Visions for Required Postgraduate Year 1 Residency Training by 2020: A Comparison of Actual versus Projected Expansion

Abstract

To explore the feasibility of expanding postgraduate year (PGY) 1 residency training as proposed by the American College of Clinical Pharmacy and American Society of Health-System Pharmacists (ASHP). Prospective survey analysis. The ASHP Online Residency Directory was used to obtain PGY1 residency program data from June 2007-June 2008. A four-item questionnaire was developed to survey future residency growth in identified PGY1 programs. Survey data were aggregated to project future residency growth in the "next few years" (range 2-4 yrs). Estimates of Doctor of Pharmacy (Pharm.D.) graduates to 2020 were used to calculate PGY1 residency positions and average annual growth rates required if 24% (scenario 1), 75% (scenario 2), and 100% (scenario 3) of pharmacy graduates pursue PGY1 residencies. Projected growth from the survey was compared with required growth under the scenarios, as well as with actual PGY1 growth from June 2007-June 2008. A subset analysis of college-affiliated and Veterans Affairs (VA) PGY1 programs was performed. The survey response rate was 57%. The PGY1 positions were projected to increase by 8.3%/year in the next few years or 4193 positions by 2020 if 8.3% growth is sustained. Required average annual growth rates for scenarios 1-3, respectively, were 4.8%, 14.4%, and 17%. Projected growth rates were sufficient to achieve only scenario 1 in which 24% (percentage of pharmacists estimated to practice in health systems) of graduates pursue PGY1 residencies. The actual PGY1 growth rate from 2007-2008 was 9.9%. The VA positions actually grew at 12.5% and college-affiliated positions grew at 8.3% over this period, whereas VA projection for growth was 4.8% and college-affiliated projection was 9.6%. Having sufficient PGY1 residency positions available for all Pharm.D. graduates by 2020 would require at least a 17% average annual growth rate, whereas survey respondents predicted 8.3%. Actual residency growth in 2008 (9.9%) exceeded survey projections. Study data suggest that the ASHP aspiration to have all graduates who pursue health-system pharmacy careers complete a PGY1 residency is achievable. Higher percentages, 75% or 100%, are only partially achievable. Continued growth of college-affiliated residencies and sustained growth in the VA system are important to achieving residency growth goals.