Credentialing in Pharmacy© Copyright 2003, Council on Credentialing in Pharmacy
The Council on Credentialing in Pharmacy;
Washington, DC, September 2003

INTRODUCTION
The credentialing of pharmacists and pharmacy technicians is an important topic in theprofession of pharmacy. Discussions about credentialing, inherently complex, have been further
complicated by the lack of a common lexicon. Many different words are used to describe theprocess by which health care practitioners are educated, trained, licensed, and otherwise
recognized for their competence and achievements. Additionally, many different organizations,public and private, are involved in assessing pharmacists’ and pharmacy technicians’ knowledge
and skills, granting credentials, and accrediting educational programs and institutions.
As pharmacy becomes more integral to the therapy decision-making and patient-monitoring
activities within the health care system (institutional and community-based), employers, othercare providers, patients, and health care payers have the need to better understand and appreciate
the breadth and depth of pharmacist and pharmacy technician education and training and the
myriad post-graduate education and training opportunities available to pharmacists. Most
importantly, those within and outside the profession must share a common language andunderstanding of credentials so as to make educated, rational decisions regarding scope ofpractice, privileging, and eligibility for compensation. A clear understanding of the knowledge,
skills, and abilities of contemporary pharmacists and pharmacy technicians and the meaning ofvarious credentials held by them will lead to a more effective health care workforce deployment,
appropriate privileging and responsibility assignments, equitable compensation mechanisms, andimproved quality of patient care.
Council on Credentialing in Pharmacy
The Council on Credentialing in Pharmacy (CCP) is a coalition of 12 national pharmacyorganizations founded in 1999 to provide leadership, standards, public information, andcoordination for professional voluntary credentialing programs in pharmacy. Members of the
CCP include the following organizations:
Academy of Managed Care Pharmacy
Accreditation Council for Pharmacy Education(formerly the American Council on Pharmaceutical Education)
American Association of Colleges of Pharmacy
American College of Apothecaries
American College of Clinical Pharmacy
American Pharmacists Association
American Society of Consultant Pharmacists
American Society of Health-System Pharmacists

1Board of Pharmaceutical Specialties
Commission for Certification in Geriatric Pharmacy
Pharmacy Technician Certification Board
Pharmacy Technician Educators Council
Purpose of this Paper
The purpose of this paper is to provide for those within and outside the profession an overview
of the current status of the spectrum of education and credentialing activities and processes forpharmacy personnel (pharmacists and pharmacy technicians), to create a common frame ofreference and understanding for discussions concerning pharmacist credentialing, and to raiseissues to be considered as credentialing of pharmacy professionals evolves and matures. It begins
with definitions of several terms that are essential to any discussion of credentialing. A shortsection highlighting the importance of credentialing to pharmacists follows this. The next three
sections, which form the body of the paper, discuss in detail the three categories of credentials
that pharmacists may earn:•••credentials needed to prepare for practice (i.e., academic degrees);
credentials needed to enter practice (i.e., licensure) and to update professional knowledge andskills (i.e., relicensure) under state law; andcredentials that pharmacists voluntarily earn to document their specialized or advanced
knowledge and skills (i.e., postgraduate degrees, certificates, certification).

Each of these sections contains, as applicable, information about the credential awarded, thetraining site, whether the credential is voluntary or mandatory, the credentialing body, and theagency that accredits the program. Particular attention is given to pharmacist certification
programs, an area that has engendered much of the current interest in pharmacist credentialing.
The paper also includes a brief section on credentialing of pharmacy supportive personnel. It
concludes with two appendices. Appendix A contains a comprehensive glossary of key terms
relating to pharmacist credentialing. Appendix B is an alphabetical list of organizations involvedin pharmacist credentialing and program accreditation. The list contains names, addresses, anduniform resource locators (URLs).
Essential Definitions
Discussions of credentialing are often complicated by a lack of common understanding of key
terms and the contexts in which they are used. To clarify these misunderstandings, one must first
distinguish between processes (e.g., credentialing) and titles (a credential). Distinctions must also
be made between processes that focus on individuals (e.g., credentialing and certification) andthose that focus on organizations (accreditation). Finally, it is essential to understand that forpracticing pharmacists, some credentials are required (e.g., an academic degree or a state license)
while others are earned voluntarily (e.g., certification).

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Beyond these distinctions, it is also necessary to understand the definitions of the words that
commonly come up in discussions of credentialing and to be able to distinguish the sometimessubtle differences among them. A comprehensive glossary of such words and their definitions
appears in Appendix A. The following definitions are provided here because an understanding ofthese terms is a prerequisite to any meaningful discussion of credentialing in pharmacy.
•

A credential is documented evidence of qualifications. Pharmacist credentials include
diplomas, licenses, certificates, and certifications. These credentials are reflected in a variety
of abbreviations that pharmacists place after their names (e.g., Pharm.D. for “doctor ofpharmacy,” an earned academic degree; R.Ph. for “registered pharmacist,” which indicatesstate licensure; and acronyms such as BCNSP for “Board-Certified Nutrition Support
Pharmacist,” which indicates that an individual has demonstrated advanced knowledge orskill in a specialized area of pharmacy). For pharmacy technicians, there is only one
nationally recognized credential – CPhT, which indicates certification by the Pharmacy
Technician Certification Board.

•

Credentialing is the process by which an organization or institution obtains, verifies, andassesses a pharmacist’s qualifications to provide patient care services.

•

Accreditation is the process by which a private association, organization or government
agency, after initial and periodic evaluations, grants recognition to an organization (or aspecific program of an organization) that has met certain established criteria.

•

A certificate is a document issued to an individual upon successful completion of thepredetermined level of performance of a certificate program or of a pharmacy residency or
fellowship.

