1. The Profession of Pharmacy
Brigitte T. Sicat, Pharm.D, BCPS
Assistant Professor of Pharmacy
VCU School of Pharmacy
When asked about pharmacy, most people will respond by saying pharmacy is a drugstore or a place where you buy your medication. Some people may talk about pharmacists and drugs. But many people may not know about the Profession of Pharmacy

2. An informal survey of pharmacists at VCUHS
What do you feel your specific discipline brings to the health care team?
What don’t you know that you look to others for?

3. Learning Objectives
After this learning session, you should be able to:
Discuss how pharmacists are trained
Explain what pharmacists do
Discuss career paths of pharmacists
Discuss governmental and voluntary oversight of pharmacy
Discuss the continuing education requirements for pharmacists
Discuss current issues in pharmacy

4. Pharmacist training Pre-pharmacy Pharmacy School Residency Fellowship
4 years to earn Pharm.D. degree
Some programs pre-pharmacy & pharmacy work is combined
Residency
Supervised practice
Specific field of practice
Fellowship
In the next few slides, we’ll talk about how pharmacists are educated and trained.
Today, students of pharmacy must study at least 6 years at the college level to earn the doctor of pharmacy degree (Pharm.D.).
The first 2 years are, and liberal studies, are considered “prepharmacy” requirements that can be earned at a college or university before being accepted into a college or school of pharmacy.
While some students complete their pre-pharmacy work at a college or university before entering a school or college of pharmacy, there are some 6 year programs in the US where students complete their prepharmacy and pharmacy work as one continuous program.
While we only require students to have completed the required prerequisites before entering the VCU School of Pharmacy, over 90% of our first year students have their 4 year degree.

5. Prerequisites for the VCU School of Pharmacy Doctor of Pharmacy Program
8 SH General Biology (6 SH lecture and 2 SH laboratory)
8 SH College Chemistry (6 SH lecture and 2 SH laboratory)
8 SH Organic Chemistry (6 SH lecture and 2 SH laboratory)
4 SH Physics (3 SH lecture and 1 SH laboratory)
3 SH Human Anatomy (also, 1 SH lab is preferred)
3 SH Human Physiology
3 SH Microbiology (also, 1 SH lab is preferred)
3 SH Biochemistry
6 SH English (3 SH of composition and rhetoric is required)
3 SH Calculus
3 SH Statistics
3 SH Public Speaking
35 SH Elective Courses1
90 SH Minimum Total
These are the required prerequisites students must complete in their prepharmacy work before applying to the VCU School of Pharmacy.
Most of the prepharmacy requirements are in biology, chemistry, and liberal studies, and some schools such as VCU, require physics and calculus.
To be admitted to most pharmacy schools, candidates must have above average grades. They also must have strong interpersonal skills and enjoy working with and helping people. High ethical behavior is a must. Other traits of pharmacy student applicants are understanding, drive, flexibility, perseverance, problem solving skills, being decisive, and having a good knowledge of pharmacy.
1 Cell biology, genetics and immunology are highly recommended and are the only science courses that can count towards the minimum of 35 semester hours of electives.
Other highly recommended electives are computer science, economics, psychology, and sociology. Others include political science, anthropology, history, foreign languages,
philosophy and religious studies

6. Pharmacist training Pre-pharmacy Pharmacy School Residency Fellowship
4 years
Some programs pre-pharmacy & pharmacy work is combined
Residency
Supervised practice
Specific field of practice
Fellowship
The curriculum is designed to prepare pharmacists with the knowledge, skills, and abilities for a successful career in pharmacy. Although I won’t go into detail about every course offered in the VCU School of Pharmacy, I have listed them for you here and will highlight a few of them as we move through the slides.

7. P1 Fall Course Title Course Credit Basic Pharmaceutical Principles for
the Practicing Pharmacist
3.0
Pharmaceutics & Biopharmaceutics I
Evidence Based Pharmacy I (Drug Info)
1.0
Health Promotion & Disease Prevention
2.5
Contemporary Pharmacy Practice
3.5
Communications in Pharmacy Practice
2.0
Scholarship I
Continues
Student Pharmacist Professionalism
Foundations I
IPPE I: Community I
Semester Total
17.0

8. P1 Spring Course Title Course Credit Pharmacokinetics* 2.0
Pharmaceutics & Biopharmaceutics II
2.5
Pharmacognosy
Clinical Chemistry for the Pharmacist
Clinical Therapeutics Module I: Intro to Medicinal Chemistry
1.0
Clinical Therapeutics Module II: Introduction to Pharmacology
Clinical Therapeutics Module III: Intro to Special Populations
Self-care, Alternative and Complementary Treatments*
3.0
The U.S. Health Care System
Managing Professional Patient-centered Practice
Scholarship I
Student Pharmacist Professionalism
Continues
Foundations II
IPPE II: Community II
Semester Total
21.0

