Are we here for the wrong reasons? Pharmacy School—for money or for knowledge?

           Flash back to high school, to the fall of your senior year.  We all were busy, not only with classes, but also with extracurricular activities, sports and, most important, a strenuous college application process and SATs that made for stressful Saturdays.  Yet all of us somehow figured out, during those young, busy lives of ours, that pharmacy was the right choice for us.  Was it though?  I ask myself this very question every day.

It is hard to believe that at 17 we all knew we wanted to become pharmacists for the next 50 years of our lives?  After all, most of us had absolutely zero experience as you must be at least 18 to work in a pharmacy (in most states).  So the interesting question is actually quite simple.  What led us to enter the pharmacy field?  Did we really know much about pharmacy coming into our freshman year of college?

              Yes, many of us knew there was retail and hospital, but there are so many other niches in the pharmacy profession.  Besides retail or hospital, we have consulting pharmacy, managed care, government (for example, the U.S. Public Health Service, which includes the FDA and the Indian Health Service, and the Bureau of Prisons), insurance companies, as well as the pharmaceutical industry.  With so many areas of practice within pharmacy, why have so many graduates of MCPHS gone the retail route?  I honestly find it hard to believe that our dream was to work at a job where we could never sit down, slog through insurance issues and get yelled at by customers because their co-pays are too high.
              So again the question remains, why pharmacy?  To be honest, I feel that at 17 we were young and immature.  Heck, we weren’t even legally adults.  The main incentive that I’ve heard from many students about why they chose pharmacy was the money.  To be frank, the allure of a six-figure salary brought many of us to pharmacy school.  Maybe we came because we thought that becoming a pharmacist would lead to a big payday.  So if we came for the wrong reasons, will we leave with the right intentions?
             It seems that to become a successful pharmacist, you need to enjoy at least one of two things.  First, you need to have a passion for the science (the knowledge behind pharmacy such as disease states, pharmacology, kinetics, etc).  However, you must also love the practice, actually being a pharmacist in the real world.  Unfortunately, with the stressful workload and the pressure to do well, the love for the science is lost.  But many of us like at least one aspect and then you have the infinitesimal, exceptional group that enjoys both the science and the practice of pharmacy.  These students are the ones that have a love for pharmacy and are likely to advance the profession.  Unfortunately, those that love neither the science nor the practice may not be in pharmacy school for the right reasons.  Will they make good pharmacists?
             Let’s face it; we all need money and the paycheck that a pharmacy career promises is nothing to scoff at.  However, with so many schools and so many students that are graduating each year, I feel we are obligated to ask ourselves, are we graduating top-caliber pharmacists who truly care about the profession of pharmacy?  Sure, you say that if they pass the NAPLEX, they are qualified, but maybe we merely have learned to be able to study and pass a test without actually learning, because we don’t care about what we are learning.  One cannot look solely at pass rates, but also introspectively for the love for the profession that helps drive an excellent, high-quality, patient-focused pharmacist.

The content of this particular blog entry does not represent the official views of the Massachusetts College of Pharmacy and Health Sciences (MCPHS) nor of The Rho Chi Society or the Psi Chapter of the Rho Chi Society at MCPHS. The content represents solely the view of the author

Increased opportunity to obtain the entry-level PharmD over the last decade: an overview and a student’s perspective

The content of this particular blog entry does not represent the official views of the Massachusetts College of Pharmacy and Health Sciences (MCPHS) nor of The Rho Chi Society or the Psi Chapter of the Rho Chi Society at MCPHS. The content represents solely the view of the author.

As recently as 2000, the Department of Health and Human Services (HHS) released a white paper documenting evidence of an emergence of a pharmacist shortage, which was attributed both to an increase in the demand for pharmacists and limits in the ability to increase pharmacist supply to meet that demand. Many institutions of higher education addressed the latter through the establishment of new PharmD programs, the creation of satellite campuses for existing programs, and expansion of class sizes, thereby expanding opportunities for pharmacy education.

