Opinion: PharmD Quality vs Quantity

In my 20 years as executive director of the Accreditation Council for Pharmacy Education (ACPE), and more so recently, we have been asked why we don’t call a moratorium on opening new pharmacy schools, or why we don’t better control the number of students enrolled and graduating from accredited programs each year. Or, why isn’t ACPE acting as the “gatekeeper” for new schools and pharmacists entering the marketplace to help manage and preserve jobs and salaries in the industry?

We live in a free market society. When I started in my position, pharmacy had 78 accredited schools, and we were graduating approximately 7,000 students a year. Because projections were made of an upcoming pharmacist shortage due to an aging population with increasing medication needs, existing colleges and schools of pharmacy expanded their class sizes and/or opened branch campuses. Many new schools began to apply for accreditation. 

Now we have 143 accredited schools and are graduating approximately 14,500 students per year. Until recently, this dramatic increase in graduates has been accommodated by the job market, with almost all students having employment options, although lately, not always in their preferred geographic area. As the urban job market started to saturate, enrollment numbers to pharmacy programs have begun to take a downturn. 

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This is the type of market response I learned about years ago in economics. Had ACPE acted to limit the growth of existing programs or new ones, many of the new graduates would have been robbed of the opportunity to practice pharmacy. 

Educational program accreditors do not exist to control the employment markets of their associated professions. ACPE’s standards are based on quality, not quantity. Our focus is making sure students have the best information to make career and program decisions at the time of application. 

Unfortunately, sometimes a market shifts quickly before a cohort of students graduate from a four-year program. As ACPE monitors licensing exam performance and the employment of graduates, it is important to ensure students are properly informed about these market shifts. We have noted that program sizes have begun to “right size” on their own by accepting fewer students and ensuring acceptance of only qualified candidates, and by closing branch campuses. These actions are the responses seen in a free market system. 

By monitoring enrollments, graduation and employment rates, and information available to applicants and students, we as accreditors allow the market to respond based on the availability of relevant information. However, if a program continues to accept students when their graduation, licensing, and employment rates fall, we can (and have) engaged its leaders in serious conversations about their need to better inform prospective students about these rates and/or adjust program size. If the pharmacy program is unable to meet ACPE accreditation standards, that is a different story that requires different considerations.

I have great compassion for those pharmacy students who struggle to find employment after graduation while trying to manage substantial student loan debt. On the other hand, I believe there are jobs for pharmacists in rural America for people willing to relocate, even for a few years until the job market opens up and as more baby boomers retire.

Although I feel bad for those students facing job placement difficulties, ACPE is unable to change its review process that would either close programs or stop accrediting new programs as a means of protecting them.