Pharmacy education: Change is the only constant

I read this article this morning and thought it was rather relevant. So I have posted it in its entirety here and you can read it by clicking on the title of this blog post. I thought the author raised some interesting points. Let me know what you guys think of this article. I am going to start posting daily news clips for pharmacists to keep everyone up to date on what is going in the job market and pharmacy in general.

Pharmacy education has been in an almost constant state of change for the past 150 years, since the era when a pharmacist learned by being an apprentice. That era was followed by a combination of apprenticeships and courses at local apothecary schools, and then by matriculating in schools of pharmacy for degree programs that gradually have been extended over the years.

The past decade saw the entry-level degree for the profession change over from a bachelor of science degree to the doctorate in pharmacy (Pharm.D.). But for the past decade and more, the entire profession has been undergoing change, as it attempts to move away from primarily dispensing medications toward being the chief source of medication information in health care, toward disease state management, and even medication therapy management.

Currently, the requirement for a Pharm.D. consists of four years of pharmacy school preceded by at least two years of prepharmacy preparatory classes. The previous entry-level degree had been a B.S.Pharm. degree (a five-year course), but all pharmacy students graduating since 2004 have earned a Pharm.D., said Lucinda L. Maine, Ph.D., R.Ph., executive VP of the American Association of Colleges of Pharmacy (AACP).

With the Pharm.D., the entry-level pharmacy degree is equivalent to a medical degree or a dentistry degree, Maine said. "People think we are still overeducating people for the practice, but we are not. The person we are graduating today will be practicing for the next 25 years or more." Because no one will be able to predict what will happen in therapeutics during that time, the goal of pharmacy education is to create a learner who is committed to keeping up with the changes, she said.

The move to a Pharm.D. "is recognition that the dispensing role is not going to be the only role that we contribute to health care in the long term," said Marilyn K. Speedie, Ph.D., dean and professor at University of Minnesota College of Pharmacy and president of AACP. "It is a major paradigm shift." Taking care of patients and helping them with their medications is what the profession will be known for in the long run, she said.

There is a commonality of expectations for a pharmacist's performance, regardless of what degree is earned, said Cynthia L. Raehl, Pharm.D., FASHP, FCCP, professor and chair, Texas Tech University Health Sciences Center School of Pharmacy and president-elect of AACP. "To earn a degree is just the beginning of a career," she said. "It is not just the degree, it is the lifelong learning that a pharmacist must embrace that allows a pharmacist to continue in the practice."

All these advances demand that tomorrow's pharmacy practitioners understand and integrate into their own practices the new scientific principles that will be coming. "Science is moving at a very fast pace, and we must keep pace with science," said Raehl. There will be a reaffirmation of the need for sound scientific foundation in pharmacy education that is stimulated by advances in such fields as stem cell research, genomics, physiology, and biochemistry, she said.

"The dynamics of pharmacy education in the past five years is that we cannot produce pharmacists fast enough," said Maine.

Preparing pharmacists for working in the real world, whether it is in a hospital or a community setting, has taken a lot of input from various groups. "It is very exciting to see the active collaboration taking place among the colleges and schools of pharmacy and community pharmacy owners and operators to prepare pharmacy students as future practitioners," said Sandra Kay Jung Guckian, M.S., R.Ph., VP, pharmacy education and research, National Association of Chain Drug Stores. She noted that NACDS and the American Pharmacists Association are collaborating on the development of the Community Pharmacist Preceptor Education Program, which will be available to all pharmacy schools and community pharmacists.

There's no doubt there will be a lot of discussion about this issue. The important fact, Guckian said, is to keep a focus on attracting students to the profession who have a desire to help people and are entering pharmacy school with a vision for direct patient care practice.

Pharmacy students are now gaining the skills they need in order to be the kind of practitioners who can perform disease state management regardless of practice setting, said Jennifer Athay, Pharm.D., associate director of student development with APhA. There is less emphasis on the dispensing role of pharmacists, but there is still a dispensing role for pharmacists to play, she added. "I look at it as 'Oh boy! Look at how much time I have to spend with patients.' "

Before 2000, the Pharm.D. degree was an alternative choice to the B.S. in pharmacy. The transition to an entry-level doctoral degree was not met with universal approval, and some disapproval still continues. Many in chain drugstores and community pharmacies questioned the need for adding a year and upping the degree to a doctorate. An on-line Drug Topics survey of 488 R.Ph.s in 2006 found that pharmacists were almost equally divided as to whether the move to a Pharm.D. was a good idea, with 52% saying No. The survey found that 42% of respondents felt that a pharmacist with a B.S. degree was capable of meeting the needs of community pharmacy practice and that 11% felt that the doctoral degree was "watered down" by the requirement that all new pharmacists have one.

"The chains do not want any part of this professional pharmacist model," claims Dennis B. Miller, R.Ph., Delray Beach, Fla. Miller, a graduate of West Virginia University School of Pharmacy, has more than 30 years of experience working as a pharmacist in chain drugstores. The idea that the profession will move away from dispensing medications and toward having a greater hand in counseling patients has been touted for years, he noted. Many chains would be happy to replace pharmacists with pharmacy technicians or even robots, he believes.

The views of pharmacy colleges are diametrically opposed to the views of the chains, Miller continued. "The chains want quantity and not quality, and the schools, quality and not quantity."

Now is the time for pharmacists to step up to the plate and provide patient care, and for the people who hire pharmacists to make it possible for them to do so, Speedie said. "We are providing outstanding clinical education, but we need to do better at empowering our graduates to be leaders for change, so that they will demand to use the skills we are giving them," she said.

Society has to come to terms with the fact that we must have a "medication use specialist," added Maine. "When there were four-year pharmacy grads, there were only about 600 individual chemical entities approved and in use. That number today is in excess of 15,000. And, gosh, they are powerful and they are complicated and they are being used in an aging population."

Change may be the only constant in pharmacy education. The six-year Pharm.D. program is now the norm, but many pharmacy students enter pharmacy school today already holding a bachelor's degree, making a Pharm.D. a de facto eight-year program. Whether that course of study becomes the required norm remains to be seen.

THE AUTHOR is a writer based in New York State.

Six (or more) degrees of pharmacy

Pharmacists in the United States have been awarded many different academic degrees—or none at all, if you hearken back to the days of apothecary apprenticeships. The result is an alphabet soup of degrees, many of which are now obscure. Who wouldn't look at Ph.G. and not assume it is a typo for Ph.D.? Here are a few pharmacy degrees and their abbreviations, plus a few that didn't get abbreviated:

Doctor of Pharmacy Pharm.D.

Bachelor of Science in Pharmacy B.S.Pharm.

Master of Science M.S.

Doctor of Philosophy Ph.D.

Pharmacy Doctor P.D.

Graduate in Pharmacy Ph.G.

R.Ph. Registered Pharmacist

Pharmaceutical Chemist

Master of Pharmacy

Bachelor of Pharmacy