Navigating obstacles: Perspectives of US pharmacy residency directors on non-US candidates for PGY-1 residencies: A survey-based research

Introduction: Pharmacy education and postgraduate training in the United States (US) are esteemed, drawing international students to American Council for Pharmacy Education (ACPE)-accredited schools and pursuing residency training after graduation. Despite this, limited literature addresses the obstacles international students face in pursuing American Society of Health-System Pharmacists (ASHP) accredited residency programs. Objectives: To summarize potential eligibility barriers for international graduates of ACPE programs during the residency application process from residency program directors' (RPDs) perspectives. Methods: A 16-question electronic survey was developed and distributed to all RPDs of US-based ASHP-accredited postgraduate year-1 (PGY-1) programs in July 2021. Questions addressed whether non-US citizens were eligible to apply, barriers to recruiting non-US citizen candidates, and barriers to offer visa sponsorships. Descriptive statistics were used to summarize the data. Results: A total of 196 programs responded to the survey (response rate, 13.5%). Eighty-nine (45.4%) programs reported that candidates with F-1/optional practical training (OPT) status were eligible to apply for their program, while 86 programs (43.9%) reported candidates were not eligible. Barriers for recruiting candidates with F-1/OPT status included lack of resources to support application process (n = 42), citizenship requirements (n = 41), institution policy (n = 33), department preference (n = 12), and unfamiliar with procedures in selecting these candidates (n = 18). Over 70% (n = 146) would not offer visa sponsorship for pharmacy resident positions. Barriers to offering sponsorship were lack of support resources (n = 62), cost (n = 60), time preparing applications (n = 46), citizenship requirements (n = 45), and department preference (n = 23). Conclusion: This study investigates the obstacles encountered by non-US citizens in the residency application process, as perceived by program directors. The primary obstacle in recruiting candidates with F-1/OPT status and providing visa sponsorships revolves around the inadequate support and resources available for the application process.