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Understanding and preparing for pharmacy practice residency interviews

CARISSA E. MANCUSO AND FRANK P. PALOUCEK
Am J Health-Syst Pharm. 2004; 61:1686-9

The Notes section welcomes the following types of contributions: (1) practical innovations or solutions to everyday practice problems, (2) substantial updates or elaborations on work previously published by the same authors, (3) important confirmations of research findings previously published by others, and (4) short research reports, including practice surveys, of modest scope or interest. Notes should be submitted with AJHPs manuscript checklist. The text should be concise, and the number of references, tables, and figures should be limited.

he 2003 ASHP Resident Matching Program for pharmacy practice residency programs set numerous records,1 proving that the competition for pharmacy practice residency positions is becoming more intense. Compared with the programs 2002 results, there was a 21% increase in the number of applicants seeking a position through the program but only a 7% increase in the number of positions available. While published literature is available to assist pharmacy students with the interview process for employment,2-8 this information may or may not be applicable to residency interviews. An exhaustive MEDLINE search yielded no published guidelines regarding interview preparation for candidates for residencies in pharmacy practice or any other medical specialty. ASHP does provide general recommendations to help prepare applicants for the residency interview.9 Our institution previously conducted a survey of pharmacy practice residency programs to determine if a

consensus exists among programs in the selection criteria for future residents.10 The results of that survey, which have not been published, revealed that the personal interview with the candidate was the highestranked criterion. Therefore, it is imperative that candidates do well during the interview in order to secure a residency. This follow-up survey was conducted to decipher the process used in evaluating candidates during the residency interview. Methods. Common interview questions were identified via an informal survey of the pharmacy practice residents at the University of Illinois at Chicago during the 20022003 academic year. The residents provided a list of questions that were frequently
CARISSA E. MANCUSO, PHARM.D., and FRANK P. PALOUCEK, PHARM.D., are Clinical Associates, Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago. Address correspondence to Dr. Mancuso at the Department of Pharmacy Practice (MC 886), College of Pharmacy, University

asked and themes that were addressed during the interviews they participated in as part of the ASHP Resident Matching Program. From this list, a 45-item questionnaire was created. Five members of our institutions pharmacy practice residency selection committee reviewed the survey for content and clarity. The survey consisted of yesno, shortanswer, and fill-in-the-blank questions. Representatives of residency programs were asked to indicate which of 16 questions they asked during interviews and to use a 5-point scale (with 1 being not important and 5 being very important) to rate the importance of those questions. The questionnaire was divided into seven sections: (1) the interview process, (2) the interview committee, (3) factors that invite a candidate for an interview, (4) reflective questions, (5) experiential questions, (6) demographics of the program, and (7) the structure of the interview. The final section provided space for additional comments and questions not represented by the survey. The survey was e-mailed on March 25, 2003, to the contact persons of 336 ASHP-accredited pharmacy practice residency programs. A cover letter accompanied each e-mail and provided information regarding the purpose of and instructions for completing the survey. The programs were given two weeks to submit the
of Illinois at Chicago, 833 South Wood Street, Room 164, Chicago, IL 60612-7230 (cmancuso@uic.edu). Copyright 2004, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0802-1686$06.00.

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questionnaire. In an effort to improve the response rate, a follow-up e-mail was sent, extending the due date for completed surveys by an additional week. Results. Fifteen e-mails (4.5%) were undeliverable. One hundred and two surveys were returned, yielding a 32% response rate. The majority of pharmacy practice residency programs (n = 72) did not invite all applicants for an interview. The most common criteria used to determine which applicants are offered an interview are listed in Table 1. The residency program director or coordinator solely determines the candidates receiving an invitation for an interview for 38% of the programs, and 28 programs reported that a residency committee, which may or may not include the program director, determines which candidates will be interviewed. Regarding the structure of the interview, less than half of the programs (n = 45) provided the interviewers with mutually exclusive questions to ask the candidates. The majority of the programs (n = 100) had their current residents participate in the interview process. The current pharmacy practice residents are involved in the selection of candidates for an interview in 53% of programs, and 85 programs reported that current residents are involved in the formal evaluation of the candidate on the interview day. Table 2 shows the respondents use of interview questions and how they were rated in importance. Fiftyfive respondents indicated additional questions asked during the interview at their institution, with the majority citing more than one question (Table 3). Respondents were asked to provide information regarding the structure of the interview process at their institution. Approximately 2 candidates (range, 111) are interviewed on a given day. Fifty-one percent of the programs classified their inter-

