In the 1995-1996 academic year, 75 colleges and schools of pharmacy had enrolled students in first professional degree PharmD programs. For the purposes of our study, we designated these colleges/schools as “old.” Between fall 1996 and spring 2007, 14 additional colleges/schools established PharmD programs, graduated at least 1 class by spring 2007, and became fully accredited by the ACPE. We designated these colleges/schools as “new w/grads.” An additional 12 colleges and schools of pharmacy had enrolled PharmD students by fall 2007 but had not graduated any PharmD students by spring 2007. We designated these colleges/schools “new/enr/no grads by S07.” Another 8 colleges and schools were preparing to admit a first PharmD class in fall 2008 (“new/enr in F08”). Several more colleges/schools were in earlier stages of development. From 1996 to 2008, the number of functioning colleges and schools of pharmacy increased by 45% (from 75 to 109).

The total enrollment in the first professional degree PharmD programs of the “old” colleges/schools grew by over 30% from approximately 33,000 in fall 1996 to approximately 43,400 in fall 2007. A large part of this growth can be attributed to the transition from the 3-year to the 4-year professional program which took place for most “old” colleges/schools in the mid-to-late 1990s. The 14 “new w/grads” colleges/schools added an additional enrollment of 4,900 PharmD students, bringing the total PharmD enrollment in these 89 colleges/schools to 48,300, an increase of over 46% during the 11-year period.

This growth dwarfs that of other health professions. For example, while the Association of American Medical Colleges has recommended an increase in US medical college/school enrollment of 30% by 2015, based upon first-year enrollment in 2002, the number of medical colleges/schools has remained at about 126 since 1980. In 2007, 7 new allopathic medical colleges/schools were in development. Osteopathic medicine has opened 10 new colleges/schools since 1981.⁴ The number of dental colleges/schools has declined since 1985 and even with the recent addition of new colleges/schools has not returned to that level.⁵

The large increases in the number of colleges and schools of pharmacy and in PharmD enrollment raise important issues linked to pharmacy workforce needs, the ability of colleges/schools to recruit and retain the quantity and quality of faculty members needed to deliver PharmD programs with larger enrollments, the change in the nature of pharmacy education, and the impact of the changing attributes of colleges and schools of pharmacy. The primary driver of increases in PharmD program enrollment and the initiation of new colleges and schools of pharmacy has been the shortage of pharmacy practitioners. Numerous studies over the past 10 years have explored the shortage and related it to the growing sales of prescription medications; increased third-party coverage for prescription drugs; aging of the baby-boomer generation, which has increased the number of elderly patients who use more pharmaceuticals; and the retirement of a large cohort of pharmacy practitioners.⁶ A conference exploring professionally-determined need for 2020 forecasted a shortfall of some 150,000 pharmacists.⁷

While the pharmacist shortage may precipitate the founding of a new college or school of pharmacy, other factors also contribute to the decision, such as the desire to fulfill an institutional mission, the needs of related campus educational programs, the aspiration of the parent institution to expand its offerings (especially revenue-generating programs), and/or the availability of substantial additional resources and external support. Rapid growth of colleges and schools of pharmacy may overwhelm their ability to arrange adequate experiential sites and appoint qualified faculty members.^8,9 A shortage of faculty members, especially in the practice arena, is a major concern to the AACP¹⁰ and the American Foundation for Pharmaceutical Education (AFPE).^11,12 Since colleges and schools of pharmacy vary in the size of their PharmD programs, making comparisons based upon the absolute number of full-time (FT) faculty members would be misleading. However, the PharmD student-to-faculty member ratio is commonly used to provide some guidance to prospective students seeking information about colleges and schools of pharmacy. For example, the AACP provided advice to prospective pharmacy students to “…inquire about the following issues:…The number of faculty members…and student-to-faculty ratios.”¹³ Therefore, PharmD student enrollment-to-FT faculty member ratios are of consequence.

