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N O T E S

Understanding and preparingfor pharmacy practice residency

interviews CARISSA E. MANCUSO AND FRANK P. PALOUCEK

Am J Health-Syst Pharm. 2004; 61:1686-9

CARISSA E. MANCUSO, PHARM.D., and FRANKP. PALOUCEK, PHARM.D., are Clinical Associ-ates, Department of Pharmacy Practice, Col-lege of Pharmacy, University of Illinois atChicago.

Address correspondence to Dr. Mancusoat the Department of Pharmacy Practice(MC 886), College of Pharmacy, University

of Illinois at Chicago, 833 South WoodStreet, Room 164, Chicago, IL 60612-7230(cmancuso@uic.edu).

Copyright © 2004, American Society ofHealth-System Pharmacists, Inc. All rights re-served. 1079-2082/04/0802-1686$06.00.

T he 2003 ASHP Resident Match-ing Program for pharmacypractice residency programs set

numerous records,1 proving that thecompetition for pharmacy practiceresidency positions is becomingmore intense. Compared with theprogram’s 2002 results, there was a21% increase in the number of appli-cants seeking a position through theprogram but only a 7% increase inthe number of positions available.

While published literature is avail-able to assist pharmacy students withthe interview process for employ-ment,2-8 this information may or maynot be applicable to residency inter-views. An exhaustive MEDLINEsearch yielded no published guidelinesregarding interview preparation forcandidates for residencies in pharmacypractice or any other medical specialty.ASHP does provide general recom-mendations to help prepare applicantsfor the residency interview.9

Our institution previously con-ducted a survey of pharmacy practiceresidency programs to determine if a

consensus exists among programs inthe selection criteria for future resi-dents.10 The results of that survey,which have not been published, re-vealed that the personal interviewwith the candidate was the highest-ranked criterion. Therefore, it is im-perative that candidates do well dur-ing the interview in order to secure aresidency. This follow-up survey wasconducted to decipher the processused in evaluating candidates duringthe residency interview.

Methods. Common interviewquestions were identified via an infor-mal survey of the pharmacy practiceresidents at the University of Illinois atChicago during the 2002–2003 aca-demic year. The residents provided alist of questions that were frequently

asked and themes that were ad-dressed during the interviews theyparticipated in as part of the ASHPResident Matching Program. Fromthis list, a 45-item questionnaire wascreated. Five members of our institu-tion’s pharmacy practice residencyselection committee reviewed thesurvey for content and clarity. Thesurvey consisted of yes–no, short-answer, and fill-in-the-blank ques-tions. Representatives of residencyprograms were asked to indicatewhich of 16 questions they askedduring interviews and to use a5-point scale (with 1 being not im-portant and 5 being very important)to rate the importance of those ques-tions. The questionnaire was dividedinto seven sections: (1) the interviewprocess, (2) the interview committee,(3) factors that invite a candidate foran interview, (4) reflective questions,(5) experiential questions, (6) demo-graphics of the program, and (7) thestructure of the interview. The finalsection provided space for additionalcomments and questions not repre-sented by the survey.

The survey was e-mailed onMarch 25, 2003, to the contact per-sons of 336 ASHP-accredited phar-macy practice residency programs. Acover letter accompanied each e-mailand provided information regardingthe purpose of and instructions forcompleting the survey. The programswere given two weeks to submit the

The Notes section welcomes the following types of contributions: (1) practical innovations orsolutions to everyday practice problems, (2) substantial updates or elaborations on workpreviously published by the same authors, (3) important confirmations of research findingspreviously published by others, and (4) short research reports, including practice surveys, ofmodest scope or interest.

Notes should be submitted with AJHP’s manuscript checklist. The text should be concise,and the number of references, tables, and figures should be limited.

1687Am J Health-Syst Pharm—Vol 61 Aug 15, 2004

NOTES Residency interviews

questionnaire. In an effort to im-prove the response rate, a follow-upe-mail was sent, extending the duedate for completed surveys by an ad-ditional week.

Results. Fifteen e-mails (4.5%)were undeliverable. One hundredand two surveys were returned,yielding a 32% response rate.

The majority of pharmacy prac-tice residency programs (n = 72) didnot invite all applicants for an inter-view. The most common criteriaused to determine which applicantsare offered an interview are listed inTable 1. The residency program di-rector or coordinator solely deter-mines the candidates receiving an in-vitation for an interview for 38% ofthe programs, and 28 programs re-ported that a residency committee,which may or may not include theprogram director, determines whichcandidates will be interviewed.