9. P2 Fall Course Title Course Credit
Evidence Based Pharmacy II: Research Methods & Statistics
2.5
Evidence Based Pharmacy III: Literature Evaluation
2.0
Biotechnology, Pharmacogenomics & Pharmacogenetics
Pharmacy Informatics
1.5
Clinical Therapeutics Module IV: Cardiovascular
4.5
Clinical Therapeutics Module V: Endocrinology
Clinical Therapeutics Module VI: Neurology I
3.0
Scholarship II
Continues
Student Pharmacist Professionalism
Foundations III
1.0
IPPE III: Hospital
Semester Total
19.0

10. P2 Spring Course Title Course Credit Applied Pharmacokinetics 2.0
Pharmacoeconomics
Epidemiology & Pharmacy Practice
Patient Medication Safety
Clinical Therapeutics Module VII: Neurology II
1.0
Clinical Therapeutics Module VIII: Psychiatry
3.0
Clinical Therapeutics Module IX: Respiratory/Immunology
Electives
Scholarship II
Student Pharmacist Professionalism
Continues
Foundations IV
IPPE III: Hospital
Semester Total 21

11. P3 Fall Course Title Course Credit
Pharmacy Practice Management I - Community Practice
4.0
Clinical Therapeutics Module X: Infectious Diseases
4.5
Clinical Therapeutics Module XI: Hematology/Oncology
2.5
Clinical Therapeutics Module XII: Nephrology/Urology
Clinical Therapeutics Module XIII: Dermatology/EENT
1.5
Electives
Scholarship III
Continues
Student Pharmacist Professionalism
Foundations V
1.0
IPPE IV: Clinical Patient Care
Semester Total

12. P3 Spring Course Title Course Credit
Pharmacy Practice Management II - Institutional Practice
2.0
Clinical Therapeutics Module XIV: Gastrointestinal/Nutrition
2.5
Clinical Therapeutics Module XV: Women's Health/Bone, Joint
Clinical Therapeutics Module XVI:Toxicology/Critical Care
1.5
Clinical Therapeutics Module XVII: Special Populations
1.0
Pharmacy Law
3.0
Electives
Scholarship III
Student Pharmacist Professionalism
Continues
Foundations VI
IPPE IV: Clinical Patient Care
Semester Total

13. P4 – Experiential Year Acute Care APPE 10.0 Hospital Pharmacy APPE 5.0
P4 – Experiential Year
Acute Care APPE
10.0
Hospital Pharmacy APPE
5.0
Geriatrics APPE
Primary Ambulatory Care APPE
Elective I APPE
Elective II APPE
Advanced Community Practice APPE
Student Pharmacist Professionalism
1.0
Annual Total
41.0

14. Pharmacist Training Pre-pharmacy Pharmacy School Residency Fellowship
4 years
Some programs pre-pharmacy & pharmacy work is combined
Residency
Supervised practice
Specific field of practice
Fellowship
Postgraduate graining is available in the form of residencies and fellowships.
Residencies – provide in-depth experiences leading to advanced practice skills and knowledge. Most residencies last 1 year and usually begin on July 1st of each year. Examples of pharmacy residencies include a general PGY-1 Pharmacy Practice residency, ID, ambulatory care, critical care, primary care, community pharmacy, drug information, oncology, psychiatry. Many residency programs are accredited by the American Society of Health System Pharmacists. Pharmacists may complete a PGY-1 general pharmacy residency followed by a 2nd year specialty residency.
Fellowships – individualized, postgraduate program designed to prepare pharmacists to become independent researchers. They are typically offered through schools of pharmacy, academic health centers, etc. and usually exceed 12 or even 24 months. Examples of pharmacy fellowships include cardiology, drug development, ID, oncology, psychiatry, transplantation, pharmacoeconomics.

