Pharmacists

What is a pharmacist?

Pharmacists are health professionals and experts on medicines in the community. They understand their composition, chemical and physical properties, manufacture, uses, side effects and interactions with food and other medicines. They have the skills and knowledge to help patients understand and use their medicines in the most appropriate way.

The practice of pharmacy includes the development and manufacture of medicines, the supply and dispensing of medicines to patients, and the giving of information about medicines, drug therapy and disease management to patients. They also provide specialised information to doctors, nurses and other health practitioners. A pharmacist must be registered by the Pharmacy Council of New Zealand.

What Do Pharmacists Do?

• Pharmacists are involved in every aspect of the preparation and use of medicines, from the research and development of new drugs to ensuring the patient is taking the correct medicine.
• Often a pharmacist is the first point of contact in the health care system, assessing patients and deciding whether to refer them to a doctor or to treat them with one of the many medicines available over the counter. In this way, pharmacists are a link between doctor and patient.
• Pharmacists dispense medicines and advise people how, and when, to take their medicines safely for maximum effect; how to reduce side effects, and how to use specialised devices such as inhalers, syringes, and blood glucose meters.
• Increasingly, pharmacists are moving more towards disease and medicines management roles, carrying out medication reviews, monitoring patients' use of medicines and helping patients with conditions such as diabetes or mental illness to manage their medicines and their illness.
• Pharmacists often work as a team with other people and are likely to be responsible for others working with them.

Where Do Pharmacists Work?

Because of the different careers pharmacists can follow, there is a wide choice of careers open to them after registration. Pharmacists work in community and hospital pharmacy, industry, marketing and sales, Government agencies, teaching, publishing and pharmaceutical related agencies.

What personal qualities should a pharmacist have?

• Almost every pharmacist works with people so it is important that prospective pharmacists like people, are good listeners and can communicate well. They also need to be good team players.
• Pharmacists work within a code of professional ethics that encompasses their relationship with other pharmacists, other health professionals and the public. A well-developed sense of responsibility is essential and an ability to communicate effectively with other health professionals and the general public is important.
• Often pharmacists meet people when they are ill or worried, so they need to be caring and concerned for others. Pharmacists maintain a special relationship of trust and confidentiality with their patients.
• Pharmacists' decisions and actions may involve human life and well being. They must be constantly vigilant to avoid errors that could endanger patients' lives or reduce the effectiveness of treatments.
• Because they are likely to be responsible for managing staff, pharmacists need to be good organisers and administrators to ensure the work is carried out efficiently. Pharmacy provides an opportunity for individuals to be innovative and develop new concepts in practice. It is important to have an ability to meet the challenges of change.

What qualifications are needed to become a pharmacist?

To be eligible for registration as a pharmacist, an applicant must hold a Bachelor of Pharmacy degree (BPharm) and complete the Pre-registration Training Programme EVOLVE. All pharmacists must be registered with the Pharmacy Council of New Zealand.

What training is required to become a pharmacist?

It takes a minimum of 5 years to become a registered pharmacist.

The Bachelor of Pharmacy (BPharm)

• The BPharm degree is a four year university course that is offered at the Schools of Pharmacy at the University of Otago, Dunedin and the University of Auckland.
• The entry requirements for the BPharm degree are set out in the University Calendars, which are available from the universities.
• Pharmacy is a science-based profession and therefore it is useful to have a sound background in science. Intending students must study Biology, Chemistry, Physics and Mathematics (calculus or statistics) to year 13 level and must also have NCEA Level 3 English.

For more details on the courses and the subjects studied contact The University of Auckland http://www.health.auckland.ac.nz/pharmacy or "The University of Otago http://www.pharmacy.otago.ac.nz/

What is the EVOLVE^® Training Programme?

• A graduate (pre-registrant) must undertake a one year period of practical training in an approved pharmacy site prior to registration as a pharmacist. During this time the pre-registrant must complete the pre-registration programme which is a competence-based programme that includes assignments and assessments throughout the year. The pre-registration programme is the link between academia and practice, where the pre-registrant achieves the skills, knowledge and attributes of a registered pharmacist.
• The pre-registrant is an employee during this year and can expect to earn between $25,000 and $28,000 in this pre-registration period. The fees for the pre-registration programme are approximately $3000.

