The Big Debate

The Big Debate

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The Big Debate #12: Is the MPharm still fit for purpose?

Started 3 months ago

This afternoon’s discussion will focus on the question: is the MPharm still fit for purpose?

We’ve seen lots of changes to the MPharm in recent years to stay in line with the shift in pharmacy practice away from dispensing and towards clinical services.

But is the MPharm keeping pace with changes to everyday pharmacy practice? And is the shift towards independent prescribing in undergraduate degrees the right move?

So, where along the spectrum do your own views lie? Join the Big Debate to tell us what you think.

We’re expecting lots of your will want to share your views on this important topic. Simply type your comment or question into the ‘leave a reply’ box below and let us know what you think.

The “live” part of the debate will close at 2pm, but feel free to continue to exchange views for as long as you like.

Join your pharmacy peers this afternoon to discuss:

  • Whether the content of the MPharm is keeping up with the realities of modern pharmacy practice
  • What fluctuating registration exam pass rates do and don't tell us about the quality of pharmacy education
  • The pros and cons of baking independent prescribing training into the MPharm

C+D has introduced a streamlined functionality that allows users to mention each other in a comment. Simply use ‘@’ and type in the person’s name.

This debate will start at 1pm.

Hello and welcome to this afternoon's Big Debate on whether the MPharm is fit for purpose. I'm C+D's editor Beth Kennedy. I know we've got representatives from student bodies, schools of pharmacies and other education providers ready to tell us what they think, so I'm looking forward to hearing everybody's views on this important topic. 

Let's kick off proceedings by looking at whether the content of the MPharm is keeping up with the realities of modern pharmacy practice. Who'd like to start us off?

YES: The GPhC revalidation serves as a crucial assurance of adherence to the latest standards. The new learning outcomes integrate key enhancements such as expanded clinical training, diversified clinical placements, experiential learning across pharmacy sectors, and supplementary education in patient assessment, diagnostics, and simulation-based methodologies. All universities are now being revalidated tooth new standards. While acknowledging the comprehensive nature of these advancements, there is a need for a meticulous review of the scientific components within the curriculum, ensuring their relevance and alignment with the evolving landscape of pharmacy practice

Really interesting stuff, Marvin! Do you think any adjustments need to be made to the course structure?

I think we've got some academics and some students with us today, as well. What are your experiences with this?

Its interesting to see that a new pharmacy school is set to open in Teesside. We know that in the past the prospect of new pharmacy school has been controversial – so what do people think about it?

Don't forget to hit refresh to see the latest replies!

I believe the new standards need time to implement as they are fairly new but already a massive improvement from the old satandards. There is the challenge of perhaps extending the degree to a 5 year programme to successfully incorporate  Independent prescribing training or to review some current scientific modules such as medicinal chemistry from example and fine tune these to ensure they focus on what is absolutely relevant and applicable in practice, allowing more room and time to focus on  prescribing training. I see more challenges with funding and working with stakeholders and integrating more placements into the structure

Ah, funding - that old chestnut! And I like the idea of extending to a five-year programme to accommodate some of these changes. What do some of our pharmacy students think?

IP training is all well and good - and clearly in line with the direction of travel with all the new services coming in - but are there enough DPPs? Do we think there's enough training and support out there?

Schools of Pharmacy have been integrating more advanced clinical skills and clinical decision making into their programmes for a number of years, even prior to the new educational standards — and many have been running IP programmes and are involved in the teaching (and research) of prescribing. There is a rigorous level of accreditation, and the introduction of tariff is creating more opportunities for experiential learning. We should be reassured that HEIs can do this. What is an unknown is creating the new Foundation programme and the interaction of the MPharm with that new year, and embedding the prescribing element. There are resource issues, a relative inexperience of clinical teaching and assessment in a practice setting, but work is being done to address these issues.

Thanks for this, Anthony, and great to hear from you. Good to hear that HEIs are keeping up with the changes we're seeing. I like your point about the foundation programme - what issues do you think that could throw up? What do you mean by resource issues?

That sounds great Anthony - I'd love to hear more about the work you mentioned that's being done to address the issues

At the start of the 2010s, there was widespread concern that there would be too many Schools of Pharmacy, producing too many graduates for too few pre-registration places, with some arguing for a cap on student places. Despite an increase in the number of Schools at that point, and a corresponding increase in student numbers from existing providers, we find ourselves in a position of a lack of pharmacists due to changes in the nature of the workforce and the creation of new roles. Those fears were misplaced and we should be thankful that policies which would have made our current situation worse did not happen. The NHS workforce plan is asking for a large increase in pharmacy student places, but the concern should be is this going to create enough pharmacists to ensure that we can deliver as a profession, rather seeing it as a threat. 

@Costanza Potter thats the biggest challenge and worry and an area that i personally don't think the Government has given enough thought to. However, i do believe we will see an increase in funding geared towards DPP training and an increase in numbers of available DPPs. There may also be a few reforms around eligibility but this is still in the balance, only time will tell but certainly an area for concern

At Keele University the course focuses more on science and getting us into labs during first and second year. Then we spend third and fourth year learning how to put that into practice. This leads to us having a “spiral curriculum”, so we end up revisiting and building upon topics that we have already learnt about previously, and with our added placement experience, we build better understand of how these scientific concepts then come to life in practice. 

What I think our course and pharmacy in general does well, is teach students how to apply our knowledge in a variety of ways. Over the years I’ve had to demonstrate my learning through more than just timed tests or essays. Doing oral presentations, health promotion campaigns and writing blogs, to name a few examples. Not only has this pushed me to actually make sure I understand the content I am learning, but it has helped develop a lot of the skills that are vital for pharmacists across any sector.

