AH018 - What's the Right Path? Post-grad Options for Pharmacists

Transcript

Lightly edited for clarity.

[00:27] Justin Venneri: Hello and thank you for listening to this episode of the Astonishing Healthcare podcast. I'm Justin Venneri, Director of Communications at Capital Rx, and I've got an awesome group of pharmacists with me today, all of whom are or have been involved in our residency program here at Capital Rx: Allison Gallant, Caitlyn Tung, and our current resident, Nicole Bergman. Thank you all for joining us today.

[00:47] Allison Gallant, PharmD: Thanks, Justin.

[00:48] Caitlyn Tung, PharmD, MBA: Thank you. So glad to be here.

[00:50] Nicole Bergman, PharmD: Thanks for having us.

[00:51] Justin Venneri: It is our pleasure. Okay, so let's start off with some intros and your backgrounds, where you went to school, what your current role is at Capital Rx. Allison, want to go first, since you are our first resident?

[01:03] Allison Gallant, PharmD: Sure, I'd love to. So, I graduated from the University of Pittsburgh – twice, actually. The first time with a bachelor's degree in economics and the next with a PharmD. I then went on to complete a residency year with Capital Rx, and now I'm a Senior Clinical Account Manager on the Client Services team. And I also now serve as the client services preceptor for the Capital Rx residency program.

[01:24] Justin Venneri: Awesome. Caitlyn, how about you?

[01:26] Caitlyn Tung, PharmD, MBA: Thanks, Justin. So, yes, I went to University of Washington for both my undergraduate as well as my graduate degree. I graduated in 2022 with my PharmD as well as my MBA and completed my residency with Capital Rx before also joining the client services team as a Clinical Account Manager.

[01:49] Justin Venneri: Amazing. And Nicole?

[01:50] Nicole Bergman, PharmD: Yes. Hi, everyone, I'm Nicole. I graduated from the University of Illinois at Chicago, UIC for short. And I am the current resident here at Capital Rx, and we're wrapping up my residency in July.

[02:04] Justin Venneri: Excellent. All right, Allison, let's come back around to you. So, tell me about the typical options for pharmacists post-grad. What sort of training and options are most often considered?

[02:15] Allison Gallant, PharmD: Sure. So, traditional career paths for pharmacists are usually within a retail or institutional setting. So, community pharmacies, hospitals, ambulatory care environments, I think those are the roles that the general public is most familiar with when they think of a pharmacist, and it's also what pharmacy students tend to get the most exposure to during school. So, hands-on patient care, which is really the foundation of a pharmacist practice.  

But there are so many other opportunities that exist for pharmacists that look quite different than that face-to-face patient care. Pharmacists can use their clinical expertise in dozens of unique roles within the pharmaceutical industry and managed care industry. So, things like PBMs and health plans. But in order to specialize in a setting or a clinical field, pharmacists often choose to participate in postgraduate training through a residency program or fellowship program.  

So, there are programs that are offered at really any and all of the settings I mentioned, retail, PBM, hospital, pharma, really a whole range of them. In my experience, hospital residency programs, which can be one to two years depending on the level of specialization, are the most widely offered. But I think managed care and pharmaceutical industry fellowships are becoming a more popular and desirable path for students and even pharmacists who've been out of school for some time.

[03:32] Justin Venneri: Okay, Caitlyn, what's the level of difficulty with each of those that Allison mentioned? And, as a recent graduate, can you get a foot in the door without a residency, or is that where residency comes into play?

[03:45] Caitlyn Tung, PharmD, MBA: I would say the level of difficulty depends on who you are and what you want to do with your career. So, if you are interested in doing hospital pharmacy, are you more clinical focused? Are you able to, you know, put in those hours that will require you to do a little bit of patient care, but a lot of clinical evaluation and assessment? And then, if you're interested in doing pharma, do you have an understanding of the market? Did you have experience, whether it be an internship or an APPE, like a student rotation, within those practices, that'll make you a better fit for those roles?  

You can definitely get your foot into the door for any of these roles, with or without a residency, but that residency gives you a leg up into getting your foot in the door. I would say, though, that if you apply for residency or fellowship and you don't get it the first time around, it's not a huge deal because then you can go work for a year and build that work ethic and really figure out how to carry yourself as a professional pharmacist and build on those transferable skills.

