PHARMACY PROFESSION IN THE 21 CENTUARY

All professions possesses certain core features and the pharmacy profession complies with most of the core functions of a profession (refer to Table 2.2) in that the pharmacist has specialised knowledge of medicine obtained through lengthy training at accredited educational institutions. There is strict legal control over the practice of the profession

and the profession is service orientated. Monopoly of practice is the only core feature, which the profession struggles to fulfill because the general practitioner and the nursing profession under certain conditions may fulfill the role of the pharmacist.

Table 2.2 Core features of a profession

1 Specialised theoretical knowledge of a subject that can not be learned by practice alone.

2 Lengthy training of a subject, at recognized educational institutions and the professional competence are tested before admission to the profession.

3 Self-regulation with strict legal control over the practice of the specific profession. Professionals normally have more control over their work with the control normally being independent from external control with self-regulation by means of registration, embodying standards of training and practice in some statutory form. Ethical controls also normally exist.

4 Service orientation in which professions are also normally central to important human values and are important services for example health and the specialized knowledge are put to use in the service of mankind.

5 Monopoly of practice meaning that no one else can practice that profession.

(Sourced from: General dealer versus Health Care professional. 2005: 22)

Training of pharmacists has changed along with the requirements of the profession. Many years ago it was customary for trainees to complete five years in a chemist’s shop before taking a college course for one year (Wilson, Schlapp & Davidson, 2003: 382). This pattern operates in reverse today as student pharmacists undertake a degree course,

followed by a period of pre-registration, typically of one year’s duration (Anderson, 2002: 396; Wilson, et al., 2003: 382). The degree course is science based, with a strong emphasis on the pharmaceutical sciences, social and administrative pharmacy, and forensic pharmacy. The exact syllabus varies substantially from country to country (Anderson, 2002:

396). In South Africa the undergraduate degree lasts four years at recognised universities (refer to Table 2.3) as determined by the South African Pharmacy Council (SAPC) (Pharmacy Act No 53 of 1974: PRE 27). The SAPC also stipulates minimum curriculum requirements (refer to Table 2.4)

Table 2.3 Training institutions located across South African provinces

Province University

Eastern Cape Nelson Mandela Metropolitan University Rhodes University

Limpopo University of Limpopo (Medunsa campus) in collaboration with Tshwane University of Technology

University of Limpopo (Turfloop campus) North West University of the North-West

KwaZulu-Natal University of KwaZulu-Natal Western Cape University of the Western Cape Gauteng University of the Witwatersrand

(Sourced from: Updated list of approved providers and courses for pharmacy education and training, 2010: 12 & 13)

Table 2.4 Minimum curriculum requirements

1 Major subjects presented over a minimum of four semesters with a total of at least 19 semester courses for the four major subjects Pharmacology Study of the actions and uses of medicines including

absorption, distribution and excretion from the body Pharmaceutical

Chemistry

Study of the chemistry of medicinal substances including their synthesis and analysis

Pharmaceutics Conversion of medicinal substances into suitable dosage forms such as tablets, injections and inhalers Pharmacy

Practice

Study of medicinal substances of natural origin, primary health care, social pharmacy, economic aspects of medicines and forensic pharmacy (laws in relation to medicines and pharmacy)

2 Preparatory and supplementary subjects General and Organic Chemistry

3 Miscellaneous subjects exposing the students appropriate elements of the following subjects

Communication skills Computer literacy

Social and behavioural sciences

(Sourced from: Pharmacy Act No 53 of 1974: PRE 28)

After completion of the course, pharmacists are qualified to practice as interns in either community, hospital or pharmaceutical setting under supervision. The pharmacist intern is required to write a pre-registration examination, present a portfolio to the SAPC and then complete a community service year prior to the final registration as a pharmacist with the SAPC.

A degree and registration with countries pharmaceutical council is not all that is required to perform higher-level collaborative patient care activities such as pharmaceutical care. It requires additional education and training (continuing education) because pharmacists’ functions become more diverse and more specialised by the day (Manasse, 2003: 2488). Ten to fifteen percent of community pharmacists in England are estimated to be participating in continuing education, which implies that approximately 85% have no engagement with further learning (Wilson, Schlapp &

Davidson, 2003: 381). Currently, pharmacists undertake continuing education on a voluntary basis in South Africa.

Pharmacy is a self-regulating profession and the control thereof varies from country to country, each with its own regulatory and disciplinary body. Most countries have written standards of practice for pharmacists, which are usually established by the appropriate professional bodies (Anderson, 2002: 398). In South Africa the control over the profession of pharmacy is divided into statutory (or legal) control, and non-statutory control and all practicing pharmacists must be registered with the SAPC.

The two main acts that govern the profession in South Africa are the Pharmacy Act, No. 53 of 1974, as amended (deals with the practice of the profession) and the Medicines and Related Substances Control Act, No.

101 of 1965, as amended (governs the manufacture and sale of medicines). These two acts can be found in the Compendium of Laws and Regulations. The pharmacy profession in South Africa is also

influenced by the government of South Africa’s National Drug Policy (NDP), which clearly outlines its commitment to ensuring availability and accessibility of medicines to all people (refer to Chapter 1). Other acts regulating the profession of pharmacy in South Africa are; the Medical, Dental and Supplementary Health Services Professions Act, Medical Schemes Act, Abuse of Dependence-producing Substances and Rehabilitation Centers Act, Hazardous Substances Act, and the Liquor Act. The pharmacy profession is a service orientated profession which is explained under the role of pharmacists.