I have been an MTM pharmacist for the past 6 years and here is my two cents. You do not need to be certified to get position as an MTM pharmacist. I started in a major chain pharmacy as a floater pharmacist after passing the FPGEE, MPJE, Naplex and getting licensed. I took a position in our new MTM department when no one ever heard of MTM at that time. Recently my DM strongly recommended board certification to fill certain positions such as our specialty pharmacy department, clinical department, and MTM department. I would strongly suggest you to acquire at least a BCACP or BCMTMS if you would like to pursue a career in medication therapy management. In regards to which certification is more valuable, it seems like any would be preferred as my DM said "as long as you are board certified...". BCACP is a little bit more challenging than BCMTMS because you need to have experience prior to sit for their exam, while BCMTMS requires either experience or proof of MTM training. Therefore for someone that just passed the FPGEE and received state license, it is nearly impossible to be BCACP. Pharmacy market is getting more and more competitive and most desired position now require board certification.