Making the Switch from Retail to Hospital Pharmacist
Key takeaways:
Given the high burnout rates among community pharmacists, some of them are thinking about transitioning to other settings such as a hospital pharmacy.
When changing from a retail environment to a hospital setting, community pharmacists might experience many barriers.
Although the switch to a hospital pharmacy can be difficult, there are ways to position yourself as a desirable candidate.
Many community pharmacists experience burnout. Even before COVID-19, their rates for burnout — when pharmacists reported feeling exhausted, depleted, or negative about their work — varied from 65% to 84%, with a positive correlation to prescription volume. Given greater prescription demand throughout the COVID-19 pandemic, these burnout rates could be higher. What’s more, having a drive-through service might be making burnout rates worse.
With such a large number of retail pharmacists experiencing burnout, many are looking to change pharmacy settings. In fact, some community pharmacists are interested in switching into a more clinical role — like hospital pharmacy — but they’re unsure if the change is possible.
Let’s discuss the particulars about switching from retail to hospital pharmacy and how to overcome certain obstacles.
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Barriers to the switch
When changing from a retail environment to a hospital setting, many community pharmacists experience the following difficulties:
Board certifications: If you don’t have residency training, then hospital pharmacies will typically ask for board certifications.
Clinical experience: Although many pharmacists use their clinical knowledge to dispense medications, some hospitals might place more emphasis on clinical experience during patient care services — like reviewing labs, making recommendations to healthcare providers, working at an anticoagulation clinic, or counseling patients. However, according to a 2019 Pharmacy Workforce Center (PWC) national report, full-time retail pharmacists only spend about 12% of their time on patient care services, compared with 37% for full-time inpatient pharmacists.
Competition: The pharmacy job market is saturated, and the availability of hospital pharmacist opportunities continues to be lower than community openings. In fact, the U.S. Bureau of Labor Statistics estimates that inpatient pharmacist positions will hold steady between 2016 and 2026 at 25%, while retail positions will also remain unchanged at 60%. Since hospital opportunities are consistently less available than community openings, there is additional competition for hospital roles.
Internal candidate preference: Some hospitals prefer to hire internal candidates who started out as pharmacy technicians, students, or residents. If you received a referral from a current employee, though, you might be treated similarly to an internal candidate.
Residency: To make matters more difficult for retail pharmacists, hospital pharmacy settings tend to require residency, when in fact many community pharmacists don’t have residency training.
Overcoming the barriers
Due to a number of obstacles, transitioning from a retail pharmacy to a hospital setting can be challenging. Here’s how to break through.
Apply for less competitive shifts
Although there are fewer hospital openings than community positions, there is typically less competition for unpopular hospital hours — like the as-needed (PRN), graveyard, weekend, and holiday shifts. Consider applying for these undesirable times to get your foot in the door.
Once you obtain a hospital pharmacist position, more desirable shifts might open up in time. Then you can discuss with your manager about transitioning to a more desirable schedule.
Board certification
Many hospital pharmacists tend to have at least one board certification after their residency training, but you don’t need to have residency training to sit for a board exam and obtain certification. However, based on the eligibility requirements for many of the board exams, residency training will save you some time. Without residency training, you’ll need to have the minimum amount of experience to sit for the exam. Some board exams will require at least 4 years of applicable experience.
These certifications show your commitment to staying up to date and your dedication to providing high-quality patient care. Many hospital settings see a board certification as equivalent to residency training. If you’re interested in receiving a new board certification, you may be wondering how you can get more clinical experience to be eligible for the exam. We’ll discuss this next.
Clinical experience
Hospital pharmacies usually expect you to have clinical experience, which is also a typical requirement for a board certification. While the community pharmacy environment can be very hectic, and you may already be stretched thin in your schedule, consider some of the following ways to get more clinical experience:
Assisted living facilities (ALF): Build rapport with local ALFs and offer to assist them with medication fulfillment needs for their residents. If they agree, then you may gain some experience with helping older adults in a long-term care (LTC) setting.
Collaborative practice agreements (CPAs): If you have great rapport with nearby doctors, leverage these relationships. These doctors already trust you. So consider asking them to trust you with more responsibilities — like reviewing patients’ medical history, performing encounter visits for specific disease states, ordering certain labs, and optimizing drug therapy.
Education classes for diabetes or other medical conditions: Find out common medical conditions in your patient population. Then consider offering a class about these disease states on a monthly basis to help patients reach their health goals.
Health screening and point-of-care (POC) testing: Host occasional health screening events and provide various POC tests, such as hemoglobin A1C, glucose levels, cholesterol levels, strep tests, and more.
Insurance and formulary management tasks: Think about providing insurance clinics to help older adults find the best Medicare Part D plan — based on their medications and preferences for premiums, deductibles, and copays. Also, pay attention to insurance reimbursement rates for certain medications, and stay up to date with clinical guidelines to better manage the formulary or inventory.
Medication therapy management (MTM) services: Have set times and dates to have appointments for MTM services.
Regional or district tasks: Ask your managers about regional tasks or projects that will help you focus on addressing your skill gaps. You can also request a change in title, which might be beneficial on your resume.
Vaccine clinics: Coordinate with local employers and ALFs to set up vaccine clinics and increase the immunization rates within the community.
By being involved in these projects, you’re positioning yourself as an ambulatory care pharmacist with a focus on clinical care and enhanced pharmacy services. In addition, you’ll broaden your skill set to include specializing in specific disease states and developing some familiarity to LTC and formulary management tasks.
Internal candidate treatment
As we’ve mentioned, transitioning into a hospital setting can be difficult — especially if the hospital tends to hire internally. So how can you receive treatment that’s similar to internal candidates?
Networking can help. In fact, networking is the shortcut that might help you become a hospital pharmacist without residency or board certifications. After you know which hospitals you like, consider networking with inpatient pharmacists and directors of pharmacy at these hospitals. These pharmacists might invite you to apply to hidden jobs, invite you for interviews, and introduce you to helpful connections.
Residency training
Many hospitals prefer residency training for their pharmacists. However, this path will result in a pay cut for 1 to 2 years. For example, Johns Hopkins Medicine provides a stipend of $50,130 and $52,740 for year 1 and 2 of residency, respectively. The lower pay may not be a feasible option for everyone. Nevertheless, it’s still possible to become an inpatient pharmacist without residency.
The bottom line
High burnout rates among community pharmacists has led plenty of pharmacists to think about a change in setting such as a hospital pharmacy. Switching to a hospital setting can be difficult, but it can be done with some proactive steps.
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