"Multiple tiered degrees would better serve the diverse nature of pharmacy practice"

[Rockinacoustic]

Thought this article deserved it's own thread- it's the same author of the "cannot sustain 140 schools thread".

TL;DR- Support for an all PharmD degree in the 90's was only from academics, the workforce is full of over-trained yet lower quality pharmacists, and a tiered system of BS, MS, and PharmD education should come back into existence to match market demands.

Attached the article for those without access. Some juicy quotes below:

"In the early days of PharmCAS, only about a third of applicants were admitted. That value has exceeded 80% in recent years... Twenty years ago, it was highly unusual for an applicant with a cumulative grade point average (GPA) below 3.0 to be admitted.

"Pharmacy must be doing something wrong if society deems nurse practitioners more qualified to prescribe drugs than pharmacists"

"At this point, if there is anything to be learned from the all-Pharm.D. experience, it is that the profession should not be driven by a vocal minority of academic and organization leaders. To the contrary, it is the silent majority of rank and file pharmacists, those engaged in the arena of practice, who know what is best for their profession."

---

Members don't see this ad.

 

[Marzapan]

I am genuinely curious how this particular professor still has a job. I mean, he is doing god's work by publishing these articles but is he not just derailing his own line of work? If anything, I'd expect a PharmD in consulting or a 3rd party to publish this kind of work.

 

[VA77]

I am genuinely curious how this particular professor still has a job. I mean, he is doing god's work by publishing these articles but is he not just derailing his own line of work? If anything, I'd expect a PharmD in consulting or a 3rd party to publish this kind of work.

He is branding himself. Even if it costs him, he is willing to speak what he feels is truth. You said he is doing God's work and I believe every truth started as a blasphemy. The man has courage and conviction in a time where both are deficient.

 

[Hels2007]

I am genuinely curious how this particular professor still has a job.

If he is tenured, he is pretty much impossible to fire.

And my inner cynic can see how the conversion to the three-tier system can lead to EXPANSION of pharmacy faculty. If you add bachelor's classes, you can open them to everyone and anyone who is admitted to the university; if salaries are significantly higher for PharmDs than for BPharms, there is an incentive to continue into additional 1-2-3 years (if you make PG-1 residency essentially a part of PharmD program) and if you don't raise the admission standards, you can keep up massive programs just because you can, and because student loans given out like candy make it possible.

 

[Amicable Angora]

Multiple degree paths to setup barriers to entry are at best a small bandage over a gaping wound to the current over saturation of schools.

Residency, years one and two, already serve a similar purpose, as additional barriers of entry, and look where that got the profession.

 

[Marzapan]

If he is tenured, he is pretty much impossible to fire.

And my inner cynic can see how the conversion to the three-tier system can lead to EXPANSION of pharmacy faculty. If you add bachelor's classes, you can open them to everyone and anyone who is admitted to the university; if salaries are significantly higher for PharmDs than for BPharms, there is an incentive to continue into additional 1-2-3 years (if you make PG-1 residency essentially a part of PharmD program) and if you don't raise the admission standards, you can keep up massive programs just because you can, and because student loans given out like candy make it possible.

Going back to a BPharm is already too late because the PharmD has already been invented, so it would actually devalue the PharmD further because there would be no difference between a grandfathered PharmD grad and a "new" PharmD grad as they are still the same credential. Much easier to just keep piling on years of residency training and use that as the new tiered system:

Tier 1: no residency - you can only count pills and do MTMs.
Tier 2: PGY-1 residency - you can take staffing roles or "general" clinical roles
Tier 3: PGY-2 residency or more - you can get into specialist roles

Under this structure, residency is still technically "not required" but you won't go anywhere without one.

 

[spacecowgirl]

What is South University in SC? I thought they were in Georgia

 

[confettiflyer]

Residency, years one and two, already serve a similar purpose, as additional barriers of entry, and look where that got the profession.

Yeah, I was about to say, the market already solved this issue of tiers more than a decade+ ago.

 

[lord999]

There's faculty who remember the late 90s debates on the matter which isn't brought up and it doesn't work like that. It wasn't just academics, the early 00s grads were in an artificial shortage made by that decision and were huge beneficiaries (the 04 and 05 years especially). This was a known consequence when that decision was undertaken. He could have done a lit review on the situation as there was a faculty push NOT to have PharmD from the sciences faculty as the lowered emphasis made it impossible to recruit pharmacists for graduate work and make it a terminal dead-end. It wasn't as much a push for more clinical as he describes, it was a push by the clinical faculty to get better resourced which did not succeed in the end from the academy's side. On the practice side, the accreditation rules at the time were such for the BS that building a pharmacy school was FAR easier because you only had to arrange for IPPEs and the BS Pharm's would then have to get a 1000 or so afterwards. If the PharmD did not happen, we would have had a school saturation by the early 00s though the sciences would have been better resourced than they are now. In this era, the sciences faculty really are divorced from any reason to care for the undergraduates as they cannot recruit or get resourced from tuition (this is a reminder that for most public schools, tuition is not the main driver for the school's funding, it's at best a marginal cost) and suck up time which is a shame. It also gave rise to a true second-class faculty in clinical without tenure or real avenues for votes thanks the PharmD no longer being a credential differentiator for upper level practice. But the clinical faculty got easy jobs to have power over clinical and the sciences got to have little interaction with the undergraduates, and the students got credential inflation, so everyone "won." It tastes bitter now, but we are winners from that process. But this guy has no idea of the long history of this process and everyone had bad intentions, not just academia in this matter.

This is just another note in a long history of pharmacy leadership doing the greedy thing and not the right thing and everyone going along with it because they got paid now. I've written elsewhere of how pharmacy blew it on getting provider status (we were begged to get it and turned it down) from HCFA/CMS. I think the next note is the lowered standards for the BC series as the exams now are definitely easier than a decade ago (better preparation also is affecting scores, but there was a conscious decision to lower the bar) which eliminates that as a credentialing matter.

 

[BidingMyTime]

While interesting, I think tiered degrees is a bad idea. Nursing has/had tiered degrees forever, and it was not beneficial to the profession. Nursing has been trying to move away from this and make BSN the standard (or maybe it's the NP they want to make the standard ) LPN's are pretty much unhirable in a hospital setting (pretty much relegated to nursing homes.) RN's are still hirable in certain hospital departments, but advancement is pretty much nil unless they get their BSN.

While it is debatable if the Pharm D should have been the entry degree settled on, it is what it is, and I think having a standard entree degree is a must.

 

[owlegrad]

I don’t know if going to the PharmD was the right move or not but I think reversing that decision now would be a mistake.

 

[TheBlaah]

What is South University in SC? I thought they were in Georgia

They have campuses in both SC and georgia.

 

[KidPharmD]

I think we are already here. The difference as others have said is that PharmD is the base line with PGY1 and PGY2s serving as the upper tiers. What we should be working towards is a balancing of the throughput of all of these programs.

There are too many new grads each year for the amount of jobs+PGY1s. However, there aren't enough PGY1 programs to supply both the PGY2 programs and all of the positions we would like to make PGY1 required. Reduction in the number of new grads and expansion of PGY1 programs would be the ideal situation.

 

[Marzapan]

I think we are already here. The difference as others have said is that PharmD is the base line with PGY1 and PGY2s serving as the upper tiers. What we should be working towards is a balancing of the throughput of all of these programs.

There are too many new grads each year for the amount of jobs+PGY1s. However, there aren't enough PGY1 programs to supply both the PGY2 programs and all of the positions we would like to make PGY1 required. Reduction in the number of new grads and expansion of PGY1 programs would be the ideal situation.

However this model only works if there were enough jobs for PGY-2 grads. The problem today is that with a 0% growth, there isn't even enough jobs for PGY-2's, so the issue isn't that most pharmacists aren't "qualified" for roles, but rather the value of even rhe most credentialled, experienced pharmacists haven't been proven. Sure, you can point to specific examples here and there to show that certain individuals bring value, but these are largely isolated cases and success stories on the individual level, which is not scalable.