How I decided to Skip PGY2 and Pursue a Clinical Position

Hi friends!

Today’s post is a highly requested, and highly debated topic for that matter…and I think it is the perfect time of year to address this subject because this is right around the time last year that I was making my final decisions on where I wanted to take my career after a PGY1 residency!

First, I want to address that obviously the job market and practice of pharmacy is going to vary across the country, so some things I may say that were true for me may not apply to you and where you practice/want to practice. With that being said, I will try to explain my experience as much as possible so that you can compare it to your circumstances.

Things to Consider

1. Your interests –

Do you like multiple areas of practice or do you really love a specific speciality and wouldn’t be happy doing anything else? *Be careful to make sure this interest is real and not one you are holding on to from APPEs/school. Sometimes one rotation may be great but then you have a rotation in that area as a resident and you could change your mind.

2. Your financial situation – 

Will doing a PGY2 set you back financially enough that it is not worth it? I know friends who have done PGY2s with more debt than me but it was absolutely the right decision for them. Remember everyone’s situation is different, and how big of a role the financial aspect plays will differ greatly pharmacist to pharmacist.

3. Relocation vs staying local – 

Are you open or willing to relocate and look at PGY2 programs and potentially jobs in that specialty after PGY2 across the country? Or are you someone who really has your roots planted and you don’t want to or simply can’t relocate? The amount of PGY2/speciality positions available near you will differ based on where you live but generally speaking there are a lot less PGY2 programs and spots available compared to PGY1 residencies so this may make it harder to find and match to a program locally.

4. Your desired job/field – 

The field or specialty you want to work in may or may not require a PGY2. For example, in my opinion you are less likely to need a PGY2 to land an internal medicine position compared to if you want to land a transplant pharmacist job. It can vary depending on if the position is more entry level vs advanced specialist but some specialities are just harder to make your way into without a PGY2, at least at first (can’t undermine years of experience on the job this is obviously so important to). AGAIN, it will also depend on your area and what the current market looks like. A great example I’ve run into lately is my health system’s expansion of oncology services, normally this is an area I would think of as needing a PGY2 but I have seen several pharmacists hired without PGY2 oncology experience because we had so many job openings/growth in that area.

5. What is the standard around you – 

This “standard” has more to do with the culture/demand of where you are looking for a job. This may mean a highly demanded city vs something more rural with less job competition but it could also be distinct differences even between local health systems. I see this a lot where I practice in Connecticut with the differences between my health system and Yale New Haven Health System. YNHH has essentially every PGY2 speciality there is and they often early commit their PGY1 residents into the majority of these PGY2 spots. If you are a PGY1 resident there wanting to get a job in _____ speciality, their preference is going to be that you do their PGY2 in that speciality because that is the standard that has been set there and what most likely the rest of those specialist have done. This doesn’t mean you can’t get a job at a health system like this post PGY1 graduation but it may more likely be a general or multi specialty position. At my hospital we have one PGY2 spot so we are much more likely to hire our graduating PGY1 residents without the additional year of training. These roles may still be generalized or floating but there may be more options for full time positions or more options to float into speciality areas at my hospital in comparison because of our differences in residency structure. Hopefully you are able to draw similarities to your area and health systems based on these examples!

6. Other commitments in your life – 

People go to pharmacy school or into residency at all different stages in their life and it may not be as easy for some to commit to another year of residency. Maybe you have children, or have a parent/loved one with medical needs, or have a business/side hustle you want to focus on or maybe you just bought your dream home and can’t afford the pay cut, etc you get it. Each of us has a life outside being a pharmacist and that part of our life deserves some love too, so just keep in mind everyones situation is different.

The day I announced my Clinical Pharmacist position
The day I announced my Clinical Pharmacist position

My Story

I went into PGY-1 residency pretty open-minded. I knew that I really enjoyed Ambulatory Care and could see myself ending up in that field, but I also knew how much I enjoyed my other clinical rotations that were more inpatient focused. As residency continued I realized there really wasn’t too many fields that I would truly be unhappy in (except maybe Oncology, nothing personal to anyone who loves it I just realized I didn’t enjoy it) and I tried to start evaluating my plans for post-residency in the Fall.