•

A statement of continuing education credit is a document issued to an individual following
participation in an accredited continuing education program.

•

Certification is a voluntary process by which a nongovernmental agency or an association
grants recognition to an individual who has met certain predetermined qualifications
specified by that organization. This formal recognition is granted to designate to the publicthat the individual has attained the requisite level of knowledge, skill, or experience in a welldefined, often specialized, area of the total discipline. Certification usually requires initialassessment and periodic reassessments of the individual’s qualifications.

•

Privileging is the process by which a health care organization, having reviewed an individual
health care provider’s credentials and performance and found them satisfactory, authorizes
that individual to perform a specific scope of patient care services within that organization.

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IMPORTANCE OF CREDENTIALS IN PHARMACY“Credential” and “credentialing,” like the words “creed” and “credence,” derive from the Latinverb credere, which means “to trust,” “to entrust,” or “to believe.” A pharmacist’s credentials areindicators that he or she holds the qualifications needed to practice the profession of pharmacy
and is therefore worthy of the trust of patients, of other health care professionals, and of society
as a whole.
In the profession of pharmacy, the interest in credentials has been catalyzed in recent years byseveral factors. First among them are the pace of change and the increasing complexity of healthcare. A second factor is the pharmacist’s expanding clinical role. Interest in credentialing has
likewise been stimulated by the growing trend toward specialization in pharmacy practice and by
the need to document the pharmacist’s ability to provide specialty care.
Another contributing factor has been the need to assure the public, employers, payers, other
health providers, and other pharmacists that practitioners are competent no matter were they arein their careers and where they practice.
Finally, economic realities enter the picture. Pharmacists who are providing cognitive services or
specialized care should be compensated for the services they provide. Similarly, payers rightfully
expect and deserve to receive validation that pharmacists are qualified to provide such services.
Credentials, and in many cases, more specifically, certification, can help provide thedocumentation that Medicare and Medicaid, managed care organizations, and other third-party
payers require of pharmacists today and in the future.

OVERVIEW OF CREDENTIALING IN PHARMACY -- PHARMACISTS
Introduction
Pharmacist credentials may be divided into three fundamental categories.
•••

College and university degrees are awarded to mark the successful completion of apharmacist’s academic training and education.
Licensure is an indication that the pharmacist has met minimum requirements established by
the state in which he or she intends to practice.
Post-graduate degrees and certificates are awarded to pharmacy practitioners who havecompleted programs of various types (e.g., residencies) that are intended to develop andenhance their knowledge and skills, or to those who have successfully documented a
specialized level of knowledge and skill through an assessment process.

These three categories of pharmacist credentialing are illustrated in Figure 1. The sections that
follow provide information on each of the credentials offered in pharmacy, the credentialing or
accreditation body involved, whether the credential is mandatory or voluntary, and other related
information.

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Preparing for the Pharmacy Profession•••

Credential earned: Doctor of Pharmacy degree: Prior to June 2004, pharmacy graduates
are/were eligible to sit for state licensing examinations with a bachelor of science inpharmacy degree or a doctor of pharmacy degree from an accredited professional degree
program. After June 2004, only the doctor of pharmacy degree will be awarded by U.S.
colleges and schools of pharmacy. A program leading to the doctor of pharmacy degree is theequivalent of four academic years in length and includes didactic, small group, laboratory,
and experiential instruction. Admission to the doctoral-level program requires appropriate
pre-professional, collegiate-level study.
Credential awarded by: College or school of pharmacy.
Accreditation body for professional programs in pharmacy: Accreditation Council for
Pharmacy Education (ACPE – formerly the American Council on Pharmaceutical
Education). The U.S. Department of Education has recognized the ACPE accreditation of theprofessional degree program in pharmacy.

Until fall 2001, an individual who wished to become a pharmacist could enroll in a program ofstudy that would lead to one of two degrees: a Bachelor of Science degree in pharmacy (B.S.
Pharm. or Pharm. B.S.) or a Doctor of Pharmacy (Pharm.D.) degree.
Standards for the accreditation of programs leading to the Pharm.D. degree (as the sole
professional degree in pharmacy) were adopted in July 1997 and became effective in July 2000.
Accreditation of baccalaureate degree programs in pharmacy will cease in June 2004. Pharm.D.
programs typically involve four academic years of doctoral-level study that follows appropriate
collegiate-level, pre-professional study. A few programs offer the professional education overthree years of full time education. Accreditation Standards and Guidelines for the Professional
Program in Pharmacy Leading to the Doctor of Pharmacy Degree may be found at
http://www.acpe-accredit.org/frameset_ProfProg.htm.
State boards of pharmacy require a Pharm.D. or B.S. degree from a program approved by theboards (almost always an ACPE-accredited program) to satisfy the educational requirements fora candidate to be eligible to take the state licensing examination. A listing of accredited
professional programs offered by colleges and schools of pharmacy is published by ACPE, andis available on the ACPE web site (www.acpe-accredit.org).
Entering Practice and Updating Professional Knowledge and Skills•••

Credentials earned: Licensure as registered pharmacist (R.Ph.); relicensure to continue topractice over time.
Credential awarded by: State board of pharmacy
Licensure process overseen by: State regulatory authorities

