Residency Night October 6, 2009 Sponsored by: Midwest College of Clinical Pharmacy

Why Consider a Residency or Fellowship Patrick D. Fuller, BS, PharmD, BCPS Clinical Specialist Staff Development Residency Program Director, PGY1 Adjunct Assistant Professor, UNMC College of Pharmacy The Nebraska Medical Center Oct. 6, 2009

Sara J. White- 2006 Harvey A.K. Whitney Award Lecture Future of Pharmacy “Every pharmacist must be a leader in their practice or on their shift. Each must connect with their inner drive, their passion for what they do and for making things better.” Sara J. White- 2006 Harvey A.K. Whitney Award Lecture

Joint Commission of Pharmacy Practitioners Vision Statement “Pharmacists will be the health care professionals responsible for providing patient care that ensures optimal medication therapy outcomes.” Joint Commission of Pharmacy Practitioners 2004

ACCP Vision “…by 2020, pharmacy residency training should be a prerequisite for pharmacists engaged in direct patient care practice.” Murphy JE, Nappi JM, Bosso JA, et al. American College of Clinical Pharmacy’s vision of the future: postgraduate pharmacy residency training as a prerequisite for direct patient care practice. Pharmacotherapy 2006;25:722–33.

2015 ASHP (revised March 2008) Goal 4 Objective 4.7 Increase the extent to which pharmacy departments in health systems have a significant role in improving the safety of medication use. Objective 4.7 90% of new pharmacists entering hospital and health-system practice will have completed an ASHP-accredited residency.

Residency Trends 2009 saw a record number of residency applications PGY1: 2,508 applicants sought 1,873 available positions, with 1,651 individuals matching across the United States. PGY2: 296 applicants sought 292 positions with 209 individuals matching across the United States. 

Growth in PGY1 Residency Programs, Positions and Applicants 1998 2002 2007 2009 PGY1 Residency Programs (Accredited) 247 380 653 792 PGY1 Residency Positions 582 887 1612 1,873 PGY1 Residency Applicants (in Match) 737 802 1900 2,508 Data from ASHP Accreditation Services Division

Board Certification

Why Choose Residency or Fellowship Enhanced employment opportunities Development of leadership and practice experience Career planning Personal growth and professional vision Enhancement of patient care

Residency “…organized, directed, postgraduate training program in a defined area of practice…” Goal of a residency To provide residents experience in taking care of a wide variety of patient populations To provide residents with many experiences working with other health-care professionals

So what is different PGY1 vs PGY2? Postgraduate Year One (PGY1) First year of post graduate residency training Wide variety of disease states/patients Advances individual beyond PharmD Training a generalist Postgraduate Year Two (PGY 2) Second year of post graduate residency training Advances training beyond PGY1 Usually focused on a specialized area of practice

Residency Benefits Increase knowledge base Increase experience Increase personal growth and development Develop/enhance research skills Increase teamwork experiences Enhance communication skills

ASHP Accreditation ASHP administers the only process that grants accreditation status to practice sites conducting pharmacy residencies. Provide criteria that every program must meet in order to receive and maintain accreditation Programs vary in strengths, but each program is flexible and can be tailored to meet the needs of the individual resident

ASHP-Accredited recommended for following reasons Programs are surveyed periodically In-depth information about programs available through ASHP Residency Directory www.ashp.org Future employers will have confidence in hiring pharmacists who have completed an ASHP-Accredited program

Fellowship “…A highly individualized, postgraduate training program designed to prepare the participant to become an independent researcher…” Goals of a fellowship (2 years in length) To develop competency in the scientific research process Most programs emphasize on bench-top/clinical research

Fellowships Ambulatory Care Cardiology Critical Care Infectious Disease Pharmacoeconomics Pharmacokinetics Pediatrics

Fellowship ACCP Fellowship Review Committee Assess whether a program meets the ACCP guidelines for research fellowship training Overall process is not intended to standardize fellowships A highly individualized experience is the hallmark of an excellent training program http://www.accp.com/resandfel/?page=guidelines

Basic Residency Requirements Tammy L. Burns, PharmD, BCPS Clinical Coordinator Residency Coordinator Creighton University Medical Center

