The Biggest Question of All: Do I Stay or Do I Go?

Life is constantly about making decisions, and one of the major decisions for a pharmacy student is whether to pursue residency. If so, where?

There are a plethora of options around the nation, but how does one know if this program is right for them? Part of the decision starts before one is even a fourth-year pharmacy student. The first choice is to decide if one would do a large block of rotations at one hospital or do multiple rotations at different institutions. For me, I chose to stay with one organization. I completed seven out of my eight advanced pharmacy practice experiences with Legacy Health.

At first, I was concerned if this was the right choice. I questioned if I would be a good, well-rounded candidate, and if I could be limiting my pharmacy social network for new connections. I can confidently say that staying with Legacy was the right choice for me. As I submitted my applications for a postgraduate year one pharmacy residency, I questioned if I should apply to Legacy Health or whether I should expand my clinical horizon and go somewhere else. Throughout the entire residency application process and up until the ranking deadline, I continued to question: Do I stay or do I go? Questions that continued to go through my mind were: Am I too comfortable? Would I continue to be challenged? Should I go to a larger hospital instead of a community hospital? Would I still be seen as a student and not a licensed pharmacist?

Expanding my pharmaceutical horizons at Legacy Mount Hood Medical Center was the best decision to help me become an autonomous clinical pharmacist. It started when I was a student. Legacy integrated me into the team from the beginning. My voice mattered in providing recommendations to the provider. My preceptors encouraged me to speak up during rounds and to jump in to gain hands-on experience during a code or other clinical experiences. While I was scared and challenged, I always felt supported. I noticed how my clinical pharmacists would stop with staff members and have long, detailed conversations about their personal life. The providers look to pharmacists to play a vital role in patient care, and they truly value our opinion. One of my favorite aspects of working in the Legacy system was being able to take the time to have one-on-one conversations to ensure patient safety whether it was discussing medication barriers or concerns. The connections I created with my mentors were more than just academic. They were also personal relationships. These were things I wanted to continue into my residency journey.

Staying in the Legacy system for residency provided me more time to focus on my clinical practice and growing knowledge. On the first day of residency, I was able to spend more time understanding the pharmacy operations and workflow rather than the pharmacist protocols. I also better understood the basic pharmacy workflow for the pharmacy team and worried less about first impressions. I was able to be myself, as most of the team already knew me. It made the transition into residency seamless and streamlined. There was less stress about fitting in and finding my footing and more focus on my transition from a student to a resident/clinical practitioner.

One of the biggest things I have appreciated about staying at Legacy is continuing my relationships with my biggest supporters – my mentors. They knew my goals and wanted me to succeed in all of my life endeavors. My residency was personalized to what I wanted to do and how I could learn best, and my mentors always advocated for me throughout my residency journey. As they have watched me grow into an independent clinical practitioner, they helped me grow into a strong individual who has learned to advocate for myself and deal with hard patient relationships. I was never a burden, and every situation I had, challenging or not, they found time for me in their busy schedule. Every check-in always started with the question, “How are you doing?” And each ended with, “What can I do for you?” These questions were not directed solely towards my residency but towards my personal wellness, too. I knew I mattered.

Staying with the same institution does not come without some considerations. One may not be learning a new system and allowing one to question protocols and/or hospital practice. Learning from multiple preceptors and institutions allows one to find one’s way in practicing medicine. If one loves to learn, broadening into new horizons allows one to experience different laws and practices. Getting out of one’s comfort zone could be a challenge, but also allow for new growth, clinically and personally.

Another potential downside to staying at the same hospital is setting one’s standards too high. Because I knew residency was on the table, I wanted strong letters of recommendation from my preceptors and that made me work extra hard to show that I would be a good candidate but it also brought challenges for me during my transition into residency because my preceptors knew where my baseline knowledge and effort was. If I turned in something that was below my standard performance, I was provided constructive feedback about how I could do better.

Even though there may be some negatives, the positives outweigh the negatives by a long shot. After almost 11 months into my residency experience, I have never been let down by my Legacy Mount Hood Pharmacy Team or the pharmacy members throughout the Legacy system. I am appreciative of the opportunities that Legacy has provided me. It has become a home away from home. Not only during my residency experience, but as a pharmacy student. The best part about Legacy is the people you work with – your team.