Specialty Tracks Research Articles

Emerging Trends in the Prevalence of Military Medicine Interest Groups and Specialty Tracks at U.S. Medical Schools.

A challenge confronting health care is the national physician shortage, notably impacting the DoD's recruitment of military physicians. To address this, the Health Professions Scholarship Program is annually awarded to medical students to facilitate their transition into the U.S. Armed Forces. There is a glaring absence of military medical education in civilian schools to accommodate the unique interests of these students. While medical schools have adapted with interest groups and specialty tracks, the current presence of military medicine interest groups (MMIGs) and military medicine specialty tracks (MMSTs) remains under-explored. This study aimed to (1) update the prevalence of MMIGs in U.S. medical institutions, (2) identify the presence of MMSTs, and (3) compare military medicine involvement between allopathic and osteopathic programs. The study was approved for exempt status from the Kansas City University Institutional Review Board (study number 20,211,568-1). In a cross-sectional analysis, surveys were sent to 208 U.S. medical schools, with responses from student services or available public data from 200 institutions included in the final analysis. A secondary survey was sent to respondents who provided MMIG or MMST contacts. Results indicated that 62% (n = 124/200) of schools currently have an established MMIG, a modest growth from 56% (n = 70/125) in 2015 (p = .14). MMST prevalence, however, is minimal at 2.5% (5/200). Osteopathic institutions demonstrated a significantly greater engagement in military medicine education (88.7%) compared to allopathic schools (52.4%) (p < .001). This research underscores the need for comprehensive military medical training in medical schools to meet the interests and career aspirations of their students. Future studies should also evaluate the efficacy of MMIGs and MMSTs in preparing students for military medical roles.

Culinary Medicine: Needs and Strategies for Incorporating Nutrition into Medical Education in the United States.

In the past decade, medical education has increasingly incorporated evidence-based lifestyle interventions as primary strategies for preventing and managing noncommunicable diseases. This shift embraces the growing recognition of the significant impact of lifestyle on health outcomes, driving diseases including obesity, diabetes, heart disease, and cancer. Now deemed "food is medicine" (FIM), diet-related interventions witnessed integration into healthcare systems and recognition in the United States' White House Conference on Hunger, Nutrition, and Health in 2023. As FIM gains traction, investigating optimal strategies for team-based education becomes essential. Healthcare teams need the necessary knowledge and tools to effectively administer FIM services and collaborate across disciplines, ultimately enhancing disease prevention, chronic disease management, health quality, value, and overall wellness. Culinary medicine (CM), a vital component of FIM, bridges nutrition education, pragmatic culinary skills, and conventional strategies to improve chronic disease management. CM involves experiential learning, imparts practical skills, and encourages behavior change by addressing food-related determinants of health and promoting equitable access. Teaching kitchens serve as physical or virtual learning spaces and as a didactic and experiential method (skills lab), playing a crucial role by integrating culinary, lifestyle, integrative, and conventional medicine. A growing number of medical schools in the United States and globally offer CM education via diverse methods including interest groups, electives, and specialty tracks, encompassing didactic sessions, hands-on kitchen education, and virtual teaching methods. Given the rising demand for CM programs, this article aims to describe, map, and compare existing CM education types in medical education. It provides actionable recommendations for medical schools to establish and expand CM programs by fostering service-learning partnerships, clinical innovation, and interdisciplinary research. As FIM gains prominence, cultivating a robust foundation of educational strategies is vital to ensure seamless integration into both medical education and collaborative medical practice.

Pathophysiology and pharmacology course grades and prediction of success in a graduate nurse practitioner program.

