How to Increase Your Chances of Getting a Pharmacy Residency [Part II]

So, you’ve made the excellent decision to pursue a residency! Residency training is challenging but immensely rewarding and you will find yourself a better person at the end of it. Getting there, however, is no easy process. Whether you’re a P1 or a newly minted APPE student thinking about applications, being informed about how to maximize your application is essential to land your dream program. Below are 5 tips to help you increase your chances of getting a pharmacy residency.

(In an earlier post, we covered what the chances are of getting a pharmacy residency. If you haven’t read it yet, we recommend you do.)

1. Find a Mentor

The first thing you need to do after deciding to pursue residency is to find a mentor. Anyone can be a mentor, but ideally your mentor should have gone through the process and is someone you are personally and professionally comfortable with. 

It is crucial to your success that you have someone who is invested in your success, available to answer questions, and available when you need support. 

The residency application process can be grueling, and having a mentor is fundamental in helping to curate your application and keeping you sane during the process.

Next, let’s talk about the sorts of things pharmacy students do to make themselves good residency candidates. One of the reasons it is so important to begin the preparation process early is because a well-rounded candidate with a full extracurricular section is a generally good candidate. 

2. Expand Your Extracurricular Activities

During pharmacy school, seek out as many varied activities as you can balance. 

Join professional organizations you are passionate about and volunteer to be engaged and involved. Leadership positions often come naturally to the most engaged members and leadership is always a welcome sight on a residency application. And extracurriculars don’t need to be professional pharmacy organizations, but these organizations can serve as springboards for networking and additional professional opportunities

One word of caution is to balance the quality of your involvement with the quantity. 

A candidate who is a paying member of a dozen organizations who occasionally shows up to chapter meetings is less impressive than a candidate who is a dedicated member or leader in a single organization and can speak to this in his or her letter of intent (more on that later).

3. Research, Publications, and Presentations

Research and publications are admirable but not required for every residency applicant. If you foresee yourself in academia, teaching, or research and plan to say so on your letter of intent, however, make every effort to be involved in research during school. This is also true if you foresee applying to large, academic medical centers.

Faculty are often looking for engaged students to work on projects with, so ask a faculty mentor if they have any ideas for research you could participate in. Research does not need to be large-scale clinical investigation. Ask your mentor or a faculty member what sort of research is reasonable for a student to participate in if you need guidance!

Poster presentations at professional conferences are a great way to demonstrate dedication to completing a project, provide networking opportunities, and are generally less labor-intensive than a full publication while still carrying significant weight for application reviewers

4. Get Work Experience

Work experience is another key component of a residency application. The location of work experience is less important than having any work experience at all, although work experience in the setting that you are applying to (generally hospital intern experience for inpatient PGY1s) is preferred. 

An important consideration that is often missed is that many states have a minimum intern hour requirement to be licensed that may not be met by rotations alone. 

Minnesota, for instance, requires 1600 hours of internship, 800 of which must be in a dispensing capacity to be eligible for licensure. If a candidate has no work experience, he or she will not be eligible for licensure and thus his or her application would not be considered by any program in Minnesota. 

5. GPA Needs to be Good Enough

GPA is another factor many students worry about. Treat GPA like a minimum qualifier – it just has to be good enough. This is not a reason to slack off – an excellent GPA will only help your application – but do not think you cannot get a residency if you don’t have a 4.0.

It is uncommon for GPA to be the sole differentiator between two otherwise qualified candidates. A GPA that is very low, however, raises suspicion you may have trouble passing the NAPLEX. So what GPA do you need to be competitive for a pharmacy residency?

A high GPA, while impressive, is less important than having a well-rounded CV. A candidate with a 4.0 GPA but no extracurriculars is less impressive than a candidate with a 3.3 GPA but a variety of high-quality experiences and excellent letters of recommendation. 

While some programs do have minimum GPA cutoffs, most evaluate the whole candidate. Most programs with GPA cutoffs will list the cutoff on their website. The average GPA of pharmacy residents is usually around 3.5.

