Pharmacy Residents' Pursuit of Academic Positions
Pharmacy Residents' Pursuit of Academic Positions
Though there is still a need to fill positions, a reexamination of the pharmacy faculty shortage based on the results of this study suggests that the supply of interested candidates may be starting to meet the demand for new faculty members. Combatting the shortage has been an AACP priority for more than a decade. At the height of the faculty shortage in 2006–2007, AACP reported 582 vacant faculty positions at schools of pharmacy in the United States, more than 300 of which were in clinical sciences/practice divisions. In 2011–2012, this decreased to 395 vacant faculty positions with approximately 210 positions in clinical sciences/practice divisions.
This was a comprehensive study of all pharmacy residents in a given residency year. Previous studies evaluating residents' pursuit of academia were retrospective or cross-sectional in design and relied on recall or correlations across populations. As a presurvey/postsurvey design, this study was able to correlate residents' initial interest in academia and eventual pursuit of an academic position within a residency year. Recall bias was reduced by collecting teaching, precepting, and research experiences prior to current residency in the initial survey, then collecting experiences during the current residency in the follow-up survey. No other studies were found that differentiated between application to academic positions and attainment of positions. We were able to determine that more residents applied for academic positions than ultimately obtained positions.
Many 2011–2012 pharmacy residents in the United States were interested in academia, with 48% seriously considering a faculty position early in residency and 28% applying for a faculty position. By May 2012, 6% of residents were waiting on offers for positions, and 7% accepted faculty positions at a school of pharmacy. By graduation, as many as 13% of residency graduates (the 7% who had accepted positions and the 6% still waiting for faculty positions) may have committed to an academic pathway.
Extrapolating this data to the entire population of more than 2500 residents in 2011–2012, one can estimate that as many as 175 residents may have accepted a faculty position and 150 more may have been ready to accept a faculty position at a school of pharmacy. Though this extrapolation is potentially overestimated because of response bias, it does suggest that there is enough or nearly enough interest by pharmacy residents to fill needed positions across the country today. In fact, these values match closely to data obtained from AACP's 2012–2013 faculty database, which found there were 307 total first-time faculty hires and 167 first-time faculty hires in pharmacy practice departments for the 2012–2013 academic year. Many of the 167 first-time faculty hires in pharmacy practice were likely recently graduated residents.
Even so, there remained a consistent number of vacancies year to year, with more than 350 open positions each year from 2003–2013. Based on this, the discrepancy between the number of residents wanting those faculty positions and of those obtaining them is in alignment with the AACP reports' most cited reason for vacancies: a lack of qualified candidates in the pool. Though the qualifications themselves are based on various factors, this is likely the difference between those residents who obtained a faculty position and those who wanted a position but did not get one. The implications of this shift (greater supply and demand for high-quality candidates) are substantial in that the focus of faculty training programs will be increasingly geared toward independence in teaching rather than introduction of skills. Clinical practice expertise alone may no longer be sufficient. Better preparing residents to become qualified for faculty positions and developing guidelines for faculty search committees could help close faculty gaps in schools of pharmacy.
A major differentiating factor among candidates when evaluating preparedness for faculty positions was the completion of a PGY1 vs a PGY2 residency. In this study, both PGY1 and PGY2 residents showed a similar interest in pursuing academia. However more PGY2 residents ultimately applied for, were offered, and accepted a faculty position. Nevertheless, PGY1 residents were still interested in academia, with half of the PGY1 residents who elected further training expressing interest in pursuing academia after completing their training. This decision by PGY1 residents is likely strategic, as it would be expected to improve candidates' level of experience, confidence, and maturity. This would provide an advantage to manage the demands of faculty life, particularly for more junior faculty members. This is also consistent with the recommendations from AACP and ACCP that completing a PGY2 residency be required to obtain the rank of assistant professor. We also found that more PGY1 residents with specialties such as community or ambulatory care than general pharmacy practice residents applied for faculty positions. These specialty PGY1 residents possibly felt more prepared and better able to compete against the larger candidate pool with only general pharmacy practice training. Specialty PGY1 residencies are also more commonly associated with schools of pharmacy, which likely increased their exposure to academia overall.
