Pharmaceutical education and careerñan overview

Pharmaceutical education and careerñan overview * Bhupinder Singh Sekhon and Seema Rani Kamboj PCTE Institute of Pharmacy, near Baddowal Cantt. (Ludhiana) 142 021, India. *Email: sekhon224@yahoo.com Received April 06, 2011; Accepted May 30, 2011 ABSTRACT Over the last decade there is a tremendous change in the practice of pharmacy profession around the world and the demand of pharmaceutical degree programs is increasing every day as these programs are extremely career focused. The pharmaceutical education is the backbone of pharmaceutical industry and pharmaceutical industry is generally considered as the index of the growth and development of any nation. Pharmaceutical education should satisfy the needs of today and tomorrow for continuous professional development. The present pharmacistsí role and responsibility does not lie merely in dispensing of medication but in the provision of patient focussed care such as providing drug information and drug therapy recommendation i.e. pharmacist are also the primary health professionals. There should be a close relationship among pharmacists, doctors and patients that may help improve patientsí use of medicines and simplifying various complexities. In view of above, harmonisation of pharmaceutical education is desirable which will cover the developments that have taken place in basic, medical, nursing and pharmaceutical sciences in helping the needs and prospect of society. Non-traditional roles for pharmacists in drug information and research centre, drug discoveries, clinical trials and clinical research, regulatory affairs, marketing and sales, poison information centre, industry and military pharmacy are also gaining importance. The slogan of the Pharmacy Councils throughout the world should be to protect the wellbeing of patients in all parts of the world. Key words: Pharmaceutical education, pharmacists, pharmacist s registration, pharmacy curriculum, healthcare worker, workforce. Introduction The pharmaceutical industry is growing in the entire world and is regarded as one of the most profitable industry. The pharmacy profession has evolved over the past forty years in response to the growth in medication use and patients demand. Today, pharmacy profession is considered as one of the most preferable and respectable profession. Pharmacy has changed and continues to change even as health care delivery systems change around us. Pharmacy is the science concerned with therapeutic substances their discovery, origin and nature, their development into medicines and their use in disease prevention and treatment. Pharmacy also denotes the profession which uses its unique knowledge of medicines in the service of society. The present pharmacists role and responsibility does not lie merely in dispensing of medication but in the provision of patient focus care such as providing drug information and drug therapy recommendation i.e. pharmacists are also the primary health professionals. People should not assume that pharmacist s job is only standing behind the counter at the local drugstore/ 73 chemist-druggist shop to hand over bags of medication day in and day out. In fact, the pharmacist behind the counter of your local drugstore actually has a Doctor of Pharmacy (PharmD) degree or equivalent pharmacy degree which meets the requirement for Pharmacists registration. A Doctor of Pharmacy is a professional doctorate degree in pharmacy. In some countries, including the US, it is a first professional degree, and a prerequisite for licensing to exercise the profession of Pharmacist. But there are other people (pharmacy technicians or pharmacy assistants) working behind the counter at a pharmacy. Pharmacy assistants are not allowed to dispense medications but work closely with pharmacy technicians. They work as supporting staff for the pharmacy such as clerks or cashiers who primarily answer telephones, handle money, stock shelves, and perform other clerical duties. They deal with customers and computer systems and generally help keep the system working properly. The education to become a pharmacy assistant is up to a certificate program, usually from a 2- year college. Pharmacy technicians are the next step on the ladder

and usually perform more complex tasks than do pharmacy aides/assistants [1]. Pharmacy technicians help licensed pharmacists provide medication and other healthcare products to patients. Technicians usually perform routine tasks to help prepare prescribed medication for patients, such as counting tablets and labelling bottles. Technicians refer any questions regarding prescriptions, drug information, or health matters to a pharmacist [2]. In hospitals, nursing homes, and assisted-living facilities, technicians have added responsibilities. They read patient charts and prepare and deliver the medicine to patients. However, the pharmacist must check the order before it is delivered to the patient. The technician then copies the information about the prescribed medication onto the patient s profile [3]. Technicians are not required to have any special type of education and many receive on the job training. But to become a certified pharmacy technician, which is a requirement for some jobs, technicians must pass a test called the National Pharmacy Technician Certification Exam or equivalent examination. The preparation for the examination may be on the job, but more likely, it would be a program through a 2-year college. To maintain the certification, the technician must complete a certain number of continuing education units per year in the field. Pharmacists dispense prescription drugs to patients and provide information about those drugs. They also help patients to understand the instructions provided by their doctors or other health practitioners. Pharmacists monitor their patients health and progress to make sure their medications are working effectively and safely. A strong desire by pharmacists to adapt to the changing health care environment has been indicated based on a survey that pharmacists should shift from their traditional dispensing functions to more non-traditional activities associated with medication management and other medical services [4]. A pharmacist is a health-care professional who specializes in drugs. In addition to graduating from an accredited college, pharmacists must receive a license by passing a series of tests. Pharmacists not only dispense drugs and medicines; ointments, powder, pills, tablets and injections prescribed by medical practitioner, dentist or veterinarian, but they can counsel patients about diet, home-health care, medical equipment and health-related topics. Pharmaceutical science students should have a wealth of knowledge pertaining to drugs and their effects on the body and, therefore, it is important that pharmacists know how to effectively communicate this information with care-providers, insurance companies, and patients to promote safety and well-being [5]. Besides dispensing drugs, pharmacists must help customers with side effects, maintain records and supervise the pharmacy. Growth in the pharmacy industry is expected as more and more of the population becomes elderly. Elderly people take a lot of drugs, so pharmacists, technicians and aides are in demand. But these jobs generally require a fair amount of time spent working at night and during the weekend, so keep that in mind when considering a pharmacy career [6]. Advancement of Pharmacists After gaining experience and securing necessary capital, pharmacists working in independent pharmacies may become owners or part-owners. Pharmacists working in chain drugstores may be promoted to pharmacy supervisors or store managers, then to district or regional managers and eventually to executive positions at the headquarters. Hospital pharmacists may be promoted to supervisory positions, while those working in the pharmaceutical industry may advance in areas including marketing, sales, research, or quality control. The median expected salary for a typical Pharmacist in the United States is around $113,006.[7] With many companies developing new drugs and formulations, pharmacists are involved in conducting clinical trials and quality assurance programs to ensure safety and effective use of the drug in treating the disease. In addition, skilled pharmacy graduates are needed in formulation research and development, production, quality assurance, regulatory affairs and marketing. Increasing number of specializations and super specializations has opened new opportunities for budding pharmacists. Pharmacy specialties A pharmacy (commonly the chemist/drugstore/retail pharmacy) is the place where most pharmacists practice the profession of pharmacy. Pharmacists manage the purchasing, storing, and dispensing of drugs and medicines. Civilian pharmacists practice in a variety of areas including: drug stores, drug departments of stores, supermarkets, hospitals, clinics, nursing homes, mental 74

