From Project to Publication: A Decade of Pharmacy Residency Research in the British Columbia Lower Mainland (2011/12–2020/21)

Abstract

Background

Research is a key component of pharmacy residencies, helping residents to develop research, communication, and time management skills. Publishing benefits residents professionally and shares findings with the clinical community, potentially improving patient care. Previous research found that pharmacy residency publication rates were 13% in the United States (1981–2018) and 32.2% in Canada, with a British Columbia–specific rate of 34.4% (1999/2000–2008/2009).

Objectives

To determine the publication rate of Lower Mainland Pharmacy Services (LMPS) pharmacy residency projects for the period 2011/12 to 2020/21 and to characterize the studies performed.

Methods

A scoping review was conducted. Posters from LMPS residents (2011/12–2020/21) were compiled, and data on project and team characteristics were extracted. A standardized search of multiple data sources was used to identify publications based on the poster projects. Publication date and journal information were collected.

Results

Of the 241 residency projects over the study period, 85 (35.3%) were published in 39 peer-reviewed journals across various topics; of these, 43 (50.6%) appeared in the Canadian Journal of Hospital Pharmacy. The average time to publication was 24 (standard deviation [SD] 13) months after graduation. The 241 projects had an average of 3.4 (SD 1.6) collaborators, and 107 (44.4%) involved multidisciplinary members. Most of the 241 projects were conducted at a single site (68.5%, n = 165), most were retrospective (73.9%, n = 178), and most were cohort studies (63.9%, n = 154). The direction of inquiry (i.e., prospective vs retrospective) significantly affected publication status (p = 0.012), whereas the number of collaborators, the project’s scope, and the study design did not affect publication.

Conclusions

Despite growth in the LMPS pharmacy residency program, publication rates for residents’ projects were similar to those previously reported, and most projects remain unpublished. Using qualitative and quantitative methods to survey residents and preceptors may identify barriers to publication and inform the development of targeted supports.

INTRODUCTION

Completion of a pharmacy residency program is a key milestone for pharmacists aiming to work as clinical pharmacists in institutional settings such as hospitals. In Canada, more than 30 pharmacy residency programs are accredited by the Canadian Pharmacy Residency Board (CPRB).¹ Lower Mainland Pharmacy Services (LMPS) hosts one of the largest year 1 residency programs in Canada, spanning 4 health authorities in British Columbia: Vancouver Coastal Health (VCH), Providence Health Care (PHC), Fraser Health (FH), and the Provincial Health Services Authority (PHSA).² Since 1970, hospitals now part of LMPS have trained more than 650 pharmacy residency graduates in the areas of adult and pediatric inpatient care through a 52-week program that provides clinical research experience and rotations across various medical fields, aimed at equipping residents with the expertise and skills needed to deliver high-quality patient care.²

Research is a crucial training component of many residency programs, including pharmacy. Currently, PharmD programs prioritize academics and direct patient care experiences, leaving graduates with limited opportunities to develop research skills.³ Residency programs address this gap by engaging their residents in project management, a core competency that aligns with the “Scholar” and “Professional” outcomes defined by the Association of Faculties of Pharmacy of Canada (AFPC).^4,5 Research enhances residents’ critical thinking, communication, and time management skills.⁶ Research projects can be shared through abstracts, poster presentations, and/or full-text manuscripts.⁷ Achieving publication can benefit residents by opening doors to collaboration, grants, awards, and career growth.⁸ The publication process itself can be challenging, as it often requires multiple revisions and resubmissions, testing residents’ resilience and self-confidence. By disseminating findings, particularly through open-access journals, residents contribute to the transparency of science, facilitate global accessibility, improve their international reputation, and shape future research directions, ultimately advancing patient care.^7,9 However, many residency projects remain unpublished due to constraints such as limited time, financial barriers, study design challenges, unfamiliarity with the publication process, or inconclusive findings.⁷

Previous research has suggested that pharmacy residency publication rates are low to moderate. Specifically, a systematic review and meta-analysis found an overall publication rate of 13% (95% confidence interval [CI] 9%–19%) among US pharmacy residency graduates from 1981 to 2018.⁷ A study of pharmacy residency publication rates across 6 Canadian provinces found an overall publication rate of 32.2% and a BC-specific rate of 34.4% between 1999/2000 and 2008/2009.¹⁰ When the current study was conceived, no data existed on pharmacy residency projects published after 2009 in Canada, a situation warranting investigation. The LMPS pharmacy residency program has a robust review and selection process for residency projects and maintains a repository of projects, but it does not track project publication rates or methods used to share study results. To address this gap, we investigated the publication rates and characteristics of LMPS pharmacy residency projects from one of the largest pharmacy residency programs in Canada between 2011/12 and 2020/21.

