Pharmacist

Pharmacists, also known as chemists (Commonwealth English) or druggists (North American and, archaically, Commonwealth English), are health professionals who control, formulate, preserve and dispense medications and provide advice and counselling on how medicines should be used to achieve maximum benefit, minimal side effects and to avoid drug interactions.[1][2] They also serve as primary care providers in the community. Pharmacists undergo university or graduate-level education to understand the biochemical mechanisms and actions of drugs, drug uses, therapeutic roles, side effects, potential drug interactions, and monitoring parameters. This is mated to anatomy, physiology, and pathophysiology. Pharmacists interpret and communicate this specialized knowledge to patients, physicians, and other health care providers.

Pharmacist
A patient consults a pharmacist.
Occupation
NamesPharmacist, Chemist, Druggist, Doctor of Pharmacy, Apothecary
Occupation type
Professional
Activity sectors
Health care, health sciences, chemical sciences
Description
CompetenciesThe ethics, art and science of medicine, analytical skills, critical thinking
Education required
Doctor of Pharmacy, Master of Pharmacy, Bachelor of Pharmacy
Fields of
employment
Pharmacy
Related jobs
Physician, pharmacy technician, toxicologist, chemist, other medical specialists

Among other licensing requirements, different countries require pharmacists to hold either a Bachelor of Pharmacy, Master of Pharmacy, or Doctor of Pharmacy degree.

The most common pharmacist positions are that of a community pharmacist (also referred to as a retail pharmacist, first-line pharmacist or dispensing chemist), or a hospital pharmacist, where they instruct and counsel on the proper use and adverse effects of medically prescribed drugs and medicines.[3][4] In most countries, the profession is subject to professional regulation. Depending on the legal scope of practice, pharmacists may contribute to prescribing (also referred to as "pharmacist prescriber") and administering certain medications (e.g., immunizations) in some jurisdictions. Pharmacists may also practice in a variety of other settings, including industry, wholesaling, research, academia, formulary management, military, and government.

Nature of work

Historically, the fundamental role of pharmacists as a healthcare practitioner was to check and distribute drugs to doctors for medication that had been prescribed to patients. In more modern times, pharmacists advise patients and health care providers on the selection, dosages, interactions, and side effects of medications, and act as a learned intermediary between a prescriber and a patient. Pharmacists monitor the health and progress of patients to ensure the safe and effective use of medication. Pharmacists may practice compounding; however, many medicines are now produced by pharmaceutical companies in a standard dosage and drug delivery form. In some jurisdictions, pharmacists have prescriptive authority to either independently prescribe under their own authority or in collaboration with a primary care physician through an agreed upon protocol called a collaborative practice agreement.[5]

Increased numbers of drug therapies, aging but more knowledgeable and demanding populations, and deficiencies in other areas of the health care system seem to be driving increased demand for the clinical counseling skills of the pharmacist.[1] One of the most important roles that pharmacists are currently taking on is one of pharmaceutical care.[6] Pharmaceutical care involves taking direct responsibility for patients and their disease states, medications, and management of each to improve outcomes. Pharmaceutical care has many benefits that may include but are not limited to: decreased medication errors; increased patient compliance in medication regimen; better chronic disease state management, including hypertension and other cardiovascular disease risk factors;[7] strong pharmacist–patient relationship; and decreased long-term costs of medical care.

Pharmacists are often the first point-of-contact for patients with health inquiries. Thus pharmacists have a significant role in assessing medication management in patients, and in referring patients to physicians. These roles may include, but are not limited to:

  • clinical medication management, including reviewing and monitoring of medication regimens
  • assessment of patients with undiagnosed or diagnosed conditions, and ascertaining clinical medication management needs
  • specialized monitoring of disease states, such as dosing drugs in kidney and liver failure
  • compounding medicines
  • providing pharmaceutical information
  • providing patients with health monitoring and advice, including advice and treatment of common ailments and disease states
  • supervising pharmacy technicians and other staff
  • oversight of dispensing medicines on prescription
  • provision of and counseling about non-prescription or over-the-counter drugs
  • education and counseling for patients and other health care providers on optimal use of medicines (e.g., proper use, avoidance of overmedication)
  • referrals to other health professionals if necessary
  • pharmacokinetic evaluation
  • promoting public health by administering immunizations
  • constructing drug formularies
  • designing clinical trials for drug development
  • working with federal, state, or local regulatory agencies to develop safe drug policies
  • ensuring correctness of all medication labels including auxiliary labels
  • member of inter-professional care team for critical care patients[8]
  • symptom assessment leading to medication provision and lifestyle advice for community-based health concerns (e.g. head colds, or smoking cessation[9])
  • staged dosing supply (e.g. opioid substitution therapy[10])

Education and credentialing

Hospital Pharmacist
Industrial Pharmacist

The role of pharmacy education, pharmacist licensing, and continuing education vary from country to country and between regions/localities within countries. In most countries, pharmacists must obtain a university degree at a pharmacy school or related institution, and/or satisfy other national/local credentialing requirements. In many contexts, students must first complete pre-professional (undergraduate) coursework, followed by about four years of professional academic studies to obtain a degree in pharmacy (such as Doctorate of Pharmacy). In the European Union, pharmacists are required to hold a Masters of Pharmacy, which allows them to practice in any other E.U. country, pending professional examinations and language tests in the country in which they want to practice. Pharmacists are educated in pharmacology, pharmacognosy, chemistry, organic chemistry, biochemistry, pharmaceutical chemistry, microbiology, pharmacy practice (including drug interactions, medicine monitoring, medication management), pharmaceutics, pharmacy law, pathophysiology, physiology, anatomy, pharmacokinetics, pharmacodynamics, drug delivery, pharmaceutical care, nephrology, hepatology, and compounding of medications. Additional curriculum may cover diagnosis with emphasis on laboratory tests, disease state management, therapeutics and prescribing (selecting the most appropriate medication for a given patient).

