Doctorate required

Left to right: Alexa Mitchell and Holly Moore, both second-year pharmacy students at Washington State University

College of Pharmacy, work with clinical assistant professor Kimberly McKeirnan, PharmD, to deliver health screenings

at a local Albertsons pharmacy.

Going back at least to the mid-1800s, many community pharmacists have been given the informal title of “doc” or “doctor” by grateful local residents, particularly in smaller towns and rural communities where the local pharmacist might be the only health provider within miles. These days, the title is more than honorary; it’s a requirement.

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Before they even attend their first class, today’s prospective pharmacists have undergone the rigorous selection process required of any student applying to one of the nation’s 135 colleges of pharmacy. Once enrolled, they begin an intensive, six- or seven-year journey toward the doctor of pharmacy degree now required to practice pharmacy in the United States. By the time a student has earned a doctor of pharmacy, they will have completed approximately 140 graduate school-level required course credit hours — about one-third of which are experiential in nature via prescribed types of clinical practice mentoring.



“The doctor of pharmacy degree program requires at least two years of pre-professional (undergraduate) study followed by four academic years of professional study,” noted the American Association of Colleges of Pharmacy. What’s more, said the organization, “a growing number of first-year students enter a pharmacy program with three or four years of college experience.”



Given the fact that pharmacists literally bear responsibility for the health, well-being and in some cases the lives of patients, it’s no surprise that they undergo extensive training and advanced education before donning the white coat. In addition, the field of pharmacy has become increasingly complex as advances in pharmaceutical therapy and genomics have taken hold — and as pharmacists’ patient-care activities have become more integrated with those of doctors and other members of the healthcare team.



Harry Leider, chief medical officer for Walgreens, said, “The level of education and training pharmacists receive has increased significantly in recent years. Pharmacy students are now required to earn a doctor of pharmacy degree (PharmD), which typically takes seven to eight years to complete — including undergraduate and pharmacy school education. Many pharmacists go on to receive additional specialized training in areas of growing need like immunizations, diabetes or HIV/AIDs.”



Learning to collaborate

“The role of the pharmacist is rapidly changing,” agreed the University of Pittsburgh School of Pharmacy in a mission statement. “Pharmacists are able to contribute to the healthcare team by utilizing tools and skills that facilitate patient care. With significant national support for pharmacists’ ability to impact the healthcare of patients, there is an imperative need to address the significant gaps in access to patient care services.”



“Pharmacists are patient-care providers who focus on the appropriate, safe and effective use of medications while collaborating with members of a healthcare team,” added Pitt Pharmacy School dean Patricia Kroboth. “Changes in the U.S. healthcare system are driving an exciting evolution of responsibilities and roles for pharmacists. Our graduates practice in a variety of environments on the continuum of keeping healthy communities healthy to caring for the sickest of the sick.”



At the University of North Carolina’s Eshelman School of Pharmacy, the education of prospective pharmacists now features “more patient-care experience, expanded research ... and a flipped classroom that shifts the lecture[s] outside of class and replaces them with more interactive, team-oriented and critical-thinking activities.” In this “new curriculum,” said Russ Mumper, Eshelman’s vice dean and professor, “the role of patient care ... will begin much earlier in the student’s educational process.”



According to Evan Robinson, founding dean of Western New England College School of Pharmacy, new educational guidelines from the American Association of Colleges of Pharmacy reflect the dramatic evolution of pharmacy practice. This expansion of pharmacists’ expertise and engagement comes as pharmacists fill a broader and more clinical role as frontline patient care providers, working in partnership with physicians and health systems as part of an integrated care team focused on improving patient outcomes and long-term wellness.



“Pharmacists have been very effective communicators, and now the question is, ‘How do we grow in our role as educators?” Robinson said. “The goal now is to enhance our therapeutic knowledge to make us far more valuable as a member of the interprofessional team in collaborative services for patient care and outcomes management, whether it’s in a patient-centered medical home, in care-based activities, etc.”



The nation’s schools of pharmacy have significantly expanded their curricula and community outreach, said the pharmacy educator, to give newly minted doctors of pharmacy the fully rounded, advanced-degree education in pharmacotherapy and health sciences they’ll need for today’s more complex and clinically oriented model of pharmacy practice. But today’s pharmacy students also are gaining a deeper understanding of patient relationships, empathetic long-term care, counseling on healthier lifestyle choices for patients, the management of chronic diseases and the team-based approach to patient care that increasingly defines today’s healthcare system.



“Our curricula have evolved in a very solid, stepwise, evidence-based manner to try and find ways to capitalize collaboratively for patient outcomes,” Robinson said.



‘Redefining pharmacy’s role’

Today’s pharmacy curricula is preparing new generations of community pharmacists for work as behavior management experts spending less time dispensing and more time on patient management activities.



“Communication skills are critical,” said pharmacy educator Kimberly McKeirnan. “As pharmacists, we regularly interact with people who are faced with difficult situations like health concerns of their own, health concerns of a family member or financial difficulties.”



As a result, “PharmD education includes training and opportunity to practice communicating — interviewing and counseling patients, effective communication with other healthcare providers,” said McKeirnan, clinical assistant professor in the College of Pharmacy at Washington State University Health Sciences.



Pharmacy schools are aligning with the changes in pharmacy practice in order to better prepare students for a more clinical and holistic approach to patient care by pharmacists. At the University of Iowa’s College of Pharmacy, for instance, “classes are now organized by disease state and will be team-taught.”



“PharmD students in small groups will learn about the scientific process, develop a scientific project and present