PharmD options

While opportunities for pharmacists are only growing in the healthcare arena, those who lack a doctorate of pharmacy degree could face some rough seas ahead.

Many pharmacy leadership positions now require applicants to have the PharmD degree, rather than BS Pharm or an equivalent, and it's now the only track offered for new graduates who enter the field. At the same time, the number of pharmacy schools that offer a nontraditional option for pharmacists already practicing in the field is on the decline.

Idaho State University and Campbell University have both recently made the decision to discontinue their nontraditional option for PharmD students, leaving fewer than half a dozen programs still available in the United States.

"The applicant pool is dropping," said Vaughn Culbertson, PharmD, director of the nontraditional PharmD program at Idaho State University. "Most of the BS practitioners who wanted to get a PharmD degree I think have done so, so our applicant pool is declining. Plus there’s the fact that it's extremely hard for us to offer it across the country, nationally at least, because of the difficulty of finding clerkship sites in the student practitioner's area."

Ruth NemireDespite the smaller number of programs, pharmacists with bachelor's degrees who plan to continue practicing in pharmacy in the years ahead may want to at least consider pursuing the higher degree, said Ruth E. Nemire, PharmD, EdD, associate executive vice president and chief academic officer of American Association of Colleges of Pharmacy.

"I think many people have thought that the PharmD was a specialty pharmacy degree, but in 2014 it is not just a specialty pharmacy degree anymore," she said, adding that in the years ahead it will only become more prevalent. "We are going to need the pharmacists out there providing primary care and ambulatory care in places that we haven't been before."

The value of going back

Alla Marks, PharmD, made the decision to go back to school to earn her doctorate after finding that opportunities were closed to her at work. At the time, she was working as a therapeutic specialist at a large pharmaceutical company and wanted to apply for a position as medical science liaison within the organization.

Alla Marks

"I was not even able to interview for it, because I didn't have my PharmD," she said. "That gave me the wakeup that said, wait a minute, even by working in a specific institution, without the PharmD, I am not even considered."

She decided in her early 40s to return to school and ultimately ended up fulfilling a pharmacy practice residency at a Veterans Affairs medical center while also completing her PharmD degree through a nontraditional program.

"It was just really about managing time. I had to live away from my husband on the weekdays and then come to Northern Virginia on the weekends to spend time with him, but basically it was just managing time," she said.

Marks is now an associate professor and director of professional education at Shenandoah University, where she manages the school's nontraditional PharmD program. For her, she said, it was a decision that ultimately paid off.

"I am glad for it, because I wouldn't have had the experiences I've had in academia if I hadn't done that," she said.

Selecting a program

There are no separate accreditation requirements for nontraditional pharmD programs, according to Greg Boyer, PhD, assistant executive director and director of the professional degree program accreditation for the Accreditation Council for Pharmacy Education. Instead, he said, the ACPE evaluates the Doctor of Pharmacy degree as a whole, regardless of the number of pathways offered to achieve the degree.

"Essentially, if any one pathway falls short of the expectations of the ACPE accreditation standards, then the entire program is impacted and found lacking on the compromised standard or standards," he said.

While a handful of schools across the country have chosen to offer a nontraditional option as part of their PharmD program, each program is structured differently.

"They have some very big differences in how they provide their courses, in their practice experiences, and what the requirements are for those practice experiences," Nemire said.

The following is a breakdown of each school's unique features.

Howard University

Howard University, based in Washington D.C., has one of the more significant credit hour requirements for nontraditional programs but allows the lowest average time to complete the degree.

Youness KarodehYouness R. Karodeh, PharmD, RPh, assistant dean and program director for the Non-Traditional Doctor of Pharmacy degree program, said the program is distinctive because it is self-paced and somewhat fast-tracked.

"It's not an easy program," he said. "Any professional degree at a doctoral level really requires a lot of hard work, but because our applicants are already licensed pharmacists practicing in the United States, they do have a strong background, they do have strong skills, and the courses that are offered in the didactic portion of the program are new techniques and knowledge that will augment their previous schooling."

The school requires students to complete 65 credit hours, including 35 credit hours of didactic course work and an additional 30 credits for the experiential aspect of the program.

The didactic portion of the program is online and can be completed at a student's own pace; however, the school does require that all students participate in two executive weekends held on campus.  

Students are responsible for finding their own site to fulfill the experiential component of the program, which can be completed anywhere in the United States.

Idaho State University

For almost a quarter of a century, Idaho State University has offered pharmacists a nontraditional route to obtaining a PharmD, but Culbertson said the school has probably already enrolled its final group of students in the program this fall.

He said the school will reconsider the issue next autumn, but at present it is planning to discontinue its nontraditional program, which launched in 1990.

At present, students enrolled in the program must complete 37 semester credits in didactic education and complete three six-week clerkships.

"We videotape all of our classes taught to the traditional students here on campus, so that they have an opportunity to go back and review lectures and so forth. So what we've done is taken content from the video files we have and restructured it into coursework that is appropriate for practicing pharmacists," he said.

Pharmacists enrolled in the program receive a DVD with lectures they can work through on their own, and students take exams where they live by reporting to a proctor who administers the tests. The school makes every effort to secure clerkships near the student's home base, but the difficulty of finding clerkship locations is one reason the school plans to discontinue the program, Culbertson said.

