Meetings Meetings Everywhere!

Today's blog post is about the wealth of pharmacy meetings which are scheduled between now and residency application deadlines (early January).  Each one offers slightly different professional development and/or residency applicant resources.  Lower student registration prices reflect the costs for members of the organization. Organized by date...

September 14th, 2013 Utah Society of Health-System Pharmacists ($40 for students)
University of Utah Campus (HSEB), Salt Lake City, Utah

• Opportunities to network with local residency preceptors and directors
• Residency "speed dating." Students rotate between stations to learn about PhORCAS, the Match, letters of reference, ASHP Midyear residency showcase, PPS, letters of intent

October 4th - 5th, 2013 Nevada Society of Health-System Pharmacists ($25 - $35)
John Ascuaga's Nugget, Reno, Nevada

• Opportunities to network with local residency preceptors and directors
• Professional development roundtables (details TBA)

October 12th - 16th, 2013 American College of Clinical Pharmacy ($165 - $230)
Albuquerque, New Mexico

• Opportunities to network with residency and fellowship preceptors and directors
• Residency-related programming:  Emerge from the crowd: how to become a standout residency candidate
• Clinical Pharmacy Career Path Roundtables where you can speak with practitioners about 15 different specialties in clinical pharmacy
• Opportunities to meet residency and fellowship preceptors and directors via the Residency and Fellowship Forum
• CV and portfolio development workshop
• Mock residency interviews

October 15th - 18th, 2013 Academy of Managed Care Pharmacists ($120 - $140)
San Antonio, Texas

• Opportunities to meet preceptors and directors via the showcase of managed care residencies and fellowships
• CV review clinic
• Programming on understanding the residency match

October 31st - November 3rd, 2013 California Society of Health-System Pharmacists Annual Seminar ($225 - $305)
Anaheim, California

• Opportunities to meet preceptors and directors via the residency showcase
• Student programming

December 8 - 12th, 2013 American Society of Health-System Pharmacists Midyear Meeting ($270 - $375)
Orlando, Florida

• Opportunities to network with residency preceptors and directors
• Residency-related programming (the Match, applications, PhORCAS, interviews, PPS, CVs)
• Opportunities to meet preceptors and directors via the residency showcase
• Opportunities for a mini-interview with some residency programs

Pharmacy Specialties? There may or may not be student or residency-specific programming, but why not go to network? 

• Society of Infectious Disease Pharmacists (September 9th, Denver, Colorado)
• Hematology/Oncology Pharmacy Association (September 27th, Chicago, Illinois)
• Pediatric Pharmacy Advocacy Group (April 2014)
• College of Psychiatric and Neurologic Pharmacists (April 2014)

Scramble blues?

We've learned in the last few weeks that nothing has gone completely according to plans in the scramble.  It made sense to us that programs would want to see information from scramblers populate in their PhORCAS "inbox" starting on March 25th.  What happened instead is that perhaps programs were waiting to hear from those still interested in an effort to save students the time and expense of loading a bunch of stuff into PhORCAS without prior contact with the program.  We feel this is unfortunate and it may have put some students who were trying not to be a nuisance at a disadvantage over the "squeaky wheels."  We did hear of a few cases of programs responding with "don't email us" or "don't call us" so this was definitely not always the case.  We also wondered why students didn't seem to be given the opportunity to make changes to their pre-match application without forking over another $25 per program.  Dr. Sebranek spoke with Janet Teeters at ASHP last week and made her aware of this issue.  This is something they were definitely interested in hearing about.  Ms. Teeters couldn't confirm whether the cause of programs disappearing from PhORCAS before April 1 was the filling of positions or programs already receiving plenty of inquiries/applications.  She mentioned that the moratorium on offers before April 1 may become mandatory in the future.

What to do now?

Option 1: Keep your eyes peeled for new positions coming open in PhORCAS.  Since there is no cost to the programs, it would seem they would want to put their openings in there.  In case inertia is the issue, keep your eyes peeled in other places as well such as the pharmacy association email distribution lists and web sites which display openings (especially ACCP).  Continue to let people in your area and in your speciality (ex. managed care) know you are still looking.