Putting Your Application Together

Once you have a mentor and you select the programs you want to apply to either through talking to them at Midyear or through online research (side note: Midyear is for you and is not a requirement to get a residency. That’s a topic for another time!), it’s time to put together a stand-out application. 

The key components of a residency application are:

• Your CV 
• Your letter of intent
• Your letters of recommendation (usually 3). 

These are all entered in the Pharmacy Online Residency Application System, also known as PhORCAS. This also has several forms to list employment history, extracurriculars, and the like. 

Having a successful residency application involves excellence in all sections, so let’s review the highlights of each to make sure you increase your chances of getting a pharmacy residency.

The CV

If you are early in your pharmacy school career, you may not have a CV yet. Now is a perfect time to fix that. A CV, or “curriculum vitae,” is a “living document” of all the accomplishments and experiences in your professional career. There are a litany of resources available to help develop your CV so I will not spend time explaining how to develop a CV here.

• The earlier your start developing your CV, the easier it will be to maintain it.
  • Set a reminder on your calendar to update it about once a month to once a quarter. This will prevent you from forgetting all the valuable things you have done! 
• Avoid online templates. They are a poor reflection of your willingness to develop your own document.
  • To avoid formatting nightmares, make your entire CV a table and hide the borders to get a consistent format.
• Get feedback from as many people as possible.
  • ASHP and ACCP both have phenomenal CV review services that you should take advantage of early – not just the review cycle right before applications are due!
    • You know your CV is good when the only feedback you get is stylistic. That means the only thing people can point out is their personal preferences. 
• When developing your PhORCAS-specific CV, avoid bulleted explanations of internships, APPEs, or other common positions.
  • The job description of a pharmacy intern is nearly universal – avoid wasting space and remove bullets from your CV unless they outline something unique.
    • Bad: “Prepared prescriptions for pharmacist to verify and counseled patients on new prescriptions and self-care inquiries”
    • Good: “Developed monthly blood pressure clinic at local pharmacy which services an average of 50 patients and assists in setting up physician follow-up”
• A stand-out CV highlights your accomplishments without frivolous detail in a logical manner. Many program directors skim CVs looking for specific things (job experience, for example) and having a confusing order, bad formatting, or tons of unneeded detail makes this more difficult for reviewers.
  • There is no “right” order, though – seek feedback and make it your own!

The Letter of Intent

Your letter of intent is where you can control the narrative on your goals and aspirations and how a residency will help you get there. Your letter of intent is also where you share with the program director exactly why you want their residency.

• For many programs, the letter of intent is a significant factor in deciding who does and does not get an interview – usually more so than your GPA!
• Letters of intent should be personal but professional, specific as to why you want that residency position, and should outline not only why you think a residency will help you achieve your goals, but how your skills and experience will help to contribute to the program and the institution. 
• Like your CV, seek feedback from a wide variety of mentors.
  • ACCP has a letter of intent reviewing system similar to their CV reviewing system. 
• Write unique letters for each program.
  • You can start with a general skeleton, but a good portion of the letter should be unique to each program
  • Explore what got you interested in the institution, the department, the program, or other unique things that intrigue you

It is not uncommon for a letter of intent to go through a dozen rounds of revisions before submitting to PhORCAS. It may never feel like it is done, but you should feel comfortable that is an accurate reflection of who you are as a residency candidate.

The Letters of Recommendation

Letters of recommendation are crucial for program directors to understand what kind of a resident you will be. Be intentional with who you pick for your letters because of this! 

