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Revision as of 12:32, 18 May 2007

The mortar and pestle is an international symbol of pharmacists and pharmacies.

For the precursor profession, see Apothecary.

Pharmacists are health professionals who practice the art and science of pharmacy. In their traditional role, pharmacists typically take a request for medicines from a prescribing health care provider in the form of a medical prescription and dispense the medication to the patient and counsel them on the proper use and adverse effects of that medication. In this role, pharmacists ensure the safe and effective use of medications. Pharmacists also participate in disease state management, where they optimise and monitor drug therapy – often in collaboration with physicians and/or other health professionals. Pharmacists have many areas of expertise and are a critical source of medical knowledge in clinics, hospitals, and community pharmacies throughout the world.

Pharmacists are sometimes small-business owners, owning the pharmacy in which they practice. They are also very skilled and specialized individuals with specific knowledge that makes them a vital part of any healthcare team. They act as a learned intermediary between patients and healthcare providers to ensure that proper medical therapy is chosen and implemented in the best way possible.

Pharmacists are sometimes referred to as chemists (or dispensing chemists), which sometimes causes confusion with scientists in the field of chemistry. This term is a historical one, since pharmacists originally were required to complete an undergraduate degree in Pharmaceutical Chemistry (PhC) and were known as "Pharmaceutical Chemists".

Skills and roles

Pharmacists are trained in medicine-related fields including pharmacology, chemistry, pharmaceutical chemistry, pharmacy practice (including drug interactions, medicine monitoring, medication management), pharmaceutics, pharmacy law, physiology, anatomy, biochemistry, kinetics, nephrology, hepatology, and compounding medications. Additional curriculum covers basic diagnosis with emphasis on disease state management, therapeutics and prescribing (selecting the most appropriate medication for a given patient).

Pharmacists are often the first point-of-contact for patients with health inquiries. This means that pharmacists have large roles in the primary care of patients. These roles may include, but are not limited to:

clinical medication management
specialized monitoring of simple and complex disease states
reviewing medication regimens
monitoring of treatment regimens
general health monitoring
compounding medicines
general health advice
providing specific education to patients about disease states and medications
oversight of dispensing medicines on prescription
provision of non-prescription medicines
counseling and advice on optimal use of medicines
advice and treatment of common ailments
referral to other health professionals if necessary
dosing drugs in renal and hepatic failure
pharmacokinetic evaluation
education of physicians and other healthcare providers on medications and their proper use
prescribing medications in collaboration with other healthcare professionals
providing pharmaceutical information
promoting public health by administering immunizations

Qualifications and registration

The basic requirement for pharmacists to be considered for registration is an undergraduate or postgraduate Pharmacy degree from a recognized university. In most countries this involves a four-year course to attain a Bachelor of Pharmacy (BPharm) degree. However in the United States, to become a registered pharmacist, students graduating after 2005 must complete a Doctor of Pharmacy degree which takes six years from an accredited college of pharmacy. In the United States, a Bachelor of Science (BPharm) degree in Pharmacy will not be sufficient to become a licensed or registered pharmacist in any state. Any college graduate who has graduated on or prior to 2005 is grandfathered and can register, however new students after 2005 must complete the Doctor of Pharmacy program or PharmD.

In order to practice as a pharmacist, the person must be registered with the relevant statutory body, which governs the registration and practice of pharmacy within the territory of its jurisdiction. There is often a requirement for the pharmacy graduate to have completed a certain number of hours of experience in a pharmacy, under the supervision of a registered pharmacist. The statutory body will usually administer a written and oral examination to the prospective pharmacist prior to registration.

Australia

In Australia, apart from the four-year BPharm course, there is the option of a postgraduate two-year Master of Pharmacy (MPharm) course for those with undergraduate science degree background.

Pharmacists are registered by Pharmacy Boards in individual states such as the Pharmacy Board of New South Wales. In Western Australia, pharmacists are registered by the Pharmaceutical Council of Western Australia. Individual states have differing requirements for pharmacy graduates for registration, but generally graduates are required to complete approximately one year of practice under the supervision of a registered pharmacist. In addition, graduates are required to complete an approved graduate training course for that state, for example the Pharmacist Graduate Training Course (PGTC) offered by the Pharmaceutical Society of Australia NSW Branch is required in New South Wales. On meeting these requirements, graduates are eligible to sit the registration examination which may involve both written and oral components.

