Recent pharmacy school graduates will encounter a rapidly changing health-care landscape. Drug Topics Executive Editor Anthony Vecchione sat down with Lucinda Maine, RPh, PhD, Executive Vice President and CEO of the American Association of Colleges of Pharmacy (AACP) at its annual meeting in Nashville to talk about some of the pressing issues facing students as they enter the work world.
DT: What trends have you been seeing in pharmacy school enrollment over the past few years?
Maine: We have seen a progressively declining applicant pool. We record it two different ways. We run PharmCAS, a centralized application service. One hundred and twenty-nine schools engaged at least some part of their admissions through PharmCAS in the cycle that just ended.
In 2010, we had 18,000-plus individual applicants who applied to about five programs per applicant, so we had 85,000 applications in play for the schools that were in the system at the time.
This year, in the cycle that just finished, we had about 16,500 applicants. We’re seeing slightly less than four applications per applicant. So there were about 65,000 applications.
Unequivocally, there has been a downward trend in applications. Part of that is because a lot of schools have gone to an early decision model where they will guarantee a student who meets and exceeds their qualifications if they only apply to that school and accept early decision. Then the student would know by December that they are going to be in pharmacy school next August.
We knew that we were going to see a plateauing at least, if not a reduction in the number of applicants, because the high school graduation cohort has been, for the last couple of years, at the lowest level in quite a long time.
The children of the boomers have passed through the system. Their late high school was in the midst of the recession—and they are very debt-averse. Professional school debt really scares them even though they can feel pretty confident that they are going to earn six figures when they get out of at least our program in four more years, six years total for some of them.
However, we have not been successful in attracting under-represented minorities, largely African American and Hispanic, except some unique schools who have done that really well because of their geography, but also because of some other things.
This high school graduation cohort has a higher percentage of under-represented minorities than before because of the growing Latino population.
Debt, lower numbers, higher percentage of under-represented minorities, and the last issue is that the clinical health professions aren’t considered to be STEM [science, technology, engineering and mathematics] careers—not medicine, not nursing, not dentistry, not pharmacy. For really bright students, regardless of ethnic characteristics, they are being driven to STEM, STEM, STEM, but a lot of times that’s [seen] as computer science and engineering, and some of the other physical sciences.
So part of our strategic plan is to work with our colleagues across the health professions to make sure that health professions are on the Bureau of Labor Statistics list as a STEM careers.
DT: What does the job outlook like for recent graduates?
Maine: More and more pharmacists are working in clinics. It’s shifting. We keep our ear closest to the ground around graduation time about how the class of 2017 is doing.
By all accounts, our grads are still receiving offers of employment—more of them are seeking residency training before they go out into the job market. The demand right now for a limited number of positions is soaring.
Part of the reason is because health systems are preferentially hiring their residents—that’s the reason why hospitals are offering residencies because it gives them the opportunity to look at the cream of the crop.
Faculty is saying: If you want to aspire to an academic position, it’s almost essential if you’re a clinician, to have a PGY1 and PGY2 residency. If you want to do psychology or oncology, or any of the highly technical or specialized fields, you have to do postgraduate work.
The percentage of the typical class that’s going to work in classic chain community environment is in fact shrinking. It’s shrinking proportionally of course because a higher percentage of the class is going into residency training and that has to mean something’s shrinking.
Typically in a class of 100, 85 or more have a defined job in a defined location when they cross the stage.
Up next: What's going on with salaries?
DT: What are some of the new opportunities that you’re seeing for graduates?
Maine: I believe that the next shortage of pharmacists is going to be stimulated by a piece of research that is underway at University of North Carolina that is being funded by the American College of Clinical Pharmacy.
They are placing pharmacists in 45 different physician office practices around the country. They are looking at characteristics of physician practices that makes it the best place for pharmacists; what kind of pharmacy services are needed; what kind of patients need services, and the financial components of this practice and what makes that practice sustainable.
DT: What has been happening with salaries?
Maine: Some chains are playing games with hours and benefits. Some are not offering full-time positions. In rural areas, we are seeing incentive bonuses and salaries going up, but it’s very location-specific.
DT: What significant trends do you see down the road?
Maine: We are going to do everything in our power to reverse this trend in the pipeline. We are going to do that by helping people understand more about what our grads are equipped to do, where they’re working, and how rewarding it is. More challenging for us is getting our head around how AACP, as a national organization, can identify the right opportunities to lead change in both education and practice so that our grads and faculty really are the leaders in the volume-to-value transition. We know that medication use is an essential component of volume-to-value.
We also know medication use is a team sport and we just want everybody to understand and appreciate the role the pharmacist plays on that team.