"There are so many schools now that it is difficult finding clerkship sites that aren't already saturated with traditional student enrollments and experiential programs and so forth," he said, adding that legal requirements and a declining applicant pool also factored into the decision.

To date, 319 graduates have completed the program, which typically takes an average of three-and-a-half or four years to finish.

Shenandoah University

Twice a year, Shenandoah University admits a new cohort of about 30 students into its Non-traditional Doctor of Pharmacy Pathway program.

The program begins with six terms of online didactic learning courses, which run consecutively, and moves on to the experiential portion of the program, which includes acute care, ambulatory care, and medication information rotations.

While the lecture material, exams, assignments, and quizzes are exactly the same as those given to traditional students, participants in the nontraditional program are able to work through the course material at their own pace during the semester.

"Everything is activated on the first day of the term, so that they can study at their pace, but we give them a guided calendar of how to take exams every two weeks," she said.

A central aspect of Shenandoah University's program is its cohort-based design, under which students who enroll at the same time work consecutively through the six didactic courses together.

"We find that it's much more successful in terms of graduation rate, because they have each other as support and they do group projects together, so they have the active learning," Marks said.

Students who received their bachelor's degrees in the United States can seek sites close to home for fulfillment of their three experiential rotations, of which each accounts for five credits. International students in the program may have to take an additional rotation to gain more experience working in a retail or hospital pharmacy setting in the United States.

According to Marks, completion of the program takes an average of about two-and-a-half years. All students must complete it within seven years.

University of Colorado

The iPharmD program at the University of Colorado offers two separate tracks: one for licensed pharmacists working either in the United States or Canada, titled the North American-Trained Doctor of Pharmacy program, and another new track specifically for pharmacists licensed outside North America, titled the International-Trained Doctor of Pharmacy program.

Kari FransonThe North American track, which started in 1999, is a hybrid of distance-based learning and local experiential education. According to Kari Franson, PharmD, PhD, associate dean for professional education at the University of Colorado, the program requires a total of 65 credits, 30 of which are experiential.

"We've increased the amount of experiential learning over time, because we recognized that's what people want," she said.

The program, which typically enrolls between 30 and 60 students a year, enables students to complete most of the didactic requirements online at their own pace. The experiential requirements include six advanced pharmacy practice experiences that can be performed either within the student's home state or in Colorado. The school permits completion of one elective rotation outside of the United States.

"We ask our students to complete several clinical rotations and really demonstrate their clinical abilities while they are in the program," she said.

The average duration of program completion is just under four years.

The International track, which launched this year with three students, requires 90 credit hours. More credit hours are required for this track, Franson said, because international students must also be taught U.S. laws.

University of Florida

The nontraditional PharmD program at the University of Florida differs from some of the other programs in that it offers students a blended learning experience that includes attendance at monthly live day-long sessions as well completion of online coursework.

Sven NormanSven A. Normann, PharmD, DABAT, assistant dean of pharmacist education and international affairs, said that during each of the program's nine semesters, students are required to attend three live sessions in which they give case presentations, take exams, receive their assignments, and present on pharmacy topics. For completion of the live component of the program, the school has 18 regional sites across the country as well as three remote sites. The remote sites are structured slightly differently for students who are not within driving distance of a regional site, but they require the same overall number of hours.

 Each semester also includes about 20 hours of online lectures that students watch on their own.

Instead of requiring a clerkship, the school uses clinical practice assessments, which at present are performed in-house in a clinical setting at the University. The assessments, which take a minimum of four weeks, cover experience in both inpatient and ambulatory care settings, along with a fourth week of experience that is more flexible.

The school decided to perform assessments rather than require a clerkship, Normann said, in acknowledgement of the skill levels that some pharmacists have acquired through previous experience in the field.

"We said okay, what are the outcomes, what are the competency outcomes that are required in our curriculum? We looked at those and we developed a method in which the students could demonstrate their competency," he said.

While the program's enrollment numbers peaked at 700 at one point, Normann said, the program currently includes about 320 students.

"We still have a pretty healthy enrollment," he said.

Western University of Health Sciences

The nontraditional program at Western University of Health Sciences focuses primarily on pharmacists who earned their pharmacy degrees internationally and are interested in obtaining a PharmD degree in the United States.

Daniel RobinsonDaniel Robinson, PharmD, FASHP, dean of the College of Pharmacy, said the school accepts up to 20 students each year in the International Post-Baccalaureate PharmD program. After completing a campus interview and some testing to show that applicants possess the knowledge that would typically be covered during the first year of the school's traditional program, they admit the students into the second year of their traditional PharmD program. Students who are part of the nontraditional program then attend classes on campus along with the students enrolled in the traditional program.

"Once they enter into the second year, they are completely integrated from then on, so there is really no distinguishing our international students from our direct-entry students," he said.

The students are required to complete 76 experiential credits before receiving their degree.

Since the program began in 2003, 200 students have graduated from the International Post-Baccalaureate PharmD program. Robinson said students have come to the school from all over the globe and represent 25 different countries.

Jill Sederstrom is a freelance writer in Kansas City.