Professional Documents
Culture Documents
Makalah
Makalah
Introduction
Health care services (hospitals and clinics) in Pakistan usually exhibit a very prominent role of physicians assisted by nurses. Pharmacists duties are being performed by nurses, mid-wives, lady health workers and other paramedical staff.1 As health policies are made by such a
committee that consists mainly of senior physicians so they allocate no
space for pharmacy profession in health care services. Perhaps, physicians feel fear by the increasing role of pharmacists in health department so they are ignoring pharmacy profession as much as possible.
The number of pharmacy institutes has increased quantitatively
not qualitatively since 2001 both in public and private sector throughout Pakistan (15 public and 8 private pharmacy institutes = 23 registered pharmacy institutes in whole country in 2009). These accredited
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Methodology
A random sample of 145 pharmacy teachers (Lecturers, Assistant
professors, Associate professors and Professors) were selected from 17
departments of pharmacy of public and private universities in eleven cities and were interviewed about their perception regarding key features
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TABLE I
Pharmacy institutions shall allocate not more than 2% of the total annual
admissions of students in the First Professional for nominee of the
proprietors, partners and directors of pharmaceutical industry as specified in
the Companies Ordinance, 1984.
The teacher and student ratio of 1:10, shall be maintained and adequate
facilities including that of hospital will be provided for teaching and training
of students.
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and various shortcomings of pharmacy education and practice in Pakistan. Ethical approval for this study was obtained from the University of
Faisalabad.
The questionnaire used consisted of two parts. The first part of the
questionnaire included demographic queries and basic questions about
current status of pharmacy education and practice in Pakistan. The participants were asked to identify key shortcomings in the subject. The second part of the questionnaire included questions regarding approaches
necessary for the development of pharmacy education and practice in
Pakistan.
Different institutes were visited with prior consents and the questionnaires were presented to the participants to fill out personally during the interviews.
Student Issues
According to most (59%) of the pharmacy teachers, majority of students since their childhood have strong desire to become physicians.
Those who fail to achieve this goal join pharmacy program by chance,
not by choice. Due to this failure, most students are dejected and do not
take their keen interest in their studies and fail to become competent
pharmacists. Beside this, economic status of students (10%), increased
interest to extra-curricular activities (14%), lack of proper guideline (10%)
and similar other issues (7%) are challenges to pharmacy students.
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Accreditation
There are increasing number of private pharmacy institutes in country. PCP has established rules and regulations for the accreditation of
pharmacy institutes but their implication is very loose. Majority (67%)
of the teachers think that many institutes are violating the rules of PCP
such as enrollment of higher number of students than that of permitted,
twice registration in a year, deficiency of well equipped laboratories and
teaching staff, but no serious action is taken against such institutes.
These institutes are conducting pharmacy programs for profit and thus
are compromising quality for money.
Administration
Most (82%) of the teachers expressed that now a day a lot of research in various fields of pharmacy and their presentation through a
number of journals are being made through out the world. On the other
hand students in Pakistan are unable to get updated knowledge because
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TABLE II
Subjects
First Professional Year
Credit hours
Marks
Theory
Practical
Theory
Practical
100
100
Pharmaceutical Biochemistry
100
100
Physical Pharmacy
100
100
Physiology
100
100
Anatomy
50
100
Pharmaceutical Preparations
100
100
100
100
Pharmacognosy-I
100
100
10
Pharmaceutical Microbiology
100
100
11
100
100
100
13
Pharmacognosy-II
100
100
14
100
100
15
Instrumentation
100
100
Pathology
100
16
Hospital Pharmacy
100
18
Clinical Pharmacy-I
100
100
19
Industrial Pharmacy
100
100
20
Biopharmaceutics
100
100
21
100
100
Medicinal Chemistry
100
100
23
Clinical Pharmacy-II
100
100
24
Pharmaceutical Technology
100
100
25
Forensic Pharmacy
100
100
26
27
50
50
115
78
2600
1950
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TABLE III
The institutions will follow the curriculum approved and notified by the
Pharmacy Council of Pakistan;
The academic session will not be less than nine months in one academic year
or two semesters in one academic year;
administrations of institutes do not subscribe high impact journals. Public sector institutes are providing this facility through on-line subscription to some extent but students in private institutes are still deprived
of this source of latest knowledge. Many (49%) teachers told that all
universities appoint faculty members on permanent basis rather than
hiring faculty on tenure track so they are least interested in pedagogic
principles, research and students affairs. Few (17%) teachers pointed
out that politics and internal conflicts among faculty members (particularly in Public sector institutes) are barriers to academic and research
activities and thus majority of students avoid facing teachers due to the
fear of unexpected failure.
