US Pharm. 2008;33(10)(Student suppl):12-14.

The profession of pharmacy is evolving into a new and exciting area of health care now that pharmacists are being prepared to become emerging leaders of medication therapy management. Pharmacists' knowledge and skills are no longer unseen and unrecognized behind the counter at the local community drugstore. Pharmacists are now a considerable force at the forefront of disease-state management. The passage of the Medicare Prescription Drug, Improvement, and Modernization Act on December 8, 2003 ushered in a new era for pharmacist utilization.1 New opportunities have opened up, and pharmacists can finally receive reimbursement for medication therapy management services.2 In their curriculum, today's pharmacy students are prospectively trained about disease states and how to properly manage them. Additionally, pharmacy students are encouraged to complete residencies and become credentialed to gain a thorough understanding of disease-state management. A residency can provide unique opportunities for an individual to explore different aspects of pharmacy as a licensed practitioner. Whether one is a recent graduate or a practitioner with years of professional experience, residency training can successfully provide any pharmacist with the practical skills needed in this new era of health care management.

Many pharmacists in practice today are becoming increasingly interested in retrospectively completing a residency. With the gradual change in the profession, the additional training and experience afforded by a residency are an effective way to better prepare pharmacists for the changing market. Making a career change like this usually means investing both your time and your money. Getting the necessary information to formulate a plan can be difficult, but this goal is attainable. As with any investment, it is important to be informed before you make a life-altering decision. Before you make the change, it is wise to take certain necessary steps to ensure your success.



Planning a Career Change
Decide Whether a Change Is Needed: Before seriously considering a practice change, decide whether you actually need one. A lot of people change careers because they dislike their job, their boss, or their company.3 Identifying your dislikes is often the easiest part of the step; however, you will not know which direction your career should take unless you examine your likes as well. What excites and energizes you? What's your new passion? Ask yourself whether the job you seek requires a residency. Maybe the needed change can be certification in a specific disease state, which doesn't require giving up a year or two to complete a residency. If you are seeking a promotion or advancement, then completing a residency may be one of the qualifications. Keep in mind that most pharmacy graduates today have a Doctor of Pharmacy degree; a residency can set you apart from other PharmD graduates.

Assess Yourself: Evaluate your attitude, values, skills, personality, and interests.3 Do you believe that you have what it takes to complete a residency? Are you willing to sacrifice salary and time away from family? Will you be able to integrate and work with a whole new staff? Have you considered the possibility that additional training or education may be needed to gain the skills to be competitive in your new career goal? Start slowly with research, and evaluate yourself truthfully.

Explore Each Potential Career Possibility: For each new career option on your list, examine the job description, educational and other requirements, job outlook, advancement opportunities, and earning potential.3 Pharmacy is a broad profession with existing and emerging career opportunities. Take advantage of all potential networking possibilities by seeking out pharmacists working in your new career interest and contacting professional organizations and alumni associations.3 Build a relationship with a contact or mentor in your new career interest, and confer with him or her frequently.3

Set Your Goals: Once you decide on a new career choice to pursue, put a plan in place to eventually find a job in your chosen field. Set short-term and long-term goals and reevaluate your progress periodically.

Consult a Financial Planner: Map out a budget and get your family on board.4 Think about how you and your family can trim expenses for the next few years. Even though residents can make from one-fourth to one-half of a registered pharmacist's salary, difficult questions still must be addressed. Will you relocate, or will you choose to apply for residency in the area? Can the family cover all the bills and still maintain the lifestyle you are accustomed to? What sacrifices will your children, your spouse, or family as a whole have to make? Scaling down vacations, limiting eating out, and doing away with luxuries like lawn service can save money. Use your assets.4 Chances are, pharmacists who have been out of school for many years have something new that graduates do not have: home equity and perhaps a substantial amount of money in their savings and retirement accounts. An experienced financial advisor can help you map out a plan for maintaining financial security for the family while you pursue your career change.

Train for Your New Career: Changing your career may require a particular type of residency. Are you currently in retail pharmacy, but want to become a clinical pharmacist? A pharmacy-practice residency in a hospital setting with an emphasis on internal medicine would be appropriate. Community clinics would benefit from a pharmacist completing an ambulatory residency. If you know that you want to do a residency but are undecided about which type, then a general-practice residency would probably suit you best.

What a Residency Involves
A residency is an organized, directed postgraduate training program in a defined area of pharmacy practice.5 It provides the knowledge and experience pharmacy practitioners need to handle the challenges of today's complex health care environment while also teaching essential skills for meeting the practice demands of the future.5 Increasingly, many employment opportunities indicate a strong preference for individuals who have completed a residency accredited by the American Society of Health-System Pharmacists (ASHP).5 The type of residency to select depends on your career interest. Residency training can take place in such diverse settings as hospitals, community pharmacies, patients' residences (home infusion), long-term care facilities, ambulatory-care facilities, and other establishments.5 There are many reasons for doing a residency, but the best reasons involve learning how to apply the knowledge and skills you've learned in school and practice to real patients, situations, and settings. During a residency, you will have the chance to work with patients as part of an interdisciplinary team, sharpen your critical thinking skills, and learn the subtleties of leadership.5 You also will be exposed to different facets of practice and learn about the many and varied career paths available to pharmacists today.5 These experiences are unique to residencies and help set you apart from your peers as you progress in your career.5

The Application Process
All pharmacists interested in a postgraduate ASHP-accredited pharmacy residency should participate in the matching process.5 To participate in the ASHP Resident Matching Program (or, as it is familiarly known, "the Match"), you must be a graduate of a college of pharmacy that is accredited by the Accreditation Council for Pharmacy Education or a graduate of a foreign school of pharmacy.5 National Matching Services Inc. (NMS) maintains a Web site for the Match at www.natmatch.com/ashprmp.5 To register, an applicant agreement must be completed and the application fee paid to NMS.5 Registration for the Match does not constitute an application to any programs participating in the Match.5 Applications to residency programs are made independently of the Match.5 Each residency program has its own application deadline, which may be earlier than the January deadline for registering for the Match.5 Information about residency programs may be obtained from the ASHP Residency Directory, which can be found at www.ashp.org.5 You must apply directly for any residency program in which you are interested.5 All application requirements, including the interview, must be completed by the March deadline.

Conclusion
With the emergence of medication therapy management services, properly trained pharmacists will have more opportunities to provide services. Increasingly more pharmacy students and graduates are electing to complete residencies to gain the necessary experience. Pharmacists are a key component of the health care system, and they are continuing to develop pharmaceutical-care services. Investment in the proper training for disease-state management is increasingly becoming the standard for pharmacy practice. In essence, pharmacists are generating a supply of pharmaceutical-care services for a need it has identified in the health care system--a need that results primarily from negative outcomes associated with poor patient care and drug-therapy problems. Pharmacists need to prepare today for evolving changes in the health care system of tomorrow.

REFERENCES
1. Medication therapy management program (MTMP). Fed Regist. 2005;70:4541.
2. Altman JS. Medication therapy management and the new practitioner. Am J Health Syst Pharm. 2007;64:590-592.
3. American Society of Health-System Pharmacists. Why should I do a residency? www.ashp.org/s_ashp/docs/files/RTP_ASHPResidencyBrochure.pdf. Accessed November 30, 2007.
4. Cheney K. Shifting gears at mid-career. Money. 2007;12:39-43.
5. Hansen RS. The 10-step plan to career change. Quintessential Careers. www.quintcareers.com/career-change.html. Accessed November 15, 2007.

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