view as a half-day or as a time period of five hours or less, and 78 programs provide the candidates with breakfast or lunch or both. Hotel or travel accommodations for out-of-state applicants were only provided by 16% of the programs. Group interviews, involving one interviewer and more
Table 1.

than one candidate, were not common (n = 9). Each candidate has an average of three one-on-one interviews, which last about 38 minutes (range, 1560 minutes) each. A formal presentation is required by 18 programs, usually lasting 20 minutes (range, 540 minutes), and is attend-

Common Criteria for Inviting a Residency Candidate for an Interview (n = 102)

Criterion
Grade point average and grades Letters of recommendation Completed application Curriculum vitae Letter of intent Clerkship rotations References Personal goals Interaction and interview at ASHP Midyear Clinical Meeting Leadership roles School of pharmacy attended Extracurricular activities Number of applicants

No. (%) Responses

53 (52) 41 (40) 18 (18) 18 (18) 17 (17) 9 (9) 8 (8) 7 (7) 6 (6) 6 (6) 5 (5) 4 (4) 4 (4)

Table 2.

Questions Asked during Residency Interviewsa

Question
Reflective Why do you want to do a residency? Where do you see yourself after a pharmacy practice residency? What areas of pharmacy most interest you? What qualities do you possess that would make you a good resident? What are your worst qualities? Are you considering a specialty residency or fellowship? Why did you attend pharmacy school? What is your definition of pharmaceutical care? Experiential What was your favorite rotation? Describe the most significant contribution you made to a patients care this past year. What was your least favorite rotation? Describe your most memorable experiences from clerkship rotations. If I were to ask preceptor X to describe you, what words would he or she use? Describe your favorite or most memorable patient. Who was your favorite preceptor? Describe or discuss the most interesting medical journal article you have recently read.

No. (%) Respondents Asking Question

102 (100) 99 (97) 95 (93) 90 (88) 74 (73) 60 (59) 57 (56) 24 (24) 74 (73) 61 (60) 57 (56) 48 (47) 38 (37) 33 (32) 19 (19) 13 (13)

Median Importance
5 4 4 4 4 3 3 3 4 4 3 4 4 4 4 3

aRespondents were presented with a list of 16 questions and identified those that they asked. The importance

of questions was indicated only for questions that were asked (1 = not important, 5 = very important).

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ed by the residency committee, faculty, staff, preceptors, current residents, and other candidates. Discussion. Our survey was designed with four objectives in mind: (1) gather basic information about the interview process for pharmacy practice residents, (2) evaluate the criteria used by committees that interview pharmacy practice residents, (3) determine if a consensus exists among programs when interviewing prospective residents, and (4) provide prospective pharmacy practice residents with general information about the current interview process. Our summary of what candidates for pharmacy practice residencies can expect on the day of their interview is provided in Table 4. It is somewhat difficult to assess the consistency of questions asked during the interview and the value placed on these questions. Reflective questions were asked by the majority of programs, and the questions asked by the most programs were deemed the most important. Although there was less consistency among the programs in asking the listed experiential questions, they were ranked as fairly important. We believe that consistently higher value is placed on the reflective questions, if asked, during a pharmacy practice residency interview. The final response rate of 32% was disappointing and may be explained by a few limitations. We chose to e-mail the survey, which may not have been the most user-friendly method. In addition, the programs may not have been willing to disclose information asked during the interview, believing that it is confidential. A final limitation was the people we surveyed. The questionnaire was sent to contact persons of each pharmacy practice residency program. The contact person is often the residency program director or coordinator. Our results showed that many faculty or staff are involved in the interview process. A more accurate analysis would have

Table 3.

