Miami Dade College US Pharmacy Education Reflection Reflection Paper In the 1950s, two schools in California did NOT transition from the 4-year BS degree t

Miami Dade College US Pharmacy Education Reflection Reflection Paper In the 1950s, two schools in California did NOT transition from the 4-year BS degree to new 5-year BS degree in Pharmacy. What was the impact of them moving directly to the entry-level PharmD?The entry-level PharmD degree is now 20 years old as the required degree to practice pharmacy in the USA. How do you feel this significant change in educational requirements has impacted our practice?Are current “apprenticeship” requirements a key component to learning how pharmacy practice works? Should they be changed?What other relevant questions would you ask about this content? Rennebohm Hall n University of Wisconsin-Madison School of Pharmacy
777 Highland Avenue n Madison, WI 53705-2222 n 608.262.5378 n aihp@aihp.org
This slide presentation was compiled and produced by Robert
McCarthy, Ph.D., Professor and Dean Emeritus at the University of
Connecticut School of Pharmacy for his class “The History of
American Pharmacy.” Prof. McCarthy created this version of the
slide talk for his class in the Spring of 2016.
This slide presentation was downloaded from the Teaching the
History of Pharmacy section of the website of the American Institute
of the History of Pharmacy (https://aihp.org/historicalresources/teaching-the-history-of-pharmacy/) where a copy of the
syllabus (.pdf) for Prof. McCarthy’s class is also available.
This .pdf copy of the slide presentation was shared with the permission
of Prof. Robert McCarthy for the personal and educational use of
interested readers.
PHRX 4001W-002
The History of American Pharmacy
Spring 2016
— Although medical schools began to be established in
the 18th century, pharmacy continued to use an nonstandardized, apprenticeship model.
— Given the scarcity of apothecaries, physicians would
often provide the apprenticeship, which may have been
via an indenture for a period of 5-7 years.
— 1854: APhA’s Committee on Education urged drug
clerks (employee pharmacists) to read the pharmacy
literature, but did not advocate formal education for
pharmacists.
— Prior to the end of the Civil War, formal pharmacy
education was only available in American at a New
Orleans medical school and at six independent
schools operated by local pharmacy associations;
these schools were to supplement apprentice training
not replace it.
— The first schools of pharmacy: Philadelphia (1821),
Massachusetts (1823), New York (1829), Baltimore
(1841), Cincinnati (1850), Chicago (1859), and St. Louis
(1865)
— Lectures at these early pharmacy schools were
provided during the evening by physicians and
“master” pharmacists.
— These schools had no admission requirements and
little laboratory instruction.
— Graduate requirements: pass an examination and
complete a 4 year apprenticeship
— Before 1860, less than 5% of all American pharmacists
graduated from these schools; in 1873, there were 12
American schools of pharmacy with an enrollment of
less than 600 students .
— Practical Pharmacy: The Arrangements, Apparatus, and
Manipulations of the Pharmaceutical Shop and Laboratory
(1849)—William Procter, Jr.: “Father of American
Pharmacy;” during his life he was a practitioner, teacher,
scientist, author, and editor
— An Introduction to Practical Pharmacy: Designed as a Textbook for the Student, and as a Guide to the Physician and
Pharmaceutist (1856)—Edward Parrish: first American
textbook based on American sources
— Practice of Pharmacy (later referred to as Remington’s
Pharmaceutical Sciences and now titled Remington: The
Science and Practice of Pharmacy or simply known as
“Remington’s;” 1885)—Joseph Remington: latest edition is
still used today
— Morrill Act (1862): created the land grant university
(UConn is one), which provided federal land to each
state that could be sold to fund the establishment of a
university that taught the agricultural and mechanical
sciences
— A number of pharmacy schools ultimately were
established at or joined these land grant universities.
— The Connecticut College of Pharmacy, established in
1925, officially joined UConn in 1941, although it
would be 10 years before it moved from New Haven to
Storrs.
— 1870: First convention of delegates from schools of
pharmacy; their goal was to attempt to develop
standards for all pharmacy graduates across the
nation (there were concerns about the University of
Michigan program, the first pharmacy program at a
public institution, that did not require an
apprenticeship, but did offer laboratory training)
— During this period, there was a general belief that
pharmacy could only be learned through an
apprenticeship and schools that graduated
pharmacists without an apprenticeship were not
competent to practice.
— 1874: Conference of Schools of Pharmacy (established by
APhA)
— Agreed that pharmacy graduates would receive a Ph.G.
(Graduate in Pharmacy) diploma (University of Michigan
awarded the Ph.C. [Pharmaceutical Chemist])
— Tennessee College of Pharmacy was nearly expelled for
awarding the Doctor of Pharmacy (Pharm.D) for the same
requirements as the Ph.G.
