pillpharmer14

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Mar 17, 2015
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Without this turning into a discussion about increased schools and pharmacist surplus, do you feel like there is proper vetting of PharmD candidates? I've had several encounters with students while in school and after that had the book smarts to make them an attractive candidate, but simply couldn't apply any of the knowledge. Preceptors are then left to deal with them during 4th year, most of them being passed on to the next preceptor because no one wants to deliver the fatal blow. Even some students that failed multiple rotations would just repeat a year and eventually graduate. It's really a failure of the administration to allow these people into school in the first place.

There was one guy my final year who had been held back two years straight (last chance and he had become somewhat of a legend). I happened to be present for his final presentation and realized that he was actually mentally challenged. Not sure exactly what he suffered from, but he literally read every single word on his slides and would awkwardly look up at the audience every 20 seconds or so. I've met people before who are genius level smart and just a bit socially awkward but this was different. There was also a minimum time to meet of 40min, with 8min grace period. I don't think he even got halfway there and whats worse is he didn't have a clue.

I know people should be given equal opportunity but to what end? It was obvious to me that preceptors were passing him along out of pity, but he never should've been admitted in the first place. Who's to blame when someone gets hurt? Just curious if this is an isolated incident or if others have seen this at their schools/institutions.
 

Son_Goku

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40 min presentations are stupid. If you need 40 mins to get your point across than administrations really need to re-evaluate their priorities.
 
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zelman

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40 min presentations are stupid. If you need 40 mins to get your point across than administrations really need to re-evaluate their priorities.
Have you never had a 40+ minute class you found to have value?
 
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confettiflyer

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I've had several encounters with students while in school and after that had the book smarts to make them an attractive candidate, but simply couldn't apply any of the knowledge.
Isn't this the entire point of rotations? I primarily work with UCSF students, and they're bursting with information, but on rotation 1, there's practically zero application skills. By week 3 I usually see substantial improvement, though, and by the end of the rotation, we've set them up pretty well.

That's my job. There's a reason I didn't go fully into academia, it's my job to turn that rote knowledge into something serviceable.

Preceptors are then left to deal with them during 4th year, most of them being passed on to the next preceptor because no one wants to deliver the fatal blow. Even some students that failed multiple rotations would just repeat a year and eventually graduate. It's really a failure of the administration to allow these people into school in the first place.
There's an assumption here that a) the preceptors aren't doing their jobs, which is plausible and b) the student has no capacity for change after failing a rotation, which is less plausible. These two assumptions lead to your conclusion that it's a failure of admission policy, when really fault lies with the 4th year preceptors and the student themselves.

Churning out good pharmacists is not a perfect science and cannot be solved through admissions policies. All of the problematic students I've worked with had impeccable backgrounds. There's no magic crystal ball that says "99 PCAT, 4.0 GPA, top 10 undergrad = will rock clinical rounding/workflow 3 years from now." You pick based on likely aptitude, and cross your fingers.

Sometimes, it just doesn't work out.

There was one guy my final year who had been held back two years straight (last chance and he had become somewhat of a legend). I happened to be present for his final presentation and realized that he was actually mentally challenged. Not sure exactly what he suffered from, but he literally read every single word on his slides and would awkwardly look up at the audience every 20 seconds or so. I've met people before who are genius level smart and just a bit socially awkward but this was different. There was also a minimum time to meet of 40min, with 8min grace period. I don't think he even got halfway there and whats worse is he didn't have a clue.
That's a cute story, but what does a potentially undiagnosed mental illness in one single person have to do with the systemic admission of tens of thousands of matriculants and their subsequent progression through 3 years of didactic & 1 year of clinical rotations?

Are you implying the admissions committee should break out the DSM V when evaluating candidates and practice some medicine while they're at it?

I know people should be given equal opportunity but to what end? It was obvious to me that preceptors were passing him along out of pity, but he never should've been admitted in the first place. Who's to blame when someone gets hurt? Just curious if this is an isolated incident or if others have seen this at their schools/institutions.
I think this is preceptor specific, we've failed students before, usually with several weeks warning. Failing students are warned at midpoint, seriously deficient students are warned at midpoint AND their institution is notified. If it's a preceptor mismatch/performance issue, we try to own up to it and accommodate... but at the end of the 6 weeks, it's our name and institution that sits on this person's CV, and we're a proud group of pharmacists who refuse to advance anyone who fails to meet our minimum standards.

I can't imagine every site doggedly approaches training this way, but I feel that many do.
 

Carboxide

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That's a cute story, but what does a potentially undiagnosed mental illness in one single person have to do with the systemic admission of tens of thousands of matriculants and their subsequent progression through 3 years of didactic & 1 year of clinical rotations?