[04:55] Justin Venneri: Okay. And then Nicole, our current resident, what does a residency in managed care, a PBM like us, what does that look like? What's the day to day? Or what are the expectations for the year?

[05:05] Nicole Bergman, PharmD: Yeah. Thanks, Justin. So, a residency in managed care, specifically a PBM like us, Capital Rx, it's typically a year-long experience, and the goal of this is to provide new pharmacists or newer pharmacists somewhere in their career with a strong foundational understanding of the field or the managed care area or whatever they're working in. So in our case, a PBM.  

So, each residency is set up differently depending on the organization. But here at Capital Rx, our residency is rotational. And what that means is that every four to five weeks, the resident works with a different team in the company and rotates through the teams for the year. And so, this could be teams from formulary operations, clinical programs, clinical account management, or prior authorization, just to name a few. But in addition to the rotations, the residents will also have various longitudinal or ad hoc projects. And these really help create a well-rounded managed care pharmacist by wearing a lot of hats and participating in as many things as you can to really grow your knowledge and your expertise.  

That being said, the day to day definitely varies greatly, and it can depend on the rotation, the time of the year, what longitudinal or ad hoc projects you have going. I think the expectation or the goal for the year, it's really that the resident grows. They get this foundational knowledge, and they figure out, you know, where they want to pursue after residency, and that the goal is that they can graduate from the residency program and be best prepared for a career in the area of their choice.

[06:32] Justin Venneri: And by ad hoc, you mean something like a podcast about residency programs, right?

[06:37] Nicole Bergman, PharmD: Yes, exactly. Something like a podcast

[06:38] Justin Venneri: Or crunching lots and lots of data on GLP-1s.

[06:44] Nicole Bergman, PharmD: That as well, yes. Whatever is needed, whatever the company needs are, is typically where your ad hoc projects come in.

[06:50] Justin Venneri: Okay, Allison, so what would you say is the best thing or most important thing to consider when choosing or setting up a residency program? If you're looking at it from sort of an operationalization perspective, I think with.

[07:03] Allison Gallant, PharmD: So many different programs out there, it's important to have an open mind about the experiences that are offered. The residency year, like Nicole mentioned, is really about growth and learning. That's a time for residents to ask questions, to figure out what they enjoy, and important to also figure out things that they maybe don't enjoy as much.  

So I think a well-rounded residency program gives its residents enough distinct experiences to figure that out while also building a strong foundation to launch their career in that field. So, understanding the rotations and curriculum offered by the program and building that out is really important. There's, of course, a cultural fit component, as there isn't any professional setting. I think my year at Capital Rx as the resident -- and at the time the company still kind of being considered a startup -- really highlighted that point for me. It was a great match for me and my personality, but probably not an environment where everyone would thrive.  

And then having preceptors that are dedicated and invested in teaching and fostering your development is also invaluable. So having the right team to support the program is huge. They are a large part of the network that the resident builds that year, and so it's a big decision, not just for the resident, but also for the program and how that's structured. Both sides are really making an investment of their time, money, and resources.

[08:16] Justin Venneri: That makes sense. And, Caitlyn, anything you'd add there? And then if you could explain that the residency and fellowship are different -- I think they're different. Can you explain the difference?

[08:26] Caitlyn Tung, PharmD, MBA: Sure. So, yeah, just building off what Alison said, the residency is very instrumental to where you'll be taking the rest of your career. So, thinking about how to make the resident feel the most comfortable and get the most exposure to all the different departments so they can really figure out where they'll shine the most, I think, is one of the most important things to consider in a residency. And I. I'll just say that the Capital Rx residency does quite a good job at doing that. I felt like I got such a well-rounded experience and got to see things I never thought I would see in a residency. So, I'm really grateful for that.

[09:06] Justin Venneri: Is that just because there are so many stops on the journey, so to speak, over the course of the year, or is it the variance in roles over the year that helps with that?

[09:14] Caitlyn Tung, PharmD, MBA: I think because of the nature of Capital Rx, the pharmacists are doing a bunch of different things that usually you wouldn't be doing at a bigger company. You're not just siloed into your clinical formulary team, but you're more helping out the PA team. You're also helping out clinical programs -- and, sorry, PA stands for prior authorization.  

