106年/University of Washington School of Pharmacy/王聖凱 Gabriel Wang
「Overview of US Pharmacy Education」
「Overview of US Pharmacy Education」
Pharmacy is the 3rd-largest healthcare profession in the United States of America (USA), after doctors and nurses. There are around 146 schools of pharmacy in the USA, and around 300,000 pharmacists across the country. Before, the US only offered Bachelors of Science in Pharmacy (BSPharm) degrees for pharmacist training. In 2000, the Doctor of Pharmacy (PharmD) degree became mandatory for pharmacist training, and BSPharm degrees were no longer offered. In the United States, pharmacy school is 4 years long (except for special 3-year accelerated programs), and it is considered an entry-level doctorate program, similar to medical school and dental school. After completing an accredited pharmacy program, pharmacy students take the NAPLEX (pharmacy practice) and MPJE (pharmacy law) exams to become licensed pharmacists (Registered Pharmacists, or RPh). While the NAPLEX is the same nationwide, the 50 US states each have their own version of the MPJE, because pharmacy laws vary from state to state.
To enter pharmacy school, students must complete at least 2 years of pre-requisites, usually during their undergraduate education. Most students find that completing a Bachelor of Art or Bachelor of Science degree makes them more competitive applicants, and some pharmacy schools actually require Bachelors’ degrees for admission. Pre-pharmacy students take the PCAT (Pharmacy College Admission Test), which is a standardized test with reading, writing, biology, chemistry, and math sections. The application to pharmacy school includes essays, PCAT score, letters of recommendation, interviews, and resume information. Most pharmacy students complete an undergraduate degree before entering the 4-year PharmD program. However, there are some “0+6” programs in the US where even high school seniors can apply directly. 0+6 programs consist of 2-year pre-professional studies, and then guaranteed admission into the 4-year professional program.
想入學藥學院，要先在大學完成2年的先修課程才能申請。而取得BS (Bachelor of Science)或BA (Bachelor of Art)之後，才申請4年制PharmD，這種人的競爭力最強，極少數的藥學院則會要求申請人必須大學畢業。先修課程結束之後就要考藥學院入學考試(Pharmacy College Admission Test，簡稱PCAT)，考試內容包含閱讀、寫作、生物、化學和數學。除了PCAT成績，許多學校還要求申請者提供論文、介紹信、自傳履歷，此外還會有口試環節。在美國，大部分學生會在大學畢業後才念PharmD，但也有少數學校提供0+6供高中畢業生直接申請，意即在同一所學校完成2年的先修和4年的專業課程，免去藥學院申請那些手續。
Typical pharmacy school curricula consist of 3 years of didactic (classroom) learning, and then a 4th year of experiential learning (rotations). In the first 2 years, pharmacy students also complete 2-4 week rotations in community pharmacy and hospital pharmacy (Introductory Pharmacy Practice Experiences, IPPE’s). Pharmacy Year 3 (PY3) is known to be difficult, because that’s usually when pharmacy programs focus on pharmacotherapeutics. Pharmacy Year 4 (PY4) is filled with different 4-6 week rotations (Advanced Pharmacy Practice Experiences, APPE’s) that students set up. APPE’s can be in community pharmacy, hospital pharmacy, critical care, pharmacist-run clinics (such as for anticoagulation or diabetes), specialty pharmacy, and other pharmacy practice environments. Students also typically work in pharmacies as student interns throughout school. In the US, pharmacy interns can legally perform many of the roles entrusted to pharmacists, including administering immunizations and counseling patients.
所謂的4年制是3年的課程加上最後1年的實習，但其實在一二年級時，學生就會在社區藥局或醫院進行為期2-4個星期的初階實習(Introductory Pharmacy Practice Experiences，簡稱IPPE’s)，而三年級則是最艱辛的一年，藥物治療學等臨床相關重點學科都會放在此時修習。第四年就是進階實習(Advanced Pharmacy Practice Experiences，簡稱APPE’s)，學生可以選擇至社區藥局、醫院、急重症照護、藥師診所(例如：監測抗凝血用藥或糖尿病照護，由藥師負責管理)，或者其他藥師執業場所。大部分的學生也會在課餘時間到藥局擔任藥學實習生，在美國，藥學實習生可以合法執行疫苗注射或病患衛教等藥事照護相關業務。
After graduating, some pharmacy students choose to enter pharmacy residencies for further specialized training in clinical care (especially for clinical settings such as in hospitals). These residencies are typically structured 2-year programs, with a general residency year (Pharmacy Graduate Year 1, PGY1) and a specialized residency year (PGY2). PGY2 specialty areas include cardiology, neurology, pediatrics, and infectious disease. In hospitals, these residency programs have basically become required training for pharmacists who wish to work in clinical roles. The US has also started some community pharmacy residencies, which focus on pharmacy administration, leadership, and clinical services. Pharmacists may also choose to get more training and become board certified in specialties such as critical care, geriatrics, oncology, pediatrics, and psychiatric pharmacy.