Evolution of a Pharmacist: The Residency Experience

To the Editor:

Two to 4 years of undergraduate education, then 4 years of learning the theory and practice of your craft. That’s what it takes to become a pharmacist. Rather, that’s what it takes to get your PharmD.

It took me 8 years to realize my goal of becoming a licensed pharmacist and more hard work after that to get a residency position. But why, after all of that work, didn’t I feel like a pharmacist when I started my residency? During that first year, I realized that becoming a pharmacist was an evolutionary process. It went from taking orders to writing orders, looking for mentors to becoming a mentor, listening to continuing education (CE) to giving CE. My first year out of pharmacy school was a process, and I knew where I was in that process by the way I introduced myself.

Hi, I’m from pharmacy. When I first started rounding with a medical team, this was how I introduced myself. It was true enough to allude to what my function for the team would be, yet vague enough to leave the question unanswered as to whether I was a student, intern, resident, or clinical pharmacist. Although I doubt I said it with enough confidence to make anyone think the latter was the case.

I made sure to contribute every day with what I was certain would be right and well received by my team. I started to gain their trust and began to trust in my own abilities to serve my function.

Hi, I’m the pharmacy resident. As I began to feel more comfortable, my introduction to medical teams evolved. By stating that I was a resident, I assured them that I was licensed, yet they knew that I was still learning. I naturally figured that if they knew I was still learning, they would be more accepting when I had to look something up. Fortunately, because I completed my residency at a teaching institution, the medical team was understanding and accustomed to having members at different levels of learning.

On my very first day of my first rotation, the wellaged attending asked my preceptor who I was. She responded, “This is our pharmacy resident.” He said nothing and appeared almost confused as if he had never heard of a pharmacy resident. My preceptor continued, “It’s an equivalent to a medical intern,” to which the attending nodded in realization and understanding.

An intern? I hadn’t thought about it until that moment, but a first-year resident was the equivalent to a medical intern. I recognized that there would be a lot of learning on my part before I would be seen differently. My second thought was, “Is she only saying that to decrease the level of expectation from the attending?” I was almost relieved.

Hello, I’m your pharmacist. I couldn’t tell you when I changed my opening line, but I did. My evolution was complete. I had worked-up enough patients, read enough guidelines, had enough topic discussions, completed enough journal clubs, presented enough CEs, and built enough relationships that along the way I became a pharmacist.

My confidence and sense of responsibility to my team and patients had grown. I had made myself invaluable to my medical teams in just the 4 short weeks I had with them on my rotations without my even realizing it.

The process from student to resident to pharmacist is a journey. You won’t feel it on day one or even month one, but it happens. In speaking with my fellow graduates, mentors, and teachers who have become my colleagues, it turns out to have been a common theme for all of them. That sense of not feeling any smarter or different after getting your license and going straight to practice turns out to be another step in the process of your working goals becoming a working reality. It took a few years to get the title of pharmacist, so what’s a little longer for the feeling of pharmacist?

Good luck on your journey. Cheers!