Pharmacy school admissions crisis

[BenJammin]

I'm hearing from students and alumni of schools across the country that the class of 2027 might be one of the smallest in over 30 years. Several schools in Texas have less than 30 entering their P1 year.

Pharmacist job shortage 4 years from now? I still don't think so. Technicians are the future of the profession.

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[RXDOC1986]

A while back, I came up with the idea of a Vocational School Type Pharmacy degree. Sort of in-between a Technician and a Pharm.D. Most pharmacists jobs out there doesn't require clinical knowledge, ie retail chains. There will always be jobs for you clinical pharmacists, but how about a lower level degree, with graduates coming out with zero student loans, who can then work for $40/hr.

 

[PrincessSnow]

I agree with both of the posts above. Technicians are the future of the profession and there needs to be a change in the education and wage for the profession. All of this is due to expansion of automation, technology, and AI, as well as the shift from fee for service to value based care. All of these new models they are coming out with can be done by other health care workers. They are also working on AI to verify orders to "free up the pharmacist". Most orders will not need review by a pharmacist. The board certifications are the same for the Clinical Nurse Specialist and the Clinical Pharmacist Specialist. My managers are always asking me if I want to work as a nurse since I am licensed as a nurse and a pharmacist and they know it is the same job in the PCMH and ACOs. I may leave healthcare all together under value based care if no outcome= no income. There is not a way for pharmacist to bill for services except for maybe some state Medicaid plans with individual states or "incidence to billing". Clinical Nurse Specialist independent practice and prescribing is expanding rapidly under value based care but I am not seeing this with pharmacy. They are promoting for pharmacist to get paid for patient counseling but patient counseling can be automated too. See dietitian story:

South Carolina hospital adds robot dietitian

Orangeburg, S.C.-based Regional Medical Center has instituted a robot dietitian that roams the hospital to provide nutrition counseling to patients, The Times and Democrat reported Jan. 2.

www.beckershospitalreview.com

South Carolina hospital adds robot dietitian​

Giles Bruce - Tuesday, January 3rd, 2023
Orangeburg, S.C.-based Regional Medical Center has instituted a robot dietitian that roams the hospital to provide nutrition counseling to patients, The Times and Democrat reported Jan. 2.
"Norma" the robot is operated by an off-site employee of food service company Morrison Healthcare, according to the story. "It is demonstrating that we are definitely moving into the high-tech area," hospital CEO David Southerland told the news outlet.
Hospital officials told the Times and Democrat the robot will save money by cutting back on the need for a salaried employee.
The robot is being used by about 10 other hospitals across the country, the newspaper reported.

APhA, ASHP, and NABP Unveil Strategies to Bolster Pharmacy Workforce​

Published: September 27, 2023

APhA, ASHP, and NABP Unveil Strategies to Bolster Pharmacy Workforce -ASHP

he American Pharmacists Association (APhA), the American Society of Health-System Pharmacists (ASHP), and the National Association of Boards of Pharmacy (NABP) are pleased to share a new report including actions to implement solutions to improve pharmacy workplace conditions.

news.ashp.org

https://nabp.pharmacy/wp-content/uploads/2023/09/Implementing-Solutions-Report.pdf

Some of the things mention in this document:

Several participants again supported creating a professional level between PharmD and pharmacy technician (e.g., a mid-level pharmacist associate or advanced technician role).

Show evidence of pharmacist value on total cost of care to justify payment. The niche is comprehensive medication management—show value, cost savings, and improved outcomes

Promote and advocate for team-based care.

Allow tech check tech without cutting pharmacy hours—prohibit cuts to labor when there are expanded roles and efficiencies.

Decrease the culture of fear from pharmacists that they will lose their job (not have a role) if a technician has an advanced role

Develop a shared resource center of evidence/studies justifying the value of pharmacist services to assist with advocacy efforts at state/federal levels.

Expand payment models by working with payers directly (provider status has been priority, but there are other ways that we can expand practice).

Advocate for reimbursement of pharmacy services, leveraging outcomes-based research/model legislation/case studies/implementation science around best pharmacy practices.

 

[libra08]

I'm hearing from students and alumni of schools across the country that the class of 2027 might be one of the smallest in over 30 years. Several schools in Texas have less than 30 entering their P1 year.

Pharmacist job shortage 4 years from now? I still don't think so. Technicians are the future of the profession.

