Are Pharmacy Residency Salaries Fair?

The opportunity cost, e.g., the financial sacrifice many graduating pharmacy students will make to take a residency rather than a traditional post-graduate position, is immense. The average pharmacy resident salary is around $54,000 as opposed to the average pharmacist's salary, around $90,000 to $140,000, not including the recent surge in sign-on bonuses.

However, that pay rate of $54,000 is not likely for 40 hours of work. Unlike their working pharmacist staff pharmacist counterparts who get paid hourly and are not in management, an hour worked is not an hour paid at a certain rate. Still, the promise of a job that aligns with pharmacy residents' aspirations is often worth the tradeoff.

However, with the recent rise in inflation, including rental housing, should pharmacy residency salaries go up to counter the effect of inflation?

Six years ago, ASHP's Senior Vice President and Interim Chief Operating Officer Kasey K. Thompson, who, according to ASHP's Form 990, earns about 7 times what a pharmacy resident does, sent a letter to the U.S. Department of Labor, worried that the number of available residencies would go down significantly if resident salaries went up too quickly.

However, as they say, times have changed, and demand for pharmacy residencies is cooling as 904 fewer applicants applied for a residency last year than the year prior, and the number of positions filled and unfilled has risen dramatically.

In 2016, there were 3991 pharmacy residency positions, and 37 unmatched positions.

In 2022, there were 5232 pharmacy residency positions, and 220 unmatched positions.

As the graduating pharmacy school class sizes become smaller (the last four years have seen a reduction of 1600 accepted pharmacy students) and residency positions continue to expand, we should see a point where the number of pharmacy residency applicants could exceed the number of available residency positions.

I believe now is the time we should start the conversation about ensuring that residents are fairly compensated for their work and that salaries should rise with the

You can find the ASHP leadership's salaries and expenditures here in their Form 990.

https://projects.propublica.org/nonprofits/organizations/520807628/202131059349301578/full

You can find the original letter to Mary Ziegler here:

ASHP Urges Caution on DOL Overtime Rule-1

February 16, 2016?

Mary Ziegler

Assistant Administrator, Office of Policy, Wage and Hour (WHD)

U.S. Department of Labor, Room S-3502

200 Constitution Avenue, NW

Washington, DC 20210

Reference: Regulatory Information Number (RIN) 1235-AA11

Subject: "Defining and Delimiting the Exemptions for Executive, Administrative, Professional, Outside Sales and Computer Employees"

Dear Ms Ziegler:

ASHP (American Society of Health-System Pharmacists) submits the following comments in response to the Department of Labor (DOL) proposed rule entitled, "Defining and Delimiting the Exemptions for Executive, Administrative, Professional, Outside Sales and Computer Employees." ASHP is aware that the comment period for this proposed rule has expired; however, we would like to offer our perspectives on this proposal and its potential impact on patient care services provided by pharmacy residents in hospitals and clinics across the country. We are concerned that the new salary floor for certain employees is set for immediate implementation, rather than a gradual increase over time. This could negatively impact pharmacy residency programs that provide critical hands-on training for pharmacists as they apply their medication-use expertise in a direct patient care capacity.

ASHP represents pharmacists who serve as patient care providers in acute and ambulatory settings. The organization's more than 43,000 members include pharmacists, student pharmacists, and pharmacy technicians. For over 70 years, ASHP has been at the forefront of efforts to improve medication use and enhance patient safety.

Pharmacists must graduate with a doctor of pharmacy (Pharm.D.) degree from an accredited pharmacy school. In addition to pharmacy education, many pharmacists complete postdoctoral training such as postgraduate year one and two residencies in a particular healthcare setting to prepare them to provide complex medication-related services to patients. Residency programs train pharmacists in specialty areas such as oncology, infectious diseases, cardiology, psychiatry, pediatrics, geriatrics, emergency medicine, ambulatory care, and a host of other general and specialized areas. These programs represent an essential application of the skills needed to provide complex medication-related care to patients in both the inpatient and outpatient settings. In the hospital and clinic setting, completion of a pharmacy residency is a necessary step that must be taken to provide direct patient care services.

The proposed rule by the DOL would require many postdoctoral training programs, such as pharmacy residencies, to establish a salary floor for the residents at $50,440 or require that residents be paid overtime when they exceed the eight-hour workday. ASHP is concerned that the rule does not allow for flexibility, nor does it provide an incremental timetable for these salary increases. Given the current climate of scarce resources, we believe that such increases must be phased in over a period of time to allow pharmacy departments to plan for future budgetary expenditures. By not taking a phased-in approach, we risk a reduction in the number of residency positions that can be offered by hospitals and clinics and, in turn, jeopardize the capacity needed for postdoctoral training in a period of increased demand for the patient care services of pharmacists. The risk to small community hospitals and those in rural areas is even greater, as the hospital may be the only healthcare access point for patients living in these areas.

For the reasons outlined above, ASHP is requesting that the DOL re-evaluate the proposed rule and consider developing a graduated timetable to achieve the salary floor. We believe strongly that this approach is reasonable and would not jeopardize the crucial patient care services provided by pharmacy residents.

Sincerely,

Kasey K. Thompson, Pharm.D., M.S., M.B.A.

Senior Vice President and Interim Chief Operating Officer

Cc: Senator Lamar Alexander