— Important point: Schools of pharmacy were often
prevented from making needed changes by the state
associations that established and operated them; this led
to the dissolution of the Conference of Schools of
Pharmacy in 1883.
Albert Benjamin Prescott (1832–1905)
transformed American pharmacy education
by creating a full-time university-based
program of study leading to a pharmacy
degree in 1868 at the University of
Michigan. Within 30 years, every pharmacy
program in the country followed the model
he established.
— Correspondence Courses
— National Institute of Pharmacy: 24 lectures that could
be completed in a year
— The Era Course of Pharmacy: two years of
correspondence lectures and examinations
— Self-Study
— A Compend of Pharmacy (1886)–Francis E. Stewart
— A Course of Home Study for Pharmacists (1891)–Oscar
Oldberg
— With the dissolution of the Conference of Schools of
Pharmacy in 1883, the APhA established the Section
on Pharmaceutical Education.
— In 1892, the APhA Section on Pharmaceutical
Education voted to encourage all pharmacy schools to
establish a 3-year course of study.
— 1900: the American Conference on Pharmaceutical
Faculties (later American Association of Colleges of
Pharmacy) was formed; its Constitution mandated
that it would meet at the APhA annual meeting.
— 1905: the American Conference of Pharmaceutical
Faculties and the APhA Section on Education &
Legislation adopted the following degrees:
— Ph.G. (graduate in pharmacy)
— Ph.C. (pharmaceutical chemist)
— Phar.B. (bachelor of pharmacy)
— 1906: Pharmaceutical Syllabus was developed by
APhA, National Association of Boards of Pharmacy,
and American Conference of Pharmaceutical Faculties
to provide uniform instruction in pharmacy; the
Syllabus was intended to be revised every 5 years.
— American Conference of Pharmaceutical Faculties
approved a 4-year baccalaureate in pharmacy
program for all member schools effective 1932.
— 1935: University of Michigan Hospitals proposed a
one-year internship after graduation prior to
licensure.
Source: American Pharmacists Association.
— 1937: American Journal of Pharmaceutical Education
established by the American Association of Colleges
of Pharmacy.
— 1940: National Association of Boards of Pharmacy
established the first national apprenticeship
guidelines.
— 1942: American Foundation for Pharmaceutical
Education was founded and provided financial
support to many pharmacy schools during WWII.
— After WWII, the American Council on Education
recommended a universal 6-year program for pharmacy
(pre-professional + professional); most schools were
unwilling to make the jump from 4 to 6 years; thus, the 5year compromise program was adopted (although several
west coast schools did adopt the 6-year, PharmD
program( University of Southern California offered the
PharmD as its only degree beginning in 1950). In 1954,
AACP approved a standard program of at least 5-years no
later than April 1965 (which helped to ensure an adequate
general education portion). Ohio State University was the
first to establish a 5-year program in 1948.
Evolution of Pharmacy Degrees in the 20th Century
Evolution of Pharmacy Degrees in the 20th
Century
Ref: Zebroski, A Brief History of Pharmacy: Humanity’s Search For Wellness
— 1968: APhA urged that the internship be replaced by
an externship that would occur 6 months before
graduation.
— 1974: ACPE proposed that school externships and
clerkships should be used in place of internships as a
requirement for licensure (even today, not all state
boards of pharmacy have adopted this).
— The 1960s and 1970s, saw the genesis of the clinical
pharmacy shifting pharmacy practice from productfocused service to patient-oriented care that emphasized
patient counseling.
— Courses such as analytical chemistry, pharmacognosy, and
industrial pharmacy were replaced by anatomy/ physiology,
pathophysiology and biopharmaceutics.
— Federal capitation grants in the early 1970s required a
clinical component in the curriculum; as a result,
pharmacy schools added clinical faculty, sometimes
causing friction between pharmaceutical sciences and
clinical faculty over resources and curriculum (a challenge
that still exists today).
— Key National Studies:
— 1975: Pharmacists for the Future (also known as the Millis
Commission Report) advocated a competency-based
curriculum
— Suggested ending educational practices that trained pharmacy
students without interactions directly with patients and other
health care professionals
— Advocated shifting the focus from the drug product to the patient
and helping them optimize the benefits of their drug
— 1979: National Study of the Practice of Pharmacy established
standards of practice to assist curriculum committees in
developing practice-oriented courses and help accrediting
bodies evaluate educational programs.
— Accreditation Council for Pharmacy Education
— Founded as the American Council on Pharmaceutical
Education (ACPE) in 1932, the agency’s name was changed to
the Accreditation Council for Pharmacy Education in 2003.
— At its inception, ACPE established standards for the
baccalaureate degree in pharmacy; later, standards for the
doctor of pharmacy were added.
