What is it like to work at non-academic institution?

[dextroam11]

I was just wondering what is daily task like in non-academic hospitals? Since I have only completed my acute care rotations in an academic medical center, I have no idea what it is like in other hospitals.

If they do not have medical residents and if pharmacists do not round with the team, what do residents do in those rotations? Do they mainly focus on order verification and some monitoring? Are they still responsible for working up the patients and deliver recs to the team?

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[rl123]

2 things at play here, there are overlaps, but are not inherently the same:
teaching vs nonteaching:
- teaching: has physician residency programs (ie medicine, surgery, pediatrics, emergency, etc)- theres an inherent teaching component of rounds, as the attending physician will interject teaching components during rounds. as a pharmacy resident, expect to have more opportunities to deliver interdisciplinary presentations/ education. you make recommendations to resident physicians 90% of the time, and escalate to the attending physician level when you get pushback from a resident physician or you need to resolve an issue
- nonteaching: no physician residency programs, so you make recommendations directly to the attending. Rounds are typically faster, since there's no teaching component built into it. Typically more midlevel providers in these types of institutions (NPs/PAs), but since this is their job (ie they don't rotate from area to area)

academic medical center vs nonacademic (community) hospitals:
- academic: affiliated with a school of medicine, and sometimes other allied health training programs/schools, hence a lot of trainee individuals across the spectrum (Ie med students, pharm, nursing, OT/PT, etc). Here is where there's a lot of overlap between "academic" and "teaching". Typically have more resources (financial) than community hospitals, and more tertiary services (more clinical service lines, more surgical programs, etc). Greater emphasis on scholarly work (ie, participation as a clinical trial hospital, original research, emphasis on publications/ national conference presentations). Usually brings in bigger name guest speakers for noon conferences, grand rounds guest lecturers, etc.
- nonacademic: not closely affiliated with a school of medicine per se, but can be staffed by resident physicians. Biggest difference I see, is a lower emphasis on/expectation for scholarly work

by definition, any academic medical center will be a teaching hospital. I trained at a mid-sized community teaching hospital and had plenty of learning opportunities

 

[rx25295]

It's very different than an academic institution, but residents do still work up patients and provide recommendations. In my experience, a challenging aspect is that rounds can be a little disjointed, but it teaches you in different ways.
If you have questions about a specific program I would ask the current residents. Even within one hospital, different areas may have very stark differences. I think it's good to get experience at a non-academic center, though, because not all hospitals are teaching hospitals. It can also help clarify what kind of institution/pharmacy model you prefer in looking for a job post-residency.