“It’s the appliance of science, Brian!”
The ongoing debate about non-pharmacist pharmaceutical scientists joining the Royal Pharmaceutical Society has led us to consider the importance and function of science as a component of pharmacists’ professional identity.
The shaping of this identity commences on the first day of undergraduate education and training. When examining this process in a study five years ago, we interviewed students at a number of pharmacy schools, it was apparent to us that many perceived the MPharm to be largely a science degree rather than a vocational preparation for future professional life.
The scientific basis of the MPharm degree was further exemplified in recent weeks during final year oral examinations conducted at several pharmacy schools, in which students had readily to hand (the good ones at least) a wealth of detailed scientific knowledge about medicines — pharmacological, chemical, pharmaceutical and clinical — which they are able to put into the legal and ethical context of pharmacy practice. Asked if they would define themselves as scientists, the likely answer from such students would be a resounding “yes”.
Notwithstanding ongoing developments in courses designed to enhance the professional orientation of the MPharm, it remains characteristically a science degree. However this raises the question: “Is this appropriate as a preparation for practice?” Certainly, great swathes of science being taught to pharmacy undergraduates are hard to justify simply because they provide an “underpinning” for their future learning and practice. Science taught in abstraction from its application is neither an efficient nor a stimulating way of learning, nor is it an effective or appropriate way to introduce students to the social mores associated with their chosen occupation which are central to the process of professional acculturation.
Self-evidently, students require a scientific foundation to their professional practice, but contextualisation of science is essential. The traditional model of pharmacy education, whereby heads are first filled with scientific knowledge followed by consideration of how best to implement it into practice, is inefficient and increasingly anachronistic.
And what of practitioners — do they consider themselves scientists? We recently heard one pharmacist say to a professional colleague (albeit one not currently practising), “you would say that, you’re a scientist” — a curious riposte perhaps, suggesting that science is not considered core to pharmacists’ professional identity. Moreover, the label “scientist” was used in this instance, almost pejoratively: an illustration of the professional sectarianism we have witnessed on several occasions over the years. Much of the problem when discussing the place of science in practice (and this is a running sore that has beleaguered pharmacy for decades) is that somehow science and practice are frequently considered in opposition to each other, rather than being complementary.
Much of the debate thus far appears to have focused on reconciling a science-based undergraduate training with the reality of modern professional practice, which is increasingly patient-oriented. The importance of science to pharmacy extends well beyond its utilitarian value. It is all too easy to let the commonplace of practice obscure and diminish the true value of professional knowledge.
The practice of a GP, diagnosing the third case of an inner ear infection during a morning surgery, and subsequently writing the third prescription for amoxicillin suspension, might appear as mechanistic and far removed from GPs’ many years of academic training in the clinical sciences. Yet the public continues to consult with and, most importantly, trust the judgements of GPs because they and the State share confidence in their unique knowledge, insight and understanding of the human body.
Pharmacists, too, currently posses an unparalleled breadth and depth of scientific understanding of all aspects of medicines that distinguishes them from other members of the healthcare team. This unchallengeable sphere of expertise, which when utilised for patient benefit, legitimises their professional status. The activity of dispensing, or checking the dispensing of yet one more patient pack of omeprazole capsules, appears far removed from a pharmaceutical science-based education. However, pharmacists, like doctors, retain the confidence of both the public and the State, since they alone have the insight and understanding of medicines, rooted in a scientific understanding of their chemistry, pharmacology, formulation and modes of delivery.
Blueprint for pharmacy
The General Medical Council’s document “Tomorrow’s doctors”, which is predicated on the doctor being a scholar, a scientist, a practitioner and a professional, makes for an excellent blueprint to shape pharmacy’s future professional development, in so much as it embraces the scientist/practitioner nexus and links it inextricably with a professional remit that involves knowledge generation and application.
An effective, modern pharmacy curriculum recognises the importance of both science and practice which, when seamlessly integrated, strengthens the role and functions of pharmacists, both intra- and inter-professionally. Thus modern pharmacy curricula being developed by all schools aim to achieve this integration, increasingly incorporating opportunities for workplace learning to provide a context for students in which to learn and apply their scientific knowledge.
The importance of pharmaceutical science to pharmacy is clearly evident. A vibrant profession needs not only to own and use a unique body of knowledge, but should also be actively engaged in creating new knowledge. Science and practice should ideally co-exist symbiotically within pharmacy. At a time in which traditional identities within healthcare – bounded by knowledge and skills — are diminishing in response to calls for ever greater service efficiency and cost cutting, a thriving contemporary profession should celebrate and strengthen its unique knowledge base, not undermine it.
Citation: The Pharmaceutical Journal URI: 11080639
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