During a program review, faculty identified that nurse practitioner (NP) students who received a C grade in Advanced Pathophysiology (Patho) and Advanced Pharmacology (Pharm) appeared to perform poorly in the later NP management courses and on other program outcomes. The research aimed to determine whether grades in graduate Patho and Pharm courses could predict performance in NP management courses, program progression and completion, and certification pass rates. This research included deidentified student data from 2016 to 2018 across seven NP specialty tracks ( n = 4,575). Nonparametric and parametric tests were used in the analysis. A significant correlation ( p < .001) existed between Patho and Pharm grades. Lower grades in these two courses were significantly related to each other and to lower management course grades. Logistic regression showed that graduate pathophysiology grades significantly predicted certification examination performance, with lower grades associated with lower certification examination performance. Graduate pharmacology grades, pathophysiology grades, composite management course grades, and admission grade point average (GPA) significantly predicted final cumulative GPA, with lower grades associated with lower performance for all variables. Results of this research support the hypothesis that grades of C in Patho or Pharm courses significantly predict C performance in the management NP courses and lower certification success rates. The project model can be used in future research. Study findings can be helpful to NP faculty when considering curriculum decisions.

Everyday Water-Related Emergencies: A Didactic Course Expanding Wilderness Medicine Education.

This small group session is appropriate for any level of emergency medicine resident physicians. Drowning is defined as the process of experiencing respiratory impairment from submersion or immersion in liquid. It is the third leading cause of unintentional injury-related deaths worldwide, accounting for 7% of all injury-related deaths.1 Our group sought to improve resident education regarding the basics of water safety and rescues as an event developed by our wilderness medicine (WM) interest group. With the growing number of WM Fellowships, specialty tracks, interest clubs and the regular inclusion of WM topics in residency didactics, exposure to WM topics has increased greatly.2 There is a large overlap between wilderness medicine and the field of emergency medicine. Both require stabilization, improvisation, and the treatment of environmental/exposure illnesses. It is imperative that emergency medicine physicians understand the complex pathophysiology of drowning, as well as recognize and manage potential associated traumatic injuries including fractures and critical hemorrhage. Our goal is to provide additional curricular instruction on prehospital management of water-related emergencies and related injuries to emergency medicine residents. By the end of the session, the learner will be able to: 1) describe the pathophysiology of drowning and shallow water drowning, 2) prevent water emergencies by listing water preparations and precautions to take prior to engaging in activities in and around water, 3) recognize a person at risk of drowning and determine the next best course of action, 4) demonstrate three different methods for in-water c-spine stabilization in the case of a possible cervical injury, 5) evaluate and treat a patient after submersion injury, 6) appropriately place a tourniquet for hemorrhage control, and 7) apply a splint to immobilize skeletal injury. A group of 16 resident learners received a thirty-minute introduction discussion (with open discussion) regarding water safety, basic water rescue methods, and submersion injury pathophysiology. They then progressed through three stations designed to emphasize select skills and knowledge related to submersion injury management, water rescue, and tourniquet and splint placement. Participants completed a six-item questionnaire after the event designed to help gage participant comfort level of treatment, management, and experience regarding water safety, drowning, and related traumatic emergencies. Each item was ranked from 0 for "strongly disagree" to 10 for "strongly agree." Total mean scores before and after were compared. Sixteen individuals participated in the sessions and survey. The total mean score for the six-item analysis increased following the workshop (26.3 before versus 46.9 after, p = 0.001). The positive improvement in all categories indicated increased comfort in the topics of the small group sessions, with the largest improvement in the question about comfort in effectively evaluating and treating a patient presenting to the ED after a submersion injury. Utilizing discussions and hands-on group sessions increased residents' perceived learning. This model can be applied to an extensive number of wilderness medicine topics for learners of all levels. For individuals with time-restrictive schedules, this model is an efficient mode of learning and teaching drowning and injury management skills with the potential for further topics and future courses. Wilderness medicine, water safety, pathophysiology of drowning, in-water rescues, in-water cervical spine stabilization, management of drowning in the ED, splinting, tourniquets.

