Pharmacy schools turning out too many grads

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For pharmacists, the salad days were just a decade ago, a time when a young man or woman newly in possession of a pharmacy doctorate could find a job in any state, working flexible hours, for handsome pay. And if the pay wasn't handsome enough, he or she could pick up and move from a more saturated city like Pittsburgh -- which has two pharmacy schools -- to someplace in the Southwest, where druggists were in critically short supply and higher demand. Six-figure salaries, $30,000 signing bonuses, even new cars, weren't uncommon.

You know what comes next: Universities responded by churning out new pharmacy grads, to meet the expected demands of a graying baby boomer generation and the seniors who were outliving actuarial forecasts. From 1987 to 2012, the number of accredited pharmacy schools in the United States grew from 72 to 128. Existing schools expanded their class sizes, as well.

Instead of creating 6,000 new doctors of pharmacy a year, as was the case in 2002, U.S. higher education is now putting out around 13,000.

It's too many, says Daniel L. Brown, pharmacy professor at Palm Beach Atlantic University in Florida. He's studied and written about the issue.

"By 2007, you could see the winds starting to change," he said. "Some of it's the economy. Some of it's people not retiring. But most of it is the overexpansion of schools." The job market, he said, just can't absorb all of the new pharmacists, and it may take until the end of the decade or longer for a rebound.

PG graphic: Pharmacy degrees
(Click image for larger version)

Another issue facing new grads -- in some of the areas where growth was expected, the new jobs never materialized. Pharmacy schools were banking on the fact that changes in health care delivery would put pharmacists in new places, much like nurse practitioners are being deployed in clinics in lieu of medical doctors. For at least two decades, pharmacists and pharm schools have talked about how the profession must move away from a product-dispensing focus, and toward a broader "patient-centered" approach.

And that still may happen -- for example, druggists are now allowed to administer flu shots, something they weren't allowed to do in the 1990s. But for now, the bulk of the pharmacy job market is still tied up in retail and in-patient hospital settings. As a result, the cars and signing bonuses are gone, and some grads are being asked to work 32 hours a week, or to serve as "floating" pharmacists, rotating among several locations within a drugstore chain.

"At this point, there is no push on the demand side," said Patricia D. Kroboth, dean of the University of Pittsburgh School of Pharmacy. And there are schools that can't place all of their students.

A 'glut' in the Pittsburgh area

Both Pitt and Duquesne still place 100 percent of their graduating pharmacy students, though the math behind "placement" has changed, as well.

If a grad has been placed, that means he's either found a job or is pursuing a residency or additional educational training. A decade ago, perhaps 10 to 15 percent were entering residencies, and the rest found jobs. But today, at Duquesne University's Mylan School of Pharmacy, nearly a quarter of graduates postpone the job search and are placed in a residency.

J. Douglas Bricker, dean of the Mylan School, said that while the job market has been historically tight here, there's now a "glut" of pharmacists in the Pittsburgh area.

"Everybody wants to stay home, right?" he said. "There are still pockets of the country where there are still deficits in the number of pharmacists, [but] you might need to go somewhere to be able to come back" to Pittsburgh.

The supply of pharmacists is building nationally, thanks to the dramatic increase in the number of pharmacy schools. In Pennsylvania two decades ago, there were four pharmacy schools -- now there are seven (LECOM School of Pharmacy, Wilkes University School of Pharmacy and Jefferson School of Pharmacy are recent additions). The same thing happened in Ohio; four schools turned into seven.

Of those new schools nationally, 17 of them have yet to graduate a single student, meaning they were launched within the past four years. "It's possible that they see pharmacy as a cash cow," Ms. Kroboth said, speaking of academia generally.

Prior to 1990, pharmacists were routinely educated at the undergraduate level (with a bachelor of science pharmacy degree), but in 1990, the American Association of Colleges of Pharmacy mandated that a pharmacy doctorate would be the profession's new job requirement. Bachelor's pharmacy programs were phased out after that, and accreditation of bachelor of science degree programs ended in 2004, turning what had been a five-year program into one that takes at least six years -- and, thus, is more costly for the student.

The growth is not just in the number of schools, but also the number of students at existing schools. Pitt grew its class size from 83 a decade ago to 106 first-year students in 2012, for example (the school's total enrollment is 432 students). Duquesne now has 206 students on track to graduate in 2013, and 1,187 enrolled in the pharmacy school, total.

Students seem to be catching on to the somewhat altered job prospects. Pitt's pharmacy school applications were down 14 percent between 2011 and 2012. A decade ago at Duquesne, the pharmacy school received 1,200 or 1,300 applications a year -- now it's down to around 800.

Nationally, there were 99,800 pharmacy school applications submitted in 2011-12.

"My estimate [is] 20 percent unemployment of new grads by 2018," Mr. Brown said. "The job market is [stagnant], but we're still pumping out graduates every year. They've got six-figure loans."

Supply and demand

So whose responsibility is it to make sure the number of graduate roughly matches the number of jobs available? Is this a problem for the law of supply and demand to figure out, or should higher education better police itself?

Or is it a job for the organization that gives accreditation to the new schools, called the Accreditation Council for Pharmacy Education? Today, the council issues accreditation based on a school's standards, means and ability to carry out its mission. It does not take need into account, however.

"If the school is able to demonstrate that they meet the standard, [there] is no ability to say, 'I'm sorry, there are enough schools,' " Ms. Kroboth said.

"There is no entity that has the power to tell 'East Podunk University' that they shouldn't develop one."

The deans have a more optimistic view of the job market than does Mr. Brown, believing that the Affordable Care Act (which should create millions of newly insured Americans), the aging boomer generation, a turn toward holistic team care of patients and a shifting of responsibilities for pharmacists will eventually help to relieve some of the glut.

Those boomers who had hoped to retire five or six years ago but postponed those plans after their retirement accounts cratered, should be able to step aside soon, too.

On the other hand, there will be continued contraction on the pill-dispensing side of the profession. Mail-order pharmacies, robotics in hospitals, automated bar-coding -- "a pharmacist never has to touch the medication," Ms. Kroboth said. "Technology [has] really changed the face of dispensation."

That's true, said Jennifer L. Adams, a senior director at the American Association of Colleges of Pharmacy. The profession is already much different than the one she envisioned when she graduated from pharmacy school 10 years ago.

But she also says concerns about a persistent glut of pharmacists are overblown. For every state with a surplus of pharmacists -- and Pennsylvania has the largest surplus of them all -- there are more states where pharmacists are in shorter supply, such as Texas, Kansas and California.

After a decade of building up the number of pharmacy graduates, new school accreditation has begun to taper off, and "we're pretty close to equilibrium," Ms. Adams said. "I don't think that's a bad thing."

Bill Toland: btoland@post-gazette.com or 412-263-2625.


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