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Pharm D: For a flawless curriculum
Subal C Basak | Thursday, December 11, 2008, 08:00 Hrs  [IST]

The main objective of offering a Pharm D programme is to impart the necessary training and skill to undertake pharmacy practice in the field of patient care. The curriculum is designed to produce pharmacists who can assume expanded responsibilities in the patient care and assure the provision of rational drug therapy. The focus in pharmacy practice today is on the patient, determining their requirements for healthcare and what should be provided to best meet those requirements.

In March 2008 Indian health ministry approved the 6-year Pharm D course, which would be regulated by the pharmacy council of India (PCI). The PCI has approved 35 institutions (at the time this article was written) across the country to start Pharm D programme from 2008-09 academic year. The details of Pharm D regulations are in public domain of PCI website. The syllabus, infrastructural facilities, internship and examining authority requirements are prescribed by the PCI under appendices a, b, c and d of the Pharm D regulations.

The syllabus under appendix 'a' on the PCI website seems to have shortcomings and does not meet standards of an advanced pharmacy practice curriculum. There are numerous errors in desktop publishing, including poor editing and inconsistent paragraph structure, requirements for bibliography and incorrect use of the text and reference books. The content and the subjects, especially pharmaceutics, are not given enough emphasis on recent developments. Many mediocre text books are listed, while many established and 'must read' text books are ignored.

Subject layout
The curriculum planners have designed each subject to be segmented into four clear sections. For theory the proposed segments are:
● Scope and objectives
● Upon completion of the course the student should be able to
● Course materials (text books and reference books)
● Lecture wise programme
The four sections of the practical include:
● General requirement
● Course materials (text books and reference books)
● List of experiments
● Scheme of practical examination

However, these guidelines are not followed in all subjects. On some subjects, only three sections are present. On some occasions, the scope and objectives are divided and section two is wrongly given under subdivided objectives.

There are missing sections number, straightway objectives instead of scope and objectives and only reference books instead of both text and reference books.

A comprehensive editing, desktop publishing and uniform segmentation would help to minimise all the serious errors. It was surprising to note that fourth and fifth year important theory subjects (subject codes 4.4, 4.5 and 5.1, 5.2 and 5.3) do not have first three sections. That means students have to study these very important subjects without knowing scope, objectives and text and reference books. These deficiencies could easily lead to misunderstanding.

Text & reference books
Another serious matter is the inappropriate book listing and failure of citation of well established books. In several occasions, there are no mention of editor, edition number, publication year and publisher. Other examples of inadequate book referencing, particularly pharmaceutics books, inclusion of the citation from very old edition book, non-existing book, incorrect name and classification of text and reference books. The books/references like "Register of General Pharmacy by Cooper and Gunn (in subject 1.2)," "WHO consultative group report (in subjects 2.5 and 4.2)," "Reports of the Pharmaceutical enquiry Committee" and "Various reports of Amendments (in subject 3.4)" are confusing and misleading.

The "Register of General Pharmacy by Cooper and Gunn" is a very old book and was available as a pirated xerox copy during 1980's. The references "WHO consultative group report" and "Reports of the Pharmaceutical enquiry Committee" are not that popular. There is a need for complete name and full book reference of text books as there is a change in the names of some books in the latest edition. For example there is (among others): "Remington's pharmaceutical sciences" and "RPS" for "Remington: The Science and Practice of Pharmacy, 21st edition, Lippincott Williams & Wilkins, Philadelphia, 2005".

There is a need to utilise newer edition of book. The book "Tutorial Pharmacy - Cooper &Gun (in subject 3.6)" is a very old book. The next and sixth edition was edited by S J Carter as "Copper and Gunn's Tutorial Pharmacy." The present book is Aulton M.E., Pharmaceutics: The Science of Dosage Form Design. A further important book needed is "Aulton M.E. and Collett D.M., Pharmaceutical Practice, ELBS edition 1991" instead of "Cooper and Gunns Dispensing for pharmacy students (in subject 1.2)." All subjects need greater emphasis on the latest edition of a book or reference in order to know present status of the text.

Subject contents
It seems pharmaceutics subjects and pharmaceutics-related issues have been undermined. Many experimental preparations in pharmaceutics (monographs of 2nd or 3rd edition of Indian pharmacopoeia) are unrelated to contemporary needs because most of the preparations (mainly practical exercises) have become obsolete a long time ago and are hardly utilised as medications in the pharmacy. Areas such as physical pharmacy principles, drug delivery devices/ dosages and novel drug delivery systems and their proper use have been mostly ignored.

The curriculum does not include topics such as dispensing prescriptions and medication orders, sustained release concept, dosage form design and formulation development, new drug development, evidence based medicine and healthcare delivery in India among others. There is a need for comprehensive editing of pharmaceutical jurisprudence subject as there are many errors. Study of 'dangerous drug act' is repeated in scope and objectives and also under case study. However this act was repealed way back in 1985. Patent and design act 1970 is wrong and should be patent act 1970 (with amendment in 2005) and design act 2000. The statement 'other laws as prescribed by the Pharmacy Council of India from time to time' under objectives is ambiguous. Manufacture of drugs and cosmetics is required to be included in drugs and cosmetics act section.

Pharmacy education is a dynamic phenomenon that must recognise the rapid changes in advancement of knowledge and respond to the growing challenges in providing patient care. The first step is the design of an explicit and flawless curriculum based on national needs and international trends. Perhaps a future revision will focus to address all these issues.

(The author is Reader in pharmacy with Annamalai University, Annmalainagar)

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