how to become a pharmacist

The main responsibility of a pharmacist in the retail setting is to accurately dispense medications to patients as well as provide counseling to them. They are responsible (as well as legally responsible) to ensure that the medication being dispensed is safe and the dosage is appropriate.

They must also review that the dispensed medications does not interact with other medications and/or dietary supplements the patient may be taking. As for day by day procedures, all companies use different systems to complete their operations.

As a general overview, the pharmacy gets the prescription, the pharmacist ensures all the data is correctly entered into their electronic record and from there the pharmacist conducts their drug utilization review. It is at this point they go over the patient's medication profile to review appropriate dosing and monitor for drug interactions etc.

The pharmacist is also legally responsible for consultation. Laws vary by state but in most cases they are responsible for conveying the following information to a patient:

The medicine's name
What it is supposed to do
When the medicine should be taken and for how long
How the medicine should be taken
Common side effects
Foods, drinks, other medicines, or activities you should avoid while taking the medicine
What you should do if you miss a dose
How you should store the medicine
If there are any refills of the prescription

The consultation (or counsel) is a very important part of the job. Pharmacists have in-depth and extensive knowledge of drugs and how they work and interact with the body. The information can get extremely technical and it is their responsibility to convey information in terms a patient can understand.

If a patient wants to know how warfarin works, do you tell them that warfarin inhibits the synthesis of vitamin K coagulation factors II, VII, IX, and X or do you say that warfarin is an anticoagulant, also known as a blood thinner, that has multiple uses including prevention of stroke and heart attack?

Depending on the patient, you may give either answer. If a biochemistry student asks you, you would probably go with option 1 but if an elderly woman asks, you should probably go with option 2. The good thing is you know both! Always cater to your audience.

Overall Retail Practice Positives & Negatives

Positives:

High starting salary
Flexible scheduling
Personal connections with patients

Negatives:

Fast Paced & Stressful
Limited use of pharmacy knowledge
Often need to deal with managed care insurance carriers
Limited upward mobility

In addition to the actual legal responsibilities, pharmacists are commonly regarded as the "first line" in the medical profession world.

Countless patients will call and stop by the pharmacy to ask you questions about pretty much any subject imaginable because you are a knowledgeable individual and most importantly, free (in their eyes)! Not only are you counted on to provide advice, but one of the most important things you do is knowing when to refer patients to a physician. Pharmacists are not trained in diagnosis and therefore need to know when to tell a patient to see a doctor!

Pharmacists will learn about 3rd party insurance and have open communication with physicians' offices and other healthcare professionals. The company you work for may have additional services such as medication therapy management, and comprehensive medication reviews.

You learn a lot of information in school and have extensive training in medications, disease state therapy guidelines, patient assessment and more.

Retail is also not for everyone. In most cases it is extremely fast paced and stressful. Burn out can be an issue as you are subjected to high stress and fatigue very often. Retail pharmacists typically are on their feet all day with short breaks. The work can also be repetitive.

Also, while pharmacists earn a high starting salary, the money does not change much over a pharmacist's career in retail unless you progress into management or diversify into other areas. Once you become a pharmacist, if you don't want to progress your career, you will likely be doing the same thing 20 years from now for a similar salary.

For some, this is all they could ever ask for, for others, not so much. Anyway, you will have experience in the retail setting during rotations and shadowing in school so you will have a good idea before you make the jump. Fortunately,if retail is not for you, there are a plethora of other options!

**Just a quick note to end this section on the retail setting. A major concern for all pharmacists really, but surely for retail pharmacists, is the concern for errors. Dispensing errors can and do happen. We are all human and no one is perfect. Unfortunately if a significant error does happen (such as checking an incorrect medication because you misinterpreted poor handwriting), it can be very serious for your career and you could have disciplinary action brought against you.

As a retail pharmacist, you are checking hundreds upon hundreds of prescriptions a day and even the smartest and most thorough will make a mistake at some point. It's just very important to realize you have a lot of responsibility riding on you and that responsibility includes the supervision of all the technicians involved in the preparation of a prescription. We don't want to scare anyone, but this news story has been a poster boy for what can go wrong. Click here for the story. Part of the reason for the high salary is the responsibility associated with it.

The Hospital Setting

Hospital

In the hospital setting, you are more involved with the actual mixing/preparation of medications and well as administration. Some hospital pharmacists "go on rounds" with the residents and physicians to look after and review their patients.

The hospital setting is becoming a dynamic field for pharmacists and is constantly evolving. In contrast to a retail pharmacy, hospital pharmacies typically stock a much different inventory of drugs. They have many more specialized medications and injections.

They also typically carry a wide range of drugs for intravenous use

that retail pharmacists have limited knowledge of. It is often difficult for pharmacists to transition to hospital pharmacy from retail and vice-versa.

Not only are the laws and regulations significantly different, but the pharmacy operations are fairly unique to each location. In general, hospital pharmacies are open for longer during the day that retail pharmacies. In many cases the pharmacies in hospitals are 24 hours and must be staffed by a licensed pharmacist at all times.