What career prospects are open to pharmacists?

Pharmacists are found in a wide variety of careers and the final choice depends on the interests and abilities of the individual.

Community pharmacy

Community pharmacists work in an environment that combines professionalism and business. While professional requirements are paramount, the challenges of commerce must also be met. These include functions such as business planning, accounting, buying, merchandising, marketing, as well as staff recruitment, training and development. Community pharmacy offers pharmacists the challenge of free enterprise and professional fulfilment. One of the main roles of community pharmacists is the dispensing of prescriptions from a variety of approved health practitioners. The pharmacist must ensure that the patient understands what the medicine is for and how best to use it. Advice is given on any possible side effects that the medicine may cause and also information on storage and expiry dates. The pharmacist should also provide a follow up service to ensure that the patient is receiving the maximum benefit from treatment.

The other main role of community pharmacists is the provision of advice and counselling on treating a wide range of health conditions and the maintenance of good health. Increasing emphasis is placed on "self-care" as the public take more responsibility for maintaining their own health through the assistance of their pharmacist. Most customers seek the pharmacist's advice on medicines to treat minor problems like coughs, colds, stomach upsets and skin problems. Pharmacists, using their professional judgement, will advise and supply a suitable medicine or refer the customer to their doctor. Patients can use the services of a pharmacist to monitor their health. Some pharmacists undertake blood pressure measurements and other monitoring functions, e.g. diabetic self-care centres, cholesterol testing, etc. While most of a pharmacist's work revolves around customers who present themselves at the community pharmacy, services are also provided to care facilities such as rest homes and small hospitals.

Community pharmacists are integral members of the primary health care team and increasingly are becoming involved in joint initiatives with other healthcare providers. These initiatives are designed to provide enhanced services to the public for conditions such as Diabetes, Mental Illness and Asthma or to provide extra help to people who need assistance managing their own medicines.

Hospital pharmacy

Pharmacists in hospitals work with doctors, nurses and other health practitioners caring for the patients on the wards and in out patient clinics.

Some hospital pharmacists specialise and develop expertise to work with particular groups of patients such as children, the elderly or those with cancer. Age or illness often affects the way that the body systems work so these patients have special requirements and need medicine doses calculated on an individual basis.

Pharmacists have training in the preparation of medicines such as injections or eye drops, which must be sterile i.e. free from microbial contamination that could seriously injure a patient. Cytotoxic injections, which are used to treat patients with cancer, have to be handled under special conditions as they have the potential to be harmful. Other pharmacists prepare intravenous nutrition for patients, who because of surgery, or other reasons cannot take food by mouth.

Some pharmacists are involved in the national network of Drug Information Centres and answer queries from doctors and other health practitioners about medicine problems such as side effects, interactions of medicines and the use of medicines in pregnancy. The Drug Information Centre also provides newsletters for the hospital and provides reviews of new medicines for consideration by the Hospital Drug and Therapeutics Committee. Computer databases, medical journals, the internet and reference books are all used to enable pharmacists to provide up-to-date answers.

Specialised Pharmacy Services

Medication Management describes a range of services that help at risk people get more benefit from their medicines. While they vary in complexity these services typically include a medicine review where the pharmacist collects information from the patient about their medicines use, health problems and lifestyle then evaluates the information to determine how the patient's medicine use could be improved. Then the pharmacist works with the patient and if necessary the patient's doctor to develop strategies that address any actual or potential medicines related problems, to improve the patient's use of their medicines, and to ensure that the patient gets the best possible effect from their medicines. These services can be provided by pharmacists already working in community pharmacy, or pharmacists working independently who contract their services to community pharmacies or to doctor's groups.

By completing additional training pharmacists can gain accreditation to provide Emergency Contraception counselling and where safe and appropriate prescribe the Emergency Contraceptive Pill. A large number of pharmacists working in community pharmacy now provide this service.

Advisory pharmacists or pharmacist facilitators

These pharmacists may be employed by a group of doctors, an Independent Practice Association or a Primary Health Organisation. They provide information on medicines, and prescribing protocols for the treatment of common conditions seen in general practice and often liaise between community or hospital pharmacists and doctors. Some provide medication reviews and they also carry out background research and develop guidelines for specialised projects e.g. smoking cessation. Advisory pharmacists also carry out analysis of medicine use including costs and make recommendations for more effective use and/or cost reduction of treatment.