Pharmacy Practice Residency (PGY1) Required Outcomes Manage and improve medication-use process Provide evidence-based, patient-centered medication therapy management with interdisciplinary teams Exercise leadership and practice management skills

Pharmacy Practice Residency (PGY1) Required Outcomes Demonstrate project management skills Provide medication and practice-related education and training Utilize medical informatics

Pharmacy Practice Residency (PGY1) Elective Outcomes Conduct pharmacy practice research Exercise added leadership & practice management skills Demonstrate knowledge & skills particular to generalist practice in the home care or managed care environments

Pharmacy Practice Residency (PGY1) Elective Outcomes - continued Participate in the management of medical emergencies Provide drug information to HCP or the public Demonstrate additional competencies that contribute to working successfully in the health care environment.

Specialized Residencies (PGY2) Critical care Drug Information Geriatrics Infectious Diseases Internal Medicine Nuclear pharmacy Nutrition support Health system administration * Specialized residencies may not be accredited Ambulatory Care Oncology Managed care Pediatrics Pharmacotherapy Management Primary Care Psychiatric pharmacy Pharmacy informatics Medication Use Safety

What to do now? 25

Now what? Research potential residency programs Talk to others www.ashp.com www.accp.com Go to specific residency program websites Contact specific residency programs Talk to others Faculty and preceptors People in jobs of interest Current residents Current programs 26

Select a residency program that is right for you…. Specific area of interest (i.e. pediatrics, critical care, transplant, etc.) Specific area of country University vs. community Teaching commitment Small program vs. large program Quality of the program 27

ASHP Midyear Clinical Meeting Decide if you need to attend or not attend Register for the meeting if attending Student member $215 Student non-member $265 Las Vegas, MN Dec 6 - 10, 2009 Make contacts See the programs attending (ASHP website) Let them know you will be there Find out who will attend from their program Bring copies of CV 28

Residency Showcase Take advantage of it! Do your homework Monday and Tuesday of Midyear Most residency programs attend Do your homework Know the programs you are interested in and WHY Talk to the programs interested in Wear business attire! Come prepared with questions First impression---first interview 29

Personnel Placement Service (PPS) Formal one-on-one interviews Sunday-Wednesday Usually for specialty residencies, unaccredited programs, jobs Cost $60 through 10/21 After 10/21, $105 ($105 onsite) 30

Differences between the two Showcase More informal Features ASHP-accredited, ASHP-application submitted, and new and prospective residency programs Limited times (Monday 1-4, Tuesday 8-11 or 1-4) Access to all residency programs in showcase Included in meeting registration PPS Prearranged, one-on-one interview time More time to ask questions PPS features all types of residency programs, fellowship programs and employers recruiting for pharmacy positions Interviews Sunday through Wednesday 8 to 5 Separate fee 31

Application If Attended Midyear Start application process Follow-up with a thank-you to the programs interested in The more contact, the more they will remember you Start application process Each program has specific requirements CV, transcripts, letter of intent Read requirements closely Note deadlines!! 32

Letters of Recommendation Faculty/preceptors are busy – ask early! Be organized Packet for preceptor All applications and requirements Contact person, title and address Clear deadlines Self-addressed, stamped envelopes for non-faculty preceptors A copy of your CV Ask faculty/preceptors, co-workers Avoid friends, neighbors, family members 33

Preparation Timeline P1 and P2 year P3 year Work Get involved Choose variety of rotations Select clinical rotations Try to get at least one rotation in a teaching hospital 34

Preparation Timeline P4 year: Prepare CV Narrow down residency programs If going to Midyear, determine which programs to visit prior to meeting If not going to Midyear, begin making contacts with programs in fall Speak to faculty/preceptors/co-workers who have completed residencies 35

Preparation Timeline Fall – P4 year Make sure CV is updated Prepare cover letters Apply to match Travel plans for Midyear – if attending Request additional info from programs of interest 36

Preparation Timeline December January/February March ASHP Midyear Request letters of recommendation Submit applications Order transcripts January/February On-site interviews March Match 37

How a Program Chooses You: The Curriculum Vitae, Cover Letter, and Interview April Puhl, PharmD Assistant Professor of Pharmacy Practice Creighton University School of Pharmacy & Health Professions

