STANDARDS IN PHARMACEUTICAL EDUCATION. [1]

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By Henry Kraemer.

If we consider the present awakening in pharmacy, it may seem to some that we are making very rapid strides, but as a matter of fact the progress of pharmaceutical education in this country has been comparatively slow. The history of pharmacy in this country may be divided into three periods: (1) The pioneer period during the sixteenth century, when there were no physicians, and the general storekeeper who sold dry goods, groceries, books and paints, also sold medicines and prescribed them; (2) the colonial period during the seventeenth and eighteenth centuries, when educated physicians from abroad emigrated to the colonies and prescribed as well as dispensed medicines; (3) the college period, or the period of organization and development, during the nineteenth century, when pharmacy became a distinct profession and business, and colleges of pharmacy were established, these numbering nearly 100 at the present time. We are now entering, after nearly a century, upon the fourth period, namely, that of standards in education, and we are endeavoring to fix the position of pharmacy among the other professions.

The problem of pharmaceutical education involves two phases, namely (1) that of the natural ability and preliminary qualifications of the applicants for entrance to the colleges and schools of pharmacy, and (2) that of the character and kind of instruction that shall be given by a recognized teaching institution in pharmacy. Not only are these two classes of standards being considered by the teaching bodies themselves, but also by the boards of pharmacy, and with the enactment of laws in various States it will now be possible for more or less concerted action to be taken throughout the United States.

Our system of popular education is the boast of our country, and well may it be, for it has been making steady advances during all the years of our national existence. At the present time the facilities for instruction and the opportunities for obtaining a good general education are so ample that it seems hardly credible that any one who is desirous of obtaining an education should fail in the attempt.

It follows logically that as the standard of general education is advanced, the standards in colleges, technical schools and universities will also be advanced, and thus we find to-day that the majority of these institutions are not only constantly improving their curricula but they are seeing to it that those who go to them for instruction are qualified to pursue the prescribed line of studies. The only wonder is that the entrance standards in some of the professional schools have not been advanced more rapidly than they have, for in no other way have they been more handicapped than in this.

It is true there may be some parts of our country where the opportunities for obtaining an education are more or less limited, but this is no argument why those in the vanguard should stop in their course and wait for the center of population to shift a few hundred miles. We know that in Alaska and the Philippines the means for education are not so ample as they are with us, but we are not thinking of stopping to wait for those countries. On the contrary they desire us to go ahead and they will follow as rapidly as possible. And so if the youths of the country districts of Iowa, or Kansas, or Missouri have not, as is claimed by some, the opportunity for obtaining a high school education, is that any reason why those in Ohio, or Michigan, or Pennsylvania should be excused for neglecting theirs? No, this is not the way of progress.

If there are any two professions or callings where the unfit should be culled out more than in others, it is in those of medicine and pharmacy. These are the professions calling for the highest type of manhood, and at the same time special educational equipment and intellectual acumen. Being largely answerable to himself in the conduct of his business, it is plain that the pharmacist must be of a high moral type, and if he is of the type that he should be to assume such a responsible calling, he will first see to it that his general education warrants him in undertaking its pursuit. But if there are those who have not the moral sense to conscientiously qualify themselves by obtaining the necessary preliminary education, then the teaching bodies should exercise their power to eliminate them. Here is where the highest obligation of the schools and colleges of pharmacy rests, and here is where the supreme test of their sense of their obligation to the public comes in.

Certainly those applicants for entrance who have had opportunities for obtaining an education and have been so indifferent as not to improve them, can hardly be considered fit candidates for the practice of pharmacy. Entrance to a college presupposes a good general education; the studies to be mastered require it, and to admit the unqualified reacts on all those engaged in the practice of pharmacy and in the teaching of pharmacy. It also does harm to those who are still in the public schools, for instead of finishing their courses they discontinue their studies knowing that they can fit themselves by short cuts. It lowers the standard of the schools of pharmacy and so tends to keep away those who are qualified to pursue the work. In short, it lowers the tone of pharmacy at every point. And who can say that it does not eventually make an impression on the general public and influence them in withholding their support, both moral and financial?

I know of a young man who desired to study law, but who had not gone further than the grammar school. When he came to inquire about the terms of admission to the bar, he found that graduation from a high school was required. He then decided to enter school again and go through the high school. Can any one doubt the advantage of such a course to this young man or to the profession of law in requiring him to complete his preliminary education?

There are those who incline to take pity on those applicants in pharmacy who have not the desired amount of preliminary education and who argue that they should be given a chance. But this is a false kind of charity; if the applicants are sincere and have natural ability, they should be advised to go back to school, but if they belong to the shiftless class, they should above all things not be allowed to ally themselves with pharmacy. No, this is not the place for the exercise of charity, particularly when we think of our obligations to the great public who have so long and so implicitly trusted us.

