PGY1 at a VA... how to choose?

[rs37982]

I was looking into VA residencies throughout the country and they pretty much have a program in every major city in every state. How would you go about determining which program is more reputable? On paper, they all appear very similar in regards to the rotations and opportunities they offer. Other than deciding based on what city/state you wanna live in and the patient population served, how would one go about deciding which is "better"? Any advice is appreciated!

All the VA programs are here: VA Pharmacy Residency Program - Pharmacy Benefits Management Services

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[Selladore]

You can take a look at the types of PGY2 programs that are offered, the staffing components, what types of pharmacists lead protocols are there, number of pharmacists at the hospitals, what current residents are doing, how many residents there are, and how residents interact with RPD. Although I would caution any program can look "reputable". You might have to talk to current/past residents to get a feel for the program and if it'll be a good match for you.

 

[lord999]

Do not use demographic characteristics of a VA to make a decision (or the choice of city). Definitely talk to the residents outside of the view of the preceptors. And reputation inflation and power abuse are intrinsic characteristics of the program that can be part of but not necessarily part of the academic culture of the place.

For OR, there's two different VA's, and the one I would recommend isn't in the city that everyone wants to go (not so subtle hint: if you are looking for a good Inpatient VA pharmacy residency experience, I don't suggest looking at any site in VISN 20, but there are excellent nursing home/ambulatory care experiences there if you know where to look and who to talk to). In VISN 12, there's an outstanding residency within that area that isn't well-known in outside VA circles besides the immediate area (and hires well both inside and outside the VA due to its reputation in the area), one residency that is a research powerhouse but has a reputation in the same area for poor resident outcomes as they sacrifice the residents for research productivity, and one that ASHP promotes highly but is not so well-regarded within VA due to preceptor abuse issues and erratic quality control of outcomes.

You wouldn't know any of this without knowing the people. And then there's the VA culture which is very different. I'd recommend you try for a VALOR internship or a clerkship if you still can to get an understanding of the place. It's one hell of a depressing year if you can't cope with the institutional dynamic. There's also a personal fit. One of the residencies in NV is a fairly laid back group of irregulars and the other a regimented serious staff, both have good outcomes, but they don't deal with misfits to their working cultures very well. That's what the interview flushes out supposedly.

 

[sld14]

I think you should evaluate them are you would any other program when you are preparing for midyear and interviews. I am a PGY2 at a VA and also did my PGY1 at the same VA, so the PGY2 programs offered and location (I wanted to stay in the northeast) were a very large component when I ranked them. Other things would include staffing component, research (this was also big for me because of my interests), electives available and also talking w/ the current residents on interviews. I also wanted a program that had more than 2 co-residents. I was a VA VALOR intern and did my P4 in critical care at a VA as well - I would try to open yourself to opportunities to get a better feel for the VA.

I applied to numerous VAs and a few non-VAs. Feel free to message me with any questions.

 

[bacillus1]

First, look how big the facility is. You will typically have more opportunities for learning at a larger VA than a smaller one. Otherwise, it really comes down to your personal interests. Do you want to do a PGY2 and does that VA have a PGY2 in what you want to do it in? Do you really want to do a rotation in something like cardiology? Not too many VAs have that, but some do. Also, some VAs have what's called dual appointment, where you actually get paid a pharmacist's salary for staffing. Employment post residency is also a concern, though this is a double-edged sword. Some programs are able to employ many of their residents, but that may also mean that it's a high-turnover facility where no one sticks around more than a few years. Finally, definitely talk to current residents to get a feel for how they like the program. There are some great programs out there as well as ones where your year will be a living hell.