Career Column

Is A Residency or A Fellowship Right for You?

Lindsey Parker
Post-Doctoral Fellow
US Oncology Medical Affairs, Pfizer


ne of the reasons I chose to pursue a Doctor of Pharmacy (PharmD) degree is the versatility of career options available after graduation. PharmD graduates can work in a variety of settings including community care, hospital, health insurance, and the pharmaceutical industry.

As a pharmacy student, it can be challenging to decide which career path is the best fit. Advanced Pharmacy Practice rotations and work experience can provide valuable exposure to different career areas, but they don’t always offer a comprehensive picture.

In recent years, post-graduate training programs, such as residencies and fellowships, have gained popularity. These one- or two-year training programs provide immersive experience in a specific area. Programs are available in various settings including managed care, community pharmacy, and research. The most well-known programs are hospital pharmacy residencies and pharmaceutical industry fellowships.

I’ve had the unique opportunity to experience life as both an acute care hospital pharmacy resident at a large academic medical center and as a pharmaceutical industry fellow in oncology medical affairs. Here’s what I’ve learned.

Hospital Pharmacy Residency

After working closely with pharmacy residents as a student, I was reasonably confident that I knew what residency entailed. Nevertheless, during the first month of my residency I found myself surprised by the volume of projects and clinical care responsibilities. While I was getting comfortable verifying pharmacy medication orders, I was simultaneously learning to respond to medical codes, leading topic discussions and journal clubs, precepting students, and looking after approximately 35 patients each day. I was also involved in longitudinal projects such as continuing education presentations, research projects, and drug class reviews. Additionally, residents edited and contributed to the pharmacy department journal, participated in committees, taught at local pharmacy schools, and assisted with administrative projects. Fitting all of these experiences into a one-year program requires hard work, long days, and a passion for learning and patient care.

Residency will test you, but also make you stronger. I learned how to comprehensively evaluate patients, collaborate effectively with physicians and nurses, and staff an oncology pharmacy. My residency also helped me develop strong time management, public speaking, and clinical skills. Pharmacy school was where I earned my PharmD, but residency is where I learned how to be a pharmacist.

Pharmaceutical Industry Fellowship

Instead of spending my days making rounds, counseling patients, and writing notes in medical charts, I now spend my time collaborating with cross-functional colleagues on project-based work. As a medical affairs fellow in a pharmaceutical company, I provide medical expertise and feedback on promotional and medical materials to ensure they are scientifically accurate and fairly balanced. I also support medical conferences, help coordinate and plan advisory board meetings, review and present investigator-initiated research proposals, and collaborate on manuscripts, scientific responses, and dossiers. In addition to the work I do at my company, my fellowship program is academically affiliated, and offers fellows the opportunity to participate in teaching, committee leadership, professional development sessions, and other scholarly activities. Balancing many projects with various colleagues can be challenging; however, my preceptors are cognizant of my workload and help set achievable deadlines.

I gained experience and skills during my residency that I use in industry daily. I frequently reflect on past experiences with physicians, nurses, and patients and provide these insights to the team. I regularly leverage the time management, teamwork, and clinical skills that I learned during residency. Overall, this allowed for a smooth transition to my fellowship and has helped me juggle numerous projects, effectively collaborate with others, and provide accurate and comprehensive medical comments.

My favorite aspect of the fellowship is working on a team to produce high-quality materials that are used across the country and globally to educate healthcare providers, payers, and patients about our products. I’ve also gained valuable experience working on Director-level projects and presentations with the appropriate guidance and support from my preceptors. Additionally, there are many opportunities for a fellow to collaborate cross-functionally with colleagues eager to take fellows under their wing. Using your “fellow card” is a great way to network across your company, learn about different roles in industry, and get involved in exciting new projects. I’m confident that the valuable training and networking opportunities offered to me through my fellowship will prepare me for a successful career in industry.

Is a Residency or a Fellowship Right for Me?

I often hear students confess that they’re having a difficult time choosing between residency and fellowship. My advice is to imagine your future career and consider what motivates you.

If working to optimize the care of individual patients brings you personal and professional satisfaction, residency will give you the clinical knowledge and skills you need to become a competent clinical pharmacist. But if you shudder at the thought of spending every day participating in morning rounds, counseling patients, and dosing vancomycin, the role of an inpatient clinical specialist might not be the right career for you.

Likewise, if you see yourself collaborating with cross-functional colleagues to launch and support products across the US and globally, a fellowship will provide training that sets you up for a successful future in industry. But if you’re motivated by face to face patient interactions, a career in industry may not bring you the same satisfaction that a clinical role would.

Whether you choose to pursue a residency, fellowship, both, or neither, it’s important that each individual make the decision that’s right for them. Professors, friends, and mentors can offer valuable advice to help inform your decision, but at the end of the day consider your personal and professional goals when choosing which path to pursue after graduation. You will learn and grow from whichever path you take–and it’s never too late to change directions if you change your mind along the way!