Pharmacy Education in India:Past, Present and Future

In India, the profession of pharmacy is still in its developing

stages and is yet to bloom to its fullest extent. Here the pharmacist performs a job of a drug seller and does not practice the profession independently and depends on a doctor who is the decision maker.

To cater to these needs presently, B. Pharm. & M. Pharm.

is available and D. Pharm. being the minimum need. But all these higher courses are regular courses and the practicing pharmacist may not get an opportunity to attend the college regularly for updating the educational qualification. With advancement in every field, the profession of pharmacy has also witnessed tremendous changes. The community expects more professional services from pharmacists and not as just drug sellers. There are many community pharmacists serving the country with just D. Pharm. qualification, who are not well equipped with adequate information. The pharmacy council of India has taken a decision to discontinue the D. Pharm. course soon. India being one of the developing countries is yet to meet the needs of people as basic education, health, hygiene etc. Most of our people live in rural areas and do not have basic facilities such as primary health centers, clinics or even approach roads. This rural population including the urban population needs multifarious activities from pharmacists. The PCI defines Pharmacy as a profession which is concerned with the art and science of preparing from natural and synthetic sources, suitable and convenient materials for distribution and use in the treatment and prevention of disease. It embraces a knowledge of the identification, preservation, combination, analysis and standardization of drugs and medicines besides synthesis of new drug molecules, manufacturing of various dosage forms, (Liquid orals, powders, tablets, capsules, ointments, injections, ophthalmic products, etc.) quality control, clinical trials, bio-availability, research, side-effects, compatibility, in-compatibility, indications, contra-indications, pharmacokinetics, pharmacodynamics, toxicology etc.

A Flashback: Germination of Pharmacy Education

The history of

pharmacy education in India is as old as when the country was being gravitated towards British Emperorship. A wind of revolution had been started to innovate something different in the education system of Indian Medical Services. Upto the middle of the nineteenth century, the pharmaceutical education and training remained in a state of neglect. The scenario of pharmacy practice was pathetic. The dispensing of prescriptions continued to be carried out by compounders, who had a low level of preliminary training and education.  The compounders were lowly paid professionals. There were a few European trained pharmacists who were employed by private firms. The seed of the pharmacy education in India was sown first by Medical College, Madras in 1860. Steps were taken to start pharmacy classes to impart pharmaceutical skills for the students qualifying for medical degrees or diploma or hospital assistance ship. The steps proved to be useful for the students intending to qualify as chemist and druggists. Broadly it was copying the practice as it prevailed at the time in Britain. The classes continued with increase of the duration of study to 2 years and entry qualification being made matriculation in due course.

The Materia

Medica proved supportive to boost up the pharmacy education. The students were taught Materia Medica and instructed in the mode of preparing the principle compounds of the Pharmacopoeia and Materia Medica. In the middle of the nineteenth century these professionals got scientifically educated and trained. Initially the 'chemist and druggist' class at Madras Medical College didn't get popular and attracted less than half dozen students per annum. The reasons could have been the limited prospects of employment for the so qualified personnel.  Voices were raised favoring the view that the "present chemist and druggist course be washed out". However the class remained in operation and received Government sanction for continuance in the Madras Medical College as a permanent arrangement. The curriculum of studies was revised with inclusion of study of organic chemistry also. After that the course underwent various revolutions at many times and also started in some other universities like Medical College, Visakhapattnam.

The pharmacy

education in India was going to pass through a mutation when the founder of Banaras Hindu University Mahamana Pt. Madan Mohan Malviya met Prof. M.L. Schroff and Mahamana offered him to join B.H.U. By the nontiring efforts of Prof. Schroff in July 1937 "Pharmaceutical Chemistry" and "Pharmacognosy" were introduced as the subjects for B.Sc. degree. Since then there has been no looking back. Pharmacy came to be recognized as a well-established course with fruitful outcomes.

Current Scenario

Pharmaceutical education plays a very prominent role in

attaining sustainable and equitable development of a country. The curriculum of the degree in some developed countries (B. Pharm.) usually requires 5 academic years of study. In most of the European countries successful completion of a university degree leads to a one-year internship. The formal pharmacy education in India (3 year degree in BHU) dates back 1932, and since then, there has been a continuous growth in number of such institutions. As per PCI 2005 diary calendar, the total numbers of recognized degree institutions are 220 with intake of 12506 students. And as per AICTE, the total number of degree colleges are 445 with the intake of 24672 students as well 30 institutions for the post graduation in various fields.

