Pharmacy Council of India (PCI) has recently opened a new era in the pharmacy education by starting the Pharm D programme. No doubt, it is a welcome step that is supposed to take the pharmacy profession to a higher level, hitherto unknown to Indian pharmacists. Definitely the PCI president Dr B Suresh and his team deserve appreciation from all the pharmacists. They did a wonderful job in persuading Govt of India to permit such a course. On going through the requirements, the facilities and faculties, syllabus and training published in the website of PCI, one can imagine the homework done by PCI and the committee formed for the purpose.
By starting this course, this author's suggestion made 5 years ago for bifurcating B. Pharm and undergraduate level specialization ["Re-energizing pharmacy education - A proposal" Pharmabiz - 14-8-2003 and "Pharmacy education at cross roads - challenges ahead" -Presentation in 55th IPC Chennai] is being implemented though in a different way. So far so good!
However, there are few unavoidable questions which creep into the mind of an onlooker. The foremost one being, where these Pharm. D holders will be employed in India? Without any job provided for these people how the course could succeed? Leave alone educated fore thinking people who asks questions on each and every thing. Think of lay parent who wishes to admit his son or daughter in this course. The first question he asks on introducing this course to him is where my son or daughter will get the job? Is it not? The next question may be on the salary level.
What answer the colleges which are starting this course going to give to the anticipating parents? As of now, Pharm D course seems to satisfy the requirements of foreign employment. Well. Then the next question is how much percentage of these students will get job in abroad? Without any opportunity locally, where they will gain experience, till they go abroad for employment?
These questions are not to discourage the people who did a nice job by starting the course, on the other hand, to point out the unfinished and important remaining part of the work, which they must follow it up.
Of course knowingly or unknowingly, they have initiated the work, even before starting this Pharm. D programme, by writing to Medical Council of India, sometime back, to start "Department of Pharmacy Services' in all the medical college hospitals. What happened to that request sent to MCI? PCI must come forward and publish the reply from MCI or the follow up action of PCI and/or MCI took on this matter. PCI has knocked at the correct door, but the door is not yet opened. What it proposes to do next?
Why our consumer organizations are keeping quiet? Consumers are being denied the services of graduate and postgraduates pharmacists they deserve. First they should be educated. When modern, potent and complicated medicines are used in hospitals, why a qualified pharmacist is denied his role? Why our MCI and honourable doctors are adamant to employ a bullock cart driver to drive their Benz? MCI must be appreciated the role of a postgraduate pharmacist in safe and rational use of drug, Pharmacovigilance and therapeutic drug monitoring, ADR and drug-drug interactions etc.
Lack of ADR monitoring in India
In fact, in a recent IMA Conference at Hyderabad, a foreign invitee pointed out the lack of ADR monitoring in India. It is natural when there is vacuum and nobody appointed to look for ADR and its monitoring. In developed countries, it is being done by [graduate] clinical pharmacists. The Conference might have forgotten that we employ only diploma in pharmacy people as pharmacists here in India and there is no clinical pharmacy services, why, even pharmacy department in our hospitals!
Hence, PCI must constitute a committee and open dialogue with MCI, if necessary, in all other important forums of doctors like IMA etc. It must convince the doctors that the services of highly qualified pharmacists are to help them by providing drug information, patients medication history and patient counselling etc.
It is high time the PCI must start working on these lines so that when these Pharm D graduates come out of the colleges, the Department of Pharmacy Services will be available in all the big hospitals. Given the slow movement of files in Govt offices it is not too earlier, as some may think, because Post Baccalaureate, i.e., lateral entry B. Pharm graduates into the Pharm D course will come out in 3 years.
Already there are M. Pharm Pharmacy Practice and M. Pharm Pharmacology graduates available, who can also be employed in place of Pharm. D graduates, as HODs of these departments as an interim or permanent arrangement. Naturally we have to strike a balance between these postgraduates [M. Pharm] and Pharm. D graduates as both undergo a 6 years pharmacy education after +2 they may have to be treated equally. Because of this M. Pharm studies some industry-oriented subjects in their B. Pharm, they can go to industries as well, whereas the Pharm. D holders are specially made for hospital job. Hence, without creating the job preparing manpower for it is akin to putting the cart before the horse!
Otherwise the syllabus for Pharm. D programme seems to be adequate, may be in line with the expectations of the developed countries that employ these graduates in their hospitals. One glaring omission noticed by this author is absence of the subject 'alternative systems of medicines' especially our traditional systems like Ayurveda and Siddha in the syllabus. One chapter on this subject if available in Pharmacognosy paper of II year Pharm D cannot be sufficient as the stakes involved are higher. Even the Western and other countries also use Phytomedicines in large scale. The medicines too have side effects, toxicity due to improper formulation etc. requiring monitoring by pharmacists similar to allopathic drugs.
Hence "Phytotherapy" as a subject should be included in the syllabus. As there are only three subjects in the 5th year of the course, it can be inducted there. This also will give a local look to the course and leads to some service to our own people by these "Doctors in Pharmacy". It helps to avoid the image that the course is suitable only for foreign employment.
Let us hope our PCI will take it in right spirit and proceed with suitable steps and let our voice of support give them the needed boost and energy to fight for a noble cause!
(The author is Ex President of IPGA, Madurai)