Upon graduation, pharmacists are licensed, either nationally or regionally, to dispense medication of various types in the areas they have trained for.

Some may undergo further specialized training, such as in cardiology or oncology. Specialties include:

Training and practice by country

Armenia

The Ministry of Education and Ministry of Health oversee pharmacy school accreditation in Armenia. Pharmacists are expected to have competency in the WHO Model List of Essential Medicines (EML), the use of Standard Treatment Guidelines, drug information, clinical pharmacy, and medicine supply management. There are currently no laws requiring pharmacists to be registered, but all pharmacies must have a license to conduct business. According to a World Health Organization (WHO) report from 2010, there are 0.53 licensed pharmacists and 7.82 licensed pharmacies per 10,000 people in Armenia. Pharmacists are able to substitute for generic equivalents at point of dispensing.[11]

Australia

The Australian Pharmacy Council is the independent accreditation agency for Australian pharmacists.[12] The accreditation standards for Australian pharmacy degrees include compulsory clinical placements.[13] with an emphasis on encouraging rural experiences to develop a rural workforce.[14][15] It conducts examinations on behalf of the Pharmacy Board of Australia towards eligibility for registration. The Australian College of Pharmacy provides continuing education programs for pharmacists. The number of full-time equivalent pharmacists working in Australia over the past decade has remained stable.[16] Pharmacy practice is described by the practice standards [17] and guidelines including those from the Pharmaceutical Society of Australia.[18]

Wages for pharmacists in Australia appear to have stagnated, and even gone backwards. As of 2007, the award wages for a pharmacist is $812 a week.[19] Pharmacist graduates are the lowest paid university graduates most years. Most pharmacists do earn above the award wage; the average male pharmacist earns $65,000, a female pharmacist averages $56,500. There are more graduates expected in the next few years making it even harder to get a job. Job security and increase in wages with regards to CPI could be unlikely. This is due to the large numbers of pharmacy graduates in recent years, and government desire to lower PBS costs. Contract and casual work is becoming more common. A contract pharmacist is self-employed and often called a locum; these pharmacists may be hired for one shift or for a longer period of time. There are accounts of underemployment and unemployment emerging recently.[16]

Canada

The Canadian Pharmacists Association (CPhA) is the national professional organization for pharmacists in Canada. Specific requirements for practice vary across provinces, but generally include a bachelor's (BSc Pharm) or Doctor of Pharmacy (PharmD) degree from one of 10 Canadian universities offering a pharmacy program, successful completion of a national board examination through the Pharmacy Examining Board of Canada (PEBC) (Quebec being the exception), practical experience through an apprenticeship/internship program, and fluency in French or English.[20] International pharmacy graduates can begin their journey of becoming licensed to practice in Canada by enrolling with the National Association of Pharmacy Regulatory Authorities (NAPRA) Pharmacists' Gateway Canada.[20][21] The vast majority (~70%) of Canada's licensed pharmacists work in community pharmacies, another 15% work in hospital, and the remainder work in other settings such as industry, government, or universities.[22][23][24] Pharmacists' scope of practice varies widely among the 13 provinces and territories and continues to evolve with time.[25][26] As a result of pharmacists' expanding scope and knowledge application, there has been a purposeful effort to transition the professional programs in Canadian pharmacy schools to offer doctors of pharmacy over baccalaureate curriculums to ensure graduates have the most up to date level of training to match the increasing practice requirements.[27][28]

Germany

In Germany, the education and training is divided into three sections, each ending with a state examination:

  • University: Basic studies (at least four semesters)
  • University: Main studies (at least four semesters)
  • Community Pharmacy / Hospital Pharmacy / Industry: Practical training (12 months; 6 months in a Community Pharmacy).

After the third state examination a person must become licensed as an RPh ("registered pharmacist") for a licence to practice pharmacy. Today, many pharmacists work as employees in public pharmacies. They will be paid according to the labour agreement of Adexa and employer associations.

History

In ancient Japan, the men who fulfilled roles similar to pharmacists were respected. The place of pharmacists in society was settled in the Taihō Code (701) and re-stated in the Yōrō Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists — and even pharmacist assistants — were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.[29]

Contemporary

As of 1997, 46 universities of pharmacy in Japan graduated about 8000 students annually.[30] Contemporary practice of clinical pharmacists in Japan (as evaluated in September 2000) focuses on dispensing of drugs, consultation with patients, supplying drug information, advising on prescription changes and amending prescriptions. These practices have been linked to decreases in the average number of drugs in prescriptions, drug costs and incidence of adverse drug events.[31]

Nigeria

Training to become a registered pharmacist in Nigeria involves a five-year course after six years of secondary/high school or four years after eight years of secondary/high school (i.e. after 2 years of Advanced-level studies in accredited Universities). The degree awarded by most pharmacy schools is a Bachelor of Pharmacy Degree (B.Pharm.) However, in the near future, all schools will offer a 6-year first Degree course leading to the award of a Pharm.D (Doctor of Pharmacy Degree). The University of Benin has started the Pharm.D programme with other pharmacy schools planning to start soon. The Pharmacy Degree in Nigeria is unclassified i.e. awarded without first class, second class upper, etc., however graduates could be awarded Pass with Distinctions in specific fields such as Pharmaceutics, Pharmacology, medicinal chemistry etc. Pharmacy Graduates are required to undergo 1 year of Tutelage under the supervision of an already Registered Pharmacist(a preceptor) in a recognized and designated Institution before they can become Registered Pharmacists. The Profession is Regulated by a Government Statutory body called the Pharmacists Council of Nigeria. The West African Post Graduate College of Pharmacy runs post-registration courses on advanced-level practice in various fields of pharmacy. It is a college jointly funded by a number of Countries in the West Africa sub-region. There are thousands of Nigerian-trained pharmacists registered and practicing in countries such as the US, the UK, Canada etc., due to the relatively poor public sector salaries in Nigeria.

