Pharmacists are commonly encouraged to pursue post-graduate residency training, but what is it like to be a PGY1 Pharmacy Resident? Learn here from a 2015-16 PGY1 Pharmacy Practice Residency graduate and current 2016-17 PGY2 Pharmacy Resident.
Authored By: Ali Vyain, Pharm.D.
Even before commencing my journey in pharmacy school, I was interested in the extraordinary clinical opportunities that were available to pharmacists. Frequently, completing a post-graduate year one (PGY1) pharmacy residency seems to be a minimum requirement for obtaining a clinical pharmacist position in a hospital or academic settings.
With this in mind, securing a PGY1 pharmacy residency became my end goal of pharmacy school. Although I knew that more opportunities would accompany completing a PGY1, it was also important for me to gain valuable clinical experience so that I could become confident enough to function in a clinical setting. For me, it was the necessary bridge between my pharmacy school education and my long-term goals.
Once I secured a PGY1, I began mentally preparing for what would be the most challenging year I faced. I envisioned many sleepless nights and struggles. I knew that the time management skills I had gained to this point would be tested, and I was anxious about performing my best with so many additional responsibilities. I knew that I would be pushed to greater limits.
I was also nervous about working twelve days on and two days off for a whole year; would I be able to handle such a time commitment while still maintaining a healthy personal life?
I had many ideas of what I thought residency would be like. What I could not foresee, however, was how much I would enjoy nearly every aspect of it. Completing a PGY1 was one of the best experiences of my life. I grew a great deal personally and professionally through the challenges of my residency. I am eternally grateful for the learning experiences and people who shaped my first year of post-graduate training.
That being said, no residency experience is exactly the same; we are all comprised of different experiences that have impacted our professional identities to varying degrees.
As a recent graduate of a PGY1 pharmacy residency, I wish to extend some of my own experiences in hopes that they may assist others on their journey through pharmacy residency.
1. Working with medical residents… nerve-wracking, right? – I beg to differ.
Entering into residency, one of my biggest sources of anxiety was how I would be perceived by the medical residents. Would I perform well enough to earn their respect? Would they be receptive to my recommendations? Would we have a positive working relationship? Was I capable of making an impact on their experience?
The answer to all of these questions was yes. Incoming medical residents share many of the same struggles adjusting to increased levels of expectation and responsibility, and they appreciated our help more than I could have predicted.
One of the most memorable interactions I had with a medical resident happened earlier in the year. I received a call late at night when I was almost asleep about a linezolid drug interaction. This may seem inconsequential to some, but I was happy to build a rapport with her and make her feel comfortable to ask me questions.
Encounters like that pushed me throughout the year; I felt a great sense of pride in building positive relationships between medicine and pharmacy, even on a small scale.
Needless to say, leaving the amazing group of residents that I worked with was one of the saddest parts of completing my PGY1. I no longer get to work with them every day and I genuinely miss the comradery and relationships that we built together. Every day was a unique learning experience, and I formed strong friendships with many of them.
The medical residents were patient and understanding and they did not get irritated when I needed to look up an answer I was unsure about. If I could give any advice to an incoming PGY1, it would be that these individuals are going to be who you likely spend a whole lot of your time with. Therefore, treat them like normal people and give them the respect that you desire to be given. Finally, strive to learn as much as you can from them. A healthy combination of mutual respect and peer-based learning was the recipe for a very positive and memorable experience during my PGY1 residency.
2. Confidence – I found a lot more of it.
One of the largest areas of growth during my PGY1 year was developing more confidence in my abilities as a pharmacist. Unlike others, I did not have much clinical experience outside of my required introductory pharmacy practice experiences (IPPE) and advanced pharmacy practice experiences (APPEs aka rotations) when entering into residency.
Like many other pharmacy students, I struggled with finding my own confidence as a member of the healthcare team. During my year as a PGY1, I was given a large amount of responsibility. Sometimes I felt plagued with fear that I was going to make a mistake. Guess what? I did make mistakes. And guess what else? I was a better pharmacist for it. Those little mistakes that I made, I will never forget. I remember to emphasize those same points to the next wave of pharmacists that I have the privilege of precepting.
Furthermore, grinding through feelings of self-doubt and embracing learning opportunities each day helped build my self-confidence. As months 10, 11, and 12 reared around, I was frequently able to make high quality interventions.
Experience was something I needed to build my confidence, and residency gave me that.
