Tips to avoid getting stuck in the retail pharmacy setting

Many pharmacists have asked how they could get out of retail pharmacy.  Well, first of all, not getting stuck there in the first place is the easiest way to avoid it.  For example, if you are confident that you do not see yourself in a retail pharmacy position in the long run, try to work in the clinical setting right out of pharmacy school.  Many pharmacists in a retail pharmacy setting may find themselves in a bind because they want to earn money as quickly as possible to provide for themselves and their families, or paying off debts after toiling in pharmacy school for years and losing money to pay for tuition and its compounding interest.  This may be fine in the short run to take care of financial issues, but the long term career aspirations and goals may be compromised, stunted, or delayed by years for doing so.  Therefore, for those of you not interested in a retail pharmacy career, it may be beneficial to work towards a non-retail (e.g. clinical) career early on as long as financial issues could be deferred for a few more years after graduation.  Just like anything else in life, preparing and planning early may allow one to avoid long term regrets.  Here are some tips to land a clinical gig after pharmacy school.

Aim for a pharmacy internship or technician position in a hospital before or during pharmacy school to gain exposure to the work and services provided by a hospital pharmacy.  Learning how to compound intravenous admixtures, total parenteral admixtures, answering frantic phone calls, working with nurses, filling medication carts, and delivering medications to dispensing cabinets may provide a good comprehensive background of what to expect in the clinical setting.

Networking with other hospital inclined pharmacy students, professors, and pharmacists is a great way to get connected to the hospital world.  Networking with them may provide helpful and interesting tips and assistance.  They may be the first to know about hospital job openings at their own hospital, and even refer you to the right hiring managers so that you may receive a proper introduction.  Networking, regardless or pharmacy settings, is probably one of the most powerful tools at your disposal for any type of career and job.  Be sure to participate in relevant organizations, clubs, and social activities to expose yourself to meeting new people who may be of assistance later on.  For those that have already been in retail pharmacy for some time, and are having a difficult time landing a hospital pharmacy position, networking is probably one of the best ways to transition over to the clinical setting.  Joining a local hospital pharmacy organization, and attending local pharmacy conferences will allow one to network with many other local professionals, some who may work in the hospital setting, and provide you with tips and information about job openings.

Applying for a hospital residency or fellowship is another great way to get acclimated to the hospital environment.  After the conclusion of the residency and fellowship, a position may even be offered to you by your supervisor if there are openings upon successful completion of the residency or fellowship.  Having completed a residency is one of the best ways to be considered for a hospital position after graduation.  It may set you apart and above those that lack of a residency, or put you on par with those that have hospital experience.

Obtaining a board certification, such as board certified pharmacotherapy specialist (BCPS) may also beef up one’s resume to compete for the limited openings for hospital pharmacists.  This is not the easiest or cheapest route, but many hospitals appreciate the knowledge and skill provided by the BCPS pharmacist.  There are books and courses offered at pharmacy conferences dedicated to preparing pharmacists for this test.



Will you enjoy a career in pharmacy?

Do you really want to do this?  Do you really want to be a pharmacist?  If you finish a full PharmD (Doctor of Pharmacy) Professional Degree program – you’re looking at around four years of your entire life.  Even less if you attend an accelerated program, but it is a big investment in time and money regardless.  It would be all for nothing if you decide you dislike being a pharmacist after working for only a short period of time.  If you decide to change careers midway through pharmacy school, or shortly after you graduate, you would have to spend additional time and money searching for a new career that you may or may not enjoy compared to a career in pharmacy.  This is why it is very important to do your research in this industry by doing some reading into this field, talking to current pharmacists and pharmacy students, talking to your trusted family members, advisors, and friends, or even your school’s career counselor, and other available and legitimate resources on the Internet.  Working as in intern in the pharmacy department within a hospital or a retail setting before applying to pharmacy school is a great way to receive some real exposure to the life, and get some hands-on experience.  This is a good method of testing whether the pharmacy world is a good fit for you…and whether you’ll be able to endure the next 30-40 years of it…assuming you work until retirement.  Therefore, a little investment in your time to do some preliminary research will go a long way for the rest of your life.  You’ll spend generally eight hours of your day (a third of a full day) if employed full-time, and so it may be beneficial to find out if this career path will bring happiness or dread.