The primary objective was to determine the overall publication rate for research projects completed by year 1 and year 2 residents in the LMPS pharmacy residency program in British Columbia from 2011/12 to 2020/21. The secondary objectives were to describe the key characteristics of published and unpublished residency projects, to compare publication rates from 2011/12 to 2020/21 and between year 1 and year 2 projects, and to identify potential factors associated with publication status.

METHODS

Inclusion Criteria

The study included hospital pharmacy practice residency projects completed by year 1 and year 2 residents within the LMPS pharmacy residency program in British Columbia for academic years from 2011/12 to 2020/21.

Study Design

For this scoping review, posters from the LMPS pharmacy residency program in British Columbia from 2011/12 to 2020/21 were compiled by year. Resident names, residency level, year of residency completion, project title, collaborators’ names, number of collaborators, previous publication by the resident, previous publications by team members, multidisciplinary nature of the team (yes/no, based on presence of other authors from nonpharmacy field), direction of study (prospective, retrospective, not applicable), study design (e.g., cohort, cross-sectional, case–control, survey, interviews, quality assurance, quality improvement, systematic review, other), health authority (i.e., VCH, PHC, FH, PHSA), and number of sites where research was conducted (single-site, multiple sites, provincial, national, not applicable) were extracted from the poster. For missing data, the resident’s supervisor was contacted by email.

“Publication” was defined as the appearance in a published journal or similar vehicle of a full-text manuscript, abstract, or letter to the editor. Oral presentations and poster presentations were not counted as “publications” for the purposes of this study. To determine the publication status of each project, a standardized search was applied across multiple databases and other resources in the following order: Google Scholar, MEDLINE, Embase, and the Canadian Journal of Hospital Pharmacy (CJHP). The searches used a combination of each resident’s last name, first name, and/or initials, title of the project, and project keywords, with the publication date range limited to the period from 2012 to the present. Searches were conducted between May 19 and June 1, 2025. If no publication was identified under the resident’s name, the subsequent author’s name was searched to account for potential name changes, such as maiden, married, alias, and legal names. Previous publications by the resident were searched in the same order. To determine previous publications of a team member, we started with the principal investigator’s name (where the last-named author was assumed to be the principal investigator), followed by the other team members in order of authorship.

For published projects, additional data included publication date (month and year), journal(s) or website(s) where the study was published, study design, publication type (e.g., abstract, full-text manuscript), and time to publication. The time to publication was calculated in months, using the end of the residency program as the starting point and the publication month as the end point.

Data Analysis

Excel spreadsheet software, version 16.88 (Microsoft Corporation), and GraphPad software, version 10.6 (GraphPad Software), were used for analysis. The publication rate and study characteristics were reported using descriptive statistics. Continuous variables (e.g., time to publication) were summarized as means with standard deviations (SDs) or medians with interquartile ranges (IQRs). The categorical variables (e.g., study design, health authority, publication status) were reported as counts and proportions. Temporal trends in publication rates across residency project completion years (2011/12–2020/21) were assessed using a one-way analysis of variance. The Mann–Whitney test was used to determine differences between 2 groups (e.g., difference in time to publication between year 1 and year 2 residency projects). To assess differences between published and unpublished projects, a χ² (Fisher exact) test was used. Logistic regression was used to examine the relationship between independent variables (e.g., time to publication or number of collaborators) and the binary outcome of publication status (published vs not published).

Ethics Approval

Ethics approval was not required for this study because conference abstracts and published manuscripts are publicly accessible, and past resident names are publicly available on the Canadian Society of Healthcare-Systems Pharmacy (CSHP) and LMPS websites (https://cshp-scph.ca/lower-mainland-pharmacy-services and http://www.lmpsresidency.com).

Data Availability

The data supporting the findings of this study are available from the corresponding author upon reasonable request.

RESULTS

LMPS Publication Rates

Between 2011/12 and 2020/21, a total of 241 residents graduated from the LMPS program, 236 from the year 1 program and 5 from the year 2 program (Figure 1A). The overall publication rate for all projects was 35.3% (n = 85) (Table 1). By year, the highest publication rate was 50% (11/22 projects) for 2012/13, and the lowest was 28% (5/18 projects) for 2015/16 (Figure 1B). The overall publication rate was 35.2% (n = 83) for year 1 residents and 40% (n = 2) for year 2 residents (Figure 1C; Table 1).