hospitals, and regulatory agencies. Pharmacists can specialize in various areas of practice including but not limited to: hematology/oncology, infectious diseases, ambulatory care, nuclear, nutrition support, drug information, critical care, pediatrics, geriatric, psychiatric etc. The job of retail pharmacists is to administer medications at drug stores or grocery stores. Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues. To improve pharmaceutical care, clinical pharmacist job involves assisting doctors during determining which medications and how much doses would be effective for each patient depending on his/ her physical conditions. A psychiatric pharmacist provides medication for people who have been diagnosed with mental illness, and works with the treating physician and the patient to make sure there are no negative drug interactions with the drugs prescribed. A pediatric pharmacist has specialized training in filling the prescriptions of children and at the same time, pediatric pharmacists need to be aware that children do not always respond to a medication the same way as an adult does. Pediatric pharmacists also counsel parents on the use of medication for their children. The geriatric pharmacist works with the elderly. It is the pharmacist s responsibility to make sure that there are no adverse reactions when combining medications prescribed by a doctor as the elderly tend to take more medications than young people. A nuclear pharmacist (radiopharmacist) works with radioactive medications prescribed for a patient undergoing radiation therapy. The nutrition support pharmacist works with a team of support personnel, including dieticians, to make sure the patient receives optimal nutrition. A military pharmacy meets the needs of a military health care system. Military pharmacy is an entirely different working environment due to the fact that technicians perform most duties that in a civilian sector would be illegal. State laws of technician patient counselling and medication checking by a pharmacist do not apply. Military pharmacy is quite unique from conventional pharmacy. Firstly, your role changes frequently (i.e. with posting), so there needs to be an ability 75 to assimilate into different environments to meet the needs of that particular unit, task etc. Also, if you want to be solely a clinical pharmacist and nothing else, then the Army probably isn t the best choice as it requires you to utilize your clinical knowledge more to deliver logistic and forensic outcomes in support of tasks/operations rather than individual patient care. Internet pharmacy/online pharmacy Online drug stores carry out its functions of providing medicines over the internet and runs 24/7. One can trust those pharmacies that have regular customers since a long period of time. It is a convenient process to make an order for the required drugs through the internet while sitting at home as the prescriptions will be delivered right to your door besides saving time, money and effort. The common types of online pharmacies one can find include generic online drug stores, discount online pharmacy and licensed online pharmacy stores. The use of online pharmacy is in great demand as almost every drug can be ordered by visiting the required site. The internet drug stores are controlled by the international and state laws. But there are few online stores that function against the laws. Online pharmacies that dispense drugs not approved by the FDA or equivalent agencies might be counterfeit, contaminated, sub-potent, super potent or the wrong drug, all of which could jeopardize your health. In the worstcase scenario, one may not receive any medication at all despite paying for it. It is important to make sure that the online pharmacy you choose only dispenses FDA approved prescription medications. Thus, it is recommended that the necessary and appropriate investigation of an online pharmacy should be done before buying medications online so as to optimize the likelihood of a medically, legally, financially and emotionally safe buying experience [8]. Many of internet pharmacies are similar to community pharmacies. Some customers consider this to be more convenient and private method rather than travelling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies are also recommended to some patients by their physicians if they are homebound. Online drugstore is the perfect place for those who want to save money and time and get privacy and security. While most internet pharmacies sell prescription drugs and require a

valid prescription, some internet pharmacies sell prescription drugs without requiring a prescription. Many customers order drugs from such pharmacies to avoid the inconvenience of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. There also have been reports of such pharmacies dispensing substandard products. Pharmacy2U Ltd founded internet pharmacy in the UK in 1999 and is now the country s largest dedicated internet pharmacy. Canada is home to dozens of licensed internet pharmacies. In recent years, many consumers in the US and in other countries with high drug costs have turned to licensed internet pharmacies in South American countries, India, Israel and the UK, which often have even lower prices than those countries. Recently developed online services like Australia s Medicine Name Finder and the Walgreens Drug Info Search provide information about pharmaceutical products but do not offer prescriptions or drug dispensations. These services often promote generic drug alternatives by offering comparative information on price and effectiveness. Education and training requirements for pharmacists Firstly, a look at the qualifications of the pharmacists required to practice pharmacy in different countries varies. In developed countries, the qualifications of the pharmacists required to practice pharmacy is: B.S/B.Sc pharmacy in Europe, Pharm. D in U.S.A/Canada, Diploma in Pharmacy (D.Pharm)/ Bachelor of Pharmacy (B. Pharm) in underdeveloped countries like Asian/African countries. Total duration of study to basic degree attainment is generally four years, with slightly longer programs in the US (six years), France (six years) and Canada (five years). An additional two to three years are generally required to specialize or obtain an advanced degree in countries where the option is available. Many countries including US, UK, France, Canada, Germany, Australia and Singapore require clinical training, generally four months to one year, either during the course of study or as a post-graduation internship or residency. Specialty training is an option in the US, UK, France, Canada and Singapore. The legislation for registration as a pharmacist with professional and/or regulatory bodies in most countries is available [9]. Many countries require licensure or certification of pharmacy graduates through a national examination before they can enter practice. However, there appears to be little standardization of relicensure processes both within and between countries. The mechanism to enforce mandatory completion of continuing education credits for relicensure does not exist. Only Singapore enforces mandatory completion of continuing education credits for relicensure every two years. With the expansion of the role of pharmacists, the topic of prescribing authority continues to be debated. The UK allows independent prescribing by pharmacists, but only after specialty accreditation. The US, Australia, and Canada allow limited prescribing privileges under certain circumstances or for certain drugs. Singapore, France does not allow prescribing by pharmacists, with the exception of provision of emergency contraception in France [10]. Countries as geographically widespread as New Zealand, Australia, Singapore, Brazil, Saudi Arabia have also developed 4 plus 1 model of pharmaceutical education. A minimum of four years undergraduate university education for the award of an accreditable pharmacy degree in the European Union, followed by 1 year practical training (called pre-registration in UK, internship in Germany) in a pharmaceutical setting and under the supervision of a pharmacist is required. In some countries, one year practical training may be incorporated into degree structure. The education and training requirements for pharmacists in several countries are described here. United States (US) Three degrees of pharmacy education are available in USA. i) Pharm.D, ii) M.S. Programs, and iii) Ph.D. Program. The educational course to become a pharmacist in the US takes approximately six years. The Doctorate of Pharmacy (Pharm.D) degree is a four-year professional program that generally follows two or more years of prepharmacy undergraduate education. To enter a doctoral program in pharmacy, students are required by most programs to have at least two years of coursework completed at an accredited college or university. Most states require students to take an entry test [11] (Pharmacy College Admissions Test, PCAT) and complete 60-90 76