Iowa Funds Expansion of Rural Psychiatry Training, Services for Underserved Populations

Iowa Funds Expansion of Rural Psychiatry Training, Services for Underserved Populations

Redesigning a Clinical Advancement Program to Promote and Strengthen Competencies of Clinical Nurses.

Clinical advancement programs (CAPs) benefit direct care nursing staff, patients, and healthcare institutions. As standards in nursing practice and workforce evolve, changes in CAPs are necessary. In this quality improvement project, nursing leadership and a 15-member nurse committee redesigned a CAP using Benner's Novice to Expert Model. Changes included self-selection of specialty tracks by shadowing senior nurses in direct patient care, education, and leadership. CAPs increase satisfaction, collaboration, and generation of innovative knowledge.

Innovative Team Approach for Achieving DNP Program Competencies for Distance Learners During the COVID-19 Pandemic.

Doctor of nursing practice (DNP)-prepared nurses must be competent in organizational and systems leadership, advanced clinical skills, and initiation of policy and programmatic changes. Students develop competencies in the DNP advanced practice and nurse administrator specialty tracks through online didactic and in-person practicum experiences within various settings. The COVID-19 pandemic created a barrier to in-person practicum experiences and an urgent need for flexible practicum opportunities. In response, faculty developed, implemented, and evaluated an innovative pedagogical strategy utilizing a team-based case study assignment to facilitate achievement of DNP program competencies for distance learners in these specialty tracks.

Adapting clinical experiences during a pandemic: One college of nursing's approach.

Graduate level nursing programs are having increasing difficulty obtaining clinical sites for their students. Nurse practitioner (NP) students need a minimum of 500 direct care hours in addition to indirect hours. Simulation experiences may not be used as direct patient care hours for NP students, but telehealth experiences may be used if the focus is on obtaining similar competencies to what would be acquired with face-to-face patient experiences. One college of nursing adapted several opportunities for NP students to acquire indirect clinical experiences and specific NP competencies during the coronavirus (COVID-19) pandemic. Several different clinically focused teaching methodologies were planned and implemented. These varied by NP specialty track and included complex case analyses, virtual (Zoom) rounds, well-child cases, and objective structured clinical examinations. These adapted clinical experiences are effective methods of helping students acquire clinical competencies and skills; however, they bring their own challenges. Post-COVID may be a time of new beginnings, moving nursing education forward on finding new and better ways to ensure that students acquire clinical competencies. What the new normal will be for nursing education is yet to be determined, but nursing education will likely never return to where we were before the pandemic.

A National Survey of postgraduate physician assistant fellowship and residency programs

IntroductionThe development of postgraduate programs for physician assistants (PAs) began in 1973 and by 2020 there were approximately 72 programs spread across a broad range of medical and surgical disciplines. PA Post-graduate education programs are voluntary and available to American licensed PAs. Therefore, an assessment of the characteristics of PA post-graduate fellowships and residencies programs was initiated.MethodA non-experimental, descriptive research study was designed to obtain information on the characteristics of PA postgraduate education programs in the US. The source of information was from surveyed members of the Association of Postgraduate Physician Assistant Programs (APPAP). Questions were drawn from consensus discussions. Directors of postgraduate programs that were operational in 2020 were eligible to participate.ResultsSeventy-two postgraduate program directors were invited to the survey and 34 program directors replied. These programs are geographically distributed across the US in 13 states. The respondents represent a wide range of medicine: surgery, emergency medicine, critical care, orthopaedics, hospitalist, psychiatry, oncology, primary care, pediatrics, and cardiology. Most programs are associated with an academic medical center and some institutions have more than one postgraduate specialty track. The curriculum includes bedside teaching, lectures, mentorship, assigned reading, procedures, simulation, and conferences. An average program length is 12 months and awards a certificate. Stipends for PA fellows are $50,000–80,000 (2020 dollars) and benefits include paid time off, health and liability insurance. About half of the programs bill for the services rendered by the PA. Over 90% of graduates are employed within 2 months of completing a PA postgraduate training program.ConclusionA trend is underway in American medicine to include PAs in postgraduate education. PA postgraduate training occurs across a broad spectrum of medical and surgical areas, as well as diverse institutions and organizations overseeing these programs. Most PA postgraduate programs are in teaching hospitals where the PA resident or PA fellow also serves as a house officer alongside a categorical resident. This study sets the stage for more granular economic and social research on this growing phenomenon in American medicine.