Pharmacy, like medicine and the other health professions, is regulated at the state level by stateboards of pharmacy. Candidates are licensed to practice after having (1) graduated from a5college or school of pharmacy approved by the board; (2) completed a minimum number ofhours of experience in practice; and (3) passed a licensing examination.
Candidates for licensure in all states but California must pass the North American Pharmacist
Licensure Examination™ (NAPLEX®), a computer-adaptive, competency-based examination thatassesses the candidate’s ability to apply knowledge gained in pharmacy school to real life
practice situations. California administers a unique examination process. Most states also requirecandidates to take a state-specific pharmacy law examination. Currently, over half of the states
use the Multistate Pharmacy Jurisprudence Examination™ (MPJE™), a computer-adaptive
assessment that tailors each examination to address federal pharmacy law as well as thepharmacy law and regulations of the state in which the candidate is seeking licensure.
Both the NAPLEX and the MPJE are developed by the National Association of Boards ofPharmacy (NABP) for use by the boards of pharmacy as part of their assessment of competence
to practice pharmacy.1 Development of these examinations is directly related to NABP’s
mission, which is to assist its member boards and jurisdictions in developing, implementing, andenforcing uniform standards for the purpose of protecting the public health. The NAPLEX and
MPJE examinations are administered by appointment, daily, throughout the year at a system oftest centers located in all 50 states.
In addition to the NAPLEX and MPJE, some states require a laboratory examination or an oral
examination before licensure is conferred. All state boards also require that candidates complete
an internship before being licensed. The internship may be completed during the candidate’s
academic training or after graduation, depending upon state requirements.
State licensure is an indication that the individual has attained the basic (entry-to-practice) levelof competence necessary to ensure that the public health and welfare will be reasonably well
protected. Individuals who have received a license may use the abbreviation “R.Ph.” (for“registered pharmacist”) or other designation authorized by the board of pharmacy after theirnames.
Most state boards of pharmacy require that registered pharmacists complete a minimum numberof continuing education units (CEUs) before they can renew their licenses. The CEUs must be
earned through participation in a continuing education (CE) program whose provider has been
accredited by the Accreditation Council for Pharmacy Education (ACPE – formerly theAmerican Council on Pharmaceutical Education). The Criteria for Quality and Interpretive
Guidelines for Approval of Providers of Continuing Pharmacy Education may be found at
http://www.acpe-accredit.org/frameset_AppProv.htm.

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The Foreign Pharmacy Graduate Examination Committee® (FPGEC®) also operates under the auspicesof the NABP. FPGEC oversees the development of the Foreign Pharmacy Graduate Equivalency
ExaminationTM (FPGEE®), and evaluates the qualifications of foreign pharmacy graduates who apply for
FPGEC Certification. FPGEC Certification is one of the pre-requisites for foreign pharmacy graduateswishing to sit for NAPLEX® and apply for licensure.

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Note that ACPE accredits providers of continuing education, not individual CE programs. CEUs
may be secured by attending educational seminars, teleconferences, and meetings; reading
journal articles; or completing traditional home study courses or computer-based education
programs. Receipt of a satisfactory score on an assessment that is created by and submitted to the
CE provider is generally required as a documentation of completion of a CE program. ACPE
publishes a directory of accredited providers of continuing pharmacy education, which isavailable on the ACPE web site (www.acpe-accredit.org).
Licensure and licensure renewal are mandatory for pharmacists who wish to continue to practicetheir profession. In their regulatory role, state boards of pharmacy are ultimately responsible tothe administrative and legislative bodies of the state.
Developing and Enhancing Knowledge and Skills
Pharmacy practitioners who wish to broaden and deepen their knowledge and skills may
participate in a variety of postgraduate education and training opportunities. They include thefollowing:•

Academic Postgraduate Education and Training -- Pharmacists who wish to pursue acertain field of study in depth may enroll in postgraduate master’s or doctor of philosophy(Ph.D.) programs. Common fields of study for master’s candidates include businessadministration, clinical pharmacy, and public health. Common fields for Ph.D. studies
include pharmacology, pharmaceutics, pharmaceutical and medicinal chemistry,
pharmacotherapeutics, pharmacy practice, and social and administrative sciences. For more
information about graduate programs offered by U.S. colleges and schools of pharmacy, see
http://www.aacp.org/Docs/MainNavigation/ForStudents/4568_200203GraduatePrograms1.doc?DocTypeID=4&TrackID=&VID=1&CID=86&DID=309.
B.S.-level pharmacists who have been in the workforce may also return to a college or schoolof pharmacy to earn the Pharm.D. degree. These programs, which are tailored to theindividual’s background and experience, may follow “non-traditional” pathways; however
they must produce the same educational outcomes as traditional Pharm.D. degree programs .

•Residencies• Credential earned: Residency certificate• Credential awarded by: Residency training program• Program accreditation: The American Society of Health-System Pharmacists (ASHP)(independently or in collaboration with other pharmacy organizations)
A residency is an organized, directed postgraduate program in a defined area of pharmacy
practice. Pharmacy practice residencies focus on the development by the resident ofprofessional competence in the delivery of patient care and practice managements activities.
Specialized pharmacy practice residencies focus on the knowledge, skills, and abilities
needed to provide care in a specialized area of pharmacy practice (e.g., critical care, drug
information, pharmacotherapy, or oncology). Residencies are usually 12 months in duration,7

