and I chose adventure! Good luck on deciding! We're almost done

 

[ornithoptor]

This is a fun scenario. Why not making a decision tree with probabilities for the next five years. Let us review and balance the outcome with desires and logics.

Going to Colorado: Have you done research on the business itself? Why are they attempting to hire someone from out of the state? Have you done some financial analysis of the market as well? What is the likelihood of the independent Rx going to sell itself to CVS? It is a dream location, but ask yourself what marketable and transferable skills do you gain at the end of five year? What is plan B if something goes unexpected?

Staying in Midwest: Work with hospital position for a few years. Save some money, learn some skills, networking, and make a name for yourself. How difficult to find a job at Colorado mountain in 5 years? What do you miss out by staying in Midwest. Do you position yourself geographically, or professionally?

It is about "delayed gratification". A famous experiment on children with one candy now or two candies later. Of course, there could be other factors, money, spouse, family or skiing and rafting.

There is no wrong path. Of course if the world ends in two years, you know what to do.

Best Wishes.




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[KansasPharmGirl]

This is a fun scenario. Why not making a decision tree with probabilities for the next five years. Let us review and balance the outcome with desires and logics.

Going to Colorado: Have you done research on the business itself? Why are they attempting to hire someone from out of the state? Have you done some financial analysis of the market as well? What is the likelihood of the independent Rx going to sell itself to CVS? It is a dream location, but ask yourself what marketable and transferable skills do you gain at the end of five year? What is plan B if something goes unexpected?

Staying in Midwest: Work with hospital position for a few years. Save some money, learn some skills, networking, and make a name for yourself. How difficult to find a job at Colorado mountain in 5 years? What do you miss out by staying in Midwest. Do you position yourself geographically, or professionally?

It is about "delayed gratification". A famous experiment on children with one candy now or two candies later. Of course, there could be other factors, money, spouse, family or skiing and rafting.

There is no wrong path. Of course if the world ends in two years, you know what to do.

Best Wishes.




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I appreciate your thoughts. Oh trust me, I have thought this through a million times. Yes, I know it is more logical to take the hospital job. I just can't stop wondering about the independent.

To answer your questions, I know the manager from networking. When I reached out to her about the job, it was just the right time. The pharmacy has been there for over 60 years. It's an icon. I was going to try to get on PRN at a hospital near there. I suppose Plan B would likely be retail.

Yes the hospital is more logical. I'm not even sure if I'm ready to go from student to Pharmacy Manager at a hospital, though. That would be my title. It would open more doors for my future, though.

 

[KansasPharmGirl]

Wow it is crazy to me that they would even consider a new graduate for a manager job in a hospital.

We've had several rural hospitals reach out to my school for new grads to apply for pharmacy director positions.

The hospital that I have an offer at really wants me to work there. They seem to have no doubt that I can do it...

 

[spacecowgirl]

Take the hospital job. You will be 10000x more marketable vs a retail job. Which equals the flexibility to move later. The CoL is so crazy in most of CO. You could save money and gain a ton of experience if you wait it out. A few years now vs a career...

 

[KansasPharmGirl]

Are they the only pharmacist?

Yes, I'd be the only pharmacist.

 

[Chodronfan]

Yes, I'd be the only pharmacist.

Go Colorado!
Pick up a hospital job later and see if it is for you. I work a retail pharmacy job full time. I picked up a rural hospital job on my days off prn with very little effort. When I am at the 70 bed rural hospital where I fill as the only pharmacist in the facility it's stressful. One stat order after another, many not really urgent, trying to borrow drugs if we are out of stock, trying to reach drs, trying to answer nurse's questions, for a lot less money than retail. The Director of Pharmacy at the hospital is also the director by default-they are the only pharmacist and therefore DOP- has difficulty taking off, even in the event of emergency medical need unless I am off from my retail job or they can find another person to cover for them.It's a psych hospital tho.

 

[spacecowgirl]

Only pharmacist in a 70 bed? That's as bad as Mikey's WVa experience. That would change my answer. Even 1 pharmacist for a 25 bed is not nearly enough to do more than the very minimum of "make sure this doesn't kill anyone". That's terrible.

 

[Amicable Angora]

What are the salaries for both positions? Working schedule? Vacation/sick time? Other benefits?

 

[deleted820760]

People keep saying on these forums to take a hospital job in an undesirable area and use that experience to find a job in a desirable city in a few years, but that is not likely to happen anymore for the majority of pharmacists. You will likely be stuck in an undesirable area.