Definitions Résumé Brief summary of career objectives, education, & work experience Keep to 1-2 pages Curriculum Vitae (CV) Comprehensive document that includes virtually all education, achievements, and experiences An organized outline of your professional life Length varies for each individual

Key Components of a CV Personal data Education Work experience Name, address, phone, email Education University, degree, actual or expected graduation date Work experience Job title, dates worked, employer Brief description of responsibilities, especially if unique Focus on healthcare jobs Certifications and Licenses Intern Licenses BLS, Immunizations course, etc. Clerkship rotations Include site, preceptor, and dates Include planned rotations

Components of a CV cont. Presentations/Publications/Posters Date and setting (in-service, conference, etc.) Audience (pharmacists, nurses, physicians, etc.) Professional memberships/Affiliations Include leadership positions Honors and Awards Scholarships, community recognition, etc. Professional & Community Service Health Fairs, Service trips, etc. References Be sure to ASK FIRST!

CV “Do’s” Proofread, proofread, proofread Professional format and layout Easy-to-read, professional font Be clear, concise, and consistent Be honest but do NOT be modest Promote yourself here as this is your ticket to an interview Place information in reverse chronological order Most recent first

CV “Don’ts” Informality Wasted space Wild colors/fonts/designs/images Inappropriate stationery (use white/ivory paper) Erroneous information Inclusion of personal information/photograph (age, ethnicity, gender, hobbies, etc.) Inclusion of anything you are NOT prepared to discuss

The Cover Letter Position you’re applying for & why you’re interested First paragraph Position you’re applying for & why you’re interested Second paragraph Skills, attributes, qualifications for the position Do NOT rehash your CV Third paragraph Brief summary and thanks for consideration End with a statement pertaining to looking forward to an interview…

Letters of Recommendation Good references lead to good residencies/fellowships Who to ask? Previous employers Academic professors who taught you skills you value Make sure they know you Ask for letters early in the game Provide due dates; its your responsibility to follow-up Decide how letters will be sent to the program Provide your CV & contact information for each program’s director Respect their other obligations

The Interview Research the organization, program, & interviewers Rehearse questions & responses Develop your questions pertaining to the residency/fellowship Dress professionally & wear comfortable shoes Be punctual (5-15 minutes early) Bring a copy of your CV & references list Relax, but don’t be casual http://www.careerpharm.com/careertools.aspx Send a Thank You letter after the interview

Description of the Match Carla Christensen, Pharm.D. Assistant Professor of Pharmacy Practice Creighton University School of Pharmacy and Health Professions

What is the Match? ASHP accredited and accreditation-pending postgraduate year 1 (PGY1) residency programs ASHP accredited postgraduate year 2 (PGY2) do participate in the match Results in binding commitment, can not withdraw without mutual written agreement

Important Link http://www.natmatch.com/ashprmp/

Match Rules All accredited programs are required to participate Applicants and programs may NOT communicate about ranking prior to release of match results “Early Commitment Process” Programs that offer both PGY1 AND PGY2 programs Elect to allow current PGY1 residents to commit to 1 of the program’s PGY2 residencies

Applications Application agreements ($112) January 8, 2010 Application confirmation Applicant Code Number Provide to programs Program applications (to each residency program) Interviews January 11, 2008 Recommended date by which applicants should return their Agreements to National Matching Services Inc. to register for the Match

Important Dates Rank Order Lists (ROLIC) March 5, 2010 March 17, 2010 Program Code Numbers Opens February 5, 2010 March 5, 2010 Match deadline March 17, 2010 Match results March 17 - April 16, 2010 Confirmation letters to matched applicants Sign and return letter MARCH 7, 2008 Final date for submission of applicant and program Rank Order Lists. No Rank Order Lists or Agreements can be accepted after this date. MARCH 19, 2008 Results of the Match are released to applicants and program directors. No action to fill positions remaining unfilled is to be taken prior to 12 noon Eastern Standard Time on this date. MARCH 19, 2008 - APRIL 18, 2008 Program directors must send letters of confirmation of the Match result to matched applicants, who must sign and return the letters of confirmation.