credit hours (2 3 years) of university coursework in the sciences, mathematics, composition and humanities before entry into a professional program. Many pharmacy students complete a bachelor s degree before entry to pharmacy school. The American Association of Colleges of Pharmacy endorses the PCAT as a preferred entrance exam for pharmacy college [12]. In the United States, 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[13]. Currently all accredited schools and colleges of pharmacy in the US offer the Pharm.D degree. International students from Asian countries who have graduated after Jan 2003 require a 5 year B.Pharmacy degree to be eligible to register for the Foreign Pharmacy Graduate Equivalency Examination (FPGEE). This change was made to keep the standards of foreign pharmacists on par with U.S. standards. Many institutions also offer post- Pharm.D graduate programs in specialized areas of the profession. Generally, total time required include 2 4 years undergraduate (Associate or Bachelor degree), 4 years professional (PharmD), optional 1 3 years of specialization (residency/fellowship). In the US, pharmacists do not generally have broad prescribing privileges, however, through legislation, or under certain circumstances, limited prescribing authority is allowed in some states and institutions. United Kingdom (UK) Pharmacy education in the UK is a four-year undergraduate master s program that results in the Master of Pharmacy (MPharm) degree. The program is considered an undergraduate Master s degree because a bachelor s degree is not required for entrance into the program. The UK s program is the shortest of the European pharmacy programs, as most other European countries require five to six years of study. Beyond coursework, pharmacy students are not required to complete a clinical placement or other practicum during their studies, however it is generally expected that some clinical practice will be completed. Clinical placements may last anywhere from one week to four weeks over the four-year program [14]. In UK, prospective pharmacists have to successfully complete the preregistration year and the registration examination before registration with Royal Pharmaceutical Society of Great Britain. Ireland One must have registered with the pharmaceutical society of Ireland before you can practice pharmacy in the republic of Ireland. According to the Pharmaceutical Society of Ireland (PSI) [15] to become a pharmacist in Ireland you must: i) register with the Pharmaceutical Society of Ireland on starting your course, ii) complete a four-year accredited pharmacy degree in a school of pharmacy in Ireland, iii) complete a period of one year s practical training, approved by the PSI, under the supervision of a practising tutor pharmacist (preregistration training), iv) pass the Pharmaceutical Licence Examination. On completing all four requirements above, the person is entitled to apply to become registered as a pharmacist in Ireland. South Africa To be able to work as a pharmacist s assistant in South Africa, registration with the South African Pharmacy Council is a pre-requisite. All persons who wish to register as pharmacists in South Africa must pass the full professional examinations. In order to qualify to enter the Professional examinations candidates must be in possession of: i) a Bachelor s degree, or its equivalent, in pharmacy (evaluated by the South African Qualifications Authority as being equivalent to a South African Bachelor of Pharmacy Degree), which is prescribed in terms of the Pharmacy Act, 1974 for purposes of registration as a pharmacist, ii) proof of having completed at least twelve months of practical training, and iii) a working knowledge of the English language which is essential for the practice of pharmacy in South Africa. Nigeria Presently, The University of Benin, Edo State is the only institution offering the Pharm D degree. It is a six (6) year undergraduate program. Students are giving clinical training in Pharmaceutical Care in various hospitals in the City [16] 77

Saudi Arabia PharmD programs duration is six years in total, including one academic year of clinical rotations. United Arab Emirates (UAE) UAE Pharmacy license is granted in 2 stages: i) passing full Pharmacy examinations and ii) granting approval pharmacy license by Pharmacy Committee in UAE Ministry of Health for any licensed pharmaceutical establishment in UAE. For full pharmacy examinations, The UAE full Pharmacy examinations is consisted of 2 stages (for Arabic speaking candidates) or 3 stages (for non Arabic-speaking candidates). The Arabic language exam is for non- Arabic speaking candidates, it ensures that licensed pharmacist or technician is fluent enough and having the basic communication skills to deal with Arabic customers in UAE. France Pharmacy education programs in France offer a sixyear and a nine-year option. The purpose of the Bologna Process (or Bologna Accords) is the creation of the European Higher Education Area by making academic degree standards and quality assurance standards more comparable and compatible throughout Europe. Beginning in 2010 as part of the Bologna Process, French pharmacy students will start their education by taking a year of common curriculum with medical studies, midwifery, and dentistry [17]. After completing one year of undergraduate pharmacy study, students must pass a competitive examination to move forward in the program. Students complete coursework and receive some clinical training in the first four years of education. In year five, students complete a 12-month, half-time internship at a university hospital. Depending on a student s area of interest, this may be followed by a six-month, full-time internship in a community pharmacy or industry in year six. After six years of classroom and practical training, as well as completion and defense of a thesis, students receive the Doctor of Pharmacy degree and may practice in a community or industrial setting. To enter practice, pharmacists must register with the College of Pharmacists (Ordre National des Pharmaciens). Pharmacists in France do not prescribe drugs, except in the case of emergency contraception [18]. 78 Germany Pharmacy education in Germany is a four-year program that includes coursework, clinical experience, a 12-month practical year, and a three-part state exam with written and oral components. The first two years focus on coursework, with an eight-week clinical practice (Famulatur) completed during the school holiday. Four weeks of Famulatur must be completed in a community pharmacy, and the remaining four weeks can be completed in a hospital, army pharmacy, industry, or drug control institute. After the second year of studies, students take part one of the three-part pharmaceutical exam. Each part of the exam must be passed before moving on to the next phase of studies. After two more years of coursework, including herbal medicines, students must pass part two of the exam. Students then complete one year of practical training, six months of which must be completed in a community pharmacy. Upon completion of the practical year, students must pass part three of the exam in order to receive a state license or Approbation to practice. A student may also choose to spend half of the practical year doing research in a university setting and may complete a thesis to earn a post-graduate diploma comparable to a master s degree [19]. Germany has a voluntary system for continuing education of pharmacists. Australia Pharmacy education in Australia most commonly involves a four-year Bachelor of Pharmacy degree, including clinical training, followed by one year of supervised internship in pharmacy practice. Pharmacists in Australia do not have prescribing privileges for most medications; however they may prescribe from a defined list of pharmacist-only medicines, such as certain decongestants and asthma inhalers, used to treat minor ailments or symptoms that do not require diagnosis by a physician. To practice as a pharmacist in Australia it is necessary to be registered with the Pharmacy Board of Australia [20]. Registration standards define the requirements that applicants or students need to meet to be registered and include the following: (i) An individual applying for initial general registration must undertake an examination (written and oral) determined by the Board.