Colorado is saturated. Most hospitals in desirable areas are going to want residency plus experience. Pharmacists with years of experience are unable to find jobs in new cities when they are trying to relocate. Since there are so many applicants, hospitals will likely toss applications from out of state pharmacists and those without residency and years of experience. I've had directors tell me this happens. I have friends with 5 to 15 years of hospital experience who needed to relocate due to their spouse's job and they either had to scrape by with prn jobs, or they were unemployed for months. This is not even in desirable states and cities.

It's bad advice to tell someone to get experience in middle of nowhere and move to good location after a few years if they have the option of moving to their desired location right out of school. I would recommend taking the Colorado job. There is no guarantee that you would be able to find a hospital job in Colorado in your dream location after a few years of working at a hospital in a small town. Would you be ok with that?

The other poster was right in saying, work to live not live to work. Life is more than just a hospital pharmacy job. Besides, your other offer is at an independent pharmacy. That's great! I don't know anyone who is unhappy at an independent.

 

[deleted820760]

To all the people saying take the hospital job, would you seriously be happier working as the only pharmacist in a tiny hospital in the middle of nowhere? Independent in Colorado would be awesome, especially in mountain area. You could ski or hike or go whitewater rafting on your days off. Independents usually have shorter hours so you still have your evenings. They're also usually closed for holidays, and close early on weekends. I love hospital pharmacy, and I've worked as a pharmacist in both retail and hospital, and even I would take the independent job. Your quality of life would be so much better, and that's so much more important than being a hospital pharmacist.

If I were in your shoes and it was 10 years ago, and I knew for sure I could put in 2 years at small hospital in Midwest and then transfer to my desirable location in Colorado, I would consider it. Times are different now. I have years of hospital experience in cities and huge hospitals, and even I don't think I could land a hospital job in Colorado. Believe me, I researched it. Just look on indeed. There aren't even a lot of postings. The only ones I saw when I was looking a year ago were random prn positions. I looked into San Diego, too. I don't think I could land one there, either.

My point is, people need to stop pretending like moving to random deserted places for jobs is the answer to everything. It's not anymore unless you want to be stuck there. The fact that you have reservations about taking the hospital job should be a sign. Think about your options logically, but also consider what is more important to you--job satisfaction or life satisfaction. Lol. Go with your gut feeling. I actually think your job satisfaction is going to be better at the independent, in addition to your quality of life due to location. Since you will be the only pharmacist at the hospital, you will most likely be on-call even when you're off work. Landing hospital jobs in desirable areas is not going to be easy anymore even with a couple years of rural hospital experience. Not when you will be competing with at least 100 other candidates, many of which will have residency plus experience.

Btw, if you don't take that independent job, I would love to know what it is, for a friend. She's in mountain town in Colorado and was so happy with her target pharmacist job until cvs bought them out. Now she's looking because she hates cvs along with the rest of humanity. Lol.

 

[Chodronfan]

Only pharmacist in a 70 bed? That's as bad as Mikey's WVa experience. That would change my answer. Even 1 pharmacist for a 25 bed is not nearly enough to do more than the very minimum of "make sure this doesn't kill anyone". That's terrible.

It's a psych hospital. No ICU. I'd better qualify that! Psych hospital!

 

[Chodronfan]

Did I mention it's a psych hospital? 70 bed psych hospital. No ICU orders to fill. No chemo to compound. So no not as bad as Mikey's WV hospital.

 

[PumpkinSmasher]

I would go with the independent in CO, if you think that is where you want to spend the rest of your life. What are the chances of you buying out the owner one day, are you interested in that idea?

-You will likely be working for the next 30-40 years, ~40hrs/wk, so you need to pick something you would at least enjoy doing, maybe not perfect but definitely not miserable.
-The quality of life in CO sounds much better to me assuming it is well staffed and you have ability to take time off
-Only pharmacist at a rural hospital sounds terrible. I would think taking PTO would be very difficult. PTO and time away from work with my family and friends is the most important thing to me, I am lucky to also have a job that I love.