Most Common Nonlisted Interview Questions Asked By Respondents (n = 102)a

Question
Why are you interested in our program? How do you handle conflict? What do you like to do for fun? Describe a conflict with a preceptor or attending physician. Describe your time-management skills. How do you handle stress? Describe a leadership role that you had. Given a scenario, how would you handle the situation? What is your definition of a clinical pharmacist? Why are you the best candidate for this program? Do you prefer to work individually or as part of a team?

No. (%) Respondents Asking Question

13 (13) 10 (10) 9 (8) 7 (7) 7 (7) 6 (6) 4 (4) 4 (4) 4 (4) 4 (4) 4 (4)

aQuestions that were not among the 16 listed on the questionnaire but were indicated by respondents as being commonly asked. Fifty-five respondents (54%) provided nonlisted questions.

Table 4.

What Residency Candidates Should Expect During an Interview

Be prepared to meet with approximately 10 faculty or staff members throughout the day. On average, you will have three separate one-on-one interviews, each usually lasting 30 40 minutes. You will be meeting with current residents, which provides a good opportunity to ask questions about the programs. Most programs consider the opinions of the current residents in the formal evaluation of the candidates. The length of the interview day varies between a half-day and a full day; expect to be onsite for about five hours. If you are from out of state, expect to pay your own way; most programs do not reimburse hotel or travel expenses. Although the majority of programs do not require a formal presentation, you should be familiar with a topic that you have presented because you may get asked questions regarding the topic and conclusion. If you are required to give a formal presentation, ask for specific guidelines. Most presentations last about 20 minutes, and the residency committee, faculty, staff, clinical preceptors, current residents, and fellow candidates may attend. Review the structure and content of SOAP notes; you may be given a patient case and requested to write a SOAP note.a Reflective questions are asked more commonly than experiential questions. The answers to the experiential questions are highly valued.
aSOAP = subjective, objective, assessment, and plan.

surveyed all members of the interview committees of each program. The majority of additional questions were experiential. This survey was not intended to assess the importance of some subjective factors, such as the candidates appearance or attire. None of the respondents mentioned that such factors were important. Although intangible items are important, we believe that they represent a common message understood by all interviewing applicants. Conclusion. A survey of residency programs revealed that many use

similar criteria to select candidates to interview and that many ask the same interview questions.
References
1. American Society of Health-System Pharmacists. The communique. www. ashp.com/rtp/Communique/May03.pdf (accessed 2003 May 30). 2. Questions commonly asked by employers during job applicant interviews. Hosp Pharm. 1979; 14:86-7. 3. Bell AH. Pharmacy interviewing: how to hire the best. Consult Pharm. 1989; 4: 299,303. 4. Charupatanapong N, Rascati KL. Comparison of pharmacy recruiters and students views toward job interviews. Am J Pharm Educ. 1995; 59:358-64.

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5. Covington TR. Preparing for a job interview. Consult Pharm. 1991; 6:86-8. 6. Dasher H. Interviewing 101: preparation primer. Hosp Pharm. 1985; 20:489,493. 7. Enright SM, Enright SJ. Tips for making the job search productive and enjoyable. Am J Hosp Pharm. 1984; 41:924-7. 8. Hasegawa GR. How to be interviewed for a job. Am J Hosp Pharm. 1991; 48:1180, 1183.

9. Traynor K. Prepare for residency interviews. www.ashp.com/news/ showArticle.cfm?cfid=5980761& CFToken=98976623&id=1895 (accessed 2003 Apr 15). 10. Khorana K, Paloucek FP. Survey of selection criteria for pharmacy practice residents. Paper presented at ASHP Midyear Clinical Meeting. Atlanta, GA; 2002 Dec 11.

