Tomorrow's Pharmacist (2004)

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Pharmacy training in Australia

Pamela Mason interviews Lachlan Rose, a pharmacy student at the University of Sydney, Australia

page 38-39

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If you are doing your pharmacy degree at Manchester, Leicester or Aston, you might just wish you were studying in a place where the sun shines on most days of the year and where you can hang out in a bar next to the beach. Sydney is one such place and although a pharmacy degree is hard work wherever you are, you could be justifiably envious of Lachlan Rose, who at the time I spoke to him, was a fourth year undergraduate at the faculty of pharmacy at the University of Sydney.

Career plan

Lachlan never planned to do pharmacy. Because his mother was a pharmacist, it was the last thing he wanted to do and he decided to be an engineer. However, his gap year made him realise that engineering was not for him because he wanted more contact with people. He therefore began to think more seriously about pharmacy, but with the underlying idea of moving into medicine. Again, a further year — this time on the undergraduate pharmacy course — convinced him that pharmacy offered plenty of scope for an interesting career. “By then I had begun to feel that pharmacy was actually much broader than medicine,” he added.

Gap year

Spending six months of his gap year in the UK — he worked for three months in remedial classes in a school in Wimbledon before going on to a tertiary education facility for physically disabled students in Mansfield, Nottinghamshire — proved to be a great learning experience. Budapest was his next stop where he taught English to Hungarian students. He also took time out for white water rafting in Zambia, a safari in Zimbabwe and travelling in Europe, Israel and Egypt before finally making his way home via India where he worked with street children in Bombay. After trekking in Nepal and a visit to Thailand, Hong Kong was his last port of call before flying back to Sydney and pharmacy school.

Pharmacy degree course

I gained the impression that Lachlan had enjoyed the pharmacy programme. In particular he valued the availability of practical placements in the second, third and fourth years. “There were lots of opportunities not only in community and hospital, but also in specialist clinics and residential homes,” he explained. What did surprise me is that he thinks the course places too heavy an emphasis on pharmacy practice as opposed to pharmaceutical science. “It’s great for those who want it but not everyone does.”

In Australia, about 60 to 70 per cent of students live at home. “Leaving home is not such a big thing as it is in the UK,” Lachlan says. Students from the outback have to live in college, and because of a lack of pharmacies in rural areas to serve the indigenous population (Aborigines and Torres Island people), there are financial incentives to encourage school leavers in rural areas to study pharmacy. Payments are also made to pharmacists in rural pharmacies who open up pharmacies or buy a pharmacy that would otherwise have closed.

Finances

School of pharmacy fees are around A$4,500 a year (approximately A$2.5 = £1) and loans are available through a higher education contribution scheme. However, because the majority of students have no accommodation costs, money is not such a huge issue, Lachlan says. “In any case, most of us have evening or Saturday jobs in community pharmacies, and you actually feel disadvantaged professionally if you haven’t done this.”

During his last year at university, Lachlan was student president. Organising pub crawls, harbour cruises, ski trips, barbecues and a gala ball did not leave him much time for other activities.

Preregistration training

The academic year in Australia runs from March through to November, with the summer vacation starting in December. By now Lachlan will have started his preregistration training at St Vincent’s Hospital, one of the top three teaching hospitals in Sydney. Preregistration training is much like ours, and generally you do it either in a community pharmacy or a hospital. It is not common to split the year. Lachlan chose hospital because he wanted to get a good grounding in therapeutics, which as he says “will stand in him good stead wherever he works in the future.” Exposure to a large variety of clinical conditions and the challenge of medication dosing in critical care patients is something that he was looking forward to.

Hospital placements are not so common as those in community, which is where many of his contemporaries will be doing their training. But unlike many British preregistration trainees, they will not be working for a pharmacy chain. In most of the states and territories, pharmacies have to be owned by a pharmacist and one pharmacist can own three pharmacies at the most. However, this may be set to change, since Woolworth’s and other department stores are developing a growing interest in opening pharmacies. In the first instance, these in-store pharmacies will be owned by independents, but if the government has its way, chains may be part of the Australian pharmacy scene before long.

Non-pharmacy outlets are also fighting for the deregulation of pharmacy-only medicines, for example, small packets of ibuprofen. The Pharmacy Guild of Australia (a similar organisation to the National Pharmaceutical Association) is heading up a strong defence on deregulation of medicines and the development of pharmacy chains, but the pressure is on for pharmacy to prove the worth of its current monopoly position, Lachlan says.

Not surprisingly, Australian pharmacists are beginning to provide other services. Blood pressure monitoring, weight checks and advice on minor ailments have been part of the service for several years, but more recently, pharmacists have begun to conduct medication reviews in both the domiciliary setting and in nursing homes. Even better, they are paid for doing so.

Preregistration training in Australia is subject to continual assessment throughout the year. In addition to the practical component, students have to attend tutorials and complete a variety of training modules and group assignments. At the end of the year, there is a written examination which consists of multiple choice questions and some extended answer questions. There is also an oral component in which the student has to prepare a patient case study with recommended pharmaceutical interventions and then present this to the examiners as if it were for a doctor. The oral examination also tests counselling skills.

When Lachlan has passed his preregistration training, he will be qualified to practise as a pharmacist — but only in the state of New South Wales. It is possible to transfer to other states in Australia, but the pharmacist must pass a further examination for each state. Broadly, all the states have similar exams, but pharmacy laws vary from state to state, Lachlan says. Not that I suspect Lachlan will want to move for a while. Sydney looks a great place to work — even if you have been born and bred there.