This of course means some late night shifts! The salary of a hospital pharmacist tends to be slightly lower than that of a retail pharmacist. It can be a great setting to work in to really apply all that knowledge and information you learned in pharmacy school.

Overall Hospital Practice Positives & Negatives

Positives:

Often use more clinical knowledge
Can be more hands-On
Work more in conjunction with MDs

Negatives:

Schedule (Could be a positive based on your preferences)
Lower Salary
Minimal contact with patients

Pharmaceutical Sciences

The pharmaceutical sciences field is more research and application oriented. Pharmacists practicing in the pharmaceutical sciences setting have in-depth knowledge regarding pharmacokinetics, pharmacodynamics and pharmacogenomics of medications.

Pharmacists in this field typically get into drug development and clinical research. For those interested in this field, we recommend reading our article: From The Lab To You: How Drugs Are Discovered, Made and Marketed.

In that article, we discuss in detail the process of how new drugs are formed and how they go about being tested. The pharmaceutical sciences is typically a different part of most pharmacy schools as the information you learn is very often quite different and specialized that than knowledge you obtain in pharmacy school. It's much more chemistry based.

Other Practice Settings

There are countless other practice settings and specialties that licensed pharmacists can get into. Nuclear pharmacy is a specialty that has been around for a long time and is a specialty that is recognized by the board of pharmacy. It takes specialized knowledge and skill to become a nuclear pharmacist.

It involves the use of radioactive materials to both diagnose and treat many diseases. Radioactive materials have a huge benefit to the medical community and as such, nuclear pharmacists are incredibly important.

Working in academia is always an option for a licensed pharmacist as there are many potential opportunities in this field. It combines the love of teaching and use of your pharmaceutical knowledge. In order to become eligible for an academia position, you typically need additional experience after pharmacy school such as completion of residencies.

A career in academia can be extremely fulfilling and give you the ability and resources to help shape future pharmacists as well as participate in research and academic studies.

MTM pharmacy is an up and coming field for the world of pharmacy. This specialty focuses on medication therapy management and helping patients with finding the most appropriate therapy for what is being treated. Historically, pharmacists have been compensated mostly on product (e.g. prescriptions).

With MTM, pharmacists are now being compensated by patients and insurance companies alike on services, just as you would pay your physician for a consult. MTM is extremely exciting for the profession and will continue to grow in the future. Many pharmacists occupy positions at health insurance companies or pharmacies and are considered MTM specialist pharmacists. it is a great specialty to get into to show off all the knowledge attained in school and impact lives.

Salary/Job Outlook

Before we get going with the schooling, let's talk salary. Salary obviously can vary depending on job position, geographical location etc. According to the Bureau of Labor Statistics, the average annual salary for pharmacists is $122,230, based on 2016 data.

Average hourly salary comes in around $50.00-$60.00 per hour. In the past (before 2012), sign on bonuses were common. The typical sign on bonus was around $2,500 and $20,000. Nowadays, especially in areas that are saturated with pharmacists (usually locations that have a pharmacy school), sign on bonuses are now extinct. In fact, in areas that are saturated, it can be difficult to find a position. Pharmacists do have the benefit of enjoying job security and stability. There are rarely layoffs for pharmacists, but of course that can change as time goes on and the landscape of the profession shifts.

Pharmacist Salary

Education

Pharmacists graduating from school today earn a PharmD, otherwise known as a doctor of pharmacy degree. Yes, pharmacists with a PharmD have the title of Doctor. Before the PharmD was available, pharmacists graduated with a bachelor's degree and do not have the doctor title. You can no longer graduate pharmacy school without a PharmD. There are a variety of ways to go about earning your degree and it depends on how the school you are looking into does it. Most commonly a pharmacist has been in school for 6 years, but increasingly pharmacists are staying in school for 8 years or longer.

A recent trend is for schools to offer an "accelerated" program allowing students to finish schooling in 5 years, typically by taking shorter breaks and longer semesters or trimesters. Right now, the most common progression is to go to school for 2 years as an undergraduate, complete the required classes with appropriate grades (more on this a little further down), take the test known as the PCAT (Pharmacy college admission test) and then apply to schools.

As always, there are differences among schools and programs, so look specifically into your prospective schools. For example, some schools REQUIRE a 4 year bachelor's degree before accepting applicants. Some schools allow students to do a pre-pharmacy/early assurance program and waive the PCAT exam altogether with appropriate grades.

The Undergraduate Years:

The classes taken as an undergraduate are typically the same classes that prospective physicians and biomedical science students take. These usually include:

Two semesters of General chemistry with lab
Two semesters of Organic chemistry with lab
Two semesters of Physics
Two semesters of Calculus
Two semesters of English
Four semesters of Biology (usually cell biology, life/evolutionary biology, microbiology and biochem)
Two semesters of Physiology
Two semesters of Social sciences
One semester of statistics.

So obviously this is no cake walk. Every school has slightly different requirements but this gives you a general idea of what you will need to complete. The classes themselves are certainly doable if you put in the time and effort and have a decent background from high school in math and science.

