SURVIVING THE MIDYEAR AND THE RESIDENCY MATCHING PROCESS
What is a residency?
A residency is a salaried postgraduate training program in a defined area of pharmacy practice. Residencies are generally one year commitments, and are organized so that residents receive training in professional practice in addition to management activities. Residencies entail daily activities in pharmacy services in addition to the completion of a residency project. Residency projects range from clinical research in hospital settings to the implementation of new pharmacy services in the outpatient arena.
Residencies are intended for those planning patient-care and practice-oriented careers. For example, careers in clinical pharmacy generally require the completion of a residency. It is generally held that a one year residency is worth four years or more of practice experience, and increasingly, employers indicate a strong preference towards applicants who have completed a pharmacy practice residency.
What is a fellowship?
A fellowship is a postgraduate program designed to prepare the participant to become an independent researcher. Fellowships are generally two-year commitments, and are highly-individualized to the participant’s career goals, with their research interests as the focus of education and training. Fellowships primarily develop competency in the scientific research process, emphasizing the conceptualizing, conducting and reporting of research.
Fellowships are two-year programs, often structured so that one year is spent becoming a clinical expert in a specific area, and the other year is spent developing expertise in the research process. Activities emphasized as far as research goes are grant writing, hypothesis development, study design, data collection and analysis, and manuscript preparation/publication.
Fellowships are intended for those planning research-oriented careers, for example research coordinators in the pharmaceutical industry. Graduates of fellowship programs should have the capability to conduct collaborative research or function as a principal investigator.
What can I expect during a residency?
Residencies are typically one year commitments, and generally begin in July, although this does vary. Residencies are salaried positions, and most programs include healthcare benefits, paid vacation and educational allowances. Compensation varies between programs, but most Midwestern residencies range from between $29,000 and $40,000.
As far as day-to-day activities, pharmacy practice residencies differ between sites, with most programs offering discreet rotations, frequently four or six weeks in length, in various areas of the facility. These areas differ by residency, but frequently include acute care, internal medicine, practice management, and ambulatory care. In this type of rotation, there are generally required rotations and then elective rotations that a resident can choose for themselves based on their areas of interest. These elective rotations are often used to prepare for PGY2 residencies.
Residents work with their preceptors in the various areas of pharmacy and may be expected to complete multiple small projects and presentations. Residencies associated with colleges of pharmacy also frequently have residents perform some teaching functions as well. In addition to small projects on a regular basis, every resident will also complete a larger residency project. These projects are required for completion of the residency and usually presented at a regional or national conference.
What is the accreditation for residencies?
The American Society for Health-System Pharmacists (ASHP) is a pharmacy organization that grants accreditation status to residency programs. ASHP has a process that requires each site to demonstrate compliance with established standards of practice and offer a program that meets requirements for training. On ASHP’s website, there is a list of accreditation standards, as well as a list of the outcomes, goals, and objectives that residency programs must fulfill in order to become accredited.
Although traditionally, most residencies were offered in institutional setting such as hospitals, there has been a trend towards the accreditation of residency programs in other settings, including community practice sites and long-term care facilities. It is important to note that even in non-health-system residencies, ASHP sets accreditation standards. Frequently, however, this is done in conjunction with other pharmacy organizations (e.g. Community Pharmacy Residency accreditation with APhA). The ASHP website (www.ashp.org) has a searchable directory of accredited residencies, sortable by location or specialty. Some programs are currently undergoing ASHP accreditation, and past residents will be grandfathered in after accreditation is complete.
Not all residencies are accredited. There are many non-accredited programs that are very good programs. This situation may occur when a practice site is very specialized or very new. As such, these sites are frequently hard to find. If you cannot find the kind of residency you’re interested in through the ASHP Online Residency Directory, another resource to look through is the American College of Clincal Pharmacy (ACCP) website. The ACCP has a searchable database of residencies and fellowships available at www.accp.com/resandfel.
What is the Residency Showcase?
Anyone that is interested in pursuing a residency should attend ASHP’s Midyear Clinical Meeting (MCM, also frequently referred to simply as “Midyear”). At Midyear, which is held in early December, a Residency Showcase is held, where all ASHP-accredited residencies set up a booth, allowing potential applicants to talk to residency directors and current residents. The Residency Showcase is an excellent opportunity for potential applicants to get a feel for specific programs and make decisions as to which programs they will apply to.
What is "The Match"?
All ASHP-accredited PGY1 and now PGY2 residencies take part in the Resident Matching Program (RMP, or simply “The Match”), a service conducted by the National Matching Service (NMS). The purpose of The Match is to match residency applicants with residency programs. It is important to note that both applicants and residency programs taking part in the RMP agree to limit their choices to those participants/programs taking place in the Match until the results of the Match have been announced. This means that by not participating in the Match, applicants are not allowed to apply to ASHP-accredited residencies until mid-March.
