How to Match for a Residency
Editor's Note: The following article was first published in Pharmacy Times
53.7%
Do you know what that number represents? It represents the number of students who applied for the Match in 2016 and actually ended up matching with a PGY1 program.
I'm not making this up. Over 5600 students applied for the Match in 2016. Of these, more than 1000 students dropped out before ranking any programs (most because they did not get an interview). And in the final tally, just over 3000 students matched with a PGY1 program.
Let that sink in for a second.
Based on last year's numbers, your odds of getting into a residency are just a little better than 1 in 2.
Let me pour more fuel on the fire with another story. Recently within my hospital network, there was an opening for an inpatient staff pharmacist. There were 84 applicants. Of these, half had residency training. And of those with residency training, half had greater than 2 years of clinical experience.
Let's say you are someone who is going to graduate in the next year or two. You've decided that you don't want to work in a community pharmacy, and you plan on applying for inpatient jobs.
Unless you live in a rural environment, you should assume that at least 20 of the applicants you're competing against will have a residency and several years experience. And another 20 applicants will have just completed their residency training. Many of these people will have board certification as well, since you meet the requirements to sit for the test if you've completed a PGY1 residency.
How are you going to stand out against that?
It's a common "truism" in our profession that you do not need to complete a residency in order to get the job you want. I won't try to convince you that that statement is false. Ask around and you can find plenty of stories of pharmacists who got their dream job straight out of school.
I can name over a dozen off the top of my head.
But the job market is changing. Every year that passes will be even more difficult. The number of graduating pharmacists is increasing faster than the number of jobs available.
So you may not need a residency to get the job of your dreams, but a residency will make the process a lot easier. At the bare minimum, it will give you essential clinical experience and open you up to networking opportunities you might not otherwise have.
The next question is: How do you make sure that you're one of the 53.7% that actually matches?
For that, you're going to have to do some prep-work (and the earlier you start it, the better). I like to break it down into 4 phases.
Phase 1: Before Midyear
Phase 2: Midyear
Phase 3: After Midyear
Phase 4: The Match
Phase 1: Before Midyear
Your focus here needs to be on making yourself the most competitive candidate possible. Your grades play a part in this, but not nearly as much as you might think. It's far more important to focus on obtaining (and excelling at) leadership roles as a student.
Strive to become a class officer or chapter president for a professional organization. The experiences and networking opportunities you'll gain will do more for making you a competitive candidate than your grades ever could.
Even more important is to set up the right rotation schedule. You want to get as many difficult clinical rotations as possible up front. Try to get a rotation that's universally accepted as "hard." Critical Care, Hematology/Oncology, and Emergency Medicine are all good options here.
Your main mission during these rotations is get clinical experience and to impress your preceptor enough to ask them for a letter or recommendation. In my opinion, the letters of recommendation are the most important part of your residency application. You'll want at least two recommendation letters from preceptors who can speak directly to your patient care experience.
This is why you want to set up your clinical rotations early. Having a glowing recommendation letter from the right preceptor helps to boost your application to the top of the pile.
Phase 2: Midyear
Your main focus here is to network as much as possible and to try not to get too frazzled by The Residency Showcase (here's a handy article that will help you prepare for The Showcase). Don't underestimate how overwhelming The Showcase can be, and be mentally prepared to bring your A game the entire time.
Phase 3: After Midyear
Now it's time to focus on your letter of intent and preparing for interviews. Your letter of intent should be compelling and easy to read. If you load it up with a bunch of meaningless buzzwords like "dynamic" and "forward-looking" you will sound like everybody else and no one will read it.
Remember, reviewers are reading literally hundreds of personal statements, so make sure yours stands out. The single best way to improve your writing is use active voice instead of passive voice (which is the default setting for most of us).
Residency interviews are among the most stressful and draining job interviews you will ever go through. They last anywhere from 5 - 8 hours and involve you getting hammered with questions, solving clinical cases on the spot, and giving a 15 - 30 minute presentation. It's grueling. Talk to friends who have been through the process or find a good resource to make sure you're ready to shine at the interview.
Phase 4: The Match
Here is you have to decide how to rank your programs. Don't try to "game the system" by ranking where you think you are most likely to match. Look at everything that's important to you from location to rotation schedule to availability of a PGY2 program and rank accordingly.
Don't forget to think about the overall "personality" of the program and how it fits with yours.
You also want to have a doomsday strategy in place in case you don't match in the first round. There are several opportunities to match with each cycle now, so be prepared. You are far from "out of the running" if you don't match on the first cycle, so have a strategy in place to take advantage of that.
Summary
Simply put, completing a residency will improve your job prospects. Especially in the early part of your career. Even if you're undecided about residency, put the work in now to set yourself up to match. The experience you gain will benefit you no matter where you go in your professional life.
If you'd like to read more, consider reading Mastering the Match: How to Secure a Pharmacy Residency. It is a comprehensive guide that will make you the most competitive candidate you can be.