Pharmacy residency training and pharmacy leadership: An important relationship

Abstract

Since its inception in the early to mid-1900s, pharmacy residency training has focused on the development and cultivation of pharmacist leaders. When ASHP first accredited residency programs in 1962, the primary focus was to develop pharmacy managers and leaders for the hospital environment.1 As the profession evolved to concentrate on clinical pharmacy activities, so did residency training. Residencies were categorized as clinical and general, with the former designation often considered of greater prestige. The Hilton Head Conference in 1985 sought to recognize product-oriented, distributive, and clinical pharmacy activities as valuable services that should be identified as parts of a clinically oriented profession.2 The Hilton Head Conference, along with the inauguration of “pharmaceutical care” in 1990,3 ushered in the return of the residency in pharmacy practice. Current ASHP accreditation standards state that the purpose of a postgraduate year 1 (PGY1) residency is “to accelerate growth beyond entry-level professional competence in patient-centered care and in pharmacy operational services, and to further the development of leadership skills.”4 We agree that the main purpose of a PGY1 residency is to increase the competency of pharmacists in the clinical environment and that PGY1 training should focus on effectiveness, efficiency, and competence in the clinical environment underpinned by experience in a strong pharmacy operations environment. In our zeal to be recognized as a clinical profession, our training programs have devoted the vast majority of resources to patient care and clinical activities. This is done at the expense of training practitioners who are not knowledgeable about the operations of a pharmacy department and have difficulty integrating clinical expertise and patient care with the skills necessary to navigate complex organizations. While operations and management expertise can be obtained through completing a postgraduate year 2 residency in health-system pharmacy administration, we believe the emphasis on the interconnectedness of operational knowledge and clinical practice success should be a solid part of PGY1 residencies.