Option 2: Start planning for next year.  Look for job openings in areas which are related to your practice site of interest.  Think about casting a wide geographic net and don't forget about rural areas where demand might be higher.  One Roseman student started working per diem for a hospital shortly after graduation.  This position eventually turned into a full-time night-shift position. That position eventually turned into a 9 - 5 M-F shift in a hospital in another city.

Hang in there and continue to feel free to reach out to Dr. Sebranek or myself for assistance.

How to select programs in the scramble

I know it's been a long and arduous process, but if you are scrambling, get ready for the final sprint.  By now you have probably at least browsed through the unmatched position list, but where to start?  Here are some steps which might help you break this down a little. 

1. Look for places for which you have already applied.  They might not be THE hospital you sent your original application to, but consider the possibility that they might be willing to consider you more seriously since you have already been vetted by their "sister" hospital.  Another reason I put this first is that you might be able to swing a rotation at the other hospital which first attracted you to the system.  This couldn't hurt if they have a PGY-2 you are interested in for next year as well.
2. Ask a few mentors for ideas.  They might know someone at one of the sites.  Make sure they know what you are looking for so they don't try to send you to a critical care place when you really want more of an ambulatory care place.  This means you need to give people copies of the unmatched list so that they can browse and do a little research.  As I was poking around, I found a former student from Henderson who is now in a completely different part of the country at a site with an unmatched slot.
3. Since you have a much smaller list than when you did this the first time around, consider a process of elimination vs. a process of adding sites to your list.  If you don't want home infusion, for example, you can cross off all of the "Critical Care Systems" slots.  If you are considering this program, give me a call, I know the director pretty well.
4. If you are thinking about a PGY-2 in an inpatient specialty, consider the benefits of a good solid well-rounded PGY-1 experience at a community hospital.  If they offer the basics like cardiology, critical care, pediatrics, internal medicine, administration, and infectious disease, you will have a good foundation for future specialization.  Some of these places might be in more rural areas, which might mean less competition from students at other schools.
5. Don't be afraid of programs in candidate status.  Like the regular application process, you want to apply broadly to more well-known and lesser-known to improve your chances.  EVERY program started in candidate status at some point.  There could be something in there with great potential as long as you will get the experiences you are looking for.

More updates to come!  Hang in there scramblers.  I have a long list of former Roseman students who started out in the scramble and now are gainfully employed in top-notch positions.

Upcoming Dates -- Residency Match 2013

March 22, 2013 at 12:00 PM Eastern Time

• Match results are released to applicants and program directors.
• The PhORCAS application portal will be reopened so that unmatched applicants may begin updating their information (CVs, letters of intent, letters of recommendation, etc.).  Previous information will be accessible in the system for students who used PhORCAS pre-match.
• The list of programs with openings will be preloaded into PhORCAS.
• New applicants may participate in the scramble however they must register for the match and PhORCAS and pay associated fees. 
• New programs and new positions for existing programs can be added.

March 25, 2013 (update: 12:00 PM Eastern Time)

• Designation portal is again open to applicants in PhORCAS. No distinction will be made between "in progress" and "complete" applications. The fees of $25 per application will again apply.
• Programs may designate a new application deadline or they may keep the default deadline of May 31, 2013.   April 1, 2013
• Available applicant list is posted for programs.

April 1, 2013

• The Commission on Credentialing has asked for a moratorium on position offers to applicants until this date in an effort to give programs and applicants sufficient time to make good decisions without the fear of competition with the best applicants/programs. This is non-binding but Dr. Sebranek and I believe this recommendation will be followed by the residency programs.
• Programs will begin to remove remaining unmatched positions as they are filled

April 22, 2013

• Matched applicants must sign and return their letter of confirmation to their residency program.

May 31, 2013

• PhORCAS closes for the post-match process.

Rank Order Decisions

As a reminder, rank order lists are due to the National Matching Service (NMS) or "The Match" are due on Friday, March 8th and Match results will be released on Friday, March 22nd!

