Pharmacy students hear many rumors regarding what happens to new pharmacists who opt to become a PGY1 pharmacy resident. What is myth and what is fact? Here a recent PGY1 graduate takes a stab at clearing the air by identifying what she found to be myth and what she found to be fact.
Authored By: Melissa Santibañez, Pharm.D.
I have always prided myself on being dogmatic and untiring in my work, almost machine-like in dedication to the goal at hand. Prior to residency, I was simultaneously balancing days as a full-time pharmacy student at clinical rotations plus school plus work as a pharmacy tech in 3 hospitals, all with nights as a martial arts student to preserve my sanity and reinforce my skills.
My parting message to my residency program director (RPD) after a year of awesomeness was: “PGY1 year has been the most exhausting year of my life so far.”
So now, at the start of my PGY2 experience and what promises to be a double-edged sword of an extremely demanding, challenging, yet rewarding year of professional development, it both surprises and amuses me that virtually every night I end up passing out from sheer exhaustion on my couch in the midst of some project.
For the pharmacy students out there on the inter-web pursuing residency and postgraduate training, I would like to share some facts and dispel some myths about life as a PGY1 resident. Let’s do this.
Statement #1: You are not going to have a life during residency
Be aware that you will be spending the majority of most days at work and that you will be interacting more with your coworkers than with your own loved ones at home. But you can have a normal life, of course.
Do not hesitate to integrate the different spheres of important people in your life. My 10 coresidents last year became my family and we built so many memories in our office and in the little moments spent hanging out together, and those relationships can never be replaced and I still speak with those 10 people almost every day.
Statement #2: You are going to be on your own all year as a resident
Lies, lies, lies! Your faculty and preceptors are there to be the backbone of your professional education. Build your networks and know on whom you can rely for help.
Most programs, especially those with an on-call component, will have a designated faculty back-up for questions/concerns that arise during your shifts. Your direct preceptors on your different rotations are also here for this purpose; go to them with your rotation-related concerns. Know your preceptors’ specialties/skills and reach out to them accordingly in situations where there expertise is warranted.
As a PGY1 despite the rotation you are on, you answer directly to your RPD and this individual is your voice and can serve as your bridge/liaison for whatever conflict you may encounter. Your biggest support system during PGY1 year, though, will be your co-residents — whether PGY1s, PGY2s, or fellows. My PGY1 RPD would always remark that when we encountered questions while on-call, we first reached out to our fellow PGY1s, then to our PGY2s and very often to our ID fellows, more often than we collectively reached out to our faculty back-ups the entire year!
Small and large programs have their own strengths/weaknesses. Speaking only from my own experience, one of the biggest strengths of a large PGY1 residency class with a strong on-call component was that in almost every situation, you were sure to have a co-resident covering the medical service that was paging you with questions, and as such you always had someone to count on if you were absolutely lost when addressing a question.
People are there to help you during PGY1 year, but don’t just blindly ask for help – instead do your research and come prepared with a plan.
Statement #3: You will need to know everything on rounds and during rotations
The purpose of PGY1 training is to build your knowledge base on a wide range of pharmacy-related areas. You are not expected to be an expert, especially on rotations dealing with patient populations you are completely unfamiliar with.
I remember feeling inadequate the entire month I was on the Pediatric Intensive Care Unit service as a PGY1, because I had to look EVERYTHING up every day and it felt like I was learning pharmacy all over again. You are going to feel like that, maybe at several points during the year, but know that this is perfectly normal to go through.
On the flip side, be aware that the healthcare professionals you will work with will think that you know everything! I completed my PGY1 in the Midwest and at an institution with a heavily established history of innovative and autonomous clinical pharmacy practice, and on many medical services the pharmacy residents actually steered the boat on what the plan for the day was. This can be pretty intimidating on your first overnight on call shift when responding to a cardiac arrest and answering drug info calls about everything and every patient under the sun, but please do not be scared or embarrassed to reach out for help or to say that you need more time to look something up.
Statement #4: Pharmacy is a small world
Professional development is a huge goal of PGY1 year. Have your sources of reinforcement, whether among your coresidents, your RPD, a faculty or preceptor, or someone at home.
Many programs will assign you a “mentor” based on your initial interests, so you can have some connection to a like-minded individual and can use this to build a mentorship. You do not need to rely solely on any such assigned mentor. Find your own mentor, and it’s ok to have multiple mentors for different situations. Keep those relationships alive and make them mutual exchanges between the mentors and the mentee, because you will be encountering these mentors repeatedly for support, inspiration, or just to vent well after residency ends.
I still reached out to my mentors during pharmacy school while I was a PGY1, and now as a PGY2 I have a larger net of mentors to exchange ideas with.
Statement #5: You will have to do many tasks you will not like
One of the unfortunate truths about residency is that you will get relegated to completing many projects and assignments beyond what is outlined in your residency handbook, many of which will not be anything in which you are even remotely interested. But take every situation as a learning experience and as an opportunity for improvement. Have a goal in mind. Be prepared to wear many hats, because you will be a much stronger and well-rounded (and capable!) pharmacist for doing so. Let’s face it, in the real world you’re not only going to be given projects that you absolutely love, so take advantage during this year of general postgraduate learning (aka PGY1) to complete the seemingly odd projects assigned to you.
I had the opportunity to take on an internal initiative to improve staff pharmacist accuracy and patient safety with verification of opioid orders during my Administration rotation as a PGY1, which developed into creating a full 1 hr ACPE-accredited continuing education (CE) lecture on best practice strategies for our most commonly prescribed opioids with one of my coresidents. This involved working on the CE materials and us then actually giving 3 versions of the lecture to capture the full staff well after our Administration rotation had ended, but it left us with a successful CE presentation in addition to the one required for our PGY1.
I hope all of this has offered some clarification in the search for your “best-fit” program. Get ready for a memorable ride!
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