although certain specialized residencies require an additional 12 (or continuous 24) months
for completion.
The American Society of Health-System Pharmacists (ASHP) is the recognized accrediting
body for pharmacy practice and specialty residency programs in pharmacy. The ASHP
Commission on Credentialing (COC), a committee of the ASHP Board of Directors, is
responsible for the development of standards for residency programs, administering theaccreditation process and granting accreditation. The COC consists of 14 appointed
pharmacists, who have served as residency program directors and who represent a variety ofpractice settings, as well as two “public” members. ASHP partners with appropriateorganizations, including the Academy of Managed Care Pharmacy (AMCP), the American
College of Clinical Pharmacy (ACCP), the American Pharmacists Association (APhA), and
the American Society of Consultant Pharmacists (ASCP), in developing standards and/or
accrediting residency programs of a specialized or practice-setting-specific nature.
The majority of pharmacists who pursue residency training currently do so by completing apharmacy practice residency. These residencies are usually based in a particular practicesetting or practice type, such as a hospital, ambulatory care clinic, community pharmacy,
managed care organization, or home or long term care practice. Specialized residency
training often involves additional education and training experiences beyond the pharmacy
practice year, usually in specialized areas of practice such as pharmacokinetics; the care of
specific types of patients (e.g., pediatrics); or a focus on specific diseases (e.g., oncology).
Accreditation standards for residencies in pharmacy practice may be found at
http://www.ashp.org/rtp/Starting/practiceresidencies.cfm?cfid=2202023&CFToken=27475618.
Accreditation standards for specialized pharmacy residency training may be found at
http://www.ashp.org/rtp/Starting/specializedresidencies.cfm?cfid=2202023&CFToken=27475618.
The Centers for Medicare and Medicaid Services (CMS), an agency of the federal
government, recognizes residency accreditation bodies within the health professions,
including ASHP in its role as the accrediting body for pharmacy residency training.
Consequently, ASHP-accredited residency programs are eligible for inclusion by a Medicare“provider” (i.e., usually a hospital) in the calculation of (and reimbursement for) the entity’s
costs for providing services to Medicare beneficiaries. The rules and regulations guiding thisreimbursement policy are reviewed regularly by CMS and are subject to change.

8•Fellowships2• Credential earned: Fellowship certificate• Credential awarded by: Fellowship training program• Program accreditation: No official accreditation body
A fellowship is an individualized postgraduate program that prepares the participant tobecome an independent researcher in an area of pharmacy practice. Fellowship programs,
like residencies, usually last one to two years. The programs are developed by colleges ofpharmacy, academic health centers, colleges and universities, and pharmaceuticalmanufacturers.
There is no official accreditation body for fellowship programs; however, an official position
statement by ACCP on Guidelines for Clinical Fellowship Training Programs can be found at
http://www.accp.com/position/pos15.pdf.

•

Certificate Programs• Credential earned: Certificate of Completion• Credential awarded by: Educational institutions and companies, pharmacy organizations,and others• Provider accreditation: Accreditation Council for Pharmacy Education (ACPE – formerly
the American Council on Pharmaceutical Education)
A certificate program is a structured and systematic postgraduate continuing education
experience for pharmacists that is smaller in magnitude and shorter in duration than degree
programs. In addition to didactic instruction, the design of certificate programs includes
practice experiences, simulations, and/or other opportunities for the demonstration of desired
professional competencies. The length of any particular certificate program is determined byits stated goals, desired professional competencies, and outcome measures. This generally
requires a minimum of 15 contact hours (1.5 CEUs). Certificate programs are designed to
instill, expand, or enhance practice competencies through the systematic acquisition of
specified knowledge, skills, attitudes, and behaviors. Certificate programs are usuallyrelatively focused; for example, the American Pharmacists Association offers programs insuch areas as asthma, diabetes, immunization delivery, and management of dyslipidemias.
Certificate programs are offered by national and state pharmacy organizations and by schools
and colleges of pharmacy and other educational groups. The programs are often held inconjunction with a major educational meeting of an organization. ACPE accredits providersof such programs. The Standards and Quality Assurance Procedures for ACPE-Accredited2

Several pharmacy organizations, including the American College of Clinical Pharmacy, the American
Society of Health-System Pharmacists, and the American Pharmacists Association, award the honorary
title of “Fellow” to selected members as a means of publicly recognizing their contributions to theprofession. A Fellow of ASHP, for example, may write “FASHP” for “Fellow of the American Society of
Health-System Pharmacists,” after his or her name. The two uses of the word “fellow”--one denoting an
individual participating in a postgraduate training program and the other denoting receipt of an honorary
title--should be clearly distinguished.
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Providers of Continuing Pharmacy Education Offering Certificate Programs in Pharmacy arefound at http://www.acpe-accredit.org/docs/pubs/CPStandards.pdf.
•

Traineeships -- Traineeships, in contrast to certificate programs, are defined as intensive,
individualized, structured postgraduate programs intended to provide the participant with theknowledge and skills needed to provide a high level of care to patients with various chronic
diseases and conditions. Traineeships are generally of longer duration (about five days) andinvolve smaller groups of trainees than certificate programs do. Some are offered on acompetitive basis, with a corporate sponsor or other organization underwriting participants’costs. Pharmacy organizations currently offering traineeships include the American Collegeof Apothecaries, the American Society of Consultant Pharmacists, and the American Societyof Health-System Pharmacists’ Research and Education Foundation.

•

Certification• Credential earned: certification in area of practice• Credential awarded by: Board of Pharmaceutical Specialties; Commission on
Certification in Geriatric Pharmacy; National Institute for Standards in Pharmacist
Credentialing• Provider accreditation: No official accrediting body
Certification is a credential granted to pharmacists and other health professionals who havedemonstrated a level of competence in a specific and relatively narrow area of practice thatexceeds the minimum requirements for licensure. Certification is granted on the basis of
successful completion of rigorously developed eligibility criteria that include a written
examination and, in some cases, an experiential component. The certification process isundertaken and overseen by the Board of Pharmaceutical Specialties, the Commission on
Certification in Geriatric Pharmacy, and the National Institute for Standards in Pharmacist
Credentialing.
The development of a certification program includes the following steps: (1) defining thearea in which certification is offered (role delineation); (2) creating and administering a
psychometrically valid examination; (3) identifying other criteria for awarding the credential(e.g., experience); and (4) identifying recertification criteria.
• Role delineation. The first step is to define the area in which certification is to be offered.
This is done through a process called role delineation or “task analysis.” An expert panelof individuals in the proposed subject area develops a survey instrument to assess how
practitioners working in the area rate the importance, frequency, and criticality of specificactivities in that practice. The instrument is then sent to a sample of pharmacists who arepracticing in that field.
• Development of content outline. On the basis of responses to the survey, a content outline
for the certification program is developed.
• Preparation of examination. The written examination component of the certification
program is developed on the basis of the content outline.
• Other activities. Appropriate measures are taken to ensure that security and confidentiallyof the testing process are maintained, that the examination and eligibility criteria are10

