From shortage to surplus: the hazards of uncontrolled academic growth.

Take yourself back in time just 10 short years to an imaginary meeting at an imaginary place. You have been appointed to a special AACP blue-ribbon panel to study what the academy can do to address the pharmacist shortage. It's the year 2000. We've just gone all PharmD. There are about 80 schools of pharmacy in the country, and roughly 7,000 graduates enter the workforce every year--but it's not enough. One outspoken member of the panel proposes that the academy add about 50 new schools of pharmacy over the next 10 to 15 years. As you almost fall off your chair, another member chimes in to suggest that 50 new schools will not be sufficient and that most of the current programs should either increase enrollment or establish new satellite campuses. Would you have thought they were out of their minds, or at least been a bit dumbfounded by the overly aggressive nature of their proposals? Is it reasonable to assume that if 80 schools are not quite meeting the demand, we must need 130? You can stop imagining now. It's 2010, and as absurd as it sounds, those imaginary proposals are being enacted before our eyes; but no one seems to be alarmed. Indeed, truth is sometimes stranger than fiction. As a pharmacist practitioner and academician whose career spans the last 3 decades, I appreciate the depths of the pharmacist shortage that has plagued our profession. I personally spent many a day, first as a director of a hospital pharmacy and then as a dean of a school of pharmacy, exasperated by the seemingly impossible task of recruiting qualified candidates to fill long-standing vacant positions. I understand the law of supply and demand, as well as the powerful market forces that fueled the pharmacist shortage for so many years. And now, findings of the Pharmacy Manpower Project notwithstanding, here I am in the year 2010, utterly in awe at how dramatically and how suddenly conditions have changed. It is time for all of us in academia to step back and objectively assess what's happening to the pharmacy job market on the ground and in real time. Sometimes it is best to set aside the weather report and look out the window. Long-held assumptions about the rate of pharmacist job growth are beginning to crumble amid the uncertain health care and economic realities of our times, and yet we, as an academy, continue to perpetrate a rate of unprecedented growth that has reached alarming proportions and shows no signs of abating. In many areas of the country the number of pharmacy graduates is beginning to match the number of vacant pharmacist positions. That observation in and of itself is a good thing and should be no cause for alarm. But the growth of PharmD programs does not appear to be acutely responsive to the marketplace. Growth marches on without restraint though it is no longer warranted. The pharmacist shortage has been diminishing in recent years, despite that many new PharmD programs have not yet graduated a class and the expansion of many existing programs is not yet reflected in the number of their graduates. Understandably, rates of increase in the number of graduates reflect a 4-year lag period from the point of creating or expanding a program. Here in Florida, the primary pharmacist employers filled their vacancies this year and some graduates were forced to seek employment outside the state. One Florida pharmacy school will graduate its first class next year and the University of South Florida is currently pursuing plans to start a PharmD program. It begs the question, "What problem are we trying to solve by continuing to expand?" Florida is not alone. One need only look at what is happening in California, Texas, New York, Tennessee, Ohio, Illinois, North Carolina, South Carolina, Georgia, Pennsylvania, etc, to see that growth within the academy is getting out of hand. Make no mistake, this is not just a matter of concern for a select group of states; it is a national problem, the repercussions from which no one in pharmacy will be immune. …