Pharmacy education system of Japan: An insight

Pharmacy education system of Japan: An insight

Authors:

Dr. Sarath chandran C, M.Pharm, Ph.D, Assistant Professor, Department of Pharmaceutics, Academy of Pharmaceutical Sciences, Pariyaram Medical College, Pariyaram- 670 503, Kerala, India

.

Dr. Yoko Amagase, B.Sc., Ph.D, Assistant Professor, Department of Pathophysiology, Faculty of Pharmaceutical Sciences, Doshisha Women’s College of Liberal Arts, Kodo, Kyotanabe City, Kyoto, 610-0395, Japan.

Japan “land of rising sun” is a small island nation located in Pacific Ocean. The approximate population of 126 million makes them worlds tenth largest. The Japanese economy is fastest growing and country itself is considered to be most developed and innovative in the world. Even though, Japan is super developed in most of the sectors, but their professional pharmacy sector may be still in infancy! The situation may be more or less comparable with what we have in India. But the country, which has long history and tradition of ‘no compromise’ with quality has made strong attempts to make a positive change in pharmacy sector by bringing updated policies in pharmaceutical education and professional regulations.

In early part of 2000, there were only 46 pharmacy schools available across Japan which could educate and train only 8000 odd graduates. But after 2006, there was huge rise in number of pharmacy schools. At present, 74 pharmacy schools function under different universities across Japan, which can admit approximately 13000 students each year. This reason for rise in number of pharmacy schools in Japan may not be same as that of ours! This rise in pharmacy schools was mainly because of government policy to employ more pharmacists to work as experts of drugs and pharmaceuticals in Japan.

The pharmaceutical education in Japan had two phases ie before and after 2006. The situation of pharmacy education in Japan before 2006 was more or less similar to what we have in India. It was a 4 year undergraduate course awarding bachelor degree of pharmacy to the student. This was prescribed education qualification for a student to enrol for national examination to become a registered pharmacist in Japan. But after 2006, the pharmacy education program in Japan was modified and pharmacy schools started offering two types of courses. Along with existing 4 year course, a new 6 year course was introduced. But unlike in India, this decision to introduce a new 6 year course was done with more precise objective. The name of the pharmacy course depends up on the university which offers it. For eg: Doshisha Women’s College of Liberal Arts (DWCLA) founded in 1876 call it “Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences”.

The 6 year course was introduced to train the student as a drug specialist in clinical as well as community pharmacies and to enable them as registered pharmacist in Japan. As part of modernising pharmaceutical education, the traditional 4 year undergraduate course was retained to train the students who are aiming for master’s degree or PhD and others get jobs at industry, government or education. The student who has completed 4 year course is no more qualified to take part in national examination for pharmacist. This clearly laid down objectives for both programs, proves the vision of policy makers in Japan.

The medical and pharmaceutical technology is in rapid transformation. With changing trends, Japanese policy makers decided to change their existing pharmacy regulations and completely separated pharmacy from clinic. This change in policy created more independent pharmacy establishments under community as well as hospital sector. These pharmacies required professionally skilled, competent and knowledgeable pharmacist. This situation was compensated with new 6 year pharmacy course with modern curriculum. In a 6 year course, student is getting enriched with humanism, integrity and ethical value as a healthcare professional. The successful completion of this course helps the pharmacist to acquire abilities to discover and resolve problems in a clinical setting. During the 6 year course, the students are provided with basic knowledge and techniques of pharmacy. The liberal arts and clinical onsite training is also provided to a pharmacy graduate. Since the 4 years were not sufficient enough for students to learn and acquire all these skills and knowledge, the new 6 year course was quite effective.