FIGURE 1.

A: Number of year 1 and year 2 residents in each year of the study period. B: Publication rates, as percentage of projects, from 2011/12 to 2020/21. C: Publications by number and residency year (year 1 or year 2), from 2011/12 to 2020/21. D: Time lag to publication, in months, from 2011/12 to 2020/21. *p = 0.004 for comparison of time to publication between 2012/13 and 2018/19. There was no significant difference in time to publication between year 1 and year 2 residents (p = 0.13).

TABLE 1.

Team and Project Characteristics

Characteristic	Study Group; No. (%) of Projectsa
	Year 1 Residency (n = 236)	Year 2 Residency (n = 5)	Overall (n = 241)
Projects published	83 (35.2)	2 (40)	85 (35.3)
Team characteristics
No. of collaborator(s) (mean ± SD)	3.4 ± 1.6	3 ± 1	3.4 ± 1.6
Multidisciplinary team	106 (44.9)	1 (20)	107 (44.4)
Team member(s) with prior publication	234 (99.2)	5 (100)	239 (99.2)
Residents with publication before residency	9 (3.8)	1 (20)	10 (4.1)
Scope of project
National	0 (0)	2 (40)	2 (0.8)
Provincial	4 (1.7)	1 (20)	5 (2.1)
Multiple sitesb	36 (15.3)	0 (0)	36 (14.9)
Single site	163 (69.1)	2 (40)	165 (68.5)
Not applicablec	33 (14.0)	0 (0)	33 (13.7)
Direction of inquiry
Prospective	26 (11.0)	3 (60)	29 (12.0)
Retrospective	176 (74.6)	2 (40)	178 (73.9)
Not applicabled	34 (14.4)	0 (0)	34 (14.1)
Study design
Cohort	152 (64.4)	2 (40)	154 (63.9)
Case–control	13 (5.5)	0 (0)	13 (5.4)
Cross-sectional	8 (3.4)	0 (0)	8 (3.3)
Survey	16 (6.8)	3 (60)	19 (7.9)
Mixed	4 (1.7)	0 (0)	4 (1.7)
Quality assurance or improvement	14 (5.9)	0 (0)	14 (5.8)
Systematic review	18 (7.6)	0 (0)	18 (7.5)
Othere	11 (4.7)	0 (0)	11 (4.6)

SD = standard deviation.

^aExcept where indicated otherwise.

^bMultiple sites within one geographic region, not province-wide.

^cFor scope of project, “not applicable” included but was not limited to systematic reviews and meta-analyses.

^dFor direction of inquiry, “not applicable” represents systematic reviews, meta-analyses, quality improvement studies, and quality assurance studies.

^eFor study design, “other” included but was not limited to narrative review and interview studies.

Team Characteristics

All projects had at least 1 collaborator, with a range from 1 to 11 collaborators. Approximately half of the projects had multidisciplinary, nonpharmacist team members, such as nurses, physicians, and academic collaborators (e.g., collaborators with Doctor of Philosophy [PhD] degree) (Table 1). Most projects had one or more team members with a previous publication, whereas most of the residents did not have any publications before their residency (Table 1).

Project Characteristics

The majority of projects were conducted at a single site (Table 1), and most projects were retrospective in nature. The most common design was a cohort study, followed by systematic reviews and survey studies. Other study types were less common (Table 1).

In the comparison of year 1 and year 2 projects, the latter less frequently involved multidisciplinary teams (20% [n = 1] of year 2 projects vs 44.9% [n = 106] of year 1 projects) but were more likely to be broader in scope, with 60% (n = 3) of the year 2 projects having a national or provincial scope, whereas 1.7% (n = 4) of the year 1 projects had a provincial scope (Table 1).

Publication Characteristics

Of the 85 publications, 95.3% (n = 81) were full-text manuscripts, 2.4% (n = 2) were research letters, and 2.4% (n = 2) were abstracts. Research was published across 39 peer-reviewed journals representing a diversity of topics, including pharmacy, pediatrics, emergency and critical care medicine, and nephrology (Table 2). Slightly more than half of all publications were published in CJHP (50.6% [n = 43]).

TABLE 2.

Topics of Journals Where Residency Projects Were Published

Topic of Journal	No. (%) of Publications (n = 85)
Anesthesia	1 (1.2)
Cardiology	2 (2.3)
Emergency and critical care medicine	6 (7.1)
Geriatrics	1 (1.2)
Infectious disease	3 (3.5)
Pediatrics	8 (9.4)
Pharmacya	54 (63.5)
Psychiatry	3 (3.5)
Nephrology	4 (4.7)
Otherb	3 (3.5)

^aPharmacy journals covered topics such as education, pharmacotherapy, technology, and systems.

