According to the American Society of Hospital Pharmacists (ASHP), a pharmacy residency is "an organized, directed postgraduate training program with a stipend in a defined area of pharmacy practice." Residencies allow students to directly apply the skills they have acquired in a professional environment. They may be of particular interest to pharmacy graduates whose career goals include hospital practice or becoming a member of a clinical faculty at a pharmacy college or school.

The ASHP is the accrediting body for pharmacy residencies and most residencies are ASHP-accredited (exceptions exist in certain pharmacy settings such as home health care or community pharmacy). International pharmacists considering residencies that are not ASHP-accredited need to look with special care at other indications of quality to ensure that the residency has the resources to meet their needs.
Two main types of pharmacy residencies exist: pharmacy practice residencies and specialized residencies. Pharmacy practice residencies are designed to develop skills and knowledge in a broad range of pharmaceutical services, including acute patient care, ambulatory patient care, drug information, drug use policy development, and practice management.

Most pharmacy practice residencies are not affiliated with a pharmacy school but are administered by U.S. hospitals and medical centers. However, some residencies, called "affiliated residencies," are administered in conjunction with a Pharm.D. or M.S. program. These residencies usually last a year or more longer than do non-affiliated residencies because students pursue the residency part-time while also academic work to earn their degree. The minimum time requirement for residency completion is 2,000 hours over at least 50 weeks.

To obtain a residency in pharmacy practice, U.S. pharmacists generally enter the Residency Matching Program (RMP), sponsored by the ASHP to match applicants and programs. Entering the RMP does not guarantee that a candidate will be accepted to a residency program. Pharmacists must also apply directly to individual residency programs in addition to participating in the RMP.
Graduates of pharmacy schools outside the United States can enter the RMP only upon earning a Foreign Pharmacy Graduate Examination Committee (FPGEC) certificate. To obtain an FPGEC certificate, students must pass the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and achieve a score of at least 550 on the TOEFL. To be eligible to take the FPGEE, students must have earned a degree from a school of pharmacy that has at least a four-year curriculum or its equivalent and be licensed or registered to practice pharmacy in the country where their degree was earned.

The FPGEE is a one-day examination testing knowledge of the preclinical sciences (physical science, biological science, and mathematics); pharmaceutical sciences; biomedical sciences; social and behavioral sciences; and pharmaceutical services management. It is administered only once a year in the Chicago, IL, area.

Certain pharmacy residencies require residents to be U.S. licensed. Others may accept only Pharm.D. graduates of schools accredited by the American Council on Pharmaceutical Education (ACPE)—that is, U.S. schools—into their residency programs. On the other hand, occasionally ASHP-accredited pharmacy practice programs allow foreign pharmacy graduates to apply directly for pharmacy practice residencies without participating in the RMP. Foreign pharmacy graduates should check with individual programs to determine their eligibility for residencies.

Specialized Residencies

Pharmacists are generally expected to have completed a pharmacy practice residency prior to applying for a specialized residency. However, some programs may accept professional experience as a substitute for the pharmacy practice residency.
Specialty area residencies accredited by the ASHP include programs in administration, adult internal medicine, clinical pharmacokinetics, critical care, drug information, geriatrics, nuclear pharmacy, nutritional support, oncology, pediatrics, primary care, and psychopharmacy. Far fewer specialized residency programs exist than do pharmacy practice residencies and many of the specialized programs are university-affiliated.
Specialized residency programs do not participate in the RMP. Individuals interested in such opportunities should contact programs of interest directly to get information on their programs and requirements.