appropriate, and that the knowledge and skills of those who are certified do, in fact,reflect competence.
A professional testing company typically assists in the development of the role delineationand the examination to ensure that the examination meets professional standards of
psychometric soundness and legal defensibility.
Certifying Agencies for Pharmacists Only -- Three groups, the Board of Pharmaceutical
Specialties, the Commission for Certification in Geriatric Pharmacy, and the National
Institute for Standards in Pharmacist Credentialing, offer certification to pharmacists.
Board of Pharmaceutical Specialties (BPS) http://www.bpsweb.org/
Established in 1976 by the American Pharmacists Association (then the American
Pharmaceutical Association), BPS certifies pharmacists in five specialties: nuclear
pharmacy, nutrition support pharmacy, oncology pharmacy, pharmacotherapy, andpsychiatric pharmacy. Descriptions of each specialty area are provided in Appendix C.
Pharmacists who wish to retain BPS certification must be recertified every seven years.
The recognition of each specialty is the result of a collaborative process between the
Board and one or more pharmacy organizations, which develop a petition to support andjustify recognition of the specialty. This petition must meet written criteria established by
the BPS.
A nine-member board that includes six pharmacists, two health professionals who are notpharmacists, and one public/consumer member, directs the BPS. A specialty council ofsix specialist members and three pharmacists not in the specialty direct the certification
process for each specialty.
BPS examinations are administered with the assistance of an educational testing firm,
resulting in a process that is psychometrically sound and legally defensible. Each of thefive specialties has its own eligibility criteria, examination specifications, andrecertification process. All five examinations are given on a single day once a year inapproximately 25 sites in the United States and elsewhere.
In 1997, BPS introduced a method designed to recognize focused areas within recognizedpharmacy specialties. A designation of “Added Qualifications” denotes that an individual
has demonstrated an enhanced level of training and experience in one segment of a BPSrecognized specialty. Added qualifications are conferred on the basis of a portfolio
review to qualified individuals who already hold BPS certification. Within the specialtyof pharmacotherapy, infectious diseases and cardiology are the two areas of Added
Qualifications currently approved by BPS.
Commission for Certification in Geriatric Pharmacy (CCGP) http://www.ccgp.org/
In 1997, the American Society of Consultant Pharmacists (ASCP) Board of Directors
voted to create the CCGP to oversee a certification program in geriatric pharmacy
practice. CCGP is a non-profit corporation that is autonomous from ASCP. It has its own

11governing Board of Commissioners. The CCGP Board of Commissioners includes fivepharmacist members, one physician member, one payer/employer member, one
public/consumer member, and one liaison member from the ASCP Board of Directors.
To become certified, candidates are expected to be knowledgeable about principles ofgeriatric pharmacotherapy and the provision of pharmaceutical care to the elderly.
Pharmacists who meet CCGP’s requirements are entitled to use the designation Certified
Geriatric Pharmacist, or CGP. Pharmacists who wish to retain their CGP credential mustrecertify every five years by successfully completing a written examination.
CCGP contracts with a professional testing firm to assist in conducting the roledelineation or task analysis, and in developing and administering the examination. The
resulting process is psychometrically sound and legally defensible; it also meets
nationally recognized standards. The CGP certification exams are administered twice ayear at multiple locations in the United States, Canada, and Australia. CCGP publishes acandidate handbook that includes the content outline for the examination, eligibility
criteria for taking the examination, and the policies and procedures of the certification
program.
National Institute for Standards in Pharmacist Credentialing (NISPC)
http://www.nispcnet.org/index1.html
The NISPC was founded in 1998 by the American Pharmacists Association (then theAmerican Pharmaceutical Association), the National Association of Boards of Pharmacy(NABP), the National Association of Chain Drug Stores, and the National Community
Pharmacists Association. The purpose of NISPC is to “promote the value and encourage
the adoption of National Association of Boards of Pharmacy disease-specificexaminations as the consistent and objective means of documenting the ability ofpharmacists to provide disease state management services.”
NISPC offers certification in the management of diabetes, asthma, dyslipidemia, andanticoagulation therapy. At the time of its founding, the organization's immediateobjective was to design a process that would document the competence of pharmacists
providing care for patients with these disease states. The NISPC credential was firstrecognized in the state of Mississippi, where it was used to enable pharmacists to qualify
for Medicaid reimbursement as part of a pilot project in that state. NABP developed thecompetency assessment examinations and oversees their administration. The NISPC tests
are administered nationally as computerized examinations, and are available throughout
the year.
Multidisciplinary Certification Programs -- Some certification programs are available toprofessionals from many health disciplines, including pharmacists. Areas in which suchcertification is available include diabetes education, anticoagulation therapy, pain
management, and asthma education. Some of these programs are still in the early stages ofdevelopment. Several of these providers are listed in Appendix B; however, the information
is not intended to be exhaustive.

