Tomorrow's Pharmacist
2006:pp54-57
January 2006

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Canadian adventure: How to become a licensed pharmacist in Canada

By Louise Crandall

Canada faces a pharmacist shortage. Think you might like to help them out? If the thought of living and working in Canada appeals to you, make it happen . . .

Pharmacists make up the third-largest segment of health professionals in Canada. There are approximately 28,530 licensed pharmacists (January 2005 figure from the National Association of Pharmacy Regulatory Authorities) in the country, 75 per cent of whom work in 7,590 community pharmacies. Another 15 per cent work in hospital pharmacies while the remaining 10 per cent work in universities, associations, pharmaceutical and insurance companies, or as consultants.

Shortages in the pharmacist workforce first became evident in the 1990s and it is now estimated that Canada has an unfilled demand for 2,000–2,500 pharmacists. These shortages have forced some pharmacies to cut back services and hours of operation. This shortfall is projected to grow as the workforce continues to age and retire and as more pharmacists seek part-time work. Some of the large pharmacist employers now, in fact, have campaigns to recruit pharmacists from outside Canada.

Licensing and regulation of pharmacists in Canada

Pharmacists are licensed and regulated by the pharmacy regulatory authority (PRA) in the province or territory in which they practise. All pharmacists must meet the entry-to-practice standards as established by the provincial or territorial PRA (see Panel for contact information).

The National Association of Pharmacy Regulatory Authorities (NAPRA) outlines the competencies required by a pharmacist at the point of licensure in Canada (PDF, 120K). The six main required competencies are the following:

• Practise pharmaceutical care Pharmacists in partnership with patients and other health care providers, use their unique knowledge and skills to meet patients’ drug-related needs. To achieve positive patient outcomes by maintaining or improving the patient’s quality of life
• Assume ethical, legal and professional responsibilities Pharmacists practise within legal requirements, demonstrate professional integrity and act to uphold professional standards of practice and codes of ethics
• Access, retrieve, evaluate and disseminate relevant information Pharmacists assume responsibility for information access, retrieval, evaluation and dissemination to ensure safe and effective pharmaceutical care and promote health
• Communicate and educate effectively Pharmacists educate and communicate with groups and individuals to support optimal patient care and promote health
• Manage drug distribution Pharmacists manage drug distribution by performing or supervising the functions of acquisition, preparation, and distribution of drugs to ensure the safety, accuracy and quality of supplied products
• Apply practice management knowledge and skills Pharmacists apply knowledge, principles and skills of management as they pertain to the site of pharmacy practice with the goal of optimising pharmaceutical care and inter-professional relations

The core requirements for initial licensure in most provinces are:

• A bachelor’s degree in pharmacy from a Canadian university or equivalent
• Completion of Pharmacy Examining Board of Canada (PEBC) national board examinations, except for Quebec (see below)
• Practical experience through an apprenticeship or internship programme
• A particular level of fluency in English or French

Specific provincial and territorial requirements for licensure are available from NAPRA (www.napra.org/docs/0/94/109.asp).

PEBC national pharmacy examinations

The Pharmacy Examining Board of Canada assesses the qualifications of both Canadian and foreign graduates acceptable to participating pharmacy-licensing bodies. All provinces (except Quebec) require pharmacy candidates to have the PEBC certificate of qualification. The PEBC evaluation process involves a few steps:

The PEBC evaluates various documents submitted by the non-Canadian-trained pharmacist to ensure the candidate has a degree in pharmacy that is acceptable to the PEBC. If the documents are accepted, the candidate then sits an examination.

Most international pharmacy graduates (IPGs) must sit an evaluating examination to determine whether or not they have completed a programme of study comparable to that taught in Canada. Following successful completion of the evaluating examination, IPGs can then take the PEBC qualifying examination, which is held twice a year.

The qualifying examination is designed to ensure that successful candidates have met the required standard of competence for safe and effective practice. The qualifying examination has two parts: multiple choice questions and an objective structured clinical examination. The latter consists of a series of tasks simulating common and/or critical, practical situations, which involve interactions with a standardised patient or client (eg, parent or care-giver) or standardised health professional.

In 2004, 951 pharmacy graduate candidates passed the PEBC qualifying examination (Parts I and II); 590 (62 per cent) were Canadian pharmacy graduates and 361 (38 per cent) were international pharmacy graduates (IPGs).

Supporting international pharmacy graduates in Canada

Since 2001, there have been significant increases in the number of successful IPG candidates passing the evaluation and qualifying examinations. However, there is still a substantial gap between the numbers of candidates who successfully pass the evaluation examination and those who pass the qualifying examination.

Challenges for IPGs wishing to practise pharmacy in Canada

The PEBC examinations and other requirements for licensure in Canada aim to promote uniformity in high standards of practice and the knowledge and skills of pharmacists. For some IPGs, meeting the language requirements can be a challenge, as can simulating common and/or critical, practical situations. Another potential issue for foreign-trained pharmacists is learning how to interact with physicians, nurses, allied health providers and, most importantly, patients within the context of pharmaceutical care. These would be less of a challenge, of course, for UK pharmacists who speak English and have a similar practice model to Canada.

Support available to IPGs qualifying to practise in Canada

Many IPGs can benefit from support to facilitate successful completion of the licensing and examination processes and to integrate effectively into pharmacy practice in Canada. Two universities offer structured programmes to assist pharmacists from other countries to gain the language, workplace and practice skills necessary for licensure in Canada. One of the aims of these programmes is to assist IPGs to prepare for the PEBC national board examination. Fees for these programmes range from C$7,500–13,000.

The international pharmacy graduate programme at the University of Toronto Leslie Dan Faculty of Pharmacy, is the longest running pharmacy bridging programme in Canada. The Ontario College of Pharmacists and the Ontario Ministry of Training provided the funding to support development and implementation of the programme. Results from the programme have been positive, with over 90 per cent of participants passing the PEBC qualifying examinations. Satellite programmes have been launched in Ottawa and in Waterloo. The programme has two modules, each running for nine week. The University of British Columbia (UBC) has also started a new 12-week programme, the Canadian pharmacy practice programme.

Individual provincial regulatory authorities are also supporting other programmes aimed at helping pharmacy candidates deal with specific challenges. For example, the Manitoba Pharmaceutical Association has been involved with Manitoba Labour and Immigration on two initiatives: “Language benchmarks for pharmacy” (a fluency assessment tool for IPG candidates), and the “Prescription for learning curriculum” (a mentoring programme for licensed foreign graduates). Further information is available (PDF, 980K).

Living in Canada

Canada is the second largest country in the world (after Russia) with an area of nine million km2 and a population of 32.8 million. About 90 per cent of the population is concentrated within 160 km of the US border. English is the mother tongue of 59 per cent of the population, while 23 per cent speak French and 17 per cent another language. Depending where you live in the country, the temperature can reach 36 degrees Celcius in summer and minus 30 degrees in winter. Average annual snowfall can range from 47cm in Victoria to 2.4m in Montreal. Since each region of Canada has different characteristics, UK pharmacists considering emmigrating to Canada would be well advised to research the province they would like to live in along with the type of lifestyle they envision (urban, small town, country). For more information on emmigrating to Canada, read the Newcomers Guide to Canada published by Citizenship and Immigration Canada.

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