Problems in China’s Licensed Pharmacists System and Suggestions for Improvement

Wang Lili

(Medical and Nursing Branch,Panjin Vocational and Technical College,Panjin 124000,China)

Abstract Objective To study the main problems existing in the current licensed pharmacists system in China.Methods The relevant literature was searched,and the differences of licensed pharmacists system at home and abroad were compared.Results and Conclusion By comparison,it is found that there are obvious differences in the management system,access system and continuing education of licensed pharmacists between China and foreign countries.In order to improve the system of licensed pharmacists in China,the supervision of licensed pharmacists should be strengthened by introducing relevant laws and regulations as soon as possible.Besides,the admittance criteria of licensed pharmacists should be enhanced,and the continuing education system of licensed pharmacists should be optimized as well.

Keywords:licensed pharmacists;management system;continuing education

With the development of economy,people have become more and more aware of drug safety.Since licensed pharmacists shoulder the function of public rational drug use,it leads to an increase in demand and quantity of licensed pharmacists.At the same time,the problems existing in current licensed pharmacists system are also serious.Based on the differences of licensed pharmacists system at home and abroad,we can learn from the good aspects of foreign licensed pharmacists system to solve the problems existing in the licensed pharmacists system in China.And some suggestions and opinions are put forward.

1 Differences in registration system of licensed pharmacists at home and abroad

Many developed countries in the world have clear legislation for licensed pharmacist system[1].In the United States,the Standard State Pharmacy Act was formulated by the National Federation of Pharmacy Council in 1904,which has clear and specific provisions on the qualifications,registration,continuing education and daily business management of licensed pharmacists[2].As early as the 19th century,Britain put forward the regulation of controlling the retail supply of poisons and the regulation of pharmacist registration.The current laws for pharmacist include Pharmacy Law,Pharmacists and Pharmacy Technicians Law and Modern Pharmacy Management Measures.According to these laws,the functional departments can carry out the education and training of pharmaceutical students,the registration of pharmacists,pharmacy technicians and pharmacies,and the formulation of relevant standards[3].The licensed pharmacists system in Australia has been implemented for more than 100 years.The registration laws include the National Health Practitioners Management Law,Pharmacy Law and Pharmacist Registration Law,which were revised in 2010.The Pharmacy Committee is responsible for the registration,continuing education and other related management of pharmacists[4].The current legal system of licensed pharmacists in Japan mainly includes the Medical Regulations formulated in 1889,Pharmacist Law formulated in 1898 and 1948 respectively.The General Affairs Department of Food Safety under the Medical and Food Administration of the Ministry of Health,Labour and Welfare is responsible for the registration of pharmacists and other related work[5].

In the above developed countries,the legal basis of licensed pharmacist registration system are different,but the laws and regulations clearly stipulate the licensed pharmacist system.Compared with these countries,China began to establish the licensed pharmacist qualification system in 1994.The Interim Measures for the Administration of Continuing Education of Licensed Pharmacists has been implemented since January 1,2002.But the licensed pharmacists system does not have clear laws and regulations to supervise it[6].In order to make the licensed pharmacists system more perfect,the following suggestions are put forward.

1.1 Establishing and perfecting the legal system of licensed pharmacists

In order to give full play to the role of licensed pharmacists and ensure people’s rational drug use,it is expected to promulgate the licensed pharmacists law and other relevant laws as soon as possible.These laws will clarify the rights,obligations and responsibilities of licensed pharmacists,which can improve their social status.Besides,the laws can strengthen their legal awareness of practicing and enable them to maintain their professional status while enhancing professional ethics and skills.These laws should stipulate the behavior standard,certification standard and method,registration,supervision and management of licensed pharmacists.We should establish the Pharmacy Law to strictly supervise the pharmacies of hospitals and medical institutions.Besides,we must improve the system of hospital pharmacy license access.Pharmacists in hospitals must participate in the qualification identification and management of licensed pharmacists,so as to realize the unified and coordinated management of pharmacists in the society.

1.2 Establishing a standard practice system

The registration of licensed pharmacist qualification examinations in China requires corresponding work experience.Those people who meet the requirements can register as long as they pass the examination without practice.This will result in the problem that the new pharmacists’ practical skills cannot meet the needs of their posts.Therefore,it is necessary to establish a standardized practice system to change the situation.After passing the licensed pharmacist examination,they also need to have the internship in hospitals to gain the post skills.Only those who have passed the corresponding practical examination can take up their posts after the internship.