Involvement with an entire course at a school of pharmacy was one of the few factors in our study that significantly impacted a resident's likelihood of being offered a faculty position. These experiences (ie, longitudinal exposure to mentoring as well as a variety of faculty roles and responsibilities) are likely desirable to pharmacy programs with limited resources and multiple open positions. Skills related to student relations, course management, academic conduct, and curriculum oversight and assessment would be highly desired by an academic search committee. Residents with these experiences may have also had a better understanding of academia as a career, and thus projected increased confidence in becoming a faculty member. This combination would result in a candidate who truly stands out in the search process. Still, approximately one-third of faculty positions were left vacant as a result of a lack of qualified candidates, suggesting a disconnect between expectations and competencies across all residency training. Vacancies can be the result of experienced faculty retirements (the cause of nearly a fifth of vacant positions in 2011–2012) or the establishment of newly formed schools and enhanced curricula, so the workload balance of faculty life is also a concern. In other words, retirements may result in fewer resources for mentoring new faculty members, and may increase teaching or practice loads for senior and mid-level faculty members. New faculty members may have greater workload as well, and consequently less time for training and integration. When Conklin and Desselle evaluated job turnover intentions of pharmacy faculty members, they found one of the main reasons why faculty members desired to leave positions was excessive workload. Faculty satisfaction and retention become greater challenges if young faculty members do not have requisite skills to manage contemporary educational demands. By adequately preparing residents for the rigors of balancing clinical, teaching, research, and service responsibilities, they should be better equipped to take on the role of contemporary pharmacy educators. Methods to best address this area could be the focus of future research.
In our study, mentors, positive teaching experiences in residency, and positive teaching experiences as students were highly influential factors in a resident's' pursuit of academia and could have related to successful attainment of faculty positions. To promote faculty recruitment and preparedness, schools of pharmacy could encourage the provision of robust teaching experiences through academic practice experiences and longitudinal relationships with residents and students. Both ACCP and AACP recommend schools of pharmacy and residency programs partner together to provide teaching experiences to residents. We advise residency programs to consider that many residents are interested in academia as a career. Our study showed that significantly more residents who had an initial interest in academia applied for a faculty position. Residency programs should work to provide these residents with teaching opportunities. A helpful resource for residency programs is the ACCP white paper, Guidelines for Resident Teaching Experiences, which includes recommendations for basic teaching experiences for all residency programs and recommendations for residencies with teaching certificates. They recommend residents concentrate on 4 components: developing a teaching portfolio and self-reflection statement, interacting with a teaching mentor, completing pedagogical readings and discussions, and being involved in various teaching experiences. Residencies with teaching certificate programs should have more robust involvement with these components as well. One strategy to improve the quality and preparedness of residents for faculty positions is the development of academic-focused residencies, the goal of which would be to develop future faculty members. In their study of PGY2 academic-focused residencies, Greco et al reported 69% of residents accepted a faculty position immediately after residency. This demonstrates the increased effectiveness of academic-focused residencies in producing pharmacy faculty members. Though incorporating ACCP guidelines for teaching experiences will help standardize the experiences across residencies, no guidelines are currently available for developing adequately trained faculty members. This may be an impetus for additional years of training as suggested by Helling and Johnson in their article regarding PGY3 subspecialty residencies. However, this is a task beyond the scope of this study. We suggest an organization such as AACP create a task force to address the issue and help guide residency programs and schools of pharmacy in creating recommendations to train qualified faculty members.
Limitations of our study include a low survey response rate; however, the overall number of participants was large. Though the survey could not be distributed directly to pharmacy residents, we were able to identify individual residency program directors and provide incentives beneficial for both the director and resident. Though there may have been a response bias towards residents who were already interested in academia, we believe the methods chosen attracted a broader sample. Resident baseline characteristics and initial interest in academia did not significantly change between participants in the initial survey and participants in both surveys, suggesting that participants who responded to both surveys were likely representative of participants in the initial survey. Additionally, the demographic data from our study was similar to McCarthy and Weber's study of a 2011–2012 residency class, which had 91% aged 20–30, 29% male, and 71% PGY1. Overall, we believe our sample provides a reasonable snapshot of residents' interest in academia and provides valuable information on potential trends regarding postgraduation interests.