Pakistan

In Pakistan, the Pharm.D. (Doctor of Pharmacy) degree is a graduate-level professional doctorate degree. Twenty-one universities are registered with the Pharmacy Council of Pakistan for imparting Pharmacy courses. In 2004 the Higher Education Commission of Pakistan and the Pharmacy Council of Pakistan revised the syllabus and changed the 4-year B.Pharmacy (Bachelor of Pharmacy) Program to a 5-year Pharm.D. (Doctor of Pharmacy) program. All 21 universities have started the 5-year Pharm.D Program. In 2011 the Pharmacy Council of Pakistan approved the awarding of a Doctor of Pharmacy degree, a five-year programme at the Department of Pharmacy, University of Peshawar.

Poland

Polish pharmacists have to complete a 5+12-year Master of Pharmacy Programme at medical university and obtain the right to practice as a pharmacist in Poland from District Pharmaceutical Council. The Programme includes 6 months of pharmacy training. The Polish name for the Master of Pharmacy Degree (M.Pharm.) is magister farmacji (mgr farm). Not only pharmacists, but also pharmaceutical technicians are allowed to dispense prescription medicines, except for narcotics, psychotropics and very potent medicines. Pharmacists approve prescriptions fulfilled by pharmaceutical technicians subsequently. Pharmaceutical technicians have to complete 2 years of post-secondary occupational school and 2 years of pharmacy training afterwards. Pharmacists are eligible to prescribe medicines in exceptional circumstances. All Polish pharmacies are obliged to produce compound medicines. Most pharmacists in Poland are pharmacy managers and are responsible for pharmacy marketing in addition to traditional activities. To become a pharmacy manager in Poland, a pharmacist is expected to have at least 5 years of professional experience. All pharmacists in Poland have to maintain an adequate knowledge level by participating in various university- and industry-based courses and arrangements or by undergoing postgraduate specialization.[32]

Sweden

In Sweden, the national board of health and welfare regulates the practice of all legislated health care professionals, and is also responsible for registration of pharmacists in the country. The education to become a licensed pharmacist is regulated by the European Union, and states that minimum educational requirements are five years of university studies in a pharmacy program, of which six months must be a pharmacy internship. To be admitted to pharmacy studies, students must complete a minimum of three years of gymnasium, similar to high school (school for about 15–20-year-old students) program in natural science after elementary school (6–16-year-olds). Only three universities in the whole of Sweden offer a pharmacy education, Uppsala University, where the Faculty of Pharmacy is located, the University of Gothenburg, and Umeå University. In Sweden, pharmacists are called Apotekare. At pharmacies in Sweden, pharmacists work together with another class of legislated health care professionals called Receptarier, in English so-called prescriptionists, who have completed studies equal to a Bachelor of Science in pharmacy, i.e., three years of university. Prescriptionists also have dispensing rights in Sweden, Norway, Finland and Iceland. The majority of the staff in a pharmacy are Apotekstekniker or "pharmacy technicians" with a three -semester education at a vocational college. Pharmacy technicians do not have dispensing rights in Sweden but are allowed to advise on and sell over-the-counter medicines.

Switzerland

In Switzerland, the federal office of public health regulates pharmacy practice. Four Swiss universities offer a major in pharmaceutical studies, the University of Basel, the University of Geneva, the University of Lausanne and the ETH Zurich. To major in pharmaceutical studies takes at least five years. Students spend their last year as interns in a pharmacy combined with courses at the university, with focus on the validation of prescriptions and the manufacturing of pharmaceutical formulations. Since all public health professions are regulated by the government it is also necessary to acquire a federal diploma in order to work in a pharmacy. It is not unusual for pharmaceutical studies majors to work in other fields such as the pharmaceutical industry or in hospitals. Pharmacists work alongside pharma assistants, an apprenticeship that takes three years to complete. Pharmacists can further specialize in various fields; this is organized by PharmaSuisse, the pharmacists' association of Switzerland.

Tanzania

In Tanzania, pharmacy practice is regulated by the national Pharmacy Board, which is also responsible for registration of pharmacists in the country. By international standards, the density of pharmacists is very low, with a mean of 0.18 per 10,000 population. The majority of pharmacists are found in urban areas, with some underserved regions having only 2 pharmacists per region. According to 2007–2009 data, the largest group of pharmacists was employed in the public sector (44%). Those working in private retail pharmacies were 23%, and the rest were mostly working for private wholesalers, pharmaceutical manufacturers, in academia/teaching, or with faith-based or non-governmental facilities. The salaries of pharmacists varied significantly depending on the place of work. Those who worked in the academia were the highest paid followed by those who worked in the multilateral non-governmental organizations. The public sector including public retail pharmacies and faith based organizations paid much less. The Ministry of Health salary scale for medical doctors was considerably higher than that of pharmacists despite having a difference of only one year of training.[33]