1.3 Establishing a standard management system

It is necessary to combine the licensed pharmacists practice system with the qualification management of licensed medical units.For drug retail companies equipped with licensed pharmacists,they should display their licensed pharmacist registration certificate to the public.Most important,they should perform corresponding responsibilities and obligations in accordance with relevant laws and regulations.Drug retail companies without licensed pharmacists will be punished and ordered to rectify.

1.4 Establishing a standard online registration management system

At present,the whole process of online registration of licensed pharmacists has already been realized,which improves the efficiency of administrative examination and approval.Licensed pharmacists can apply for online registration,but the supporting management system needs to be further improved.It is suggested to establish a standardized online registration management system as soon as possible to ensure the security of network information by strengthening the professional level of corresponding technical personnel.In this way,it can help realize the efficient online management.

2 Difference in admittance system of licensed pharmacists at home and abroad

There is a phenomenon of four low standards and one high mobility among licensed pharmacists in China.It means low entry threshold,less equipment,low on-the-job rate,low supplement rate,but high mobility,which seriously blocks the development of licensed pharmacists[7].In the developed countries,licensed pharmacists must have at least bachelor’s degree in pharmacy major and a certain period of practical training.For instance,in the United States,pharmacy major and certain practical training is a must for licensed pharmacists.Only those who have passed the pharmacy internship examination are qualified.In Japan,the licensed pharmacists must receive six-year pharmacy education.After getting doctor’s degree and having one-year practice in a hospital or pharmacy,they can be qualified as a pharmacist[8].The licensed pharmacists in the UK should possess master’s degree in pharmacy,and before they become licensed pharmacists,52 weeks of registration training is also required.

In China,licensed pharmacists are required to have at least a technical secondary school degree or above.They don’t need any internship.Their study at school or college are taken as work experience.According to incomplete statistics,68.7% of licensed pharmacists in China have bachelor’s degree or below,and 47.5% are not pharmacy major[9].The loose admittance system,low requirements for education and major lead to serious consequences.Most licensed pharmacists in China with limited ability and single knowledge structure cannot provide high quality pharmaceutical care for the patient[10].Therefore,in order to improve the practice ability of licensed pharmacists,the registration for licensed pharmacists should be strict.It means they must have pharmacy major and certain time of internship in hospitals.Specific suggestions are as follows.

2.1 Improving the qualification of licensed pharmacists

To improve the qualifications of licensed pharmacists,it is necessary for them to have a bachelor degree or above in pharmacy.Besides,they should have corresponding work experience,participating in training of job,and passing related examination.For candidates with bachelor’s degree or below,continuing education should be encouraged.Only when they have obtained bachelor’s degree can they register for licensed pharmacist.This way can make them provide high quality service.

2.2 Restricting the major of licensed pharmacists

At present,the professional conditions for registration of licensed pharmacists are not strict,and people with majors such as chemistry,pharmacy,biology and others can register.Graduates of nonpharmacy major normally lack the knowledge of clinical medication,which makes them difficult to adapt to the post requirements.Therefore,the administration department should limit the specialty for registration when formulating the qualification examination requirements,which means pharmacists must have obtained pharmacy qualification first,then they can apply for the registration.The nonpharmaceutical professionals must complete the systematic study of pharmaceutical theory within the specified time first,and then they can enter for the examination after a certain period of internship.

2.3 Strengthening the publicity of licensed pharmacists

The working years of candidates are stipulated in licensed pharmacists examination,but there are still some disputes on the determination of the standard.Therefore,the relevant laws and regulations should be changed and the examination form of licensed pharmacists should be reformed.In addition to the traditional theoretical examination,the assessment of practical ability should be appropriately increased.According to the positions the candidates intend to work in,different types of practical assessment should be carried out.When the theoretical assessment and practical operation meet the standards,they are allowed to have the examination.

2.4 Increasing the number of licensed pharmacist qualification examination

At present,the number of licensed pharmacists in China is still in short supply.To make up for this gap,it is suggested to increase the number of examinations appropriately.The theoretical assessment for licensed pharmacists should be conducted twice a year,respectively in the first half and the second half of the year.Four practical operations should be offered,and the results will be effective within two years.This can increase the number of pharmacists after passing the examination.

2.5 Strengthening the publicity of licensed pharmacists

Through the media of blog,wechat and mobiles,licensed pharmacists can be organized to enter the community to do more publicity so as to strengthen their status and important role in pharmaceutical care.By improving their social status,the quality and quantity of licensed pharmacists will grow at the same time,which can make up for the small number of domestic licensed pharmacists.

