Pharmacists advise health professionals and the public on the proper selection and use of medicines. The special knowledge of the pharmacist is needed because of the complexity and potential side effects of the large and growing number of pharmaceutical products on the market.
In addition to providing information, pharmacists dispense drugs and medicines prescribed by physicians, podiatrists, and dentists. Pharmacists must understand the use, composition, and effects of drugs and how they are tested for purity and strength. Compounding--the actual mixing ingredients to form powders, tablets, capsules, ointments, and solutions--is now only a minuscule part of a pharmacist's practice, since most medicines are produced by pharmaceutical companies in the dosage and form used by the patient.
Pharmacists practicing in community pharmacies may have other duties. Besides dispensing medicines, these pharmacists--especially those who are small-career owners- -buy and sell nonhealth-related merchandise, hire and supervise personnel, and oversee the general operation of the pharmacy. Some pharmacists, however, practice in community pharmacies that dispense only medicines, medical supplies, and health accessories. Increasingly, pharmacists give advice about and provide durable medical equipment and home health care supplies.
Widespread use of computers in retail stores allows pharmacists to create medication profiles for their customers. A medication profile is a computerized record of the customer's drug therapy. Pharmacists use these profiles to insure that harmful drug interactions do not occur and to monitor patient compliance with the doctor's instructions-- by comparing how long it takes the patient to finish the drug versus the recommended daily dosage. Pharmacists in hospitals and clinics dispense medications and advise the medical staff on the selection and effects of drugs. They may make sterile solutions, buy medical supplies, teach health professions students, and perform administrative duties. They also may be involved in patient education, monitoring of drug regimens, and drug use evaluation. In addition, pharmacists work as consultants to the medical team on drug therapy and patient care. In some hospitals, they make hospital rounds with physicians-- talking to patients and monitoring pharmaceutical use. Their role is crucial to safe, efficient, and proper therapeutic care.
Some pharmacists prepare and dispense radioactive pharmaceuticals. Called radiopharmacists or nuclear pharmacists, they apply the principles and practices of pharmacy and radiochemistry to produce radioactive drugs that are used for patient diagnosis and therapy.
Pharmacists usually work in a clean, well-lighted, and well-ventilated area that resembles a small laboratory. Shelves are lined with hundreds of different drug products. In addition, some items are refrigerated and many substances (narcotics, depressants, and stimulants) are kept under lock and key. Pharmacists spend a lot of time on their feet. When working with potentially dangerous pharmaceutical products, pharmacists must take the proper safety precautions, such as wearing gloves and masks and working with special protective equipment. Because pharmacies in many communities and hospitals are open around the clock, pharmacists in those settings may have to work evenings, nights, weekends, and holidays.
Pharmacists held 164,000 jobs in 1990. The majority of pharmacists practice in community pharmacies, which can be independently owned, part of a national drug store chair, nor even part of a grocery or department store.
Hospitals are the second largest employer of pharmacists. Health maintenance organizations (HMO's), home health agencies, and clinics provide a relatively small but rapidly growing number of jobs. Pharmacy services in nursing homes generally are provided on a consultant or contract basis rather than by staff pharmacists.
Pharmacists employed by the Federal Government work chiefly in hospitals and clinics of the Veterans Administration and the U.S. Public Health Service. State and local health departments, pharmaceutical manufacturers, and professional associations also employ pharmacists. Some pharmacists held more than one job. They may work a standard week in their primary work setting and work several hours a week in a secondary setting, as a consultant to a nursing home or clinic, for example.
Although most rural areas and small towns have at least one pharmacy, most pharmacists practice in or near cities that have the largest populations. All States require a licensed pharmacist to be in attendance during pharmacy hours.
Self-employed pharmacists usually work more hours per week than those in salaried positions because of the additional responsibility of managing a career.
Training, Other Qualifications, and Advancement
A license to practice pharmacy is required in all States, the District of Columbia, and U.S. territories. To obtain a license, one must graduate from an accredited pharmacy program (a few States allow graduate from certain foreign pharmacy programs), pass a State board examination, be over 21, demonstrate good character, and--in all States--have a specified amount of practical experience or serve an internship under the supervision of a licensed pharmacist. Internships generally are served in a community or hospital pharmacy.