Then to answer your other question, Justin, what's different from a fellowship? And I'll just zero in on the pharmacy. Managed care residencies versus fellowship. So, managed care residency is a one-year training program where you're usually with either a health plan or a PBM and kind of going towards the career of a managed care pharmacist, whereas a fellowship, you're usually doing a one- or two-year training program under a manufacturer or a university that partners with the manufacturer. And when I say manufacturer, I mean someone that is making those medications that patients get. So, it's one- or two-year training program, and you're usually dealing with either clinical trials or health economics and outcomes research. So, it's a little bit more business and policy focused, whereas managed care is more about access to medications.

[10:30] Justin Venneri: Interesting. Okay. And then, Allison, I think there are some differences in accredited versus non-accredited programs or residencies. Can you elaborate on that?

[10:40] Allison Gallant, PharmD: Yeah, absolutely. So, a lot of residency programs become accredited by ASHP and participate in what's called the Match. Those programs have to meet certain requirements and offer particular experiences and rotations. The differentiator that was most important for me when deciding what type of residency to consider was the direct patient care component. So ASHP accreditation requires direct patient care rotation, which many non-accredited programs choose to just forego that in lieu of more data-focused rotations or other alternative experiences, or because they simply just can't offer that type of experience.  

And I'm speaking, you know, about managed care residencies here. Hospital residencies, and more clinically or ambulatory care residencies would clearly have more of that face-to-face interaction with patients. But I felt more drawn to some of the non-accredited programs because of the flexibility they could offer me in terms of rotation experiences that Caitlyn touched on a bit. You know, we get to see a lot throughout our residency at Capital Rx. It's also very flexible and tailored to what your interests are and what your long-term goals are.  

So, for example, during my residency, I got to spend quite a bit of time with the client services team, and I made that rotation more of a longitudinal experience. It didn't have to just be structured into a four- or five-week time block.  

So, my advice for pharmacists looking into a residency program specifically within managed care is to explore the non-accredited programs as well. Don't count them out just because they don't participate in the Match. You want to find a fit that aligns with your interests and can really help foster your growth in those areas.

[12:17] Justin Venneri: Got it. And Nicole, as we discussed earlier, working through residency now, what have you liked best thus far?

[12:24] Nicole Bergman, PharmD: I have actually completed all of my core rotations so far. So, the way that our residency is set up is you have your core rotations in the beginning of the year and then your last two rotations. So, your last eight weeks of residency are your electives, and you get to choose what you want to do and what you want to see through those. So, it could be something you've already seen, or it could be something brand new that you haven't really seen much of, and you want to learn more about.  

Now that I have completed all of my core rotations, I think my very favorite was formulary. To me, formulary is a really great mix of strategic work, but also operational work, both of which I really enjoy. And I think being on any team at Capital Rx, being that we're pretty small still, we get to wear a lot of hats and we get to work really closely with different teams. So, I like that as well, that I'll get to still work with account management, for example, and answer questions that they might have regarding the formulary or something that comes up. So that was my favorite.

[13:19] Justin Venneri: Cool. And Caitlyn and Allison, you both moved into account management roles. So, can you tell us about that decision and how your experience helps you there? Caitlyn, you want to go first, please?

[13:29] Caitlyn Tung, PharmD, MBA: Sure. So, similar to what Allison said, I was very interested in client services because I realized you're able to be the face of Capital Rx and represent the company and also help maintain that client satisfaction and success. So that was a really interesting part of the role for me.  

I also really liked that you're doing a little bit of everything. I know every role in Capital Rx, you're doing a little bit of everything, but this little bit of everything, I really enjoyed, like the contracting piece, the renewal piece, doing the performance reviews. I really liked diving into the data and just identifying those trends and spends and providing recommendations that will impact our clients and consequently their members. So I really like that piece.

And I just thought the team was so welcoming and supportive. I remember during my rotation, I was definitely very intimidated by how amazing everybody was. But then once I got to know everybody and got to see their day to day, I just was really excited to even have the opportunity to get this kind of role because it really is kind of rare and unique for a pharmacist to be able to participate as an account manager in this way.

