University Times

Applications to pharmacy schools nationwide are in a six-year downward spiral, one factor contributing to concern about a national shortage of pharmacists.

But Pitt's School of Pharmacy is bucking that trend, said a school official, and Pitt is producing graduates who meet the growing patient-care responsibilities of the professional pharmacist.

According to the American Association of Colleges of Pharmacy, applications to the 82 accredited U.S. pharmacy colleges and schools are down about 30 percent from 1994. Applications in the '90s peaked at 34,200, compared to 24,100 last year, the most recent figure available.

"However, in 1999-2000, while 44 pharmacy schools reported decreases in their application pools, 36, including Pitt,reported increases," said Gary Stoehr, Pitt pharmacy associate dean for student and academic affairs.

"These data, coupled with the increasing numbersof students taking the Pharmacy School Admission Test, indicate that the application pool decline may be bottoming out."

Stoehr said Pitt's increase in applications is partially due to the high ranking given the school. Pitt ranked 7th among the nation's schools and colleges of pharmacy in research funding awarded by the National Institutes of Health, topping more than $4 million in fiscal year 2000.

He added that fall 2000 enrollments were up nationally by 6 percent over fall 1999, and that the number of pharmacy first professional degrees conferred rose by a modest 1.7 percent over the previous year.

In addition to concern about pharmacy school applications, increased use of prescription medications, increased access to health care, expanded health insurance coverage and a lengthened pharmacy education program are factors causing an increasing demand for more and better-qualified pharmacists.

Anxiety over shortages prompted a U.S. Department of Health and Human Services study of the national pharmacy scene in 1999. The congressionally mandated study, released in December 2000, concluded that the nation faces a serious shortage of pharmacists, a side effect of which is the potential for medical errors due to stress and overwork.

There are 196,000 licensed pharmacists nationwide. The number is expected to grow by about 28,500 over the current decade, 800 fewer than the number of new licensees in the 1990s. And the demand for pharmacists continues to climb, the national study indicated.

The study estimated that there were 7,000 unfilled full- and part-time pharmacy positions nationwide as of February 2000.

"It should be noted there are also parallel shortages in several other health care fields, everything from medical/technical writers to tissue informatics specialists," Stoehr said. "This is not just limited to pharmacy." Medical and nursing schools showed declines in enrollment in recent years as well, he noted.

Part of the changing scene in pharmacy is due to a shift in educational programs that began in the early 1990s, when schools started awarding doctorates as their entry-level degree instead of bachelor's degrees.

In 1996, Pitt replaced its five-year bachelor of science program with a six-year doctor of pharmacy (Pharm.D.) program. At that time, about two-thirds of the 75 schools and colleges of pharmacy offered the Pharm.D. doctorate as their entry-level degree.

Currently, about 350 students are enrolled in Pitt's Pharm.D. professional program. Students must have completed the two-year, 62-credit pre-professional curriculum, typically taken in the College of Arts and Sciences, prior to admission to the four-year first professional program.

Based on current enrollment figures, the school expects to award 90-plus pharmacy doctorates a year, on average. (The first class to complete the new program, the class of 2000, had 97 graduates.) According to Stoehr, there are two special considerations in evaluating Pitt's application and enrollment pools.

"First, it's difficult to compare raw numbers of our application pool to other schools of pharmacy because manyadmit freshmen, and we don't," Stoehr said. "Instead, we offer conditional acceptance to high school seniors, but intentionally limit the number of students in this group, selecting only those who are truly likely to succeed. Other schools, Duquesne for example, admit large numbers of freshmen then go through a natural selection process to arrive at the same point."

Second, the number of high school students applying to Pitt for conditional acceptance to pharmacy declined with the 1996 elimination of the bachelor of science program, Stoehr said. But the number of students applying to transfer to the school has more than offset that decrease in the last few years.

"Much of the decline in applications comes from high school students unwilling to commit six years to their education," Stoehr said. "Pharmacy is attracting more and more students with prior degrees. Consequently, the quality of student admitted to the Pitt program, as measured by QPA and SAT scores, has increased over time. Our graduates' performance on both parts of the licensing exam continues to outpace state and national performances. Last year, 99 percent of the graduates taking the theoretical exam passed on their first try and 100 percent of our graduates passed the law portion of the exam on their first try."

Pitt pharmacy students spend at least two terms working with pharmacists in a clinical setting. Their training includes courses in pharmaceutical chemistry, pharmacology and clinical pharmacokinetics, part of a radically different curriculum from the school's bachelor-degree days.

Starting salaries for Pharm.D. holders can run in the six-figure range, particularly where shortages are most acute such as the Southwest, Texas and parts of California. "Our students are recruited for jobs while they're still in school," Stoehr said. A recent student survey indicated that 100 percent of respondents had jobs in the pharmacy field, one of the few positive aspects of the nationwide shortage.

Among the Health and Human Services study's recommendations for addressing the pharmacist shortage are to increase the responsibilities of non-Pharm.D. technicians, to streamline health insurance processes and third-party payment tasks, to build an Internet system that allows pharmacies to fill prescriptions and provide health information at remote sites and to develop technologies to aid in the distribution of pharmaceuticals.

–Peter Hart