(ii) (iii) Canada An applicant who is an international student must have the necessary English language skills for registration purposes by achieving an overall total score of 7.5 in the IELTS academic module. Test results will generally need to be obtained within two years, but preferably within 12 months prior to applying for registration. Additionally, a current English Language test result will be required for applicants who did not complete their secondary education in English in specifically listed countries. A period of supervised practice, which includes internship, undertaking pharmacy practice under the direct supervision of a pharmacist who holds general registration (a preceptor), while the pharmacist is providing pharmacy services in pharmacy premises or other circumstances as determined by the Board. An approved undergraduate degree in pharmacy, such as that offered by the Faculty of Pharmacy and Pharmaceutical Sciences is also required. To undertake supervised practice for initial general registration, interns (pre-registrants) require provisional registration with the Pharmacy Board of Australia, and are known as provisionally registered pharmacists. In general, pharmacy study in Canada is a five-year Bachelor of Pharmacy (B.Sc. Pharm) program for entrylevel professionals that includes one year of pre-pharmacy coursework, four years of pharmacy study, and clinical training (generally 16 weeks in clinical rotations)[21]. Currently in Canada, the PharmD program is a postbaccalaureate program. Students enrolled in the program must have graduated from a CCAPP (Canadian Council for Accreditation of Pharmacy Programs) or an ACPE (Accreditation Council for Pharmacy Education) school with an accredited teaching program or must have passed the PEBC (Pharmacy Examining Board of Canada) Evaluating and Qualifying examinations. As of fall 2007, the PharmD program is offered at the Université de Montréal (in French) and is the first Canadian university to give this program instead of the baccalaureate program in pharmacy. The PharmD program was offered as a graduate program. Malaysia Upon graduating, one must apply for provisional registration. Then you work for 1 year as a provisional pharmacist in a govt hospital/bureau. After that, you get to apply for full registration. Then, you re apparently required by LAW to serve the govt for 3 years, although it doesn t say that you can t work as a pharmacist anywhere else till you re done with that. In order to register as a pharmacist in Malaysia a person must, i) posses a degree recognized by the Pharmacy Board of Malaysia, ii) undergo pupilage training not less than a year that is recognized by the pharmacy board and iii) pass a forensic examination conducted by the Pharmacy Board. Additional requirements for a foreigner are i) he/she is married to a Malaysian, ii) he/ she is the spouse of a foreigner working in Malaysia under a valid working permit, and thus must also be no restriction in the applicant s own visa. Any pharmacy graduate who completes his or her degree after September 2004 and who seeks to register as a pharmacist in Malaysia must apply for provisional registration with the Malaysian Pharmacy Board called the Lembaga Farmasi and undergo 12 months of pupilage training in a government hospital or institution. In addition, 3 years service in a government hospital or institution is required, after which the graduate applies for full registration with the Malaysian pharmacy board The pharmacy board of Malaysia has put up Pharmacy Forensic/Jurisprudence Examination as one of the requirements to get registered as pharmacists. The following groups of pharmacists need to pass this examination (i) Provisionally registered pharmacists who are undergoing training; (ii) Pharmacists registered in recognized country before 2 September 2004, who intend to get registered in Malaysia [22]. Singapore Pharmacy education in Singapore is a four-year undergraduate professional program resulting in a Bachelor of Science in Pharmacy degree (B.Sc. Pharm). The pharmacy program includes coursework, practical experience, and two 6-week clinical rotations ( preceptorship ) in community pharmacy (2nd year) and hospital pharmacy (3rd year). Graduates who wish to 79

practice pharmacy in a hospital, clinic, or elsewhere must be registered with the Singapore Pharmacy Council and first complete one year of clinical training [23]. Pharmacists are required to register with Singapore s Pharmacy Board. China The course of instruction leading to a Bachelor of Science in pharmacy (B. Pharm) extends at least four years. Many institutions also offer graduate courses in pharmacy leading to the degrees of Master of Science and Doctor of Philosophy in pharmacy. The State Food and Drug Administration is the governing body that is charged with oversight of the licensing examination, registration of licensed pharmacists, and continuing education required for licensed pharmacists [24] India Diploma in Pharmacy (D. Pharm, 2 years course) is the minimum qualification required to be a registered pharmacist in India. B. Pharm (4 years course) is offered in various universities. Some Universities also offer Pharm.D (6 years course). The first batch of Pharm.D students will graduate by 2011. Pharmacy Council of India permitted few universities to start Pharm.D (post baccalaureate)(2 years + 1 full working year internship in a 300 bedded hospital) for B pharmacy graduates. To practice as a pharmacist in India, one needs at least a Diploma in Pharmacy (DPharm), which is awarded after only 2 years and 3 months of pharmacy studies. These diploma-trained pharmacists are the mainstay of pharmacy practice. A variety of pharmacy degree programs are offered in India: Diploma in Pharmacy (DPharm), Bachelor of Pharmacy (BPharm), Master of Pharmacy (MPharm), Master of Science in Pharmacy [MS(Pharm)] and Master of Technology in Pharmacy [MTech (Pharm)], Doctor of Pharmacy (PharmD), and Doctor of Philosophy in Pharmacy (PhD). The entry point, for DPharm, BPharm, and PharmD programs is 12 years of formal education in the sciences. The DPharm program requires a minimum of 2 years of didactic coursework followed by 500 hours of required practical training anticipated to be completed within 3 months in either a hospital or community setting [25]. If you graduated after Jan 2003 with a 4 year B. Pharmacy degree, you are, unfortunately, not eligible to register for the FPGEE in 80 U.S.A. You will have to take the PharmD course if you want to become a pharmacist in U.S.A. or have a 5 year B. Pharmacy degree. You can t make up 5 years with 2 years of your Masters either. The duration of PharmD in USA is 3-6 years after the BPharm completed in India? Some of the courses in PharmD will be waived since one has already completed some courses in B.pharmacy level. One will be eligible to give NAPLEX and law exam to get licence and there is no need to give FPGEE and TSE. MS in Pharmacy and PhD in Pharmacy are different from PharmD and one can t become a pharmacist with these degrees. However, one can get into industry jobs with these degrees. Today pharmacy education and practice is at crossroads in India. It is facing numerous challenges that need to be addressed at this stage. Currently, pharmacy graduates (B.Pharm) from Asian countries are not eligible to take up jobs as practising pharmacists in other countries, particularly the western countries where PharmD has become the professional degree for practice of Pharmacy. The six year Pharm.D programme and three year Post-Baccalaureate Pharm D in the country can help in bringing pharmacy education on par with other countries. Those who have completed their B.Pharm (Bachelor of Pharmacy) course can pursue the three year Pharm.D (Post Baccalaureate) course. Pakistan A five years Pharm.D (Doctor of Pharmacy) programme was started in 2003 in Pakistan in various Universities. It is the least required degree for a Pharmacist to get Registration by the Pharmacy Council of Pakistan. Pakistan upgraded their four degree to the five year Pharm.D in all their institutions. Spain In Spain, Pharmacy studies can be accessed after completing five and a half years of University College (with at least 6 months of initiation to Pharmacy Practice). The Licenciado en Farmacia or Grado en Farmacia Spanish degree is the only title that allows practicing the profession of Pharmacy in Spain Career Opportunity in the Pharmaceutical Industry Various opportunities in the Pharmaceutical Industry include manufacturing /production, pharmaceutical production management, quality control,

quality assurance, research & development, clinical research, contract research organization, regulatory affairs & IPR, sales & marketing, product management, bio-informatics and medical transcription. Pharmacist major fields of works include community, hospital, pharmaceutical industry, academia and non-traditional pharmacy. No significance of difference was found between perceptions of students on roles of pharmacist in all of the major fields [26]. Industry, regulation, funding and academia are the most crucial driving forces that might affect the evolution of the pharmaceutical sciences [27]. The WHO, in the report of its consultative group on Preparing the Future Pharmacist (Vancouver 1997) identified seven roles, (the seven star pharmacist ), which should be considered essential, minimum common expectations of pharmacists by health care systems world-wide [28]. Global Dilemmas for Pharmaceutical Education: First of all, a number of problems exists which creates barrier in development of global pharmaceutical education. Secondly, there is need to address limited capacity of pharmacy higher education institution, particularly in low income countries to ensure a sustainable pharmacy workforce relevant to needs such as health education and market.thirdly, world is a global village and there must be a similar nomenclature of the degree in pharmaceutical sciences to become eligible to practice pharmacy all over the world. Generally, there are two sides to every story with respect to changes in pharmacy curriculum and our plans to determine if these changes will make a difference in the way our graduates practice and the way their patients receive their care. The extent of science, professional experience, faculty requirement, types of practice experience and evaluation should be debated over a broad platform. The International Pharmaceutical Federation has joined with UNESCO and the World Health Organization to establish a Global Pharmacy Education Task Force with an Action Plan for promoting comprehensive education development and achievement of competencies in global pharmacy practice. The Task Force is leading a number of initiatives, including recommendations for improving academic workforce capacity and educational institutions, developing a framework for quality assurance of pharmacy education programs, and developing a competency framework for the pharmacy workforce [28, 29]. Students are active learners who can solve problems, think about education critically and they become proficient in training by applying their knowledge, attitudes and behaviors in a clinical setting [30]. The availability of pharmacists is increasing in many countries, in part due to a rise in the number of accredited/ approved pharmacy programs and other training options, such as online and distance learning programs. In the United States, pharmaceutical care or clinical pharmacy has had an evolving influence on the practice of pharmacy [31]. In addition, consultant pharmacists, who traditionally operated primarily in nursing homes are now expanding into direct consultation with patients, under the banner of senior care pharmacy [32]. On 8 September 2009 at the FIP Congress in Istanbul the FIP Council adopted an official FIP Statement of Policy on Quality Assurance of Pharmacy Education [33]. The pharmacist workforce shortage experienced in many countries depends on a number of factors [34]. Pharmacy education capacity and training institution distribution The capacity to provide pharmaceutical services in each country is dependent upon having an assured competent workforce and a similarly integrated academic workforce to train sufficient numbers of new pharmacists and other supporting staff at both basic and enhanced levels. As a result, colleges and schools of pharmacy have undergone significant budget cuts, with many resorting to quick fixes to meet their financial woes, such as increased student enrolment, tuition hikes, faculty and staff layoffs, and choosing not to fill vacant positions. Although it may be a reasonable supposition that increased pharmacy student enrolment and/or tuition will generate funds to support immediate financial needs, and in some schools increase profit margins, one should be mindful of the risks of this approach: these quick fixes are not cures and do not usually become long-term, beneficial solutions. Although there remains a shortage of pharmacists in the workforce, this shortage has shifted, resulting in a reduction in demand and increased competition for pharmacists wanting positions in many areas [35]. Reasons for this decline in demand include increased use 81

of automation and technology, high pharmacist salaries, and expanded pharmacy technician responsibilities [36]. The difficulty in filling pharmacist positions, particularly with higher salaries has contributed to the decline in demand, with health care organizations and retail pharmacies seeking alternate solutions to meet the needs of the public, such as regional prescription refill centres. To safeguard its sustainability in this era of uncertainty, pharmacy education and the profession must face the current economic crisis directly and identify points of longterm opportunity rather than settling for quick fixes alone [36]. Pharmacist should be educated in the advances of the Human Genome Project and the implications of such advances on their professional responsibilities [37]. Nontraditional roles for pharmacists in drug information and research Centre, drug discoveries, clinical trials and clinical research, regulatory affairs, marketing and sales, poison information centre, industry and military pharmacy are also gaining importance [38]. Role of pharmacist in Drug Information and Research Centre The Drug Information and Research Centre (DIRC), the largest of its kind in North America, is a drug resource centre of the Ontario Pharmacists Association, a voluntary, not-for-profit professional association of pharmacists and pharmacists-in-training in Ontario. The DIRC is dedicated to providing unbiased information to pharmacists and the public on matters relating to pharmaceutical products and disease conditions. DIRC s approach to answering drug information questions is highly respected and trusted by hundreds of clients daily. DIRC staff includes a senior pharmacist and more than 30 drug information pharmacists. DIRC operates a call centre that provides drug information 16 hours a day, 365 days a year (Monday to Friday, 8am - 5pm), responding to more than 60,000 inquiries. The centre s drug databases are continuously updated, and its drug information experts can sort through the most current medical literature to provide immediate, patient-focussed answers to the most complex questions. In addition to its call centre, DIRC provides outsourced medical information services to pharmaceutical companies and other organizations, medical writing services, drug information publications, and a wide range of innovative continuing education programs. In 2008, DIRC began providing drug information services to the Department of National Defence and the Canadian Forces, expanding its services both nationally and globally and highlighting its reputation for a timely, accurate, and evidence-based approach to answering drug information questions. DIRC s Quality Management System is independently audited and registered to the ISO 9001:2008 standard [39]. The number of DRICs has declined steadily since 1986, and the number of drug information pharmacists is at its lowest in 30 years. DRIC services continue to be comprehensive. Only half of the DRICs surveyed had a formal quality assurance program [40]. In the last few decades there has been a great increase in the number of new drugs available for general use. In consequence, drug information centres have been developed, particularly in U.S.A., to disseminate information on the uses, toxicity and cost of these drugs. Such centres have been slower to appear in the United Kingdom, with the exception of certain specialised centres, e.g. Poisons Information Bureaux. The present report describes the development of a drug information centre in Glasgow and gives preliminary data on its use during the last year. It is proposed that such centres provide a valuable aid in encouraging rational drug use particularly in hospitals. The centres may be run by a variety of interested personnel but in our view the professional group most likely to fill this role adequately is hospital pharmacists [41]. Role of pharmacist in poison information centre Clinical pharmacist can support the clinicians in the management of poisoning by way of providing timely information. Management of poisoning is one of the biggest challenges faced by the health care professionals at present globally [42]. Role of pharmacist in marketing and sales In marketing, a pharmacist can reapply his/her clinical knowledge in a competitive manner in order to gain a product s share in the marketplace. Pharmacists excel in the sales field, as they possess a strong technical background and excellent people skills. Performing physician and specialist calls as well training new reps are common roles for pharmacists in sales. 82

Role of pharmacist in drug discoveries, clinical trials and clinical research Pharmacists who pursue research careers are still a small minority, their ranks are expanding quickly within the pharmaceutical industry and the myriad organizations developing and testing pharmaceutical compounds [43,44]. Role of pharmacist in regulatory affairs Regulatory affairs is the real safeguard of the pharmaceutical industry. Pharmacist can consider Clinical Data Management as a career in order to make use of their analytical skills and clinical knowledge in a setting other than a hospital. Clinical Data Management is a key component of the multidisciplinary team involved in setting up, running and reporting clinical trials. A data manager defines how these data are collected, tracks the data and checks their completeness, accuracy and the consistency. Pharmacist may develop an interest in the wider drug development process e.g. coding of medication and wish to move into clinical data management role to explore these interest. Pharmacists have the multiple career path ways in Clinical Research. Crossfunctional alignment is key in order to ensure that everyone from the drug s approval process and marketing proceeds without difficulty or delay [45]. Implementation of computer-aided pharmacy education World has witnessed alarming progress in computer technology. There is a need to emphasis the student to habituate for utilization of multimedia computers and software technologies. Pharmaceutical and technological aspects requiring graphic representation and mathematical complexities in biopharmaceutical calculations, computeraided programs can simplify GMP, validation etc. Many software applications are available [46]. For example, CADIS BIOWARE FACTOP QUICK TABLET Drug information Bioavailability concepts Optimization of pharmaceutical Dosage form Fundamentals of tablet dosage Form The opportunities for the computer aided Pharmaceutical education with facilities of software, digital library, and microteaching exist. This includes tutorials, assignments, fieldwork projects etc. in order to consolidate student knowledge and skills. Models of mobile computing initiatives exist in terms of device obtainment, technical support, infrastructure, and utilization within the curriculum of pharmacy education. Responders identified flexibility in teaching and learning as the most positive aspect of the initiatives and computer-aided distraction as the most negative. Numerous factors should