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OVERVIEW OF CREDENTIALING IN PHARMACY -- PHARMACY TECHNICIANS
A pharmacy technician is an individual who assists in pharmacy activities that do not require theprofessional judgment of a pharmacist. For example, pharmacy technicians may accept orders
from patients, prepare labels, enter drug information into the pharmacy’s computer system, andretrieve medications from inventory. The term “pharmacy technician” is used in a majority ofstates, however, other terms are also used to describe pharmacy support personnel carrying out
functions similar to those described above. As pharmacists assume an increasing number ofclinical roles, pharmacy technicians are taking more and more responsibility for distributivefunctions in pharmacies in all settings.
The exact functions and responsibilities of pharmacy technicians are defined by state laws andregulations and are also determined by the willingness of pharmacists to delegate thenonjudgmental activities of their practice. Pharmacy technicians always work under thesupervision of a licensed pharmacist. The education and training, certification, and continuing
education of pharmacy technicians are similar in some ways to those of pharmacists. There is,however, more inter-state variation in the regulation of and requirements for pharmacy
technicians than for pharmacists.
Education and Training
Most pharmacy technicians today have been trained on the job, either formally or informally. As
the responsibilities of pharmacy technicians grow, however, more and more individuals areenrolling in formal training programs. These programs are generally affiliated with a community
college, a four-year college, a hospital, or another health care organization. Graduates of these
programs may be awarded an associate’s degree or a certificate of completion.
Not all states have education and training requirements for pharmacy technicians, but some state
require board of pharmacy approval of the training program. ASHP is the accreditation body forpharmacy technician training programs. Technician Training Programs Accreditation
Regulations and Standards can be found at http://www.ashp.org/technician/techregs.pdf.
Accreditation of training programs is voluntary in the majority of states.
In early 2003, at the request of the Council on Credentialing in Pharmacy (CCP), theAccreditation Council for Pharmacy Education (ACPE – formerly the American Council on
Pharmaceutical Education) initiated a profession-wide dialog concerning the possible
development of national standards and an accreditation process for pharmacy technician
education and training.
Regulation
State boards of pharmacy oversee the regulation of practice of pharmacy technicians. Practices
differ substantially among the states. Approximately 60% of states currently require registration
or licensure of pharmacy technicians by the board of pharmacy. Virtually all state boards ofpharmacy have amended their pharmacy practice acts and regulations in recent years, allowing

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an expanded role for pharmacy technicians in the delivery of pharmacy services. It is anticipatedthat further changes in the regulation of pharmacy technicians will be made.
Certification
The Pharmacy Technician Certification Board (PTCB) was established in 1995 as a national
voluntary certification program for pharmacy technicians. Its founders were the American
Pharmacists Association (then the American Pharmaceutical Association), the American Societyof Health-System Pharmacists, the Illinois Council of Health-System Pharmacists, and theMichigan Pharmacists Association.
In collaboration with testing experts, the PTCB developed a national examination, the Pharmacy
Technician Certification Examination (PTCE). The examination is designed to assess thecandidate’s knowledge and skill base for activities that are most commonly performed by apharmacy technician, as determined by a national task analysis. Information about PTCB and the
PTCE may be found at http://www.ptcb.org/.
The Board administers the PTCE three times a year at more than 120 sites across the nation. A
technician who passes the PTCE is designated as a Certified Pharmacy Technician (CPhT).
Pharmacy technicians must renew their certification every two years. To qualify forrecertification, they must participate in at least 20 hours of pharmacy-related continuing
education that includes an hour of pharmacy law.
A growing number of states require pharmacy technicians to be certified, and/or recognize
certification in other ways in their regulations.
CREDENTIALING – THE FUTURE
The pharmacy profession is continuing to evolve in response to a changing health care system in
the U.S. This evolution creates opportunities for pharmacists to provide an expanded scope ofservices within their defined scope of practice. It is incumbent on the profession to assure thepublic, as well as employers, payers, other health professionals, regulatory agencies, andgovernmental agencies, that pharmacists and pharmacy technicians who provide specific services
possess the knowledge, skills, and abilities to safely and competently perform those services. It isthrough an established and widely understood system of credentialing, including licensure topractice and recognition of skills evolved beyond general practice to specialty practice in definedareas, that this will be accomplished.

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Figure 1. U.S. Pharmacy Credentials and Oversight Bodies (oversight bodies are described in text)
Education

Entry into Practice

Practice

Pharmacists
Doctor of Pharmacy(Pharm.D.) Degree(ACPE)

Licensure (R.Ph.)(State Boards ofPharmacy)

License Renewal (State Boards ofPharmacy)state-specific criteria may
include mandatory continuing
education (ACPE)
Postgraduate Education (optional)
Advanced Degrees
M.S., Ph.D. (College/schoolsof pharmacy)
Postgraduate Training (optional)
Residency (ASHP)
Traineeship (ASHP)
Fellowship (ACCP, ASHP)
Certificate Programs (ACPE)
Continuing Education (ACPE)

Certification (optional)
Specialty (BPS)
Non-specialty (CCGP)
Disease management (NISPC)
Multidisciplinary (various)

Pharmacy Technicians*
Education/Training(ASHP/State Boardsof Pharmacy)

Registration/Licensure
in some states(Boards of Pharmacy)

Certification (PTCB)Generally optional*State differences exist; refer main text.