3. I never felt like I knew enough – A feeling that as a pharmacist, I hope never goes away.
From day one of residency to the day I walked out of my office for the last time, I never felt like my knowledge was where I wanted it to be.
Although this is very frustrating at times, it is one of the aspects of the profession that makes it so beautiful. You will never know everything and better yet, you are not expected to know everything as a resident.
You are however, expected to learn every day and take initiative to read up on areas of weakness. So let me re-iterate: it is normal to feel inadequate at times during your residency. Furthermore, how you manage that expectation will shape the year ahead of you. I hope I always experience that feeling of humility, as it has pushed me throughout my PGY1 to broaden my knowledge, ask questions, and dig deeper than I may have otherwise.
Additionally, I learned to celebrate my successes. One of my preceptors helped identify this as a weakness of mine. I was always more concerned with what I could do better instead of celebrating what I had done well.
As a pharmacy resident, you have a lot on your plate most of the time. It is important to give yourself credit for things you do well, as this self-praise will come in handy during more overwhelming times.
4. Time management- yes, it is really that important!
Managing my time most efficiently has never been one of my deepest strengths; however I knew that in order to survive a PGY1 I would need to make this a priority.
Efficiently managing available time is a skill that one must hone either before or during residency in order to be successful. As a resident, I was expected to help precept students, conduct long-term research, construct lectures, prepare presentations, participate in journal clubs, compose newsletters, and work on numerous other projects.
Furthermore, it is important to manage a healthy personal life to avoid getting burned out. I chose to complete residency out-of-state where I had no friends or family to lean on when I was stretched too thin. This made the experience even more difficult at times, and perhaps added to some of my stress. Other times, it felt like an advantage to be alone because I did not feel conflicted to spend time with family and I could focus more on my residency.
When looking back at this past year, I would say my best friends in time management were three things: my calendar (both written and electronic), constant communication with my co-resident (we had each other’s backs, which is how it should be), and open communication with my residency director when I needed help staying on track.
Residency truly sheds light on your ability to manage time, and I am thankful that I had the opportunity to practice this every day.
5. The number of PGY1 interviews extended is not directly correlated to the number of PGY2 interviews extended.
I worked hard through pharmacy school; my grades were not poor, but they could have been better. However, overall I thought my CV would seem impressive to many programs.
After spending a significant amount of money in application fees, hours developing letters of intent, and varying forms of preparation for Midyear, I felt that my application was going to be received very well. In turn, I expected a number of interviews to come my way.
Contrary to this expectation, I was faced with a harsh reality; I received very few PGY1 interview offers. On top of applying only to out-of-state programs where I had not completed APPE rotations, the 2015 PGY1 application pool was very strong; my application did not stand out enough. Although I eventually matched with my #1 ranked program, the fear and anxiety that accompanied the whole experience was quite jarring. Needless to say, when I continued on to apply for PGY2 programs in Infectious Diseases and HIV, my anxiety lingered; would this whole whirlwind repeat itself?
I feel it necessary to point out what I learned to those of you considering continuing on to a PGY2. Just because you received very few or very many interviews for a PGY1 does not mean the same will occur when applying for your next year of training. It is about what you do during your PGY1 year that defines you and helps separate you from others.
Commit yourself to this goal. Do everything you can to show your passion and dedication. Take on challenges within your residency that scare you. You will surprise yourself at how much you can accomplish. Seek out mentors in your program, and emulate their successes. I believe that it was a combination of tenacity plus receiving great mentorship that enabled me to achieve an interview offer from almost every PGY2 program that I applied for.
A vast amount of growth can occur during even just one year of residency, so do not allow your confidence to be shaken. One is not an embodiment of the number of interviews they receive.
Lastly, go to ASHP’s Midyear Clinical Meeting and pay the extra fees for participating in personal placement service PPS. Applying for PGY2 positions is a much more personal experience than that of a PGY1 in my opinion. I never attended PPS as a 4th year pharmacy student, so the experience was new to me this past year.
In most cases at PPS, I met directly with the residency director and current PGY2. This was an integral part of selecting where to apply, because I wanted strong mentorship from the director and the comfort of knowing the current PGY2 felt passionate about their position. In many cases there will only be one PGY2 per specialty. Knowing that you are the only PGY2 means that you will be spending far more time with your director than in your previous role as a PGY1. My opinion: the decision to do PPS was 100% worth it!
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