Regarding the structure of the in-terview, less than half of the pro-grams (n = 45) provided the inter-viewers with mutually exclusivequestions to ask the candidates. Themajority of the programs (n = 100)had their current residents partici-pate in the interview process. Thecurrent pharmacy practice residentsare involved in the selection of candi-dates for an interview in 53% of pro-grams, and 85 programs reportedthat current residents are involved inthe formal evaluation of the candi-date on the interview day.

Table 2 shows the respondents’use of interview questions and howthey were rated in importance. Fifty-five respondents indicated addition-al questions asked during the inter-view at their institution, with themajority citing more than one ques-tion (Table 3).

Respondents were asked to pro-vide information regarding the struc-ture of the interview process at theirinstitution. Approximately 2 candi-dates (range, 1–11) are interviewedon a given day. Fifty-one percent ofthe programs classified their inter-

Grade point average and grades 53 (52)Letters of recommendation 41 (40)Completed application 18 (18)Curriculum vitae 18 (18)Letter of intent 17 (17)Clerkship rotations 9 (9)References 8 (8)Personal goals 7 (7)Interaction and interview at ASHP Midyear Clinical Meeting 6 (6)Leadership roles 6 (6)School of pharmacy attended 5 (5)Extracurricular activities 4 (4)Number of applicants 4 (4)

Table 1.Common Criteria for Inviting a Residency Candidate for an Interview(n = 102)

Criterion No. (%) Responses

view as a half-day or as a time periodof five hours or less, and 78 programsprovide the candidates with breakfastor lunch or both. Hotel or travel ac-commodations for out-of-state ap-plicants were only provided by 16%of the programs. Group interviews,involving one interviewer and more

than one candidate, were not com-mon (n = 9). Each candidate has anaverage of three one-on-one inter-views, which last about 38 minutes(range, 15–60 minutes) each. A for-mal presentation is required by 18programs, usually lasting 20 minutes(range, 5–40 minutes), and is attend-

ReflectiveWhy do you want to do a residency? 102 (100) 5Where do you see yourself after a pharmacy

practice residency? 99 (97) 4What areas of pharmacy most interest you? 95 (93) 4What qualities do you possess that would

make you a good resident? 90 (88) 4What are your worst qualities? 74 (73) 4Are you considering a specialty residency

or fellowship? 60 (59) 3Why did you attend pharmacy school? 57 (56) 3What is your definition of pharmaceutical

care? 24 (24) 3Experiential

What was your favorite rotation? 74 (73) 4Describe the most significant contribution

you made to a patient’s care this past year. 61 (60) 4What was your least favorite rotation? 57 (56) 3Describe your most memorable experiences

from clerkship rotations. 48 (47) 4If I were to ask preceptor X to describe you,

what words would he or she use? 38 (37) 4Describe your favorite or most memorable

patient. 33 (32) 4Who was your favorite preceptor? 19 (19) 4Describe or discuss the most interesting

medical journal article you have recentlyread. 13 (13) 3

aRespondents were presented with a list of 16 questions and identified those that they asked. The importanceof questions was indicated only for questions that were asked (1 = not important, 5 = very important).

Table 2.Questions Asked during Residency Interviewsa

Question

No. (%)Respondents

Asking QuestionMedian

Importance

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Why are you interested in our program? 13 (13)How do you handle conflict? 10 (10)What do you like to do for fun? 9 (8)Describe a conflict with a preceptor or attending physician. 7 (7)Describe your time-management skills. 7 (7)How do you handle stress? 6 (6)Describe a leadership role that you had. 4 (4)Given a scenario, how would you handle the situation? 4 (4)What is your definition of a clinical pharmacist? 4 (4)Why are you the best candidate for this program? 4 (4)Do you prefer to work individually or as part of a team? 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 3.Most Common Nonlisted Interview Questions Asked By Respondents(n = 102)a

No. (%) RespondentsAsking QuestionQuestion

ed by the residency committee, facul-ty, staff, preceptors, current resi-dents, and other candidates.