Today, according to the American Association of Colleges of Pharmacy, there are now 123 distinct colleges and schools in the continental U.S. that will offer a PharmD as a first professional (entry-level) degree for fall 2012, and this figure does not include any institutions that are seeking accreditation status from the Accreditation Council for Pharmacy Education (ACPE) or those that are not accepting applicants for fall 2012. In contrast, there were about 80 schools or colleges of pharmacy in the U.S. as of 2000. In New England alone, at least 5 new schools and colleges of pharmacy or satellite campuses have opened within the last 4 years (one in Connecticut, one in Massachusetts, two in Maine, and one in Vermont). This expansion of pharmacy education has occurred despite a downward trend in the demand of pharmacists nationwide based on survey data collected by the Pharmacy Manpower Project.

The extent and rate of the increase of PharmD programs has not escaped the attention of pharmacists and pharmacy graduates facing a tight job market. The blog of Fred Eckel, a professor at the University of North Carolina Eshelman School of Pharmacy and the Editor-in-Chief of Pharmacy Times, provides one perspective regarding the struggles of those seeking employment (“Do We Need More Pharmacy Schools?” and “Will the Pharmacy Job Market Self-Correct?” among Mr. Eckel’s entries). Nor has the pharmacy academe failed to note a scarcity of potential IPPE and APPE sites accompanying the rapid increase in new pharmacy schools and an emerging disconnect between the number of future graduates and the number of vacant positions in the near future, with 7 new colleges or schools of pharmacy graduating their inaugural class in 2010, 3 in 2011, 9 in 2012, 5 in 2013, and 6 in 2014.

And in November 2010 the American Pharmacists Association (APhA) and the American Society of Health-System Pharmacists (ASHP) jointly released a white paper discussing concerns about the expansion of pharmacy education, including a shortage of faculty in colleges and schools of pharmacy, an inability of programs to comply with ACPE standards for experiential education, and a decrease in the collective quality of pharmacy applicants, all of which could affect adversely the quality of pharmacy education.

What does the expansion of pharmacy education, in conjunction with current trends in the job market, augur for current pharmacy students and potential future applicants? It may be instructive to note difficulties for graduates of other professional or doctoral degree programs, where the grass is not necessarily greener.

In April 2011 the journal Nature published a series of articles on “the future of the PhD,” highlighting a dissonance between the traditional expectation that science PhDs pursue a career in tenure-track academia and the low proportion of those PhD graduates who actually achieve it. Similarly, current and prospective pharmacy students aware of increased competitiveness in the job market could benefit from an increased awareness of niches in areas of pharmacy beyond the traditional modalities of community and institutional pharmacy practice (e.g., clinical research, regulatory affairs) and actively tailor their career development according to their interests. Accompanying this awareness could also be a recalibration of expectations regarding the necessity of pursuit of a residency or fellowship.

And the plight of newly minted law school graduates, saddled with onerous debt and facing a dismal job market despite an increase in tuition, existing class sizes, and the number of new schools, has received much attention in the New York Times (“Job Market Weakens, Tuition Rises,” “For Law School Graduates, Debts if Not Job Offers”) and elsewhere in the media. While pharmacy education differs from law education in many important aspects (barriers to increasing pharmacy student enrollment such as the limited availability of rotation sites, for example), the APhA/ASHP report has noted that the majority of new PharmD programs have been established in private institutions and even for-profit institutions, a trend mirroring that in law school expansion.

Prospective pharmacy students might be advised to weigh carefully the opportunity costs of pursing a pharmacy education against future earning potential and the availability and quality of rotation sites available to newer programs. Pharmacist graduates with high debt levels are also likely to suffer from market corrections in response to any pharmacist oversupply and may have to re-evaluate any personal constraints to labor mobility given regional variability in the demand for pharmacists.

Paul Le is a doctor of pharmacy candidate at the Massachusetts College of Pharmacy and Health Sciences in Boston, MA.