So, I definitely believe from my experience the delivery of the MPharm course is fit for purpose.

The 5 year programme is not going to happen. Creating a functional Foundation programme that can deliver prescribing pharmacists needs to be the focus.

@Anthony Cox yes, I remember that exact conversation taking place! Really interesting, as you say, that we've seen a shortage of pharmacuists working in community, rather than the projected oversupply

Great to hear from you on this Nonye - brilliant to hear from a pharmacy student first hand. Are there any areas you think could be improved upon?

We've seen pass rates for the registration exam go up and down a bit over recent years - do we think that's in any way indicative of MPharm training, or are there more factor at play here?

As pharmacy student, working in community pharmacy, I believe the teaching methods on MPharm degree doesn’t focus on the Consultation gap being given by the doctor and Pharmacist to the patient.

On the other hand, I believe the time pressure community pharmacists face, doesn’t allow the in-depth patient consultation.

That's really interesting Shadi, I hadn't considered that before. What sort of gap do you think there is? And do you have any suggestions of how teaching could be tweaked to address it?

@Beth Kennedy 

Theres an intricate interplay of diverse factors, encompassing prior qualifications, university education, Oriel performance, foundation training experience, effects of the pandemic, these all complicate the assessment of pass rates across different institutions. There is also a need for standardisation of placement training. To further refine the educational process, there is a pressing need to equip students with robust preparation for assessments, emphasising exam techniques and time management. 

Do keep refreshing, folks, to make sure you're seeing the latest comments

I feel that the MPharm is still too "science-heavy"... still seeing focus onto skillsets that a pharmacist working in a healthcare profession wouldn't use. From physics based calculations to processes in organic chemistry, it felt more like a tick-box examinations to just prove how smart you can be rather than being a pharmacist. We still need to be pushing the courses a lot more towards practical pharmacist skills, such as running clinics, and pull back on the excessive science. A core foundation of science is still important, but not at the expense of being clinically knowledgeable. Just for perspective, I feel that I learnt more in my first 3 months as a trainee pharmacist compared to my whole 4 year degree.

Pass rates for the examination are going to be hit by various factors, the nature of the cohort, external factors hitting on the pre-registration year, so it is hard to draw a general point about Schools of Pharmacy as a whole from fluctuations in the pass rate.

Thanks @marvin munzu for this. I think the impact of the pandemic was probably greater than any of us realise. I think some of the pharmacy students on this chat @Nonyelum Anigbo @Shadi Alhalabi will have experiences part of their MPharm during the pandemic. What were your experiences of this like?

@Zhyar Said Many pharmacists go on to run their own pharmacies, or are heavily involved in buying/business administration - would you suggest that accountancy/business management modules be an important addition to courses?

@marvin munzu really great point - what sort of thing would you like to see in standardised placement training? I'd love to hear your thoughts on this too @Nonyelum Anigbo @Shadi Alhalabi 

I believe a changed in teaching to implement more case studies/ consultations when possible to equipping students with the knowledge and confidence to think out of the box when possible.

And what do we think about baking independent prescribing into the MPharm degree, which we're starting to see. Is this a positive development?

From my experience I believe the pandemic impacted my first two years of study negatively, as we didn’t have the chance to take on the opportunities available (placement,summer work experience and many more extra pharmacy related activities)

That makes sense @Shadi Alhalabi. Have you noticed a big difference since the end of the pandemic?

@Beth Kennedy Our first year was almost entirely online with us only going in 2-3 times in the whole year for social distanced lab classes. 

In ways it wasn’t too bad learning during the pandemic, mainly because the content was less practical and mainly lectures. However the social aspect was missed a bit.

It’s very hard to accurately cover and assess all the practical elements of pharmacy virtually. The main struggle coming out of the pandemic in second year was having to quickly build up the social and practical pharmacy skills.

Also going from online open book assessments back to closed book on-campus assessments was a jump. For my year group that was the first time many of us had to sit official closed book exams since GCSEs, as we didn’t sit our A-Levels. 

Now that we are in fourth year, I think we have gotten back into the swing of things but initially it was a hard transition.

Yes @Nonyelum Anigbo, sounds like that would have been a difficult transition! 

We've got just five minutes left of the 'live' part of today's debate. However, you're welcome to continue posting your views and interacting with one another for as long as you like

@Costanza Potter

When we go on placements, particularly hospital placements it often feels like the staff don’t know what to do with us. 

Looking at my medical student peers, they are shadowing doctors and actively getting involved. They seem to gain a lot from their placements, whereas I often feel out of place and “in the way”.

My university has tried to rectify this disconnect by giving us scrubs that we can wear, which definitely makes me feel less out of place. I think as pharmacy students are sent on more clinical placements this will hopefully become less of an issue.

If NHS WT&E would also be able to support in creating more structure for clinical pharmacy placements that would be ideal.

I love that detail about being given scrubs!

And that's a wrap, folks. This concludes the live part of today's debate, but please feel free continue posting your views for as long as you like. We'll see you again next time for C+D's Big Debate.

Thanks so much for joining us and sharing your views!

@James Stent I think there are less useful things that are currently in the MPharm degree, but similarly not sure if the degree is the right place to learn that. A lot of it comes from experience, and you can learn that by working in a small-chain independent. I also think that once you're at that level of owning a pharmacy, its best to leave it to the professionals to manage the accounting end and take their advice whilst you can focus on providing more services