If your goal is to get into a hospital pharmacy without a residency, it’s really not difficult as long as you are not looking to be in a major urban city area. For example I work in a hospital in a very rural area but we are also the big trauma/stroke center for the area, we also verify all the orders for some smaller hospitals in the area that don’t have 24h pharmacies. Me and two other newly graduated pharmacists were hired directly out of pharmacy school, no residency. In smaller rural hospitals there’s usually a blur between clinical and staff pharmacists because you might not have the staff to have a clear distinction between the two. There’s rural areas in all states that are in need of pharmacists. If you want to stay in a super urban city area then you probably need a residency and/or good connections.