What’s the “Big Ideal” about Resident Candidates: Varying Perspectives

By Stephanie S. Bethay, PharmD, MBA

As a current resident finishing up my first resident recruitment season, I am now “on the other side” and have been considering what makes an ideal residency candidate. I can’t help but think of a student whom I recently encountered who was kind, helpful, and had solid clinical knowledge. However, he “found his niche” later on in his pharmacy school path, he was not as involved as other students, and thus due to commonly used selection criteria he may be at risk for being declined for interviews.

How do we consider both types of candidates: those who are well-rounded and those who may have great potential but less robust experiences? Just as with pharmacy school admissions, should resident candidate evaluation processes become more holistic?

Student Perspective
While there are many perspectives as to what qualifications make a great residency candidate, most prescribe that candidates must meet objective criteria1 such as:

  • professional organization involvement
  • extensive work experience
  • clinical rotation variety
  • excellent grades
  • multiple projects and presentations
  • scholarly publications

This “standard of practice” is now common knowledge, as many students have sought residency advice during the first week of pharmacy school. Even pre-pharmacy clubs discuss residencies in the early undergraduate stages! Students then push themselves and join a multitude of organizations, take on leadership positions, apply for competitive intern positions, and participate in research projects. As these students matriculate throughout the pharmacy curriculum, they begin to stress about gaining the “best” rotations, top notch recommendations, and sometimes worry that their curriculum vitae documents are not long enough.

This increased student stress could lead to burnout, which then could even lead to less productive residents. One study of 410 pharmacy students compared students in the first two years of pharmacy school with those in the last two years concerning burnout. Students of all years reported being affected by burnout which was negatively correlated to academic satisfaction.2

Conversely, what about those students who may not take this proactive, aggressive approach? While potentially great future residents, they, unfortunately, risk being “lost in the mix” in programs with large numbers of applications. Those candidates are dependent on good recommendation letters and/or personal experiences with application evaluators.

Personal Perspective
I was of the “highly involved” mindset throughout pharmacy school. While I ultimately enjoyed my experience, I quickly became one of the aggressive students. I enjoyed all opportunities that I pursued but quickly became an inactive member of many organizations. Most would say that I was overcommitted, and this contributed to a great deal of stress in pharmacy school. I matched at one of my top preferences, but that positive outcome did not come without personal consequences on my stress level, health, and work/life balance.

Residency Program Perspective
Each residency program wants the best candidate. While there have been many qualities mentioned in regard to ideal candidates that many residency programs may consider, we need to determine which of those are most important. A strong clinical foundation is very important, which may be reflected in strong rotations and/or good grade point averages.1 Many other characteristics for consideration can likely be taught in residency, such as advanced presentation skills, medical writing, and project involvement. It is more difficult to teach motivation, grit, and great communication skills, and it may be ideal to have these skills weighted more heavily in the application process.

Future Focus
If we are not already doing so, should we consider focusing more on letters of intent, strong references, unique experiences and characteristics, or answers to supplemental essay questions? These may truly diversify candidates. A recent posting in Pulses on this very topic in academic pharmacy suggests grit should also be considered.3 Some candidates may have had to work harder in certain areas and display a large amount of resilience and courage, which are likely helpful characteristics in residency. Focusing on some of these other characteristics holistically and looking at applicants who may not fit the traditional mold could bring a new perspective and more diversity to programs.

Final Thoughts
While I don’t claim to have any of the answers, it is important to evaluate the entire candidate. Should we consider placing a higher emphasis on more subjective, qualitative aspects of applications, or should we continue with current methods and mentalities as they have proven successful? There are advantages and disadvantages to each approach, and perhaps there is no real “ideal” solution.

Special thanks to Craig Martin, PharmD, MBA, University of Kentucky College of Pharmacy for his guidance on this article.


  1. Phillips JA, McLaughlin MM, Rose C, Gallagher JC, Gettig JP, Rhodes NJ. Student Characteristics Associated with Successful Matching to a PGY1 Residency Program. American Journal of Pharmaceutical Education. 2016;80(5):84. doi:10.5688/ajpe80584.
  2. Silva RG, Figueiredo-Braga M. The roles of empathy, attachment style, and burnout in pharmacy students’ academic satisfaction. Am J Pharm Educ. 2018. Available from: http://www.ajpe.org/doi/pdf/10.5688/ajpe6706. Accessed January 22, 2018.
  3. Cain J. Three questions for pharmacy educators to consider with regard to grit. Pulses. Currents in Pharmacy Teaching and Learning Scholarly Blog. September 19, 2017. https://cptlpulses.com/2017/09/19/3gritquestions/.

nullStephanie Bethay is a PGY-1 Health-System Pharmacy Administration Resident at UK HealthCare in Lexington, Kentucky. Educational scholarship interests include student professional development, student assessment, and novel classroom teaching techniques. In her free time, Stephanie enjoys spending time with family and friends, watersports, and Ole Miss athletic events.

Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning


  1. Ideal Candidate?…Ideal pizza? Your points are spot on and let me just add something that doing this for like…forever…has lead me to strongly believe that ideal is in the eye of the beholder. The more we try to standardize what we look for, the more disservice we are doing to the profession. And would anyone really want a world where the only ingredients you could use to make pizza was cheese, sauce and flour dough? My cravings for all the meats or white pizza, or cauliflower dough would never be satisified And what would happened to all the vegetarians?

    A 10+ PGY1 resident class with > 20 years of existence may want very different traits or experiences both within and from without in their applicants from a brand new program recruiting for first ever class of one resident just because of the huge variance in expectations of the other health care discipline sat the site.


  2. Hi, Frank,

    Thanks for your comment! I couldn’t agree more and appreciate your analogy. I hope to remember this analogy as I move into post-residency life! While most who meet “standard” expectations turn out to be great residents, I’ve come to appreciate (in my very short time) those individuals who bring traits and attitudes that may not fit the mold. While they may not meet our ideal criteria initially, we have been lucky to match with these individuals. Their unique perspectives have brought value to our department that we would not have otherwise experienced.


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