Trinidad and Tobago

In Trinidad and Tobago, pharmacy practice is regulated by the Pharmacy Board of Trinidad and Tobago, which is responsible for the registration of pharmacists in the twin islands. The University of the West Indies in St. Augustine offers a 4-year Bachelor of Science in Pharmacy as the sole practicing degree of pharmacy. Graduates undertake a 6-month internship, known as pre-registration, under the supervision of a registered pharmacist, at a pharmacy of their choosing, whether community or institutional. After completion of the required pre-registration period, the graduate can then apply to the Pharmacy Board to become a registered pharmacist. After working 1 calendar year as a registered pharmacist, the individual can become a registered, responsible pharmacist. Being a registered, responsible pharmacist allows the individual to license a pharmacy and be a pharmacist-in-charge.

United Kingdom

In British English (and to some extent Australian English), the professional title known as "pharmacist" is also known as "dispensing chemist" or, more commonly, "chemist". A dispensing chemist usually operates from a pharmacy or chemist's shop, and is allowed to fulfil medical prescriptions and sell over-the-counter drugs and other health-related goods. Pharmacists can undertake additional training to allow them to prescribe medicines for specific conditions.[34]

Practices

In the United Kingdom, most pharmacists working in the National Health Service practice in hospital pharmacy or community pharmacy. The Royal Commission on the National Health Service in 1979 reported that there were nearly 3,000 pharmacists employed in the hospital and community health service in the UK at that time. They were enthusiastic about the idea that pharmacists might develop their role of giving advice to the public.[35]

The new professional role for pharmacist as prescriber has been recognized in the UK since May 2006, called the "Pharmacist Independent Prescriber". Once qualified, a pharmacist independent prescriber can prescribe any licensed medicine for any medical condition within their competence. This includes controlled drugs except schedule 1 and prescribing certain drugs for the treatment of addiction (cocaine, diamorphine and dipipanone).[36]

Education and registration

Pharmacists, pharmacy technicians and pharmacy premises in the United Kingdom are regulated by the General Pharmaceutical Council (GPhC) for England, Scotland and Wales and by the Pharmaceutical Society of Northern Ireland for Northern Ireland. The role of regulatory and professional body on the mainland was previously carried out by the Royal Pharmaceutical Society of Great Britain, which remained as a professional body after handing over the regulatory role to the GPhC in 2010.[37]

The following criteria must be met for qualification as a pharmacist in the United Kingdom (the Northern Irish body and the GPhC operate separately but have broadly similar registration requirements):[38]

  • Successful completion of a 4-year Master of Pharmacy degree at a GPhC accredited university. Pharmacists holding degrees in Pharmacy from overseas institutions are able to fulfill this stage by undertaking the Overseas Pharmacist Assessment Programme (OSPAP), which is a one-year postgraduate diploma. On completion of the OSPAP, the candidate would proceed with the other stages of the registration process in the same manner as a UK student.
  • Completion of a 52-week preregistration training period. This is a period of paid or unpaid employment, in an approved hospital or community pharmacy under the supervision of a pharmacist tutor. During this time the student must collect evidence of having met certain competency standards set by the GPhC.
  • A pass mark in the GPhC registration assessment (formally an exam). This includes a closed-book paper and an open-book/mental calculations paper (using the British National Formulary and the GPhC's "Standards of Conduct, Ethics and Performance" document as reference sources). The student must achieve an overall mark of 70%, which must include at least 70% in the calculations section of the open-book paper. From June 2016, the assessment will involve two papers, as before but the use of a calculator will now be allowed. However, reference sources will no longer be allowed in the assessment. Instead, relevant extracts of the British National Formulary will be provided within the assessment paper.
  • Satisfactorily meeting the GPhC's Fitness to Practice Standards.

United States

In 2014 the United States Bureau of Labor Statistics revealed that there were 297,100 American pharmacist jobs. By 2024 that number is projected to grow by 3%.[39] The majority (65%) of those pharmacists work in retail settings, mostly as salaried employees but some as self-employed owners. About 22% work in hospitals, and the rest mainly in mail-order or Internet pharmacies, pharmaceutical wholesalers, practices of physicians, and the Federal Government.[4]

All graduating pharmacists must now obtain the Doctor of Pharmacy (Pharm.D.) degree before they are eligible to sit for the North American Pharmacist Licensure Examination (NAPLEX) to enter into pharmacy practice.[40] In addition, pharmacists are subject to state-level jurisprudence exams in order to practice from state to state.[41]

Pharmacy School Accreditation

The Accreditation Council for Pharmacy Education (ACPE) has operated since 1932 as the accrediting body for schools of pharmacy in the United States.[42] The mission of ACPE is "To assure and advance excellence in education for the profession of pharmacy".[42] ACPE is recognized for the accreditation of professional degree programs by the United States Department of Education (USDE) and the Council for Higher Education Accreditation (CHEA).[43] Since 1975, ACPE has also been the accrediting body for continuing pharmacy education. The ACPE board of directors are appointed by the American Association of Colleges of Pharmacy (AACP), the American Pharmacists Association (APhA), the National Association of Boards of Pharmacy (NABP) (three appointments each), and the American Council on Education (one appointment). To obtain licensure in the United States, applicants for the North American Pharmacist Licensure Examination (NAPLEX) must graduate from an ACPE accredited school of pharmacy. ACPE publishes standards that schools of pharmacy must comply with to gain accreditation.[44]

A Pharmacy school pursuing accreditation must first apply and be granted Pre-candidate status.[43] These schools have met all the requirements for accreditation, but have not yet enrolled any students. This status indicates that the school of pharmacy has developed its program in accordance with the ACPE standards and guidelines. Once a school has enrolled students, but has not yet had a graduating class, they may be granted Candidate status. The expectations of a Candidate program are that they continue to mature in accordance with stated plans. The graduates of a Candidate program are the same as those of fully accredited programs. Full accreditation is granted to a program once they have demonstrated they comply with the standards set forth by ACPE.

