1950–1965: Setting the Stage
The UCSF School of Pharmacy curriculum transitioned significantly from a bachelor’s degree program to a doctor of pharmacy (PharmD) degree program in 1955. The PharmD curriculum emphasized basic and applied sciences in addition to traditional pharmaceutical studies. It included such courses as biopharmaceutics, pathophysiology, biochemistry, and gross anatomy.
The curriculum trained students in all aspects of pharmacology, from drugs’ basic chemical, physical, and biological properties to their dosage formulations and use in the clinical setting (although no clinical experiential courses were offered). The students were told that their education would provide them with the tools to achieve expanded roles beyond traditional drug dispensing, but they had few tangible role models.
1963: Pharmacy Practice Residency Program
The Pharmacy Practice Residency Program began in 1963, accepting first-year residents (PGY1) and various second-year specialty residents (PGY2). Residents are trained by the combined efforts of the Division of Clinical Pharmacy and the UCSF Medical Center Department of Pharmaceutical Services.
Turning Point film creates pharmacy education awareness
Students from the classes of 1964 and 1965 wrote, financed, and produced Turning Point, a film intended to demonstrate that the profession was poised to make a significant transformation. Led by Michael Stern, Robert Miller, and William Smith, and under the faculty direction of Walter Singer, the filmmakers documented student concern about the disparity between the advanced curriculum and the lack of jobs that took advantage of their knowledge. They wanted to display the UCSF program to other pharmacists, members of the health professions, and laypersons.
The premise of the film was that the revised curriculum prepared students to become both drug consultants (drug experts) to physicians and advisers to the public on health issues. It was shown at the California Pharmacists Association convention in Palm Springs, on television in San Francisco, at the International Federation of Pharmacy Students meeting in Dublin, and at the Federation Internationale Pharmaceutique in Prague. The film achieved the intent of the students: it created a dialogue between pharmacists and educators about the scope of practice of pharmacy at a time when the disconnect between pharmacy education and the realities of practice created frustrated graduates from colleges of pharmacy.
America’s drug problem: too many errors
There was a growing realization that a problem existed in the American drug distribution system: drugs were identified as the cause of a large percentage of hospitalizations because of inappropriate prescribing, unanticipated drug interactions, or medication errors. Time magazine, Parade magazine, and studies published in peer-reviewed medical pharmacy journals documented the problem.
Pharmacists respond to medication errors
In the early 1960s, the Universities of Kentucky, Arkansas, and Iowa began experimenting with centralized and decentralized unit-dose systems to reduce the incidence of medication errors in hospitals. The University of Kentucky established a drug information center to provide unbiased drug information to prescribers. These early experiments provided hints that pharmacists could help resolve hospital medication errors and inappropriate prescribing.