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To the Editor. The concept and practice of pharmaceutical care and outcome-based pharmaceutical services has led to the development of numerous postgraduate programs in clinical pharmacy and pharmacy practice across the world. These postgraduate programs are offered either through coursework, mixed mode, or research mode. Generally, the objectives of coursework and mixed mode programs are to enhance clinical knowledge together with research skills. Conventionally, the objective of a doctorate program (PhD research work) is to produce independent researchers. Research being the primary focus of a doctorate program in basic and applied sciences is appropriate, but for clinical/practice sciences, acquisition of clinical skills should not be overlooked. Most of the PhD programs in pharmacy practice in Australia, the United Kingdom (UK), and the Asia-Pacific region are purely research-driven with little or no emphasis on the acquisition of practice skills. Such programs are inadequate, especially for tomorrow's clinical pharmacy and pharmacy practice academicians who are supposed to be leaders in both practice and research. Arguably, the required clinical/practice skills are covered well during undergraduate courses, but not all undergraduate programs across the globe are clinically oriented, and advanced clinical/practice skills can always be incorporated into the curriculums of higher degree programs.1,2 These programs are suitable only if coupled with a clinically oriented undergraduate program. The only example of such a clinically oriented undergraduate degree is the doctor of pharmacy (PharmD) program in the United States.
Well-structured, mixed mode PhD programs have potential to overcome this problem. Few mixed mode programs, such as the doctor of pharmacy (DPharm) at the University of Auckland, New Zealand,3 doctor of clinical pharmacy at the University of South Australia, Australia,4 and doctor of philosophy (clinical pharmacy) at the Universiti Sains Malaysia, Malaysia,5 have been developed. These programs focus on the acquisition of both clinical and research skills. However, the utilization of evidence-based effective teaching and assessment methodologies in these programs remains to be demonstrated. In addition, there is no evidence to support that the quality of graduates produced by such mixed mode programs is better than the traditional research-based doctorate programs. Extra course fee, longer course duration, shortage of skilled practicing academicians, and additional workload for clinical faculty members are potential barriers to offering mixed mode doctorate degrees. Centralization of financial and human resources, together with careful selection of students can help overcome the said problems.
In summary, there is a need to review and revise current doctorate programs in clinical pharmacy with a view to equip future academicians and practitioners with necessary knowledge and skills required to become competent researchers and practitioners. Thorough research is needed to assess the current needs and future demands of the clinical pharmacy profession, together with curriculum design and methods of instruction and assessment. In our view, it is an issue of great importance that should be dealt with professionally, without any political or commercial interests.