Compassion fatigue, presenteeism, Adverse Childhood Experiences (ACES), and resiliency levels of Doctor of Nursing Practice (DNP) students

BackgroundDoctor of Nursing Practice (DNP) students often experience challenges that can cause poor academic performance and attrition. Known threats to nurses' professional quality of life and patient care include compassion fatigue and presenteeism; it is not known how these phenomena carry over from prior nursing experience to DNP students' academic experiences and subsequent NP practice. Adverse Childhood Experiences (ACEs) can also threaten nursing students' coping ability and overall wellbeing. Building resilience can combat the negative effects related to professional quality of life and traumatic experiences and promote nursing student success. ObjectivesMeasure compassion fatigue, presenteeism, ACEs, and resiliency in DNP students. Design: A cross-sectional survey was conducted with three cohorts of DNP students. SettingA DNP program at a large public American University. Participants: DNP students (n = 118) from four NP specialty tracks: Family, Pediatric, Psychiatric Mental Health, and Adult-Gerontology Acute Care. MethodsOnline surveys were sent to three cohorts of DNP students: one group before beginning the program and two groups, one year apart, before starting clinical rotations in the program. Surveys included measures for compassion fatigue, presenteeism, ACEs, and resiliency. ResultsThe demographics of this study sample was similar to other published DNP student samples. The students reported moderate levels of compassion fatigue, presenteeism, and resiliency. ACE scores ranged from 0 to 8 out of 10, and 50% reported at least one ACE. ConclusionsSurvey results from three DNP student cohorts indicate that many are pursuing advanced practice nursing education with a history of traumatic childhood events, demands of balancing work and school, and moderate resiliency levels. Many have symptoms of negative professional quality of life and presenteeism that could inhibit their job satisfaction and quality of care as an NP. Promoting DNP students' resiliency may improve their ability to thrive amidst academic and professional challenges.

Implementation of Universal Adolescent Depression Screening: Quality Improvement Outcomes

Introduction Despite the increasing incidence of adolescent depression, suicide and evidence-based recommendations for adolescent depression screening, 70% of teens report not discussing depression with their provider. The aim of this quality improvement project was to improve the identification and management of adolescent depression by implementing a practice-based, universal depression screening. Method The Patient Health Questionnaire-9 modified for Adolescents was implemented during annual wellness visits for adolescents aged 12–18 years over 3 months. Retrospective chart reviews were conducted to determine a change in the rates of depression screening, depression diagnoses, referrals to mental health, and pharmaceutical treatment of depression. Results Pre/postimplementation data were compared. Documented adolescent depression screening increased from 0% to 74.5%. Increased rates of diagnosed depression (12.1%), mental health referrals (8%), and pharmaceutical treatment of depression (4.9%) were clinically and statistically significant. Discussion Adopting evidence-based recommendations for universal depression screening in pediatric primary care can improve the early diagnosis and management of adolescent depression. Despite the increasing incidence of adolescent depression, suicide and evidence-based recommendations for adolescent depression screening, 70% of teens report not discussing depression with their provider. The aim of this quality improvement project was to improve the identification and management of adolescent depression by implementing a practice-based, universal depression screening. The Patient Health Questionnaire-9 modified for Adolescents was implemented during annual wellness visits for adolescents aged 12–18 years over 3 months. Retrospective chart reviews were conducted to determine a change in the rates of depression screening, depression diagnoses, referrals to mental health, and pharmaceutical treatment of depression. Pre/postimplementation data were compared. Documented adolescent depression screening increased from 0% to 74.5%. Increased rates of diagnosed depression (12.1%), mental health referrals (8%), and pharmaceutical treatment of depression (4.9%) were clinically and statistically significant. Adopting evidence-based recommendations for universal depression screening in pediatric primary care can improve the early diagnosis and management of adolescent depression. Jeff Bose, Nurse Practitioner, Kiddie West Pediatric Center, Columbus, OH. Rosie Zeno, Assistant Professor of Clinical Nursing and Director of MS in Nursing Program, The Ohio State University, Columbus, OH. Barbara Warren, Professor of Clinical Nursing and Psychiatric Mental Health Nursing Across the Lifespan Specialty Track Director, The Ohio State University, Columbus, OH. Loraine T. Sinnott, Research Statistician, The Ohio State University, Columbus, OH. Elizabeth A. Fitzgerald, Associate Professor of Clinical Nursing, The Ohio State University, Columbus, OH.