 

[rxdawg21]

To all the people saying take the hospital job, would you seriously be happier working as the only pharmacist in a tiny hospital in the middle of nowhere? Independent in Colorado would be awesome, especially in mountain area. You could ski or hike or go whitewater rafting on your days off. Independents usually have shorter hours so you still have your evenings. They're also usually closed for holidays, and close early on weekends. I love hospital pharmacy, and I've worked as a pharmacist in both retail and hospital, and even I would take the independent job. Your quality of life would be so much better, and that's so much more important than being a hospital pharmacist.

If I were in your shoes and it was 10 years ago, and I knew for sure I could put in 2 years at small hospital in Midwest and then transfer to my desirable location in Colorado, I would consider it. Times are different now. I have years of hospital experience in cities and huge hospitals, and even I don't think I could land a hospital job in Colorado. Believe me, I researched it. Just look on indeed. There aren't even a lot of postings. The only ones I saw when I was looking a year ago were random prn positions. I looked into San Diego, too. I don't think I could land one there, either.

My point is, people need to stop pretending like moving to random deserted places for jobs is the answer to everything. It's not anymore unless you want to be stuck there. The fact that you have reservations about taking the hospital job should be a sign. Think about your options logically, but also consider what is more important to you--job satisfaction or life satisfaction. Lol. Go with your gut feeling. I actually think your job satisfaction is going to be better at the independent, in addition to your quality of life due to location. Since you will be the only pharmacist at the hospital, you will most likely be on-call even when you're off work. Landing hospital jobs in desirable areas is not going to be easy anymore even with a couple years of rural hospital experience. Not when you will be competing with at least 100 other candidates, many of which will have residency plus experience.

Btw, if you don't take that independent job, I would love to know what it is, for a friend. She's in mountain town in Colorado and was so happy with her target pharmacist job until cvs bought them out. Now she's looking because she hates cvs along with the rest of humanity. Lol.

Great points. You may still be able to put in a few years hospital and move to a decent city. You will have to be one of the luckiest people/right place right time to move to a highly desirable area (anywhere near Denver) in 2-3 years with only 2-3 years hospital experience out of state.

Think about this logically, I have so many classmates and friends who did a PGY1 and PGY2 and are now working all over the country. If it happened in just my local area I'm sure this is the norm nationwide now. So you with your 2-3 years rural hospital experience are going up against likely PGY2's with 1-2 years experience. It is a no brainer who wins there unless you have some type of connections or did rotations there and were an all-star.

The sad part is doing a PGY1 or PGY2 doesn't make you a more competent/efficient pharmacist. I work with several non-residency trained people who are just as competent if not more and definitely more efficient then residency trained ones. But what your credentials look like on paper, how you interview, and your references (who if you aren't stupid are only going to say nice things because you picked them) aren't going to beat out the PGY2 pharmacist unless he bombs the interview or has awful references.

 

[MountainPharmD]

Dear SDN readers,

I'm about to graduate in May and I have a dilemma that has been weighing on me for about a month. I've been offered a position at a rural hospital in the Midwest. I think the job would be fine, it's just not where I want to live. I have another offer at an independent pharmacy in a beautiful mountain town in Colorado. It's my life's dream to live there. I've thought about it a LOT all throughout pharmacy school (I know that sounds obsessive, but it helped motivate me). I'm just worried that if I take the independent pharmacy job, I will be missing my last chance to ever get hospital experience. And if I take the hospital job, I will be frustrated that I didn't leave here yet. Any advice is appreciated.

Sincerely,

A Kansas Pharm Girl who is dreaming of adventure

I graduated from KU and went straight to Colorado. I never did get my license in Kansas. Colorado is the best place I have ever lived. I wish I were still there! Working in a small Colorado mountain town for an independant sounds pretty close to heaven on earth to me.

 

[KansasPharmGirl]

I graduated from KU and went straight to Colorado. I never did get my license in Kansas. Colorado is the best place I have ever lived. I wish I were still there! Working in a small Colorado mountain town for an independant sounds pretty close to heaven on earth to me.

Hey fellow Jayhawk

Thank you for sharing. Do you mind me asking where you were in CO?

 

[MountainPharmD]

Hey fellow Jayhawk

Thank you for sharing. Do you mind me asking where you were in CO?

We lived in Woodland Park, a little town 20 miles west of Colorado Springs. I'd go back in a second!

 

[PAtoPharm]

Just curious, what is the typical salary for a DOP at a small rural hospital like the OP is considering?

 

[TheWisePharmacist]

What is your ultimate goal in life?
What would you not mind doing everyday for the rest of your life?