15. Governmental & Voluntary Oversight of Pharmacy
Governmental Oversight
Federal & State laws
Voluntary Oversight
Accreditation of training programs
E.g. ASHP accreditation of residency programs
Certification
Board of Pharmaceutical Specialties (BPS)
Certified Geriatric Pharmacist (CGP)
Certified Anticoagulation Care Provider (CACP)
A complex array of federal and state laws and regulations govern the practice of pharmacy
Federal: FDA & DEA, Centers for Medicare & Medicaid Services (CMS)
State: State boards of pharmacy promulgate the specific regulations that govern the practice of pharmacy on a day-to-day basis. Boards issue licenses to pharmacists and pharmacies. One requirement for relicensure every year in Virginia, is a requirement to complete continuing education hours each year. The rate of new drug development has accelerated and many continuing education programs are available to assist pharmacists in being lifelong learners.
Voluntary Oversight
Accreditation – ASHP is an accrediting body that sets standards for residency programs
Certification – Certification is become increasingly common in pharmacy, particularly in two areas: for pharmacists who practice in highly specialized areas and for pharmacy technicians. The purpose of pharmacy certification is to demonstrate personal achievement in a specialized area. Some examples of pharmacy certifications that you may encounter are:
BPS has several specialty areas including Pharmacothearpy (BCPS), Cardiology, Psychopharmacy, Oncology, nuclear pharmacy, etc.
Other examples of common certifications that you may see that pharmacists obtain are: CACP (Certified Anticoagulation Care Provider), CGP (certified geriatric pharmacist).

16. What do Pharmacists do? Drug-Use Process
Manufacture
Distribution
Prescribing
Preparation
Storing
Dispensing
Administering
Monitoring
Reviewing of drugs and their use
Pharmacists help patients make the best use of their medications
Pharmacy’s role is to oversee the complicated drug-use process, to make it safe, and make it efficient.
The drug use process in the US is a complex, structured process involving the ……..
Although it is designed with multiple checks and balances to help keep patients from experiencing a preventable drug misadventure, it is not perfect.
Pharmacists are intimately involved in multiple parts of the process to help ensure the drugs are used safely and effectively.
Simply stated, in their multiple roles, pharmacists help patients make the best use of their medications.

17. Career Paths of Pharmacists
Community pharmacy
Institutional pharmacy
Long-term care pharmacy
Managed care, home care, and mail-service pharmacy
Pharmacy academia
Other careers
Industry
Government
Associations
Others
Most pharmacists practice in community pharmacy. However, pharmacists work in all areas of health care, health care education, and medical research. They are practice in community pharmacies, hospitals, managed care organizations, pharmaceutical companies, academia, nursing homes, home health care agencies, clinics, and physician offices, government, professional pharmacy organizations, and pharmacy software companies and as private consultants.
Pharmacists hold positions as staff members, supervisors, managers, teachers, researchers, and entrepreneurs. As mentioned earlier, some pharmacists have advanced training in pharmacy and work in specialized areas such as oncology, psychiatry, etc.

18. Current Issues in Pharmacy
The profession of pharmacy has evolved
Pharmaceutical care
“the functions performed by a pharmacist in ensuring the optimal use of medications to achieve specific outcomes that improve a patient’s quality of life; further, the pharmacist accepts responsibility for outcomes and ensue from his or her actions, which occur in collaboration with patients and other health- care colleagues”
Pharmacy practice has changed in the US from making drug preparations from plants to helping physicians decide which drug to prescribe and having a direct role in helping patients make the best use of their medication. Today pharmacists are striving to practice pharmacy using the principles of pharmaceutical care.
Pharmaceutical care is an important term in pharmacy that is defined as the functions performed by a pharmacist in ensuring the optimal use of medications to achieve specific outcomes that improve a patient’s quality of life; further, the pharmacist accepts responsibility for outcomes and ensue from his or her actions, which occur in collaboration with patients and other health-care colleagues

19. Current Issues in Pharmacy
There is a need to move even more rapidly to re-deploy pharmacists from medication order fulfillment to patient care. This will require:
Supporting payment mechanism
Provider status for pharmacists under Medicare
Commitment to obtaining and maintaining the knowledge, skills, and abilities required by increased patient care demands
Fully embracing the tenets of pharmaceutical care
Programs in order to grow the total size of the profession
IOM Preventing Medication Errors.
Given these alarming estimates, there is a ned to move even more rapidly to redeploy pharmacists from medication order fulfillment to patient care.
Many pharmacists today are balancing the responsibilities of medication order fulfillment (e.g. dispensing) with performing pharmaceutical care. Many in the profession believe that in the future, the responsbility of medication order fulfillment will be done by technology and that pharmacists will then be freed to spend more of their time on fully using their knowledge, skills, and abilities to provide pharmaceutical care.
To successfully accomplish this will require several things including:
Knapp DA. AJPE 2002

20. Summary
Pharmacists:
Help patients make the best use of their medications
Receive rigorous education & training
Practice in a variety of settings
Are licensed to protect the public from harm
Are caregivers, clinicians, advisors, teachers, and life-long learners
We look forward to working with you in the Primary Care Teaching Clinic this month and in the future.
William N Kelly 2004