Abstract
Objective
To assess the prevalence of curricular programs or other structured activities designed to prepare students for and to promote residency training.
Methods
An electronic survey instrument containing 12 questions regarding institutional demographics and activities related to pharmacy student preparation for residency training was sent to administrators of all US colleges and schools of pharmacy.
Results
Ninety-one survey instruments were e-mailed to US colleges and schools of pharmacy administrators, and an overall response rate of 78% was attained. Twenty-two percent of respondents identified a structured curricular program to prepare students for postgraduate training. In addition, informal programs or informational sessions varying in scope and content were offered by many colleges and schools to prepare students for residency training.
Conclusion
Many of the US colleges and schools of pharmacy reported structured activities or programs that promote residency training to students. Ten programs had a designated clinical-track curriculum.
Keywords: students, curriculum, residency, survey
INTRODUCTION
The number of pharmacy students opting to enter postgraduate training programs has continued to increase over the past few years.1 According to the American Society of Health-System Pharmacists (ASHP), approximately 14% of students enter residencies after graduation. The number of residency programs also has grown steadily since ASHP began accrediting these programs in 1962, doubling since 1994. There are over 800 accredited residency programs in 49 states and Puerto Rico.
ASHP's goal for all graduates who pursue health-system pharmacy careers to complete a PGY1 residency is achievable only with continued growth of college-affiliated residencies and sustained growth in the United States Department of Veterans Affairs.2 Residency training is beneficial to the individual and to the profession of pharmacy for several reasons. In addition to preparing pharmacists to meet the needs of patient populations with a variety of disease states, residency training gives the individual a competitive advantage in the job market, provides networking opportunities, and facilitates a professional vision.1 Pharmacy organizations such as ASHP as well as the American College of Clinical Pharmacy (ACCP), the American Association of Colleges of Pharmacy (AACP), and the American Pharmaceutical Association (APhA) promote postgraduate training. In 2005, several organizations, including those listed above, discussed the future of pharmacy residency training, agreeing that accredited residencies were necessary for advancing the clinical maturity of pharmacy school graduates so that they may affect changes within health care.3,4 In 2006, ACCP proposed that residency training be required for all pharmacy school graduates as a prerequisite for direct patient care responsibilities.5 ACCP has been working with ASHP and other organizations to advance the principle that accredited residency training should be a requirement for clinical practitioners. Six recommendations are given in this position statement, defining the methods to achieve the goal of residency training as a prerequisite for direct patient care practice. In addition, AACP published a separate white paper on the subject, stating that colleges and schools should provide formal programming at repeated intervals throughout the PharmD curriculum to introduce students to academia and encourage them to pursue graduate pharmacy education programs targeted at preparing them to become faculty members after graduation.6 Fourteen recommendations are given for achieving these goals, including the promotion of residencies to qualified pharmacy students, and mentoring students and residents who show an interest in becoming faculty members. The purpose of this study was to identify the prevalence of activities intended to prepare and encourage students to pursue residency training.
METHODS
In October 2007, a 12-question survey instrument was e-mailed to associate and/or assistant deans from each of the US schools and colleges of pharmacy for online completion via Surveymonkey (Menlo Park, CA). The list was obtained from the American Association of Colleges of Pharmacy Web site (www.aacp.org). The survey instrument was developed and approved by a committee of faculty members involved in the clinical track program at our institution. In addition to demographic data, information regarding activities that promote or prepare students for residency training was solicited. Activities included, but were not limited to, panel discussions, small group discussions, free-standing lectures, lectures as part of a course and/or seminar, or interactive workshops. Information on number of clinical rotations available/required is included, as it is clear that many residency programs use this number as a marker for screening applicants. If a formal curriculum existed, a program description was requested. Follow-up e-mails and telephone calls were made over the course of 2 months to those who did not respond initially. Descriptive statistics were used for data analysis. This study was approved by the Institutional Review Board for Research with Human Subjects at the Medical University of South Carolina. The content of the survey instrument is in Appendix 1.