The following may be some indicators that you’ll be content with the pharmacy field:

  • Enjoy working with people of all personalities
  • Enjoy providing customer service to everyone
  • Enjoy learning new things
  • Independent
  • Thick-skinned
  • Disciplined
  • Patient
  • Intelligent, and the passion to seek knowledge and find answers quickly
  • Enjoy science
  • Enjoy working in a busy environment
  • Teaching and training

If you possess the opposite traits from those listed above, you may want to rethink this career, or at least do some more research and work in a pharmacy before you decide to invest more time and money into it.  Keep in mind that although the majority of pharmacists work in a retail drugstore or a hospital setting, there are other career paths such as academia, insurance companies, pharmaceutical companies, research, and consulting.  Pharmacists are known to  be valued for their knowledge on medications, insurance, general science, and some various aspects of healthcare, which is why their skills and knowledge may be utilized in various industry sectors.  To learn about atypical careers outside of the hospital or retail pharmacy setting, it may be a good idea to inquire from your pharmacy schools before you apply on the available elective courses and experiential programs they offer.  You could also inquire about the teachers and professors about their backgrounds to see if your career interests have any relation to their employment history.  They may be able to mentor or advise you on certain career paths based on their own experiences.  Therefore, not only is it a good idea to do some research into the work of a pharmacist, it is an equally sound idea to research the schools you are interested in applying to, and whether they offer special elective courses and experiential programs that will assist you in your pursuit of the your ideal job.



Complaints in Hospital Pharmacy

Have you ever worked in a hospital pharmacy?  It is much different from working in a retail setting, and it is highly recommended to volunteer or spend some time as a technician before you decide to devote your entire career in this setting.  Hospital pharmacies are usually referred to as inpatient pharmacy.  Although hospitals may have an outpatient pharmacy, which is similar to a retail setting, most people generally think of inpatient pharmacies when thinking about a hospital pharmacy setting.  The inpatient pharmacy serves medications generally for patients who have a room and bed.  Therefore, their policies, protocols, and systems are designed to serve in this capacity depending on the type of medical services offered at the hospital, and the size (e.g. number of rooms and patients) that can be admitted to a hospital.  Many hospital pharmacies require new hires to have experience in a residency if they’ve had no prior hospital experience as a pharmacist.  This may be due to the expanding role of a pharmacist to include clinical duties in areas of anticoagulation, infectious diseases, emergency room support, pediatrics, oncology, and many others.  These “clinical” services being offered by clinical pharmacists are becoming appreciated by other healthcare professionals (e.g. doctors, nurses) and patients as they offer educational services about novel medications to staff, provide optimal medication recommendations in regards to effectiveness and safety for complex treatments as medicines become more and more complicated over time, and even ensure the cost-effectiveness of such treatment in some cases.

The above all sounds great on paper, but unless you have worked in a hospital pharmacy operation, you may not know what you’re getting yourself into.  There are nuances to understand in hospital pharmacy that you may not have to deal with as often or at all in retail pharmacy.  Here, we compile some of the many complaints that could arise in a hospital pharmacy operation in a full-service, or general hospital.

  1.  The schedule.  Full-service general hospitals don’t usually close…they can be open 24 hours a day.  Therefore, pharmacies are usually staffed around-the-clock which means pharmacists will need to work around-the-clock also in shifts.  Sometimes these shifts are not desirable if you’re stuck with the midnight to morning shift.  Sometimes they are not the most preferred if stuck working on weekends or on holidays when you would rather be with your family or have a social life.
  2. Call-outs.  Similar to above, when other members of the pharmacy call out sick, or go on vacation, maternity leave,  you may have to cover them or be asked to take their shift. This happens often as people will always get sick, and workers will always take vacation.
  3. Lack of communication.  When a prior shift (e.g. a morning pharmacist) is working on something important and complex, but does not communicate what they worked on to the next shift pharmacist (e.g. evening pharmacist) for a job they did not finish before they leave the pharmacy to go home.  You can imagine the results when a doctor or nurse calls about the order being worked on by the morning pharmacist, but the evening shift has no clue what they are talking about.
  4. Staff shortages.  Without proper staffing, a hospital pharmacist will be overwhelmed and perform the job of 2-3 pharmacists and technicians.  This is risky because it could lead to errors and fatigue.
  5. Nurses. Nurses want the medication quickly, and may not always provide enough time for the pharmacist to process and send the medication after the order is sent to the pharmacy.  They may not understand that only a few pharmacists manage and review the medications for proper dosing and safety for the entire hospital.  Also, some medications require further processing, such as mixing in the correct diluent, etc.
  6. Missing medications.  Sometimes, even after medications are sent, nurses cannot find the delivered medications…thus requiring pharmacists to scramble and look for the medications in the pharmacy to see if they were sent up.  This wastes a lot of time, and results in duplicative work.  Many times, those missing medications are later found by the nurses themselves because they may not have looked in the correct locations, or when another nurse takes the delivered medication without telling the other nurses who are looking for the medication (lack of communication).

