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Pharmacy School: Is it Time for an Extreme Makeover?

pharmacyFriends, Romans, Pharmacykind: Lend me your ears. For I am about to get on my soapbox and pontificate about…pharmacy school. (That, and I’m avoiding editing galley 1 of my next book tonight. Writing for me always trumps editing.)

So…pharmacy schools these days. A lot of conversations about them and what they teach of late, I have had. And now that I’m on the outside of them and only educating as a preceptor, I think it’s time to drop what I think we should consider for schools of pharmacy.  The following are my opinions and mine alone, but I don’t think I’m alone in a lot of what I’m about to say; it’s just that others in pharmacy may not be as opinionated as I am, or as overt about it. But, I’m going out on my own with these ideas. Here we go.

I think it’s time for an extreme makeover of pharmacy schools.

What do I mean by this? Well, I’ll outline below 5 areas that I think need attention IMMEDIATELY in US schools of pharmacy.

1. Department re-orgs - Today, as it has been for I don’t know how many decades, most schools of pharmacy have only two departments: 1. pharmacy practice and 2. pharmaceutical sciences. That’s it. (Okay, some may have a social and administrative sciences department too, but very few.)

This is not only an overly simplistic view of pharmacy as a profession, but it’s borderline malpractice in pharmacy, because pharmacists do so much more these days than these 2 slivers of pharmacy practice. And while I’ve personally had a variety of pharmacy gigs over my career thus far, I never refluxed ANYTHING after organic chemistry, and I personally don’t work daily with patients in clinical pharmacy any more.

Ergo, I believe we need more than these 2 departments in schools of pharmacy. We need departments in:

  • 1. big data/analytics/informatics/stats,
  • 2. managed care, law, policy, and advocacy,
  • 3. entrepreneurship, business, and leadership and
  • 4. gene therapies and genetic counseling. 

The faculty to lead these departments may or may not be pharmacists as well. If you think I’m wrong, go look at a few pharmacist job descriptions over at Glassdoor or LinkedIn. What do you see? You’ll see that employers need pharmacists that can play with big data sets and pull out meaningful data. They need compliant pharmacists (i.e. pharmacists that know and understand the law). They need pharmacists who are creative, innovative and lead.  I can’t remember the last time I saw a job posting for a pharmacist that asked them to be able to draw a chemical structure of a drug. Wait, that’s been…never.

With this re-org I would also say that I think smart schools of pharmacy have co-deans of the program. One co-dean could focus on the internal college issues (like new programs, the vision for the college internally, working across colleges), and one co-dean could focus on external college issues (fundraising, working with external stakeholders, community building, etc.). A good dean would never be home, because she would be on campus during the day, and off campus at the same time integrating the school into the community. There is no way one person can manage everything a dean has to do. And even though there should be an associate dean – that associate dean should be focused on academic issues within the college, not setting up new programs, or attending a bunch of cross college campus meetings.

2. If the departments change, so must the curriculum - Therapeutics and pharmacology consume most of the classroom time in schools of pharmacy. Courses like pharmacy law are crammed in a 1-3 credit hour class one semester, and treated like a red-headed stepchild of the curricula in schools of pharmacy. However, pharmacy law should be a very large chunk of the curriculum, because NO ONE WILL CARE HOW MUCH YOU KNOW ABOUT PHARMACY if you don’t have a pharmacist license and are in jail, because you violated the law. Let alone the new MPJE being a really tough test. TAs and Pharmacists alone should not be teaching pharmacy law, in my opinion. The law has become far too complex. Also, advocacy and policy are barely touched upon in pharmacy schools. And yet, they are absolutely critical to the profession surviving and thriving in years to come. Regulation is made by LAWYERS, not pharmacists or healthcare professionals.

Similarly, the therapeutics and pharmacology should be cut back and more emphasis should be placed on data and digging through it. Look at hospital EMRs as one example. Or, big data sets for public and population health. A pharmacist counseling one patient may have an impact, but a pharmacist spotting a trend through a large data set can positively impact an entire community. Very few pharmacy schools are teaching how to look at big data, by learning SQL or R, for example. Also, big data analysts will be future leaders, because they can better study population trends, understand the data, and make meaning again.

Same deal with the other categories/departments above. There are new gene therapies coming out each and every day that may cure diseases! However, they are expensive. Also, in the era of genetic mapping, we are just on the cusp of understanding what someone’s personal genotyping means. Do and can pharmacists share appropriate therapies with patients? Absolutely! IF they are trained.

3. Apprenticeships – While some may argue that we have residencies and fellowships to cover this, along with APPE and IPPE, I’m not so sure we’ve got that right in pharmacy schools, either. Since there aren’t enough residencies and fellowships, maybe it is time to consider a first or second year pharmacist out of school under an apprenticeship instead? IPPE is a bit of a waste, because students are too green, but is APPE long enough? I don’t know the answer to this. What I do know is that this is a profession in which you learn by doing, not just studying textbooks in a classroom. I do know that on APPE we also focus way too much on pharmacy instead of the BUSINESS of pharmacy.

4. More project based learning - So much of pharmacy school is: memorize a bunch of stuff, then take a test. That’s again 20th century learning and mindset instead of preparing students for the 21st century. Now, employers want employees who can see problems, turn them into opportunities and create something from nothing into value-added service and/or products. This means hands on, project-based, problem-based learning. And not just one on one with patients. We need to think bigger. So, can we all ditch all these standardized tests and instead start giving students projects and problems that the real world and bosses try to manage every day? What can pharmacists do to solve environmental challenges? Emergencies? Public health issues? Education of the masses? More Shark Tank, less test-taking. More writing and speaking, less test taking. More assignments on finding better answers, rather than THE BEST answer…for the test.

5. All faculty should be practicing – Not just pharmacy practice, or clinical practice. But all professors should be out in the real world practicing. If you’re in pharm sci, that means you’re in a lab making something. If you’re in pharm practice, you should be out in practice (and NOT just in clinical practice.) If you’re in any of my new departments above – you should be practicing in those areas. While I’m sure there are some career academicians out there who think that full time faculty on campus should only be focused on teaching and publishing in some journal with a high impact factor, they need to be practicing in the real world too–otherwise, how can you see the issues coming, teach to the issues, and the change within the profession? I think many of the outdated dusty structures and curricula were also put in place by faculty who have taught in an institution for 30 years without working in the real world for decades. Also, I think tenure needs to die as well, because of this bullet – everyone needs to keep their hands in the practice and not in the ivory tower alone. No one should rest on her laurels just because she has tenure. We all must stay hungry and a bit foolish if we’re truly going to be innovative.

There. These again are my opinions and mine alone. But, I do not believe that pharmacy schools are adapting to changes fast enough. Change is coming, whether or not we choose to adapt. We must fix this, or we are doomed as a profession.

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