What I wish I had learned in pharmacy school

January 7, 2015

Looking back, what do you think was missing from your pharmacy education? And what should a 21st century curriculum include?

I’ve always had an interest in the social sciences, so perhaps the tech-heavy pharmacy curriculum was not a good match for me. I probably would have been much happier with a sociology degree, if the employment prospects hadn’t looked so dismal.

Where pharmacy is concerned, I don’t think my interest in the social sciences is misplaced. Social sciences ought to receive greater emphasis in pharmacy school. They would help pharmacists-in-training to understand the social, cultural, psychological, political, and economic factors that are important in the causation of human illness. The current mechanistic and reductionistic focus of pharmacy school benefits the pill-for-every-ill attitude of corporate America far more than it benefits the general public.

So what would a curriculum with an expanded public-health perspective look like?

First, consider these questions.

Do you believe that human health is significantly connected to lifestyle choices? Or do you believe it has more to do with the technical manipulation of molecules and cells with potent pharmaceuticals? To put it another way, do you believe that human health is directly proportional to the per capita consumption of pharmaceuticals?

If you believe that human health has more to do with lifestyle choices, perhaps you too would prefer a college curriculum that pays more attention to culture and society. Here are a few thoughts, pro and con.

Sociology, anthropology, psychology

During my college years I would have loved to attend classes in medical sociology, medical anthropology, and psychology. A semester of medical anthropology could teach pharmacy students about many of the cultural myths and misconceptions surrounding the causes of human illness. A semester of psychology might help pharmacists understand the behavior exhibited by nonpharmacist store managers and by techs, clerks, and customers. 

Political science

A semester of political science might give pharmacists a better understanding of prevailing issues, such as the debate over Obamacare vs. the simplicity of a single-payer (Medicare for all) model. Insight into political science might also help pharmacists see how Big Pharma uses lobbyists to influence Congress into pressuring the FDA to expedite the approval of drugs that critics say should not be approved. 

Public health

Although many large universities have schools of public health, the university I attended did not. Courses in public health could give pharmacists a macro (epidemiological) view of health rather than the micro (molecular/cellular) view that we are force-fed in pharmacy school. 

Calculus, physics, English literature

This was my experience: I took calculus as an elective during the pre-pharmacy segment of my studies, but I never used any of my knowledge of that subject throughout my entire career as a chain pharmacist. Similarly, I have used nothing from two pre-pharmacy semesters of physics. My semester of English literature was a waste of time (I’ve read zero fiction since graduation in 1975), even though I absolutely understand the need for well-rounded graduates. 

 

Medicinal chemistry

In my opinion, there was way too much emphasis on chemistry during my college years. For example, I remember memorizing the structural formulas for perhaps a few hundred drugs. That has had zero benefit in my career.

Again in my opinion, the main benefit derived from memorizing structural formulas would be to help pharmacists recall which drugs contain a sulfur atom and consequently could trigger a sulfa allergy.

I attended pharmacy school before the widespread use of computers. Surely everyone would agree that pharmacy computers are infinitely better at catching drug allergies in comparison to our feeble memory of which drugs contain a sulfur atom in their structural formula.

In my opinion, courses in medicinal chemistry reflect the occupational and intellectual interests of medicinal chemistry professors far more than they do the needs of pharmacists in the trenches. I would like to see chemistry of all stripes (inorganic, organic, medicinal, and biochemistry) play a dramatically less prominent role in the education of pharmacists. To my way of thinking, pharmacology should be at the center of a pharmacist’s education. Not chemistry. 

Spanish

With the huge growth of the Hispanic population in America, having two semesters of Spanish would be infinitely more valuable than the many semesters of chemistry. 

Toxicology

I think we had two lectures in toxicology in pharmacy school. I wish there had been many more. Drug safety has been an enduring interest of mine. I feel that Big Pharma exaggerates the benefits of drugs and minimizes their risks. Toxicology would help pharmacists more fully appreciate the potentially adverse effects of pharmaceuticals.

Nutrition

We had much discussion of the biochemistry of vitamins, but I think we had only one lecture on nutrition during my time in pharmacy school.

Our single lecture on nutrition was taught by a member of the medical school faculty. I seldom stayed after class to ask questions of lecturers, but I felt compelled to do so after this lecture on nutrition.

I approached the speaker and commented that I wished nutrition (i.e., the consumption of whole foods rather than vitamin pills) were given more emphasis in pharmacy school. The speaker smiled and told me, “I hope you have the biggest drugstore in the country some day.”

But of course his statement was absurd, because the modern drugstore is about quick-fix pills, not whole foods or nutrition.

What do you think? What would you have liked to see in the curriculum you studied at pharmacy school? And what should a 21st century curriculum include that the 20th century did not foresee?

Dennis Millleris a retired chain-store pharmacist living in Delray Beach, Fla. He welcomes feedback at dmiller1952@aol.com. His books "Chain Drug Stores are Dangerous" and "Pharmacy Exposed" are available at Amazon.com.