Raising the Standard: Requiring a Bachelor's Degree for PharmD Programs.

To the Editor: Pate and Harrell wrote compelling Viewpoints regarding decreasing or increasing preprofessional pharmacy school admission requirements, respectively.1-2 As faculty members at one of the seven pharmacy schools in New York and at the only school in the state requiring a bachelor’s degree for admission, we agree with Harrell: a bachelor’s degree should be a pharmacy school prerequisite. Our professional students are recruited from colleges and universities across the nation and have varied majors and minors, including biology, chemistry, nutritional science, and business administration. They have already exhibited the grit necessary to acquire their first degree, thus it is expected that they will strive to obtain their doctor of pharmacy (PharmD) degree as well. Years ago, Boyce and Lawson advocated for a standardized preprofessional curriculum to be adopted by United States pharmacy schools.3 Nearly a decade has passed, and Pate still bemoans the differing preprofessional requirements among pharmacy schools nationwide. Adopting a uniform policy of requiring a bachelor’s degree from incoming students would level the playing field in an era where competition for the best students must be balanced against an increasing number of pharmacy schools. This requirement would not mitigate competition, rather bachelor’s degree-holding applicants would already possess some degree of self-motivation, diligence, and determination—qualities essential for success in pharmacy school. These attributes may otherwise be difficult to assess during admissions interviews or on applications. A caveat to our argument is that at least six American Association of Colleges of Pharmacy (AACP)-accredited pharmacy schools currently accept students directly from high school in 0-6 programs.4 A few accelerated medical programs also admit students directly from high school.5,6 However, after completion of the appropriate coursework, a bachelor’s degree is awarded as well as the doctor of medicine (MD) degree. This suggests these institutions value the step-wise approach to medicine advancement and choose not to award the MD degree without a bachelor’s degree. Pharmacy should be the same. Harrell states that most nurse practitioners, physical therapists, and physicians earn a bachelor’s degree prior to their professional degree. Why should pharmacy students be held to a different standard while attaining similarly high levels of practice and responsibility? As Pate discusses, preprofessional training is costly.1 However, publicly educated pharmacy students likely incur less debt then those privately educated. In New York alone, two new public pharmacy schools may begin accepting applicants as early as 2017, increasing the number of public pharmacy schools in the state to three. These schools may be attractive for students looking for more affordable education. We realize that other states’ pharmacy applicants may not have the luxury of choosing between private and public education and that some schools may have high tuition for both in-state and out-of-state residents.7 Moreover, public school tuitions may be almost as expensive, or more expensive, than private pharmacy schools in other states. However, considering the availability of loan forgiveness programs, scholarships, and long-term loan repayment plans, coupled with a median pharmacists’ salary of $120 000 annually, we do not agree that cost should be a major factor in the debate of a bachelor’s degree requirement for pharmacy school admission.8 Academic fatigue is a concern cited by Harrell.2 We believe students who persevered and obtained a bachelor’s degree prior to pursuing their PharmD may be no less likely to “burn out” before obtaining the PharmD, than those who satisfy entry prerequisites without a bachelor’s degree. Students awarded bachelor’s degrees are generally considered to have evidence of self-discipline, motivation, and persistence, which are traits we believe will withstand and overcome academic fatigue. These students will surely remain motivated to pursue their chosen field of study. Prior to the year 2000, most pharmacists graduated with a bachelor’s of science in pharmacy. Subsequently, the Accreditation Council for Pharmacy Education (ACPE) published standards granting the entry-level PharmD to students graduating after 2003. This was a major transition in pharmacy education. Pharmacy education will continue to transform as we advance the profession and meet the needs of the public. AACP has a new tagline: “Pharmacists help patients live healthier and better lives.” This tagline communicates that pharmacists are essential players in transforming US health care.10 Our profession is advancing, pharmacists continue to add value to health care teams while expanding the profession, and provider status is becoming an actuality. Yet, such achievements in the field should be preceded by excellence in the classroom. One of the most widely agreed upon predictors of academic success is the attainment of a bachelor’s degree.2,9-11 We hope that someday this degree will be the standard prerequisite for all pharmacy schools in the United States.