Which is the best way to address the pharmacist oversupply issue?
From Professor D. Q. M. Craig, FRPharmS, and others
The recent debate and Higher Education Funding Council for England consultation on MPharm student numbers in England has produced the expected diversity of views, with HEFCE suggesting three possible courses of action for consideration (PJ 2013;291:425).
First, there is the “free market” option, whereby there is no entry control and students compete for preregistration places on the basis of their quality and suitability for the positions available. Secondly, there is the control at entry model, whereby schools are designated a set number of students that they are allowed to recruit. Finally, there is the “in-process” model whereby a decision is made within the degree as to which students move on to a four-year MPharm and which graduate with a three-year bachelor’s degree, with the ratio being flexible according to workforce need.
The outcome of this discussion will have implications well beyond the immediate situation in schools of pharmacy because the quality as well as quantity of the future UK workforce is in the balance here. We believe that it is crucial that consideration be given to how we ensure that we have the most highly trained and committed graduates possible, and it is this quality agenda that should determine the decision rather than seeing the issue as simply being a numbers game among schools of pharmacy. To achieve this quality agenda we must consider the implications of any decision on the standard of the pharmacists produced and the practicalities of implementation.
We believe that the free market approach certainly has attractions because employers will be able to choose from a pool of applicants according to their workforce needs and students will be able to select their chosen school on the basis of where they believe they will receive the highest quality education and support for subsequent preregistration training. We also believe that the control on entry model has the potential to allow a quality agenda. However, we would support this option only if there were guarantees of transparent and quality-based criteria (“A”-level entry grade or registration examination results, for example). As yet, no such criteria have been put forward and hence this option represents a considerable risk. The reality is that it may be implemented on a “minimum fuss” basis and result in a simple cross-school cut, irrespective of the quality outcome.
Our view is that the flexible in-process model is almost certainly unworkable because it would be difficult in the extreme to implement the transfer decision on a fair and flexible basis throughout the schools and would lead to financial and staffing planning becoming almost impossible. We also believe that there needs to be a moratorium on opening any new providers that are not already well advanced (beyond stage 2 accreditation) for a period of two or more years until the current issues have been resolved.
Any reasonable outsider would look with incredulity at the current situation whereby we are simultaneously opening new schools and debating numbers control.
However, we reiterate our central point: the decision that is reached must be based primarily on the quality of the pharmacists that will be produced. If we go down the path of convenience or egalitarianism we will not just damage those schools that are committed to promoting excellence in pharmacy, we will damage and limit the future of the profession itself.
UCL School of Pharmacy
Head of the School of Pharmacy and Pharmaceutical Sciences
Dean of Pharmacy
Head of the Department of Pharmacy
King’s College London
Head of the Manchester Pharmacy School
University of Manchester
Head of the Aston Pharmacy School
Head of the School of Pharmacy
Head of the School of Pharmacy
University of Nottingham
Head of the Department of Pharmacy and Pharmacology
University of Bath
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11129483
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