Are you implying the admissions committee should break out the DSM V when evaluating candidates and practice some medicine while they're at it?
Just saying, he said they were mentally CHALLENGED, not metally ILL.
 

confettiflyer

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Just saying, he said they were mentally CHALLENGED, not metally ILL.
The operative word was "suffered" in the next line, implies illness, which includes developmental disabilities, high functioning or not.

But we're just parsing words at this point. The first thought that came to mind was Asperger's...high functioning and high intelligence, but unable to surmount non-book P-4 requirements.
 
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pillpharmer14

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There's an assumption here that a) the preceptors aren't doing their jobs, which is plausible and b) the student has no capacity for change after failing a rotation, which is less plausible. These two assumptions lead to your conclusion that it's a failure of admission policy, when really fault lies with the 4th year preceptors and the student themselves.

I think this is preceptor specific, we've failed students before, usually with several weeks warning. Failing students are warned at midpoint, seriously deficient students are warned at midpoint AND their institution is notified.
Yes, I am concluding that the student had no capacity for change. Isn't that demonstrated by failing multiple rotations with different preceptors? I don't know what reasons you typically fail students for, but at my school it was usually laziness and apathy and not incompetency that would get you cut. Lack of knowledge can be corrected with good preceptors, the behavioral issues go much deeper.

That's a cute story, but what does a potentially undiagnosed mental illness in one single person have to do with the systemic admission of tens of thousands of matriculants and their subsequent progression through 3 years of didactic & 1 year of clinical rotations?

Are you implying the admissions committee should break out the DSM V when evaluating candidates and practice some medicine while they're at it?
Lol because in order for that person to be admitted, they have to be interviewed one on one like everyone else. Trust me, there is no way they didn't notice this kid. You make it sound like they herd the candidates through by the thousands.

Overall, you're right that admissions can't always choose correctly, but this seemed like such an extreme circumstance that it begs the question of how he was accepted in the first place. And I was serious about asking about mentally challenged people in healthcare. While your DSM V joke was "cute" you still didn't shed any light on how this is actually handled.

In the end I suppose it will all sort itself out the job market. If he really is that inept then it will catch up to him.

The operative word was "suffered" in the next line, implies illness, which includes developmental disabilities, high functioning or not.

But we're just parsing words at this point. The first thought that came to mind was Asperger's...high functioning and high intelligence, but unable to surmount non-book P-4 requirements.
I have no idea what was actually wrong with him, so obviously I couldn't choose the correct term. It wasn't meant to imply anything.
 

297point1

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The operative word was "suffered" in the next line, implies illness, which includes developmental disabilities, high functioning or not.

But we're just parsing words at this point. The first thought that came to mind was Asperger's...high functioning and high intelligence, but unable to surmount non-book P-4 requirements.
In the end I suppose it will all sort itself out the job market. If he really is that inept then it will catch up to him.
In the past, a situation like this didn't strike me as a tremendous concern of pharmacy schools. "Will they be able to graduate?" was a more pressing question than "Will someone want to hire this person when they graduate?"

It soon will be a concern: beginning in 2016, the employment status of graduates is a metric that is a required report into ACPE.

Some schools will continue to not care, but for most others: changes in the admissions processes are a-comin'.
 

297point1

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https://acpe-accredit.org/pdf/ReportofProceedingsJune2015.pdf
Page 5

Approval of Changes to Policies and Procedures
The ACPE Board made the following changes to the Policies and Procedures for ACPE Accreditation of Professional Degree Programs July 2014 and authorized re-issuing the document as Policies and Procedures for ACPE Accreditation of Professional Degree Programs July 2015: Section 11.6 (various subsections, including insertion of new subsection Job Placement/Gainful Employment); Section 20.2
 
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pillpharmer14

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https://acpe-accredit.org/pdf/ReportofProceedingsJune2015.pdf
Page 5

Approval of Changes to Policies and Procedures
The ACPE Board made the following changes to the Policies and Procedures for ACPE Accreditation of Professional Degree Programs July 2014 and authorized re-issuing the document as Policies and Procedures for ACPE Accreditation of Professional Degree Programs July 2015: Section 11.6 (various subsections, including insertion of new subsection Job Placement/Gainful Employment); Section 20.2
Interesting. I'm almost afraid of the things schools may begin to do to bump up their numbers. My days at CVS taught me that humans are wily creatures, especially when metrics are involved.
 

Digsbe

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Don't some schools in NYC have like 30% grad unemployment? I wonder how they'll stay accredited. Maybe it will deter more schools, especially if they have to prove projected employment when applying for candidate status.
 
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pillpharmer14

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Don't some schools in NYC have like 30% grad unemployment? I wonder how they'll stay accredited. Maybe it will deter more schools, especially if they have to prove projected employment when applying for candidate status.
30%?!? Is that just one year post grad? seems incredibly low.
 