• Program directors want to glean as much information about your clinical abilities, personability, work ethic, and projected success as a resident from your application. The letter of recommendation form provides a voice for letter writers to speak to these attributes. 
• The weight of the writer’s position or prestige pales in comparison to the quality of the content in the letter.
  • Avoid asking individuals who are only casually familiar with you or only know you from the classroom as they will not be able to speak to the depth of your characteristics as a close mentor or preceptor. 
  • Surveys of residency program directors have revealed letters written by clinical rotation preceptors are the most valuable, with letters by college deans or professors who only had you in lecture being the least valuable.4 
  • Do not ask friends or family unless you truly have no one else to ask
• When asking individuals to write you a letter of recommendation, ask early (as soon as possible, but absolutely no later than the last week of November before applications are due) and explicitly ask if they are willing to write you an excellent letter of recommendation.
  • A poor letter of recommendation will sink an otherwise excellent application, so do everything in your power to select individuals who will speak highly of you.
• If you are asking someone who has never filled out a PhORCAS recommendation template before (like a community pharmacy manager), ask them to speak with someone with experience with the form (like a faculty member). The form can be long and intimidating but can be submitted with little to no detail which is very disappointing for application readers. Short, undetailed letters with good intentions are challenging to interpret and usually end up hurting your application. 
• PhORCAS can be horrifically confusing – when sending letter writers requests to write letters, you can either send a single “request” to each writer or send a request for each program you are applying to.
  • Ask your letter writers which one they prefer. 
• You should provide your writers with a brief explanation as to why you specifically want each program you are applying to. Letter writers can then comment on those attributes specifically.

The PhORCAS Application Itself

PhORCAS will have you re-enter most of the same information that is present on your CV of letter of intent and may seem redundant. It is crucial, however, that you enter all the details it asks for.

The “extracurricular” section is the first section of a downloaded PhORCAS application after your demographic information (your CV and transcript are last). 

If this section is half-filled out or, even worse, not filled out at all, that will set the tone of the rest of the application for whomever is reading it.

Is this really worth it?

There is no doubt that the residency application and interview process is exhausting. Residency, however, is the best way to prepare yourself for a fulfilling career in pharmacy. The opportunities for mentorship, professional and personal growth, and learning are boundless and have contributed to significant growth in the definition of the profession of pharmacy. Residency graduates, both from PGY1 and PGY2 programs, are better prepared to provide high-quality patient care, lead effective organizations, and be role models for the profession.

But, two points bear repeating – 

• A residency is not for everyone
• Not getting a residency does not mean your career is over. 

Many pharmacy graduates aspire to be excellent community of hospital pharmacists as soon as possible after graduation and entering the workforce after graduation may be in their best interest. 

On the flip side, many pharmacy students who are driven to pursue residency will not match. In this scenario, it is important to understand two things – 

1. Residency program directors cannot interview or match with all the candidates they want to interview or match with. 
   • Getting an interview denial or not matching is devastating, but it is not a personal decision against you from the program director. 
   • Many programs receive hundreds of applications and only take a small group of candidates to interview for a handful of spots. Unfortunately, this means many qualified candidates are not selected because it is just not possible to interview all the candidates who deserve to be interviewed. 
   • This is also difficult for program directors – they cannot know whether the best resident was in the group who didn’t make the final cut. 
2. Residency is just one path to achieve a fulfilling career in pharmacy.
   • Many successful pharmacy leaders did not complete residency or went back to residency after several years in the workforce
   • Not matching simply puts you on a different path to the same destination – a successful career.

All things considered, the residency process can be boiled down to this – with a good application, you get an interview. With a good interview, you match. Focus on preparing early and with purpose, and all the details will fall into place and you’ll increase your chances of getting that pharmacy residency spot.

Author: Andrew Webb, PharmD, @AJWPharm, PGY1 Resident at Mayo Clinic, Rochester, MN, incoming PGY2 Critical Care Resident at Oregon Health Sciences University, Portland, OR

References

1. 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;26(5):722-733.
2. ASHP Match | Statistics of the Match. Available from National Matching Services
3. Zinurova E, DeHart R. Perceived Stress, Stressors, and Coping Mechanisms Among PGY1 Pharmacy Residents. Am J Pharm Educ. 2018;82(7):6574.
4. Jellinek-Cohen SP, Cohen V, Bucher KL, Likourezos A. Factors used by pharmacy residency programs to select residents. Am J Heal Pharm. 2012;69(13):1105-1108.