The curriculum for 6 year pharmacy course may be slightly different for each pharmacy school of Japan. Therefore, we explain about the course using the case of Doshisha Women’s College of Liberal Arts (DWCLA) as an example in this article. The Fig No.1 summarises the key areas covered by a student in a 6 year pharmacy course. The student admitted for 6 year pharmacy course; generally learn the basic pharmaceutical sciences, health care system and medical ethics in the first 4 years of the course. The skill to improve basic communication and skills essential for communication during clinical practice will be taught in the first 4 years of the course. These are done through regular theory and practical classes. From the 5^th year onwards student gets exclusive practical training at hospital and community pharmacies. But prior to enrolling for 5^th year practical training, the student must pass the pharmaceutical common achievement test. This test ensures that a pharmacy student has skills and knowledge to get trained at hospital and community pharmacy.

Fig No. 1: Key areas of exposure for pharmacy student in 6 year course at DWCLA (http://www.dwc.doshisha.ac.jp/english/faculty_dep_info/pharmacy/clinical/index.html)

The pharmaceutical common achievement test comprises of Computer Based Testing (CBT) and Objective Structured Clinical Examination (OSCE). The CBT is performed to evaluate whether pharmacy students acquired the fundamental knowledge in basic science, pharmacology and ethics. This is purely a computer based examination, where student answer the questions displayed on a computer monitor. The questions for CBT is mainly based on physics, chemistry, biology, practical pharmacy, pharmacology, information science, humanism, health & environment, pharmacy & society and any previously learned theory or practical training topics. The questions for OSCE are based up on patient interview/counselling, dispensing of medicines, inspection of dispensed medicines, germ free operations and drug information services. The OSCE is done to evaluate the skills and attitude of a student as a prospective pharmacist. This examination is conducted before two examiners; one external and one internal examiner. The pharmaceutical common achievement test ensures that only skilled and knowledgeable pharmacy students are getting trained as future pharmacist of Japan.

Activities in the 5th year comprises of clinical training at hospital and community pharmacy (2.5 months each) and research activities in the laboratory. At DWCLA, students choose their laboratories in the middle of the third year. Once they reach to their opted laboratories, they get involved in the active practical works and spend their time with in the laboratory even when they don’t have regular lectures or practicals. In the laboratories, the students learn laboratory techniques, research skills, reading papers, presentation and so on. This activity continues until the first semester of the sixth year. In the sixth year, students are aimed to develop their advanced skills in the area of basic and clinical pharmacy. At the end of the first semester of 6th year, students have to write up a dissertation, make a poster and give a presentation. At the presentation, they have to defend their work successfully. The dissertation, poster presentation and defence are all required for achieving their degree. Other than that, 6th year students take lectures of more specialised professional topics such as nutrition, infusion, oriental medicine, immunology, infection, pharmaceutical management, the latest scientific achievements, and so on. At the end of each year, students have to submit a report what they have achieved in their research.

After the successful completion of 6 year pharmacy course, which includes regular examinations, CBT, OSCE and practical training and graduation examinations, the pharmacy student is entitled to appear for pharmacist national examination. This examination is carried out once in a year in the month of March. The passing of pharmacist national examination make a person eligible to work as a pharmacist in Japan. The passing of pharmacist national examination is not an easy task. The candidate has to answer 345 questions and should secure a minimum of 65% to pass this examination. The examination is based on approved subjects and each subject has two categories of questions ie compulsory questions and general questions. The general questions will have both theory and practical sections. Apart from 65% over all pass score, candidate should secure separate score of 70% from compulsory questions and 30% from each subject. The national pass rate for pharmacist national examination is only 63%, which shows how tough it may be for a person to get approved as a pharmacist in Japan.

The goal of Japanese pharmacy education system is to cultivate pharmacists as medical professionals on the basis of their educational principles. In addition to this, institution like DWCLA adopts principles of Christianity, internationalism and liberal arts within the pharmacy education system. The Japanese pharmacy education system attempts to produce pharmacists and researchers equipped with practical skills to work in various fields including medical practice, drug development and health service with high ethical standards, well-rounded character, international perspective, and broad knowledge. The educational as well as professional regulations designed and executed efficiently to create pharmacist who can be unavoidable partner of a society, which has probably highest percentage of ageing population in the world.