The nation’s need for quality health care services includes the vital services provided by pharmacy residency programs, which prepare pharmacists to work effectively as an integral part of a multidisciplinary health care team. Today’s residency-trained pharmacists participate directly in clinical decisions regarding the use of medications and are leaders in the fight to improve patient outcomes by reducing drug-related morbidity and mortality. There is an urgent need for more pharmacy residency programs, and it is in the public’s best interest that such programs be adequately funded.

Reports in the literature over the past few years demonstrate that considerable improvements are needed in management of the medication use process. One recent study suggests that drug-related morbidity is the fourth leading cause of death in the U.S. Another study estimates that the economic toll of drug-related problems among ambulatory patients is $76 billion per year. The profession of pharmacy has taken a leadership role in addressing the problem and pharmacists have been highly successful in their respective settings in improving outcomes from medication use. But to attack the $76 billion problem head-on, many more highly-trained pharmacists are needed—pharmacists with a broad "systems" understanding of the medication use process, a strong clinical background, and sound leadership skills. Pharmacy residency programs play a critical role in training clinicians who are best prepared to greatly improve the medication use process.

Accredited pharmacy residency programs provide structured training in several prescribed areas of practice, including individual patient care, population health services, drug use policy development, and practice management skills. Examples of practice settings in which residency-trained pharmacists are needed include primary care, critical care, pediatrics, oncology, nutrition support and home care.

There is clearly a growing need for advanced pharmacy practitioners, capable of providing leadership in the medication use process. Pharmacy residency programs are the most likely source of such practitioners in the future; however, residency positions are currently available for only about 10% of pharmacy school graduates.

Most of the funding for existing pharmacy residency programs is provided by the health care organizations that conduct them. Very little reimbursement at the present comes from Medicare graduate medical education (GME) funds. In fact, Medicare reimbursement for all allied health programs (exclusive of nursing) constitutes only 1–1.5% of total GME expenditures.

The Balanced Budget Act of 1997 directed the Medicare Payment Advisory Commission (MedPAC) to develop recommendations addressing "whether and to what extent payments are being made (or should be made) for training the various non-physician health professions. . . ." As Congress and the nation addresses the future of public funding for GME, we urge that the critical need for residency-trained pharmacists be kept in mind.

ASHP specifically recommends the following:

• Ensure that pharmacy residencies are adequately funded in any future federal reimbursement program.

• Establish dedicated funds for pharmacy residencies which specifically address critical public needs.