International Pharmacy Graduates Research Articles

Supporting unlicensed International Pharmacy Graduates in Canada: The IPG Mentorship and Integration Project.

Supporting unlicensed International Pharmacy Graduates in Canada: The IPG Mentorship and Integration Project.

Association between Pharmacists' Country of Qualifying Education and Practising in a Hospital Setting: A Cross-Sectional Ontario Study.

It is hypothesized that international pharmacy graduates (IPGs) are underrepresented in more clinically challenging work. To examine the association between country of qualifying education for pharmacists in Ontario and the likelihood of practising in a hospital setting. This study was based on publicly available data from the Ontario College of Pharmacists website, specifically records for all Ontario pharmacists with authorization to provide patient care and for whom country of qualifying education and an accredited pharmacy as a place of practice were reported. Pharmacists who met the inclusion criteria were categorized as Canadian graduates or IPGs. The odds ratio (OR) and 95% confidence interval (CI) for reporting hospital pharmacy as a place of practice were estimated by fitting a logistic regression, with adjustment for gender and years since graduation. A total of 14 689 pharmacists were included in the study: 7403 (50.4%) Canadian graduates and 7286 (49.6%) IPGs. These pharmacists worked in a total of 5028 accredited pharmacies (243 hospital pharmacies [4.8%] and 4785 community pharmacies [95.2%]). Among Canadian graduates, 2458 (33.2%) reported at least 1 hospital pharmacy practice site, whereas the proportion was much smaller among IPGs (427, 5.9%). Canadian graduates represented 85.2% (2458/2885) of all pharmacists who reported hospital practice. The estimated crude OR for practice in a hospital pharmacy was 7.98 (95% CI 7.16-8.91), and the adjusted OR was 7.12 (95% CI 6.39-7.98). IPGs may face barriers impeding their ability to practise in a hospital setting. Providing opportunities such as structured clinical training and experiential placements may facilitate integration of IPGs in institutional settings.

Pursuing postgraduate pharmacy training in the United States for international pharmacy graduates: Approaches, current status, challenges, and future perspectives

AbstractAimsThis paper aims to describe the procedures and current status regarding the pursuit of postgraduate pharmacy training in the United States for international pharmacy graduates. Also, it highlights some of the challenges those individuals may face throughout their journey and provides future perspectives.MethodsTo describe the procedures regarding the pursuit of postgraduate pharmacy training in the United States, we searched and summarized the information in public online platforms, such as the National Matching System, National Association of Boards of Pharmacy, and many others. To describe the current status, we searched the publicly available American Society of Health‐System Pharmacists residency online directory and the American College of Clinical Pharmacy fellowship online directory for programs offered to international pharmacy graduates.ResultsTwo main pathways were identified to pursue postgraduate pharmacy training in the United States for international pharmacy graduates. Of the currently available residency training programs, we identified 16 programs that offer postgraduate year one and eight programs that offer postgraduate year two positions for international pharmacy graduates. We identified 64 fellowship programs in the American College of Clinical Pharmacy fellowship directory. However, the directory does not provide information on whether or not these fellowship programs will accept international pharmacy graduates.ConclusionIn order to pursue postgraduate training in the United States, international pharmacy graduates face several logistical, administrative, and immigration obstacles. This is the first article to describe the current status, provide guidance on the approaches to pursue postgraduate pharmacy training in the United States, address some of the challenges, and provide several recommendations to be considered in the future.

Missing the other half: Considering institutional experiential training for international pharmacy graduates in Ontario.

Missing the other half: Considering institutional experiential training for international pharmacy graduates in Ontario.

Pharmacist working conditions.

I applaud the British Columbia College of Pharmacists for supporting an examination of pharmacist working conditions.1 This issue has been swept under the table for far too long, and it isn’t surprising to see that this study suggests that almost a third of pharmacists feel they are practising in an unsafe work environment. Almost 2 years ago, I had to walk away from a job that I really liked and patients I cared about because the practice environment was changed by corporate direction that took away pharmacist breaks and pharmacist overlap and affected patient safety. The absolute nail in my coffin was impacts to patient safety. My patients trusted me, and there was no way I could stay on when the organization I was working for made my work environment less safe for them. Pharmacists ensure patient safety and should not be influenced by the proprietor, but we are being forced to toe the company line or be replaced by international pharmacy graduates who are even more vulnerable to duress than their Canadian-trained counterparts.

