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Key takeaways:

• Pharmacists can start practicing immediately after graduating from pharmacy school and taking the required exams — a path distinct from that of physicians.

• After obtaining a pharmacist degree, though, pharmacists can go to residency and receive board certifications.

• With additional training and specialization, these advanced practice pharmacists are usually successful in an interdisciplinary collaborative environment, in which they can assist other healthcare providers in multiple ways.

To practice pharmacy, pharmacists must obtain a pharmacy degree (a PharmD), pass the North American Pharmacist Licensure Examination (NAPLEX) exam, and then pass the Multistate Pharmacy Jurisprudence Examination (MPJE) for each state they plan to practice in. After that, some pharmacists begin to practice immediately, while others pursue additional training through a residency or board certification.

Below, we’ll talk about advanced pharmacy training and how an advanced practice pharmacist can help other healthcare providers (HCPs). 

Pharmacy residency: postgraduate Year One

After graduating from pharmacy school, some pharmacists pursue residency training. The first year of pharmacy residency training is called postgraduate Year One (PGY1), which many pharmacists say has multiple benefits. Among them are: 

• Having additional, intense training: Some pharmacists pursue a residency because they want another year of serious training under the guidance and supervision of a knowledgeable pharmacist.

• Having time to decide next steps: Pharmacists may choose the residency route to bolster their experience and take more time to decide on their career path, such as choosing to specialize by pursuing another year of residency training or applying for a pharmacist’s position.

• Honing a competitive edge: With a PGY1, these pharmacists will have a higher likelihood of obtaining in-hospital and clinical positions.

• Needing less time to qualify for a board certification: Without residency training, pharmacists will need a certain number of practicing years to be qualified for the board certification exams. PGY1 pharmacists, however, can take the exam right after their residency. 

• Achieving title perks: Pharmacists who complete a PGY1 typically fill roles as a clinical pharmacist.

Additional residency training with the postgraduate Year Two

After finishing a PGY1, some pharmacists end their training. Others, however, may pursue a second year of residency training, also known as the postgraduate Year Two (PGY2).

Pharmacists usually choose this path to further specialize and get a board certification. Some pharmacy PGY2 residencies and specialties include:

• Ambulatory care

• Cardiology

• Critical care

• Emergency medicine

• Infectious disease

• Oncology

• Pediatrics

• Psychiatric pharmacy

• Solid organ transplantation

Upon completing PGY2 training, these pharmacists can immediately take the board exam in their specialty. Nonresidency-trained pharmacists, on the other hand, will need more years of applicable experience to qualify.

Compared with other pharmacist positions, specialized pharmacist openings are rare. To practice in their specialty, many PGY2-trained pharmacists will likely need to move to a part of the country with such positions available.

Pharmacists who specialize in a specific area of pharmacy usually have a job title similar to that of a clinical pharmacist specialist.

Board certifications

After PGY1 and PGY2, many residency-trained pharmacists will sit for a board certification exam. However, pharmacists don’t need to have residency training to be eligible for board certifications. Residency just cuts down the amount of time needed to qualify for the exam. If a pharmacist has the necessary years of experience, then a residency is not required to become board-certified.

Pharmacists may seek board-certification credentials for the following reasons:

• To keep up to date: Pharmacy is always changing. Having a board certification encourages pharmacists to stay on top of guidelines, landmark trials, and evidence-based drug information to assist HCPs in delivering high-quality patient care. 

• To have a competitive edge: Hiring managers usually see board certifications as equivalent to residency training. Nonresidency-trained pharmacists may obtain board certifications to be considered for clinical positions.

• To fulfill a job requirement: Although pharmacists may have worked in a particular role for a period of time, having a board certification might become an on-the-job requirement. 

There are 14 board certifications. We’ve already mentioned nine of them — from ambulatory care to solid organ transplantation. Along with pharmacotherapy, the remaining four board certifications, which have a stronger focus on experience than residency, are:

• Compounded sterile preparation

• Geriatrics

• Nuclear

• Nutrition support

How an advanced practice pharmacist can help other providers

Having pharmacists’ involvement can help improve patient outcomes and achieve cost-saving goals. The following are a few examples of roles in which an advanced practice pharmacist can assist other HCPs:

• Ambulatory care pharmacist: An ambulatory care pharmacist usually works in the offices of primary care providers (PCPs), who can focus on new and complex cases while allowing pharmacists to assist with follow-up visits for an established diagnosis. During these follow-ups, pharmacists may help with managing a chronic condition by counseling patients, ordering disease-specific labs, and adjusting medication doses.

• Emergency medicine pharmacist: An emergency medicine pharmacist may help prevent errors by performing a thorough medication reconciliation before the patient is admitted to the hospital.

• Infectious disease pharmacist: An infectious disease pharmacist can help with antibiotic stewardship goals by regularly following up on patients taking antibiotics to ensure the appropriate drug, dose, and length of therapy based on the type of infection, the patient’s response to treatment, and the patient’s labs.

• Oncology pharmacist: An oncology pharmacist can help create oncology-specific policies, procedures, protocols, and references for other HCPs in order to prevent dosing errors of oncology products.

The bottom line

Although pharmacists can start practicing after graduating with passing scores on the NAPLEX and MPJEs, some pharmacists decide to pursue residency and become board-certified. Residencies and board certifications remain optional for pharmacists in contrast to physicians.

ABOUT THE AUTHOR:

Ross earned her doctorate in pharmacy (PharmD) at The University of Texas at Austin (UT Austin). Her years of experience practicing in various pharmacy settings also lead to multiple board certifications, including ambulatory care, geriatrics, and pharmacotherapy. She currently serves as the director of the PharmacyChecker international verification program.

Ross also founded Off Script Consults, a pharmacy consulting business. She strives to combine her passion for pharmacy, education, and writing to improve the quality of life and financial outcomes for people with chronic medical conditions, caregivers, and healthcare providers.

She particularly enjoys creating relatable and helpful content for her readers and viewers. For writing samples, please visit her Muck Rack portfolio. For videos, please visit her “Off Script Consults” YouTube channel.

Ross currently resides with her husband and two dogs in her home state of Texas to be closer to family. She also tries to find time for hobbies, which include rock climbing, running, and playing pickle ball.

Find out more about Ross via phone, e-mail, or social media (LinkedIn, TikTok, Instagram, Twitter, Facebook, and Pinterest).