The Commission to Implement Change in Pharmaceutical Education proposed that while individual colleges and schools of pharmacy have distinctive missions and that these missions may differ, the pharmacy education enterprise as a whole also has a mission. The Commission defined that mission as responsibility not only for educating future pharmacists (the PharmD program) but also for “…generating and disseminating new knowledge about drugs and about pharmaceutical care systems.”¹⁴

The Commission also emphasized the responsibility of the enterprise for fostering research and scholarship, graduate studies, postgraduate clinical residencies and fellowships, and the continual evaluation of the nature and scope of its activities. While the Commission noted that it does not expect all colleges/schools to do all of these things, all should endorse them as part of the mission of the enterprise. The incremental attributes of each new college/school change the configuration or profile of the entire pharmacy education enterprise and in so doing influence how it might meet its mission and broad responsibilities.

In order to examine college/school attributes in relation to PharmD enrollment and faculty member characteristics, only the 75 “old” colleges/schools and 14 “new w/grads” colleges/schools were included in subsequent analyses. These 89 colleges/schools offered all the US fully-accredited PharmD programs that conferred entry-level PharmD degrees in spring 2007. The attributes of these 89 schools were crosstabbed to provide a more detailed description.

For the 89 colleges/schools, PharmD student enrollment-to-FT faculty ratios were computed. Only FT faculty members listed in the AACP Roster of Faculty and Professional Staff, 2007-2008 ¹⁵ with both an academic discipline and an academic rank of instructor, assistant professor, associate professor, or professor were included. Chief executive officer deans were excluded, regardless of academic rank. Also excluded were faculty members listed as adjunct, temporary, part-time, emeritus, or lecturer.

Faculty members were grouped as either “practice faculty members” or “nonpractice faculty members.” Practice faculty members accounted for about half of all FT appointments; most held a PharmD degree. Nonpractice faculty members include all other FT faculty members; most held a PhD degree.¹⁶

The following ratios were calculated for each of the 89 colleges/schools: (1) number of fall 2007 PharmD students to number of practice faculty members, and (2) number of fall 2007 PharmD students to number of nonpractice faculty members. The lower the ratio, the fewer number of PharmD students per faculty member.

Our study's most notable finding was the difference in attributes between “old” colleges and schools of pharmacy that were predominantly public and had PhD enrollees and “new” colleges/schools that were predominantly private with almost none having PhD enrollees.

While it is reasonable to expect “old” colleges/schools would have more senior than junior faculty members compared to “new w/grads” colleges/schools, the latter's much higher PharmD student-to-nonpractice faculty ratio is notable. The most likely attribute to influence this would be the presence or absence of PhD enrollment (see Figure ​Figure1).1). The existence of a PhD program probably would require more FT nonpractice faculty members not only for the graduate teaching needed but also because of the likelihood of concomitant research responsibilities. Thus, the overall PharmD student-to-nonpractice faculty ratio is likely to be spuriously low. When the ratios for colleges/schools with and without PhD enrollees were calculated, this was found to be the case. For colleges/schools with PhD enrollees, the resultant ratio (21) was similar to the overall ratio (23). However, for colleges/schools with no PhD enrollees, the results showed a higher PharmD student-to-nonpractice faculty ratio (39) compared to the overall ratio (23).

Other noteworthy findings concerned FT faculty ratios and were: (1) for colleges/schools with PhD enrollees, the much higher ratios for PharmD student-to-practice faculty and PharmD student-to-nonpractice faculty in private colleges/schools compared to public colleges/schools, and (2) for colleges/schools without PhD enrollees, the much higher ratio for junior-to-senior practice faculty for “new w/grads” colleges/schools compared to “old” colleges/schools.

Each of the relationships identified in this study may be interpreted in several different ways and reflect the interpreter's biases; however, what is undeniable is that the pharmacy education enterprise has changed. Even if the study's limitations were not present, the enterprise has yet to come to grips with: (1) the optimal mix of attributes across colleges/schools, (2) appropriate ratios of PharmD student-to-practice and nonpractice FT faculty members and FT junior-to-senior practice and nonpractice faculty members, (3) what constitutes a part-time (PT) faculty member and appropriate ratios of PT-to-FT faculty members, and (4) how faculty and student ratios could or should change with the use of new teaching technologies.

The latter 3 issues are often the subjects of discussion within individual colleges and schools of pharmacy and at educational meetings. Within limits, a college/school may resolve them internally. The value of these ratios as quality indicators awaits research linking them to process indicators, eg, curriculum design and teaching methods, and ultimately to student learning outcomes.