Attaining Communicative Competency in Pharmacy Practice: A Retrospective Analysis of the Construction of a Communication Course for International Pharmacy Graduates

<p class="2M-body">The ability to communicate effectively is an essential skill required by licensed pharmacists and it plays an integral role in meeting standards of practice. Acquiring the communication skills needed to successfully complete these standards of practice can be particularly challenging for International Pharmacy Graduates, or IPGs, many of whom are second language learners. This paper retrospectively analyses the construction of a communication course for IPGs, viewed through the theories of Lev Vygotsky and Donald Schön, which assists the IPGs in developing their communication skills for the Canadian context and applying them in increasingly independent ways. Course satisfaction surveys from two IPG cohorts were reviewed for qualitative feedback that would discuss the students’ appreciation for the course design in relation to their learning. In general, students appreciated the learning supports in the first half of the course, but had more difficulty with the second half of the course that was designed to create a level of ambiguity that mimicked real life pharmacy practice. The authors felt more research is needed in this area of instruction design; however, this unique course design could have future implications for teaching communicative competency for international health care professionals.</p>

Postgraduation employment experiences of new pharmacists in Ontario in 2012-2013.

A recent shift in the pharmacy workforce away from stable, long-term employment has been reported by students. Few data exist regarding the postgraduation employment experiences of students. An electronic survey exploring postgraduation employment experiences was distributed to 2012-2013 graduates from the Universities of Waterloo and Toronto (including the International Pharmacy Graduate program). Follow-up interviews were undertaken to explore survey findings. THREE KEY THEMES EMERGED: 1) the rising prevalence of the "survival job" in pharmacy; 2) tension between professional satisfaction and practical considerations; and 3) an employment market characterized by personal networks, not merit. Fewer students are securing full-time positions with benefits, and more are relying upon temporary, part-time work with multiple employers. Implications of this employment pattern for the ability to form pharmacist-patient relationships and provide pharmaceutical care require further investigation. Further exploration of themes identified in this study is required, as is annual study of the experiences of new graduates. Their experiences will shape the future of professional practice and are of interest to academics, educators and practitioners.

Proposal of the Implementation of an International Pharmacy Graduate Preliminary Examination

At present, graduates of international pharmacy schools can apply to take the Korean Pharmacist Licensing Examination after passing a review by the Accreditation Board of the Pharmacy Schools and Licenses. However, since the educational content of different schools and the roles of pharmacists differ from country to country, a preliminary examination might be necessary before the Pharmacist Licensing Examination. To prepare to implement a preliminary examination for foreign pharmacy graduates in Korea, we summarized the preliminary examinations used in four other countries and presented a proposal for a preliminary examination. Data were collected via the internet and through telephone interviews with appropriate persons. The proposal was revised after a public forum. There are preliminary examinations in the USA, Canada, Australia, and the United Kingdom, and these involve written, oral, practice, and English proficiency tests. We proposed that the Korean preliminary examination consist of a written test on basic pharmacy, a test in the Korean language, and an interview. The preliminary examination should include suitable items that effectively evaluate international graduates. Graduates of international pharmacy schools who have an ability equivalent to graduates of Korean pharmacy schools should be eligible to write the Korean Licensing Examination.

Integrating international pharmacy graduates into the workforce

Integrating international pharmacy graduates into the workforce

“I just don't know what I'm supposed to know”: Evaluating self-assessment skills of international pharmacy graduates in Canada

Background Self-assessment skills are an integral part of pharmacy education and practice, yet there is very little empirical evidence in health professions to indicate that students and practitioners possess adequate and appropriate self-assessment skills. Objectives To evaluate self-assessment skills of international pharmacy graduates (pharmacists from outside Canada or the United States seeking licensure in Canada). Methods An 8-station objective structured clinical examination was used. Within each station, 2 trained and experienced pharmacist raters completed analytical and global assessments of participants. After each station, participants themselves completed the same assessments, as well as providing additional anecdotal feedback regarding their performance. In stations possessing sufficient interrater reliability, comparisons were made between raters' assessments and self-assessments. Results Across all performance quartiles there was a discrepancy between self-assessments and rater assessments of clinical performance. The discrepancy was largest in the lowest quartiles, suggesting impairment of self-assessment may be greatest amongst those who have the weakest skills. Conclusions Not all individuals possess adequate and appropriate self-assessment skills. Further work is required to elucidate the link between clinical competence and self-assessment and to determine methods for improving self-assessment skills.

New pharmacist supply projections: Lower separation rates and increased graduates boost supply estimates