Pharmaceutical Companies

Pharmaceutical companies offer a number of different employment opportunities for pharmacists. Specific areas include:

Production

Pharmacists play an important part in production work that generally involves planning, inventory control, warehousing, manufacturing and packaging. Pharmaceutical analysis and control ensure that a patient receives a safe and effective medicine.

Regulatory affairs

Pharmacists in these roles manage the registration of new medicines. This involves liaison with government agencies to ensure that medicines comply with the New Zealand regulations for quality, manufacturing standards, packaging, labelling and consumer information.

Clinical Research Associates

Other pharmacists are employed as clinical research associates and monitor trials set up by pharmaceutical companies to test the effectiveness of new medicines.

Sales and Marketing Representatives

Some pharmacists are employed to visit doctors, pharmacists and specialists to provide full information on new and existing medicines. Many sales and marketing representatives also provide training on the products to pharmacy staff.

Extra qualifications in business or marketing will assist a pharmacist who is interested in the areas of Marketing, Sales and Product Management.

Government Agencies

• In New Zealand, pharmacists in the Government are employed by the Ministry of Health, Pharmac and the Institute of Environmental Science and Research (ESR)
• The Ministry of Health employs pharmacists in advisory, monitoring and enforcement roles relating to pharmacy, the use of pharmaceuticals, manufacturing process and new medicine evaluation.
• Medsafe is the division of the Ministry of Health that employs pharmacists as Medicine Control Advisors to advise prescribers e.g. doctors and pharmacists on the regulation and control of medicines. They also audit pharmacies to ensure that they are operating in accordance with legal requirements and quality standards of practice. Medicine Control Advisors work with customs and police to provide advice to the Medical Officer of Health on enforcement of the laws relating to medicines importation and use. Other roles for pharmacists within Medsafe include:

1. auditing the manufacturers of medicines and blood products to ensure that all manufacturing is carried out to the highest standards
2. evaluating the scientific data for new medicines.
3. preparing information on medicines or specific health topics which is distributed to other health practitioners

• Pharmac is the government agency that manages the expenditure on medicines in New Zealand. Pharmacists, employed as therapeutic group managers, manage the expenditure on particular groups of medicines and negotiate prices of medicines with pharmaceutical companies. Other pharmacists employed by Pharmac are responsible for producing and maintaining the Pharmaceutical Schedule (a list of all subsidised pharmaceutical products), answering queries from doctors, pharmacists and the public and for producing patient education materials.

Teaching

A small number of pharmacists are employed in teaching or are engaged in research at the Schools of Pharmacy in the Universities. For these positions a postgraduate qualification is usually required such as a Master of Pharmacy or a Doctorate.

Other pharmacists are employed in tutoring and assessment of the National Certificates in Pharmacy (Technician and Assistant).

Publishing and computing

Pharmacists are employed by publishing companies that specialise in medical publishing to edit medical and pharmaceutical books and journals, write drug information software and promotional material.

Pharmacists also work with computer companies producing dispensing software and websites.

What other opportunities are available for pharmacists?

Many young pharmacists take the opportunity to travel and experience pharmacy in other countries. New Zealand pharmacy qualifications are acceptable in Australia. Other countries may require the pharmacist to complete a further short period of study to gain registration in that country.

Postgraduate qualifications are available both on a full time or part time basis through the University of Otago and the University of Auckland. The New Zealand College of Pharmacists also offers postgraduate study and qualifications.

All pharmacists are required to be life long learners, and in any sphere of pharmacy practice it is important that every pharmacist maintains a high standard of practice and keeps pace with the ever changing pharmacy environment. This can only be achieved through Continuing Professional Development such as ENHANCE which is now a mandatory requirement for all pharmacists.

There is an increasing demand for new medicines, new innovative health services and different ways of administering present medicines, so young pharmacists will face many new challenges with expanded responsibilities and ever increasing opportunities.

For more details

For more details on the BPharm course and the subjects studied contact the Universities directly.

University of Auckland University of Otago

http://www.health.auckland.ac.nz/pharmacy http://www.pharmacy.otago.ac.nz/

For information about being a pharmacist call into your local pharmacy or contact the pharmacy department at your local hospital and ask if you can visit and talk to the pharmacists.