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To the Editor. A 2009 Viewpoint entitled “PharmD or Needs Based Education: Which Comes First?” highlighted and criticized the need for and design of doctor of pharmacy (PharmD) programs in developing countries.1 I would like to discuss the matter further from a different perspective.
Like earlier letters,2,3 the new degree title “PharmD” and issues related to clinical pharmacy staffing remained the center of criticism in the Viewpoint.1 In my opinion, the real issue of “optimum duration for an entry-level pharmacy degree” is overshadowed by the criticism on degree title. Whether bachelor of pharmacy (BPharm), master of pharmacy (MPharm), or PharmD, the title is of little significance as long as graduates have the necessary knowledge and skills to become a competent pharmacist. However, the global shortage of clinical pharmacy academicians with suitable qualifications is a matter of serious concern and requires an efficient action plan. The initiatives taken by the Pharmacy Education Taskforce of the World Health Organization (WHO) United Nations Educational Scientific and Cultural Organization (UNESCO) International Pharmaceutical Federation (IFP) in highlighting the issue of human recourse shortage and developing global pharmacy competency framework are commendable.4,5
The concept of needs-based education in the context of pharmacy education relates to the development of pharmacy programs after assessing the current needs and future demands of community and profession. Considering the Viewpoint to be an advocate for needs-based education, an attempt to prove similarity between MPharm (United Kingdom/Europe), BPharm (Australia and New Zealand), and PharmD (United States) based only on the duration of these degrees is out of context and inappropriate. The health care system in the United States is different than that of the United Kingdom or Austalia, therefore the role of pharmacists, and hence the competencies required, are different and more clinical oriented in the United States. Similarly, in the essence of needs-based education, the change of title from BPharm to PharmD in Hungary1 to attract and retain students should be considered a “smart move” to keep the profession alive.
I found it difficult to agree with the statement “PharmD courses are characterized by a considerable number of precepted clerkships with measurable outcomes.”1 This statement holds true only for the “US PharmD model,” and for others it is not necessary as courses within the PharmD program should be developed keeping in view the needs and future direction of the profession and available human and financial capital. In Pakistan, where around 50% of the pharmacy workforce is working in the pharmaceutical industry,6 it would be highly inappropriate to run a full-blown clinical-oriented PharmD program. The shift from an industrial-based pharmacy degree to a full clinical-oriented degree must occur in steps over a period of time with full political commitment. This is to ensure that necessary human and financial recourses, together with suitable career pathways for graduates, are available at the time of implementation of the clinical-oriented PharmD degree program.
Since most of the research evidence in pharmacy education and pharmacy practice come from the United States, it is not surprising that the US PharmD model is getting wide acceptance and recognition. To me, there is nothing wrong with following that model as long as it is adapted and tailored to fit each country's local needs. As pharmacists, our common goal is to improve patient health irrespective of our degree titles and job nature. However, further research is required to evaluate the optimum duration for an entry-level pharmacy program.