By: Dr. Gregory J. Hughes
Gregory J. Hughes, PharmD, BCPS, CGP is an Assistant Clinical Professor in the Clinical Pharmacy Practice department at St. John’s University College of Pharmacy and Allied Health Professions. He completed his pharmacy practice residency at the St. Louis VA Medical Center and the St. Louis College of Pharmacy with an emphasis on geriatric pharmacotherapy. Dr. Hughes’ clinical practice site is North Shore University Hospital in the Department of Internal Medicine. His areas of interest are geriatrics, anticoagulation, arrhythmias, heart failure, infectious disease, and teaching methodologies.
Upon completion of the Doctor of Pharmacy curriculum, new graduates are prepared to begin their careers as new practitioners. While some new graduates will chose to begin practice in community or hospital pharmacy settings, others will strive to hone and build on their skills, knowledge, and abilities by completing a pharmacy practice residency. This one-to-two-year, highly competitive venture is an important decision for a fledgling pharmacist.
When deciding to complete a residency, each resident will create his or her own unique experience, within the constraints of a program’s structure. No two residencies are identical. As per the accrediting organization, all ASHP-accredited first year residencies must have some core components. The program must build a structured approach for the resident to manage and improve the medication-use process, provide evidence-based patient-centered care with interdisciplinary teams, exercise leadership and management skills, provide education and training, and utilize medical informatics. Residencies will generally have a number of required rotations and may have elective rotations varying with each resident’s goals. Residencies require a project or research plan that may take the entire year, or longer, to accomplish.
The daily routine of each resident will vary depending on which program he or she chooses. The best way to find out specifically what a typical day will encompass is to ask the current or past residents, or the residency director. The best time for these questions is within the months preceding the application deadline to the program. Applications are typically due at the beginning of the calendar year. In the fall, many residency programs will take part in local, regional, or national residency showcases. The largest of these is the ASHP Midyear Clinical Meeting, where a large number of programs gather to seek out potential residency candidates. The ASHP website is a good resource for general information and many programs will have information available on their own website throughout the year.
In completing a pharmacy practice residency, the resident will transform both professionally and personally. Enhanced clinical aptitude is only one aspect that will be cultivated. Residents will find themselves in a position to deliver education and demonstrate their abilities to fellow pharmacists in addition to other disciplines. Residents will forge lifelong relationships with co-residents and preceptors. Opportunities will develop for collaboration on research and publishing that otherwise would not have existed. In addition to professional growth, maintaining a balance with a healthy social life is an important, incorporated goal in a residency. This is important, since, unfortunately, socializing may go by the wayside in intense academic programs.
One of the editors from this newsletter asked me to write briefly about my experiences and my feelings about them. Upon graduating from St. John’s University, I chose to complete a residency at a joint program of the St. Louis Veterans Affairs Medical Center and the St. Louis College of Pharmacy. My residency focused on the geriatric population; its current and future needs in our society cannot be overstated. During my residency experience, I cared for patients in a pharmacist-run geriatric clinic, a rehabilitation unit, an anticoagulation clinic, internal medicine, and several other practice settings. I performed chart reviews for nursing homes, admission reviews in a Program for All-Inclusive Care for the Elderly, was a preceptor for IPPE and APPE students, taught in Therapeutics and Advanced Pharmacotherapy courses, and spoke at a regional geriatric conference. These activities were not prescriptive, but merely examples of what a pharmacy practice residency can offer. During the residency, I developed (previously underutilized) strengths, as well as relationships that I would never forget. If I could go back and make the decision to do a residency again, I would do so without hesitation.
The following are some words of advice to those considering a pharmacy practice residency. My recommendations are to express your interests early and to get involved with pharmacy organizations that share your interests. Most pharmacy organizations offer memberships and resources to students at a discounted rate or for free. Many events take place locally where you may be able to network with pharmacists. I also recommend traveling to national meetings prior to the last professional year to those who can within their means. These national meetings open up the profession to a different level and may help you realize you really want to commit to a residency or find it is not for you. Lastly, you can always turn to your faculty at St. John’s University, who can provide you with individualized advice and guidance.