— 2000: ACPE announced the conversion to the doctor of
pharmacy (Pharm.D.) as the sole entry-level degree for the
profession of pharmacy.
— 1975: ACPE developed standards for providers of continuing
pharmacy education; in 1999, standards for the CE providers
conducting certificate programs in pharmacy were
established.
— In 1990s, spearheaded by Hepler & Strand, the
concept of pharmaceutical care became the new
mission for pharmacy. Pharmaceutical care says that
pharmacists, not just prescribers, are responsible for
the outcomes of drug therapy.
— Pharmaceutical or pharmacists care is today
considered the standard of practice expected of
pharmacists.
— 1984: APhA Task Force on Pharmacy Education identified
competencies expected of entry-level practitioners and
recommended the 6-year degree as the sole entry-level
degree into the profession (very controversial).
— 1989: AACP established the Commission to Implement
Change in Pharmaceutical Education to articulate the
mission for pharmacy practice that could serve as the basis
for pharmacy education. The commission produced two
background papers and a position paper, “Entry-Level
Education in Pharmacy: A Commitment to Change,”
which supported the Pharm.D. as the single entry-level
degree into the profession. The AACP House approved
the single-degree recommendation in 1992.
— 1992: APhA, American Society of Hospital (now Health-
System) Pharmacists, and National Association of Retail
Druggists (now National Community Pharmacists
Association) jointly supported the Pharm.D. as the sole
degree for entry into practice; National Association of
Chain Drug Stores opposed the conversion.
— More than 130 pharmacy programs in the U.S.; nearly double
from 2000
— Most pharmacy programs today are 2+4, although some
continue to say they are 0+6 because they admit from high
school; this is a misnomer, however, given the ACPE
requirement that there be a second tier of evaluation/admission
into the professional years of the program.
— Pharmacists today are licensed by state boards of pharmacy. To
be eligible to practice in that state, they must pass a national
exam, the North American Pharmacist Licensure Examination
(NAPLEX), to determine whether the licensure applicant
possesses the minimum competence to be admitted to practice
and the Multistate Pharmacy Jurisprudence Examination
(MPJE), which contains both federal and state-specific laws.
University of Connecticut School of
Pharmacy Deans
Dean Gustavus Eliot
1925 – 1928
Dean Henry S. Johnson
1928 – 1947
Dean Harold G. Hewitt
1947 – 1969
Dean Arthur E. Schwarting
1970 – 1980
Dean Karl A. Nieforth
1981 – 1993
Dean Michael C. Gerald
1993 – 2002
Dean Robert L. McCarthy
2002 – 2013
Dean James R. Halpert
2014 –
Teaching History of Pharmacy
According to the AIHP Guidelines:
D. Pharmacy Education
Created by: Susan W. Miller,
BS Pharm, PharmD
Mercer University College of
Pharmacy
Reviewed by: James Colbert,
PharmD
UC San Diego, Skaggs School of
Pharmacy and Pharmaceutical
Sciences
Developed by the Teaching History of Pharmacy Committee of the History of
Pharmacy SIG, 2017-18
Picture: Pharmacist at People’s Drug Store No. 5, Washington, DC, c. 1920. Library of Congress Prints and Photographs, LC-USZ62-129891
Early U.S. Pharmacy Education
• Pharmacy was considered an art and not a science in the 1700s
• Pharmacy education was based on the apprenticeship model
• Most physicians provided a shop practice with an employee apothecary and/or apprentice
• The apprenticeship was similar to a period of indenture (average of four years)
• The apprentice learned by modeling the behaviors and practices of the preceptor (physician or
apothecary)
• The apprentice gained knowledge of chemistry and the healing properties of plants as well as the
practical application of such
• The Revolutionary War caused a shortage of drug preparations and patent medicines
sourced from Britain
• Druggists (wholesalers of drugs and medicines used by healers and apothecaries) rushed to learn
the compounding of early drugs and patent medicines
• Dr. John Morgan wrote Discourse in 1760 and advocated the separation of medicine
and pharmacy, with physicians writing prescriptions to be dispensed by apothecaries
Early U.S. Pharmacy Education
• Medical education was similar to pharmacy education with only four medical
schools prior to 1800:
•
•
•
•
1765 College of Philadelphia (University of Pennsylvania)
1767 King’s College (Columbia University)
1782 Harvard
1797 Dartmouth
• 1820 – First United States Pharmacopeia (USP) published to establish uniformity
in medical practices
• Prior to 1821 sporadic lecturers offered by chemists, apothecaries, and
physicians at independent schools to supplement the apprentice training, not
replace it
Early U.S. Pharmacy Education
• Independent Colleges of Pharmacy
•
•
•
•
•
1821 – Philadelphia College of Pharmacy
1823 – Massachusetts College of Pharmacy
1829 – College of Pharmacy of the City of New York
1840 – Maryland College of Pharmacy
1850 – Cincinnati College of Pharmacy
• No Formal Admission Process
•
•
•
•
Prior apprenticeship experience preferred
Attendance at occasional lectures
Some laboratory instruction
Graduation required passing an examination and proof of four years of apprenticeship
Early U.S. Pharmacy Education
• 1849 – Publication of Practical Pharmacy by William Procter, Jr.