be taken into consideration when deciding if and how a mobile computing requirement should be implemented [47]. Distance learning and online pharmacy educational programs Distance education pharmacy schools are becoming a popular option for professionals who are already licensed and working in the field. For instance, the University of Florida (USA) offers a Master of Science in Pharmacy as an online program [48]. Admission to the program does not require a PharmD and the degree do not lead to dispensing rights. Rather, it provides the expertise and credentials needed to expand pharmacy industry careers in regulation, policy, sales, economics, benefits management, patient safety, risk management, leadership and more. Distance learning and online educational programs have gained increasing popularity since the widespread adoption of broadband internet access in the United States. The University of Florida College of Pharmacy in Gainesville is considered to be one of the top schools of its kind in the nation [49]. Creighton University School of Pharmacy and Health Professions pioneered web-based training leading toward a Doctor of Pharmacy degree in 2001, according to the university s website [49]. The school now has online clinical doctorate degree programs in a number of health-related professions. Students need to plan for on-campus lab sessions during the summer. Clinical rotations are completed off campus. The pharmacy school, located in Omaha, Nebraska, has been training pharmacists and other health care professionals for more than a century. The School of Pharmacy and Health Professions has committed itself to delivering its programs using leading edge technologies, according to 83

the Vision Statement for Distance Education in the SPAHP on the university s website. The American Council on Pharmaceutical Education accredits the pharmacy program and the Higher Learning Commission of the North Central Association of Colleges and Schools accredits Creighton University. A number of pharmacy technician schools online offer distance learning courses [50,51]. Online Pharmacist degree program requirements are based on the type of degree [52]. Most of the online degrees to earn a doctorate of pharmacy degree (Pharm.D) are limited to practicing pharmacists. A few online colleges have pharmacy programs that are open to students wanting to enter pharmacy. Masters degrees in pharmacy and pharmaceutical sciences are offered online. Usually one focuses on a subspecialty of pharmacy, such as forensics or pharmoeconomics. However, a person with a master s degree in pharmaceutical science cannot dispense medication. The College of Pharmacy at the University of Georgia in Lawrenceville offers online graduate programs, including a graduate-level certificate in Regulatory Affairs, a Master s of Science degree in Pharmacy with an emphasis in Regulatory Affairs and a graduate certificate in Clinical Trials Design and Management [53]. The programs are designed for working professionals to take on a part-time basis. Instructors are drawn from industry and regulatory agencies. Programs are structured to provide flexibility for the students while being structured to ensure progress through the semester. Working pharmacists can earn a doctorate degree in pharmacy on a part-time basis from the University of Colorado School of Pharmacy in Denver. The nontraditional PharmD program is a part-time online program for licensed pharmacists [49]. Conclusions and perspectives Today, pharmacist is gaining prime importance in the healthcare system and with this increasing conscious about the health and preventive measures, the role of pharmacist has widened from simple compounder and dispenser of drug to the pharmaceutical care provider. Increasing numbers of pharmacists are expanding into non-traditional roles such as working as research scientists for pharmaceutical manufacturers, developing new drugs and testing their effects. Others are involved in home 84 health, where they supervise the preparation of infusions - solutions that are injected into patients - and other medications for use in the home. Pharmacy education should be relevant to health, education, industry and market. The limited capacity of pharmacy higher education institutions should be analysed and improvement measures should be specified in different parts of world. To achieve the collective global action proposed by WHO UNESCO FIP Pharmacy Education Taskforce, there is an urgent need to establish a global sharing platform relating to pharmaceutical education to take care of the finalisations and endorsement regarding quality assurance framework. It is desirable that pharmacists and pharmaceutical scientist working within various discipline of pharmacy should be recognized as the medicine expert as well as an expert in health promotion and disease prevention. Industry centred pharmacy education does not meet the requirements of patient care and pharmacy practice in many countries and in this direction, a positive collaboration between industry and academic institution should be strengthened. Problem-based learning should be an integral part of pharmacy education to produce qualified graduates for better service of community. Pharmacy education curriculum should be constantly revised and updated to meet tomorrow s challenges. Moreover, the number of years spent as well as academic standard regarding desired course curriculum for acquiring the minimum qualification to become a registered pharmacist should almost be same around the globe. To overcome the problems faced by many countries in pharmaceutical education, the establishment of independent Pharmaceutical Universities are desirable to have better control on pharmaceutical education and modifying service condition of faculty to upgrade their competency, innovativeness, communication skills and allaround development. A constant interaction between pharmacy institutions, educational institutions and various stakeholders (healthcare practitioners, academic centres and pharmaceutical companies) is desirable to create wellrounded knowledgeable pharmacists so that future pharmacists can meet the requirements and demands of the changing profession. Further, with growing interlinkages in the world, international standards must be maintained and the curriculum should include a section on global trends and best practices.

