The Job Search: Timelines and Expectations

Angela G. Michael, PharmD BCOP
Director, PGY-2 Oncology Residency
Clinical Pharmacy Specialist, Hematology/Oncology
Henry Ford Health System
Detroit, MI

“Choose a job you love, and you will never have to work a day in your life.” These words never have more meaning than when you are selecting your first clinical specialist position following completion of pharmacy residency training. As I reflect on the transitions within my own career and serve as a mentor to a new class of residents searching for their dream job, I wish I had been better informed about the unique challenges involved in searching for and selecting a career.

When I speak to my residents about their ideal first job, I try to help them align their passions in pharmacy with the available positions. The number of specialty residents entering the workforce in oncology pharmacy has continued to increase, up to 152 in 2017,¹ and an increase in available positions has given postgraduate year 2 (PGY-2) residents a high rate of placement into their trained specialty.² However, despite an increase in available positions, the increased emphasis placed by national organizations on ambulatory, population health, and nontraditional opportunities for pharmacists,³ as well as shifts in payer models in healthcare institutions, contrasts directly with the experiences focused largely on acute care that many residents receive in their residency training. As these residents begin searching for positions as oncology clinical specialists, they may face difficulties that could have a negative impact on their job satisfaction. I discuss a few of these difficulties below.

Having Rigid Career Goals and Interests

The American Society of Health-System Pharmacists (ASHP) purpose statement for PGY-2 residents specifies that “residents who successfully complete an accredited PGY2 pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification, if available.”⁴ This is a very broad statement, and it is often difficult for oncology residency programs to offer a wide enough array of experiences to provide specialist-level knowledge in all critical areas listed in the standard. Given the exposure to oncology services that many students and PGY-1 residents receive, a majority of incoming PGY-2 residents often have a strong interest in acute care.

As a residency director, I have often found it challenging to introduce the multitude of other rapidly expanding areas of clinical practice within oncology (ambulatory care, administration, research, academic work, information technology, specialty pharmacy) in a meaningful way within the confines of a 1-year specialty residency. Residents searching for a first position among the available career opportunities may easily be overwhelmed; so they may gravitate toward the practice areas in which they have had the most extensive protected exposure. Early communication with the residency director and an attempt to gain exposure to all practice areas early in the residency year can give a resident valuable insight during the search for positions and can make the search more manageable.

One of the largest challenges facing residents entering the workforce is caused by their setting geographic limits for positions they will accept. A 2017 ASHP survey showed that approximately one third of residency graduates compromise on geographic location when selecting an available position; however, an additional third compromise by taking a position outside their specialty area.² It is critical for residents to determine early in the residency year if geographic location will be an important factor in their career search; if so, discussing it with resource people in the program will help them establish networking opportunities and improve the likelihood that they can obtain a position in the desired location.

Feeling Stress Caused by Unfamiliar Timelines

The selection process for PGY-1 and PGY-2 residencies is highly standardized, which can be challenging and unnerving for potential specialist candidates after their residency training. Given budgetary timelines and restrictions, the availability of positions during the time frame of a residency search may be limited and cause angst. Also, because many institutions that are seeking specialists have overlapping residency programs, they often conduct interviews after completion of the match to allow for a dedicated assessment of residency candidates. Residents should be prepared to extend their career search well into the second half of the residency year and use alternative search strategies when evaluating the available positions around the country.

Making Inadequate Use of Job-Source Information

In addition to the extended timelines that are often part of the search for a first clinical position, new graduates may find cumbersome the number of avenues for identifying job prospects. Although using traditional avenues like the ASHP’s personnel placement services may be a viable option, the aforementioned budgetary timelines mean that many institutions may not yet have secured funding for positions at this juncture and may not be present to recruit. Health systems may instead outsource the promotion of their available positions through career websites and recruiters. Residents should be diligent in exploring these options and vetting opportunities through mentors in their institution or directly through the prospective institution.

Within oncology, specialty meetings are an ideal forum used by employers to promote potential career opportunities to a targeted population of job seekers. HOPA offers a variety of ways for residents to connect directly with institutions and discuss career opportunities throughout the residency year. HOPA posts pharmacy jobs on its website and holds a recruitment fair at the annual conference. At the recruitment fair residents can meet several prospective employers and build meaningful relationships while discussing available career options in a variety of practice areas. Finally, residents should use the networking opportunities afforded by their own residency program to gain access to positions not yet posted to well-known career portals.

Rushing into Career Options That May Not Be the Best Fit

Because much of postgraduate training is based on concrete, short-term goals, residents may find it difficult to take the first step in a long-range career. Because they are unfamiliar with the intricacies of job selection and may be experiencing stress over timelines, they may inappropriately accept their first job offer out of fear that they will not obtain a clinical position. Residents should pursue career options in a variety of practice settings, if possible, and compare and contrast positions before making a selection. A strong desire to practice in a certain area may mean that other factors important in job satisfaction are given too little weight. Residents entering a job search should objectively assess these factors as well: organization size and practice philosophy, size of the specialist group, research and educational prospects, the ability to enact change within the department, specialist mentorship, and personality fit.

Before choosing their first clinical position, residents should consider their own understanding of the position and institution and other information provided by advisers from their pharmacy training. Your first postgraduate position does not dictate your future path as a pharmacist, but it should build the foundation for helping you reach your ultimate career goals.

Failing to Understand the Role of Negotiation

In many instances, residents think they do not have the ability to negotiate when they are selecting their first specialist position. Although many institutions may be firm on items like salary, in other areas residents can negotiate to improve their ultimate job satisfaction. Residents should ensure that they thoroughly understand the benefits of the position, in relation to both human resources and educational opportunities. Previously established factors in career satisfaction should, at a minimum, be discussed, if not reconciled, prior to acceptance of the terms of a position.

The transition from PGY-2 resident to a clinical or academic position is an exciting, yet challenging time in a pharmacist’s career. It is crucial that a resident be able to identify the key components of a first career option that will allow for a successful transition into long-term career opportunities. The hectic nature of residency training, especially in the PGY-2 year, can make it difficult for residents to reflect upon what they are seeking in a career, especially if they wish to pursue an area within their specialty practice that they have not been heavily exposed to. Candidates should take initiative early on to establish the trajectory of oncology pharmacy practice and consider how this trajectory may affect the number and type of available positions when the time for selecting a post arrives. Although unfamiliarity with recruiting processes and timelines may make the resident uncomfortable in this transitional period, using national organizations and institutional mentors can make possible a successful first step into the professional postgraduate arena. 

References

1. National Matching Services Inc. ASHP Match Statistics. https://www.natmatch.com/ashprmp/stats.html. Accessed December 5, 2017.
2. Bishop BM, Silvester JA, Martin CY, Bush CG. National survey of pharmacy residents nearing completion of the 2014-2015 residency year. Am J Health Syst Pharm. 2017;74(11):843-852.
3. Vermeulen LC, Kolesar J, Flynn AJ, et al. ASHP Foundation pharmacy forecast 2018: strategic planning advice for pharmacy departments in hospitals and health systems. Am J Health Syst Pharm. 2017(November). http://www.ajhp.org/content/early/2017/11/15/sp180001. [Epub ahead of print].
4. American Society for Health-System Pharmacists. ASHP Accreditation Standard for Postgraduate Year Two (PGY2) Pharmacy Residency Programs. https://www.ashp.org/-/media/assets/professional-development/residencies/docs/pgy2-residency-accreditation-standard-June2017.ashx?la=en. Accessed December 5, 2017.