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The value and disparity of preregistration training

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The future of pharmacy seems to have been in a state of flux since I enrolled as a pharmacy student in 2006. Nearly eight years on and the direction of pharmacy professionals still seems to be chaotic. A few weeks ago at the Royal Pharmaceutical Society conference Earl Howe discussed the reforms to pharmacy education and funding — a core part of the professions future direction. For many, this announcement was a sigh of disappointment as pharmacists anticipated hearing the consultation’s conclusion. Once again the future of the profession has been left to float wildly on the sea of speculation and uncertainty.

The Faculty did offer a glimmering ray of hope (http://www.pharmaceutical-journal.com/news-and-analysis/news/rps-faculty-celebrates-first-birthday/11139038.article). The Faculty has now opened its doors to pharmacists who have been qualified between two and ten years — reaching out to early career pharmacists, like myself, who were disappointed post-registration with the opportunities for recognisable career developments. Although the post-nominals that are awarded are somewhat obscure at the moment, MFRPSI and MFRPSII, with time they may become vitally prized accolades, they will certainly encourage pharmacists to reach FFRPS.

By awarding a recognisable achievement to pharmacists across any sector, the Faculty is attempting what no other organisation has done before; to unite the profession in a post-registration collegiate system. This can only be good for a profession that has so far failed to crystallise a clear career path. The career path of our colleagues in medicine can sometimes be looked at with envious eyes; a structure two-year foundation programme, followed by Core Training and Specialist Training with regular review and appraisal, leading to a completion certificate that can only be achieved after ‘a good hard slog’. Reflecting on that structure, I noted that all the medics I knew had to complete their preregistration year in a secondary care environment. Comparing this to my own experience, and the vicarious experiences of my friends and colleagues in community, I wondered if there was any merit in an obligatory or compulsory secondary-care aspect to the preregistration pharmacist year.

Naturally, I turned to Twitter for the answer. I asked “Could @FaceOfPharmacy and @WePharmacists ask if prereg training should be entirely hospital based? @rpharms @TheGPhC”. The premise was that from my friends experiences of community preregistration training, that preregistration training in secondary care delivered more valuable, clinical experiences. I expected most people to agree but I was surprised to see that those rumours were quite localised. One tweeter replied ‘rumour is hospital pre-reg is glorified 12-month medicines management technician’ and went on to suggest that a more varied preregistration training year was what was needed, citing academia and primary care as potential areas for expansion for preregistration training. He suggested that the disjointed identity in the pharmacy profession came from pharmacists working silos. Industrial, community, hospital, primary care are arguably the pre-nominals that dictate a pharmacists expertise and career path more than the post-nominals of the Faculty.

In my opinion, this would just cause greater disparity between registering pharmacists. I argued, via tweet, that if the preregistration year was more consistent across the profession, the professions identity, and consequently future direction, may be stronger. Indeed spending four years at university completing a degree preparing you for a professional career as a practitioner, and being treated as a shop assistant during placements with certain high street pharmacy service providers, must damage the professional identity and integrity of students and preregistration trainees.

Although Twitter may not have provided a very good platform to build a portfolio of evidence, I suggest that it does show that the issue of preregistration training providers is a question that should be asked. If preregistration training could only be completed in NHS hospitals, there would arguably be a shortage of pharmacists available to work in community on 1 August — this could be a way to ensure that locum rates stay viable and community pharmacy stays attractive as a career option. As the number of students completing an MPharm does not look as if it is going to be resolved soon, perhaps better regulation of preregistration providers could be a way to build a stronger identity and future for the profession.

Readers' comments (1)

  • Dear Mr Rathbone,

    I appreciate the problem and the suggested solution. However, I fear that by putting the whole pre-reg year in one particular setting (i.e. hospital pharmacy), we may risk destabilising the whole pharmacy profession that spans many different working environments. I wonder whether there is a survey on how hospital-trained pharmacists cope with community pharmacy workload, not because it is more demanding but just because it may be different enough to affect efficiency and safety. Besides, the argument that less competition thus more locum jobs become available probably needs re-thinking. Surely there would be less competition, but also less community-wise pharmacists to do the job properly (because 100% are trained in hospital).

    My apology if I miss any crucial point in your article.

    Best regards,

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