Chile

In Chile, students must study six years to become pharmacists. The best school of pharmacy is at Universidad de Chile , in Santiago de Chile. Chilean pharmacist are very high skilled proffesionals, prepared not only to dispense and be able to work at clinical and communitary pharmacy, but in Pharmaceutical, Food and Cosmetic industry too at every level, including drug development (a Degree is needed here), manufacturing, management, marketing, etc., due to the very strong scientific preparation they receive, including engineering and pharmaceutical technology topics. The official title for pharmacists in Chile is Químico Farmacéutico (Chemist and Pharmacist), and their degree is Licenciado en Ciencias Químicas y farmacéuticas (Bachelor in Chemical and Pharmaceutical Sciences).

Greece

In Greece, a five-year University course must be completed. This course is offered by the University of Athens , the University of Thessaloniki and the University of Patras . The course comprises 4 years of theory and laboratory practice and a 5th year of compulsory, full-time in-service training in a community pharmacy and the pharmaceutical department of a hospital. An additional trimester placement in a pharmaceutical industry is also an option, however it does not count towards the acquisition of the license to practice. Upon successful completion of the course, a Degree in Pharmacy is awarded.

The pharmacy graduate may pursue a career in the industry after graduation. A career in this field does not require a license to practice pharmacy. However, pharmacists wishing to open a pharmacy, work in hospitals or in the National Organization of Medicines must first successfully participate in board examinations organized by the Greek Ministry of Health, in order to obtain a License to Practice Pharmacy.

New Zealand

In New Zealand, as with other western nations, a four year BPharm must be completed, followed by an internship at a pharmacy. Pharmacists are registered at the Pharmaceutical Society Of New Zealand. The degree can be taken at University Of Otago in Dunedin and University Of Auckland in Auckland.

Republic of Ireland

In the Republic of Ireland, a 4-year BPharm/BSc Pharm degree must be completed followed by one year of post-registration training. Trinity College, Dublin was the only university offering the BPharm course in the Irish Republic until recently. In 2003 two new Schools of Pharmacy were opened. A Pharmacy department was created at University College, Cork on the southern coast of Ireland as well as another Pharmacy school in the Irish capital, Dublin. (Royal College of Surgeons in Ireland)

Spain

In Spain, the Degree in Pharmacy (called licenciatura en farmacia) is consisting of 5 years. Last one is divided into two semesters, first one is similar as previous years (theory and laboratory practice) but second one is a full-time in-service training in a community pharmacy or at the pharmaceutical department of a hospital. This estructure is changing by another according to European Higher Education Area's System.

After obtaining degree certificate, there is the chance of opening a pharmacy sitting an examination in order to achieve a license. There is also the chance of postgraduate programs as Masters and Doctorates and of carrying hospital/industry specialty programs out (FIR or farmacéutico interno-residente, pharmacist intern-resident) by means of an examination like medical specialties (MIR). These specialties are: "Hospital pharmacist", "Clinical microbiology and parasitology", "Clinical biochemistry", "Clinical immunology", "Clinical analysis", "Radiopharmacy", "Galenical and industrial pharmacy" and "Drug and medicines' control and analysis".

There are 15 universities with licenciatura in Pharmacy in Spain, three of them are private universities.

Thailand

In Thailand, there are currently two kinds of programs for Pharmacy studies.
1) a regular 5 years program - Bachelor of Pharmacy
2) a 6 years program - Pharm D.

The universities in Thailand still base their teachings on the regular 5 years program while preparing itself to eb ready for the 6 years Pharm D. program. Anyone graduating with B. Pharm can take extra 2 years course to complete Pharm. D.

United Kingdom

In the United Kingdom, integration with the European Union has resulted in the BPharm and BSc courses being superseded by a four-year course for the qualification Master of Pharmacy (MPharm). In Great Britain the Royal Pharmaceutical Society of Great Britain is responsible for regulation of pharmacy affairs and in Northern Ireland it is the Pharmaceutical Society of Northern Ireland. Graduates must complete one year of practical training and pass a registration examination before they can be entered on the register of pharmacists, known as the register of pharmaceutical chemists.

Please see the List of schools of pharmacy in the United Kingdom which offer the MPharm course.

Pharmacists registered in other countries can also register in the UK. Overseas pharmacists are required to undertake the Overseas Pharmacists Assessment Programme (OSPAP), a one year intensive course focused on pharmacy practice in Great Britain. OSPAP authorisation can be given by the Royal Pharmaceutical Society of Great Britain and the course is undertaken either the University of Sunderland, Aston University or the University of Brighton. However, pharmacists that have obtained their qualifications and are registered in other countries of the European Economic Area can register with the Royal Pharmaceutical Society of Great Britain without undergoing additional or pre-registration training.

The term pharmacist is protected in the United Kingdom . It can only be used by individuals that are registered with the Royal Pharmaceutical Society of Great Britain.