To give you an idea of my financial situation, I went to school in Boston for six years without even a cosigner on my student loans. I graduated with hefty six figure debt because of this, not that I regret my schooling in anyway, but obviously this amount of student debt was factored into my decision since residents make less than half what a normal pharmacist would make. The idea of doing a PGY2 quickly started fading for me once I really started to weigh my pros/cons (stay true to your pros/cons when making this decision for yourself). I will admit there was about a 24 hour period where I highly considered it after finding out that a local PGY2 Ambulatory Care program wasn’t early committing both of their spots, but ultimately I quickly decided against it.

One of the biggest reasons was that I could truly see myself doing a million things after residency and enjoying it. Would a PGY2 give me more experience and knowledge? Absolutely, but this could sometimes be a double edged sword depending on the job market around you. I am not someone who would want to spend an entire year really digging into one specialty and then not end up being able to find a job in that specific field. Personally, ending up in a situation like that would make me feel like it was a waste of time and money in a way. It would have potentially been harder for me to find a job in a specific specialty post PGY2 because I also wasn’t willing to relocate out of Connecticut. After 7 years of making pharmacy the priority in my life I was so ready to make my relationship, family and personal goals the main focus instead. Now again, this isn’t to discourage you if you want to pursue a PGY2 residency! If you are in an area with a lot of specialities or PGY1 program that has a lot of PGY2 residencies and is really good about retaining it’s residents post graduation you may have an easier time landing these positions!

Besides knowing I would like several different jobs, not wanting to relocate and wanting to put my personal life first more, obviously for me personally the financial differences were a big motivator. With my new income as a Clinical Pharmacist I was able to refinance my student loans to a 5 year plan and cut my interest rate by more than 50% which has been a huge relief for me (I will do a blog post on this process because I know a lot of us are in the same boat). I also have more time to dedicate to things like blogging which bring me a ton of happiness and I hope helps you all as well.

I now have a job that allows me to practice in many different areas and work on exciting projects and I love it. I don’t know where the rest of my career will take me but I am confident in the decisions I have made so far and I know whatever goals I set for myself I will find a way to make them happen.

Tips for Landing a Clinical Job Post PGY-1

  • NETWORKING, networking, networking – Don’t be afraid to reach out to your past professors and preceptors from school that you were close to and utilize your current network around you in residency to it’s fullest to learn about upcoming job opportunities or put in a good word for you.
  • Leverage your health system if you are in one – I personally did this by reaching out to the Director of Pharmacy for my health system and expressing my desire to stay within our system post-graduation. I was able to get a meeting with him and the current Director of Pharmacy at my hospital to discuss my interests and career goals and it hands down played a huge role in me getting the position I did.
  • Applying to places ahead of time – Even if you are a couple months out don’t hesitate to apply to jobs that were just posted! A lot of hospitals are willing to hold job openings for residents that will be graduating in the summer. I didn’t realize what a common practice this was until I was in the job search myself, I actually accepted my offer in the beginning of April and started after I graduated at the end of June.
  • Keep your mind open – I know it can be a tough job market out there. Don’t get discouraged if on paper an opportunity doesn’t sound like your dream job! Many of us don’t get our dream job right after graduating, even with a residency, and that’s okay…especially since what we think is our dream job will likely change as we get more experience. You can often take advantage of training in different areas, joining committees or tasks forces, helping with students/residents and so much more that could expand your role and lead to your next opportunity. Stay eager but be humble <3

I hope this helps you start to answer the what’s next question for yourself! Please leave any additional questions you have in the comments below!


Welcome to The Luxe Pharmacist! My name is Madeline. I am a Clinical Pharmacist with a flair for style, wellness, and all things beauty. Here you will find my favorite things and places, as well as more of my life as a woman in pharmacy. I believe there is always room for a little luxe in your life, so go ahead and dive in! Thank you for visiting my blog, cheers to living a luxe life babes!

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