WHEN YOU THINK OF THE 1960s, chances are you think of the civil rights movement, the passage of the Medicare law, the women’s movement, and peace protests… all substantial forces for change. But the ‘60s were also a pivotal time in the evolution of pharmacy training.
In 1962, the Board of Directors of ASHP—then the American Society of Hospital Pharmacists—adopted the ASHP Statement on Accreditation of Hospital Pharmacy Internship Training Programs, which laid out objectives for post-graduate programs that would provide in-depth training.
To distinguish these programs from those geared toward meeting the legal requirements for licensure, that same year ASHP dropped the term “internship” and replaced it with “residency.” In 1963, ASHP began the process of surveying the first 32 hospitals accredited for residency in hospital pharmacy.
Over the last 50 years, the form and function of accredited residency programs have shifted several times. The 1980s saw residencies divided into hospital, clinical and specialty programs. This format gave way to the pharmacy practice and specialty residencies of the 1990s and early 21st century.
At the same time, ASHP created post-graduate year two (PGY2) residencies, which prepare residents for specialty pharmacy practice in areas such as ambulatory care, infectious diseases, and oncology.
“Residency standards have evolved from focusing on systems and production to focusing on patient care and clinical services,” said Douglas Scheckelhoff, M.S., FASHP, ASHP’s vice president of professional development. “Now students are able to build upon their skills and actually apply them as they go through their residencies.”
More than 32,000 pharmacists have completed ASHP-accredited residency programs since 1963, and the number of accredited programs has grown to 1,577.
It has been a long but necessary journey, one that serves to propel pharmacists into rewarding careers and to advance the profession as a whole.
Benefits for Residents
“Accredited residency programs ensure competency that is rooted in knowledge, skills and abilities,” Ashby said. “Accreditation is our profession’s Good Housekeeping Seal of Approval, signifying that certain requirements in training have been met.”
Kelly M. Smith, Pharm.D., BCPS, FASHP, FCCP, associate dean of academic and student affairs and associate professor, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, and a member of ASHP’s Board of Directors, added that accreditation is testimony to the atmosphere of the program in which the resident has trained.
Participating in an accredited program also gives residents an edge in seeking employment, said Janet L. Teeters, M.S., ASHP’s director of accreditation services.
“Many jobs require applicants to have had a residency,” she said. “The current market is prompting health systems to ratchet down on costs, and they are scrutinizing who they hire. When they see that someone has been through an accredited residency program, they automatically know what kind of skills and training the person has.”
At the Department of Veterans Affairs (VA), which has 585 accredited residency positions spread across 140 programs, accreditation levels the playing field, said Lori J. Golterman, Pharm.D., national director of pharmacy residency programs and education for the VA.
“Each student has different experience because they all come from different schools, and accredited residency provides an opportunity for consistent training,” she said.
Benefits for Hospitals and Other Health Care Settings
For organizations seeking accreditation, the benefits start accruing long before their ASHP surveyor visit. Simply completing the preliminary RU Ready Assessment Tool for Pharmacy Residency Programs will be enlightening, said Smith.
“The self-assessment helps organizations review their own compliance with each element or standard. It gives them a good idea of how they are doing and what their strengths and weaknesses are.”
“It comes back to the environment,” she said. “A lot of people want to be involved with the programs and work in systems with that kind of culture and recognition.”
Brian Swift, Pharm.D., vice president and chief pharmacy officer at Thomas Jefferson University Hospital in Philadelphia, the very first site surveyed for accreditation back in 1963, agrees.
“Accreditation adds credibility. It carries an association with a large body of individuals [ASHP members] who have already traveled the path [of training and experience], and includes the organization in a legacy of outstanding practitioners and leaders in the pharmacy world,” he said.
And then there is the reimbursement. “Hospitals that run accredited residencies can get Medicare pass-through funding for allied health postgraduate educational programs,” said Teeters. “If 40 percent of their patients are Medicare patients, having an accredited program will enable them to get 40 percent of the cost of their PGY1 residency program funded.”
Benefits for the Profession
Accredited residency programs advance pharmacy within organizations and among other clinicians in the allied health professions. Indeed, preparing to apply for accreditation prompts pharmacy departments to become more cohesive and visible, said Golterman.
“Everyone needs to be involved in the training to give the residents an optimal experience. If the chief of pharmacy or other professionals don’t want to teach or be involved, residency directors need to communicate the importance of their programs to them and change that.”
Because administrators must provide approval to seek accreditation, the process offers an opportunity to shine the light on the profession, said Swift.
“It helps to illustrate where pharmacy should fit in, and it forces pharmacy departments to push for recognition of their programs throughout the organization.”
Accredited residencies also drive practice innovation, which will help expand pharmacy into additional patient-care areas and promote the inclusion of pharmacists as vital members of the care team. For example, at Jefferson, residents conduct research projects and marry those projects with the needs of the pharmacy department in a way that fosters organizational and practice change, said Swift.
“We turn to residents more as practitioners and welcome creative practice methods. We look to them for their insight and energy in breaking down barriers in areas where traditional pharmacy practice may sometimes be limited.”
—By Terri D’Arrigo