The above are only some of the scenarios of things that may lead to complaints by hospital pharmacists.  Obviously, it is highly recommended to have some exposure in this setting before embarking on this career path.

Can Pharmacists Ever Be Rich?

Sure, anyone can get rich if they’re born wealthy, or inherit wealth from someone else (e.g. wealthy parents, rich relatives). One can also get rich winning the lottery, discovering oil on their land, getting lucky at the casinos or races, or in the stock market; although one could also end up poor if in the latter two things do not turn out well.   The odds of getting rich are probably very high in the above mentioned examples.  With the exception of luck or being fortunate in life, whether a pharmacist can get rich by just being a pharmacist requires further review.

First of all, it depends on the definition of being “rich” – it is relative.  For example, a million dollars for one living in California with a $5,000 per month mortgage, a wife or husband at home with three kids attending private school, and a debt of $100,000 at 7% interest owed to the bank will probably not be considered enough money considering the salary will further be reduced by taxes, insurance deductions, retirement, and other needs.  The one million dollars will be used up pretty quickly.  Of course, one living far away from urban areas such as rural parts of Iowa with a $900 per month mortgage will fare much better considering more of one’s salary will be saved, and taxes may be much lower than California residents.  Also, someone paying $900 per month on a home may be considered rich in many other countries where a U.S. dollar is worth a lot of money in their own currency.

Let’s focus on a pharmacist in the United States of America to remove any disparities in the definition of wealth between different countries, and exclude any serendipitous circumstances in life that only a fortunate few will encounter. So then, what is the answer?  It depends…meaning yes and no.  Take for example a pharmacist in California who may endure one of the most difficult times becoming a millionaire considering the high taxes and real estate in the area. Using the example from the pharmacist in the previous post, this pharmacist earns $136,100 per year, slightly higher than the $122,230 average pharmacist salary earned in 2016 according to the Bureau of Labor Statistics.   The pharmacist has a non-working spouse at home, with two children, and also maximizes their retirement contributions.  After all other deductions (e.g. insurance, taxes, etc), the pharmacist’s net earnings are roughly $74,361, or $6,197 per month goes to the bank.  Of course, these are only estimates, and may be higher or lower depending on the amount and type of deductions counted against the income.

Most people in America would say a million dollars is a lot of money, and therefore, those with a million dollars may be perceived as rich by the average working American.  Therefore, we will use one million dollars as our threshold of what is considered rich for now (although this number is probably peanuts from the standpoint of Warren Buffett or Mark Zuckerberg, but we’re looking from the viewpoint of the average American). Simply, one million dollars net worth is when “Assets” minus “Liabilities” equals $1,000,000 or more.  For example, if you have a total combined worth of $1,500,000 of cash, stocks, bonds, properties, etc. but have $500,000 in total left on your mortgage, loans, or other debt, your net worth would be $1,000,000.

A goal of $1,000,000 from a net annual income of $74,361 is feasible; however, it will depend a large part on your spending habits.  Therefore, sticking to a budget will assist with reaching this goal.  The more you spend, the less you will save, making it harder to reach your goal of one million dollars.  Spending less usually equals more savings.  If you’re starting out after graduation with mounting college loans, high-interest credit card debt, and a family that eats out and spends money on high quality fashion and services, saving money will be difficult on one singular income alone.  One way to facilitate saving money would be to avoid eating out frequently at fancy restaurants, staying healthy to avoid expensive hospital bills, living in not-so-posh neighborhoods, avoiding the brand name clothing, sending children to public schools instead of private institutions, or performing a lot of household chores yourself rather than hiring a cleaning service or landscaper.  Looking for discounts, or buying used items could also assist with cutting expenses.  These are personal choices that every family will have to make.  Some consider living in good neighborhoods to attend excellent public schools, attending private schools, sacrificing retirement savings and wealth for the sake of children are worthy investments; however, this post cannot discuss or recommend what one should do with their earnings, but rather assess whether saving a million dollars is possible for a pharmacist.  Another way to speed up the goal to a million dollars is to work more (e.g. another job), earn more (e.g. promotion), or the non-working spouse may be able to enter the workforce and help increase the income that comes into their household.  Doing well in investing your savings could also help reach the goal a lot sooner.  Earning interest on your savings and investments over time by starting early will be valuable to reaching a million dollars.