Discussion. Our survey was de-signed with four objectives in mind:(1) gather basic information aboutthe interview process for pharmacypractice residents, (2) evaluate thecriteria used by committees that in-terview pharmacy practice residents,(3) determine if a consensus existsamong programs when interviewingprospective residents, and (4) pro-vide prospective pharmacy practiceresidents with general informationabout the current interview process.Our summary of what candidates forpharmacy practice residencies canexpect on the day of their interview isprovided in Table 4.

It is somewhat difficult to assessthe consistency of questions askedduring the interview and the valueplaced on these questions. Reflectivequestions were asked by the majorityof programs, and the questionsasked by the most programs weredeemed the most important. Al-though there was less consistencyamong the programs in asking thelisted experiential questions, theywere ranked as fairly important. Webelieve that consistently higher valueis placed on the reflective questions,if asked, during a pharmacy practiceresidency interview.

The final response rate of 32% wasdisappointing and may be explainedby a few limitations. We chose toe-mail the survey, which may nothave been the most user-friendlymethod. In addition, the programsmay not have been willing to discloseinformation asked during the inter-view, believing that it is confidential.A final limitation was the people wesurveyed. The questionnaire was sentto contact persons of each pharmacypractice residency program. The con-tact person is often the residency pro-gram director or coordinator. Our re-sults showed that many faculty or staffare involved in the interview process.A more accurate analysis would have

surveyed all members of the interviewcommittees of each program.

The majority of additional ques-tions were experiential. This surveywas not intended to assess the im-portance of some subjective factors,such as the candidates’ appearance orattire. None of the respondents men-tioned that such factors were impor-tant. Although intangible items areimportant, we believe that they rep-resent a common message under-stood by all interviewing applicants.

Conclusion. A survey of residencyprograms revealed that many use

similar criteria to select candidates tointerview and that many ask thesame interview questions.

References1. American Society of Health-System

Pharmacists. The communique. www.ashp.com/rtp/Communique/May03.pdf(accessed 2003 May 30).

2. Questions commonly asked by employersduring job applicant interviews. HospPharm. 1979; 14:86-7.

3. Bell AH. Pharmacy interviewing: how tohire the best. Consult Pharm. 1989; 4:299,303.

4. Charupatanapong N, Rascati KL. Com-parison of pharmacy recruiters’ and stu-dents’ views toward job interviews. Am JPharm Educ. 1995; 59:358-64.

Table 4.What Residency Candidates Should Expect During an Interview

• Be prepared to meet with approximately 10 faculty or staff members throughout theday.

• 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 askquestions about the programs. Most programs consider the opinions of the currentresidents in the formal evaluation of the candidates.

• The length of the interview day varies between a half-day and a full day; expect to beonsite for about five hours.

• If you are from out of state, expect to pay your own way; most programs do notreimburse hotel or travel expenses.

• Although the majority of programs do not require a formal presentation, you should befamiliar with a topic that you have presented because you may get asked questionsregarding the topic and conclusion.

• If you are required to give a formal presentation, ask for specific guidelines. Mostpresentations last about 20 minutes, and the residency committee, faculty, staff, clinicalpreceptors, current residents, and fellow candidates may attend.

• Review the structure and content of SOAP notes; you may be given a patient case andrequested to write a SOAP note.a

• Reflective questions are asked more commonly than experiential questions. The answersto the experiential questions are highly valued.aSOAP = subjective, objective, assessment, and plan.

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5. Covington TR. Preparing for a job inter-view. Consult Pharm. 1991; 6:86-8.

6. Dasher H. Interviewing 101: preparationprimer. Hosp Pharm. 1985; 20:489,493.

7. Enright SM, Enright SJ. Tips for makingthe job search productive and enjoyable.Am J Hosp Pharm. 1984; 41:924-7.

8. Hasegawa GR. How to be interviewed fora job. Am J Hosp Pharm. 1991; 48:1180,1183.

9. Traynor K. Prepare for residencyinterviews. www.ashp.com/news/s h o w A r t i c l e . c f m ? c f i d = 5 9 8 0 7 6 1 &CFToken=98976623&id=1895 (ac-cessed 2003 Apr 15).

10. Khorana K, Paloucek FP. Survey of selec-tion criteria for pharmacy practice resi-dents. Paper presented at ASHP MidyearClinical Meeting. Atlanta, GA; 2002 Dec11.

