AAMC Reporter: May 2008

Viewpoint: "Pharmacy Partnerships Can Advance Medical Education, Practice, and Research"

Lucinda L. Maine, Ph.D., R.Ph., Executive Vice President, American Association of Colleges of Pharmacy

Kenneth W. Miller, Ph.D., Senior Vice President, American Association of Colleges of Pharmacy

Academic pharmacy in the United States reached two milestones in recent years, and both are important for academic medicine to know and understand. The first milestone deals with an increase in the number of graduate pharmacists. This growth is due to a combination of increased enrollment at established schools through expanded class sizes and satellite campuses, plus the addition of programs at new schools. The total number of schools with accreditation status passed 100 in 2007, and there are at least a dozen more in the earliest stages of formation. Pharmacy has the largest student enrollment in the profession's history, and this will grow over the next decade. The other and more significant milestone is that all pharmacy students are now enrolled in the professional doctoral program leading to the Doctor of Pharmacy degree, or Pharm.D. This four-year doctoral program admits students with at least two years of preprofessional study, but at present, a slight majority of students admitted to the program already have a baccalaureate degree.

Pharmacy moved slowly and deliberately to reach consensus on the need for all graduates to have doctoral-level preparation, with the original debates beginning more than 60 years ago. Analysis of the increased power and complexity of medications and the challenges of ensuring their appropriate use motivated both the pharmacy practice and academic communities to agree that 21st-century health care needed doctoral-level pharmacists.

The 2007 revision of accreditation standards for Pharm.D. programs includes the Institute of Medicine's core competencies for health professionals.Our member institutions aim to prepare pharmacists who are patient-centered and use best evidence, health informatics, and quality improvement tools to contribute to team-delivered care. Clearly, it is easier to write those words than to accomplish this goal across the profession. This is particularly true when considering that the majority of pharmacy schools are not located alongside a medical school. Similarly, most medical schools do not have a pharmacy school on their campus. However, it is exciting to note that at least 10 of the pharmacy schools that opened in the past five years are located at universities with either allopathic or osteopathic medical colleges. Examples include the University of California, San Diego; East Tennessee State University; and Thomas Jefferson University.

Today's pharmacy graduate enters practice armed with a rich and unique body of medication knowledge and patient care skills. Increased emphasis on interprofessional education equips these medication-use specialists to make important contributions to patient-centered care teams in all settings of practice. Our outcome competencies include three central areas of emphasis: pharmaceutical care, systems management, and public health. Each warrants a brief explanation.

Pharmaceutical care, in a nutshell, is evidence-based medication use that aims to tailor drug therapy to the unique needs of patients while identifying, preventing, and resolving medication-use problems in acute or chronically ill patients. Exciting demonstrations of the impact of pharmaceutical care on patients with diabetes, asthma, and heart disease are increasingly changing the standards of practice in community pharmacies, clinics, and community health centers. Pharmacists must assume responsibility for the design and oversight of systems of medication use in all settings. This involves introduction of information technology, automated dispensing technologies, and other devices related to safe medication distribution and use. Increasingly, pharmacists delegate routine dispensing activities to pharmacy technicians or employ robotics to keep pace with the escalating demand for prescription drugs. Least well appreciated of the three competencies is pharmacists' public health role, which spans the gamut of health education and disease awareness to immunization administration and epidemiologic evaluation of medication use across populations.

With medication use being central to acute and chronic care (as well as disease prevention), partnerships between medical and pharmacy schools are more important than ever. Our students need to appreciate the education and abilities of each discipline—and fully appreciate how to engage one another in the delivery of quality patient care. They must see that collaboration in the practice of their faculty role models as well. Interprofessional education is strongly emphasized in current pharmacy school accreditation standards and, ideally, is threaded throughout the curriculum. It cannot be reserved solely for the final years of clinical rotation as part of team rounds.

The increased emphasis on translational research by the National Institutes of Health (NIH) and other funding agencies offers additional opportunity for medicine/pharmacy collaboration. The research expertise among pharmacy school faculty uniquely spans from molecular discovery and synthesis of new molecular entities to product development science to clinical and social science research. Pharmacy faculty members have been strongly competitive in seeking NIH funding and are involved in many of the new Clinical and Translational Science Awards on our campuses.

Pharmacy students and faculty also place a high priority on community service. This is often done collaboratively with medicine or other disciplines that are similarly committed to introducing students to patient populations with unmet health and social service needs. All medical and pharmacy students and faculty would benefit from focused efforts to build and strengthen collaborations between academic pharmacy and medical education. The AACP and AAMC share a vision for expanding interprofessional education, practice, and research across our respective memberships. We are committed to working at the national level to facilitate new partnerships at the local level. Our work would be enhanced by learning of more exciting examples of current partnerships that are working and can serve as models for change at other institutions.

For more information

American Association of Colleges of Pharmacy

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