At least 5 years of study beyond high school are required to graduate from programs accredited by the American Council on Pharmaceutical Education in the 72 colleges of pharmacy. Five years are needed to obtain a Bachelor of Science (B.S.) or a Bachelor of Pharmacy (B.Pharm.) degree, the degrees received by most graduates. A Doctor of Pharmacy (Pharm.D.) degree normally require 6 years, during which an intervening baccalaureate degree is not awarded. Students who already hold the baccalaureate degree may be admitted to Pharm.D. programs, but the combined period of study is usually longer than 6 years. Most pharmacy schools offer the baccalaureate degree, and over one- third also offer the professional doctorate degree; eight schools offer only the latter. The Pharm. D. degree as well as the B.S. and B.Pharm. degrees may serve as the entry degree for licensure as a Pharmacist.
Admission requirements vary. A few colleges admit students directly from high school. Most colleges of pharmacy, however, require entrants to have completed 1 or 2 years of prepharmacy education in an accredited junior college, college, or university. A prepharmacy curriculum usually emphasizes mathematics and basic sciences, such as chemistry, biology, and physics, but also includes courses in the humanities, social sciences, and career administration. Because entry requirements vary among colleges of pharmacy, prepharmacy students should acquaint themselves with the requirements of the school they wish to attend.
The bachelor's degree in pharmacy is the minimum educational qualification for most positions in the profession. An increasing number of students are enrolled in advanced professional programs leading to the Pharm.D. degree. The Pharm.D. degree, which may be either an entry level or graduate one, is increasingly important for clinical pharmacy work. A master's or Ph.D. degree in pharmacy or a related field usually is required for research, and a Pharm.D. master's, or Ph.D. usually is necessary for administrative or faculty positions.
Fifty-five colleges of pharmacy offer the Master of Science degree and 48 offer the Ph.D. degree. Although a number of pharmacy graduates interested in further training pursue an advanced degree in pharmacy, there are other options.. Some enter 1- or 2-year residency programs or fellowships. A pharmacy residency is an organized, directed, postgraduate training program in a defined area of pharmacy practice. A pharmacy fellowship is a directed, highly individualized program designed to prepare the participant to become an independent researcher.
Areas of special study include pharmaceutics and pharmaceutical chemistry (physical and chemical properties of drugs and dosage forms), pharmacology (effects of drugs on the body), pharmacognosy (drugs derived from plant or animal sources), hospital pharmacy, and pharmacy administration. Courses in pharmacy administration are particularly helpful to pharmacists in developing the skills needed to manage a community or institutional pharmacy.
All colleges of pharmacy offer courses in pharmacy practice, designed to teach students the skills involved in compounding and dispensing prescriptions, and to strengthen their understanding of professional ethics and responsibilities. In many cases, professional training increasingly emphasizes direct patient care as well as consultative services to other health professionals.
Colleges of pharmacy also instruct students in the use of computers in the pharmacy. Computers are used to create patient medication profiles, to file and record prescriptions, and for inventory control, billing, and other administrative tasks.
Pharmaceutical manufacturers, chain drug stores, State and national pharmacy associations, colleges of pharmacy, and other organizations award scholarships annually to students studying full time toward a degree in pharmacy. Prospective pharmacists should be orderly and accurate and have the ability to gain the confidence of clients and patients.
Pharmacists often begin as employees in community pharmacies. After they gain experience and secure the necessary capital, they may become owners or part owners of pharmacies. A pharmacist with experience in a chain drug store may advance to a managerial position, and later to a higher executive position within the company. Hospital pharmacists who have the necessary training and experience may advance to director of pharmacy service or to other administrative positions. Pharmacists in industry often have opportunities for advancement in management, sales, research, quality control, advertising, production, packaging, and other areas.
Some individuals put their pharmaceutical training to work in related fields. Experienced pharmacists may be hired as sales or service representatives by pharmaceutical manufacturers and wholesalers. They sell to community pharmacies and hospitals and inform physicians about new drugs. Other pharmacists teach in colleges of pharmacy, supervise the manufacturer of pharmaceuticals, or are involved in research and development. Pharmacists also edit or write technical articles for pharmaceutical journals. Some combine pharmaceutical and legal training in jobs as patent lawyers or consultants on pharmaceutical and drug laws.
Employment of pharmacists is expected to grow faster than the average for all occupations through the year 2000, mainly due to the increase pharmaceutical needs of a larger and older population.
