Registration as a Pharmacist in the UK

Ian J Cubbin 19 th November 2015

The start of it all…….1815 Apothecaries Act

The Act introduced compulsory apprenticeship and formal qualifications for apothecaries, in modern terms- general practitioners, under the license of the Society of Apothecaries. It was the beginning of regulation of the medical profession in the UK. The Act required instruction in anatomy, botany, chemistry, materia medica and “physic”, in addition to six months' practical hospital experience.

Early progress in Pharmacy Education

1841 Pharmaceutical Society of Great Britain1842 The College of the Pharmaceutical

Society founded in Bloomsbury1849 The School of Pharmacy became

independent and was incorporated into University of London

1849 Liverpool School of Pharmacy founded

How did it feel?Early members were mostly members of the

Livery companyCompounding was the fundamental part and

required an apprenticeshipExpansion of the industry- Beecham,

Burroughs WellcomeThe experts in drugs-mainly in the community

Post 1948Qualifications were varied-but all required a 3

year practical apprenticeshipDispensing assistants (one year qualification from

Apothecaries Hall often taught at independent Schools of Pharmacy)

Chemists and Druggists (two year qualification, having passed the “Minors”)-many also became Dispensing Opticians (one year further study)

Pharmaceutical Chemists (three year qualifications, having passed the “Majors’)

Bachelor of Pharmacy graduates

1960s- A graduate profession

Regulation abolished ApprenticeshipsMPS -MinorsFPS - MajorsUniversities and Polytechnics offered a

bachelors degree followed by a one year pre-registration training.

Bradford Model-a sandwich course

The registration examination Initially the postgraduate training simply

involved having a pre-registration tutor who ‘signed you off’ as competent after 12 months.

Very variable levels of competence, as much to do with the tutor as the student

The RPSGB introduced its pre-registration examination in 1991 and the format has remained unchanged for 25 years.

Format and Style of the Exam2 papers, all multiple choice in 4 different formats

Closed book in the morning-90 minutes 90 questions Open book in the afternoon 150 minutes 80 questions

The open book exam included 20 calculation questions and calculators not permitted.

The approved texts were Drug Tariff, Medicines Ethics and Practice Guide and the British National Formulary

Pass mark 70% in both the calculations and the other questions.

The Master of Pharmacy degreeThe teaching of pharmacy in the

undergraduate programme changed radically when in 1997 the 4 year programme was introduced.

Consequences were varied- a fallow year of graduates was followed by a fallow year of pharmacists (2001).

Overhauling of programmes varied in Schools of Pharmacy

Separation of Roles-September 2010Royal Pharmaceutical Society of Great

BritainNow the membership body, supporting

pharmacists and the development of the profession though a range of activities

General Pharmaceutical CouncilNow the regulator of the profession, charged

with ensuring patient safety.Registers both pharmacists and pharmacy

technicians

StandardsStandards for Continuing Professional Development

(2010)

Standards for the initial education and training of pharmacy technicians (2010)

Standards for the initial education and training of pharmacists (2011) and Non-EEA pharmacists wishing to register in UK (2011)

Standards of conduct, ethics and performance (2012)

And standards of premises

Patient Safety

This is the cornerstone of the work of the GPhC.

In October 2014 the GPhC began to review the Code of Conduct in the light of the Mid-Staffordshire and other reports

The outcome is yet to be published.

Registration with the GPhCStill a two part process after gaining MPharm degree

or completing the Overseas Pharmacist Course

Pre-registration period with satisfactorily completed competencies

Passing pre-registration examination often seen as the final hurdle

4 years ago the Board of Examiners began the first substantial overhaul of the assessment since it started

Guiding PrinciplesOn Day 1 the pharmacist must be SAFE.The assessment should have as much

artificiality as possible removedThe Board do NOT have responsibility for the

training programmeSetting a syllabus no longer relevant,

demonstration of competence important

What about Mathematics?

Evidence suggested that the 20 questions in the Open book section of assessment was no longer appropriate.

Practicing pharmacists decried the absence of a calculator, saying it was unrealistic in the 21st Century

The Board of Assessors commissioned work on the subject

From June 2016 the format of the calculations section of the Assessment will be radically different

Paper 1 June 2016Calculations PaperCalculators permitted-candidates must bring

their own and it must be one of THREE manufacturer types

40 questions2 hoursWritten answers only- not MCQunits provided

Paper 2 June 2016

“Clinical” paper No calculators, but simple calculations may

occur120 questions2.5 hoursNo reference texts-but reference material may

be provided for some questions e.g. extracts from BNF

MCQ and eMCQ questions only

Life Expectancy of the New Exam The last one lasted 25 years!

Until the integrated 5 year programme?

Fit for purpose because it focuses on the barely passing candidate-not the borderline candidate.

Who will be blamed if the success rates drop?

Some observations from the insidePreceptors or pre-registration tutors can

influence the future pharmacists in a way that academics rarely do

Are we dealing with selection or recruitment?

What impact would a 5 year integrated degree have?

What about OSCEs (at any level)?

And finally……

Thank you for allowing me to share these

personal observations