The following is an open letter to the Pharmaceutical Society of Ireland, Ireland’s Pharmacy Regulator, written by 4th-year pharmacy students in Cork and across the country. It comes following the restructuring of Ireland’s pharmacy courses. The new course structure involves a five-year integrated masters programme under one of the three schools of pharmacy in Ireland – UCC, TCD, RCSI. As a result, pharmacy students must now complete a four-month placement in year 4 and an eight-month placement in year 5 – both unpaid. This letter was provided to the University Express by the 4th year pharmacy students of UCC. The letter is as follows:
An open letter to the Pharmaceutical Society of Ireland, the Pharmacy Regulator
I am writing to you on behalf of the Intern Pharmacists of Ireland.
As you are aware, the outcome of the National Forum for Pharmacy Education and Accreditation Interim Report November 2013 was to introduce a new integrated Pharmacy Degree Programme. In 2014, the Minister for Health Leo Varadkar, signed a Statutory Instrument changing the structure of the Pharmacy Degree in Ireland. The old course consisted of a 4-year undergraduate programme followed by a one-year internship, paid up to 14 euro an hour, at the discretion of the employer. The new course, introduced in 2015, is a five-year integrated masters programme under one of the three schools of pharmacy in Ireland – UCC, TCD, RCSI. As a result, pharmacy students must now complete a four-month placement in year 4 and an eight-month placement in year 5 – both unpaid. It is an essential component of this new integrated degree for the student to remain a student for the full five years of study. The fifth-year fee was also increased significantly from 3,000 euro to:
- 7,500 euro in UCC
- 8,500 euro in TCD
- 9,000 euro in RCSI
As a result, each pharmacy student is looking at an approximate deficit of at least 25,000 euro. Some students are having to work near 7 days every week to financially support themselves and to be able to attend placement. One-third of pharmacy students are currently in receipt of the SUSI grant. However, it is unclear whether the fifth year will be covered by this, thus students may have to take a year out between fourth and fifth year to work to afford their fees. The Department of Education refuse to fund fifth year and the Pharmacy Schools and the PSI are against intern pharmacists being paid for their work. We would like clarification on who used to cover the costs of the NPIP year in the past. We would like to know what we are paying for and why? These astronomical fees never had to be paid by a student in the past. This integrated degree was developed to benefit us, the students. We have yet to experience any of this benefit. All we are experiencing is financial strain, stress and unhappiness.
In a previous email you stated that the new integrated 5-year degree will inflict ‘short term financial consequences on students’. This statement undermines the consequences of this financial strain, with a worrying amount of young Intern Pharmacists experiencing various mental health issues as a result, including anxiety and depression. Contributing factors to the mental health status of Intern Pharmacists at present is not limited to the financial strain. It is also because we are unmotivated whilst at placement. If you look up the definition of extrinsic and intrinsic motivation you will understand what we are referring to. Receiving payment for the work which we do would contribute towards building the self- esteem, work ethic and work morale of student pharmacists. Receiving payment would also make us feel more competent and thus contribute to our intrinsic motivation. When we are most motivated to work and to apply ourselves at our placement settings, we will benefit the most from our placements and learn the most. It is most difficult to apply one’s self and to be willing to learn and work to the best of one’s ability when we are unmotivated.
You also mentioned that ‘the opportunity presented by the new program for careful teaching and professional mentoring would be an invaluable asset’ in this email. Could you explain to the pharmacy students of Ireland how so? What is the program for careful teaching and professional mentoring? Will the preceptors be receiving a new training plan to educate them as to how they are to deliver this ‘professional mentoring’ during the 8 months? If so, is it possible for this training plan to be circulated to the students of all three schools of pharmacy so that we can see exactly what the astronomical fifth-year fee is funding? What additional education shall we be receiving for this new fee? How will it be an invaluable asset to us?
You also mentioned that ‘the 5th year placement is not designed for pharmacy students to act as technicians’. We would like to inform you that regardless of what your intentions were when designing the new course, it is inevitable that we will be acting as technicians during our 8-month unpaid placement. We will be performing all the same tasks and duties in the pharmacy as a pharmacy technician would be doing. Examples of these activities are putting away the drugs order, putting prescriptions through the software, generating labels, gathering the drugs for final checking by the pharmacist, getting the claim ready at the end of the month, performing extemporaneous compounding etc. The tasks which we will be performing in the community pharmacy setting whilst on placement are identical to the tasks which the technicians perform. So how, can we ask, are we not to be considered a technician whilst on placement? How will the pharmacies that we complete our placement in ensure we are not treated like one? What tasks will we be performing if we are not working as a technician? Are we not to perform any of the above tasks which we have stated? How will the ‘experiential activities’ differ to the tasks usually completed by a technician?
An overwhelming majority of pharmacy students have been working in community pharmacies since they began this degree. From day one, the clear majority have been in the dispensary and performing the duties of a Pharmacy Technician. Many Intern Pharmacists are employed by the two locum recruitment agencies in Ireland as Pharmacy Technicians. They recognise the level of competency that we have due to being in our 4th year of the Pharmacy degree programme. Registered companies are accepting that we have the capability to work as professional employees. We are employed as competent Pharmacy Technicians and provide financial gain to the pharmacy and provide health gain to all that pharmacy’s patients. We are recognised as a technician by our employers, who are Pharmacists, and we will undoubtedly be recognised as technicians by the Pharmacist in the establishment where we will be doing our 8-month placement. The only difference will be that we will not be receiving any payment. It is extremely degrading and does not bode well with students or Pharmacists. How are we expected to live for 8-months earning no wage? The 8-month period when we must complete our placement runs through the Summer months. We now cannot even work our part-time jobs during those months to earn money to allow us to live, as we have done for the past 4 Summers. The PSI is restricting us from earning any possible source of income.
This new integrated degree was designed to enhance students’ learning. We urge you to listen to us, the students. Please consider our opinions and respond promptly to them. Our learning is not being enhanced. We are not benefiting from this new course in any way. We are not learning more or gaining anything different from those students in the year ahead of us who are in the old 4 + 1 model. We are suffering financially but more importantly, and alarmingly, we are suffering mentally.
We have already endured a 4-month unpaid ‘experiential learning’ placement as Intern Pharmacists. For the past 4 months, we have been doing the work that someone else would have to do if we weren’t here. It is through this work that we have been learning. In the real world, you learn on the job. The notion that a student can sit on placement for 4-months and simply ‘learn’ and not work is incredulous. Working and learning are not mutually exclusive. They go hand in hand.
This new degree programme has generated a lot of upset for students, with very little educational gain. We should be looking forward to our careers as Pharmacists. Instead, we will emerge disappointed and in low spirits. It is the duty of the PSI to take our feedback into account and listen to our concerns to ensure the course can be improved for the future pharmacy classes to come. If not, it appears the pharmacy degree will become a course solely reserved for the ‘elitist’.
4th Year Intern Pharmacists of Ireland