Trends and considerations in the pursuit of postgraduate training: Motivations, barriers, and well-being

Pharmacy residency training, endorsed by the American Society of Health-System Pharmacists (ASHP), is designed to enhance clinical pharmacy practice. However, in 2022 and subsequent years, the ASHP Resident Matching Program reported unprecedented numbers of unfilled positions, notably in postgraduate year 2 (PGY2) programs. This review explores motivations, barriers, and well-being indices in pharmacy residency pursuit and training, seeking to explain the rise in unfilled postgraduate training positions.

Two literature searches were performed using relevant resources and databases: search 1, to determine motivating factors and barriers to pursuit of postgraduate training; and search 2, to gather evidence related to resident well-being, burnout, and resiliency.

Search 1 yielded 11 studies about motivating or deterring factors for pharmacy residency pursuit, whereas search 2 produced 16 articles on resident well-being. Major motivators for pursuing postgraduate training included the desire to gain knowledge and specialized training, recognition of evolving pharmacist roles, and viewing residency as a prerequisite for certain positions. Conversely, major barriers included financial or family obligations and concerns about job availability following graduation. Most articles discussed student pursuit of PGY1 residencies. Resident well-being encompassed burnout assessments, other wellness indicators like depression, and the impact of the coronavirus disease 2019 (COVID-19) pandemic. Developed well-being programs elicited mostly positive perceptions from pharmacy residents.

There is a body of published literature elucidating motivations and barriers to the pursuit of postgraduate training and well-being related to wellness/satisfaction on the job. However, to comprehensively evaluate well-being program impact and address gaps in literature regarding barriers to and motivators for pursuit of specialized PGY2 programs, further research is needed.