The writing is on the wall. Stores are closing. Mail orders have already made things more centralized…more eRX, automation, central fill. Less labor will be needed for both pharmacists and technicians

 

[MatCauthon]

The doom news in pharmacy right now is all a negative feedback loop. Walgreens/CVS/Rite-Aid struggling to get any help, employee walkouts, terrible working conditions being displayed in the news. No one goes into pharmacy wanting to go into retail these days.

I would love for the forums to put together a list of incoming class sizes all around the country so we can see how bad this problem is getting, and how many schools are on the edge of closing.

 

[RXDOC1986]

They were telling us, back when I was in school, that we would soon be replaced by robots and computers and automation. THAT was in 1985, still patiently waiting.

 

[MatCauthon]

They were telling us, back when I was in school, that we would soon be replaced by robots and computers and automation. THAT was in 1985, still patiently waiting.

You're right, but is this time a little different? The demographic cliff from declining birthrates post 2008 will start displaying itself in 2026 at the university level. Pharmacy schools are already facing declining enrollment now, just wait for another 3-7 years and it could get real ugly. There are also other societal trends at work-- less people are going into the healthcare field in general. Anecdotally we are already hearing of many pharmacy schools that are in severe distress. Pharmacy graduates are likely to go well under 10k in the next 5 years, maybe much lower depending number of graduates and/or schools closing. The current news cycle is definitely very poor advertising for the pharmacy profession.

Big changes are definitely coming to the profession-- but that is definitely a post for another thread.

 

[RXDOC1986]

You're right, but is this time a little different? The demographic cliff from declining birthrates post 2008 will start displaying itself in 2026 at the university level. Pharmacy schools are already facing declining enrollment now, just wait for another 3-7 years and it could get real ugly. There are also other societal trends at work-- less people are going into the healthcare field in general. Anecdotally we are already hearing of many pharmacy schools that are in severe distress. Pharmacy graduates are likely to go well under 10k in the next 5 years, maybe much lower depending number of graduates and/or schools closing. The current news cycle is definitely very poor advertising for the pharmacy profession.

Big changes are definitely coming to the profession-- but that is definitely a post for another thread.

I appreciate the current climate of Pharmacy Education. It does seem to be in decline, my guess is decades as opposed to years. It could get real ugly, but I am not holding my breath, might pass out!
It's just the chicken little aspects of the forecast that cause concern and needless consternation.

 

[dgdg]

The writing is on the wall. Stores are closing. Mail orders have already made things more centralized…more eRX, automation, central fill. Less labor will be needed for both pharmacists and technicians

We spend vastly more on healthcare than any other industrialized country in the world. Yet, our markers in population health are worse and we can't afford pharmacists, advanced imaging, medications, and some types of physicians 'due to cost'. It's shameful.

 

[Gombrich12]

Why would a smart and driven person become a pharmacist when half of your college classmates will be working from home making the same amount of money as you 5 years post grad? We've been saying for years on here the effort and reward are out of wack and everything around covid just completely reinforced that point.

As for the future once someone comes up with some regulatory innovation to allow stimulants, benzos, and painkillers to be easily shipped to homes it will be the death knell of retail pharmacy. If you aren't doing procedures or touching a patient I don't think your services will be highly valued in the future. I expect a lot of doctors to get hit hard by AI augmented mid level providers.

 

[PharmDminus]

We spend vastly more on healthcare than any other industrialized country in the world. Yet, our markers in population health are worse and we can't afford pharmacists, advanced imaging, medications, and some types of physicians 'due to cost'. It's shameful.

true but that is partly because of how much it costs to pay us. how much do pharmacists get paid in europe. how about MD’s. yes our schooling costs more but that doesnt matter when you are trying to profit on hydrochlorothiazide and sertraline prescriptions. Needs to be some high margins to pay a RPh 150k plus benefits

 

[dgdg]

I expect a lot of doctors to get hit hard by AI augmented mid level providers.

That's already evolving for sure.
Frankly, when I see my (usually older and more complex) patient who had anything but a simple acute visit at UC, the mid level provider usually does not provide a complete assessment and treatment plan for the chief complaint. I wind up seeing them for follow up to finish.
No fault of theirs. It's just a matter of base training. Physicians may be replaced but at a price, in more than one perspective.

 

[gwarm01]

Why would a smart and driven person become a pharmacist when half of your college classmates will be working from home making the same amount of money as you 5 years post grad? We've been saying for years on here the effort and reward are out of wack and everything around covid just completely reinforced that point.

