Contemporary Pharmacy Practice: Part 2/4

Sarah continues her four part Wednesday series on contemporary pharmacy. Today, she focuses on education and training.

Fiction writers do mean things to their characters. If those mean things require pharmaceutical care, you may find the need to introduce a pharmacist character. Or if medications play any role in your story, you’ll need to understand how pharmacies work. As a pharmacist myself, I want to help you get those details straight.
Today’s article discusses pharmacy education and training. Last week’s article gave an overview of the profession, and the following articles will discuss practice in the community pharmacy setting and practice in the hospital setting.
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Entry Degree
The first four-year Bachelor’s of Science degree in pharmacy was offered by Ohio State University in 1925. The four-year program became mandatory with the incoming class of 1932. The doctor of pharmacy (Pharm. D.) degree was first offered by the University of California, San Francisco in 1955. As the clinical focus of the Pharm. D. degree became more desirable, the bachelor’s degree was phased out. As of 2000, the Pharm. D. degree was required for initial licensure.
Pharmacists with a bachelor’s degree sign their names with an “RPh” afterward (Registered Pharmacist) and are addressed as “Mr.” or “Mrs.” or “Miss.” Pharmacists with a doctorate sign their names with a “Pharm. D.” afterward and are addressed as “Dr.” However, it is common practice in modern pharmacies and hospitals for pharmacists to be addressed by their first names—this is controversial within the profession. Please note, the degree is a doctorate in pharmacy not pharmacology. Pharmacology is an academic discipline not a clinical profession, and pharmacologists receive the Ph.D. degree.
Length of Education
To gain admission to pharmacy school, students must complete the prerequisite undergraduate courses in math and science. A dedicated student can complete the prerequisites in two years and apply straight to pharmacy school. However, most students obtain their undergraduate degree first. Common majors of entering students include biology, chemistry, and biochemistry, but any degree is acceptable as long as the prerequisites are filled.
Pharmacy school is a four-year program. Therefore, the typical time from high school graduation to receipt of the doctorate is six to eight years. At graduation, students attend the traditional hooding ceremony. The lining of a pharmacist’s doctoral hood is olive drab.
Course of Study
During those four years, pharmacy students undergo a rigorous course of study in basic science and clinical practice. Studies in the basic sciences include organic chemistry, biochemistry, physical chemistry, anatomy, physiology, and microbiology. More specialized courses include pharmaceutical chemistry, pharmacokinetics (how the body processes medications), and pharmacology (how medications act on the body). The highlight of the academic experience is an intense series of courses in clinical pharmacy, where students learn about disease states and the proper of use of medications. The final year of pharmacy school is spent in the clinical setting. Students work on hospital floors, rounding with physicians and medical students. There they monitor patient care and recommend changes in therapy. Students (called interns) work under the supervision of experienced pharmacists, called preceptors.
During pharmacy school, students also take part-time and summer jobs to obtain their required internship hours. Interns must fulfill a certain number of hours both in the inpatient (hospital) and outpatient (clinic or retail pharmacy) to sit for pharmacy boards.
Licensure
Upon graduation from pharmacy school, completion of internship hours, and a background check, graduates can take the NAPLEX, the North American Pharmacist Licensure Examination. Each state also administers an exam in pharmacy law, since regulations vary from state to state. Since the NAPLEX is now accepted by every state, pharmacists enjoy reciprocity. To move from one state to another requires sitting for a new law exam but not the pharmacy boards.
Pharmacy licenses must be renewed every year or two, depending on the state. Continuing education is required for renewal. Since pharmacists work with controlled substances, pharmacy licenses may be suspended or revoked for crimes involving controlled substances, including driving under the influence. Pharmacy licenses may also be suspended or revoked for other crimes, malpractice, or professional ethical violations.
Residencies and Fellowships
As medications and therapy become more complex, so does pharmacy education. Many graduate pharmacists choose to do a one-year general pharmacy residency—essentially a continuation of their fourth year of pharmacy school. Pharmacists may choose to take additional residencies or fellowships to gain more specialized experience, especially if interested in an academic career.

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Sarah Sundin is the author of the Wings of Glory series from Revell: A Distant Melody (March 2010), A Memory Between Us (September 2010), and Blue Skies Tomorrow (August 2011). She has a doctorate in pharmacy from UC San Francisco and works on-call as a hospital pharmacist.

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