Significant factors that influence pharmacy students' decisions to pursue residencies.

To the Editor. Pharmacy practice residencies are essential in connecting pharmacy education to practice. There are numerous benefits to completing a residency program as suggested by various national pharmacy organizations such as American Society of Health-System Pharmacists (ASHP) and American College of Clinical Pharmacy (ACCP)1-3 as well as pharmacy educators. Currently, residency training is not mandated as a requirement for entering the pharmacy profession. However, an increasing number of employers across different practice settings have begun to require at least 1 year of residency experience prior to entering the workforce, particularly in settings that involve direct patient care. With this in mind, we believe that it is the role of colleges and schools of pharmacy to adequately inform their students of the benefits and importance of completing a residency to ensure that they make the best decisions regarding their future training and career plans. Schools must first identify which factors are most influential to their students in making decisions about postgraduate residency training, and then based on this information, develop targeted programs to promote the importance of postgraduate training to their students. In light of this, our school asked all first-, second-, and third-year (P1, P2, and P3) students at the Baltimore (main) and Shady Grove (satellite) campuses of the University of Maryland whether they were considering residency training and if so, what factors were influencing their decision. Possible factors included: didactic electives, pharmacy practice experiences, faculty advising, peers, to be more competitive for jobs, to become a faculty member, and other reasons. Almost 90 % of P1-P3 students at both campuses completed the survey instrument, and about half of them indicated an interest in pursuing a residency. When considering a residency, the 3 most common influential factors were increased competitiveness for jobs, pharmacy practice experiences, and faculty advising. In addition, the importance that lecture-based elective courses, faculty advising, and peer influence had in their plans to complete a residency increased from the P1 to the P3 year. The results of this survey provided us with some interesting insights. First, it did not surprise us that the most influential reason for completing a residency program was to be more competitive for job opportunities, especially given current employment trends. Students are looking for opportunities to make themselves more competitive in the marketplace. Second, lecture-based electives gradually became more important to students as they advanced through the PharmD program. At our school, a wide variety of lecture-based elective courses are offered to students. As students take more lecture-based elective courses, they become more able to identify a particular professional area of interest that they want to develop into their future careers. Third, faculty advising appears to be another important factor. During their academic training, students build relationships with various faculty members and learn about their experiences with innovative and diverse areas of pharmacy practice through lecture-based courses, pharmacy practice experiences, extracurricular activities, student organizations, and school meetings. As students interact with faculty members, they tend to identify those faculty members whose professional interests match theirs. Given that most clinical faculty members are residency-trained prior to their academic appointments, students are encouraged by their example to pursue postgraduate training. Thus, faculty advising can help develop and foster students’ interest in pursuing a residency. Comparisons of responses of P1, P2, and P3 students at both campuses revealed that peer influence increased in importance as students progressed through the curriculum. During their academic experience, students continually expand their professional and social circles through school and personal networking activities; thus, they have more opportunities to exchange ideas with peers regarding future career directions, including pursuing a residency. Although there is some evidence that pharmacy students’ career selections may be casual decisions made later in the course of their training, 4 some students may not be adequately informed about a variety of career opportunities that residencies can offer and may miss important opportunities to obtain information about application procedures and timelines. It is imperative for colleges and schools of pharmacy to understand the factors that influence students’ pursuit of residency training and to provide programming early in the pharmacy curricula that allows students to explore residency program, such as lectures, seminars, and small group or panel discussions.5 Furthermore, school administrators, faculty members, and experiential preceptors should recognize the influence they have on student perceptions and decision making about residency training.