Preparing Pharmacists for the Infusion Setting: A Framework for Specialty Training

In this article, Dr. Jill Paslier, PharmD, CSP, FISMP discusses the growth of specialty infusion pharmacy and the increasing demand for pharmacists. She covers the challenges in hiring and training for the infusion setting, and provides a framework for enhancing training to ensure success for pharmacy teams. 

Infusion therapy is increasingly used to treat chronic illnesses, a population projected by the National Institutes of Health (NIH) to nearly double in the U.S. over the next 30 years. Advances in infusion drugs and delivery methods have expanded access and utilization. At the same time, payers are driving a shift from costly hospital settings to lower-cost sites of care, such as patients’ homes. In response, hospitals and clinics are developing infusion programs to expand capacity and retain revenue. ¹

This growth has created a rising demand for specialty infusion pharmacists, but there are too few with the necessary expertise in biologics, rare diseases, benefit navigation, and infusion handling. Because of these specialized skill requirements, onboarding often takes longer and comes with a steep learning curve.

This article will explore challenges in recruiting experienced specialty infusion pharmacists and offer strategies to overcome them—such as identifying transferable skills, key professional qualities, and remote role options. It will also present a structured framework to train generalist pharmacists into competent specialty infusion pharmacists.

Challenges in Hiring Experienced Specialty Infusion Pharmacists

Pharmacy education and training pathways have not kept pace with the rapid growth of specialty infusion pharmacy. Most pharmacy schools offer limited exposure to specialty infusion therapies and related disease states, and few have faculty with direct experience in this area. As a result, students often graduate with little understanding of specialty infusion pharmacy until they encounter it during postgraduate training or on-the-job experience. ²

Formal training opportunities are also limited. A 2016 survey found that only 17% of U.S. pharmacy schools offered a specialty pharmacy track, and as of July 2024, there were just 51 accredited postgraduate year one (PGY-1) and PGY-2 specialty pharmacy residencies nationwide, with even fewer focused on infusion. ^2,3 Among practicing specialty pharmacists, nearly half of health-system leaders reported that fewer than 30% of their pharmacists had completed a residency, though about 60% held the Certified Specialty Pharmacist (CSP) credential. ⁴

These data reveal a major training gap. Without stronger educational pathways, mentorship, and structured onboarding programs, the specialty pharmacy workforce will continue to rely heavily on experiential, on-the-job learning.

Transferable Skills and Key Qualities

Addressing the workforce gap begins with identifying the right candidates for specialty infusion roles and recognizing the skills that translate well to this complex practice area.

Because direct specialty pharmacy experience is uncommon, employers can focus on transferable skills that provide a strong foundation for success. Retail pharmacy experience, for example, builds essential competencies in prescription processing, operations, patient communication, and medication counseling. Pharmacists with ambulatory care experience bring additional strengths in medication therapy management, clinical documentation, laboratory review, and evidence-based decision-making. While they may need further disease-specific training, their clinical reasoning skills and familiarity with guideline-based care allow for faster adaptation to specialty workflows.

Experience in multidisciplinary care settings is also valuable. Pharmacists who have participated in patient rounds or collaborated with clinical teams often demonstrate sound judgment, clear communication, and the ability to manage complex patient cases—skills that directly translate to specialty pharmacy practice.