ObjectiveTo revise the 2000 Bureau of Health Professions Pharmacist Supply Model based on new data. DesignStock-flow model. SettingUnited States. ParticipantsA 2004 estimate of active pharmacists reported by the Bureau ofLabor Statistics was used to derive the base count for the 2007 supply model. InterventionsStarting with a 2004 base of active pharmacists, new graduates are added to the supply annually and losses resulting from death and retirement are subtracted. Main outcome measuresAge- and gender-based pharmacist supply estimates, 2004–2020 ResultsIncreased U.S. pharmacist supply estimates (236,227 in 2007 to 304,986 in 2020) indicate that pharmacists will remain the third largest professional health group behind nurses and physicians. Increases were driven by longer persistence in the workforce (59%), increased numbers of U.S. graduates (35%), and increases from international pharmacy graduates (IPGs) achieving U.S. licensure (6%). Since more pharmacists are expected to be working part time the full-time equivalent (FTE) supply will be reduced by about 15%. The mean age of pharmacists was projected to decline from 47 to 43 by 2020. Because of unequal distribution across age groups, large pharmacist cohorts approaching retirement age will result in fewer pharmacists available to replace them. The ratio of pharmacists to the over-65 population is expected to decrease after 2011 and continue to fall beyond 2020; this is likely a reflection of baby boomers passing through older age cohorts. ConclusionThe revised estimated active U.S. pharmacist head count in 2006 is 232,597, with equivalent FTEs totaling approximately 198,000. The substantial increase over the 2000 pharmacist supply model estimates is primarily attributable to pharmacists remaining in the workforce longer and educational expansion. U.S. licensed IPGs account for less than 6% of overall increases. The pharmacist workforce is projected to become younger on average by about 4 years by 2020. Coincident demands for more physicians and nurses over the same period and shortages in all three professions stipulate that active steps be taken, including continued monitoring of work trends among pharmacists and other health professionals.

Geographical migration, psychological adjustment, and re‐formation of professional identity: the double‐culture shock experience of international pharmacy graduates in Ontario (Canada)

The experience of migrants with qualifications in health professions is of significance given current and projected skills shortages in western countries. The situation of pharmacy practice in Ontario (Canada) is unique in demonstrating an unusually high reliance on foreign‐trained professionals. This qualitative study examined the experience of migrant‐pharmacists in Ontario as they enculturate both personally and professionally. In negotiating re‐professionalisation and re‐licensure, these individuals reported instrumental use of professional qualifications to facilitate personal life goals, primary reliance upon mono‐cultural (rather than professional networks), an idealisation of the professional practice environment in their home country, and a diminishing social identification as a pharmacist. Most participants reported lack of engagement with the pharmacist community and a declining interest in their own professional status and development. Participants described a ‘double‐culture shock’ experience: adapting to both a new national and a new professional culture simultaneously. Addressing these issues is of importance in attracting and retaining immigrants with health professional qualifications and to engage them more fully in the professional community and their ongoing professional development.

Intersectoral collaboration to enable bridging education for pharmacists: The International Pharmacy Graduate Program in Ontario, Canada

As Canada’s economy and health care system become more reliant upon contributions made by individuals educated outside North America, there is an increasing need to develop systems and supportive programs to facilitate integration in the Canadian workforce. Collaboration between partners in different sectors is essential in ensuring success of such programs and systems. This paper reviews the development and outcome of inter-sectoral collaboration in the profession of pharmacy in Ontario, Canada. The need to develop such collaboration in pharmacy was particularly acute given the unusually high reliance upon internationally educated pharmacists in Canadian practice. The value of this collaboration, the way in which it developed and was nurtured, and challenges that emerged as part of the process, are discussed and analyzed as a case study example of how bridging education for internationally educated health care professionals may be operationalized.

“Testwiseness” Among International Pharmacy Graduates and Canadian Senior Pharmacy Students

To compare the test-taking skills and abilities (testwiseness) of Canadian senior-level pharmacy students with those of international pharmacy graduates. A 20-item testwiseness questionnaire was developed and administered to 102 participants: 35 senior-level pharmacy students, 34 international pharmacy graduates, and 34 practicing pharmacists who served as a control group. Mean testwiseness scores indicated significant differences in performance between senior-level pharmacy students and international pharmacy graduates. Testwiseness deficiencies of international pharmacy graduates were particularly severe in domains requiring discerning use of English language. Differences in testwiseness appear to exist between Canadian senior-level pharmacy students and international pharmacy graduates. The genesis and implications of these differences must be evaluated further in order to determine whether testwiseness affects learning, professional development, or clinical practice.

Influence of Attitudes Toward Curriculum on Dishonest Academic Behavior

The objective of this study was to examine possible associations between students' self-reported behaviors and opinions towards academic dishonesty, and their attitudes towards curriculum, assessment, and teaching within the pharmacy program. A questionnaire was developed and distributed to undergraduate (pre-licensure) students at 4 schools of pharmacy in Canada, including students enrolled in the international pharmacy graduate program. More than 80% of respondents indicated they had participated in one or more of the act of academic dishonesty described in the questionnaire. A weak to moderate correlation was found between students' attitudes towards pharmacy education and their self-reported behaviors related to academic dishonesty. This study confirmed previous findings suggesting widespread academic dishonesty as well as a hierarchy of values with respect to students' perceptions regarding severity and importance of academic dishonesty. Despite methodological limitations inherent in examining academic dishonesty, there is a definite need to continue to examine this important issue. While this study indicated only a moderate correlation between attitudes towards curriculum and dishonest behaviors, the problem of academic misconduct is multifactorial and will require ongoing study.