• First textbook of American Pharmacy
• 1852 – Founding of American Pharmaceutical Association (APhA)
• 1854 – Committee on Education of APhA expressed concerns regarding the
education and training of drug clerks (employee pharmacists)
• Recommended reading the pharmacy literature “regularly and understandingly” and
assist their reading by “experiment and observation” when necessary
• Schools of Pharmacy formed in one of four ways:
•
•
•
•
As a private school (by a group or association of pharmacists)
As a part of a university or college
As a division of a medical college
As a part of a state university
Early U.S. Pharmacy Education
• 1862 – Morrill Land Grant Act
• Permitted states to establish public universities to “focus on education in the applied sciences”,
“perform broad public service”, and “engage in activities designed to serve people”
• 1863 – Mary Corinna Putnam Jacobi – the New York College of Pharmacy
• First woman to graduate from a U.S. college of pharmacy
• 1867 – Founding of Howard University College of Pharmacy
• The first college of pharmacy of the historically black colleges and universities
• The pharmacy program separated from the medicine program in 1870
• 1867 – Medical College of the State of South Carolina
• First state-supported institution to produce graduates in pharmacy
• 1871 to 1883 – Eleven private and proprietary schools were founded
• Five of these eventually affiliated with private or public universities
• The remaining six failed
Early U.S. Pharmacy Education
• 1880’s to 1890’s – Sources of Pharmacy Education
•
•
•
•
•
•
Standard Textbooks
Association Schools
State Schools
Correspondence Courses
Home-Study Books
Cramming Schools
Progress in U.S. Pharmacy Education
• 1884 to 1902 – Nineteen state-sponsored schools and colleges were founded
• Three eventually failed
• 1884 to 1902 – Thirty-eight private, proprietary, association-based or medical
school-based schools and colleges were founded
• Three survived
• Nine merged or affiliated with universities
• Twenty six failed
• 1888 – APhA published the First National Formulary (NF) to standardize
compound drugs
• 1890 – APhA Section on Education and Legislation provided background and a
forum for discussion on educational issues and emerging legislation impacting
pharmacy
Progress in U.S. Pharmacy Education
• 1892 – Edward Kremers of the University of Wisconsin
• Established first four-year baccalaureate degree in pharmacy
• 1892 – Carl S. N. Hallberg Resolution to APhA
• Require “theoretical education” in a school or college of pharmacy as a prerequisite for
examination and registration as a pharmacist
• Eventually withdrawn due to much criticism
• 1900 – Two year pharmacy programs most common
• 1900 – American Conference of Pharmaceutical Faculties (ACPF) created by the
APhA Section on Education and Legislation
• Considered the start of the new era of progress in pharmaceutical education
Educational Criteria in Early U.S. Pharmacy
Education
• Early 1900’s – Variances in Typical Course of Study
• Two, three or four year programs
• Academic year varied from 24 weeks to 42 weeks
• Day and night programs were available
• Early 1900’s – Admission Requirements
• No education, some high school, or high school graduate (diploma)
• Most colleges required only the completion of elementary or grammar school
Alliances Affect U. S. Pharmacy Education
• Previously Rival Factions of Pharmacy Align to Meet Challenges
• APhA advocated for diplomas and licenses
• Schools, colleges, and boards of pharmacy collaborated on apprenticeships, board
examinations, and course content
• Boards of Pharmacy developed experience requirements for licensure and relieved
schools and colleges of pharmacy of such as requirements for graduation
• Association Schools Continued to Advocate for Apprenticeship Model
• 1903 – ACPF sought to bring order to pharmacy curricula with limited success
• 1907 – Two year pharmacy program adopted as standard
• 1910 – Publication of The Pharmaceutical Syllabus
• Created by the National Syllabus Committee of ACPF and NABP (National Associations of
Boards of Pharmacy)
• Outlined a course for a two year curriculum
Progress in U.S. Pharmacy Education
• 1925 – Three year pharmacy program was standard
• 1925 – American Association of Colleges of Pharmacy (AACP) encompassed
ACPF and approved:
• 1925 – High school graduation as entrance requirement to pharmacy program
• 1928 – Four year baccalaureate pharmacy program…
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