The increased number of middle-aged and older people will spur demand in all practice settings. Projected rapid growth in the elderly population is especially important since the number of prescriptions influences demand for pharmacists, and people over the age of 65 use twice as many prescription drugs, on the average, as younger people.
Other factors likely to increase demand for pharmacists through the year 2000 include the likelihood of scientific advances that will make more drug products available for the prevention, diagnosis, and treatment of diseases; new developments in administering medication, such as skin patches and implantable pumps; well-informed consumers, increasingly sophisticated about health care and avid for detailed information about drugs and their consequences; and improved health insurance coverage for prescription drugs.
Demand for pharmacists will be especially strong in community pharmacies. Pharmacist employment will increase with the expansion of pharmacy services into nontraditional settings such as grocery stores and department stores. At the same time, the number of traditional drug stores should continue to grow. Employers in retail settings such as these prefer graduates of entry level degree programs in pharmacy.
The number of pharmacists in hospitals is expected to grow despite pressure from third-party payers to curtail hospital industry growth. The increased severity of the typical hospital patient's illness, together with rapid strides in drug therapy, is likely to heighten demand for clinical pharmacists in hospitals, HMO's, and other health care settings.
Another factor pointing to solid job growth for hospital pharmacists is the cost control effort: Increasingly, pharmacists are being assigned to scrutinize the cost-effectiveness of pharmaceutical products. Employment prospects will be especially good for applicants who have a doctorate or who have completed residency training programs.
The job outlook for pharmacists is expected to be excellent. If current supply- demand trends persist, shortages are likely in some communities and practice settings. Shortages may develop in States with large concentrations of the elderly, for example. Employers unable to offer competitive salaries--hospitals and Veterans Administration medical centers, in particular--may experience continued difficulty attracting and retaining clinical pharmacists.
As in other occupations, most job openings will result from the need to replace pharmacists who leave the profession. In pharmacy, this generally means retirement, for pharmacists--like physicians and dentists--tend to remain in the field until they retire. Relatively few transfer to other lines of work.
Salaries of pharmacists are influenced by the location, size, and type of employer; the education and professional attributes of the pharmacist; and the duties and responsibilities of the position. Median annual earnings of full-time, salaried pharmacists were about $39,569 in 1990. Most earned between $33,589 and $45,800. The lowest 10 percent earned less than $26,290 and the top 10 percent, more than $52,100.
Pharmacists working in chain drug stores had an average base salary of $44,600 per year, while pharmacists working in independent drug stores averaged $40,400, according to a survey by Drug Topics magazine. The average starting salary for pharmacists working in hospitals, medical schools, and medical centers was about $28,300 a year in 1990, according to a national survey by the University of Texas Medical Branch; experienced pharmacists in these workplaces averaged about $40,476 a year. Pharmacists who do consulting work in addition to their primary job may have total earnings considerably higher than this. Experienced pharmacists, particularly owners or managers of pharmacies, often earn considerably more.
Pharmacists dispense the prescription orders of physicians, dentists, and other health practitioners and are responsible for selecting, compounding, dispensing, and preserving drugs and medicines. Workers in other professions requiring similar educational training and who work with pharmaceutical compounds or perform related duties include scientists, pharmaceutical chemists, and pharmacologists.
Sources of Additional Information
Additional information on pharmacy as a career, preprofessional and professional requirements, programs offered by all the colleges of pharmacy, and student financial aid is available from:
American Association of Colleges of Pharmacy, 1426 Prince St., Alexandria, VA 22314.
General Information on independent retail pharmacies is available from:
National Association of Retail Druggists, 205 Daingerfield Road, Alexandria, Va 22314.
General information on the chain drug stores industry is available from:
National Association of Chain Drug Stores, Inc., 413 N. Lee St., P.O. Box 1417-D49, Alexandria, VA 22313.
Information about hospital pharmacy can be obtained from:
American Society of Hospital Pharmacists, 4630 Montgomery Ave., Bethesda, MD 20814.
For a list of accredited colleges of pharmacy, contact:
American Council on Pharmaceutical Education, 311 West Superior St., Chicago, IL 60610.
Information on requirements for licensure in a particular State is available from the Board of Pharmacy of the State or from:
National Association of Boards of Pharmacy, O'Hare Corporate Center, 1300 Higgins Rd. Suite 103, Park Ridge, IL 60068.
Information on specific college entrance requirements, curriculums, and financial aid is available from the dean of any college of pharmacy.