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Appendix A Glossary3
Accreditation: The process whereby an association or agency grants public recognition to anorganization (or a specific program of an organization) that meets certain establishedqualifications or standards, as determined through initial and periodic evaluations.
Certificate Program: A structured, systematic postgraduate education and continuing education
experience for pharmacists that is generally smaller in magnitude and shorter in duration than adegree program. Certificate programs are designed to instill, expand, or enhance practicecompetencies through the systematic acquisition of specific knowledge, skills, attitudes, andperformance behaviors.
Certified: Adjective that is used to describe an individual who holds certification and that isincorporated into the name of the credential awarded that individual. For example, someone who
has earned BPS certification in oncology is a “Board-Certified Oncology Pharmacist.”
Certificate: A certificate is a document issued to a pharmacist upon successful completion of thepredetermined level of performance of a certificate program or of a pharmacy residency or
fellowship. See also “statement of continuing education credit.”Certification: The voluntary process by which a nongovernmental agency or association
formally grants recognition to a pharmacist who has met certain predetermined qualifications
specified by that organization. This recognition designates to the public that the holder has
attained the requisite level of knowledge, skill, or experience in a well-defined, often specialized,
area of the total discipline. Certification entails assessment, including testing, an evaluation of
the candidate’s education and experience, or both. Periodic recertification is usually required toretain the credential.
Clinical privileges: Authorization to provide a specific range of patient care services. See
Privileging.
Competence: The ability to perform one’s duties accurately, make correct judgments, andinteract appropriately with patients and with colleagues. Professional competence ischaracterized by good problem-solving and decision-making abilities, a strong knowledge base,and the ability to apply knowledge and experience to diverse patient-care situations.
Competency: A distinct skill, ability, or attitude that is essential to the practice of a profession.
Individual competencies for pharmacists include, for example, mastery of aseptic technique andachievement of a thought process that enables one to identify therapeutic duplications. A
pharmacist must master a variety of competencies in order to gain competence in his or her
profession.

3

These definitions have been developed by a variety of organizations involved in credentialing and are
generally accepted by those in the pharmacist credentialing arena.
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Continuing education: Continuing education for the profession of pharmacy is a structured
process of education designed or intended to support the continuous development of pharmacists
to maintain and enhance their professional competence. Continuing education should promote
problem-solving and critical thinking and be applicable to the practice of pharmacy.
Credential: Documented evidence of professional qualifications. For pharmacists, academic
degrees, state licensure, and Board certification are all examples of credentials.
Credentialing: (1) The process by which an organization or institution obtains, verifies, andassesses a pharmacist’s qualifications to provide patient care services. (2) The process ofgranting a credential (a designation that indicates qualifications in a subject or an area.)
Fellowship: A directed, highly individualized postgraduate program designed to prepare apharmacist to become an independent researcher.
License: A credential issued by a state or federal body that indicates that the holder is incompliance with minimum mandatory governmental requirements necessary to practice in aparticular profession or occupation.
Licensure: The process of granting a license.
Pharmacy technician: An individual who, under the supervision of a licensed pharmacist,
assists in pharmacy activities not requiring the professional judgment of the pharmacist.
Privileging: The process by which a health care organization, having reviewed an individual
health care provider’s credentials and performance and found them satisfactory, authorizes that
individual to perform a specific scope of patient care services within that organization.
Residency: An organized, directed, postgraduate training program in a defined area of pharmacy
practice.
Registered: Adjective used to describe a pharmacist who has met state requirements forlicensure and whose name has been entered on a state registry of practitioners who are licensed
to practice in that jurisdiction.
Scope of Practice: The boundaries within which a health professional may practice. For
pharmacists, the scope of practice is generally established by the board or agency that regulates
the profession in a given state or organization.
Statement of Continuing Education Credit: A document issued to an individual uponcompletion of a continuing education program provided by an organization accredited by the
Accreditation Council for Pharmacy Education (ACPE – formerly the American Council on
Pharmaceutical Education).

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Traineeship: A short, intensive, clinical and didactic postgraduate educational program intended
to provide the pharmacist with knowledge and skills needed to provide a high level of care topatients with specific diseases or conditions.

18Appendix B Referenced Pharmacy Organizations and Certification Bodies
Pharmacy Organizations
Academy of Managed Care Pharmacy (AMCP)
100 North Pitt Street, Suite 400
Alexandria, VA 22314(800) 827-2627
www.amcp.org
American Association of Colleges of Pharmacy(AACP)
1426 Prince Street
Alexandria, VA 22314-2841(703) 836-8982
www.aacp.org
American College of Apothecaries (ACA)
P.O. Box 341266
Memphis, TN 38184(901) 383-8119
www.acainfo.org
American College of Clinical Pharmacy (ACCP)
3101 Broadway, Suite 650
Kansas City, MO 64111-2446(816) 531-2177
www.accp.com
Accreditation Council for Pharmacy Education(ACPE – formerly American Council on
Pharmaceutical Education)
20 North Clark Street, Suite 2500
Chicago, IL 60602-5109(312) 664-3575
www.acpe-accredit.org
American Pharmacists Association (APhA)
2215 Constitution Avenue, NW
Washington, DC 20037-2985(202) 628-4410
www.aphanet.org
American Society of Consultant Pharmacists(ASCP)
1321 Duke Street
Alexandria, VA 22314-3563(703) 739-1300
www.ascp.com

American Society of Health-System Pharmacists(ASHP)
7272 Wisconsin Avenue
Bethesda, MD 20814(301) 657-3000
www.ashp.org
National Association of Boards of Pharmacy(NABP)
700 Busse Highway
Park Ridge, IL 60068(847) 698-6227
www.napb.net
National Association of Chain Drug Stores(NACDS)
413 N. Lee Street, P.O. Box 1417-D49
Alexandria, VA 22313-1480(703) 549-3001
www.nacds.org
National Community Pharmacists Association(NCPA)
205 Daingerfield Road
Alexandria, VA 22314(703) 683-8200
www.ncpanet.org
Pharmacy Technician Educators Council(PTEC)
800 Robin Hill Drive
San Antonio, TX 78230(800) 798-3247
www.rxptec.org
Certification Bodies for Pharmacists or
Pharmacy Technicians(May be multidisciplinary)
Anticoagulation Forum
88 East Newton Street, E-113
Boston, MA 02118-2395(617) 638-7265
www.acforum.org