When it comes to making life changing decisions or planning out your destination in life, I always find it easier to start from the end and work your way back.

When ever I make a decision I always ask the question: Will this get me to my goal faster? or Will this give me the skills needed to reach my goal?

Try finding out what your ultimate goal in life is, and from their the most efficient way of reaching it.

 

[PAtoPharm]

Not much higher than a standard pharmacist.

Really? Not even $200k? Someone told me that a local DOP makes $250k (not even a very big hospital), but on Glassdoor, other hospital DOPs have reported lower incomes like $110k.

 

[Pharmibippy]

Dude you're the only pharmacist. You probably supervise one tech and yourself....

Large hospitals yes - ours makes like 200K

This dude about to write an essay on how pharmacy is **** cuz a DOP isn't making 200k to manage one tech

 

[PAtoPharm]

Dude you're the only pharmacist. You probably supervise one tech and yourself....

Large hospitals yes - ours makes like 200K

Would a first job out of pharmacy school as DOP look as good on someone's resume as it seems like it would? Would it hypothetically make someone marketable enough to get basically any other pharmacist job after a year or two (e.g., DOP in a nice area)? Or is working as a DOP not that much of a resume booster? Just wondering

 

[spacecowgirl]

Great points. You may still be able to put in a few years hospital and move to a decent city. You will have to be one of the luckiest people/right place right time to move to a highly desirable area (anywhere near Denver) in 2-3 years with only 2-3 years hospital experience out of state.

Think about this logically, I have so many classmates and friends who did a PGY1 and PGY2 and are now working all over the country. If it happened in just my local area I'm sure this is the norm nationwide now. So you with your 2-3 years rural hospital experience are going up against likely PGY2's with 1-2 years experience. It is a no brainer who wins there unless you have some type of connections or did rotations there and were an all-star.

There is a big difference (in terms of marketability) between 2-3 years of staff hospital experience vs 2-3 years of DOP experience. Drafting policies and procedures, 340b, USP 797/800, learning BOP regs, putting any "clinical" programs into place - all of that looks much different on a resume than a staff pharmacist. Even at a rural hospital. But I do think it sets you up in an operations track vs a clinical track because yes, you'd be competing against residency-trained pharmacists for clinical positions. We can - and have - argued six ways from Sunday about whether that is fair or not.

OP - what is your long game? I guess that is the question.

 

[slothsrule89]

I would go small CO mountain town. I don't know what state you are talking about in the midwest and it's hard to asses quality of life. You seem to want to move to CO, go for it. See if you can get PRN at the IHS, I think they have spots in CO. I went and talked with an IHS pharmacist, they have a lot of freedom. For example, the one I talked with had a 4 bed hospital that he took care of but still got good experience with IV's and stuff. I'm a pre-pharmer and most likely will be living the rural life.

Here is the other thing, you can always apply for residency in 2 years and get experience that way for hospital. It seems like people are also taking that path. But finding a job is hard in CO, I would take it.

 

[PAtoPharm]

Think about this logically, I have so many classmates and friends who did a PGY1 and PGY2 and are now working all over the country. If it happened in just my local area I'm sure this is the norm nationwide now. So you with your 2-3 years rural hospital experience are going up against likely PGY2's with 1-2 years experience. It is a no brainer who wins there unless you have some type of connections or did rotations there and were an all-star.

This is all starting to sound like one big catch-22. People have been saying for a while that in order to get the experience needed to become competitive for good jobs in more desirable areas, new graduate pharmacists will have to move out of whatever state they're in to BFE territory and then plan on returning after getting a few years of experience. Okay... but now, people are starting to say that that experience isn't going to be enough to enable them to compete against many of the other candidates who are also going to want those jobs in desirable areas. So from here on out, should people expect to simply relocate to BFE to get a job with plans to stay there indefinitely?

 

[Pharmibippy]

This is all starting to sound like one big catch-22. People have been saying for a while that in order to get the experience needed to become competitive for good jobs in more desirable areas, new graduate pharmacists will have to move out of whatever state they're in to BFE territory and then plan on returning after getting a few years of experience. Okay... but now, people are starting to say that that experience isn't going to be enough to enable them to compete against many of the other candidates who are also going to want those jobs in desirable areas. So from here on out, should people expect to simply relocate to BFE to get a job with plans to stay there indefinitely?

