The Direction of Pharmacy Education

[prorx26]

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I am a pharmacy student beginning PS2 at a three year program. As I have been studying my Hypertension: Pathophys/Pharmacology notes for an upcoming exam, I noticed myself only highlighting a drug or two in each class, or writing "not used in HTN" by others. It made me think... Are we becoming so involved in .....um "grabbing market share" (for lack of a better term) in order to ensure the future viability of our profession that we are getting away from "what makes pharmacists pharmacists?" It seems that my education thus far has been more focused on disease states than it has been on drugs. It seems like we're hammered with disease state management and then just have the most common drugs used to treat a particular disease sprinkled on top. I got to thinking wouldn't it be great if the B.S. Pharm. was still the entry level degree? It could focus more heavily on physio/pathophys and med chem with some disease state stuff sprinkled in, then those who wanted to go clinical could get the Pharm. D after the B.S. and learn all the disease state management stuff. Like it used to be? I think... Like i said I'm only a student. Schools could charge half the tuition of a Pharm D. for the B.S. and employers could pay half the wage. Pay the Pharm D. the $120k and the B.S. $60k. Pharmacies could have the PIC/Clinical Pharmacist be a Pharm D. and staff the rest of the pharmacy with the B.S. people then allow the Pharm D. to provide all the clinical care and counseling and let the B.S. guys handle all the "mechanical" aspects of the job. Sort of like the "non partner track" JD, or a PA or NP. I'd like to compare all pharmacists having the Pharm D. to studying for a test: when everything in your notes is highlighted, nothing is.*

For my disclaimer: I realize that I am only a student attending one school, and a 3 year school at that; neither have I experienced any other programs, worked as a pharmacist, nor had much pharmacy experience period. I also realize that this is more of a "if I were starting the profession of pharmacy today..." type opinion. I further realize that a lot of people have done a lot of work to make the Pharm D. the only degree in pharmacy. I just want peoples opinions. As Lee "Hacksaw" Hamilton would say "React to me!" "Show me your lightning bolt!" "Goodnight now!"

 

[rxlea]

I am a pharmacy student beginning PS2 at a three year program. As I have been studying my Hypertension: Pathophys/Pharmacology notes for an upcoming exam, I noticed myself only highlighting a drug or two in each class, or writing "not used in HTN" by others. It made me think... Are we becoming so involved in .....um "grabbing market share" (for lack of a better term) in order to ensure the future viability of our profession that we are getting away from "what makes pharmacists pharmacists?" It seems that my education thus far has been more focused on disease states than it has been on drugs. It seems like we're hammered with disease state management and then just have the most common drugs used to treat a particular disease sprinkled on top. I got to thinking wouldn't it be great if the B.S. Pharm. was still the entry level degree? It could focus more heavily on physio/pathophys and med chem with some disease state stuff sprinkled in, then those who wanted to go clinical could get the Pharm. D after the B.S. and learn all the disease state management stuff. Like it used to be? I think... Like i said I'm only a student. Schools could charge half the tuition of a Pharm D. for the B.S. and employers could pay half the wage. Pay the Pharm D. the $120k and the B.S. $60k. Pharmacies could have the PIC/Clinical Pharmacist be a Pharm D. and staff the rest of the pharmacy with the B.S. people then allow the Pharm D. to provide all the clinical care and counseling and let the B.S. guys handle all the "mechanical" aspects of the job. Sort of like the "non partner track" JD, or a PA or NP. I'd like to compare all pharmacists having the Pharm D. to studying for a test: when everything in your notes is highlighted, nothing is.*

For my disclaimer: I realize that I am only a student attending one school, and a 3 year school at that; neither have I experienced any other programs, worked as a pharmacist, nor had much pharmacy experience period. I also realize that this is more of a "if I were starting the profession of pharmacy today..." type opinion. I further realize that a lot of people have done a lot of work to make the Pharm D. the only degree in pharmacy. I just want peoples opinions. As Lee "Hacksaw" Hamilton would say "React to me!" "Show me your lightning bolt!" "Goodnight now!"

How in depth are you going into physiology? Have you taken med chem, pharmacology, and therapeutics yet? if not, then maybe that is why you haven't been blasted with all the drugs.

