Pharmacist

For the precursor profession, see Apothecary

Pharmacists are health professionals who practice the art and science of pharmacy. In their traditional role, pharmacists typically take a request for medicines from a physician in the form of a medical prescription and dispense the medication to the patient and counsel them on the proper use and adverse effects of that medication. In this role, pharmacists ensure the safe and effective use of medications. Pharmacists also participate in disease state management, where they optimise and monitor drug therapy – often in collaboration with physicians and/or other health professionals. Pharmacists have many areas of expertise and are a critical source of medical knowledge in clinics, hospitals, and community pharmacies throughout the world.

Pharmacists are sometimes small-business owners, owning the pharmacy in which they practice. This unique dichotomy is often the subject of debate within the profession - in part due to the perception of pharmacists as "common shopkeepers" by many in the community. In actuality, while many pharmacists do "keep shop" they are also very skilled and specialized individuals with specific knowledge that makes them a vital part of any healthcare team. They act as a learned intermediary between patients and physicians to ensure that proper medical therapy is chosen and implemented in the best way possible.

Pharmacists are sometimes referred to as chemists (or dispensing chemists), which sometimes causes confusion with scientists in the field of chemistry. This term is a historical one, since pharmacists originally were required to complete an undergraduate degree in Pharmaceutical Chemistry (PhC) and were known as "Pharmaceutical Chemists".

Qualifications and registration

The basic requirement for pharmacists to be considered for registration is an undergraduate or postgraduate Pharmacy degree from a recognised university. In most countries this involves a four-year course to attain a Bachelor of Pharmacy (BPharm) degree.

In order to practise as a pharmacist, the person must be registered with the relevant statutory body, which governs the registration and practice of pharmacy within the territory of its jurisdiction. There is often a requirement for the pharmacy graduate to have completed a certain number of hours of experience in a pharmacy, under the supervision of a registered pharmacist. The statutory body will usually administer a written and oral examination to the prospective pharmacist prior to registration.

Pharmacists are trained in fields including pharmacology, chemistry, pharmaceutical chemistry, pharmacy practice (including drug interactions, medicine monitoring, medication management), pharmaceutics, pharmacy law, physiology, anatomy, biochemistry, kinetics, nephrology, hepatology, and compounding medications. Additional curriculum covers basic diagnosis with emphasis on disease state management, therapeutics and prescribing (selecting the most appropriate medication for a given patient).

Australia

In Australia, apart from the four-year BPharm course, there is the option of a postgraduate two-year Master of Pharmacy (MPharm) course for those with undergraduate science degree background.

Pharmacists are registered by Pharmacy Boards in individual states such as the Pharmacy Board of New South Wales. In Western Australia, pharmacists are registered by the Pharmaceutical Council of Western Australia. Individual states have differing requirements for pharmacy graduates for registration, but generally graduates are required to complete approximately one year of practice under the supervision of a registered pharmacist. In addition, graduates are required to complete an approved graduate training course for that state, for example the Pharmacist Graduate Training Course (PGTC) offered by the Pharmaceutical Society of Australia NSW Branch is required in New South Wales. On meeting these requirements, graduates are eligible to sit the registration examination which may involve both written and oral components.

United Kingdom

In the United Kingdom, integration with the European Union has resulted in the BPharm course being superseded by a four-year course for the qualification Master of Pharmacy (MPharm). In Great Britain the Royal Pharmaceutical Society of Great Britain is responsible for regulation of pharmacy affairs and in Northern Ireland it is the Pharmaceutical Society of Northern Ireland. Graduates must complete one year of practical training and pass a registration examination before they can be entered on the register of pharmacists, known as the register of pharmaceutical chemists.

Pharmacists registered in other countries can also register in the UK. Overseas pharmacists are required to undertake the Overseas Pharmacists Assessment Programme (OSPAP), a one year intensive course focused on pharmacy practice in Great Britain. OSPAP authorisation can be given by Royal Pharmaceutical Society of Great Britain and the course is undertaken either the University of Sunderland, Aston University or the University of Brighton.

United States

In the United States, individuals seeking to become pharmacists must first complete a pre-pharmacy undergraduate program. This program consists of a minimum of 60-70 semester credit hours (90-100 quarter credit hours) of undergraduate coursework in basic and advanced sciences; however many students go on to complete a four year program (between 120-130 semester credit hours) leading to a Bachelor of Science degree in biology, chemistry, or a similar field. In addition, a high PCAT (Pharmacy College Admission Test) score is required at most colleges and schools of pharmacy.

After admission, a student will complete a four year pharmacy program and will be awarded the Doctor of Pharmacy (PharmD) degree upon graduation. A pharmacy graduate may choose to complete an optional post-graduate residency (one to three years) or enter directly into pharmacy practice, e.g., community (retail), compounding, consultant (nursing home), hospital, nuclear, etc.

A pharmacy graduate must complete internship requirements and pass the North American Pharmacist Licensure Examination, or NAPLEX, and an additional state exam before they can acquire a license to practice pharmacy in that state. The NAPLEX was created by the National Association of Boards of Pharmacy (NABP).

Roles

Pharmacists are often the first point-of-contact for patients with health enquiries. This means that pharmacists have large roles in the primary healthcare of patients.

These roles include, but are not limited to:

clinical medication management
specialized monitoring of simple and complex disease states
reviewing medication regimens
monitoring of treatment regimens
general health monitoring
compounding medicines
general health advice
providing specific education to patients about disease states and medications
oversight of dispensing medicines on prescription
provision of non-prescription medicines
counseling and advice on optimal use of medicines
advice and treatment of common ailments
referral to other health professionals if necessary
dosing drugs in renal and hepatic failure
pharmacokinetic evaluation
education of physicians on medications and their proper use
prescribing medications in collaboration with other healthcare professionals
providing pharmaceutical care

Specialities

Practice specialisation

Specialties exist within the pharmacy profession, with the place of occupation being the major differentiator. Specialities include:

Academic pharmacist
Clinical pharmacist
Community pharmacist
Consultant pharmacist
Drug information pharmacist
Home Health pharmacist
Hospital pharmacist
Industrial pharmacist
Locum pharmacist
Regulatory-affairs pharmacist
Veterinary pharmacist

Specialty Practice accreditation

In the United States, a pharmacist can become certified in recognized specialty practice areas by passing an examination administered by the Board of Pharmaceutical Specialties. There are five specialties in which a pharmacist can become Board-certified. The Pharmacotherapy specialty also has two subspecialties, as follows:

Nuclear Pharmacy
Nutrition Support Pharmacy
Oncology Pharmacy
Pharmacotherapy
- Cardiology
- Infectious disease
Psychiatric Pharmacy

Additionally, other certifications are available from smaller credentialing boards, such as the Certified Geriatric Pharmacist (CGP) designation, administered by the Commission for Certification in Geriatric Pharmacy (CCGP).

In Australia, accreditation exists only for certain specialties and is provided by professional bodies for the following: