There appears to be a push in the pharmacy world to expand residency programs so â€œthat, by 2020, postgraduate year 1 (PGY1) residency training should be required for entry into practice for all pharmacists who will serve in direct patient care roles.â€ This according to a recent article in the American Journal of Health-System Pharmacy. In addition the article states that â€œASHP conducted a survey to determine if health systems were requiring specialized residency trainingâ€”now known as postgraduate year 2 (PGY2) residency trainingâ€”for clinical specialist positions10; 15% of the respondents indicated that such specialized training was required, and 67% indicated that a lesser-trained pharmacist would be hired to fill a clinical specialist position only if a candidate with specialized training could not be found.â€ Basically acute care pharmacies are looking for pharmacists with more education instead of looking for good pharmacists.
I would be left out in such a world. You see, I donâ€™t have a residency of any kind under my belt. Lots of experience, but no residency. Iâ€™ve precepted pharmacy residents, some brilliant and some as dense as rocks. Their abilities to perform at a high level had more to do with their intelligence and common sense than their education. While I like to tease other pharmacists about their alumni status, Iâ€™ve found that true skill rarely cares what pharmacy school you went to.
One of the problems I see with the call for residency is a loss of pharmacy identity. Many pharmacists want to practice at the patient bedside. I think thatâ€™s a good idea. However, I believe we should be practicing pharmacy at the bedside. Weâ€™re drug experts. We know things about medications that few other professions know because weâ€™re supposed to. Any monkey can pick out a drug to treat a disease state. Itâ€™s things that occasionally happen after that that requires specialized drug knowledge. Pharmacists are experts not only in the obvious, but the subtleties as well. Who else but a pharmacist would care about the structure activity relationship of a drug or its acid-base properties? Probably no one. While these things rarely matter in the routine care of a patient, when they do it makes a difference. Pharmacists are taught to think about the drug first, and last; everything about the drug. Weâ€™re the only profession that does that.
I agree that pharmacists have lots to offer to patient care, and I also believe that pharmacists shouldnâ€™t be tied to the physical pharmacy. With that said, donâ€™t let the fact that pharmacists are drug experts escape you. I fear that the push for residency and specialized residencies will drive pharmacists away from the very thing that makes them unique into a world already inhabited by plenty of would-be practitioners. Be careful what you wish for pharmacists, you just might get it.