Having once eliminated the unfit, the next highest duty of the colleges of pharmacy is to qualify their students for the work that they may be called upon to do. This may seem like a very trite saying to some of you, and yet I feel warranted in its utterance. We have reached a crisis in pharmaceutical history, and if the pharmacist is to continue a separate and independent existence it must be on the basis of his scientific attainments. The pharmacist has felt his hampered position for some time, but now that the Pure Food and Drugs Act has become effective, we are face to face with the issue. With the United States Pharmacopoeia and the National Formulary as the legal standards he will now be held responsible for the identity and quality of the drugs which he sells. The question then is, will he assume this responsibility, and pronounce finally on the quality and efficiency of the drugs and medicines which he dispenses, or will he shift this responsibility whenever possible? If he adopts the latter course, then will he lose in importance and standing to that extent.

By the adoption of the Pure Food and Drugs Act both the responsibility and the obligation of the pharmacist are increased and added importance must attach to his position. He should take as much pride in his ability to pronounce upon the quality of an article guaranteed by the manufacturer, or in making a preparation which he himself guarantees, as he has heretofore taken in his ability to decide upon the compatibility, or to question the dosage, of a prescription. He must stand between the manufacturer and the physician as he has stood between the physician and the public. Too much care cannot be exercised in this direction, for the manufacturer’s guarantee may in some instances prove to be only a label.

To do work of this kind means that the pharmacist shall be a master of the Pharmacopoeia, that he shall be able to identify any substance in the Pharmacopoeia, carry out any of the tests, and make any of the preparations in the Pharmacopoeia and National Formulary, processes for which are given. The least, then, that the colleges of pharmacy can do is to prepare their students to employ the Pharmacopoeia and the National Formulary as working guides.

With the proper preliminary requirements established, and without entering at this time into a discussion of the question as to the number of hours required for the work that should be done, believing as I do that the colleges and schools belonging to the Conference of Teaching Faculties will be able to decide this problem, I may say that no discussion of the educational problem is complete at this time without reference to the nature of the examinations of the Boards of Pharmacy. In years gone by these examinations have been largely theoretical, and hence were not so valuable as they might have been in testing the fitness of a candidate. Happily, there is beginning to be an improvement in this direction and the examinations are becoming more practical. To my way of thinking the aim of the boards of pharmacy should be to determine what a candidate can do. The theory has been given to him in college, and the final test should be to determine whether he has a working knowledge of the materials which he handles. Instead of asking him what are the elementary forms of matter, or what is a water-bath, or to give the family name of a plant yielding a drug, it would be better to give him some drug or chemical to identify, to carry out the tests for purity according to the Pharmacopoeia and to make a preparation.

The boards of pharmacy have a very important work to perform in determining the fitness of candidates and in determining whether the colleges are faithfully carrying on their work. As matters are now constituted they are the final arbiters and should be fully cognizant of the great trust which they hold. It should no longer be possible for the unqualified or incompetent to enter college, spend two or three years at college and be given a degree and finally pass a State Board as a registered pharmacist.

Pharmacists themselves also have a very important part to perform in raising pharmacy to the plane that it must occupy to maintain its separate existence. In the first place they should not admit into apprenticeship young men who are deficient in preliminary education, for quite naturally they hope sooner or later to enter the schools of pharmacy. Indeed to admit such as these into apprenticeship is not only an injustice to them but also to the colleges of pharmacy, and this may be considered as one of the fundamental tests as to whether the pharmacist has the true interests of his calling at heart. Pharmacists can at this point be of real service to these young men by encouraging them and advising them to continue their education in the public schools or to acquire it in some other way.

The second duty of the pharmacist is to endeavor to conduct his business in such a manner that the educated young men will be attracted to it (for undoubtedly there is no more interesting work than that connected with the profession of pharmacy), and find something to repay them for their pains, and to appeal to their aspirations as professional men.

The third duty of the pharmacist is to the physician. If the physician is willing to rely upon the pharmacist and to help him in maintaining and re-establishing the profession of pharmacy by prescribing only the preparations and medicines in the Pharmacopoeia and National Formulary, and the new and non-official remedies approved by the Council on Pharmacy and Chemistry of the American Medical Association, then should the pharmacist aim to eliminate as rapidly as possible patent medicines, nostrums and sundry articles not used as medicines, or as aids to the sick, or even as toilet preparations, and prepare to give his undivided attention to his profession, which alone by training, education and experience he is qualified to conduct.

In briefly summing up my remarks I may say that I have endeavored to emphasize the essential principles which we must bear in mind.

(1) A good preliminary education is essential to an apprentice and student of pharmacy.

(2) The least that a college or school of pharmacy should do is to send forth graduates that are masters of every detail of the U. S. Pharmacopoeia and the National Formulary.

(3) It is the duty of the Board of Pharmacy to determine what applicants for the certificate of Registered Pharmacist can do rather than what they are able to memorize.

(4) That pharmacists themselves must share in the work of elevating the standards of pharmacy.

If we are clear on these principles, sincere in our professions and earnest in our endeavors, the details can easily be worked out.

                                                                                                                                                                                                                                                                                                           

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