Implementation of a Formative Objective Structured Clinical Exam to assess self evaluation in a rural BSN-DNP program

Background and objective: The role of self-assessment in competency-based education has been controversial. The Objective Structured Clinical Exam (OSCE) has been used to assess competencies across the health professions. However, exploring the role of the OSCE as a method of self-assessment for nursing students has been limited. Objective: Implementation of a low cost pilot OSCE in a rural BSN-DNP program to explore graduate nursing students perceived self-evaluation of competencies to their actual OSCE performance.Methods: Eight students enrolled in a small, rural Bachelor of Science and Nursing to Doctorate of Nursing Practice (BSN-DNP) program in the Family Nurse Practitioner (FNP) specialty track were required to complete an OSCE. Graduate students participating in the OSCE completed a Self-Assessment of Competency questionnaire prior to performing the OSCE and the results were compared to their actual performance on the OSCE. Using available resources, undergraduate students in the BSN program at the institution were utilized as standardized patients.Results: Students perceived self-assessment of competence rated higher than their actual performance in subjective and objective data collection and implementation of a plan. Students’ actual performance was superior to their perceived self-assessment regarding communication with the patient.Conclusions: Without competency-based self-assessments, students can be unaware of their strengths and weaknesses. The OSCE is an instrument that provides faculty and students with objective measures of self-evaluation and should be considered as a component of competency-based education in rural nursing institutions.

Introducing telehealth skills into the Doctor of Nursing Practice curriculum.

Telehealth training was important for nurse practitioner (NP) students prior to the COVID-19 pandemic, but now it is essential. Training in telehealth allows access to health care for vulnerable populations in rural health areas and beyond. As the future of health care delivery changes, providers will be required to use this technology. Therefore, it is imperative that such training become part of NP education to prepare students to be technologically competent providers in the 21st century. The objective of this educational pilot project was to educate Doctor of Nursing Practice nurse practitioner students to conduct patient interviews and provide interprofessional collaboration using telehealth. The project addressed a gap in the literature on planning for simulations from varying NP specialties and provided feedback from standardized patients on their experiences. A total of 83 students from four specialty tracks received telehealth education. Students then interviewed simulated patients and provided a collaborating report. The students and patients were asked to complete questionnaires to assess the modules and the experience itself. Quantitative descriptive data were gathered, and qualitative themes were obtained from open-ended questions. Both the students and simulated patients indicated that they appreciated the ease and convenience of interviewing patients through technology. Both struggled with issues related to the technology and the need to have backup systems available. The students demonstrated that they were very capable of using telehealth and were generally very positive about the experience.

University of Nebraska Medical Center College of Medicine.

University of Nebraska Medical Center College of Medicine.