The Match process begins before Midyear, when potential applicants look on the ASHP website and assess the various programs and see which they’d like to learn more about that the actual meeting. At Midyear, applicants attend the Residency Showcase to help them decide which residency programs they would like to apply to. Also at this time, applicants schedule on-site interviews.
Based on applications received and the results of on-site interviews, the residency program will identify which applicants they find acceptable for their program and rank them in order of which applicant they would like to have. Applicants fill out similar forms, ranking which programs they would like to attend. Both Rank Order Lists are submitted to NMS, and then applicants and programs are “matched” on the basis of their preferences. It is important to note that a match at this point constitutes a binding legal agreement from which neither party can withdraw from without mutual written agreement. In other words, it’s best to limit the programs you rank to those you absolutely want to participate in, rather than ranking a program you didn’t like low.
Sometimes, after the results of the Match in mid-March, an applicant will not be matched with any of the programs they chose, or a program will not be matched with any applicants it chose (in 2007, almost 30% of applicants did not match). If this occurs, any unmatched applicant may apply to any unmatched program and vice versa.
To participate in the RMP, each applicant must sign and remit to NMS an agreement that the applicant will accept any residency program that they have listed on their Rank Order List and which they are matched to. There is also a $75 fee that must be submitted with the form. More information on the Match process can be found at the following websites:
What is the Personal Placement Service (PPS)?
Personal Placement Service is a program that is conducted at ASHP Midyear. PPS provides students as well as graduates opportunities to interview for both residencies and employment positions. PPS gives applicants the opportunity to interview for positions one-on-one and is a great place for networking. Many residency programs utilize PPS for preliminary applicant screening/interview. Many applicants find it worthwhile to interview one-on-one before final interviews for residencies in the new year. Residencies that don’t participate in the Match (notably PGY2 residencies and those who are not ASHP-accredited) frequently use PPS. PPS is the largest in-person pharmacy recruiting event held in the country each year.
At Midyear, there will be a book of information on residency programs and employers, and every registrant (students, employers and residency programs) will have their own mailbox for communication. Participants of PPS will be able to put their CV in the mailbox of up to three employers/programs, and in turn, employers/residencies who are interested in meeting a candidate will send a note to them in their mailbox.
What do residency directors look for in a resident?
Residencies are designed to produce leadership-minded practitioners with strong problem solving skills. As such, residency directors look for highly motivated people who desire advanced training and education in order to practice pharmacy on a higher level.
The minimum requirements for obtaining a pharmacy practice residency include graduation from an ACPE-accredited college of pharmacy (a PharmD degree is strongly preferred) and being eligible for licensure in the state the residency program is located in. Some programs require licensure before the beginning of the residency; others will take on residents while they pursue state board licensure.
Additionally, as the completion of a residency is becoming more and more common for recent graduates, applicants should seek to differentiate themselves from their peers. This must be done both on their CV and their interviews on-site. Applicants need to demonstrate their interest in and aptitude for advanced pharmacy training; ways of doing this include having held leadership roles in pharmacy organizations while a student, having challenging and diverse Advanced Pharmacy Practice Experiences (i.e. “rotations”), and having completed research with a professor. It should be noted that although a college transcript is frequently sent in with the other application materials, rarely is this the deciding factor used by programs to choose residents.
Specialty practice residencies may or may not require the completion of a PGY1 residency, and may have different requirements for application. Accordingly, applicants should contact these programs directly if they cannot find requirements on the programs’ ASHP profile or individual website.
Programs will frequently list the specific requirements for their residency on their profile at the ASHP Residency Directory; these should always be referenced before beginning the application process.
ASHP Residency Directory - http://www.ashp.org/s_ashp/residency_index.asp?CID=1212&DID=1254
What are some suggestions/tips when applying/interviewing for a residency?
First and foremost, everyone even thinking about completing a residency should know why they are interested in doing so. Answers such as “I don’t feel ready to start my career,” or “I’m not ready for reality,” are not adequate responses. There is no correct answer to the question “Why am I interested in a residency?”, but people should be aware of their personal answers. Look at your long-term, intermediate, and short-term goals, both career-wise and otherwise.
Examine what you are looking for in pharmacy and why you’re interested in a specific residency. Have a vision of what you want to do with your career when you are done. When you know what you’re looking for in a residency, you’re more likely to find a better match in a program.
Do your homework: find out about the residency you’re applying/interviewing for. Match what the program offers and what you want/need out of your residency. If you are able to adequately explain why you feel a particular program is the right one for you, it will have an impact on the residency director and those who interview you.
