Current State of Pharmacy Education in the Sudan

Abstract

To the Editor. The last decade has witnessed a great interest among Sudanese regarding pharmacy education. This resulted in establishment of a large number of pharmacy schools and continued submissions for approval of new ones. Currently there are 14 schools (5 public and 9 private), all but one of which are located in Khartoum. Their combined annual admission is about 1800 students (60-400 students per university), with fewer male students than female students (1:4). The undergraduate admission policy of these schools is governed by the Board of Higher Education of Sudan, which sets the minimum admission requirement as a “predetermined percentage” in Sudan High School Certificate (SHSC). Now pharmacy has become second only to medicine among students' choices for university education. The top SHSC students (about 700 out of 423,000) are usually admitted to the faculties of medicine, pharmacy, and dentistry at the University of Khartoum. Established in 1902, the University of Khartoum is the oldest and largest university in the country and graduates about 16,800 bachelor and 6,000 postgraduate students annually. The Faculty of Pharmacy at the university was established in 1964 and remained the only one for 3 decades. Before 1991, the number of students enrolled in the 5 years bachelor program was less than 200. As of 2009-2010, there were approximately 860 pharmacy students (330% increase) and about 170 graduate each year. The undergraduate curriculum follows the traditional full academic year system. The total number of hours for the bachelor of pharmacy degree (BPharm) is 3960 hours (4 years, excluding the preliminary year) and consists of 1680 hours of theory (42.4%) and 2280 hours of experiential work (57.6%). Additionally, students have 200 hours of training at a community or a hospital pharmacy after the second and third years, and 200 hours of pharmaceutical industry training at the end of the fourth year. Although some clinical aspects are taught sporadically throughout the curriculum, the majority of the teaching and practical training is product focused. Teaching methods are confined to large group lectures using the white board and multimedia projection and small group practical sessions. Traditional written, practical, and oral examinations and assignments are used to evaluate students' learning. The curricula and methods of teaching and evaluation are more or less similar at all pharmacy schools in the Sudan. The only exception is that some schools follow what is called a modified semester system where the academic year is divided into 2 semesters and each semester is evaluated separately. The challenges facing Sudanese pharmacy schools are finding the means with which to keep pace with recent developments in pharmacy education given the actual needs of our country and the facilities available. At present, the facilities, manpower and other resources available do not allow full operation of a patient-focused doctor of pharmacy (PharmD) or master of pharmacy (MPharm) degree program in Sudan. The most suitable alternative is to start by offering 2 options for the first pharmacy degree: bachelor of pharmacy (BPharm) or master of pharmacy (MPharm) to allow for a smooth transition between them. Clinically oriented teaching involves the availability of qualified clinical pharmacists for the supervision and follow-up of clinical activities as part of the curriculum. The country lacks such human resources. Accordingly, a 2-year master in clinical pharmacy (MCP) was established by the Faculty of Pharmacy, University of Khartoum, in 2004 before modification of the undergraduate curriculum. The program is the first of its kind in the country and attracts 70-100 applicants annually. Although class size is initially limited to 20 students, high demands on the program, especially by the Ministry of Health and other universities, have forced the Faculty to extend to 30 students. To date, the program has graduated 141 clinical pharmacists. Parallel to establishment of the MCP degree, restructuring of the pharmacy at the University of Khartoum-affiliated Soba Hospital to introduce modern services for clinical pharmacy training and practice was initiated. This was considered as a major breakthrough in hospital pharmacy service upgrading which was unprecedented by any other development for the past decades. Unfortunately, undergraduate curriculum development is held back by many constraints such as interdepartmental conflicts regarding the belonging of clinical pharmacy, fear among some academics that patient-focused teaching will replace their subjects, and shortage of qualified academic staff members. These difficulties need to be resolved in order to provide an educational program that can appropriately address contemporary and foreseeable future changes in the pharmacy profession. This requires a high level of collaboration between all involved parties. Sumia Sir-Elkhatim Mohamed, BPharm, MPharm, PhD University of Khartoum, Sudan