I remember the process like it was yesterday. I started researching residencies in my academia rotation during my APPE year. I knew I wanted to do a residency, but I did not know where I wanted to go or what type of residency I wanted. Should I go into community practice? What about hospital practice? What is this managed care one? The many options were overwhelming.  

 

The University of Montana Skaggs School of Pharmacy describes the purpose of a residency as “[providing] new pharmacy graduates with training and education in the fundamentals of exemplary contemporary pharmacy practice in organized health care systems. This training is achieved by providing residents with opportunities to conceptualize, integrate, and transform accumulated experiences and knowledge into improved drug therapy which will lead to improved patient outcomes.” I wanted to improve patient care and make an impact in the world of pharmacy, so I, like most residency seekers, attended the 2011 American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting in New Orleans, LA. This meeting was an opportunity for me to stand out and make a positive impression on the residency programs in which I was interested.  

 

Thousands of other hopeful residents had the same idea.  

 

Flash forward to that day in March nervously anticipated by myself and my fellow residency applicants: Match Day, the date that would seal our postgraduation fate. After months of revising my CV with a fine-tooth comb, preparing for interviews, and traveling all over the country to interview with numerous programs, the day had finally come. I waited in anticipation all morning for the e-mail, and then it came: “Congratulations! You have been matched to the Duquesne University Mylan School of Pharmacy/Giant Eagle Pharmacy for the PGY1 Community Pharmacy Residency.”  

 

After all the celebrations involved with starting my career ended, I came to a startling conclusion: “Oh no, I’m in a residency by myself! Who will I have to bounce ideas off of? Who will I have to collaborate with? Will the focus be entirely on me?”

 

As of July 2013, of the pre-candidate, candidate, and accredited residencies listed on ASHP’s online directory, 247 PGY1 programs and 347 PGY2 programs have a lone resident. This translates to about 20% of the 2,866 applicants who matched with a residency program in 2013 who will be the only resident in their program. However, being the lone resident is not necessarily a bad thing. Traditionally, residency programs that have multiple residents in the same program try to create an experience that is equal among all residents.  

 

With this in mind, a resident in such a program may not be able to participate in all of the experiences that they want to, unless all residents have been afforded that same opportunity. However, having co-residents gives you the peace of mind that you are unlikely to be singled out during a particularly difficult rotation, since all residents will have that experience. While the lone resident may not have the luxury of having the support system of co-residents, they do have more flexibility in adapting the residency to fit their specific goals and needs.  

 

In most cases, the residency director will discuss individual goals with the resident and adjust the residency to meet those goals. If a potential residency candidate is worried about not being able to have a personalized residency experience, it is appropriate to contact the residency director to inquire for more information about the program. It is also appropriate to contact the current resident to evaluate if that particular residency coincides with the candidate’s goals. 

 

The best time to contact current residents about their programs would be in November or December, just prior to or at ASHP’s Midyear. Asking a current resident earlier in the year may not be beneficial because residents are training for the first few months and don’t begin rotations until late summer or early fall.

 

So you did it! You successfully navigated the residency candidate experience, and you have matched in a program that has a lone resident. Now that you are the lone resident, you may ask yourself: “Who do I go to for support when things get tough?” There are two types of programs with lone residents: those that have other residents at the institution, but they are in different programs; and those that truly have only one resident.  

 

For example, I was the lone resident in my program, but I had eight co-residents/fellows who were in their own respective programs and fell under the umbrella of Duquesne University. While the residents and fellows were not in the same program, I did rely on them both professionally and personally. If a PGY1 resident is in a program that has a PGY2 resident, it is not a bad idea to sit down and have a conversation about their experience.

 

On the other hand, if a resident does not have the opportunity to be around other residents, it is important to find a mentor, a pharmacist who is willing to help you navigate your residency and support you in being successful. In some programs, a mentor may be assigned to you, but it is important to find a person you feel comfortable with and who understands the residency program. Another suggestion is to get involved in a local, state, or national pharmacy association. This is a surefire way to network with other pharmacists and residents and to be involved with advancing the pharmacy profession. These people can become colleagues and ultimately help your career post-residency. 

 

No matter the program, there is always a support structure in place for the resident.

 

As mentioned previously, a program with a lone resident allows flexibility to help the resident achieve his or her goals. In addition, being a lone resident allows you to have opportunities that may not be offered to residents in programs that have multiple residents. These opportunities can include delivering live continuing education programs for local, state, and national audiences; writing continuing education programs; collaborating with other pharmacists and members of the medical community; and being involved in various research projects.  

 

In order for these opportunities to occur, the resident needs to be proactive and work with his or her preceptors and/or residency director. During an APPE experience, a former professor of mine simply stated: “The APPE experience is what you make of it.” The same advice rang true a year later during my residency.

 

Whether the lone resident is applying to PGY2 programs, post-residency fellowships, or the workforce, the resident has the opportunity to “own their experience,” as their residency is based upon their aspirations and goals. It speaks volumes in an interview when you can show outcomes for your projects, research, and experiences. Being a lone resident demonstrates that you are independent, self-motivated, and thorough in your work.  

 

In retrospect, I would still make the same decision to be involved in a lone resident program. It is a unique experience that many of your residency-trained colleagues will not have had the opportunity to go through. In the end, it will be a rewarding experience, I promise.