The customary review cycle for established accredited programs is six years, whereas for programs achieving their initial accreditation this cycle is two years. These are comprehensive on-site evaluations of the programs. Additional evaluations may be conducted at the discretion of ACPE in the interim between comprehensive evaluations.

Education

Acceptance into a doctorate of pharmacy program depends upon completing specific prerequisites or obtaining a transferable bachelor's degree. Pharmacy school is four years of graduate school (accelerated Pharmacy Schools go January to January and are only 3 years), which include at least one year of practical experience. Graduates receive a Doctorate of Pharmacy (PharmD) upon graduation. Most schools require students to take a Pharmacy College Admissions Test PCAT and complete 90 credit hours of university coursework in the sciences, mathematics, composition, and humanities before entry into the PharmD program. Due to the large admittance requirements and highly competitive nature of the field, most pharmacy students complete a bachelor's degree before entry to pharmacy school.

Possible prerequisites:

Besides taking classes, additional requirements before graduating may include a certain number of hours for community service, e.g., working in hospitals, clinics, and retail.

Estimated timeline: 4 years undergraduate + 4 years doctorate + 1–2 years residency + 1–3 years fellowship = 8–13 years

A doctorate of pharmacy (except non-traditional, i.e. transferring a license from another country) is the only degree accepted by the National Associate of Boards of Pharmacy NABP to be eligible to "sit" for the North American Pharmacist Licensure Examination (NAPLEX). Previously the United States had a 5-year bachelor's degree in pharmacy. For BS Pharmacy graduates currently licensed in US, there are 10 Universities offering non-traditional doctorate degree programs via part-time, weekend or on-line programs. These are programs fully accredited by Accreditation Council for Pharmacy Education (ACPE) but only available to current BS Pharmacy graduates with a license to practice pharmacy. Some institutions still offer 6 year accelerated PharmD programs.

The current Pharm.D. degree curriculum is considerably different from that of the prior BS in pharmacy. It now includes extensive didactic clinical preparation, a full year of hands-on practice experience in a wider array of healthcare settings, and a greater emphasis on clinical pharmacy practice pertaining to pharmacotherapy optimization. Legal requirements in the US to becoming a pharmacist include: graduating from an accredited PharmD program, conducting a specified number of internship hours under a licensed pharmacist (i.e. 1800 hours in some states), passing the NAPLEX, and passing a Multi-state Pharmacy Jurisprudence Exam MPJE. Arkansas, California, and Virginia have their own exams instead of the MPJE; in those states, pharmacists must pass the Arkansas Jurisprudence Exam, the California Jurisprudence Exam, or the Virginia Pharmacy Law Exam.[45][46][47]

Residency is an option for post-graduates that is typically 1–2 years in length. A residency gives licensed pharmacists decades of clinical experience in an extremely condensed timeframe of only a few short years. In order for new graduates to remain competitive, employers generally favor residency trained applicants for clinical positions. The profession is moving toward resident-trained pharmacists who wish to provide direct patient care clinical services. In 1990, the American Association of Colleges of Pharmacy (AACP) required the new professional degree. Graduates from a PharmD program may also elect to do a fellowship that is geared toward research. Fellowships can varying in length but last 1–3 years depending on the program and usually require 1 year of residency at minimum.

Specialization and credentialing

Clinical pharmacists go on rounds with doctors in order to provide direct patient care and comprehensive medication management.

American pharmacists can become certified in recognized specialty practice areas by passing an examination administered by one of several credentialing boards.

Vaccinations

As of 2016, all 50 states and the District of Columbia permit pharmacists to provide vaccination services, but specific protocols vary between states.[51][52][53]

California

All licensed California pharmacists can perform the following:

  • Order and interpret drug therapy related tests
  • Furnish smoking cessation aids (such as nicotine replacement therapy)
  • Furnish oral self-administered contraception (birth control pills)
  • Furnish travel medications recommended by the CDC[54]
  • Administer vaccinations pursuant to the latest CDC standards for anyone ages 3+[55]

The passage of Assembly Bill 1535 (2014) authorizes pharmacists in California to furnish naloxone without a physician's prescription.[56]

With the passage of Senate Bill 159 in 2019, pharmacists in California are authorized to furnish pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) to patients without a physician's prescription.[57] In order to be eligible to dispense, a pharmacists must first "complete a training program approved by the" California State Board of Pharmacy.[57]

California pharmacists can apply for Advanced Practice Pharmacist (APh) licenses from the California State Board of Pharmacy. Senate Bill 493, written by Senator Ed Hernandez, established a section on the Advanced Practice Pharmacist and outlines the definition, scope of practice, qualifications, and regulations of those holding this license.[58] An APh can:

  • Perform patient assessments
  • Refer patients to other healthcare providers
  • Participate in the evaluation and management of diseases and health conditions in collaboration with other health care providers
  • Initiate, adjust, or discontinue therapy pursuant to the regulations outlined in the bill[58]