Majority (92%) of the teachers realize that most of the Ph. D. faculty
members are leaving their chairs in next 5 to 10 years. No sufficient
policy has yet been made to compensate these forthcoming intellectual
gaps. Though, there is some growing interest of pharmacy graduates in
higher education such as M. Phil and Ph. D., this professional force will
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Infrastructure
Many (53%) teachers are of the opinion that pharmacy profession has
undergone a so-called shift from B. Pharmacy to Pharm. D. (Patient oriented education) in Pakistan. However, there is no basic infrastructure
and economic resources in country to adopt this change. The allocation of
budget for the uplift of laboratories is very low, insufficient chemicals and
latest equipments, unavailability of latest software and hardware hinder
the students to get practical education. Pharmacy education and practice
in Pakistan is, therefore far behind developed countries. Most (62%) of the
pharmacy teachers express that Pakistan is currently facing deficiency
of highly qualified faculty in its all fields. Some subjects, such as clinical
pharmacy and Pharmacy Law, are being taught by inexperienced and
incapable teachers as no qualified personnel are available for these posts.
Regulations
Majority (73%) of the teachers express that no specific schedule is set
for students to work in some pharmaceutical organization for practical
experience except 2 or 3 one-day industrial visits during whole 5 year
degree program. However, students of 4th and 5th professional year visit
hospitals because of a major subject, clinical pharmacy. Pharm. D. is a
practice based profession but internship has not been declared compulsory after completion of program. Nevertheless, pharmacists are encouraged to do internship in some well established organizations.
Most organizations (pharmaceutical industries and hospitals) pay
nothing to pharmacist trainees, but they do not cost any fee for providing students with professional experience. However, some organizations
pay some remuneration to pharmacist trainees. Aga Khan Hospital Karachi is an example where approximately Rs. 7000 or 85 US$ are paid
monthly to the trainees, recruited through a strict selection procedure
that comprises of academic background, comprehensive written test and
interview.
Many (39%) point out that Pakistan Pharmacist Association (PPA),
only pharmacist association in country, is not working as efficient as
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Miscellaneous
Beside above mentioned problems, all pharmacy teachers think that
there are many other challenges such as rare visits to pharmaceutical industry, no memorandum of understanding between institute and
pharmaceutical industry, no quota of pharmacists in competitive exams.
Pharmacy, in a net shell is a low income profession in country.
English as language of communication, use of traditional teachings
aids, white boards due to which fresh pharmacists are not carrying sufficient and updated knowledge add fuel to the fire to the dim scenario of
pharmacy.
Student Issues
Many (69%) teachers propose that it is the need of time to conduct
seminars and educate public to realize them the scope and potential
job opportunities of pharmacy profession so that students may join this
profession by choice, not by chance. In this way, students will take keen
interest in their studies to become competent pharmacists eventually.
Most (59%) of the teachers also suggest that needy students should be
awarded scholarships to meet their educational expenses. Majority (87%)
of the teachers express that it is the moral responsibility of students to
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concentrate his education with their optimum effort and should consult
their teachers for any guidance.
Curriculum
All teachers were of the view that pharmacy is a continually developing field. Therefore, pharmacy curriculum should be revised regularly to
fulfill main national needs which can be more helpful to produce competent pharmacists. Subjects especially concerning to Pharm. D. such
as patient assessment, communication skills, pharmacotherapeutics
should be included to curriculum. Moreover, it will be helpful for pharmacists to enter pharmacy professions in advance countries such as UK,
USA, Canada and France. Basically, pharmacy education is a combination of many different fields. Thus, it is the responsibility of teachers and
other stakeholders to design a coordinated pedagogic model. An updated
curriculum is presented in Table V.
Accreditation
PCP accredits pharmacy programs through an ongoing review process because pharmacy is a continually developing profession. PCP independent panel of pharmacy experts consisting of academicians and
practitioners evaluate documented and established educational standards (Functions of PCP are given in Table IV).
For any institutes accreditation PCP sends comprehensive comments
after inspection and evaluation of that institute. These comments must
be addressed and their compliance with accreditation standards should
be ensured by the institute. PCP evaluates documented and established
educational standards again after an already given time period and decide according to situation for reconsideration, preliminary approval (At
admission of institutes first batch into the program after successful initial evaluation), provisional accreditation (If an institute fulfills all major
accreditation requirements usually after its first year of teaching) or full
accreditation (If a provisionally accredited institute fulfills all accreditation requirements usually after its first batch of graduates has passed out)
for undefined tenure. PCP keeps institutes under observation continually
even after accreditation. However, accreditation should be given for specific time-period such as 2 or 3 years and then PCP should revaluate educational standards because pharmacy is a continually developing profession.
