In the last five decades, Indian pharmacy education has witnessed a quantum leap both in terms of quantity and quality. Started the way back in 1928, the pharmacy education in India has moved from the 1 year Certificate Course to 2 year Diploma to the full fledged 4 year Bachelor Degree and to further specialized Post Graduate Degree courses. The Bachelor Degree course in Pharmacy (B. Pharm.) is being conducted in about 1,400 institutions affiliated to about 45 Indian universities.
M. Pharm. with various specializations are also available in several pharmacy colleges in the country. Similarly several Indian universities provide the opportunity for Doctoral Programme in pharmaceutical sciences. In this context, it is imperative to critically examine the opportunities and threats involved in the profession so that a flexible vision can be planned for the coordinated development of pharmacy profession.
Pharmacy profession
Pharmaceutical science is an independent branch of science that deals with all the important aspects of drugs and pharmaceuticals. A pharmacist is a vital link in the physician-patient chain. He plays a key role in the dissemination of pharmaceutical knowledge. The practice of pharmacy includes the custody, preparation and distribution of pharmaceutical products, the provision of advice on health and nutrition related aspects.
The genesis of modern pharmacy education in India is a post independence phenomenon. The government realized the importance of pharma care and was instrumental in starting a few government colleges and depts in the universities, which offered B. Pharm. The first Bachelors programme in pharmacy was started in Banaras Hindu University by Prof. ML. Schroff with the active support given by the then vice-chancellor of the University, Shri Pt. Madan Mohan Malaviya. Later several other universities started the programme. In the pre independence India, the modern pharmacy education programme was made by Portuguese in Goa in 1842, when the Portuguese government started an institution under the name of Escola Medico de Goa for imparting studies in Medicine and Pharmacy. This institution was later named Escola Medical Cirurgica de Goa and students passing out pharmacy course from this institution were called as 'Farmaceuticos' (Textbook of Forensic Pharmacy, Dr. G. Vidya Sagar, P. No. 313). The first M. Pharm. PG programme of one year by research was introduced by BHU in 1940 and Prof. GP Shrivastava became the first postgraduate of pharmacy of India produced from this university.
In India up to the starting of 20th century, country had no laws to exercise any control over operation related to drugs & pharmaceuticals. The pharmaceutical practice consisting of procurement, handling and dispensing of drugs is a specialized profession and requires qualified pharmacists for the job. Some of the important enquiry committees constituted for the development of pharmacy profession in India are 1) The drugs enquiry committee - chairman - Late Col. RN Chopra, 2) The health survey and development committee - chairman - Sir Joseph Bhore, 3) Hathi committee - Prof. Hathi.
The PCI came into existence in 1948 whose main job was to regulate the practice and education of pharmacy in the country. Initially, pharmacy education was offered only in government colleges by a university dept, but due to the advent of privatization of professional higher education in the country, a very huge corpus of private entrepreneurs started private self-financing pharmacy colleges in the length and breadth of the country. In the last two decades a record number of pharmacy colleges have come up in the states of Karnataka, Andhra Pradesh, Tamil Nadu and Maharashtra. The annual rate of production of pharmacists has increased to almost 500 fold. Does this mushroom growth of pharmacy colleges in the country augers well for the profession? This is a million dollar question for the profession today.
Regulation of pharmacy education
At present, two apex bodies are regulating the pharmacy education in the country namely - The Pharmacy Council of India (PCI) and All India Council for Technical Education (AICTE). The PCI regulates the pharmacy institutions conducting approved courses of study and the examining authorities conduction approved examinations to monitor the standards of education.
But the major influencing factor for pharmacy education is vested with AICTE I.e. the power of granting approval for new pharmacy institutions. Similarly AICTE also has the power of extending the approvals for the existing pharmacy colleges and also for introducing new courses or programmes or increase or variation in the intake of seats in the existing pharmacy colleges. Unfortunately AICTE does not have a proper agenda for regulated growth of pharmacy education in the country. A very large number of pharmacy colleges are approved in the last two years for starting the B. Pharm. course. Many colleges do not have minimum infrastructure required and majority of the pharmacy colleges approved by AICTE recently do not have qualified principal and qualified teaching faculty.
In the year 2007, for instance in Andhra Pradesh more than 150 new pharmacy colleges have been approved by AICTE to start B. Pharm. Among these hardly 5 pharmacy colleges have a qualified principal and qualified teaching staff. It is an astonishing fact that how AICTE has given approval to these institutions to start the course.