^b“Other” included but was not limited to systematic review journals, PLoS One, and general clinical practice journals.

Time to Publication

The average time to publication was 24 (SD 13) months after graduation. The time to publication ranged from −1.1 months (for a resident who published their research before graduation) to 71 months. Publication of projects from the 2018/19 residency year took significantly longer than 2012/13 projects (p = 0.004) (Figure 1D). There was no significant difference between the year 1 and year 2 cohorts in terms of time to publication (p = 0.13). Furthermore, the number of collaborators did not affect time to publication (r = 0.014).

Published versus Unpublished Research Projects

The direction of inquiry made a significant difference in terms of publication outcome, whereby prospective studies were more likely to be published (p = 0.012). The number of collaborators, the presence or absence of multidisciplinary team members, prior publication by the resident or any team members, and the scope and design of the study had no significant effect on publication outcomes (Table 3).

TABLE 3.

Characteristics of Residents’ Research Projects by Publication Status

Aspect of Project	Publication Status; No. (%) of Projectsa
	Published (n = 85)	Not Published (n = 156)
Team characteristics
No. of collaborators (mean ± SD)	3.4 ± 1.6	3.4 ± 1.6
Multidisciplinary team	32 (37.6)	75 (48.1)
Team member(s) with prior publication	85 (100.0)	154 (98.7)
Residents with publication before residency	6 (7.1)	4 (2.6)
Scope of project
National	2 (2.4)	0 (0)
Provincial	4 (4.7)	1 (0.6)
Multiple sitesb	11 (12.9)	25 (16.0)
Single site	55 (64.7)	110 (70.5)
Not applicablec	13 (15.3)	20 (12.8)
Direction of inquiry
Prospective	18 (21.2)	11 (7.1)
Retrospective	58 (68.2)	120 (76.9)
Not applicabled	9 (10.6)	25 (16.0)
Study design
Cohort	51 (60.0)	103 (66.0)
Case–control	7 (8.2)	6 (3.8)
Cross-sectional	1 (1.2)	7 (4.5)
Survey	12 (14.1)	7 (4.5)
Mixed	1 (1.2)	3 (1.9)
Quality assurance or quality improvement	5 (5.9)	9 (5.8)
Systematic review	6 (7.1)	12 (7.7)
Othere	2 (2.4)	9 (5.8)

SD = standard deviation.

^aExcept where indicated otherwise.

^bMultiple sites within one geographic region, not province-wide.

^cFor scope of project, “not applicable” included but was not limited to systematic reviews and meta-analyses.

^dFor direction of inquiry, “not applicable” represents systematic reviews, meta-analysis, quality improvement studies, and quality assurance studies.

^eFor study design, “other” included but was not limited to narrative review and interview studies.

DISCUSSION

Research projects conducted during pharmacy residency are crucial for skill and professional development both to shape future clinicians and to address the AFPC’s core competencies, such as “Scholar”, “Collaborator,” and “Communicator.”^4,5 Publication helps share a study’s findings with other health care professionals, guides clinical decision-making, and may lead to future opportunities for the author, such as scholarships and grants; however, pharmacy residency publication rates remain low to moderate.

In a study of pharmacy residency publication rates across 6 Canadian provinces for the period 1999/2000 to 2008/2009, Hung and Duffett¹⁰ found an overall publication rate of 32.2% (167 of 518 projects) and a BC-specific rate of 34.4% (44 of 128 projects), which is comparable to the LMPS publication rate of 35.3% (85 of 241 projects) for the period 2011/12 to 2020/21 reported in this study. Publication rates for US pharmacy residency programs have ranged from 1.8% to 16%.¹¹ The LMPS pharmacy residency publication rate was similar to previously reported medical residency publication rates: 28% for BC medical residency projects¹² and 30.8% for a US obstetrics and gynecology residency program.¹³

Direction of inquiry was the only factor associated with publication in this study; specifically, prospective designs were associated with studies being published, a finding also supported by Athiel and others.¹³ Observational studies were identified by McKelvey and others¹⁴ as the most likely to be published. Because of time limitations, observational study designs are more likely to be selected for residency research. In previous studies, other factors associated with publication of residency projects were younger age, male sex, completion of a PhD, previous experience with a research project, a planned career in academic medicine, and presentation at a conference.^13,15–17 In our study, publication of a residency project was not significantly associated with prior publication by the resident, and we were not able to examine other potential factors, given the design of this study.

