Key insights from a PGY-2 ambulatory care resident

Now that I have spent more than a year and a half in postgraduate pharmacy residency training, I would like to reflect on five key lessons I have learned thus far. Pharmacy residents gain a lot from their programs: Clinical skills, presentation skills, research opportunities. The following are some of the most valuable lessons that I have learned so far from my residency. I know that I will take these lessons with me as I move into my career as an ambulatory care pharmacist. 

Give yourself grace: It is not if you will make a mistake, but when 

During my PGY-1 residency year, I made an error that ended up reaching the patient. This medication error required increased monitoring to ensure the patient did not experience negative consequences. In the moment, I realized what had happened, and I felt I had completely failed as a pharmacist. Recognizing and admitting the first mistake can feel heartbreaking, discouraging and even embarrassing. 

After grappling with these emotions, I reached out to a mentor to talk it through. I had been given the following advice in pharmacy school: “It’s not if you will make a mistake, but rather when you will.”  She reminded me that because of my mistake, I will be a better pharmacist for future patients. Ruminating on this mistake longer than needed could negatively impact my future patients. Tackle the error: Own up to your mistake, reflect on what went wrong, assess any system errors that could have contributed and plan for how to act differently in the future. Once that is done, you will be a better pharmacist for future patients. When you eventually make your first mistake, be kind to yourself and give yourself grace so that you can continue to serve your patients.

Avoiding (managing) burnout

Burnout will inevitably rear its ugly head at some point within your residency year(s). However, finding ways to manage burnout will help lessen the burden each day. I think the most important part to managing burnout is to ensure you have a plan for it! For me, the plan goes like this: At least one day each week (I choose Saturday) I do not spend on residency related tasks. I put all my work supplies away so that I feel free of it for the entire day. This helps me stay away from the vicious cycle of wanting to relax but feeling guilty for relaxing because “I should be working on other things.” I also have a list of activities that fill up my bucket. You can reach for this list when you are feeling burnt out. Ideally, it should include options that you can fit into the workday when you need it. Here is my list: 

1. Go on a hike. 
2. Play pickleball or tennis.
3. Take a walk over lunch hour. 
4. Chat with my co-resident. 
5. Breathing exercises for a quick reset. 
6. Have a snack.

You do not have to know everything or do everything

By the time you enter a residency program, you have learned a lot. There is often internal pressure to know the answer to every question that may get thrown your way. I have learned to remember the whole point of being in a residency program is to continue to learn and grow! Progress is the key to success in a residency program. Soon enough, you realize that no one knows the answer to every question, and that learning to say “I don’t know” is a big part of the residency year. A lot of opportunities and responsibilities will come up during the residency year. You will get pushed out of your comfort zone and look back and realize you can handle more than you thought you could. But that does not mean you have to do it alone. Lean on your support people when needed and speak up when things become too much, or you need help prioritizing your time.

Leadership.... even if you did not intend to be a leader 

I never thought of myself as a leader. I am not the first to volunteer to chair a committee or run for president of an organization. Throughout residency, I have learned that all pharmacists are leaders. For a while, I rejected this role and did not spend time reflecting on what that meant for me or question what kind of leader I would be. However, with time and guidance from my residency programs, I have learned to embrace leadership. Just because I initially turned away from this title did not make it any less true. It only meant I would not be as prepared for this aspect of my career. Know that as a pharmacy resident, you already are a leader. Then, think about what that means for you and how you want to lead.

When in doubt, remember what is best for the patient 

The last takeaway served me well and will be a key value I hold in my work as I take the next step in my career. Anytime I am feeling rushed, anxious or worried about difficult social interactions that prevent me from doing my job to the best of my ability, I ask myself: What is best for the patient? Are you feeling anxious about recommending an intervention to a provider and aren’t sure if you should speak up? Ask yourself what is best for the patient. You made a small error and aren’t sure if you really need to say anything about it? Ask yourself what is best for the patient. Are you feeling rushed to provide a recommendation that you may be unsure of? Ask yourself what is best for the patient. 

I’ve gotten more from residency than I ever expected. Yes, I will walk away with vast clinical knowledge, patient encounters and research experience that will prepare me immensely for a career in ambulatory care pharmacy. However, I think the tools above will help me in and out of the clinic for a lifetime.