BidingMyTime

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Don't some schools in NYC have like 30% grad unemployment? I wonder how they'll stay accredited. Maybe it will deter more schools, especially if they have to prove projected employment when applying for candidate status.
They will do it the same way law schools do it....hire their own graduates as "temp" workers for low pay, then get rid of them after a year or however long they have to keep them to show them as "employed" for the stats, so they can hire on the new bunch of unemployed graduates.
 

Sparda29

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Without this turning into a discussion about increased schools and pharmacist surplus, do you feel like there is proper vetting of PharmD candidates? I've had several encounters with students while in school and after that had the book smarts to make them an attractive candidate, but simply couldn't apply any of the knowledge. Preceptors are then left to deal with them during 4th year, most of them being passed on to the next preceptor because no one wants to deliver the fatal blow. Even some students that failed multiple rotations would just repeat a year and eventually graduate. It's really a failure of the administration to allow these people into school in the first place.

There was one guy my final year who had been held back two years straight (last chance and he had become somewhat of a legend). I happened to be present for his final presentation and realized that he was actually mentally challenged. Not sure exactly what he suffered from, but he literally read every single word on his slides and would awkwardly look up at the audience every 20 seconds or so. I've met people before who are genius level smart and just a bit socially awkward but this was different. There was also a minimum time to meet of 40min, with 8min grace period. I don't think he even got halfway there and whats worse is he didn't have a clue.

I know people should be given equal opportunity but to what end? It was obvious to me that preceptors were passing him along out of pity, but he never should've been admitted in the first place. Who's to blame when someone gets hurt? Just curious if this is an isolated incident or if others have seen this at their schools/institutions.
I ****ing hated presentations. Never liked them, never will. I'd rather just submit a research paper with a poster and then let them grade that, **** having to explain it verbally. If I had to do a 40 minute presentation, I would also speed the **** through it without looking at the audience. Or I would request presenting it from my seat in the lecture hall.
 
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pillpharmer14

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I ****ing hated presentations. Never liked them, never will. I'd rather just submit a research paper with a poster and then let them grade that, **** having to explain it verbally. If I had to do a 40 minute presentation, I would also speed the **** through it without looking at the audience. Or I would request presenting it from my seat in the lecture hall.
They don't bother me too much, but some people really struggled with it. Unfortunately it was a fourth requirement at my school (one per semester), sort of like a journal club on steroids. The school does it because when they established the school (approx 25yrs ago), they felt that many PharmD graduates were going to residency without the ability to analyze large amounts of data and prepare a presentation worthy of presenting to physicians. Can't really argue with it cause we all know how to make one of hell of a presentation now. Honestly I wish they would do away with it. Probably 70% of people cruise right through, but the other 30% who are great students with excellent people skills but completely bomb it and risk being held back (not talking about the kind of person in the original post, talking about normal people that don't like public speaking). I agree that it's an important skill to develop for residency, I just don't think it should be a requirement for earning your PharmD when 70% of us are going to retail anyway. Risk > reward for many candidates.
 

confettiflyer

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https://acpe-accredit.org/pdf/ReportofProceedingsJune2015.pdf
Page 5

Approval of Changes to Policies and Procedures
The ACPE Board made the following changes to the Policies and Procedures for ACPE Accreditation of Professional Degree Programs July 2014 and authorized re-issuing the document as Policies and Procedures for ACPE Accreditation of Professional Degree Programs July 2015: Section 11.6 (various subsections, including insertion of new subsection Job Placement/Gainful Employment); Section 20.2
That's huge...but this begs the question, how much legal discussion did this receive at ACPE? I was under the impression that being a DOE recognized accreditation body meant you had to abide by antitrust regulations and using the labor market as a part of the accreditation process violated that statute?

I'm waiting for the first school denied accreditation under 11.6 to sue in federal court.
 

297point1

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That's huge...but this begs the question, how much legal discussion did this receive at ACPE? I was under the impression that being a DOE recognized accreditation body meant you had to abide by antitrust regulations and using the labor market as a part of the accreditation process violated that statute?
I can't speak to that. I can say that I predicted that this would happen about two years ago when ACPE began requiring schools to post 'notable achievements' about their students, but left each school to decide what qualified as a notable achievement. Some schools immediately started posting employment rates; others ran quickly in the opposite direction. I was right (for a change). :)

I'm waiting for the first school denied accreditation under 11.6 to sue in federal court.
What's going to be the threshold? It's going to have to be a lot higher than 30% unemployed, unless you believe Rutgers (a good program, by all accounts) is getting shuttered.
https://pharm.rutgers.edu/content/important_program_information_pharmd_students

EDIT: Also, regional differences in the job market would also have to be taken into consideration; is 35% unemployment for an Orange County CA school really any worse than 10% unemployment for the University of Montana? I sincerely doubt that this could be utilized as the sole factor used to drop accreditation.
 
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