Reconciliation of discrepanciesin medication histories and admissionorders 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

A 1999 Institute of Medicine re- port received national atten- tion by highlighting system

vulnerabilities within health care andindicating that medication errors area leading cause of morbidity andmortality.1 One area of concern wasthe increased number of errors oc-curring in the prescribing phase ofthe medication-use process2-9 due toprescribers’ lack of essential drugknowledge and patient informationat the time of ordering.2,4,9 Pharma-cists’ participation in medical roundshas demonstrated a reduction inmedication errors in the orderingstage.10-12 However, at most hospitals,pharmacists are not directly involvedin obtaining medication histories,13

despite the findings of one studyshowing that over 70% of drug-relatedproblems were recognized onlythrough a patient interview14 and an-other study reporting a 51% reduc-tion in medication errors when phar-macists were involved in obtainingmedication histories.13

Medication errors and patientharm can result from inaccurate orincomplete histories that are subse-quently used to generate medication

KRISTINE M. GLEASON, B.S.PHARM., is Re-search Pharmacist Coordinator; JENNIFER M.GROSZEK, R.N., B.S.N., M.J., and CAROLSULLIVAN, R.N., M.B.A., are Research NurseCoordinators, Patient Safety Team; DENISEROONEY, 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, Quali-ty Strategies and Patient Safety Team, Divi-sion of Quality and Operations, NorthwesternMemorial Hospital (NMH), Chicago, IL.GARY A. NOSKIN, M.D., is Associate Professorof Medicine, Department of Medicine, Divi-sion of Infectious Diseases, Feinberg School ofMedicine, Northwestern University, Chicago,and Medical Director, Healthcare Epidemiol-ogy and Quality, NMH.

Address correspondence to Ms. Gleason atthe Division of Quality and Operations,Northwestern Memorial Hospital, 676 NorthSt. Clair Street, Suite 700, Chicago, IL 60611(kmgleaso@nmh.org).

The Patient Safety Team and Failure Modeand Effects Analysis team members at North-western Memorial Hospital are acknowledgedfor their active participation and support.

Karen Nordstrom, B.S.Pharm., Michael Fotis,B.S.Pharm., and Desi Kotis, Pharm.D., pro-vided invaluable assistance and insight intothis project. The dedicated clinical staff phar-macists are acknowledged for enhancingpatient safety by obtaining medication and al-lergy histories, reconciling discrepancies inmedication histories and orders, and collect-ing data.

Supported in part by an Excellence in Aca-demic Medicine Grant from the State of Illi-nois Department of Public Aid and U.S. Pub-lic Health Service grant UR8/515081.

Presented at the ASHP Midyear ClinicalMeeting, Atlanta, GA, December 11, 2002; the5th Annual National Patient Safety Founda-tion Patient Safety Congress, Washington,DC, March 12–14, 2003; and the Institute forHealthcare Improvement 15th Annual Na-tional Forum on Quality Improvement inHealth Care, New Orleans, LA, December 4,2003.

Copyright © 2004, American Society ofHealth-System Pharmacists, Inc. All rights re-served. 1079-2082/04/0802-1689$06.00.

regimens for hospitalized patients.To ensure that medications are pre-scribed safely on hospital admission,it is necessary to have an accurateand complete medication history15

and for health care professionals tovalidate this information.16 As thehealth care delivery system becomesmore complex and specialized, thisissue becomes even more important,

as hospitalized patients may receivemedications that interact with thosetaken as outpatients. Furthermore, aspatients’ severity of illness increases,there is a greater likelihood that pa-tients will be taking an increasednumber of medications. Prior inves-tigations have demonstrated that pa-tients taking numerous medicationsare at a higher risk for adverse drugevents (ADEs).17

Discrepancies may exist amongwhat is documented in the patient’smedical record, outpatient clinic oroffice records, prescription bottles,and outpatient pharmacy recordsand what medications the patientis actually taking. In 1981, Leisterand colleagues18 reported a lack ofconcordance among physician-generated drug lists, patients’ phar-macy medication profiles, and pa-tients’ current drug lists obtainedduring home interviews. Since thattime, researchers working in a varietyof clinical settings have reported sim-ilar findings of discrepancies be-tween hospital and clinic records andthe medication lists obtained frompatients.15,19-22 Discrepancies most of-ten involved patients taking medica-tions for which there was no docu-mentation,15,20-22 patients not takingxx