Know what residency directors look for in an applicant. Keep the following facts/suggestions in mind:
1) Outside activities distinguish those who view pharmacy as a job versus those who view it as a profession. Membership in local, state and national organizations is important, as is participation in service activities. Active participation in organizations is much more valuable than membership only.
2) Pick references that know you and can best attest to your abilities. Provide letters of recommendation that will demonstrate your best traits. Also, it’s better to have letters of recommendation from people who know you well rather than someone who’s merely had you in their class. In this respect, a letter from the dean may not be an adequate representation of yourself if the dean does not know you well.
3) Provide an impressive Curriculum Vitae free of typographical errors and formatted to please the eye.
4) Be able to demonstrate enthusiasm for the profession of pharmacy through excellent written and oral communication skills.
5) Other important factors/traits: previous work experience, decent grades (be able to explain any issues on transcript), organizational and time management skills, ability to handle multiple projects, leadership ability, good decision-making skills, overall well-roundedness (having participated in both professional and social organizations).
How do I select a residency that is right for me?
There are many factors that determine whether a particular residency is right for the applicant. Some of these factors, such as location and accreditation status, are items are easily identified after minimal searching in promotional literature or on the internet; other components, like work environment, can only be found out about through direct observation or by asking questions to the residency director or current/past residents.
The following factors are ones to keep in mind when researching:
1) Program Quality - The best program is one that best suits your needs. Look into the program’s reputation and the pharmaceutical care services that the institution offers, and find out information about previous residents and where they are now. Other sources of information about the quality of the program include current residents, preceptors at the site, and faculty at Drake.
2) Patient Population and Services – Make sure that these fit your career goals. If you are interested in pediatrics, a residency at a VA hospital may not be the most ideal.
3) Teaching Commitment – Some residencies require teaching which can occur in a number of ways. Residencies directly associated with colleges of pharmacy may require didactic classroom teaching or teaching of practice lab sections. Residencies that accept rotation students may require residents to act as preceptors.
4) Staffing Expectations – What are the required staffing expectations in terms of weekends, “on-call,” and the amount of time required? Ask your director to define “on-call.” Will staffing duties be related to the residency program, or will the resident simply be filling in for staff pharmacists?
5) Work Environment – What is the general atmosphere of the site? Will there be other residents at the site while you’re there? Are the staff professional and supportive of one another? Is there a “team spirit”? You will spend an entire year at this site, and will learn and achieve more in a supportive environment.
6) Residency Projects – Residency projects serve to develop critical thinking skills in residents in addition to introducing them to the research process. How do residents choose the topic of their project? Have previous residents’ projects been completed/published? How much time is allotted for project work?
Are there some additional sources of information?
General Residency Info/FAQ’s (ASHP) - http://www.ashp.org/s_ashp/cat1c.asp?CID=1990&DID=2041
ASHP Online Residency Directory - http://www.ashp.org/s_ashp/residency_index.asp?CID=1212&DID=1254
ACCP Directory of Residencies, Fellowships, and Graduate Progams -
APhA Community Pharmacy Residency Program - http://www.aphanet.org/AM/Template.cfm?Section=Search&template=/CM/HTMLDisplay.cfm&ContentID=5904
SURVIVING THE MIDYEAR AND THE RESIDENCY MATCHING PROCESS
What is the first thing I should do when I get to the Midyear?
Go to the convention registration desk and pick up your registration materials. You will receive specific information on the overall meeting as well as the residency matching activities, such as the residency showcase. The showcase, which runs Monday through Wednesday, is where you can sit down and talk to preceptors and residents of the programs you are interested in.
Can you explain what is involved in the Personnel Placement Service (PPS)? Do I need to contact anyone prior to the midyear?
The PPS is mainly for interviewing for pharmacy practice positions. You pay a $100 fee, either before Midyear or on-site at the registration desk, and are interviewed by potential employers. However, some residencies particularly specialty residencies also schedule interviews through PPS so there may be value for you as a student here. (Generally, it is advisable to complete a general residency prior to a specialty residency). This saves the residency programs having to bring you in for an interview after the Midyear. The advantage of signing up early is that your name will be listed in a booklet for potential employers or residencies. You are not required to call or write to anyone listed in the PPS prior to the Midyear, unless you would like to make initial contact.
What should I bring to the residency showcase for the brief interview?
Your curriculum vitae, at a minimum. Be sure you check it CLOSELY for typos and for professional appearance (no smudges, tears, etc). It may be helpful to bring a small notepad to take notes during the interview and to gather names of those you met. You'll want this to send thank you notes out after you return from the midyear.
What components should be included in a curriculum vitae?
At a minimum, your personal information (full name, address, phone, email), license or certificate information, educational history with anticipated date of graduation , coursework completed, work (including internship) experience with dates, leadership or organizational activities, scholarship (publications or presentations), honors or awards, and the names of references who may be contacted. A statement of career goals is optional.