3 Differences in continuing education of licensed pharmacists at home and abroad

In March 2016,the Guiding Opinions of the General Office of the State Council on Promoting the Healthy Development of Pharmaceutical Industry(GBF [2016] No.11) clearly put forward the requirements of strengthening the construction of pharmaceutical team,improving the service quality of licensed pharmacists,and promoting safe and rational drug use[11].It is necessary to strengthen the education and training of licensed pharmacists all over the world.Continuing education is an important way for licensed pharmacists to acquire new knowledge and technology[12].

In the developed countries,continuing education of licensed pharmacists is carried out in the form of re-registration.Pharmacists should not only study related pharmacy courses,such as pharmacy management,laws and regulations,but also participate in pharmacy practice.They must combine theory and practice.The training methods are various,and the unified certification standards are adopted to ensure the effectiveness of continuing education.Thus the trained licensed pharmacists are capable of meeting the needs of patients[13].The continuing education in Australia,on the one hand,highlights the maintenance,improvement and expansion of pharmacists’ competency.On the other hand,it emphasizes the personal and professional qualities needed for job development.The contents includes knowledge that have not been assessed,knowledge and skills that have been assessed,and activities that promote practice quality.In sum,it helps cultivate practical skills[14].In the United States,the continuing education of licensed pharmacists is based on knowledge,application and practice.The practice part includes face-to-face teaching and learning,and the learners will be evaluated at last.The minimum time for obtaining credits is 15 hours of face-to-face learning[15].

In China,the responsible institutions for continuing education of licensed pharmacists are China Pharmacists Association and Provincial(Licensed) Pharmacists Association.China Pharmacists Association is responsible for online training of national licensed pharmacists,and Provincial (Licensed) Pharmacists Association is responsible for the training of licensed pharmacists in each province.In the process of continuing education for licensed pharmacists,all pharmacists participate in the same face-to-face or online courses with unified contents and standards[16].The curriculum is set towards theoretical knowledge,and credit system is implemented.The answers to the examination can be found on the Internet,and the credits can be obtained easily.As a result,the knowledge and skills acquired from the continuing education cannot meet the need of the position,because the credits obtained from licensed pharmacists’ training are not closely related to the actual ability improvement.Therefore,the continuing education for licensed pharmacists in China becomes a mere formality[17].

3.1 Strengthening the certification management of continuing education institutions

Taking the good experience of the United States for reference,the certification standards should be formulated by the Certification Center for Licensed Pharmacist of NMPA.In addition,the supervision and teaching institutions should be separated.At the same time,a standardized training base should be established for teachers to improve their teaching quality,which can ensure the quality of continuing education.

3.2 Setting up a reasonable curriculum system of continuing education

While having the continuing education,different optional course modules should be set up for licensed pharmacists according to their education background,major,practice field and specific work position.Each module must include basic theory,professional skills,and comprehensive quality.In order to highlight the cultivation of practical ability,drug consultation practice,case discussion,special lectures can be added to the courses.In addition,hospitals should pay attention to the improvement of their clinical pharmacy.Licensed pharmacists should participate in ward rounds,consultation and other work,such as monitoring and collecting adverse drug reactions of patients,establishing drug consultation window,and providing brand new drug information,which,in turn will enrich the clinical experience of licensed pharmacists.

3.3 Establishing a system of assessment and evaluation

Continuing education should not only assess the results,but also pay attention to the stage assessment.Therefore,it should establish a diversified assessment system and learning management system.The assessment should be divided into three parts:normal assessment,which mainly assesses the normal learning process,including sign in and sign out,answering questions,homework completion and so on.Theoretical knowledge assessment should be carried out in the form of examination,and the assessment content must be determined by the industry expert.Practical skills assessment mainly check different aspects of clinical medication,and the completion of different projects and tasks.These three parts are composed of different proportions to form a process assessment system.

3.4 Reducing the cost of continuing education

In most developed countries,the general continuing education and training are free of charge,or both charged and non-charged training are provided.So pharmacists can choose an appropriate one for themselves.At present,China’s continuing education training is not free of charge,which is carried out online or in the classroom.The cost of face-to-face teaching is relatively higher than the online one.Referring to the experience of foreign developed countries,China should provide licensed pharmacists with non-profit training,reflecting the principle of public welfare.

Through comparison,we find that there are many differences of licensed pharmacists system at home and abroad.While learning from the successful experience of western countries,we should combine them with our characteristics to form an effective licensed pharmacist system,which include the registration system,strict access standards,the quality of continuing education,and effectively improving the pharmaceutical service level and ability of licensed pharmacists.This can guarantee the drug safety for the public and promote the development of China’s pharmacy.