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Amber R. Douglass, PharmD, BCPS, BCPP
Clinical Pharmacy Specialist – Mental Health
Tennessee Valley VA
Murfreesboro, TN

Caitlin Wise, PharmD
Psychiatric Pharmacist
Middle Tennessee Mental Health Institute
Nashville, TN

Residency training is on the rise and is typically necessary to become a psychiatric pharmacist. Not only does residency training provide you with a large knowledge base and a framework for how to work up patients, but it also provides you with experience working as a part of a healthcare team. The old adage that one year of residency training is worth three years of practice certainly holds true. Yet, if you get that much experience in one year, do you really need to complete both a PGY1 and a PGY2? Take a look below to find out more about the career paths of the authors and several CPNP members.

PGY1 Only Experiences

We both completed a PGY1 and chose to dive right into mental health positions without completing a PGY2 in psychiatry.

Amber: “My PGY1 was based at a College of Pharmacy and State Psychiatric Hospital, therefore it had a strong emphasis in psychiatry. During the ASHP Midyear meeting in 2010, I was looking into PGY2 programs and job opportunities. I was fortunate to receive an offer to stay on at the College as an Assistant Professor with a psychiatric practice site. After weighing the options, I decided to accept the offer and started immediately following completion of my PGY1. After working for the College for four and a half years, I accepted a position in the VA system, and have been a Clinical Pharmacy Specialist in Mental Health since 2016.”

Caitlin: “I completed my PGY1 residency with the Tennessee Department of Mental Health and Substance Abuse Services. While not officially a psychiatric-focused PGY1, I spent all of my clinical learning experiences at a state psychiatric facility. The job market post-residency was significantly more challenging than it was in past years. I was ineligible for many jobs I applied for because I did not have PGY2-training or board certification. However, I completed several large projects during my residency that resulted in me being able to stay on at the state psychiatric facility, something I was very thankful for.”

We both had a psychiatric-focused PGY1, but our experience is not typical of most PGY1 programs. This is an important factor to consider when deciding to pursue a PGY2 in psychiatric pharmacy. Besides evaluating the learning practice experiences available, it is also important to consider ease of seeking board certification and becoming an ASHP-recognized PGY2 preceptor.

How does post-graduate training impact becoming an ASHP-recognized PGY2 preceptor?

For those that have completed a PGY2 in psychiatry, one additional year of practice is required to supervise PGY2 residents. For those without residency training, or having only completed a PGY1, three or more years of practice in the advanced practice area is required.

How does post-graduate training impact becoming board certified in psychiatry?

  Graduation from an ACPE accredited pharmacy program A current, active license to practice pharmacy Practice Experience
No residency 4 years after licensure including 50% or more time spent in the domains described in the Psychiatric Pharmacy Content Outline
PGY1 2 years after PGY1 completion including 50% or more time spent in the domains described in the Psychiatric Pharmacy Content Outline
PGY2 in psychiatry No additional time required post PGY2

What do you gain from a PGY2 that you didn’t get in a PGY1?

We interviewed our colleagues to find out the answer.

Traci Dutton, PharmD, BCPP, BCPS: “My PGY1 prepared me well for the PGY2 in psychiatry, but without the PGY2 I do not think I’d be the clinical specialist that I am today. For PGY2’s there’s less of a “learning curve” for how to be a general clinical pharmacist, so it was a busy year of learning to be a true clinical specialist, focusing only on psychiatric pharmacy and psychiatric patients to apply my knowledge and skills from both residency years.” 

Samantha Vogel, PharmD, BCPP: “I actually chose my PGY1 based on the reputation of their PGY2 program in psychiatry. Looking back on my PGY1 experience, psychiatry was not a strong focus. I felt my PGY2 training bridged the gap between being the pharmacist interested in psychiatry to becoming an expert in psychiatry. My PGY2 also enabled me the opportunity to develop long-lasting relationships within my local psychiatry community, many of whom still serve as mentors to me today.”

Any regrets, challenges, or advice based on your experience?

Amber:” I do not have any regrets about the path I chose. However, there have been times when I felt that I wasn’t as prepared for certain patient scenarios that I possibly could have been with a PGY2. To be honest, these instances still come up for me from time to time and I think it comes with the evolution of your practice. CPNP has a welcoming community of resources and colleagues that are easily accessible for further guidance. While I didn’t do a PGY2, the time was different in 2010-11. It was relatively easy for me to secure a position in psychiatric pharmacy and I knew I could grow “on-the-job.” At this time, with an increased number of PGY2 programs available and more positions requiring a PGY2 (or equivalent experience + board certification preferred), I would be more inclined to seek out the additional year of PGY2 training.”

Caitlin:” I do not have any regrets about the path I chose, however the job search post PGY1 was very challenging. Until I knew that I had my current position secured I applied to more jobs than I can count and saw just how competitive the current pharmacy job market was, even for those that are residency trained. I do believe that it would have been easier to secure a position if I had completed a PGY2, however even in this tough job market, I was able to reach my goal of securing a position in psychiatry through networking, hard work during residency, and not being afraid to tackle big projects.”

Currently, the CPNP directory of residency programs lists around eight PGY1 programs that offer a significant number of psychiatry offerings. Thoroughly researching PGY1 programs in advance may help to identify those and additional programs. In 2019, there were 97 PGY2 positions in psychiatry available - triple the number available in 2011. In that same time frame, the number of BCPP certifications almost doubled from 647 to 1,158. Psychiatric pharmacy is a growing field and while the typical progression involves completing a PGY2, there are other avenues that one may choose to explore. Factoring in time to get your BCPP, requirements to become a preceptor, learning experiences, and the requirements to secure a job are all things to consider when making your postgraduate training decision. CPNP’s biennial PGY2 RPD survey is another valuable resource that might inform your decisions.

References

  1. Board of Pharmacy Specialties: Psychiatric Pharmacy. https://www.bpsweb.org/bps-specialties/psychiatric-pharmacy/. Accessed: 11/12/2019.
  2. ASHP Accreditation Standard For Postgraduate Year Two (PGY2) Pharmacy Residency Programs. https://www.ashp.org/-/media/assets/professional-development/residencies/docs/pgy2-residency-accreditation-standard-June2017.ashx. Accessed: 11/12/2019.
  3. ASHP Match Statistics. https://natmatch.com/ashprmp/stats.html. Accessed: 11/12/2019.
  4. Residency Program Director Survey. https://cpnp.org/career/residencies/survey. Accessed: 11/12/2019.
  5. Psychiatric Pharmacy Residency Programs. https://cpnp.org/career/residencies. Accessed: 11/12/2019.
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