OBJECTIVE The structure and implementation of a nontraditional pharmacy residency program in a large teaching hospital are described. CONCLUSIONS A nontraditional track of the postgraduate year 1 (PGY1) residency program at a large teaching hospital in Detroit, Michigan, was developed for clinical staff pharmacists employed by the hospital. The program, accredited by the American Society of Health-System Pharmacists, allows pharmacists to complete 10 four-week rotations, in addition to three longitudinal rotations, over a three-year period. Required four-week rotations include 1 orientation rotation, 6 adult medicine rotations, 1 intensive care unit rotation, and 2 elective rotations. Because a pharmacist must first be employed by the hospital before applying to the nontraditional residency program, a staff pharmacist position is used to fund the nontraditional residency program. Since the inception of the nontraditional PGY1 residency program in 2005, two residents have graduated from the program. After completion of the residency, the first resident remained at the institution as a clinical staff pharmacist. The current and recently graduated nontraditional residents have demonstrated significant advancement of their clinical skills as a result of their participation in the program. Challenges faced during program implementation included scheduling and coordinating the resident's rotations and activities. CONCLUSIONS A three-year nontraditional residency program was developed at a large teaching hospital to provide an alternative method for enhancing a pharmacist's clinical practice skills beyond those of an entry-level practitioner through completion of a systematic training program.