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Board of Pharmaceutical Specialties (BPS)
2215 Constitution Avenue, NW
Washington, DC 20037-2985(202) 429-7591
www.bpsweb.org
Commission for Certification in GeriatricPharmacy (CCGP)
1321 Duke Street
Alexandria, VA 22314-3563(703) 535-3038
www.ccgp.org
National Asthma Educator Certification Board
American Lung Association
1740 Broadway
New York, NY 10019-4374(212) 315-8865
www.lungusa.org

National Certification Board for Diabetes
Educators (NCBDE)330 East Algonquin Road, Suite 4
Arlington Heights, IL 60005(847) 228-9795
www.ncbde.org
National Institute for Standards in Pharmacist
Credentialing (NISPC)
205 Daingerfield Road
Alexandria, VA 22314(703) 299-8790
www.nispcnet.org
Pharmacy Technician Certification Board(PTCB)
2215 Constitution Avenue, NW
Washington, DC 20037-2985(202) 429-7576
www.ptcb.org

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Appendix C Specialties Recognized by the Board of Pharmaceutical Specialties
I. Nuclear pharmacy seeks to improve and promote the public health through the safe andeffective use of radioactive drugs for diagnosis and therapy. A nuclear pharmacist, as a memberof the nuclear medicine team, specializes in procurement, compounding, quality assurance,
dispensing, distribution, and development of radiopharmaceuticals. In addition, the nuclear
pharmacist monitors patient outcomes and provides information and consultation regarding
health and safety issues. Specifically, the nuclear pharmacist:
•
•
•
•
•
•
•
•
•

procures radiopharmaceuticals and other drugs, supplies, and materials necessary for
his/her practice;compounds radiopharmaceuticals necessary to his/her practice;assures the quality of radiopharmaceuticals and of instruments, equipment, and devices
necessary for his/her practice;dispenses radiopharmaceuticals and other drugs necessary to his/her practice;
distributes radiopharmaceuticals, other drugs, and other materials necessary to his/herpractice;assures the health and safety of him/herself, co-workers, patients, and the public as
related to his/her practice;provides information and consultation related to his/her practice;provides pharmaceutical care to patients and assures optimal patient outcomes within thescope of his/her practice;
conducts research and development as necessary for his/her practice.

II. Nutrition support pharmacy addresses the care of patients who receive specialized nutrition
support, including parenteral and enteral nutrition. The nutrition support pharmacist has
responsibility for promoting maintenance and/or restoration of optimal nutritional status,
designing and modifying treatment according to the needs of the patient. The nutrition support
pharmacist has responsibility for direct patient care and often functions as a member ofmultidisciplinary nutrition support team. The nutrition support pharmacist specialist is
responsible for the following specialized services:•••

provides individual nutrition support care to patients through patient assessment
activities and the development, monitoring, and management of a therapeutic plan;manages nutrition support services;advances nutrition support pharmacy practice.

III. Oncology pharmacy addresses the pharmaceutical care of patients with cancer. The
oncology pharmacist specialist recommends, designs, implements, monitors and modifies
pharmacotherapeutic plans to optimize outcomes in patients with malignant diseases. In
providing his or her specialized scope of services, the oncology pharmacist specialist:• collaborates with other health professionals in pursuing optimal drug therapy for patientswith cancer. This requires that the oncology pharmacist collect and interpret pertinent
clinical data and recommend, design, implement, monitor and modify patient-specifictherapeutic plans;

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•
•
•

interprets, generates and disseminates knowledge in oncology as it applies to oncology
pharmacy practice;collaborates with other professionals, patients, and the public to recommend, design,
implement, monitor, and modify systems and policies to optimize the use of drugs inpatients with cancer;
collaborates with other professionals and the public in addressing risk factors, prevention,screening, and issues associated with cancer survivorship as they relate to oncology
pharmacy practice.

IV. Pharmacotherapy is that area of pharmacy responsible for ensuring the safe, appropriate, andeconomical use of drugs in patient care. The pharmacotherapy specialist has responsibility for direct
patient care, often functions as a member of a multidisciplinary treatment team, may conduct clinicalresearch, and is frequently a primary source of drug information for other health care professionals. In
providing his or her specialized scope of services, the pharmacotherapy specialist:• collects and interprets data to design, recommend, implement, monitor, and modify patientspecific pharmacotherapy in collaboration with other health care professionals to optimize drug
therapy;• interprets, generates, and disseminates knowledge in pharmacotherapy;• designs, recommends, implements, monitors, and modifies system-specific policies andprocedures in collaboration with other professionals and administrators to optimize health care.
The term “Added Qualifications” is used by BPS to denote the demonstration of an enhanced level oftraining and experience and to document further differentiation of practitioners within specialties that
BPS has already recognized in which practitioners focus on specific patient populations or diseases.
Creation of this process by BPS in 1997 responded to requests from several segments of the profession inview of the growing complexity of the profession and the needs of health care systems. As of September
2003, two areas of Added Qualifications have been approved within the Pharmacotherapy specialty:
Cardiology and Infectious Diseases.
V. Psychiatric pharmacy addresses the pharmaceutical care of patients with psychiatric disorders. As amember of a multidisciplinary treatment team, the psychiatric pharmacist specialist is often responsible
for optimizing drug treatment and patient care by conducting patient assessments, recommending
appropriate treatment plans, monitoring patient response, and recognizing drug-induced problems. In
providing his or her specialized scope of services, the psychiatric pharmacist specialist:• collaborates with other health professionals in pursuing optimal drug therapy for neuropsychiatricpatients. This requires that the psychiatric pharmacist collect and interpret pertinent clinical data
and recommend, design, implement, monitor and modify patient-specific therapeutic plans;• interprets, generates, and disseminates knowledge in neuropsychiatric pharmacy;• collaborates with other professionals and administrators to recommend, design, implement,
monitor, and modify systems and policies to optimize the use of drugs in the treatment ofneuropsychiatric patients.

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