The shell game

Magic tricks and sleight of hand have always fascinated me. How DO they do that? The essence of a magic trick is the mislead: to make the audience see and think one thing, when actually something else is going on.

One trick everyone is familiar with is the shell game. It looks simple. The game’s operator moves three shells back and forth quickly over a ball; when he stops, an observer has to guess which shell is covering the ball.

When the betting starts, the player, or “mark” (the sucker the operator targets for fleecing), always wins. So the mark feels confident and raises the bet, encouraged by the operator’s accomplices (“shills”) in the crowd. It’s when the mark starts losing and complains that things get ugly. Since the game is rigged, the mark ends up losing every cent.

The pharm school game

Pharmacy education today is another type of shell game.

Initially, it’s all good. You’re a new student, early into the debt cycle and constantly reminded of all the money you’ll make as a pharmacist in just a few short years. You’ll have to study hard, for sure, and the competition is intense for a limited number of spots in pharmacy school, but you just have to keep your eyes on the prize. Things will be great. (You’re gonna be a winner: Phase one of the shell game.)

If you work hard and are fortunate, you’re admitted to pharmacy school. The first couple of years are difficult, but you’re still looking ahead to the future. Nonetheless, your parents are uneasy about your escalating loan debt, and in the back of your mind, you are too.

Another thing that bothers you is that you have applied for some pharmacy jobs as an intern or tech and been told there are no openings. You remember that older friend from your town who told you it was easy to get a summer job with a chain when she was in pharmacy school just a few years ago, and you wonder what happened. Most of the places you visit look really busy, and you wonder why they aren’t hiring. (This is the “I might want to get out of the game” part.)

Then in your fifth year, right before rotations, you start hearing that the job market is tight. Really tight. Lots of new pharmacy schools are opening, and some of the older students are admitting that they don’t actually have a job lined up when they graduate. Others say that they’re being offered only part-time employment or that they’ll have to commute a couple of hours each way to work.

It sure doesn’t sound like what you were promised when you started the “game.”

Now they tell you

You decide to talk to someone you trust at the pharmacy school. You think of that professor who seems cool, or maybe your advisor. And they do have an answer for your worries, a way to separate yourself from all the others looking for a pharmacist job.

You need a residency. Oh, yeah, we just forgot to tell you about that early in the game, when you were young and naive.

Haven’t you heard? The position statement of the American Society of Health System Pharmacists says that by the year 2020, every pharmacist involved in direct patient care should have a residency.

Never mind that there aren’t enough residencies now for all the graduates who want one. Never mind that with the influx of pharmacy schools, more pharmacists will graduate every year, chasing the same number of spots. You just need to give us a little more of your time for the same job.

Oh, and by the way, you’ll be an alumnus then too, and we’ll be sure to call you for some money. You have to help out those students just starting out, don’t you?

I don’t need to tell you what part of the shell game that last part is.

It’s a set up

With a degree and one or two residencies, we are creating a modern-day indentured servant called a PharmD. The shills are numerous, starting with the universities and including everyone who calls for more training without regard for the enormous debt to be paid and the lack of employment prospects you face when you’re done.

In today’s pharmacy job market, anyone who is calling for more education is reaching straight into students’ pockets.

And those pockets, like the mark's in the shell game, are probably going to end up empty. 

Jim "Goose" Rawlings is a senior pharmacist in central Indiana. E-mail him atredgoose54@gmail.com.