As for the future once someone comes up with some regulatory innovation to allow stimulants, benzos, and painkillers to be easily shipped to homes it will be the death knell of retail pharmacy. If you aren't doing procedures or touching a patient I don't think your services will be highly valued in the future. I expect a lot of doctors to get hit hard by AI augmented mid level providers.

To your first point, that situation may cycle back over the next decade. If we ever get that big recession and have even more layoffs in tech, forced return to office, etc. while pharmacy experiences a labor shortage it may start looking pretty attractive again. There's a decent number of people who switched to healthcare after seeing how it weathered the last recession after all.

I also don't think retail will ever fully go away, but we definitely don't need a Walgreens and CVS staring at each other on every intersection of every town in the US. We really need to rebalance in that area. Mail order is nice, but I actually like going to my local independent shop because they treat us well and I can pick up a new Rx on the day it is written. My insurance would prefer I switch to mail order, but I have no real incentive to do so.

 

[BenJammin]

GPA above 3.0? Here's a $15,000 scholarship to attend UNT! One of the few schools that hasn't seen a decrease in NAPLEX test takers over the last 5 years is now giving away money

UNT Health Science Center to sweeten pharmacy school applications with $15,000 scholarships

The University of North Texas Health Science Center in Fort Worth is hoping to attract more 2024 applicants for the pharmacy program with academic awards.

starlocalmedia.com

 

[mentos]

LoL this is a crisis now? There's no need for any more pharmDs. Every pharmacy school could shut down today and there'd still be too many pharmacists.

The only crisis is the ****ty work conditions for current pharmacists, which was caused by schools giving out way too many pharmDs.

 

[owlegrad]

LoL this is a crisis now? There's no need for any more pharmDs. Every pharmacy school could shut down today and there'd still be too many pharmacists.

Is that true? We have been trying to hire a pharmacist for months with no luck.

 

[WVUPharm2007]

It's not a shortage until I can call up Walgreens and have a district manager buying me a steak at Ruth's Chris just for the opportunity to recruit me. Like back in the mid-00s.

 

[mentos]

It's not a shortage until I can call up Walgreens and have a district manager buying me a steak at Ruth's Chris just for the opportunity to recruit me. Like back in the mid-00s.

I heard they were giving out BMWs for sign up bonuses. Is this true?

 

[BenJammin]

Is that true? We have been trying to hire a pharmacist for months with no luck.

Walmart still sends flyers to my home address offering PIC sign on bonuses of $80k. We've had a few positions open up in our ambulatory care company and it took a lot just to get a pharmacist to consider an offer. There is no doubt in my mind that state boards will be forced to open up pharmacist duties to technicians.

 

[sunnyandseventytwo]

I heard they were giving out BMWs for sign up bonuses. Is this true?

Had a friend take one of those jobs. It was in Detroit..I think Rite Aid. They didn't actually give you a BMW. It was a 3 year lease. Rite Aid ran into a little financial trouble...and stopped paying the leases. This was like 20 years ago.

 

[GrandTheftAutumn]

Is that true? We have been trying to hire a pharmacist for months with no luck.

Hold my beer while I translate my resume into Owlish. You'll see I did 6 months of coding boot camp and you can pay me 10 trillion Hoot Dimes annually.

 

[WVUPharm2007]

I heard they were giving out BMWs for sign up bonuses. Is this true?

Leases. Nobody got a BMW out right. But I know a fellow that actually did get a BMW (or maybe it was a Benz...something moderately fancy, anyway) lease AND his loans paid off for moving to South Texas if I recall correctly. Sign a long contract, though. Mid 00s-late 00s were certainly a time to live through as an RPh/student.

 

[mentos]

Leases. Nobody got a BMW out right. But I know a fellow that actually did get a BMW (or maybe it was a Benz...something moderately fancy, anyway) lease AND his loans paid off for moving to South Texas if I recall correctly. Sign a long contract, though. Mid 00s-late 00s were certainly a time to live through as an RPh/student.

That's still really nice. Free lease!

 

[libra08]

I have a classmate who used his student loans to buy a used bmw

 

[CetiAlphaFive]

Leases. Nobody got a BMW out right. But I know a fellow that actually did get a BMW (or maybe it was a Benz...something moderately fancy, anyway) lease AND his loans paid off for moving to South Texas if I recall correctly. Sign a long contract, though. Mid 00s-late 00s were certainly a time to live through as an RPh/student.

Wouldn't happen to be a very tall Pakistani guy, would be?

 

[PharFromNormal]

The doomer news cycle about poor working conditions is just going to fuel even worse working conditions. Pharmacy (note my nuance in not saying “pharmacist”) will find a way to continue to bottom seek.