Pharma Vision 2020
An independent profession which can grow globally further and achieve drug production with a target of 20 per cent from the current 9 per cent in total volume of production of pharmaceuticals in the world. If this dream is to be realized, a total redrafting of the Drugs & Cosmetics Act and the Pharmacy Act should be immediately taken up. The PCI should be given more teeth in regulating the pharmacy education in the country. The present dichotomy between the PCI and the AICTE should go for the better future of pharmacy education in the country. The PCI should be given the total responsibility of regulating the pharmacy profession in the country. The important areas where PCI should get total control are:
1. Power to sanction financial assistance under various schemes to the selected pharmacy institutions in the country for the ongoing research projects and as travel grants to the pharmacy teachers.
2. According to approval start new pharmacy colleges.
3. Sanctioning funds for MODROBS and TIFAC projects for research activities in pharmacy.
In the existing setup the AICTE has the say in the above areas. But there are several hiccups and rejoinders in its activities. For example, giving financial assistance by AICTE to pharmacy institutions, the grants are limited only to a very small fragment of institutions of pharmacy. But today 90 per cent of the pharmacy colleges in the country are private no-grant affiliation institutions and several of them are doing extremely good in academics and research activity. Ironically these institutions are deprived of the financial grants or research grants by AICTE.
Pertaining to the inspections conducted by AICTE for approving pharmacy colleges, the situation is more pathetic. In a single day AICTE inspectors conduct four to five inspection in five different pharmacy colleges for granting approvals. This is ridiculous because it takes not less than 24 hours to physically cause inspection of various statutory norms and requirements of a pharmacy college.
The pharmacy profession should be governed by pharmacists only. The profession should be independent, united and work hard to maintain the spirit of noble profession. The new amendment proposed for the pharmacy act should consider all the above facts and it should be a comprehensive legislation governing all the aspects of pharmacy profession in India. Some of the important aspects which should be included in the new amendment are:
● Statutory powers of PCI to regulate the commercialization of the pharmacy education.
● Statutory power to give approval for the establishment of new pharmacy degree and PG colleges and five year Pharm.D programme.
● Grant of extension of approval for the existing pharmacy colleges.
● Grant of approval for introduction of new courses and new specializations in M. Pharm. or variation in intake of seats in the existing pharmacy colleges.
● Power to lay down norms and standards for pharmacy course, curriculum, physical and infra structural facilities, staff pattern, staff qualifications and examinations etc.
● Fixing of pay scales for the pharmacy teachers. The new sixth pay commission structure and the revised pay scales prescribed should be adopted for considering the new pay scales.
● Power to give 'Centre of Excellence' recognition for the pharmacy colleges doing extremely well.
● PCI should be made an autonomous council and be provided with sufficient funds for ongoing research projects in the colleges.
● Statutory power to PCI to create 'All India Board for Pharmaceutical Science Services', the centre responsible for the recruitment of teachers, scientists and technocrats in pharmacy. This board should be on par with the UPSC regarding the powers and constitution.
Current status of the profession
Pharmacies, drug store, pharma industries, hospitals and academics are some of the places where the pharmacist's services are utilized. In India, pharmacist services are provided by persons with variable qualifications. In general the following types can be recognized.
1. Highly qualified group - includes pharmacists who have an M.Pharm. or a Ph.D.
2. Qualified group - there are tow distinct categories in this group
- Graduate pharmacists: This group has a B.Pharm. degree awarded by a university and have the eligibility to work as a pharmacist or go for upward academic mobility.
- Diplomat pharmacists: D.Pharm. after +2 qualification. Eligible for registration as a qualified pharmacist.
3. Unqualified group - these persons do not hold any pharmacy qualification nor they have received any formal training. By shear observation and default they start practicing pharmacy. Most of these categories consists of the fourth class employees of the hospitals and attendants.
There exists no precise data on the numbers and distribution of these various categories. One source is the PCI. But membership number of PCI does not reflect the true number of pharmacists working in the country in different categories because several persons who have completed B.Pharm. and M.Pharm do not get registered with the council as it is statutorily not required. Therefore, the data of PCI at best represents a section of the qualified group.
The distribution of pharmacists is non uniform in the country. In some places the concentration of pharmacists is very high whereas in some states, there hardly exist any pharmacist service providers. For example the concentration of pharmacist service providers in the cities like Mumbai, Baroda, Ahmedabad and Chennai is more whereas in the states of Assam, Meghalaya, Himachal Pradesh and J&K the concentration is below average. The country requires more pharmacists and there exists a huge requirement and market for pharmacy services in India. Almost every hospital whether it is big, small or medium requires the services of a qualified pharmacist. The medical tourism is a new buzzword today. The pharmacist service in India are quite cost effective as compared to Egypt and other nations. Tapping of this advantage will garner more foreign exchange.