 

[prorx26]

@rxlea. In our program therapeutics, pharmacology and med chem are all rolled into one beloved 5 hour class. Integrated Sequence. We're in IS 4 right now.

 

[Unchained]

Prorx I think you have a good perspective given you are a P1. I believe mandating the PharmD did not have the results which were desired. I graduated in 2000 so it did benefit me monetarily in that it contributed to the shortage at the time. It has not however advanced the profession. How many clinical questions will you be asked at your CVS or Wag interview? A BS was more than adequate to work in retail. They could easily reduce the curriculum by 1 year and require a 4 yr degree for acceptance.

 

[Silvermist]

I think understanding the pathophysiology is important. After all, drugs are going to change - the specific drugs that you are studying right now may or may not be in wide use in another 10 years. So, say 10 years from now, a new blockbuster drug is invented that modulates VLDL -> IDL -> LDL. But without the pathophys aspect, would you even know what VLDL is? Or where it's made? Or why it's important? Or what it does? Or where such a drug would have its effect?

IMO, drugs may come and go, but generally the human metabolic and biochemical pathways they work on are going to stay the same. That's why I quite like the extensive pathophys my school requires =)

 

[Praziquantel86]

The thing is, you need to know the disease states to know how to use the drugs. Knowing that doxazosin is a non-selective alpha blocker does you no good if you don't realize that it's not a good drug for hypertension. There are a lot of nuances to patients and disease states that lead you to choose one drug over another, an if you don't know those nuances, you'll never know how to choose the correct drug.

I agree that a Pharm.D. is overkill for a lot of the jobs out there, but not because it teaches you pathophysiology.

 

[phathead]

Every recent pharmacy school grad I have talked to said it is way more beneficial to understand things from a therapeutic/systemic viewpoint rather than regurgitating material. Remember, we're being trained to think in a certain manner.

I also think you're demonstrating a slight mis-understanding of what a pharmacist. Should a physician who is a GP forgo part of the education from their classmates simply because they won't be "specialized"?

Of course not.

Pharmacists are vastly underutilized in our health care system. The way things are evolving, this will change to a degree.

 

[prorx26]

First off, thanks all for your responses. I don't want the opinions which I hold to be ignorant, all of your input is only helping them to mature, and I hope to hear from many more people on this.

@Silvermist, Praziquantel86: I really love physiology. The concept of therapeutically manipulating physiology is what got me into pharmacy. I just don't see how useful all the disease state management type stuff, ad nauseam, is to a busy retail pharmacist. From what I've seen in limited introductory rotations, some is great and can really benefit patients greatly, but I don't want it to be the focus of my education.*

@Phathead: I hate memorization and refuse to regurgitate material. I study my notes repeatedly until I understand the concepts. Things kind of "memorize themselves" for me that way. Also, I have heard it said before that pharmacists are "vastly underutilized in our healthcare system," but what does that mean? Can you or someone teach me so I can allow my opinions to evolve?

I love football. For others who do, here are a couple things. Regarding "training" people to think in a certain manner; isn't that analogous to "training" a player to run the 40 yard dash? With training, someone can run a great time in spikes and shorts on a track somewhere: do well on tests in school, but does it really translate to the field?: will someone think like that under stress on the job? Also, consider running back skills: drug knowledge, and receiving skills: disease state management. I think that the overlap between analogous pairs is also apt. With that in mind, I guess my question is are we as pharmacist trying to become Marshall Faulk, but heading toward Reggie Bush territory? Bush is a better receiver than any running back, and a better running back than any receiver. Yet where is the fit for his skill set? He is neither an every down receiver nor an every down running back. Yet even as a player who doesn't quite fit in anywhere and could not be fully utilized even by the Saints' great offense, he now has a 2 year $9.75 million dollar contract in Miami where he is quickly loosing touches to a rookie. Conversely Marshall Faulk is in the HOF. The question is are our future employers paying for a skill set that seems incredibly dynamic, (Bush was selected 2nd overall in 2006) but isn't practical or as useful as it sounds? Again I hope to hear from many more of you out there.