Or the alternative is to complete a residency. The number of residency programs grow each year and still there are over a 1,500 applicants that don't match each year. If you want to work in a desirable area in a competitive setting, complete a residency since the number of residency trained pharmacists grow each year.

Would I have preferred to go straight into practice and not take a pay cut? Absolutely. But you have to look at the big picture and make sacrifices that previous generations didn't have to with the way things are looking.

 

[KansasPharmGirl]

There is a big difference (in terms of marketability) between 2-3 years of staff hospital experience vs 2-3 years of DOP experience. Drafting policies and procedures, 340b, USP 797/800, learning BOP regs, putting any "clinical" programs into place - all of that looks much different on a resume than a staff pharmacist. Even at a rural hospital. But I do think it sets you up in an operations track vs a clinical track because yes, you'd be competing against residency-trained pharmacists for clinical positions. We can - and have - argued six ways from Sunday about whether that is fair or not.

OP - what is your long game? I guess that is the question.

I want to advance myself professionally. Maybe work toward my BCPS. I would like to have more career options than retail forever. I don't really want to take on the "regulatory" duties of a director either. And I won't consider going back to do a residency. I have no desire to be in a larger hospital. I hated my rotations in big hospitals with clinical pharmacists. Ideally I think I'd enjoy working in a small hospital in Colorado.

 

[lord999]

I don't have any good advice than what has been said, but to say that nothing lasts forever. Irrespective of which path you take and each have their considerations, time tends to change how those choices were valued only in hindsight. Whether you choose what you want most or what you will regret least is something of a personality preference. But, it will work out if you work at it even if the place sucks. And either choice may fluctuate as time's arrow passes. This is not marriage. Just try to flush out any clear warning signs or gut feelings as if th facts are indistinguishable, then what you call intuition usually is a way of making facts that subconsciously observe make sense.

 

[slothsrule89]

4 bed hospital?

Yep! I thought it was super interesting. His duties are split on the reservation.

 

[spacecowgirl]

I want to advance myself professionally. I'd like to earn my BCPS. I want more career options than retail forever. I don't really want to take on the "regulatory" duties of a director either, but maybe it's the best thing for my future. And I'm not going back to do a residency. I've had rotations at huge hospitals with clinical pharmacists and I hated it. Ideally I think I'd enjoy working in a small hospital in Colorado. Retail is ok, but I don't want to do it full time forever, (maybe part time or PRN)

This tells me the DOP job would open more doors for you. But agree with lord's post about intuition and gut feeling.

2 asides:
1) there are smaller hospital residencies; not all of them are at huge teaching hospitals (which I too hated). I can think of several in my state including mine.
2) I live in BFE and I like it here. I plan to stay here for a long time. Cities are nice places to visit but I wouldn't want to live there (I have). I am reminded of that every time I leave Mayberry for Charlotte and get annoyed with traffic. But I am married and have kids which puts me in a very different place socially than a single person without kids yet.

 

[Dalteparin]

[bump]

Well, OP, what did you decide?

 

[Saiyo]

I don't know that I would take a DOP position and be the only pharmacist straight out of school....actually after working I dont think I would never want a DOP position....

 

[Chodronfan]

Just curious, what is the typical salary for a DOP at a small rural hospital like the OP is considering?

Interviewed for a rural DOP in 2015 would have been 105. Hope it's better for other people!

 

[spacecowgirl]

Interviewed for a rural DOP in 2015 would have been 105. Hope it's better for other people!

Jeez - I'm sure my DOP makes way more than that because I make way more than that. I know someone going into a DOP job just now and they are making way more than that. I must live in the land of milk, honey, and unicorns.

 

[lord999]

Jeez - I'm sure my DOP makes way more than that because I make way more than that. I know someone going into a DOP job just now and they are making way more than that. I must live in the land of milk, honey, and unicorns.

Or the frozen tundra where there are other considerations involved as well.

I agree though, at $105, who do expect to show up?

 

[spacecowgirl]

Or the frozen tundra where there are other considerations involved as well.

I agree though, at $105, who do expect to show up?

Oh yeah, we get a free Polaris to ride to work during the winter months (Aug-May).

 

[KansasPharmGirl]

My hospital offer is for $100K.

 

[PAtoPharm]

Oh yeah, we get a free Polaris to ride to work during the winter months (Aug-May).

Do you work in Alaska?

 

[Saiyo]

My hospital offer is for $100K.

ehhhh.....I think DOP is a bigger headache and liability then its worth.....