Discussion
Though there is still a need to fill positions, a reexamination of the pharmacy faculty shortage based on the results of this study suggests that the supply of interested candidates may be starting to meet the demand for new faculty members. Combatting the shortage has been an AACP priority for more than a decade. At the height of the faculty shortage in 2006–2007, AACP reported 582 vacant faculty positions at schools of pharmacy in the United States, more than 300 of which were in clinical sciences/practice divisions. In 2011–2012, this decreased to 395 vacant faculty positions with approximately 210 positions in clinical sciences/practice divisions.
This was a comprehensive study of all pharmacy residents in a given residency year. Previous studies evaluating residents' pursuit of academia were retrospective or cross-sectional in design and relied on recall or correlations across populations. As a presurvey/postsurvey design, this study was able to correlate residents' initial interest in academia and eventual pursuit of an academic position within a residency year. Recall bias was reduced by collecting teaching, precepting, and research experiences prior to current residency in the initial survey, then collecting experiences during the current residency in the follow-up survey. No other studies were found that differentiated between application to academic positions and attainment of positions. We were able to determine that more residents applied for academic positions than ultimately obtained positions.
Many 2011–2012 pharmacy residents in the United States were interested in academia, with 48% seriously considering a faculty position early in residency and 28% applying for a faculty position. By May 2012, 6% of residents were waiting on offers for positions, and 7% accepted faculty positions at a school of pharmacy. By graduation, as many as 13% of residency graduates (the 7% who had accepted positions and the 6% still waiting for faculty positions) may have committed to an academic pathway.
Extrapolating this data to the entire population of more than 2500 residents in 2011–2012, one can estimate that as many as 175 residents may have accepted a faculty position and 150 more may have been ready to accept a faculty position at a school of pharmacy. Though this extrapolation is potentially overestimated because of response bias, it does suggest that there is enough or nearly enough interest by pharmacy residents to fill needed positions across the country today. In fact, these values match closely to data obtained from AACP's 2012–2013 faculty database, which found there were 307 total first-time faculty hires and 167 first-time faculty hires in pharmacy practice departments for the 2012–2013 academic year. Many of the 167 first-time faculty hires in pharmacy practice were likely recently graduated residents.
Even so, there remained a consistent number of vacancies year to year, with more than 350 open positions each year from 2003–2013. Based on this, the discrepancy between the number of residents wanting those faculty positions and of those obtaining them is in alignment with the AACP reports' most cited reason for vacancies: a lack of qualified candidates in the pool. Though the qualifications themselves are based on various factors, this is likely the difference between those residents who obtained a faculty position and those who wanted a position but did not get one. The implications of this shift (greater supply and demand for high-quality candidates) are substantial in that the focus of faculty training programs will be increasingly geared toward independence in teaching rather than introduction of skills. Clinical practice expertise alone may no longer be sufficient. Better preparing residents to become qualified for faculty positions and developing guidelines for faculty search committees could help close faculty gaps in schools of pharmacy.
A major differentiating factor among candidates when evaluating preparedness for faculty positions was the completion of a PGY1 vs a PGY2 residency. In this study, both PGY1 and PGY2 residents showed a similar interest in pursuing academia. However more PGY2 residents ultimately applied for, were offered, and accepted a faculty position. Nevertheless, PGY1 residents were still interested in academia, with half of the PGY1 residents who elected further training expressing interest in pursuing academia after completing their training. This decision by PGY1 residents is likely strategic, as it would be expected to improve candidates' level of experience, confidence, and maturity. This would provide an advantage to manage the demands of faculty life, particularly for more junior faculty members. This is also consistent with the recommendations from AACP and ACCP that completing a PGY2 residency be required to obtain the rank of assistant professor. We also found that more PGY1 residents with specialties such as community or ambulatory care than general pharmacy practice residents applied for faculty positions. These specialty PGY1 residents possibly felt more prepared and better able to compete against the larger candidate pool with only general pharmacy practice training. Specialty PGY1 residencies are also more commonly associated with schools of pharmacy, which likely increased their exposure to academia overall.
