The most uniformly structured postgraduate pharmacy training programs are pharmacy residencies. They too are the most prevalent in the United States pharmacy career development model, and thus residency training serves as the focus of this chapter.
While you may discover pharmacy residency programs in a variety of settings (e.g., hospital, community, and managed care), the origins of residency training began in the hospital over 70 years ago. Postgraduate programs, originally referred to as internships, began in the early 1930s to train pharmacists in hospital pharmacy management. Harvey A. K. Whitney, one of the founders of the American Society of Hospital Pharmacists, established the first of these internship programs at the University of Michigan Hospital. The American Society of Hospital Pharmacists developed standards for internship training in 1948; however, it wasn't until 1962 that the initial accreditation process and residency standards were developed, and the term “internship” was replaced with “residency.”1
“I had no idea that pharmacy residency training has been around for over 60 years!”
Brittany W. – Pharmacy Student, Tennessee
If you were a pharmacist enrolled in one of the first accredited residency programs, you would be learning to lead and manage hospital pharmacies. However, in the 1970s, as clinical pharmacy practice evolved, so did the development of clinical pharmacy residencies. The early clinical residencies were often associated with colleges of pharmacy as post-Doctor of Pharmacy training programs. For approximately 20 years, there were two types of residencies: clinical and general. It wasn't until 1993 that the American Society of Health-System Pharmacists (ASHP) developed a single standard for residency training called the Pharmacy Practice Residency with an emphasis on pharmaceutical care. Also between the 1970s and early 1990s, the first accreditation standards in specialty areas of practice were developed. These specialty programs grew at a rapid pace in the 1980s and 1990s; by the late 1990s, there were 15 recognized areas of specialized training.2 During this time period, some students entered specialty training directly after the completion of pharmacy school.
The next significant change in residency training occurred in 2005 with the development of the current Postgraduate Year One (PGY-1) and Postgraduate Year Two (PGY-2) residency standards. The terminology was adopted to clearly indicate the stepwise, progressive nature of pharmacy residency training, as well as to mirror the terminology used in other disciplines (e.g., medicine) so that external audiences would no longer be confused by the pharmacy practice and specialized terms. In practical terms, this new approach formalized the official requirement for completion of a PGY-1 residency prior to pursuing advanced training, hereafter known as a PGY-2 residency. While today's emphasis on PGY-1 residencies is to develop the skills necessary to provide patient-centered medication therapy management and serve as the foundation for advanced residency training (see Chapter 14), as a PGY-1 resident you will also be learning about improving the medication-use system, developing leadership, practice management ...