APDS Consensus Statement: Ideal Senior Medical Student Experiences for Preparedness for General Surgery Internship

Guide optimal standards on ideal senior medical student experiences for preparedness for general surgery internship DESIGN: Work product of task force, approved by the Association of Program Directors in Surgery CONCLUSION: General surgery rotations should mirror the learning and working environment of a surgical intern. Opportunities should mimic the next phase of learning to help guide informed decisions regarding entrustability for entry into residency training. These opportunities will also help identify students who may have an aptitude for pursuing a general surgery internship. Students should achieve entrustability in Association of American Medical Colleges Core Entrustable Professional Activities (EPAs); curricula should align Core EPAs and modified American Board of Surgery EPAs to guide essential general surgery components. Experiences should include required night, holiday, and/or weekend shifts, a dedicated critical care experience, and a resident preparatory curriculum focusing on nontechnical and essential technical skills. We encourage the opportunity for additional surgical mentorship and subspecialty experience through Surgical Interest Groups or Surgical Honors or Specialty Tracks.

Primary Palliative Care Education for Trainees in U.S. Medical Residencies and Fellowships: A Scoping Review.

Background: The medical profession increasingly recognizes the growing need to educate nonpalliative physicians in palliative care. Objective: This study aims to provide a scoping review of the primary palliative care (PPC) education currently available to graduate medical trainees in primary and specialty tracks. Design: Studies of PPC interventions in U.S. residency or fellowship programs of all subspecialties published in English and listed on MEDLINE, CINAHL, and EMBASE through January 2020 were included. To meet admission criteria, studies had to describe the content, delivery methods, and evaluation instruments of a PPC educational intervention. Results: Of 233 eligible full texts, 85 studies were included for assessment, of which 66 were novel PPC educational interventions and 19 were standard education. Total number of publications evaluating PPC education increased from 8 (2000-2004) to 36 (2015-2019), across 11 residency and 10 fellowship specialties. Residency specialties representing the majority of publications were emergency medicine, general surgery, internal medicine, and pediatric/medicine-pediatrics. PPC content domains most taught in residencies were communication and symptom management; the primary delivery method was didactics, and the outcome assessed was attitudes. Fellowship specialties representing the majority of publications were pediatric subspecialties, nephrology, and oncology. The PPC content domain most taught in fellowships was communication; the primary delivery method was didactics and the outcome evaluated was attitudes. Conclusions: While PPC education has increased, it remains varied in content, delivery method, and intervention evaluations. Future studies should include more widespread evaluation of behavioral outcomes, longitudinal persistence of use, and clinical impact.

Gender Representation by Specialty Track at Surgical Meetings: The American and Australasian Experiences

BackgroundWe compared the representation of women panelists at two large, general interest surgical meetings: the American College of Surgeons (ACS) Clinical Congress and Royal Australasian College of Surgeons (RACS) Scientific Congress. Materials and methodsWe performed comprehensive analyses of panels and panelists at ACS and RACS meetings (2013-2018). Manual review was conducted to determine counts and proportions of invited panelists by gender. We made within- and between-meeting comparisons regarding gender representation by specialty track. Tracks were characterized after our review of meeting programs. ResultsThere were 4542 panelists and 1390 panels at RACS from 2013 to 2018. At ACS, there were 3363 panelists over 693 panels. The specialty tracks with the highest proportion of men-only panels were transplant (75%) and cardiothoracic (63%) at ACS and cardiothoracic (83%) and multidisciplinary (81%) at RACS. The lowest proportions of men-only panels were in breast and pediatric surgery at ACS (5% and 11%, respectively) and breast and rural surgery at RACS (24% and 36%, respectively). At ACS, the highest proportions of women panelists were on panels in breast (63%) and endocrine surgery (48%) and in breast (44%) and rural surgery (33%) at RACS, while the lowest proportion of women panelists were in transplant (10%) and cardiothoracic (14%) at ACS and multidisciplinary (8%) and cardiothoracic (7%) at RACS. ConclusionsThere is a persistent difference in gender representation at surgical meetings, particularly within certain subspecialties. Program chairs and committees could increase the proportion of women by focusing on who serves as panelists overall and within specialty tracks.

