A Mandated PharmD PGY-1 Year: Financial Consequences.

BACKGROUND: Pharmacy education has evolved to emphasize clinical training, with residency increasingly expected for certain practice settings. However, PGY1 training remains optional despite growing pressure for expanded postgraduate education. This study evaluates the financial impact of residency training by comparing early-career earnings across different pharmacy career pathways. Given rising educational costs and limited residency capacity, the feasibility of a mandatory PGY1 requirement remains uncertain. Understanding these trade-offs is important for informing future policy and workforce decisions. METHODS: A model-based analysis was conducted using national pharmacist salary data, including average earnings without residency and stipends for PGY1 and PGY2 training. Cumulative earnings were calculated over a five-year period across three pathways: no residency, PGY1, and PGY1 + PGY2. Comparisons were made to estimate differences in early-career income and quantify the opportunity cost associated with residency training. RESULTS: Over a five-year period, pharmacists who did not complete residency had the highest cumulative earnings ($634,950). Those who completed a PGY1 earned $567,960, while those completing both PGY1 and PGY2 earned $505,970. Compared to no residency, PGY1 training was associated with a loss of $66,990 (10.6%), and PGY1 + PGY2 with a loss of $128,980 (20.3%). The additional year of PGY2 training accounted for a further reduction of $61,990. CONCLUSIONS: Residency training is associated with a clear short-term income loss compared to entering the workforce directly. If PGY1 training were made mandatory, this financial burden would apply to all PharmD graduates while current system limitations remain. Significant expansion of residency positions and preceptor capacity would be required, along with increased funding. Without these changes, a universal PGY1 requirement may introduce more challenges than benefits.