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While Benjamin Franklin's assertion that, “In this world nothing can be said to be certain, except death and taxes,” is generally viewed as a commentary on the role of government in our lives, it too reflects the inevitability of change. Such change extends to postgraduate pharmacy training; what you see today may be just that—what residency training is today. Predicting the specific seminal events and changes in residency training that will occur over the rest of your professional career is impossible, yet you can be prepared for changes that are feasible over the next 5 to 10 years. These changes, as summarized in Table 27-1, may be transparent to you as a student or eager residency candidate, while others will touch you directly. Regardless of those most affected, these changes can be illustrated by some age-old idioms, so brace yourself for what lies ahead.

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Table 27-1 Pharmacy Residency Changes on the Horizon
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While that sentiment evokes a frightening (and fortunately, unimaginable) scene, it does illustrate the concept that differing approaches to a number of life's quandaries exist, and the same holds true for pharmacy residency training. Today's stand-alone Postgraduate Year One (PGY-1) and Postgraduate Year Two (PGY-2) programs may become tomorrow's multiyear programs. In your desire to become a transplant pharmacist, you may commit to 2 years of training during your initial match process, rather than the current 1 + 1 model. That approach is seen with some areas of specialization currently, including residencies in pharmacotherapy and administration. The integration of graduate degree programs (e.g., Master of Science and Master of Business Administration) into residency training, a current feature of many health-system pharmacy administration residency programs, may also grow in numbers. And, as pharmacy grows in its intricacy and complexity, who knows if 1 year or 2 of training will be sufficient? The rate of discovery and innovation in pathophysiology, diagnosis, and therapeutic regimens is expected to escalate, or at the least not diminish during the 40+ years of your pharmacy career (gulp). Our medical colleagues have learned over the years that more time is needed to train a highly skilled physician, and the likelihood that the same is true for pharmacy is quite high. Do I hear Postgraduate Year Three (PGY-3), anyone? While such a concept has not been fully vetted by the profession, do not be surprised if you hear about it soon.

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Speaking of new training models, who says you have to be a resident for 12 consecutive months? Residents bring tremendous value ...

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