To qualify for an advanced practice pharmacist license in California, the applicant must be in good standing with the State Board of pharmacy, have an active pharmacist license, and fulfill two of three requirements, including certification in their area clinical practice.[59] The license must be renewed every 2 years, and the APh applying for renewal must complete 10 hours of continuing education in at least one area relevant to their clinical practice.[59]

Earnings and wages

According to a 2010 PharmacyWeek survey, pharmacists were paid the following average annual salaries, depending on their positions:[60]

  • Directors of Pharmacy $125,200
  • Retail Staff Pharmacists $113,600
  • Hospital Staff Pharmacists $111,700
  • Mail Order Staff Pharmacists $109,300
  • Clinical Pharmacists $113,400

The American Pharmacy Journal of Education in 2014 reported the average salary around $112,160.[61]

According to the US Bureau of Labor Statistics' Occupational Outlook Handbook, 2016–17 Edition, Median annual wages of wage and salary pharmacists in May 2015 were $121,500.[39]

In 2020 US News and World Report noted that the median pharmacist salary was $128,710. The top 25 percent of pharmacist earners made $147,690 that year, while the lowest 25 percent made $112,690.[62]

Vietnam

School students must take a national exam to enter a university of pharmacy or the pharmacy department of a university of medicine and pharmacy. About 5–7% of students can pass the exam. There are 3 aspects to the exam. These are on math, chemistry, and physics or biology. After being trained at the university for 5 years, successful students receive a bachelor's degree in pharmacy. Or they are university pharmacists (university pharmacist to discriminate between college pharmacist or vocational pharmacist in some countries of the world these trainee pharmacists are called pharmacist assistants). An alternative method of obtaining a bachelor's degree is as follows. School pupils study at a college of pharmacy or a vocational school of pharmacy. After attending the school or college they go to work in a pharmacy, and with two years of practice they could take an exam to enter university of pharmacy or the pharmacy department of a university of medicine and pharmacy. This exam is easier than the national one. Passing the exam they continue studying to gain 3-year bachelor's degrees or 4-year bachelor's degrees. This degree is considered equivalent to a 5-year bachelor's degree.

Notable pharmacists

  • Charles Alderton (1857-1941), American inventor of the soft drink Dr Pepper
  • Caleb Bradham (1867-1934), American inventor of the soft drink Pepsi
  • Ikililou Dhoinine (born 1962), Comorian politician
  • Pravin Gordhan (born 1949), minister in South African government
  • Luke Howard (1772–1864), "the father of meteorology"[63]
  • Hubert Humphrey (1911-1978), U.S. Vice President 1965–69
  • David Jack (1924–2011), leader of research that developed major asthma drugs
  • Edna O'Brien (born 1930), Irish author and playwright
  • Hans Christian Ørsted (1777–1851), Danish physicist who discovered electromagnetism
  • Tadeusz Pankiewicz (1908-1993), Polish pharmacist in the Kraków Ghetto and activist during World War II
  • John Pemberton (1831-1888), American inventor of the soft drink Coca-Cola
  • Friedrich Sertürner (1783-1841), German chemist who discovered morphine
  • Joseph Swan (1828–1914), inventor of the incandescent light bulb

