Pharmacists are key members of the hospital workforce, working closely with physicians and nurses to ensure that medications are used safely, effectively and in a cost-conscious manner. Yet the chronic shortage of pharmacists identified in AHA’s 2002 report, “In Our Hands: How Hospital Leaders Can Build a Thriving Workforce,” continues to plague many of America’s hospitals. The latest data show a 5.9% vacancy rate, according to the American Society of Health-System Pharmacists’ “2008 Pharmacy Staffing Survey.”
There is good news on the horizon. Pharmacy education has evolved in recent years to an entry-level Doctor of Pharmacy (Pharm.D), enabling graduates to enter the workforce as highly trained clinicians prepared to serve as direct patient-care providers on interdisciplinary teams. An increasing number of new graduates also are completing post-graduate residencies during their first and second years of practice.
Additionally, the number of pharmacy schools has increased from 88 to 112 schools over the past decade, helping to fill the workforce pipeline. According to the American Association of Colleges of Pharmacy, the number of students enrolled in pharmacy degree programs jumped from 43,047 in 2003 to 50,691 in 2007.
Though the number of enrolled pharmacy students has increased, challenges still exist. The influx of new pharmacy schools combined with stringent new experiential education requirements has affirmed the need for more hospital-based rotation sites. Engaging and exposing pharmacy students to hospital practice is a key component of success as a practitioner. But there are not enough rotations to go around.
Experiential education is not simply a nicety. Pharmacy students are required to complete 300 hours of introductory experiential education during the first three years of pharmacy school and 1,440 hours of advanced experiential education during the fourth year. About half of these experiential hours are to be obtained in hospital and health-system settings. While many hospitals serve as student training sites for medical, nursing and other allied health professions, not enough hospitals are offering experiential training for pharmacy students.
A recent study revealed that about 25% of hospitals do not accept pharmacy students, and many of the remaining hospitals may only take students on an occasional basis. Other data show that 16% of hospitals that currently take students are planning to reduce the number of rotations that they offer.
These numbers are troubling. If we don’t take aggressive steps to adequately train the future workforce, the talent pool of qualified pharmacists available to hospitals will certainly suffer.
Hospitals that train pharmacy students benefit from the activities embodied within typical four- to six-week rotations. The rotation, in turn, introduces students to typical hospital pharmacy practice environments. Hospitals also find that they have enhanced recruiting opportunities, leading to lowered vacancy rates and reduced recruiting costs. Additionally, because pharmacy experiential rotations are evidence of “community benefit,” they also can help not-for-profit hospitals maintain their legal status.
From a patient care and safety perspective, hospitals benefit tremendously from the training that students receive in acute care. These are the practitioners, after all, who hospitals will rely on in the future for skilled, experienced pharmaceutical care.
Hospital leaders can help reap these benefits by talking with their director of pharmacy and local or regional colleges of pharmacy, exploring creative ways to provide experiential education and attract new talent at the same time. The use of interdisciplinary patient care teams that include clinical pharmacists and pharmacy students is a great way to improve care while enhancing your hospital’s program to create community benefit.
Manasse is executive vice president and CEO of the American Society of Health-System Pharmacists in Bethesda, MD.
By Henri R. Manasse Jr.