Faculty and Student Perspectives of a Graduate Online Delivery Model Supported by On-Campus Immersion.

The purpose of this article is to describe an immersion model implemented in a doctor of nursing practice program with the goal of engaging students and optimizing learning. The immersion model was designed to support learners in an online doctor of nursing practice program to promote self-direction and active involvement in diagnosing, planning, implementing, and evaluating their own learning. The Community of Inquiry framework, based on learning and teaching theory, was used in developing this immersion model. Students expressed positive opinions about immersion. Students valued simulation and skills practice, peer interaction, engagement with faculty, and the leadership colloquium. Faculty reported value in having group advising meetings and in collaborating across specialty tracks for skills laboratory experiences. The immersion model has enhanced student engagement and helped optimize learning outcomes. Students and faculty found the use of the immersion model to be beneficial for practicing skills, use of simulated learning experiences, and student advising.

Building global partnerships through shared curricula for an MPH programme in India and Sri Lanka

ABSTRACTObjectiveTo design and implement a locally relevant competency­ based MPH programme.MethodsThe demand for trained public health professionals in South Asia is enormous and growing, which created a unique opportunity for a Fogarty International Center-funded University of Alabama at Birmingham-South Asia [Aga Khan University, Pakistan; Manipal Academy of Higher Education, India; and University of Kelaniya, Sri Lanka] international research training in environmental and occupational health (ITREOH) programme. In 2009, a Master of Public Health (MPH) degree programme was designed using a combination of competencies developed by the Association of School of Public Health, the World Health Organization and the Centers for Disease Control and Prevention.ResultsA competency­ based curriculum was developed with two specialty tracks in applied epidemiology and environmental and occupational health, emphasising applied practice and research.ConclusionsThis is the most comprehensive skill-based MPH programme in the region, which positions each institution as a regional leader in public health training. The success of the programme has been amply demonstrated by placements of graduated MPH students in leadership roles in public, private and academic sectors within their countries.

Are we on the right track? Answers from a national survey of Thai graduates' perceptions during the transition to the 6-year PharmD program.

PurposeTo serve the higher demands of pharmaceutical services, pharmacy education in Thailand has shifted from 5-year BPharm program to 6-year PharmD program with two specialization tracks: pharmaceutical care (PC) and industrial pharmacy (IP). This study aimed to compare the perceptions regarding professional competencies, pharmacy profession, and planned workplace between graduates with 5-year BPharm and 6-year PharmD and between those with PC and IP specialty.MethodsA cross-sectional national survey using a paper–pencil self-administered questionnaire was distributed to all new graduates attending the pharmacy licensure examination in March 2015.ResultsOf all 1,937 questionnaires distributed, 1,744 were returned and completed (90% response rate). Pharmacy graduates rated highest on their competencies in professional ethics, followed by PC services and system management. They rated low confidence in medication selection procurement and pharmaceutical industry competencies. The 6-year PharmD graduates showed higher confidence in ethics and professional pride than the 5-year BPharm graduates. Graduates with PC specialty rated higher perceived competency in PC, system management, primary care, and consumer protection domains, while the IP graduates were superior in IP and medication selection and procurement domains, and most graduates (PC and IP) intended to work mainly in a hospital or a community pharmacy. Hospital was preferred for the PC graduates, and the IP graduates were more likely to work in pharmaceutical industry, regulation and consumer protection, sales and marketing, and academia.ConclusionWith some gaps still to be filled, the transition from 5-year BPharm to 6-year PharmD program with specialty tracks gave extra confidence to graduates in their specialty competencies and professional pride, leading to differences in preferred workplace. The findings of this study reflect that Thai pharmacy education continues to adjust to the needs of the society and the changing health care environments. Longitudinal monitoring to observe this transition is needed for both curriculum adjustment and competency of the graduates.