Student and School-level Predictors of Pharmacy Residency Attainment

To the Editor: Lyons and colleagues recently evaluated the characteristics that affected the likelihood a doctor of pharmacy (PharmD) graduate being accepted into a residency position during 2013 to 2015. Results from the American Association of Colleges of Pharmacy (AACP) Graduating Student Survey and Degrees Conferred Survey were incorporated in the study methodology. Institutional pharmacy work experience, gender, and graduate age were among the statistically significant predictors identified for residency attainment.¹ We believe this article fills a critical gap in the literature related to residency attainment and seek to further promote dialogue about the article methodology, discussion, limitations, and subject matter.

Not only are residencies an increasingly common aspect of professional pharmacy training, they are also increasingly in demand. It was worth noting that predictive values of residency attainment can vary each year depending on residency demand.² Factors motivating pharmacy students to pursue residency training include that it is a prerequisite for certain jobs, which may be attributed to the supply and demand of pharmacists.³ According to the 2018 American Society of Health-System Pharmacists (ASHP) Residency Matching Program statistics, there was a greater than 100% increase in the number of residency applicants since 2013. This trend paralleled a disproportional increase in the number of available residency program positions.⁴ As a result, residency applicant qualifications such as institutional pharmacy work experience may become an even more prevalent predictor of residency attainment today and in the future. Lyons and colleagues did not evaluate GPA, which may also be a predictor and explained by this increasingly competitive landscape.

Female gender was determined to be a strong predictor for residency attainment. Explanatory factors contributing to the predictive nature of female gender in residency attainment should continue to be explored, as the following information was not referenced in the article discussion. According to Taylor and colleagues, a total of 13,838 PharmD degrees were conferred in 2013-2014, with 60.4% and 39.6% of the degrees being received by women and men, respectively.⁵ Lyons and colleagues reported the population that successfully matched a residency program during this timeframe was composed of 69.8% women and 30.2% men.¹ Comparing percentages of these two studies encourages inquiry into the female application rate for residency during this timeframe, which ASHP Residency Matching Program statistics do not report.

We were not surprised that institutional pharmacy work experience was found to be of the most differentiating student characteristics associated with residency attainment. This outcome may be directly related to institution preferences that are cited in several recent literature examples. According to Ensor and colleagues, pharmacy work experience is one of the seven strong factors contributing to a residency interview invitation from Johns Hopkins Hospital.⁶ Victor and colleagues conducted a survey of 377 residency program directors across the country and determined (any) work experience as a critical factor used to grant applicants an onsite interview.⁷ This critical factor also was more recently supported by Gohlke and colleagues.⁸

Interestingly, research to identify predictors of residency attainment also was performed by Phillips and colleagues during the same general timeframe as Lyons, and did not find influence of institutional pharmacy work experience in match rate success.⁸ Lyons and colleagues could have acknowledged this and expanded on the significant differences of their study methodology, including a greater total pharmacy student sample size and longer study duration. These differences more strongly support the conclusion that institutional pharmacy work experience is a predictor of residency attainment. As of April 2018, the eight articles that cited the Phillips study did not reference the respective conclusion that it is not, and we believe future articles should continue to follow suit.

• © 2018 American Association of Colleges of Pharmacy