External degree program

A survey was conducted to determine the impact of the doctor of pharmacy (PharmD) degree on the career and practice of pharmacy for graduates of the University of North Carolina at Chapel Hill (UNC-CH) School of Pharmacy's External Doctor of Pharmacy Program. The first 107 graduates of the UNC-CH School of Pharmacy External Doctor of Pharmacy Program were surveyed during June 2000. Eighty (75 percent) graduates responded to the survey. Results indicated that 35 (44 percent) respondents have received a promotion or job change since receiving the PharmD degree. Eleven additional students (14 percent) reported a change in job responsibilities. Results indicate that obtaining a PharmD degree through the UNC-CH School of Pharmacy's External PharmD Program may enable pharmacists to achieve a change in practice setting, a promotion, or new job responsibilities.

INTRODUCTION

Although the vast majority of pharmacists currently practicing in the United States were trained in Bachelor of Science (BS) programs, the educational background of pharmacists is shifting in the U.S. The BS degree is being phased out of all U.S. schools as a result of changes in national standards by the American Council on Pharmaceutical Education that mandated the Doctor of Pharmacy (PharmD) degree for all accredited programs. Thus, pharmacy education has shifted from Bachelor of Science to doctoral training, and the majority of U.S. graduates now enter the profession with the PharmD degree.

As new graduates with advanced training enter the labor market, many practicing pharmacists with BS degrees contemplate the merits of obtaining a PharmD degree. Since adults often have multiple roles that impact the time and energy that they can devote to their role as a student, it is not surprising for the potential student to ask if the benefit of obtaining a PharmD degree is worth the sacrifice or cost and time forfeited.

Research on the outcomes of nontraditional PharmD programs has been limited. Piascik, et a1.(1) surveyed the first 30 graduates of the University of Kentucky's nontraditional PharmD program and reported that 63 percent of the respondents had made changes in their professional practice after receiving the PharmD degree. When students were requested to compare their current job responsibilities with BS pharmacists, the nontraditional PharmD graduates reported that their responsibilities were more clinical (78 percent) and greater in scope (76 percent). Fjortoft and Engle(2) surveyed 172 graduates of the nontraditional PharmD program at the University of Illinois at Chicago. Their results indicated that 69 percent of the respondents reported receiving a promotion or job change after completing the PharmD degree. The graduates reported that they spent less time in prescription processing and increased time in clinical, management, educational and research activities. Respondents from a national sample(3) reported spending a greater percentage of time on clinical activities. These graduates also indicated higher levels of job satisfaction in their first position with a PharmD degree than in their last position as a BS-trained pharmacist. The primary reason given for pursuing the nontraditional PharmD was to remain competitive in the profession. Many of the graduates received promotions or moved to another institution or new practice setting that allowed them to use their new clinical skills after they obtained the PharmD degree. The purpose of the survey reported here was to determine changes in career and practice of pharmacy for graduates of the University of North Carolina at Chapel Hill (UNC-CH) School of Pharmacy's External Doctor of Pharmacy Program.

METHODS

Program Description

The UNC-CH External PharmD Program was established during the spring of 1996 to provide an accessible means for practicing North Carolina pharmacists to enhance their ability to provide pharmaceutical care within their practice setting and to earn the doctor of pharmacy degree. As shown in Table I, the program consists of 25 hours of didactic coursework and seven clerkships. Traditionally, didactic courses in the UNC-CH external program have been provided using a combination of printed material, videotapes of on-campus lectures, interactive videoconferences and Internet discussion forums.

Once students complete the didactic portion of the program, they are eligible to begin the clerkship component. Overall, one medicine and six elective clerkships are required. In order to assure all students acquire baseline skills, the first clerkship must be a full-time, inpatient family medicine or general medicine clerkship. This full-time clerkship experience is used as a template for future clerkships which may be completed in a nontraditional manner. The elective clerkships may be completed by any of the following methods: full-time or part-time (modified) traditional clerkships and nontraditional clerkships that include the Pharmaceutical Care Experiential Learning Clerkship, Continuous Patient Care Clerkship, and Project Clerkship. The nontraditional clerkships are designed to be part-time and indirectly precepted at the students' practice site or another clinical site. The Pharmaceutical Care Clerkship requires students to develop and implement pharmaceutical care plans for a minimum of 16 patients. The Continuous Patient Care Clerkship provides an extended pharmaceutical care experience for the practitioner/student with six individual patients in his/her practice site. Each patient must be followed for a minimum of eight months. Project clerkships are clinically oriented projects done on a prospective basis over no more than an eight-month period. Students who completed one clinical clerkship in their BS curriculum may receive credit for one elective clerkship.

Survey Development and Procedure

A survey was developed to determine the impact of the PharmD degree on external graduates' careers and practice of pharmacy. The survey and cover letter were mailed to the first 107 graduates of the UNC-CH School of Pharmacy's External PharmD Program during June 2000. The 101-item questionnaire contained five domains including demographics, undergraduate student experience, external PharmD experience, professional practice after a PharmD and further comments. Item responses were multiple choice, frequency estimates, fivepoint Likert scale and open-ended.

Analysis

Frequencies of sociodemographic and practice characteristic variables were totaled, and percentages are reported. In addition, responses obtained from the questionnaire were used to categorize individuals into three groups based on: (i) receiving a promotion or job change since obtaining the PharmD degree; (ii) having current job responsibilities change since receiving the PharmD, but without a promotion or job change; and (iii) having no job or responsibility changes. Proportions of respondents in each category were tabulated with variables representing attitudes about the benefits of obtaining the PharmD degree and with the time spent in job activities. Distributions of important variables were graphed and summary statistics calculated. A graphical display of attitudes about distance education and the delivery of course materials were plotted. Data were analyzed using the SAS system for Windows, Version 8.01 (Cary, NC).

RESULTS

Eighty (75 percent) of the 107 graduates completed the survey. Six of the surveys were returned as undeliverable. A description of the respondents is provided in Table II. The typical graduate of the UNC-CH External PharmD Program is female, married and is 39 years of age. Sixty-nine percent of the respondents received their BS degree in pharmacy from the University of North Carolina at Chapel Hill, and 50 percent reported a cumulative BS degree grade point average of 3.01 or higher. The majority of the respondents (55 percent) practice in hospital pharmacy settings. Thirty-five (44 percent) respondents provided 75 percent or more of their education expenses from their own resources. Ten students (12 percent) incurred loans.

Results indicated that 35 (44 percent) respondents have received a promotion or job change since receiving the PharmD degree. Eleven additional students (14 percent) reported a change in job responsibilities. For those with a promotion or job change, 80 percent of respondents reported less time with prescription processing while more time was reported in educational activities (63 percent), clinical activities (58 percent), management (43 percent) and research (43 percent) as shown in Table III. Graduates with changes in job responsibilities reported increased time in clinical (64 percent) and educational (82 percent) activities.