In another example, a single person with no debt (e.g. college loans, car loans, mortgage), zero savings, a salary of $74,361, and is able to save half  of their paycheck(~$3,100 per month) while earning an average interest of 5% a year will be a millionaire in 2034 (~17 years from this year) according to CNN’s millionaire calculator.  Therefore, a single person starting out at the age of 26 may be able to be a millionaire by age 43!  Although this is highly unlikely considering the unpredictability that life brings such as getting married, having kids, health issues, or going through an expensive divorce.

Therefore, it is entirely possible in one’s lifetime under the right circumstances to get to a million dollars as a pharmacist as long as there is a steady stream of solid income, disciplined spending control, and time for your investments to grow.


Your First Paycheck as a Pharmacist

After four long years, and maybe a year or two of residency or fellowship for some graduates, endless hours of studying into the night and early mornings before an exam, mounting college loan debt, you finally land a job. That is great news because it is primarily the reason we suffer through any rigorous schooling.  We aim to get a good job in order to get paid and make the best life for yourself and your loved ones. Some of you need income quickly as you might have kids who need clean diapers and food in their mouths. You’ll need an income to support a nice house for your spouse and children. So what happens when you receive your first paycheck? Some may gift their first paycheck to their parents to thank them. Others may put down a down payment towards a new car. Most will probably save it, and use part of it to pay your mortgage and rent. Regardless what you’ll do with your first check, be prepared that your first direct deposit into your bank account may not be what you thought it was.  This goes without saying in almost any career in America.

According to the Bureau of Labor Statistics data in 2016, the average salary of a pharmacist was $122,230. The state with the most number of pharmacists is California according to their data with an average yearly wage of $136,100. In this post, let’s focus on the paycheck of a California pharmacist, and how much they would take home after deductions to get a better understanding of our hard-earned money.  The take home pay will vary depending on the amount of deductions you have. These deductions may include the level of insurance coverage, insurance type, retirement contributions, and tax exemptions available.  For example, If we begin with an average rate of $136,100/year salary based on California’s average pharmacist wage from 2016, with the assumptions that the pharmacist has a non-working spouse and two kids, the pharmacist maximizes their 401K retirement contributions ($18,000 annually in 2016), has a standard level of health insurance for a family if we use one study as a reference ($5,277 for all family plan types), claims two exemptions (one each for marriage partners), the pharmacist would be taxed at the 28% marginal federal rate, and a 9.3% marginal state rate, plus pay FICA which subsidizes Social Security and Medicare (6.85%), and vision/dental insurance (let’s assume $1500/year for a family of four), and receiving a paycheck every 2 weeks…you can expect your paycheck to be a lot lower. Even more so if you opt to add short-term or long-term disability insurance, life insurance, and other types of optional benefit contributions the employer may offer (e.g. legal insurance).  Using various paycheck calculators available for California income taxes, $136,100 may turn into $81,138 when affected by federal/state income taxes, FICA, with two personal exemptions, and deducting the maximum allowed contribution for a retirement 401k plan in 2016 ($18,000).  When further deducting for health/dental/vision without including other optional insurances such as life and disability insurance, the $81,138 turns into $74,361.  $74,361 split into 26 paychecks per year would be around $2,860 net pay per two weeks for a family of four.  This is drastically different from a gross pay of $5,234 ($136,100 divided by 26 paychecks)… essentially a 45% reduction compared to the gross amount before deductions! Therefore, you should budget wisely as there are college loans, credit card debt, mortgage payments, childcare, sales/property taxes, food, utilities, clothes, internet, cell phones, car fuel and maintenance, and so forth to consider assuming only one person works in the household.  $2,860 is around $74,360 per year after deductions are counted for.  Remember, this example is merely a rough estimate, and may not be the actual amount since taxes and exemptions can be complicated, and insurance options and retirement contributions will vary individually.  However it is probably in the same ballpark to what a typical California pharmacist in a family of four with one working person would receive after deductions.  Every state has their own income tax rates, property tax, and sales tax, health insurance rates that will affect the net pay.  Cost of living will also affect how valuable your income is worth.  Some states have cheaper tax rates, housing, gas and food costs than others.  For example, California is known to have the highest state income tax rates, and expensive real estate, whereas Florida and Texas have no state income tax, and relatively more affordable housing compared to parts of California.  However, states may compensate for the lack of tax receipts from income taxes by raising taxes in other areas such as for sales or property tax rates.  Therefore, before you blow your paycheck on a Mercedes Benz or a big 3500-square foot house, it would be wise to establish a sound budget.