When I was initially preparing for residency as a P4 student, I felt there were so many resources that existed to navigate the process, practice for clinical and behavioral interview questions, and mentally prepare for both match day and the tough year(s) of residency training to come. Fast forward 2 years: When I finally got to the point in my PGY2 year that I could start applying for post-residency clinical transplant pharmacist jobs, I found myself unsure of where and how to start.

Finding a post-residency job is a step in your career that you are always excited to take (no longer will you be a trainee!), but it has noticeably less structure than matching to a residency program. Many questions ran through my mind as I entered the fall and winter of my PGY2 year. When should I start applying? What aspects of the job do I need to consider? How do I negotiate salaries and when is it appropriate to do so? When should I expect to hear back and how much time can I ask for to consider the job? I noticed the importance of leaning on mentors, preceptors, and residency program directors/coordinators at this time; their experience was invaluable and helped guide me in the right direction. Through conversations with my mentors and navigating the process myself earlier this year, I have developed a few pieces of advice for anyone in the process of considering post-residency jobs.

1. It is never too early in your residency to start thinking about post-residency jobs. It is important to reflect on where in the country you want to go and what kind of post-residency job you want (e.g., inpatient vs. outpatient, size of the hospital, specialty within your specialty). It is best to have thought about this by around October to November of your residency year, if possible. Early in the year is also a good time to talk with mentors in your specialty to ask for their suggestions regarding starting the application process and what aspects of the job you should consider. Taking this time to reflect will make it much easier when assessing jobs to decide which ones are best for you to apply to.
2. Network. If you are very interested in a job, don’t be afraid to talk to your residency program director, coordinator, or preceptors to see if they know anyone at the job site, and use your network to your benefit. Pharmacy is a small world.
3. Just start the process of applying. I decided to start applying in early January of my PGY2 year for post-residency jobs because finding a post-residency job was making me anxious. As a solid organ transplant pharmacist, I saw most of the jobs come through the American Society of Transplantation Pharmacy Community of Practice discussion board and into my email. After I had reflected on locations in the country and the types of jobs I wanted (see step 1), I just started applying to jobs that fit my criteria to get a sense of how competitive I was and start the ball rolling. By the time HR gets back to you and you go through the interview process, it often takes 1–2 months anyway to land the job. I accepted a job at the start of March even though I started applying at the start of January. In addition, the application process is not as daunting as for residency; most of the job applications consist of just uploading an updated CV and letter of intent on the website. It is always a good idea to have a couple of mentors review your CV and letter before submission.
4. Expect multiple rounds of interviews. Usually, there is an HR interview first with some behavioral questions and then later an on-site interview. Regarding whether they are in person, mine were 50/50 (two in person, two virtual). Like in residency interviews, it is often expected that candidates will cover their own airfare and accommodation for in-person interviews, but it is still reasonable to ask if the institution can fund it.
5. Be prepared to talk about yourself. During the interview, you should prepare stories using the STAR method, similar to how you likely prepared for residency interviews, to describe your strengths and weaknesses. Reviewing residency interview questions helps remind you of the general types of questions to prepare for. Consider the top 3 features of yourself that you want your interviewers to come away with and form your stories around them. You should also be able to describe your research projects and your experiences with clinical situations (e.g., as a transplant pharmacist candidate, I was asked to describe my experience using eculizumab and bortezomib). I would also recommend reflecting on the challenges you think you will face as an independent practitioner coming out of residency and how you will address them; this was a common question I received during interviews.
6. Ask the important questions. During the interview process, ask the questions that you think you will want to know. This is a more permanent position than a residency that you are applying for. Examples of questions I asked the teams were as follows:
   1. What is your role with resident research projects and presentations?
   2. What do you wish you had more time for?
   3. Does the organization support and encourage pharmacists to attend conferences or other learning/professional development opportunities?
   4. What does your relationship with providers look like? Do you work with them to develop protocols?
7. Nab that job ... but not too fast. It is exciting to get an offer, but don’t get so excited that you just accept it over the phone. It is completely reasonable to ask for several days or up to a week to consider the offer and ask all the questions you have about salary and benefits (e.g., retirement offer, PTO). It is also reasonable to request a relocation bonus if you will be moving far, and ask if they will be able to cover the cost of your pharmacy licensure transfer if you move to another state.
8. Get excited and get prepared! This is the best part and the part of the process I am in right now. I was lucky enough to accept a solid organ transplant position in early March in New York City. I am looking for an apartment to live in and working on getting my New York State pharmacy license. Once you accept a job during residency, the focus for the rest of the residency year can remain on learning and finishing your residency requirements. It allows for smooth sailing until the end.

Ultimately, searching for and accepting a post-residency job can be not only nerve-wracking but also very exciting. When you get to that time in your residency year, it means the end is near and you are at the point of what you have been preparing for. You are ready – so go onward and upward!

About the author: Madhumita (“Madhu”) Rao is a current PGY2 solid organ transplant resident at the University of Colorado Hospital in Aurora, Colorado, where she also completed her PGY1 training. She received her Pharm.D. degree in 2022 from Northeastern University in Boston. Her clinical interests include transplant infectious diseases and medication access, with a focus on intra-abdominal organs. In her free time, Madhu enjoys running, playing piano, traveling to new cities, and spending time with family and friends.