Reconciliation of discrepancies in medication histories and admission orders of newly hospitalized patients
KRISTINE M. GLEASON, JENNIFER M. GROSZEK, CAROL SULLIVAN, DENISE ROONEY, CYNTHIA BARNARD, AND GARY A. NOSKIN
Am J Health-Syst Pharm. 2004; 61:1689-95

1999 Institute of Medicine report received national attention by highlighting system vulnerabilities within health care and indicating that medication errors are a leading cause of morbidity and mortality.1 One area of concern was the increased number of errors occurring in the prescribing phase of the medication-use process2-9 due to prescribers lack of essential drug knowledge and patient information at the time of ordering.2,4,9 Pharmacists participation in medical rounds has demonstrated a reduction in medication errors in the ordering stage.10-12 However, at most hospitals, pharmacists are not directly involved in obtaining medication histories,13 despite the findings of one study showing that over 70% of drug-related problems were recognized only through a patient interview14 and another study reporting a 51% reduction in medication errors when pharmacists were involved in obtaining medication histories.13 Medication errors and patient harm can result from inaccurate or incomplete histories that are subsequently used to generate medication

regimens for hospitalized patients. To ensure that medications are prescribed safely on hospital admission, it is necessary to have an accurate and complete medication history15 and for health care professionals to validate this information.16 As the health care delivery system becomes more complex and specialized, this issue becomes even more important,
KRISTINE M. GLEASON, B.S.PHARM., is Research Pharmacist Coordinator; JENNIFER M. GROSZEK, R.N., B.S.N., M.J., and C AROL SULLIVAN , R.N., M.B.A., are Research Nurse Coordinators, Patient Safety Team; DENISE ROONEY, R.N., B.S.N., O.C.N., is Manager, Patient Safety Team; and CYNTHIA BARNARD, M.B.A., M.S.J.S., C.P.H.Q., is Director, Quality Strategies and Patient Safety Team, Division of Quality and Operations, Northwestern Memorial Hospital (NMH), Chicago, IL. GARY A. NOSKIN, M.D., is Associate Professor of Medicine, Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, and Medical Director, Healthcare Epidemiology and Quality, NMH. Address correspondence to Ms. Gleason at the Division of Quality and Operations, Northwestern Memorial Hospital, 676 North St. Clair Street, Suite 700, Chicago, IL 60611 (kmgleaso@nmh.org). The Patient Safety Team and Failure Mode and Effects Analysis team members at Northwestern Memorial Hospital are acknowledged for their active participation and support.

as hospitalized patients may receive medications that interact with those taken as outpatients. Furthermore, as patients severity of illness increases, there is a greater likelihood that patients will be taking an increased number of medications. Prior investigations have demonstrated that patients taking numerous medications are at a higher risk for adverse drug events (ADEs).17 Discrepancies may exist among what is documented in the patients medical record, outpatient clinic or office records, prescription bottles, and outpatient pharmacy records and what medications the patient is actually taking. In 1981, Leister and colleagues18 reported a lack of concordance among physiciangenerated drug lists, patients pharmacy medication profiles, and patients current drug lists obtained during home interviews. Since that time, researchers working in a variety of clinical settings have reported similar findings of discrepancies between hospital and clinic records and the medication lists obtained from patients.15,19-22 Discrepancies most often involved patients taking medications for which there was no documentation,15,20-22 patients not taking xx
Karen Nordstrom, B.S.Pharm., Michael Fotis, B.S.Pharm., and Desi Kotis, Pharm.D., provided invaluable assistance and insight into this project. The dedicated clinical staff pharmacists are acknowledged for enhancing patient safety by obtaining medication and allergy histories, reconciling discrepancies in medication histories and orders, and collecting data. Supported in part by an Excellence in Academic Medicine Grant from the State of Illinois Department of Public Aid and U.S. Public Health Service grant UR8/515081. Presented at the ASHP Midyear Clinical Meeting, Atlanta, GA, December 11, 2002; the 5th Annual National Patient Safety Foundation Patient Safety Congress, Washington, DC, March 1214, 2003; and the Institute for Healthcare Improvement 15th Annual National Forum on Quality Improvement in Health Care, New Orleans, LA, December 4, 2003. Copyright 2004, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0802-1689$06.00.

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