The Journey to Residency
The Journey of Residency
Hello! For those who do not know me my name is Ian Wells and I graduated from Appalachian College of Pharmacy class of 2018. I am currently a PGY-1 pharmacy resident at Kingsbrook Jewish Medical Center located in Brooklyn, NY. The whole process of residency can be a bit overwhelming at times, and I’d like to share my experiences to quell some of that anxiety that can be associated with this process.
The application process isn’t a complicated process, but keen attention must be demonstrated or you will be wasting your time and money. Something I learned throughout the process of applying was what programs are truly looking for. I was under the impression that my application was built well, including my GPA, extracurricular activities, leadership positions, and letters of recommendation. But what I failed to realize was although certain aspects of my application were strong, others were weak or non-existent. Residency programs look at your application and use their own weighted, point-based checklist system to evaluate you as a candidate. The more boxes you check off, the stronger your application is and the more likely you are to get an interview. From my own experiences, the more important factors that programs are looking at, in addition to GPA, is your research and poster presentations. Without those on your curriculum vitae, the options you have become very limited when considering programs.
Interviews and Midyear are essential for the program to find out about you, as a potential resident, and for you to really ask any questions that are not readily available on their website. This last point is extremely important because the better prepared you are at researching the institutions you are interested in, the better impression you portray to those programs. Something my residency director brought up as my current residents and I attend showcases around NY is the repetition of seeing people. Reaching out to current residents or the program director at the places you’re interested in, seeing them in person at midyear and giving them your CV, AND following up with them after midyear all put you at an advantage to other candidates that may have only dropped off their CV at midyear. When interviewing, be sure to promote yourself in the most humble way possible. If you received an offer to interview, the program clearly thinks you’re a potential fit to what they are looking for in a resident. Its perfectly fine to highlight your positives and only focus on any negatives if you are asked specifically about it, but try to twist it into a positive aspect of your application or growth as a student.
Transitioning from student to resident happens rather quickly, to be frank. My program had an orientation period known as Kingsbrook University, where we were essentially in lecture from 9-12 pm and 1-4 pm daily for the first 3 weeks. The clinical staff would educate us on the various topics we’d be frequently seeing and we’d be tested on that subject matter. Some of the topics included anticoagulation, vancomycin kinetics (it never truly leaves), phenytoin kinetics, and pain management. In my case, I was really forced into more responsibilities early on. We have a Code ICE protocol at my hospital, which is a protocol run by pharmacy for patients that experience cardiac arrest and are purposely played at hypothermic temperatures to reduce the long-term damage and effects from their arrest. I had volunteered to be one of the first residents to receive the Code ICE pager and be on call for the first week. Sure enough, just 8 hours after receiving the pager with another resident there was a Code ICE called. Fortunately for me, I was secondary this first go around but was tasked with staying over night the following night to manage the patient with a PGY-2 Medical resident. Both her and I managed the patient throughout the night, giving doses of Demerol to stop the patient from shivering, and managed the patient’s acid-base abnormalities. Residency is all about learning, personal and professional growth, and really coming into your own as a clinician. I truly relish opportunities like this, because its why I chose to do residency, and its why you too should consider pursuing a residency.
Lastly, I’d like to briefly touch on my daily responsibilities as a resident. My rotation block is on line with ACP’s, so my last rotation in Infectious Diseases concluded last Friday. Something unique at my hospital involves the use of antibiotic code books. Physicians cannot place a standing order of any antibiotic with the spectrum of activity great than ceftriaxone without a proper code from pharmacy. My preceptor granted me his code book for use on the rotation and gradually increased my responsibilities to the point of him trusting me in my clinical judgment to provide codes. I typically get to the hospital around 7:30 AM (my duty hours are from 8-5 pm) and would work up my patients on M4, which can be anywhere from 10-20 patients at a time. Being on ID, I would only focus on those patients that were being treated with any antibiotics. After working up the M4 patients, I would meet with my preceptor at 9 and quickly go over any recommendations, alterations to therapy, de-escalations based on cultures and sensitivities, and then head up to the floor to provide those recommendations to the medical residents covering the floor. From 10-12 pm, I would partake in rounds on the same floor or in the ICU with other medical residents, medical students, and sometimes some of my pharmacy resident colleagues. At 12 pm I go back to my preceptor and inform him of any deviations to what we were recommending, or any real updates for the patients we were covering. I then quickly grab some lunch and go back to my office to work up B3 patients, which can be anywhere from 20-40 patients in a given day, again only covering ID cases. After completing my work-ups, I meet again with my preceptor at roughly 1:30 pm and again go over all the recommendations I saw. After discussion of the B3 patients, I then go to B3 and provide all my recommendations to the medical residents there. B3 is harder to provide recommendations because there are 4 medical residents covering the floor versus 2 on M4. After that is done, I try to meet with my preceptor by 3-3:30 pm latest and have topic discussions. My last hour or so in the day is devoted to writing patient notes, recording my interventions, documenting my ADR and medication errors, and wrapping up my day.
In all, the entire process is very challenging but equally as rewarding. I have learned and grown so much since I started and its very hard to believe its already November! If you all have any questions please feel free to reach out to me at iwells@kingsbrook.orgor my cell at 954-803-1790. I hope this was helpful!