The PCAT

Most students have to take the PCAT (Pharmacy College Admission Test) if they plan on applying to multiple pharmacy schools. The PCAT is a standardized test with the following sections:

Verbal Ability
Biology
Reading Comprehension
Quantitative Ability
Chemistry

After completion of the exam, you are given a percentile of where you scored vs. others who took the test. Most pharmacy schools look at the sum of your percentile rank for each category. You typically need at least a 300 on the PCAT (an average of 50th percentile for all sections or in other words, you scored higher than 50% of the people taking the test) to be considered for admission. In terms of your overall grades, you typically need at least a 3.0 GPA but that's the bare minimum. You would have a much better chance of getting into a school with at least a 3.3 GPA (B+ average).

Pharmacy School Curriculum

Throughout school, you will do various shadowing and intern activities. Typically in your first year you have the opportunity to go and "shadow" (or follow) other pharmacy professionals in various settings to get a feel for what they do. After your first completed year of the school, you get licensed as a pharmacy intern and can complete all the work a pharmacist can do under their direct supervision. Your last year in school you are on rotations and will rarely set foot on campus. You will be traveling around to other pharmacy practice settings for experiential rotations to prepare you for when you graduate.

You do NOT get paid or compensated for shadowing or while being on rotations. You CAN get paid for interning however, provided you get your intern license from the state and find a job on your own to work at during school and during breaks. As an Intern, you will typically make decent money depending on who your employer is. Interns after just completing their first year of school, usually make around $10-$15 per hour while interning in your last year of school, you can make around $15-30 an hour.

How Much Does Pharmacy School Cost?

The cost varies depending on what school you attend, just like any college. Being a graduate/professional program, the price is going to steep no matter what. If you are looking for the most cost effective option, we certainly recommend going to a school located within your own state as there usually is significant savings.We will compare 3 schools here. All comparisons are for 1 academic year.

UB Pharmacy School Cost

The University At Buffalo offers significant savings for in-state residents but is still obviously expensive. If you were to take out all the estimated costs (housing, personal supplies, transportation) you are looking at over $29,000 for one year.

UCSF Pharmacy SChool Cost

As we can see, school is expensive, no matter how you look at it. Fortunately, pharmacists make a great salary right out of college and a student loan debt of $100,000 to $150,000 can be knocked off at a swift rate with careful planning. I know we all want to buy that new Audi with our great 100k salary but it pays to be prudent and carefully plan your financial future.

Pharmacy Licensing Exams

Finally we have reached the end of school and we are ready for our exams. There are commonly two to three exams you must pass to become a licensed pharmacist depending on the state in which you are taking the exams.

NAPLEX

NAPLEX

The North American Pharmacist Licensure Examination or NAPLEX is our principle board exam that tests our knowledge of pharmacy practice. It involves multiple topics learned in school from therapeutics to patient assessment. It also tests the applicants ability to identify safe and accurate methods of both preparing and dispensing medications. The NAPLEX surprisingly, is not a hard exam. The average pass rate for test takers is OVER 95%. If you paid attention in school and you study for the exam, you should pass no problem. The current cost (as of 2013) is $485.

MPJE

MPJE

All pharmacists must complete their state specific law exam. While the federal regulations are consistent throughout the states, each state has their own specific rules and regulations. If a pharmacists wishes to be licensed in more than one state, they must complete each of the states own law exam. The MPJE is typically the exam that students find the most difficult. The law can be confusing and the amount of material that can be tested on is overwhelming. Still, with proper studying, most students should be able to pass the exam.

Compounding

Not many states require this exam anymore but if you want to practice in states that do require it, you must take and pass it, regardless of where you initially got your pharmacy license. New York is an example of a state that continues to use this exam. The exam is split into sections, a written section and a laboratory session. We certainly recommend taking a preparation class for the compounding exam if you are not from a school that teaches compounding in detail. This exam is tricky and a small error (such as forgetting to put an expiration date on an IV bag) can result in failure of the exam.

There you have it! Once you have passed your examinations and completed the appropriate paperwork, you are now a licensed pharmacist! Even after becoming licensed, you have the option of continuing your education by completing two years of residencies or going out and looking for a job.

Frequently Asked Questions

Q: Is there a certain GPA you need in college to get into a pharmacy school?

A: There is no gold standard GPA you need to have in school to get into pharmacy school as every school has different requirements and GPA is only one part of the admission process. Typically you need at least a 2.5-3.0 GPA to be eligible to apply to schools.

Q: Are there only pharmacy schools where I can just take classes online?

A: There actually is one! Creighton University is mostly online. You will need in person experiential hours at local pharmacies however at some point in your college education so it isn't COMPLETELY online.

Q: What classes should I take in high school?

A: While your grades in high school don't factor into pharmacy school acceptance, they can give you a solid base of knowledge for upcoming college classes. I do recommend taking high level (e.g. AP) math and science classes in high school. Much of the material in those classes is similar to entry level college courses and can make them that much more manageable.

Q: How long is pharmacy school?

A: Pharmacy school is typically a four year program. The first 3 years you are taking classes and the fourth year you intern at local pharmacy institutions. Some pharmacy schools have accelerated programs that allow their students to graduate in 3 years. Before pharmacy school you must complete your undergraduate prerequisite classes which can take anywhere from 2-4 years.