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TABLE IV
Functions of PCP
S. No.
Functions of PCP
To approve the courses of study and practical training in pharmacy for the
purpose of admission to approved examinations.
The participants of this study suggest that trend for violating rules
and regulations of PCP should be discouraged keeping private institutes
under continuous observation even after accreditation and holding examination of all pharmacy institutes by a central agency, such as University of Pharmaceutical Sciences.
Administration
Fifty percent participants propose that faculty members should be
trained for problem oriented teaching as practice makes a man perfect.
Few (21%) teachers comment that government should appoint faculty on
tenure track which may be extended in case of good performance. Similarly, administrations of pharmacy institutes should provide students
with free access to high impact journals.
Infrastructure
Many (65%) teachers think that though pharmacy profession has
undergone a so-called movement from B. Pharmacy to Pharm. D. (Patient
150
TABLE V
T&P
200
Pharmaceutical Biochemistry
T&P
200
Physical Pharmacy
T&P
200
Physiology
T&P
200
Anatomy
Pharmaceutical Mathematics and
Statistics
Public Health
50
100
100
6
7
Pharmaceutical Preparations
T&P
200
T&P
200
10
Pharmacognosy-I
T&P
200
11
Pharmaceutical Microbiology
T&P
200
12
T&P
200
13
Pharmaceutical Immunology
T&P
200
14
Pharmaceutical Biotechnology
T&P
200
15
T&P
200
T&P
200
16
T&P
200
18
Pharmacognosy-II
T&P
200
19
T&P
200
20
Instrumentation
T&P
200
21
Pathology
T&P
100
22
T&P
200
23
24
25
Hospital Pharmacy
T&P
100
26
Clinical Pharmacy-I
T&P
200
27
Industrial Pharmacy
T&P
200
28
Biopharmaceutics
T&P
200
29
T&P
200
151
Medicinal Chemistry
T&P
200
31
Clinical Pharmacy-II
T&P
200
32
Pharmaceutical Technology
T&P
200
33
Forensic Pharmacy
100
200
T&P
100
200
248
6050
34
35
36
Regulations
The rules and regulations for the development of pharmacy profession regarding may be evaluated according to the need of the country,
establishment of training based Pharm. D. program and creation of potential job opportunities.
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153
Miscellaneous
Few (18%) teachers suggest that animations should be used to make
students better understand. Teachers should deliver compact and integrated lectures. Class quiz and general discussion should be compulsory during degree program. Its marks should be counted in final result.
Some (14%) teachers also express that memorandum of understanding
should be signed with institutes having an excel in the field of pharmacy
to exchange students and faculty members for the development of this
profession. Most (87%) of the teachers demand that optional subjects,
relevant to pharmacy, should be available for pharmacists for national
and provincial level competitive examination.
Conclusions
Pharmacy education and practice in Pakistan needs drastic improvement in the curriculum, infrastructure, administration, regulations and accreditation criteria for movement to Pharm. D., a patient
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TABLE VI
Pharmacists
working (%)
39
Pharmaceutical industries
27
Teaching
15
Others
10
Acknowledgements
The authors are grateful to the Heads/Chairmen/Deans and teachers
of all pharmacy institutes for contributing necessary information to complete this manuscript on pharmacy education and practice in Pakistan.
Summary
The objective of this article is to identify possible causes for the below par standard of the pharmacy education and practice in Pakistan
and some remedial measures for bringing it closer to the advance standards. One hundred and forty five pharmacy teachers from 17 departments of pharmacy of public and private universities were interviewed
about their perception regarding key features and various shortcomings
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of pharmacy education and practice in Pakistan. In Pakistan, pharmacists role is not squeezed into national health policy which should be accomplished on priority basis to uplift this profession. In addition, pharmacy institutes need improvement in academic and research facilities
qualitatively, not quantitatively. Moreover, pharmacy curriculum needs
drastic revision on regular basis for moving to Pharm. D. requirements.
Young academicians should be sent to developed countries to get higher
education in new subjects of pharmacy to achieve long run goals. As
short term policy, well reputed foreign faculty members should be hired
and an efficient coordination should be developed between pharmacy
institutes, pharmaceutical industries and Pharmacy Council of Pakistan (PCP). Pharmacy education and practice in Pakistan needs drastic
improvement in the curriculum, infrastructure, administration, regulations and accreditation criteria for movement to Pharm. D.
Key words : Pharmacy education, Pharmacy practice, Curriculum,
Infrastructure, Regulations.
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