December 14, 2011

Preparing Pharmacy Students for Residency Training

by Diane E. Hadley, Pharm.D., PGY2 Ambulatory Care Pharmacy Resident, University of Maryland School of Pharmacy

Over the past few years, I have been asked at three different pharmacy schools by first year students “What can I do to become the perfect residency candidate?”  Perhaps the better question is, what we can do as pharmacy educators and schools of pharmacy to prepare students to “put their best foot forward” for the ASHP Midyear Clinical Meeting (ASHP MCM) and residency interviews?  As the demand and the competitiveness for pharmacy residency training increases, acquiring accurate information about residency training and preparing students for the interview process becomes increasingly important.  In most doctor of pharmacy programs, students learn about residency training and preparation methods primarily by informal methods through peers as well as preceptors during advanced pharmacy practice experiences (APPE’s). Although beneficial, it may leave the prospective residency candidate with incomplete information regarding the type of residency to pursue and may not adequately prepare students for the interviewing and matching process.  Would a more formal approach, such as a pre-residency curriculum, be more effective than the current informal methods?

Experiential learning is a crucial part of the doctor of pharmacy curriculum that exposures students to current pharmacy practice models.  Ideally, APPE rotations should serve as an introduction to residency training.  Unfortunately, schools don’t control the “hidden curriculum” taught during APPE rotations.1  An article published in Academic Medicine, observed that values such as professionalism was often taught informally more often by peers during off hours instead of traditional methods from an instructor.2  This article illustrates how the “hidden curriculum”  is often driven by peer influence.  This notion is further supported by an article published in Clinical Orthopedics and Related Research Journal.3   Indeed, informal one on one and group interaction can impact opinions, most often in a negative way.3  Thus information and attitudes about residency training may be acquired through a “hidden curriculum” and these may be driving decisions related to residency training that are not envisioned or endorsed by the school.1,2,3  Thus a formalized pre-residency curriculum may help diminish the potentially negative influences of the “hidden curriculum.”

An article published in American Journal of Pharmaceutical Education supports the potential benefits of developing structured pre-residency instruction at the University of Buffalo School of Pharmacy.4 The author surveyed sixty-eight pharmacy students that attended either the ASHP MCM in 2007 or 2008  or both.4 Prior to attending ASHP MCM, students attended a one hour presentation and receive a handout regarding the residency process.4  The educational seminar included information about residency terminology, benefits of attending the ASHP MCM, time management,  and the pre-during-post ASHP MCM meeting residency selection.4 The survey asked about the helpfulness of the structured educational event and had an impressive 97% response rate.4 A majority of the students, 73%, ranked the educational event as extremely helpful in preparation for the ASHP MCM.4   A 2010 survey of seventy-one colleges of pharmacy showed that sixteen pharmacy institutions now have a pre-residency program in their pharmacy cirriculum.5   Of these sixteen schools, nine provided information on their pre-residency curriculum.5  The curriculums offered a variety of traditional and non-didactic learning activities including: lectures on residency training, pre-residency pathways, mentoring programs, and research project development.5

Schools of Pharmacy should provide residency information using a structured approach.  Such instruction has become crucial because the American College of Clinical Pharmacy has proposed that residencies become mandatory for pharmacists who work in direct patient care roles by the year of 2020.6  As leaders in our profession, we need to take action to formalize the instruction about residency training to keep students well informed.  We need to reduce the likelihood that students will make ill informed decisions based on misinformed that practitioners or peers may have given.  Ideally a pre-residency curriculum should be created that incorporates didactic presentation on the ASHP MCM meeting and residency interviewing process, encourages experimental learning rotations that increases a student’s preparedness for residency training,  a pre-residency mentor, and opportunities to get involved with clinically oriented research projects.  A combination of all these elements would provide a sturdy foundation for students to become the “perfect residency candidates.”

1. Gardner S. Car Keys, House Keys, Easter Eggs, and Curricula. Am J Pharm Educ. 2010; 74 (7) Article 133.
3. Gofton W and Reghr, G. What We Don’t Know WE Are Teaching: Unveiling the Hidden Curriculum.  Clin Orthop Relat Res. Number 449. Augest 2006. Pages 20-27
4. Prescott WA. Program to prepare pharmacy students for their postgraduate training search. Am J Pharm Educ. 2010; 74 (1) Article 9.
5. Dunn B, Ragucci K, Garner S, et al.  Survey of Colleges of Pharmacy to Assess Preparation for and Promotion of Residency Training. Am J Pharm Educ, 2010. 74 (3) Article 43.
6. Murphy JE, Nappi JM, Bosso JA et al. American college of Clinical Pharmacy Vision of the Future: Postgraduate Pharmacy Residency Training as a Prerequisite for Direct Patient Care Practice. ACCP Position Statement. Pharmacotherapy 2006; 26 (5): 722-733.

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