Pharmacy School Enrollments: Balancing Supply and Demand
Katura C. Bullock, PharmD, BCPS, BCACP
Ambulatory Care Pharmacist I Value-Based Care I Health Educator
The article titled "Modifying Pharmacy Enrollments by Employment Realities," published by several accomplished pharmacy faculty members in INNOVATIONS in pharmacy, explores a critical issue in the field of pharmacy education. I am well aware, as a former faculty member, of the significant impact that student enrollment and job placement rates can have on a pharmacy school's financial sustainability, academic and programmatic offerings, reputation, and student experience. However, I believe those of us who are passionate about and invested in the future of the pharmacy profession have a responsibility to acknowledge changing market forces without presenting doomsday scenarios or overly aggressive solutions.
A core principle of the article is the importance of aligning the number of PharmD graduates with the number of available job positions to avoid underemployment and salary stagnation. The article presents a compelling case for addressing the imbalance between pharmacy graduates and job market demands. Here are the key points and suggestions made by the authors:
Imbalance in Supply and Demand:
The authors highlight a stark truth: there is a current surplus of pharmacy graduates compared to job openings. This oversupply potentially leads to fewer job openings and decline in salaries. The relaxation of entry requirements by pharmacy schools, aimed at boosting enrollments amidst declining applicant numbers, has exacerbated this issue. According to the article, this is partly because PCAT scores are no longer required for admission to pharmacy schools in the United States. GPA scores of accepted students have declined over the years, indicating many pharmacy schools are becoming less selective. Data from the Bureau of Labor Statistics indicates that while over 14,000 pharmacists graduate annually, the job market is only expected to grow by 3% from 2022 to 2032.
Regulatory Suggestions:
To address this imbalance, the authors propose several regulatory measures:
Potential External Regulation:
One of the more controversial suggestions in the article is the potential involvement of external regulatory bodies, such as the U.S. Department of Health and Human Services or the U.S. Department of Education. The authors argue that these entities could enforce enrollment caps to better align the number of graduates with job market needs. They draw parallels to other regulated markets, such as narcotics, suggesting that such oversight could stabilize the profession and prevent the cyclical overproduction of graduates.
Exploring the Arguments
While the article makes a strong case for these regulatory measures, let’s take a minute to critically examine each one and potential impact on the pharmacy profession.
Necessity and Appropriateness of External Regulation:
The suggestion for external regulation of pharmacy enrollments seems drastic and potentially unnecessary. While there is a need to address the supply-demand mismatch, external regulation could lead to unintended consequences, such as reduced educational opportunities and increased costs. Education systems are complex and may not benefit from the same regulatory approaches used in industries with more straightforward supply-demand dynamics, such as manufacturing.
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Regulatory Approaches in Different Markets:
The comparison to the DEA's production caps on narcotics is not entirely appropriate. Narcotics production involves public health and safety concerns directly tied to controlled substance regulations, which are different from educational outputs.
External regulation such as those proposed by the authors for pharmacy schools is rare in educational domains. For example, medical, dental, physician associate schools each have strict accreditation standards that must be adhered to. But none not face government-imposed caps on enrollments based on job market forecasts. Just as, other professional degree programs, such as law or engineering, also do not have enrollment caps dictated by external regulatory bodies.
Stricter Entry Requirements:
The article acknowledges that involving the AACP in a mandatory program to allocate graduating numbers would likely violate anti-trust laws. Despite this, the authors suggest creating an external entity to oversee enrollment numbers or allocate budgets according to enrollment. Certainly, this proposal also raises concerns about being anti-competitive ??. Implementing uniform stricter entry requirements might enhance the quality of graduates. These measures could also limit competition and reduce access by deterring talented individuals, particularly those from underrepresented or disadvantaged backgrounds, from pursuing pharmacy.
Certificate of Need Programs and Mandatory Post-graduate Training:
Introducing certificate of need programs could help align graduate numbers with job availability, but it may also limit educational opportunities and innovation. These programs would require schools to justify their enrollment numbers based on regional job market data, potentially reducing the flexibility of schools to adapt to changing circumstances. Mandatory residencies or fellowships could ensure better-prepared graduates but would extend the duration and cost of pharmacy education, making it less attractive compared to other fields like medicine or dentistry.
Wrapping Up
Balancing the supply of pharmacy graduates with market demands is a complex issue that requires nuanced strategies. By addressing these issues thoughtfully, we can support the future of the pharmacy profession without resorting to overly aggressive regulatory measures. Next week, I will take a deeper dive into practical and innovative solutions that can help us navigate these challenges and build a brighter future for the pharmacy profession.