Deciding which program to rank can be even more agonizing than deciding where to apply.  Programs that looked good "on paper" may not be as impressive in person.  Alternatively, a program which wasn't initially the highest on your list of considerations may now have some big selling points after you have visited the site and met with staff .  You may be creating lists of "pros" and "cons" for each interview site and also weighing just how important each "pro" and "con" is to you.

Here are a few basic things to consider:
1. Let your rank order reflect your short-term and long-term goals but don't forget to consider what your training will be like in the interim.  After you finish your PGY1 residency, what do you want to do next?  If you perform well as a resident, you may have a PGY2 position or job offer at the site if positions are available.  You may be weighing objective factors such as opportunities at a site (training stucture and opportunities) against the intangible factors (organizational philosophy or how much you felt you "fit"at a site).  My recommendation is to ultimately go with the "gut instinct" because if you are self-motivated, you may be able to create some learning opportunities in your residency.  Just remember:

2. DO NOT base your ranking decisions on how much you think the site liked you. Remember, it is against ASHP residency matching rules for either the site or the candidate to overtly share rank order before the match.  Some places are better about playing "poker face" than others.  A few sites may more aggressively court candidates but the larger majority stay silent until Match Day.  Dr. Smith and I have many, many stories of candidates who didn't rank a site or prioritize them higher and then were very surprised / disappointed to learn later on how much the site wanted them.

3. Conversely, if you encountered some red flags during an interview, think about the context.  Were there extenuating circumstances on your interview day?  For instance, a local hospital had a Joint Commission survey during their major interview week so staff there were understandably pulled in many directions during that week.  Was the negative interaction with a specific person at the site or did you sense it was the overwhelming culture?  When I was interviewing for residencies, I was put off by the attitude of a current resident at the time.  I finally decided I liked the site as a whole and am so glad I matched at a site where the overwhelming majority of pharmacists were very positive and welcoming.  You do have to spent at least 40 hours a week at site so were these red flags a deal-breaker?  How much are you willing to risk not matching at any site if you decide not to rank an institution? 

Best of luck with a difficult decision!  Please keep Dr. Smith and I informed about your results so we can congratulate your success or strategize during the scramble.

What will you be asking during interviews?

Most candidates will go through the process leaving a favorable or neutral impression, but occasionally candidates come up with questions which are perceived very negatively by the residency program.  They are negative because they are judgemental or delve into privacy issues.  Other questions which leave a negative impression are those which leave the residency preceptors with an impression that the candidate doesn't want to work hard or that the candidate is "high maintenance."  Here are some examples of questions which are best left out of your interview.

1. What problem areas were identified during the last ASHP accreditation visit?  It's fine to ask about what the program is hoping to improve upon; it is not okay to try to identify "dings" from accrediting bodies.
2. Why was so-and-so ex-resident let go from this residency program? Personnel issues are private as all pharmacy residents are considered employees.  There is really not a good way to ask about this topic. 
3. Why did so-and-so ex-resident quit this residency program? See #2 above.
4. Why did this program have an unmatched position last year (or the year before, etc.)? Because the matching process starts with the candidate and not the program, there are many reasons the program may have an unmatched position which may have nothing to do with the program's quality.  Sometimes the highly competitive programs are all going after a common pool of candidates, for example. Use other questions to try to assess the quality of the program but keep in mind that you should also be thinking about "fit."
5. What time would I be allowed to leave for the day as a pharmacy resident? This question implies that there is something in this resident's life which is a greater priority than the residency.  Candidates indeed have practicality concerns when it comes to childcare and similar responsibilities, but consider instead asking the current residents about the hours of their "typical day."
6. How did I do on the interview? Even if you have done well, this will leave a negative impression because it makes it seem like you are needy for constant feedback.  Asking this question is not worth the risk because you can't change how you did and even if they think you are a good fit, another candidate may outrank you.
7. Where will you rank me or how many candidates will you be ranking? This relates to the question above.  The "how many candidates" question is a problem because there may be candidates who will not be ranked and answering the question may reveal which candidates fall into that category.
8. How many candidates were interviewed? The temptation to try to calculate where you will end up in the match is very high in this process. It is far more valuable to focus your efforts on asking detailed questions about the residency as that will help sell your committment to finding the best residency for you vs. revealing your anxiety about "getting something" in the end.