Resident Rank Order Submissions Match Process Resident Rank Order Submissions Alli Charles Madison Ayden Hosp B Hosp B Univ A Hosp B Best Rx Univ A Best Rx Univ A Best Rx

Site Rank Order Submissions Match Process Site Rank Order Submissions Univ A (2) Hosp B (1) Best Rx (1) Alli Alli Charles Charles Madison Madison Ayden Ayden

Resident Rank Order Submissions Match Process Resident Rank Order Submissions Alli Hosp B Best Rx Univ A Site Rank Order Submissions Univ A (2) Hosp B (1) Best Rx (1) Alli Alli Charles Charles Madison Madison Ayden Ayden

Resident Rank Order Submissions Match Process Resident Rank Order Submissions Alli Charles Hosp B Hosp B Charles matches w/ Univ A Univ A Best Rx Site Rank Order Submissions Univ A (2) Hosp B (1) Best Rx (1) Alli Alli Charles Charles Madison Ayden

Resident Rank Order Submissions Match Process Resident Rank Order Submissions Alli Charles Madison Hosp B Univ A Univ A Madison matches Best Rx w/ Univ A Site Rank Order Submissions Univ A (2) Hosp B (1) Best Rx (1) Alli Alli Charles Charles Madison Ayden

Resident Rank Order Submissions Match Process Resident Rank Order Submissions Alli Charles Madison Ayden Hosp B Univ A Univ A Hosp B Site Rank Order Submissions Univ A (2) Hosp B (1) Best Rx (1) Alli Alli Charles Charles Madison Madison Ayden Ayden Ayden & Best Rx go unmatched

Tips Be ahead of the timeline Applicants have the advantage in the matching process, not the programs No inquiries allowed on how applicants/programs are to be ranked Make your ranking with your highest preference 1st, then 2nd, then 3rd and so on… DO NOT RANK A PROGRAM THAT YOU DO NOT WANT!!! May match as a Couple Available for individuals desiring to positions in the same geographic location Done when submit Rank

What if you do not match?? It is NOT the end of the world Become a FREE AGENT Will be provided with a list of unmatched programs at 12 Noon on Match Day Act quickly!!! Programs may also contact you

Important Dates and Tips Carla Christensen, PharmD Creighton University SPAHP Alegent Health Bergan Mercy Medical Center

Checklist Never too early to start preparing!! Stay on task!! September Draft CV and cover letters

Checklist October Review directories of programs ASHP - www.ashp.org ACCP – www.accp.com Register for the ASHP Midyear Clinical Meeting Select programs to visit at the Residency Showcase Register for PPS PGY2 Make necessary travel and housing arrangements

Checklist November November 1, 2009 Listing of Participating Programs in the Match will be available for access by applicants Contact potential programs of interest Specialized residencies (PYG2) Use preliminary PPS listing to select residency programs for possible interviews Sign up with National Matching Services

Checklist November Request additional information and applications from programs of interest Finalize CV Request letters of recommendation Enclose any required forms Develop questions for MCM

Checklist December Attend ASHP MCM Complete all paperwork for applications Order transcripts Make note of application deadlines Schedule on-site interviews December 18, 2009 Final date for early commitment for PGY2s by current PGY1

Checklist January January 8, 2010 Recommended deadline for registration for the Match Submit application agreement form to the National Matching Service On-site interviews begin

Checklist February Complete interviews February 5, 2010 Narrow choices to programs that best meet your professional/personal needs and goals February 5, 2010 Instructions for submitting Rank Order Lists and obtaining Match results will be provided Remember to actually write Thank You notes Interview sites People writing letters of recommendation

Checklist March Submit Rank Order Form March 17, 2010 Final date is March 5, 2010 No Rank Order Lists or Agreements accepted after this date!! March 17, 2010 Receive “Match” outcome at 12 noon EST Unmatched residency candidates resubmit applications Starting at 12 noon EST

Checklist March 17, 2010 – April 16, 2010 July Program directors send letters of confirmation to matched applicants Must sign and return letters of confirmation July Most residencies begin

Application Process Best to be early!! Letters of recommendation Cover letter Will need to prepare and send letter of intent or cover letter with application Transcripts Reply to sites promptly Set up on-site interviews Send handwritten Thank You’s

Final Tip Stay positive!!! The Pharmacy Professional’s Guide to Resumes, CV’s, & Interviewing By Thomas P. Reinders ISBN: 978-1-58212-076-8 Purchase through APhA $43 ($39 for members) 800-878-0729

GOOD LUCK