Involvement with an entire course at a school of pharmacy was one of the few factors in our study that significantly impacted a resident's likelihood of being offered a faculty position. These experiences (ie, longitudinal exposure to mentoring as well as a variety of faculty roles and responsibilities) are likely desirable to pharmacy programs with limited resources and multiple open positions. Skills related to student relations, course management, academic conduct, and curriculum oversight and assessment would be highly desired by an academic search committee. Residents with these experiences may have also had a better understanding of academia as a career, and thus projected increased confidence in becoming a faculty member. This combination would result in a candidate who truly stands out in the search process. Still, approximately one-third of faculty positions were left vacant as a result of a lack of qualified candidates, suggesting a disconnect between expectations and competencies across all residency training. Vacancies can be the result of experienced faculty retirements (the cause of nearly a fifth of vacant positions in 2011–2012) or the establishment of newly formed schools and enhanced curricula, so the workload balance of faculty life is also a concern. In other words, retirements may result in fewer resources for mentoring new faculty members, and may increase teaching or practice loads for senior and mid-level faculty members. New faculty members may have greater workload as well, and consequently less time for training and integration. When Conklin and Desselle evaluated job turnover intentions of pharmacy faculty members, they found one of the main reasons why faculty members desired to leave positions was excessive workload. Faculty satisfaction and retention become greater challenges if young faculty members do not have requisite skills to manage contemporary educational demands. By adequately preparing residents for the rigors of balancing clinical, teaching, research, and service responsibilities, they should be better equipped to take on the role of contemporary pharmacy educators. Methods to best address this area could be the focus of future research.
In our study, mentors, positive teaching experiences in residency, and positive teaching experiences as students were highly influential factors in a resident's' pursuit of academia and could have related to successful attainment of faculty positions. To promote faculty recruitment and preparedness, schools of pharmacy could encourage the provision of robust teaching experiences through academic practice experiences and longitudinal relationships with residents and students. Both ACCP and AACP recommend schools of pharmacy and residency programs partner together to provide teaching experiences to residents. We advise residency programs to consider that many residents are interested in academia as a career. Our study showed that significantly more residents who had an initial interest in academia applied for a faculty position. Residency programs should work to provide these residents with teaching opportunities. A helpful resource for residency programs is the ACCP white paper, Guidelines for Resident Teaching Experiences, which includes recommendations for basic teaching experiences for all residency programs and recommendations for residencies with teaching certificates. They recommend residents concentrate on 4 components: developing a teaching portfolio and self-reflection statement, interacting with a teaching mentor, completing pedagogical readings and discussions, and being involved in various teaching experiences. Residencies with teaching certificate programs should have more robust involvement with these components as well. One strategy to improve the quality and preparedness of residents for faculty positions is the development of academic-focused residencies, the goal of which would be to develop future faculty members. In their study of PGY2 academic-focused residencies, Greco et al reported 69% of residents accepted a faculty position immediately after residency. This demonstrates the increased effectiveness of academic-focused residencies in producing pharmacy faculty members. Though incorporating ACCP guidelines for teaching experiences will help standardize the experiences across residencies, no guidelines are currently available for developing adequately trained faculty members. This may be an impetus for additional years of training as suggested by Helling and Johnson in their article regarding PGY3 subspecialty residencies. However, this is a task beyond the scope of this study. We suggest an organization such as AACP create a task force to address the issue and help guide residency programs and schools of pharmacy in creating recommendations to train qualified faculty members.
Limitations of our study include a low survey response rate; however, the overall number of participants was large. Though the survey could not be distributed directly to pharmacy residents, we were able to identify individual residency program directors and provide incentives beneficial for both the director and resident. Though there may have been a response bias towards residents who were already interested in academia, we believe the methods chosen attracted a broader sample. Resident baseline characteristics and initial interest in academia did not significantly change between participants in the initial survey and participants in both surveys, suggesting that participants who responded to both surveys were likely representative of participants in the initial survey. Additionally, the demographic data from our study was similar to McCarthy and Weber's study of a 2011–2012 residency class, which had 91% aged 20–30, 29% male, and 71% PGY1. Overall, we believe our sample provides a reasonable snapshot of residents' interest in academia and provides valuable information on potential trends regarding postgraduation interests.