Canadian pharmacy residency projects between 1999/2000 and 2008/2009 were published across 9 journals representing a limited scope of topics (pharmacy, pharmacology, and oncology), with the majority (62%) appearing in CJHP.¹⁰ By comparison, we found that LMPS projects conducted between 2011/12 and 2020/21 were published across 39 journals covering various topics, with 50.6% appearing in CJHP. The increase in journal topics reflects the expanding scope of practice for pharmacists and the importance of pharmacotherapy across multiple fields. For both studies, most publications were full-text articles. We did not observe any significant changes in publication rate due to the COVID-19 pandemic.

Nearly half (44.4%) of the LMPS projects in our analysis were conducted by multidisciplinary teams; similarly, Hung and Duffett¹⁰ noted that multidisciplinary teams were common. However, the number of collaborators differed between the 2 studies: Hung and Duffett observed about 30% of studies in each of their categories (i.e., 0, 1–3, and >4 collaborators), whereas we observed 0%, 61.8% (n = 149), and 38.2% (n = 92) in these categories, respectively. A US pharmacy residency study found that projects involving multidisciplinary coauthors and mentors with prior publication experience had higher rates of publication.⁷ Although we found that multidisciplinary teams and prior team member publications did not affect publication status or time to publication, we acknowledge that collaboration is crucial in clinical settings, including research.

In the current study, the mean time to publication was 24 (SD 13) months after graduation. This is comparable to results reported by McKelvey and others,¹⁴ who found that the mean time to publication for southeastern (US) pharmacy residents was 22.8 months. This approximately 2-year time to publication is not unique to research projects conducted by pharmacy residents: a US obstetrics and gynecology medical residency program reported a median time of 27 (IQR 18–37) months.¹³ The length of the publication process itself can be challenging, as it often requires multiple revisions and resubmissions, testing the investigators’ resilience, commitment, and time after the requirements of the residency program have been met and the program has been completed.¹⁸

Although we aimed to compare year 1 and year 2 projects, the size of the year 2 cohort was too small to allow statistical analysis. LMPS has had year 2 pharmacy residency programs only since 2018/19, with only 2 programs available during our study period (internal medicine and pediatrics). As the program grows, analysis of data for year 2 residencies could represent a future direction of this research. Initial findings suggest that year 2 projects may have a broader scope, with 3 of the 5 projects being either provincial or national.

Barriers to publication for trainee research have been well documented and vary by program.^11,15,16 Lack of time, lack of continuity after residency, burnout, lack of motivation, and/or lack of interest on the part of both residents and supervisors are commonly cited.^11,15,16 Residency program directors and supervisors have reported difficulty in obtaining research ethics approval, poor study quality, and lack of resident motivation,^11,15,16 whereas residents have reported lack of mentorship, difficulties with analysis, and program structural issues as barriers.¹¹ A majority of residency program directors reported that their programs offered a favourable environment for completing research, including formal training, assigned supervisors, and dedicated research time.¹¹ It has been recommended that institutions re-evaluate their specific needs, program goals, and residents’ interests to improve the process for residents’ research projects.⁷ Additional potential barriers or facilitators, such as access to experts in health research methodology or statistics, have yet to be explored. Furthermore, publication in a peer-reviewed academic journal is a singular modality of knowledge translation; other modalities (e.g., patient education resources, department presentations, hospital formulary changes, hospital protocol changes) were not captured in this study.

In a letter to the editor commenting on the study by Hung and Duffett,¹⁰ Yoshida¹⁵ (a physician, project supervisor for medical residents, and coinvestigator for pharmacy resident research) stated that “a change in academic culture and attitude [in residency programs]” is needed and that “the benefits of publishing should be emphasized: benefits to the individual (personal and professional satisfaction, enhanced professional profile), the department (enhanced academic stature), and the profession (improvements in clinical knowledge that may translate into better clinical practice).” Yoshida also suggested that the end point of presenting at a residency research day or national conference needs to be amended to the real (hard) end point of submission to a peer-reviewed journal. In this regard, the 2025 CPRB standards¹ require that pharmacy residents prepare a written report in a format suitable for publication in a peer-reviewed journal, but submission to a journal is not required.

CONCLUSION

Although the size of residency programs in LMPS has increased since a previous study covering the first decade of the century, rates of publication for residency projects have remained consistent. Conducting a mixed-methods qualitative study with LMPS residents and preceptors would be valuable for identifying barriers to publishing residency research and developing tools to address these challenges, specific to this program.