With the Midyear Clinical Meeting quickly approaching, it is the time of year where many students and pharmacists are inspired to reflect on their professional aspirations and career goals. Residency programs are becoming more sought after to prepare pharmacists to serve on interdisciplinary medical teams and to optimize medication regimens and improve outcomes across health systems.¹ Residency programs throughout the nation offer exceptional training opportunities to advance the pharmacist’s role and the profession. With so many opportunities after pharmacy school, it can be a daunting process to explore PGY1 programs, especially with little to no practice experience under your belt. What if there were opportunities for you to explore your interests within residency without the pressure of deciding what the next step is within six months of starting your PGY1 program? Whether you are a practicing pharmacist wanting to expand your career opportunities or a new graduate, like us, a non-traditional residency is an excellent option for you to consider! 

Classically, a non-traditional residency was designed for practicing pharmacists to take on advanced training opportunities as a resident within their own institutions. These programs offer more time to complete residency requirements, while also maintaining a staffing presence.² At Northwestern Memorial Hospital (NMH), the non-traditional position expects the same requirements as the traditional PGY1, except that it is over 24 months instead of 12. Twelve of those months comprise the clinical rotations and the remaining twelve months are spent staffing third-shift in central pharmacy on a 7-nights-on, 7-nights-off schedule. The schedule is roughly 3 months of staffing, followed by 3 months of rotations, continued throughout the 2 years.³ 

The non-traditional pathway appealed to us because we both saw so many benefits and opportunities for growth that we may not have had time to glean from a traditional residency. Firstly, the 24-month program allows more time to explore our interests. Not knowing if we wanted to pursue PGY2 residencies, the non-traditional program gives more time to find our passions within the profession and to determine if a PGY2 is a right next step. Secondly, the increased staffing requirements allow us to gain confidence as practitioners, both operationally and clinically. Staffing overnights increases our operational experience, gives us a better understanding of policies and procedures, and allows us to master the overall pharmacy workflow. Being one of only 4 pharmacists staffing overnight (2 in central pharmacy, 1 in the ED, and 1 in the oncology/women’s hospital), we challenge our critical thinking skills and problem solving abilities while serving on the front line for clinical questions and medication recommendations. We also respond to cardiac arrests and intubations, which has dramatically increased our confidence in emergent situations. We had the opportunity to complete an additional quality improvement project, impacting NMH practice, and are able to dedicate an extra year to our research projects. Additionally, the 7-nights-on-7-nights-off overnight staffing model allows for travel opportunities on our off weeks, more family time, and free weekdays to catch up on home responsibilities, like laundry! 

One of the most challenging obstacles that graduates face is the financial aspect of residency. It can be incredibly daunting to enter the workforce with student loans on a resident’s salary. A benefit that drew us to the non-traditional residency program was the hybrid salary that comes along with the hybrid staffing-residency position. It can offset the cost of living in Chicago, while allowing more financial independence to put money towards savings and paying off student debt. If you are a practicing pharmacist returning to residency, it is a less substantial salary decrease, making it a smoother transition financially. 

Residency is a personal and professional growing experience. The important thing to consider when pursuing residency is that it is your experience, no one else’s. Don’t worry about the “timeline” when it comes to residency. No matter which program type you commit to, you are still gaining valuable experience as a pharmacist with your whole career ahead of you. Whether your reason is more time to find your passion within the profession, to grow in confidence as a clinician, or to maintain balance in your family life, a nontraditional residency may be the right choice for your career. During your residency search, keep an open mind and find a program that supports you, your wellbeing, and your ambitions. This way, you will surely succeed and grow in the next year, or two, or three of your residency. 

Is the non-traditional residency accredited?
Yes! It holds the same ASHP accreditation and expectations as the traditional PGY1 program.

Can you do a PGY2 after the non-traditional program?
Absolutely! One of our past non-traditional residents is currently completing his PGY2 in a Oncology here at NMH. 

Do you have to have work experience (i.e., have been a practicing pharmacist) prior to applying to the non-traditional program?
No! At NMH, prior experience as a practicing pharmacist is not required. Three of our 4 current non-traditional residents began their residency right after pharmacy school. Many of our past non-traditional residents did have prior pharmacy practice experience. There may be some programs that prefer or require prior pharmacist experience, but that will be a program-by-program
 requirement.

Do you still interact with and learn alongside the residents in the traditional PGY1 cohort?
Absolutely! As PGY1 residents, we still work and learn alongside our co-residents. When we are on our staffing blocks, we are able to make time to see our co-residents socially. When on rotations,
 we see them every day in our office! We think we’re incredibly lucky to get the chance to get to know not one, but TWO PGY1 classes!

Yes! The programs we are aware of are: 

• NMH non-traditional PGY1³
• Rush non-traditional PGY1⁴
• University of Chicago non-traditional PGY1⁵