[14:40] Justin Venneri: Okay. And Allison would love to hear your thoughts as well. And I have a tack-on question also. Like, what advice would you offer to executives thinking they need to start or structure a residency program so that it allows someone, such as yourself or Caitlyn or Nicole, to move into an account management role or more clinical formulary role, whichever direction they want to go?

[15:03] Allison Gallant, PharmD: Okay. Yeah. So I echo Caitlyn’s sentiments quite a bit. I went into my residency year pretty drawn to the client services side of the business, not necessarily because I felt like it was something I was going to be good at right off the bat or had a ton of experience in prior, but I felt like there were skills that I wanted to grow professionally, that I felt a role as a Clinical Account Manager would position me well to practice.  

So, things like problem solving, public speaking, relationship building, and I felt like it also connects you well within the organization -- it feels like a very centralized role. After going through residency, I felt uniquely prepared for the role of a clinical account manager. I hear it all the time, and Caitlyn kind of alluded to this. Account managers are jacks of all trades, masters of none. Getting a bit of hands-on experiences within so many of the different teams at the company through the residency program really helps in the day to day with clients.  

And then as far as advice for executives or program directors to ensure that residents are set up for success afterwards, I would say, again, offering diverse rotation experiences and listening to the resident. I know that when there are requirements for programs who are accredited and participate in the Match, there are certain non-negotiables within the program structure. But hearing what the resident is interested in, incorporating that into their curriculum and into their rotation schedule, I think is huge because you can view this residency training year as an investment, as a way to, you know, retain talent long term at the company. So, I think finding the right place for your residents is really important.

[16:44] Justin Venneri: Allison, we'll stick with you for my last question and someone I'm asking everybody on the podcast, and I’d be most interested to hear your collective responses to this one. So, what's the most interesting thing you've learned or the most astonishing thing you've seen that you can share related to this discussion?

[17:01] Allison Gallant, PharmD: So, for me, I would say that the most astonishing thing that I've seen as it relates to managed care and residency, is how many different career paths can bring you to managed care. I work with pharmacists who have gone the retail route, hospital settings, consulting. There are so many different ways to get to managed care. When I was applying for residencies in pharmacy school, I think I felt like I had to get the residency or how else would I get in? But now that I'm working with so many other pharmacists in the industry, it's really cool to see their unique career paths and just how many opportunities there are for pharmacists in general.

[17:42] Justin Venneri: Okay, and how about Caitlyn? We'll go next to you.

[17:46] Caitlyn Tung, PharmD, MBA: Yeah. I don't really have anything crazy astonishing to add, but just wanted to share something interesting that I've heard throughout my pharmacy school career, and then now it's just playing out to be so true -- it's that pharmacy is a small world.  

I heard that all the time when I was a student, and I was like, how is this going to be applicable? But now I'm really seeing how much networking really helps with your career and who you know really helps put you in your place as a pharmacist in the managed care industry. People from Capital Rx are hired from all different PBMs or health plans, and everyone seems to know each other. So, it's really cool to see, and I'm really excited for my own career to continue to grow and to get to know all these people and help make the magic happen, I guess you could say, has been really cool.

[18:41] Justin Venneri: It does seem like a smaller world than it is sometimes, right? It's funny.

[18:44] Caitlyn Tung, PharmD, MBA: Yeah, definitely.

[18:46] Justin Venneri: And last but not least, Nicole, same question to you, please.

[18:49] Nicole Bergman, PharmD: Yeah, so something that maybe is not like quite as astonishing, but something that I think is just really cool about working in the PBM or managed care space is just the level of impact that you get to have on patients and members. So, I mean, I think everyone going into pharmacy wants to help people. You know, we want to help people on one scale or another, whether it's large scale or seeing one patient at a time in a hospital room or at retail. But to me, I never get over how many people we can impact at once in the PBM space. And it's just really cool to me to be able to help that many people on a large scale, and especially here at Capital Rx, continue to see that scale grow.

[19:27] Justin Venneri: That is a good thing. And so, I just want to say thank you to all of you for taking the time to speak with us today and share your thoughts on residency programs and what you like about the profession so much. So, it's super helpful to hear and I hope you have a great rest of your day.

[19:40] Caitlyn Tung, PharmD, MBA: Thanks for having us, Justin

[19:42] Allison Gallant, PharmD: Thanks, Justin.

[19:43] Nicole Bergman, PharmD: Thanks, Justin.

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