See also

References

  1. Peartree Solutions Inc. (July 2001). "A Situational Analysis of Human Resource Issues in the Pharmacy Profession in Canada" (PDF). Human Resources Development Canada. Archived from the original (PDF) on 3 December 2008.
  2. Skrabal, MZ; Kahaleh, AA; Nemire, RE; Boxer, H; Broshes, Z; Harris, M; Cardello, E (September–October 2006). "Preceptors' perspectives on benefits of precepting student pharmacists to students, preceptors, and the profession". Journal of the American Pharmacists Association. 46 (5): 605–612. doi:10.1331/1544-3191.46.5.605.skrabal. PMID 17036647.
  3. Classifying health workers: Mapping occupations to the international standard classification (PDF), Geneva: World Health Organization, 2010, retrieved 10 February 2020
  4. "Pharmacists", Occupational Outlook Handbook, 2010-11 Edition, US Bureau of Labor Statistics, archived from the original on 11 May 2011, retrieved 14 July 2011
  5. "Pharmacist prescribing". Royal Pharmaceutical Society of Great Britain. 2006. Archived from the original on 6 October 2006.
  6. Cipolle, Robert J.; Strand, Linda M.; Morley, Peter C. (2004). Pharmaceutical Care Practice: The Clinician's Guide (Second ed.). Toronto: McGraw-Hill. ISBN 9780071362597.
  7. Santschi, V; Chiolero, A; Burnand, B; Colosimo, AL; Paradis, G (12 September 2011). "Impact of pharmacist care in the management of cardiovascular disease risk factors: a systematic review and meta-analysis of randomized trials". Archives of Internal Medicine. 171 (16): 1441–53. doi:10.1001/archinternmed.2011.399. PMID 21911628.
  8. Weant, Kyle A.; Armitstead, John A.; Ladha, Alim M.; Sasaki-Adams, Deanna; Hadar, Eldad J.; Ewend, Matthew G. (November 2009). "Cost effectiveness of a clinical pharmacist on a neurosurgical team". Neurosurgery. 65 (5): 946–50, discussion 950–1. doi:10.1227/01.NEU.0000347090.22818.35. PMID 19834408. S2CID 207142177.
  9. Snoswell, Centaine; Barras, Michael (13 September 2016). "Inpatient smoking cessation – turn to your clinical pharmacist". Australian and New Zealand Journal of Public Health. 40 (5): 498. doi:10.1111/1753-6405.12567. ISSN 1326-0200. PMID 27624184.
  10. Snoswell, Centaine L.; Hollingworth, Samantha A. (27 July 2016). "Knowledge and attitudes of final year pharmacy students toward opioid substitution therapy". Journal of Pharmacy Practice and Research. 46 (3): 216–221. doi:10.1002/jppr.1202. ISSN 1445-937X. S2CID 79128020.
  11. "Armenia: Pharmaceutical Country Profile" (PDF). World Health Organization. 13 August 2010.
  12. "About APC". Australian Pharmacy Council. Archived from the original on 13 March 2018. Retrieved 24 January 2018.
  13. Kirschbaum, Mark; Khalil, Hanan; Page, Amy Theresa (2016). "Clinical placements by Australian university schools of pharmacy". Currents in Pharmacy Teaching and Learning. 8: 47–51. doi:10.1016/j.cptl.2015.09.003.
  14. Kirschbaum, Mark; Khalil, Hanan; Talyor, Selina; Page, Amy T. (2016). "Pharmacy students' rural career intentions: Perspectives on rural background and placements". Currents in Pharmacy Teaching and Learning. 8 (5): 615–621. doi:10.1016/j.cptl.2016.06.002.
  15. Page, Amy T.; Hamilton, Sandy J.; Hall, Maeva; Fitzgerald, Kathryn; Warner, Wayne; Nattabi, Barbara; Thompson, Sandra C. (2016). "Gaining a 'proper sense' of what happens out there: An 'Academic Bush Camp' to promote rural placements for students" (PDF). Australian Journal of Rural Health. 24 (1): 41–47. doi:10.1111/ajr.12199. PMID 26119965.
  16. Jackson, John K; Liang, Jenifer; Page, Amy T (17 March 2021). "Analysis of the demographics and characteristics of the Australian pharmacist workforce 2013–2018: decreasing supply points to the need for a workforce strategy". International Journal of Pharmacy Practice. 29 (2): 178–185. doi:10.1093/ijpp/riaa022. PMID 33729531.
  17. Mill, Deanna; Page, Amy; Johnson, Jacinta; Lee, Kenneth; Salter, Sandra M.; Seubert, Liza; Clifford, Rhonda; d'Lima, Danielle (2022). "Do pharmacy practice standards effectively describe behaviour? Reviewing practice standards using a behavioural specificity framework". BMC Health Services Research. 22 (1): 71. doi:10.1186/s12913-021-07358-4. PMC 8760715. PMID 35031027.
  18. Mill, Deanna; Johnson, Jacinta L.; Lee, Kenneth; Salter, Sandra M.; d'Lima, Danielle; Seubert, Liza; Clifford, Rhonda; Page, Amy T. (2021). "Use of professional practice guidance resources in pharmacy: A cross-sectional nationwide survey of pharmacists, intern pharmacists, and pharmacy students". Journal of Pharmaceutical Policy and Practice. 14 (1): 114. doi:10.1186/s40545-021-00395-8. PMC 8715411. PMID 34965894. S2CID 245542949.
  19. Pharmacist Wage Rates (PDF), The Pharmacy Guild of Australia, Western Australia Branch, 1 October 2007, archived from the original (PDF) on 21 January 2012
  20. "How to become a pharmacist in Canada - English". www.pharmacists.ca. Retrieved 17 April 2022.
  21. "Annual Reports | NAPRA". www.napra.ca. Retrieved 17 April 2022.
  22. "National Statistics | NAPRA". www.napra.ca. Retrieved 17 April 2022.
  23. "Pharmacists in Canada - English". www.pharmacists.ca. Retrieved 17 April 2022.
  24. Peartree Solutions Inc. (July 2001). "A Situational Analysis of Human Resource Issues in the Pharmacy Profession in Canada" (PDF). Human Resources Development Canada. Archived from the original (PDF) on 3 December 2008.
  25. "Pharmacists' Scope of Practice in Canada" (PDF). Canadian Pharmacists Association. January 2020. Retrieved 27 January 2020.
  26. "Updated Scope of Practice Charts for Pharmacists and Pharmacy Technicians in Canadian Jurisdictions | NAPRA". www.napra.ca. Retrieved 26 April 2022.
  27. "CPhA Position Statement: Doctor of Pharmacy Degree as an Entry-Level to Practice" (PDF). Canadian Pharmacists Association. March 2009. Retrieved 25 April 2022.
  28. "Pharm D Position Statement Resolution | afpc". www.afpc.info. Retrieved 26 April 2022.