RESULTS
Ninety-one survey instruments were e-mailed to US colleges and schools of pharmacy. Of the 82 responses received, 11 were discarded due to incomplete data or duplicate entries, resulting in a response rate of 78%. Demographic data for the respondents can be found in Table 1. The majority of participants (n = 55) did not report a formalized curriculum designed to prepare students for postgraduate training; however, many of the colleges and schools offered informal programs or information sessions to prepare students for residency training. In addition, these institutions stated that they strive to prepare all students for advanced clinical training, as some individuals decide to complete a residency or other advanced training later in their careers. Table 4 provides the prevalence of the various types of activities employed by colleges and schools of pharmacy across the United States. These sessions vary in scope and content. Examples include a residency “club” or career pathways program, elective courses, one-on-one mentoring during advanced pharmacy practice experiences (APPEs), promotion by student professional organizations, financial support to attend the American Society of Health System Pharmacists (ASHP) midyear meeting, and a required residency program visit at the end of the second or third professional year.
Table 1.
Demographic Information and Results of Survey to Assess Preparation and Promotion of Residency Training (n = 71)
Table 4.
Prevalence of Activities that Promote Residency Training to Students (n=71)
Of the 71 college and school administrators who responded, 16 stated that they offered a structured, formal clinical program: Albany College of Pharmacy, Campbell University, Ferris State University, Florida A&M, Southern Illinois University Edwardsville, Touro University, University of Arkansas, University of Kansas, University of Kentucky, University of North Carolina, University of Southern California, University of Washington, Washington State University, Wayne State University, and the Medical University of South Carolina and University of South Carolina (now the combined South Carolina College of Pharmacy). Nine of the 16 provided information regarding their program (Table 2). Additional information and comparisons to all respondents is included in Table 3.
Table 2.
Description of Formalized Programs Reported by Survey of Pharmacy to Emphasize Clinical Training
Table 3.
Information Regarding Sixteen Formalized Clinical Programs in US/All Respondents to Survey of Colleges of Pharmacy to Assess Preparation and Promotion of Residency Training
a Note that colleges may have 4-, 6-, or 8-week rotations
DISCUSSION
No information existed in the literature at the time of this study regarding formal, organized pharmacy school curricular programs designed to prepare students for residency training. However, there was information on informal activities related to this goal.7-11 We found that many colleges and schools of pharmacy have structured activities or programs that promote residency training to students, but the majority do not have a designated curricular program.
A previous survey found that the most common methods of promoting residency and fellowship training were formal and informal instruction, referral to preceptors, and involvement of residents and fellows in clerkship teaching.7 This study also found that the majority of schools offered information in the last year of the program, and 63% of pharmacy school administrators were satisfied, very satisfied, or extremely satisfied with students' exposure to residencies and fellowships. Examples of informal activities noted in the literature included online tools,8 brochures and presentations at career days,9 mandatory 1-hour seminars,10 a combination of presentations, and reading materials.11
Despite an overall good response to the survey, we were able only to obtain program information from 9 colleges. Additional details would have made it easier to report and assess the most widely used and effective tools. The descriptive data reported here were affected by reporting bias and may not have reflected accurately the true prevalence of activities or curricula designed to prepare students for advanced clinical practice or promote postgraduate residency training. In addition, the definition of “clinical rotation” could have been clarified better in the survey instrument, based upon feedback from respondents. Although assessing the long-term value of these clinical experiences was not the intent of this study, future studies should evaluate the impact of these curricular changes on residency opportunities and career advancement postgraduation.
CONCLUSION
Many of the US colleges and schools of pharmacy surveyed offered structured activities or programs that promoted residency training to students, but the majority of them did not have a structured curricular program. The majority of institutions stated that they strive to provide all students with the skills necessary to be advanced generalist clinical practitioners. Concerted efforts should be made to promote residency training within colleges of pharmacy and continue to assess long-term outcomes of such programs.
Appendix 1. Survey of Colleges of Pharmacy in the United States to Assess Preparation and Promotion of Residency Training
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