The number of accredited institutions like the

National Institute of Pharmacy Education Research (NIPER) is very few. Faculty strength and its quality is a problem. The education system is not geared for the WTO era. Management is not proactive in providing facilities and necessary educational environment. National pay scales are not fully implemented and hence good academia is missing. There are a few centers of excellence where students get all the facilities and are well placed after their graduation. In the next decade, pharmaceutical industries will scout for pharmacy graduates who are inclined to research. Therefore, pharmacy colleges must appoint the right faculty.

Education Standards at Present

There is no doubt that currently there is enormous gap

existing between education and practice of pharmacy. Most of the academic institutions providing education in pharmacy are away from practice environment. The overall basis of pharmacy education is still extrabiological synthesis, physicochemical studies, analysis, and manufacturing aspects of drug. It is a common feeling that the medical practitioner is better placed for pharmacists' job than the pharmacists themselves. The dispensing services are poor. The syllabus and duration of the two-year diploma course in pharmacy education in India is completely outdated and irrelevant in the present industry context. It is a heterogeneous mixture of clinical and industrial subjects. Since clinical subjects are there PCI comes into the picture and AICTE came in because of industrial orientation of pharmacy syllabus. Pharmacy as a nascent science developed like this in the last century. During 1940s and 50s, hospitals and industries were established in large numbers in India. Consequently, pharmacists and pharmaceutical chemists were required in huge numbers. Hence pharmacy education was developed in such a way to satisfy the requirement of industry and hospital. Short-term compounders and or D. Pharm. course to satisfy the needs of hospital and medical shops and B. Pharm. course for the industry were started. This is proved by the fact that in the last few decades D. Pharm. holders are not employed by the industry and B. Pharm. holders are not in many numbers in hospitals or medical shops.  In the West, pharmacy education is patient-oriented and is responsible for Healthcare Management, while in India pharmacy education is industry-oriented. Nearly 55 per cent of the jobs are available in the industry sector while 30 per cent in education. There are only three per cent jobs in healthcare. There must be revolutionary changes in the healthcare system e.g. making laws for appointing pharmacists at each Primary Health Centre and government hospitals. There should be adequate staff in the state drugs control departments for better control of drug distribution system. It is crystal clear that separation and improvement of clinical and industrial subjects in the pharmacy syllabus is a compulsion of the time. But it is yet to be completed, that is why there is such a situation and a lot of infighting among government authorities. Present B. Pharm. syllabus can be divided into 2 major courses like B. Pharm. (Clinical) and B. Pharm. (Industrial) as it has been already decided to abolish D. Pharm. course. Such an arrangement will increase the confidence and competitive skills of pharmacy graduates among health care team and technocrats and some sort of specialization during under graduation itself. If two B. Pharm. courses are created as above, needless to say clinical course can be controlled by PCI and industrial course by AICTE. Private college managements can opt for any one of the courses. If any college wants to run both the courses they should accept both masters, there is no other go. Existing D. Pharm. colleges who are in the verge of closure can adopt B. Pharm. (Clinical) and continue to serve the profession. This stunted growth of professional pharmacy in our country is the result of misplaced belief that profession is same as vocation. This belief has kept Indian pharmacy academics completely focused on industrial pharmacy at the cost of real - community pharmacy. While the justification for focusing pharmacy education on Industrial Pharmacy after attaining national freedom was valid, its review to make it relevant in contemporary scenario is already too late.

Our present system has produced half a million

''qualified'' pharmacists but not many ''trained'' professionals. This has effectively led to a situation where neither there is a need felt by the society nor is there anyone available to fulfill that "professed" need. This situation feeds on itself to such an extent that any attempt to keep one's knowledge updated and work professionally has strong economic disincentives in Indian retail pharmacy practice. Gravity of the situation dawns upon us when we think about petitions filed in High courts that propose scrapping of the Pharmacy Act because the pharmacists - according to petitioners - do not play any role other than selling the drugs like all other commodities. There is virtually a complete lack of any training or incentive to professionalize - as a result of which even the most enthusiastic pharmacists gradually convert into mere traders. The uninspiring implementation of statutory provisions has led to a cancerous proliferation of retail drug shops and the situation now threatens the profession itself. The retail pharmacist shall be relevant to the society `only'' if he can make a difference to the patient - by providing him information about drug usage to achieve better outcome than the patient obtains by uninformed usage of drugs.