  29. von Klaproth, Julius, ed. (1834). Nipon o daï itsi ran, ou Annales des empereurs du Japon [Annals of the Emperors of Japan] (in French). Translated by Titsingh, Isaac. London: Parbury, Allen and Co. p. 434. nipon o dai itsi ran.
  30. Kawahara, A. (1997), "Theme 1. The Ideal Profile of the Pharmacist: Reaction from Japan", The Role of the Pharmacist in the Health-Care System – Preparing the Future Pharmacist: Curricular Development, Report of a Third WHO Consultative Group on the Role of the Pharmacist, Vancouver, Canada, 27–29 August 1997, World Health Organization, retrieved 18 July 2011
  31. Yuki, Ito; Tetsuo, Ando; Toshiharu, Arakawa; Toshitaka, Nabeshima; Takaharu, Itatsu (2005). "Role of the Clinical Pharmacist in Pharmaceutical Care". Japanese Journal of Pharmaceutical Health Care and Sciences. 31 (2): 113–120. doi:10.5649/jjphcs.31.113. ISSN 1346-342X.
  32. "About Us". Polish Pharmaceutical Chamber. Naczelna Izba Aptekarska [Polish Pharmaceutical Chamber]. Archived from the original on 8 December 2015.
  33. Assessment of the Pharmaceutical Human Resources in Tanzania and Strategic Framework, Dar es Salaam: Tanzania Ministry of Health and Social Welfare, 2010
  34. "Pharmacist". Health Careers. National Health Service. 26 March 2015. Retrieved 28 January 2019.
  35. "Chapter 8: Pharmaceutical, Ophthalmic and Chiropody Services". Royal Commission on the NHS. HMSO. July 1979. ISBN 978-0101761505. Retrieved 19 May 2015.
  36. "Pharmacist independent prescribing FAQ". Department of Health. Department of Health and Social Care. 22 March 2010. Archived from the original on 7 January 2013. Retrieved 14 July 2011.
  37. "History of the Society". Royal Pharmaceutical Society. Royal Pharmaceutical Society of Great Britain. Retrieved 10 February 2020.
  38. "Registering as a Pharmacist". General Pharmaceutical Council. Retrieved 18 January 2012.
  39. "Pharmacists: Occupational Outlook Handbook". Bureau of Labor Statistics. 17 December 2015. Archived from the original on 15 December 2016. Retrieved 28 July 2016.
  40. Accreditation Standards and Guidelines for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree, GUIDELINES 2.0 (PDF), Chicago, Illinois: Accreditation Council for Pharmacy Education, 23 January 2011, retrieved 15 February 2011
  41. "MPJE". National Association of Boards of Pharmacy. Retrieved 20 November 2019.
  42. "About". Accreditation Council for Pharmacy Education. Retrieved 10 February 2020.
  43. Policies and Procedures for ACPE Accreditation of Professional Degree Programs (PDF), Accreditation Council for Pharmacy Education, January 2020, retrieved 10 February 2020
  44. Accreditation standards and key elements for the Professional Program in Pharmacy Leading to the Doctor of Pharmacy Degree ("Standards 2016"} (PDF), Accreditation Council for Pharmacy Education, 2015, retrieved 10 February 2020
  45. "Arkansas Pharmacist License". Be a Pharmacist: Degree, License, and More. Be a Pharmacist. Retrieved 10 February 2020.
  46. "California Pharmacist License". Be a Pharmacist: Degree, License, and More. Be a Pharmacist. Retrieved 10 February 2020.
  47. "Virginia Pharmacist License". Be a Pharmacist: Degree, License, and More. Be a Pharmacist. Retrieved 10 February 2020.
  48. "BPS Specialties". BPS: Board of Pharmaceutical Specialties. American Pharmacists Association. Retrieved 10 February 2020.
  49. "Solid Organ Transplantation Pharmacy Recognized as New Specialty". Board of Pharmacy Specialties. 22 August 2018. Retrieved 3 January 2019.
  50. "American Board of Applied Toxicology (ABAT)". AACT. American Academy of Clinical Toxicology. Retrieved 10 February 2020.
  51. Schmit, Cason; Reddick, Allison (1 January 2016). "Pharmacist Vaccination Laws". The Policy Surveillance Program: A LawAtlas Project. Temple University Beasley School of Law. Retrieved 21 November 2019.
  52. "Pharmacists and Immunization: Vaccination Resources for Pharmacists". www.immunize.org: Website for Healthcare Professionals. Immunization Action Coalition. Retrieved 1 November 2019.
  53. Xavioer, Sharon; Goad, Jeff (22 June 2017). "Authority and Scope of Vaccination: How States Differ". Pharmacy Times. June 2017 Immunization Supplement. Pharmacy & Healthcare Communications, LLC. Retrieved 20 November 2019.
  54. "Expanding Pharmacist Services". California Pharmacists Association. Retrieved 21 November 2019.
  55. "Business and Professions Code - BPC: DIVISION 2. HEALING ARTS [500 - 4999.129] ( Division 2 enacted by Stats. 1937, Ch. 399.), CHAPTER 9. Pharmacy [4000 - 4427.8]". California Legislative Information. California State Legislature, State of California. 1 January 2014. Retrieved 23 October 2019.
  56. "Bill Text - AB-1535 Pharmacists: naloxone hydrochloride". California Legislative Information. California State Legislature, State of California. Retrieved 14 November 2019.
  57. "Bill Information - SB-159 HIV: preexposure and postexposure prophylaxis". California Legislative Information. California State Legislature, State of California. Retrieved 24 October 2019.
  58. Hernandez, Ed (3 October 2013). "SB-493 Pharmacy Practice". California Legislative Information. California State Legislature, State of California. Retrieved 2 November 2018.
  59. "Advanced Practice Pharmacist Application Instructions (17M-100)" (PDF). California State Board of Pharmacy. April 2019. Retrieved 10 February 2020.
  60. "2010 Pharmacy Compensation Survey - Spring Edition, National Results". PharmacyWeek. 2010. Archived from the original on 1 August 2010.
  61. "2015 Pharmacist Salary Guide". Pharmacy Times. Pharmacy & Healthcare Communications, LLC. 13 April 2015. Retrieved 10 February 2020.
  62. "Pharmacist salary | US news best jobs". US News and World Report. Retrieved 10 October 2022.
  63. Thornes, John. E. (1999). John Constable's Skies. The University of Birmingham Press. p. 189. ISBN 1-902459-02-4.

 This article incorporates public domain material from websites or documents of the United States Government.

This article is issued from Wikipedia. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.