United States

Traditionally in the United States, the Bachelor of Pharmacy was the first-professional degree for pharmacy practice. However, in 1990, the American Association of Colleges of Pharmacy (AACP) mandated that a doctor of pharmacy would be the new first-professional degree beginning with the class of 2006. As of the year 2000, all pharmacy schools in the U.S. have discontinued the B.S. Pharm. (Bachelor of Science in Pharmacy) degree program, and have made the Pharm.D. (Doctor of Pharmacy) degree the only available option. In addition to a new title, the new degree intensified and lengthened classroom instruction in pharmacological management of disease, added requirements for coursework that would shape a more rounded pharmacist and additional advanced practice experience.

Admissions

Today, individuals seeking to become pharmacists must first complete a pre-pharmacy undergraduate program. This program consists of a minimum of 60-70 semester credit hours (90-100 quarter credit hours) of undergraduate coursework in basic and advanced sciences; however, many students find completion of a four year program (between 120-130 semester credit hours) leading to a Bachelor of Science degree in biology, chemistry, or a similar field enhances their chances of admission. In addition, a PCAT (Pharmacy College Admission Test) score is required at most colleges and schools of pharmacy. Additional requirements for entry may include essays, references, an interview or participation in other on-campus activities.

Professional Coursework

After admission, a student will typically complete a four year pharmacy program, although some schools offer accelerated three year programs. The curriculum typically begins with courses in physiology and pathophysiology, medicinal chemistry, pharmacognosy, pharmacology and toxicology. Once a student is proficient in these core pharmaceutical sciences, instruction in evidence based therapeutic application of pharmacologic agents begins. Aside usage of agents, students are taught to recognize and assess risk factors for disease, interpret clinical data and recognize interactions of drugs and disease states.

While most schools teach the core science courses separately, some schools take a systems-based approach, teaching all of the material from physiology to therapeutics for a particular body system before moving on to another. Augmenting the pharmaceutical sciences, courses in ethics, management, pharmacy law, communications, public health and advocacy are taught throughout the professional program.

In addition to didactic work, students of pharmacy are required to have practice experience. These experiences are generally directed by the school, conducted under the supervision of a preceptor and are intended to compliment work done in the classroom. The final year of most programs consists entirely of practice experience. Successful completion of the practice experience objectives may yield academic credit and satisfy state pharmacy board requirements for internship.

Upon completion of all professional curriculum and practice experiences, the student will graduate and be awarded the Doctor of Pharmacy (PharmD) degree and typically seek licensure by examination.

Licensure

Pharmacists must be licensed by the state pharmacy board of the state in which they wish to practice, with one exception: A pharmacist with an active license may practice in a federal facility regardless of the state which issued the license.

In order to obtain an initial license, or license by examination, a candidate must have graduated from an AACP accredited school or college of pharmacy, satisfy requirements for internship, write and pass the North American Pharmacist Licensure Examination (NAPLEX), in some states write and pass the Multi-state Pharmacy Jurisprudence Exam (MPJE) and sometimes an additional state exam. Upon licensure, one may then be designated "Pharmacist" or "Registered Pharmacist" ("R.Ph."), as usage of these titles are generally regulated by state governments

A pharmacist in good standing may reciprocate an active licensure by examination to another state. Typically the requirements for licensure by reciprocity are less intensive and may require as little as passing an additional law exam.

After obtaining a license, it must be periodically renewed by completing continuing education and other requirements as prescribed by the state of licensure.

Post-Graduate Work

A new pharmacy graduate may choose to complete an optional post-graduate residency (one to three years) rather than entering directly into pharmacy practice. A pharmacy residency consists of one to two years of general residency and one to two years of specialized residency. Residencies allow a graduate to further hone their clinical skills in a structured environment. Upon completion of a residency, a pharmacy graduate will typically enter into general practice with advanced standing or have the opportunity to enter a specialized practice not otherwise available to non-residency trained pharmacists.

Specialities

Practice specialisation

Specialties exist within the pharmacy profession, with the place of occupation being the major differentiator. Specialities include:

Academic pharmacist
Clinical pharmacist (consisting of many subspecialities)
Community pharmacist
Compounding pharmacist
Consultant pharmacist
Drug information pharmacist
Home Health pharmacist
Hospital pharmacist
Industrial pharmacist
Locum pharmacist
Regulatory-affairs pharmacist
Veterinary pharmacist

Specialty practice accreditation

United States

In the United States, a pharmacist can become certified in recognized specialty practice areas by passing an examination administered by one of several credentialing boards.