Staffing During Pharmacy Residency: Should it be Important to You?

If you saw my Instagram post, I talked a bit about staffing requirements in residency. Staffing is a requirement of ASHP (the organization that accredits pharmacy residencies) for programs to build in a staffing component for patient care (more specifically Competency area R1 — Patient Care).

BUT…ASHP does not dictate HOW programs should set up the staffing. It is solely up to the program site. This creates A LOT of variations between programs and could be another factor to look into when narrowing down your choices about which programs you eventually decide to apply to.

And because staffing is a part of your residency, most likely, you will not be getting a pharmacist salary during those hours, it is likely included in your pre-determined resident salary and you may get a shift differential depending on hospital policies.

For a majority of hospital-based residencies, staffing is on the weekends and/or weeknights at a minimum but again it varies widely between programs.

Here are some variations I have seen:

You could be working:

Once every other weekend
Once every 3rd weekend
Once every 4th weekend
On-call every other weekend (could be in combination with any of the above)
One weekday night shift (could be in combination with any of the above)
A staffing month (could be in combination with any of the above)

Keep in mind that this staffing is in addition to the assignments/duties/responsibilities you have on the clinical rotations you will be on. So let’s say you are in your PGY-1 residency on your oncology rotation Monday-Friday 8 am-5 pm.

This staffing would be in addition to that, so if it’s your weekend to staff, you come in the hospital Mon-Fri for your oncology rotation and then also Saturday and Sunday and go back to the hospital again for the next Mon-Fri which makes 12 days of working straight through

Don’t panic! This is the norm for most hospital-based residencies and will usually only be a once-a-month occurrence at minimum. HOWEVER, as mentioned above, there are variations in how programs structure staffing so you could be doing this 2-3 times a month. There are some programs that are purely outpatient, so staffing could be during the week only.

Putting it into Practice: A Visual Example

Here’s an example for the month of March (although you’ll be staffing for a majority of the residency year – I just chose March because it is a full month). This will show you how many days you may be working and how many days off you will have. Assume March 7th is your first weekend of staffing to start the staffing cycle

A program that staffs: Once every 3rd weekend
A program that staffs: Once every other weekend
A program that staffs: Once every 4th weekend

Three Possible Variations of Staffing Requirements – Lines indicate when you will be working

As you can see, each option changes how much time you staff and how many weekends fall in between when you need to work that long stretch again. Keep in mind the visual above does not include any additions the program may have such as also working one weekday night or if they require being on call. The good news though, is that SOME programs may give a day off during the week after a worked weekend to make up for it, but some may not (something else to ask about when selecting programs!).

What about Holidays? Most programs usually require residents to work some (not all) holidays such as one summer holiday + one winter holiday or one minor holiday + one major holiday

Why is this important?

As you can see, this will change how many weekends you have for yourself/family/friends, how many you have to catch up on residency projects, have a work-life balance, and how skilled you will be at staffing upon the end of your residency year.

This is a personal decision and because there are so many other factors that go into choosing where YOU want to do your residency, this shouldn’t be the sole factor, but it should be an important one.

Staffing is an essential part of a pharmacist job in a hospital, so it is an important skill to be trained in but it is up to you to decide when you look at programs if you want one that has more or less staffing requirements. Also, staffing will enhance your pharmacotherapy knowledge because you will be learning about medications while performing your duties. Lastly, staffing teaches you a lot of problem-solving, leadership, and management skills that you may not be exposed to. There are many unique clinical and operational challenges you need to answer and solve during staffing so you’re always learning.

I know some people cherish their weekends or have personal obligations so that could also be a deciding factor.

How do I Find the Staffing Requirements of the program?

The program’s individual website is a great place to start. While some programs make very clear their staffing requirements on their website, others do not, so you’ll need to ask the residents when that time comes around.

How and What To Ask:

Not sure how to approach asking? Well first, ask the resident (not the residency program director aka RPD)

“I saw on your website that this program requires staffing every 4th weekend, I just wanted to confirm that and ask if your staffing requirements change throughout the year”

Or if the website doesn’t say you can just ask “I wanted to ask what the staffing requirements are for your program and do you think that it is manageable in your opinion”

If you need even more clarification: “Are you ever on call? Is a night shift or overnight shift a part of staffing?”

WHEWW I KNOW, I know that was a lot but I hope it was helpful because this will be another piece to the selection puzzle when the time comes around to rank your programs. Personally, when I was applying, I wanted to focus on programs that residents staffed every 3rd or 4th weekend. However, if your heart is set on certain programs because of the many other amazing things they offer and they happen to have on-call or every other weekend, or even overnight staffing then don’t let that be a deterrent. If you have any questions l leave a comment on my Instagram and I’d be more than happy to help 🙂

Where to Find More Information About This Topic:

ASHP has a ‘Duty Hours’ file that outlines more about this as well as this guidance. on ASHP duty hour standards.

For more Residency content, check out the rest of my residency blog posts on here and on Instagram. I have created guides and have an Instagram highlight called ‘Rx Resi Help.’