What is the best way to prepare for the interview?
Review the Residency Directory for types of residencies and location. Give careful thought to why you want to do a residency and why you have chosen a particular institution.
What questions should I ask?
Ask about what your activities will be (they may have a listing that they can provide you), who you will officially report to, if there is a service component (such as being on call for the drug information center or assisting with other staffing responsibilities), how many other residents will be there along with you, how long has the residency program been offered at this institution, etc.
What questions will the interviewers ask?
They will likely ask you why you want to complete a residency, what your short-term and long-term career goals are, your strengths and weaknesses, your willingness to relocate, what specific goals you have for the residency, why you picked their program, type of questions. They are looking for characteristics that will enable you to successfully complete their program and for career planning on your part. (See separate handout of actual residency questions that have been asked).
What should I do when the interview is concluded?
Thank the preceptors and residents for their time. Ask them if they have a business card you may have for future contact if needed. After returning from Midyear, follow up with with a thank-you note!
Is the residency showcase the only place I can interview for residencies at the midyear?
If you are making arrangements through the matching program, this is the usual route. However, check the bulletin boards and closed-circuit monitors for information on residencies that have NOT gone through the matching process…even though a residency may not yet be accredited, this does not mean it is of low quality but may be a new program with accreditation pending.
How do preceptors chose a resident? Is it from the CV and the interview alone? Do the preceptors do this or does the decision depend on the matching program administrators?
Often the residency showcase is used as a screen to subsequently invite students to their institution for a more formal interview. Typically, the final decision is made by those directly involved in the process.
What are some common questions that I should be prepared for?
Interview Questions from Actual Residency Interviews (you supply the answers!) (Courtesy of Michael Kruse, Pharm.D., Assistant Professor of Pharmacy Practice):
1) How would a classmate describe you?
2) Describe what you think makes a good preceptor for you.
3) Have you had any problem with a preceptor, professor, or patient on rotations? How did you handle it?
4) How would you handle a student who disagreed with an evaluation you gave him/her?
5) Please tell us about yourself including why you got into pharmacy.
6) Why do you want to do a residency?
7) Why are you applying to this residency?
8) What would you do if you didn’t match for a residency?
9) If you had to select the other resident(s) for this program that would work with you, what would they be like?
10) What is the role of a pharmacist?
11) What is the role of pharmacy administration?
12) Is there a difference between a leader and a manager?
13) Why did you get into pharmacy?
14) Why did you go to Drake?
15) What are your hobbies? What do you do in your freetime?
16) Tell us about your presentation on __________ (something you presented that is on your CV).
17) Tell us about your intern experience at __________(some job).
18) What was your favorite rotation and why?
19) What was your least favorite rotation and why?
20) Why did you get involved in ________ student organization? Why bother?
21) Describe the most significant impact you had on ___________ (some student organization)?
22) Describe a pharmacy intervention that you remember most significantly.
23) You are working in a satellite pharmacy. You have the pager to be part of the "code team". The pager goes off. At the same time a nurse calls you and tells you a TPN for a patient is almost done and the next one is not there yet. Another nurse tells you a patient’s heparin PTT just came back at 110. What do you do?
24) What frustrates you or makes you angry?
25) Was four weeks the right amount of time for a clinical rotation?
26) You have a problem with a preceptor. How do you handle it?
27) I am a 16 year old patient who was just prescribed an albuterol inhaler. Counsel me. The doctor mentioned that he might add a steroid inhaler. How is that different?
28) I am a medical student. What is the difference between heparin and warfarin?
29) I am a doctor that wants to dose a patient on warfarin. What do you recommend?
30) I am a patient that was just prescribed warfarin. Counsel me. Sometimes I take Prilosec for my stomach. Is that a problem?
31) Tell me about the treatment of GERD.
32) What do you need to be concerned about in a patient receiving Amphotericin B?
33) What was the last clinical article you read? Tell me about it.
34) An elderly male presents with hypertension and diabetes and a Cr of 1.8. The patient is on Lopressor, Glyburide, and Reglan. What could be causing dystonia? How do you treat it? What other concerns do you have about the patient’s therapy? The doctor wants to add metformin. What do you say?
35) What is the treatment for community acquired pneumonia?
36) How would you dose heparin in a patient?
37) What are three adjectives that describe you?
The most important forums for students are held on Sunday. This includes orientation for first timers and mastering the basics of residency training. Try to get to as many of these as possible. Check your program when you pick up your registration materials. Monday through Wednesday you will have the opportunity to interview at the residency showcase.
What should I do when I return from the midyear?
Pat yourself on the back-YOU SURVIVED!!! Send a thank you note and let them know if you are still seriously interested in their residency or not. This is a courtesy, leaves a positive impression, and also helps preceptors prioritize their candidates.