Low enrollment and less interest in retail pharmacy by pharmacists will just lead to further progression of pharmacy of needing less pharmacists.

So many continue to get out over their skis trying to complain about the problems but never can bring realistic solutions that everyone will like… so solutions come but with other problems and challenges and the cycle repeats.

 

[PharmtoCS]

The way is to unionize and fight for not only better work conditions but also deregulation/automation.

 

[Chrish]

Walmart still sends flyers to my home address offering PIC sign on bonuses of $80k. We've had a few positions open up in our ambulatory care company and it took a lot just to get a pharmacist to consider an offer. There is no doubt in my mind that state boards will be forced to open up pharmacist duties to technicians.

Weren’t you the one who was boasting of hiring an rph for $30 an hour a while back?

 

[Chrish]

Anyways, more responsibilities for rph are in pipeline. I have already heard a talk about testing patients for flu via nasal swab.

Rph salaries will not go down. They will remain either stagnant or go up but work conditions will continue getting worse with added responsibilities.

 

[mentos]

Anyways, more responsibilities for rph are in pipeline. I have already heard a talk about testing patients for flu via nasal swab.

Rph salaries will not go down. They will remain either stagnant or go up but work conditions will continue getting worse with added responsibilities.

That sucks. Isn't that what Minute Clinic is for? Once they start swabbing for flu then they'll swab for Covid, RSV etc. too.

 

[libra08]

Anyways, more responsibilities for rph are in pipeline. I have already heard a talk about testing patients for flu via nasal swab.

Rph salaries will not go down. They will remain either stagnant or go up but work conditions will continue getting worse with added responsibilities.

I don’t get why people think a pharmacy is a medical clinic. It is not.

You don’t need a doctorate degree to do any of this crap. Someone with some basic training can do them.

The big corps are only pushing pharmacists to do them because for them it is extra money without actually spending money on extra staffing. But it makes the pharmacy experience even more unbearable. I would rather get my medications from mail order than wait an extra 10 minutes so my pharmacist can do a nasal swab on some grandpa.

 

[Chrish]

I don’t get why people think a pharmacy is a medical clinic. It is not.

You don’t need a doctorate degree to do any of this crap. Someone with some basic training can do them.

The big corps are only pushing pharmacists to do them because for them it is extra money without actually spending money on extra staffing. But it makes the pharmacy experience even more unbearable. I would rather get my medications from mail order than wait an extra 10 minutes so my pharmacist can do a nasal swab on some grandpa.

Until your medication doesn’t arrive for a week and you vow to never use mail order ever again (just happened to my dad).

 

[Chrish]

That sucks. Isn't that what Minute Clinic is for? Once they start swabbing for flu then they'll swab for Covid, RSV etc. too.

The way I see it, it’s more job security (just like how vaccines made rph jobs more secure). On a downside, it will make already poor work conditions even worse.

 

[mentos]

I don’t get why people think a pharmacy is a medical clinic. It is not.

You don’t need a doctorate degree to do any of this crap. Someone with some basic training can do them.

The big corps are only pushing pharmacists to do them because for them it is extra money without actually spending money on extra staffing. But it makes the pharmacy experience even more unbearable. I would rather get my medications from mail order than wait an extra 10 minutes so my pharmacist can do a nasal swab on some grandpa.

They're probably trying to makeup for decreased reimbursements. They've cut all the staff hours they can, now they need more revenue.

 

[libra08]

Until your medication doesn’t arrive for a week and you vow to never use mail order ever again (just happened to my dad).

Just call them and they will overnight another package. You have plenty of time to reorder before you run out especially if you get 90 days supply.

 

[libra08]

They're probably trying to makeup for decreased reimbursements. They've cut all the staff hours they can, now they need more revenue.

They make plenty from the dispensing meds especially since they also own the PBM. The problem is they used debt to buy out their competitors and other businesses. Now they need to repay that debt plus interest so they need another source of income.

 

[libra08]

The way I see it, it’s more job security (just like how vaccines made rph jobs more secure). On a downside, it will make already poor work conditions even worse.

Not enough job security when it comes to your mental health. I would not be surprised to learn working in retail causes you to die 5-10 years early. My retail friends have aged so much. You can see it on their faces

 

[nickw2401]

I'm hearing from students and alumni of schools across the country that the class of 2027 might be one of the smallest in over 30 years. Several schools in Texas have less than 30 entering their P1 year.