The president of this IPC - Prof. Kulkarni - himself

conceded in his inaugural address of IPC 2001 that talking about Community Pharmacy has become a pass-time lately. A lot of credit for this new fascination about community pharmacy goes to the Community Pharmacy Division ofIPA, which launched a persistent campaign to nudge the retail pharmacists, the academicians, professional association managers and lately the society itself. Apart from whatever else is taught in pharmacy colleges under the garb of "Pharmacy Practice"- I feel the following are mandatory subjects: Pharmaco-therapeutics, Communication skills and Hands down training on computer operations. He must be trained and experienced in working as a health-care team member and this factor is not to be underestimated in the formal education design.

Driving an automobile can be learnt only in an automobile -

on a road. Or - you at least need a simulator to learn driving. Similarly, pharmacy practice cannot be taught in an institution that has no affiliation with a patient-care set up. This fundamental principle must be kept in mind before a Pharmacy Practice course is conceived. The pharmacy teacher's community should take notice of this critical and important issue and involve a cross section of practicing pharmacists to review and suggest a relevant curriculum. Any further delay will diminish whatever slim chances we believe we have today of projecting Pharmacy as a socially relevant profession.

Control of Pharmacy Education by The PCI

The PCI controls and regulates the standards for a better

pharmacy education in India. The main aims of PCI are:

• To prescribe minimum standard of education required for qualifying

as a pharmacist i.e. framing of Education Regulations prescribing the conditions to be fulfilled by the institutions seeking approval of the PCI for imparting education in pharmacy. • To ensure uniform implementation of the educational standards through out the country. • To approve the courses of study and examination for pharmacists i.e. approval of the academic training institutions providing pharmacy courses. The curriculum of pharmacy education has been designed to produce the following professional categories of pharmacists; • Community and hospital pharmacists who will work as an important link between doctor and patient and will counsel the patient on various facets of drugs like usage, side effects, indication, contra-indications, compatibilities, in-compatibilities, storage, dosage etc. • Specialist in research and development i.e. research of new drug molecules, biotechnical research etc.  • Occupational specialist (industrial pharmacist engaged in pharmaceutical technology) i.e. manufacture of various dosage forms, analysis and quality control, clinical trials, post-marketing surveillance, patent application and drug registration, sales and marketing. • Academicians i.e. Teachers of Pharmacy education.  • Manager and Administrators of Pharmaceutical Services working for various regulatory authorities and pharmaceutical systems.  • Chemists and Druggists engaged in selling of medicines.

Future: An Overview

In the future, drug treatment will be increasingly and

confidently tailored to the individual through the help of specific diagnostics. Many new drugs will be given parenterally and targeted for specific diseases. The pharmacists will need to adapt to this changing pattern in order to be seen by the patient as part of health care team. However in spite of many lacunae in pharmacy education system, the fact cannot be overlooked that tremendous development in the field of new drug discovery and research activities, has taken place. Research centers attached with pharmaceutical institutions have played a major role in this regard. Notable among them are BRNCRC, Mandsaur; TIFAC CORE in JSS College of Pharmacy, Ooty; TIFAC CORE and ACCUNOVA in Manipal College of Pharmaceutical Sciences, Manipal and many more. These steps taken at present to upgrade the pharmacy education must be maintained for proper development and utilization of the course. Apart from these, emphasis should be given on fields like Biotechnology, Bioinformatics, Clinical Trials, Drug Regulatory Affairs (National and International).

Conclusion

Overall, the

education system is based not only on infrastructure but also on the teachers, immorality and mismanagement has taken over education. Pharmacy teachers, have to regulate themselves, update their knowledge, deliver excellence and inspire students by adapting values, time management is the other factor that they must bring in their own personality. Education, which they have to deliver, must be of highest standard so that the upcoming pharmacists should not be a liability, but should be able to deliver excellence at national and international levels.

 “Success can not be harvested until and unless its seed is sown”