Problems of pharmacy education field
The results of globalization concept can also be seen in pharmacy education field such as mushrooming of private pharmacy institutions, resulting in unethical competition and leading to rapid downward spiral of pharmacy education standards, dearth of education providers (teaching faculty) and rapid technological advances which make non standardization of curriculum and syllabus of pharmacy.
Proliferation of substandard educational institutes
Pharmacy education requires good laboratory facilities and good faculty. It is not appropriate if the emphasis is only based on theoretical teaching. This anomalous situation would erode the element of practical skill competency from the pharmacy education programme and the candidate who receives pharmacy education in such manner will not be useful to the society at all. The very purpose of human resource development would be defeated. More than 70 per cent of the pharmacy institutions which are established after 1995 do not have adequate infra structural facility. In cities like Bangalore, Chennai, Bhopal and Pune more than 40 B.Pharm colleges are there in each city. Pharmacy, a purely practical oriented subject is being taught in purely a non practical oriented approach. These institutions do not appoint sufficient number of teaching faculty. In the absence of teaching and learning, the main aim of these pharmacy institutions is to distribute degree, make money and pay lip service to the needs of the students and the society. They are not at all concerned as to what a student will do after obtaining such degree and what will happen to the unfortunate patient who falls in the care of such a Pharmacos.
Non-uniformity in syllabus and curriculum
There exists a wide variation in the syllabus and training facilities at the B. Pharm. and M.Pharm level across the country and even within a state. Hence, generalization and comparing the competency level of M. Pharm. on the basis of qualification becomes difficult. Deemed universities are the order of the day. Today in every state, several deemed universities are coming up. These universities are starting PG & Ph.D. programmes in pharmacy without sufficient experienced faculty. Recently, in Rajasthan a deemed university has accepted 100 Ph.D. aspirants in pharmaceutical sciences with a nominal one professor to guide them.
The apparent dangers of improper education is the devaluation of degree, the result is the society does not believe in the person's ability as proclaimed in the degree. This has serious repercussions both on the society and also on those who acquire such degrees.
There has been a constant influx of the pharmacy professionals who even after acquiring the highest degree are unable to render effective services to the society. The pharmaceutical industry reports say that only 25-30 per cent of the graduates of pharmacy coming out of various pharmacy colleges in the country are technically fit and suited to their needs. This has created a complex situation where a large number of pharmacy graduates and postgraduates are coming out of colleges and there are large number of pharma industries and service providers but both are of no benefit to each other for want of required skills. Hence, in this present situation, the work force will be searching for other avenues where they are naturally paid less which ultimately leads to a frustrating career.
Dearth of teaching faculty
'When work is pleasure, perfection is the output'. With rapid strides of expansion in pharmacy education, demand for qualified teachers has increased manifold. Today there is a scarcity for teachers, not to mention about good teachers. Due to the lopsided planning of AICTE, a huge cache of pharmacy colleges are given permission every year without the foresight regarding the availability of qualified manpower (teachers). Most of the time a lion's chunk of teachers are fresher and leave the institution for better pastures based on monetary and other benefits. In majority of the pharmacy colleges, managements give more importance to create good physical infrastructure and completely neglect the teachers. In the University Pharmacy Departments, senior faculty and professors are busy with their research projects and official works and ask the young PG students and research scholars to conduct B. Pharm classes. It is sad that we are in this sordid state of affairs at a time in history when a lot of stress is placed on quality assurance in pharmacy education. Beautiful landscapes, state-of-the-art labs, virtual classrooms and libraries alone cannot help a pharmacy college to become Numero Uno. It is the quality of the teachers which matter the most.
Pharmaceutical knowledge management involves knowledge creation, knowledge synthesis, knowledge dissemination and knowledge utilization. Pharmaceutical knowledge creation involves R&D that enhances the pharmaceutical knowledge base. Synthesis seeks to assimilate the primary knowledge generated from various sources in the context of the requirement of the field with respect to the changing national and international needs. The primary information is converted into secondary information in the form of books, databases, encyclopedia etc. so that it becomes a ready to use tool for knowledge dissemination and utilization. Today there is tremendous potential for pharma knowledge utilization. However, inadequate teaching staff, inadequate infrastructure and lack of proper regulatory mechanisms make the task of pharma knowledge creation, synthesis and dissemination extremely difficult.
Conclusion
The stark reality is that unless strong regulatory mechanism is in place, it is not possible to improve the quality and standard of pharmacy education in the country. Further, it will also not be possible to sustain and survive in this competitive world. Hence, it is a high time that our administrators at the helm of affairs take cognizance of these true facts and work sincerely to improve the existing regulations governing the pharmacy profession for realization of sever star pharmacist status.
(The author is principal, Veerayatan Institute of Pharmacy, and Dean, Faculty of Pharmaceutical Sciences, K. S. K. V. Kachchh University, Kutch.)