Pharmacist job shortage 4 years from now? I still don't think so. Technicians are the future of the profession.

machines will replace techs

 

[CetiAlphaFive]

Just call them and they will overnight another package. You have plenty of time to reorder before you run out especially if you get 90 days supply.

100% chance this dude's dad's voicemail box is full and he had a few missed calls from them. Lol

 

[mentos]

They make plenty from the dispensing meds especially since they also own the PBM. The problem is they used debt to buy out their competitors and other businesses. Now they need to repay that debt plus interest so they need another source of income.

They will be in even more debt if they buy Rite Aid.

 

[baronzb]

I'm hearing from students and alumni of schools across the country that the class of 2027 might be one of the smallest in over 30 years. Several schools in Texas have less than 30 entering their P1 year.

Pharmacist job shortage 4 years from now? I still don't think so. Technicians are the future of the profession.

It still wouldn't be enough because of all of the people washed out of the system from surplus. Also, though mail order has largely been completed, the fall-out on retail and institutions of a non-critical nature have yet to fully wreck their effect on employment.

To think that many of us were hoodwinked by adults to this profession, with its grand vision that was never realized of patient care, top students with options, is appalling.
Reduction of class size is one thing, but that can just be revamped. What needs to happen is mass closures of schools. Like law school, they will fight hard to keep their sinecures; raising, lowering class sizes to prevent continous excess NAPLEX fail rates, gutting the NAPLEX, failing out high percentages of cohorts to prevent NAPLEX score reflections, starting B.S. science degrees, etc.
I don't think techs are the future. The unless there is a large pay increase (double?), the class of person and the lack of motivation will not be overcome. Pharmacy has unreasonable expectations that could not be sustained without a pharmacist.

 

[Chrish]

Just call them and they will overnight another package. You have plenty of time to reorder before you run out especially if you get 90 days supply.

That’s not how it worked. Package got “lost” along the way even though it was ordered a week in advance and it was the last refill.

Was a nightmare getting it straight (multiple phone calls and an emergency refill from regular retail to get by until issue was resolved). I would never personally use mail order after that experience.

 

[Chrish]

Not enough job security when it comes to your mental health. I would not be surprised to learn working in retail causes you to die 5-10 years early. My retail friends have aged so much. You can see it on their faces

I mean work conditions have been **** for a while now. Nothing new there.

I don’t see myself doing this past 50- 55.

 

[RN2RPh]

I mean work conditions have been **** for a while now. Nothing new there.

I don’t see myself doing this past 50- 55.

Nah, you dont have to do retail until 50s. Most new grad RPh can get out of retails usually after 5 years. A lot of my classmates are still working retail because either "they choose to stay" or "they don't really want to get out"

 

[baronzb]

Nah, you dont have to do retail until 50s. Most new grad RPh can get out of retails usually after 5 years. A lot of my classmates are still working retail because either "they choose to stay" or "they don't really want to get out"

What is the main transition? I assume home infusion, rehab?

 

[RN2RPh]

What is the main transition? I assume home infusion, rehab?

I would say health system outpatient or specialty pharmacy are the main transition. Personally, I've seen my retail colleagues moving to amb.care (anticoag, refill services), vet/compounding, home infusion, LTC/rehab/hospice, managed care, mail-order, inpatient or even research pharmacy.

 

[RXDOC1986]

Well, good old Walgreens, already had a $80 million contract with Theranos (Elisabeth Holmes) to place a Blood testing machine in every store.
Who do you think was going to run those tests. Thank goodness for fraudsters.
But, it's coming soon.

 

[confettiflyer]

Probably a good time to open a pharm tech program and get it ready for the inevitable “super tech” that boards of pharmacy will sanction as a response to reduced public access.

Think we can create one virtually with no in-person classroom component?

 

[libra08]

That’s not how it worked. Package got “lost” along the way even though it was ordered a week in advance and it was the last refill.

Was a nightmare getting it straight (multiple phone calls and an emergency refill from regular retail to get by until issue was resolved). I would never personally use mail order after that experience.

Next time ask for meds to be shipped on same day for next day delivery. If you are low why would you ask med to ship in a week?

 

[libra08]

Probably a good time to open a pharm tech program and get it ready for the inevitable “super tech” that boards of pharmacy will sanction as a response to reduced public access.

Think we can create one virtually with no in-person classroom component?

Nah, no one wants to be a “super tech”. Techs are more likely to lose their job to automation. Techs can’t do final verification. There will be fewer job opportunities for both pharmacists and techs.