Impact of Facilitated Asynchronous Distance Education on Clinical Skills Development of International Pharmacy Graduates

The use of distance education for clinical skills development in the health professions has not been extensively described, due in part to the intensive nature of the relationship between the patient and practitioner. In the context of pharmacy practice, there are specific needs to develop new vehicles for clinical skills education due to growing shortages, particularly in rural areas. This article describes the experience of one model of facilitated, asynchronous clinical skills distance education for pharmacists educated outside North America who were seeking licensure in Canada. Findings suggest that this model may be an effective way of delivering clinical skills education, provided participants meet baseline English language fluency requirements.

Bridging education for foreign-trained professionals: the International Pharmacy Graduate (IPG) Program in Canada

Demand for well-qualified health care professionals (including pharmacists) is projected to increase over the next 10 to 20 years. In many jurisdictions, immigration will become an increasingly important human resource to replace aging, retiring workers and drive ongoing economic prosperity and growth. Higher education has been an underutilized resource for foreign-trained professionals seeking re-qualification. Bridging education provides a structured system for continuing professional development of professionals, linked to existing curriculum, assessments and standards in higher education. The International Pharmacy Graduate Program in Ontario (Canada) has developed a model that has been recognized by the provincial government as a ‘best-practice’ for bridging education. This model consists of four elements: prior learning assessment and recognition; university-benchmarked skills enhancement education; mentorship; and asynchronous learning opportunities. Success rates on licensing examinations for those completing all components of the program currently exceed 95%, indicating the value of bridging education.

Bridging Education in Pharmacy: The International Pharmacy Graduate Program in Ontario, Canada

Objectives. To describe development and implementation of a bridging education program for international pharmacy graduates who are seeking licensure as pharmacists in Canada. Design. The Internati...

Development of a Curriculum for Foreign-trained Pharmacists Seeking Licensure in Canada

Demand for well-qualified health care professionals (including pharmacists) is projected to increase over the next ten to twenty years. In many jurisdictions, immigration will become an increasingly important human resource to replace aging, retiring workers and drive ongoing economic prosperity and growth. A lack of a systematic professional development and enculturation program for immigrant-professionals may result in unnecessary barriers. Bridging education provides a structured system for continuing professional development of professionals educated outside North America to acquire competencies and meet domestic standards of practice. The International Pharmacy Graduate Program in Ontario (Canada) has developed a model that has been recognized by the provincial government as “best- practice” for bridging education. This model consists of five elements: prior learning assessment and recognition, individualized learning plans, mentorship, distance learning opportunities, and peer-network formation. In particular, individualized learning plans link to a series of university-based courses (Canadian Pharmacy Skills I and II) benchmarked to B.Sc.Pharm educational outcomes. This paper describes development of these courses and results on candidates’ success rates in national licensing examinations.

How Many Pharmacists Are in Our Future? The Bureau of Health Professions Projects Supply to 2020

ObjectiveTo describe a Bureau of Health Professions model for estimating the numbers and selected demographic characteristics of active pharmacists in the United States and to relate the model’s findings. DesignWe constructed a model using as base counts data from the Pharmacy Manpower Project census of 1989 to 1991 and advancing the counts annually based on estimates of pharmacists entering and leaving the workforce. The total number of active pharmacists in any year was the sum of the male and female cohorts from age 24 through age 75. The model and its underlying assumptions included consideration of U.S. graduates through 1998, international pharmacy graduates who become licensed in the United States, new schools, type of entry-level degrees, and separation states. A basic series and high and low alternative series were constructed based on different assumptions. ResultsThe basic series projected 196,011 active pharmacists in 2000, 224,524 by 2010, and 249,086 by 2020. Estimated pharmacists per 100,000 population were 71.2 in 2000, 74.9 in 2010, and 76.7 in 2020. The workforce was projected to consist increasingly of women: 32% in 1991, 46% in 2000, 50% in 2003, and 64% in 2020. Percentages of graduates receiving the BS degree fell from 94% (1980) to 64.4% (1998) and were projected to decrease to 0% by 2005. Estimated U.S. graduates were 7,945 in 2000, 8,133 in 2010, and 8,452 in 2020. The mean age in 2000 was 38 years for women pharmacists, 46 for men, and 42 overall. Estimates of total pharmacists in 1998 were similar to those from other sources, increasing confidence in the model. ConclusionThe Bureau of Health Professions model, which can be readily rewised as more and better data become available, provided estimates of active pharmacists by age and sex from 1991 to 2020. The model portrayed an increasingly female pharmacy workforce, with more pharmacists holding the PharmD degree. The model and data are useful for research, analysis, and health care planning.