References 1.http://wiki.answers.com/Q/What_is_the_ difference_between_a_pharmacy_technician_ and_a_ pharmacist#ixzz1npjzkmth. 2. http://wiki.answers.com/q/what_is_the_ difference_between_a_pharmacy_technician_ and_a_ pharmacist#ixzz1npiuhsg0, 3. http://wiki.answers.com/q/what_is_the_ difference_between_a_pharmacy_technician_ and_a_ pharmacist#ixzz1npjzyn7c, 4. Tootelian DH, Rolston LW, Negrete MJ. Expanding into nontraditional roles: Are Pharmacists receptive to change? Services Marketing Quarterly 2007;28:55 75. 5. Adriana A Noton. Different Types Of Pharmaceutical Education. http://ezinearticles.com/?different-types- Of-Pharmaceutical-Education&id=5446402 6. Pharmaceutical Education & Training ehow.com http:// www.ehow.com/facts_6744405_pharmaceuticaleducation-training.html 7. http://www1.salary.com/pharmacist-salary.html 8. http://onlinepharmacyfloridausa.com/ 9. C M Bond. The role of a pharmacist in health care. In:[Arthur J. Winfield, Judith A. Rees, Ian Smith. Pharmaceutical Practice. Churchill-Livingston, 2009, pp 3-16. 10. Bourdon, et.al., 2008. Blanchet, F., Belot, V., Dreux, C., Initiatives to Support French Community Pharmacists in the Dispensing of Emergency Contraception, French Ministry of Health, Sanitary and Social Education Committee for French Pharmacy (CESPHARM), December 2003, http://www.ordre.pharmacien.fr/upload/ Syntheses/201.pdf. 11. www.ourmed.org/index.php?title=doctor_of_pharmacy, 12. Pharmaceutical Education & Training ehow.com http:// www.ehow.com/facts_6744405_pharmaceuticaleducation-training.html#ixzz1dbadwrm7, Accessed April 6, 2011. 13. www.gken.org/.../pharmacy%20education%20 FINAL%20102609.pdf - Similar, 14. http://www.gken.org/docs/workforce/ Pharmacy%20Education%20FINAL%20102609.pdf, 15.http://www.nuigalway.ie/careers/students/faq/ pharmacy.html., 85 16. http://en.wikipedia.org/wiki/doctor_of_pharmacy, 17. Alice Pfeiffer, Special Report: Taking Europe s Medical Students Beyond 2010, New York Times, April 29, 2009, http://www.nytimes.com/2009/04/29/education/29ihtriedmedeu.html?_r=1. 18. Bourdon, et.al., 2008. Blanchet, F., Belot, V., Dreux, C., Initiatives to Support French Community Pharmacists in the Dispensing of Emergency Contraception, French Ministry of Health, Sanitary and Social Education Committee for French Pharmacy (CESPHARM), December 2003, http://www.ordre.pharmacien.fr/upload/ Syntheses/201.pdf. 19. Pamela Mason, A German pharmacy student, Tomorrow s Pharmacist, 2003, http://www.pharmj.com/pdf/tp/2003/ TP_2003_p42germany.pdf. Hans-Rüdiger Elster, The German pharmaceutical education, http:// www.angelfire.com/sc/pharmcare/phstudent.html. 20. http://www.pharmacyboard.gov.au. 21. zarrinfaria, 06/10/2009 Registration requirement for pharmacists in Malaysia, Part-2. http://www.pharmainfo. net/zarrinfaria/registration-requirement-pharmacistsmalaysia-part-2, 22.http://www.pharmainfo.net/zarrinfaria/registrationrequirement-pharmacists-malaysia-part-2, Accessed April 6, 2011. 23. National University of Singapore, NUS Pharmacy Undergraduate Programme - FAQ for Prospective Students, http://www.pharmacy.nus.edu.sg/students/ prog_ugnewintake.htm. Singapore Pharmacy Board, Competency Standards for pharmacists in Singapore (Entry to practice), September 2006, http:// www.spc.gov.sg/html/1179710781760.html. Accessed April 6, 2011. 24. Zhu S. The present situation and the tendency of licensed pharmacist qualification system rules in our country. China Pharmacist. 1999;4:176 9. 25. http://www.aicte-india.org, 26. Ismail M, Syuhadah N Perception of pharmacy students at private universities in Malaysia towards the roles of pharmacist, 2010. 27. Crommelin D, Stolk P, Besançon L, Shah V, Midha K, Leufkens H. Pharmaceutical sciences in 2020, Nat Rev Drug Discov 2010: 9: 99-100 28. Anderson C, Bates I, Beck D, Futter B, Mercer H, Rouse M et al.: The Pharmacy Education Taskforce: FIP and WHO move forward in developing pharmacy education. Int. Pharm. J. 2007, 22: 3-5.

29. http://www.fip.org/education, 30. Trinca C E. Pharmaceutical Education without Boarders: Towards a Global Pharmacist. V. Pan American Conference on Pharmaceutical Education. Accessed April 6, 2011. 31. pcdoctorsmalta.com/cms/traf.php?p=116, Accessed April 6, 2011. 32. http://www.rgip.org/pharmacy.html, 33. Anderson C, Bates I, Beck D, Brock T, Futter B, Mercer H et al.: Action! Update on the global pharmacy education consultation. Int Pharm J 2008; 22: 6-8. 34. The pharmacist workforce shortage experienced in many countries depends on a number of factors. 35. Chisholm-Burns MA. A Crisis is a really terrible thing to waste. Am J Pharm Educ. 2010; 74: 19. 36. Thomson CA. Supply of pharmacists in work force has improved, government scarce. AJHP News. April 15, 2009.http://www.ashp.org/import/news/ HealthSystemPharmacyNews/newsarticle. aspx?id=3052. Accessed February 16, 2010. 37. Sansgiry S S, Kulkarni A S. The Human Genome Project: Assessing Confidence in Knowledge and Training Requirements for Community Pharmacists. Amer J Pharm Edu 2003; 67 (2) Article 39. 38. http://www.psa.org.au/site.php?id=7451, Accessed April 6, 2011. 39. http://www.dirc.ca, 40. Rosenberg JM; Koumis T; Joseph P. Nathan; Lorraine A. Cicero; Howard Mcguire, Current Status of Pharmacist- Operated Drug Information Centers in the United States, Amer J Health-System Pharm. 2004;61(19). 41. McCabe JC, Henry DA, Lawson DH., Drug information centres: new role for pharmacists? Scott Med J. 1977;22(2):147-50. 42. Sharma A; Rani S, Importance of poison information center and role of a pharmacist in management of poisoning. 11/21/2009-10:01, http://www.pharmainfo.net/ pharmamit/publications/importance-poison- information-center-and-role-pharmacist-management- poisoning]. 43. Behind the Scenes, Pharmacists Play Key Role in Clinical Research,http://sciencecareers.sciencemag.org/ career_magazine/previous_issues/articles/2007_06_15/ caredit.a0700085]. 44. Durrant KL. Pharmacist s role in enhancing patient participation in clinical trial research. 2006, www.cop.ufl.edu/wp-content/uploads/dept/wppd/pc/ sample06b.pdf] 45. www.greatpast.utoronto.ca/175anniversary/.../industryrole.pdf, 46. Pharmainfonet.com 2007; Vol. 5 Issue 5. http:// www.pharmainfo.net/reviews/pharmacy-educationit%e2%80%99s-challenges 10/01/2007 47. Cain J, Bird ER, Jones M. Mobile computing initiatives within pharmacy education. Amer J Pharm Ed 2008;72(4) article 76. 48. http://pharmreg.dce.ufl.edu, 49. Online or Distance Education Pharmacy Schools ehow.com http://www.ehow.com/list_6149851_online-distanceeducation-pharmacy-schools.html#ixzz1nnwuocgu, 50. Suite101: Pharmacy Technician Schools Online Course Guide: How to Find Courses Pharmacy Tech Online Schools http://www.suite101.com/content/pharmacytechnician-schools-online-course-guidea191661#ixzz15e53ltjy, 51. Online or Distance Education Pharmacy Schools ehow.com http://www.ehow.com/list_6149851_online-distanceeducation-pharmacy-schools.html#ixzz15e3vsce9], 52. http://www.nursingdegree.net/blog/810/schools-offeringonline-masters-degrees-in-pharmaceutical-sciences. 53. http://www.uga.edu/gradschool/programspharmaceutical education and career an overview, Accessed April 6, 2011. 86