Projecting the Need for Pharmacy Education in Texas Page 1
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PPrroo jjeeccttiinngg tthhee NNeeeedd ffoorr PPhhaa rrmmaaccyy EEdduuccaattiioonn iinn TT eexxaass TTThhheee fffooouuurrrttthhh rrreeepppooorrrttt iiinnn aaa ssseeerrriiieeesss ttthhhaaattt ppprrrooojjjeeeccctttsss ttthhheee nnneeeeeeddd fffooorrr ppprrrooofffeeessssssiiiooonnnaaalll sssccchhhoooooolllsss iiinnn TTTeeexxxaaasss Issued by the Texas Higher Education Coordinating Board January 2004 Texas Higher Education Coordinating Board Jerry Farrington (Chairman) Dallas Robert W. Shepard (Vice Chairman) Harlingen Neal W. Adams Bedford Ricardo G. Cigarroa, M.D. Laredo Cathy Obriotti Green San Antonio Gerry Griffin Hunt Carey Hobbs Waco Lorraine Perryman Odessa Curtis E. Ransom Dallas Hector de J. Ruiz, Ph.D. Austin Windy Sitton Lubbock Terdema L. Ussery II Dallas The Texas Higher Education Coordinating Board does not discriminate on the basis of race, color, national origin, gender, religion, age or disability in employment or the provision of services. PPrroo jjeeccttiinngg tthhee NNeeeedd ffoorr PPhhaa rrmmaaccyy EEdduuccaattiioonn iinn TT eexxaass TTThhheee fffooouuurrrttthhh rrreeepppooorrrttt iiinnn aaa ssseeerrriiieeesss ttthhhaaattt ppprrrooojjjeeeccctttsss ttthhheee nnneeeeeeddd fffooorrr ppprrrooofffeeessssssiiiooonnnaaalll sssccchhhoooooolllsss iiinnn TTTeeexxxaaasss Issued by the Texas Higher Education Coordinating Board AAApppppprrrooovvveeeddd bbbyyy ttthhheee CCCoooooorrrdddiiinnnaaatttiiinnnggg BBBoooaaarrrddd aaattt iiitttsss qqquuuaaarrrttteeerrrlllyyy mmmeeeeeetttiiinnnggg ooonnn JJJaaannnuuuaaarrryyy 222999,,, 222000000444 January 2004 This report is available on the Coordinating Board website at http://www.thecb.state.tx.us/UHRI/ProfSchools.htm Table of Contents Executive Summary. ...........................................................i I. Schools ofPharmacy......................................................1 A. United States B. Texas C. 10 Most-Populous States D. Change in Degree Requirements II. Applications to First Professional Degree Programs in Pharmacy – U.S. and Texas. 3 A. Number B. Gender C. Ethnicity D. Residency III. Enrollment in First Professional Degree Programs in Pharmacy – U.S. and Texas. 7 A. Number B. Ethnicity C. Residency IV. Graduates of First Professional Degree Programs in Pharmacy – U.S., the 10 Most- Populous States, andTexas. ............................................... 12 A. Number B. Gender C. Ethnicity V. Opportunities for Students to Obtain Professional Pharmacy Education . .. .17 A. The Pharmacy Education Pipeline in Texas B. Comparisons with the U.S. and the 10 Most-Populous States C. Number of Pharmacy Seats Projected over Time in Texas D. Regional Representation in Pharmacy School VI. Pharmacists in Texas. 21 A. New Pharmacists B. Availability of Practicing Pharmacists VII. Pharmacist Practice Trends in Texas. 25 A. Location of New Pharmacists B. Changes in Practice C. Projected Need for Pharmacists VIII. Summary of Key Findings, Conclusions, and Recommendations . 29 Source Notes...............................................................36 ListofAppendices ..........................................................37 Executive Summary Brief Background/Description of Methodology This report is the fourth in a series issued by the Texas Higher Education Coordinating Board in which a supply-demand methodology (Appendix A-1) has been used to project the need for professional schools in Texas. In previous reports, the Board has examined medicine (July 2002), law (October 2002), and veterinary medicine (October 2002). In looking at the general trends in health education, pharmacy education shares many common threads with other disciplines. Among the many factors influencing the need for future health care professionals is the aging population in Texas and the nation as a whole. Pharmacy education, however, is unusual in that it is more singularly linked to one industry – the pharmaceutical industry – and the current and future availability of prescription medications. Pharmacy schools offer the Doctor of Pharmacy (PharmD) degree, generally a six-year program that requires at least two years of college study prior to admittance. This degree has replaced the five-year bachelor’s degree (a 2+3 program), which will cease to be awarded after 2005. Texas graduates must then pass the national licensing exam, the Texas Pharmacy Jurisprudence exam, and apply for licensure with the Texas State Board of Pharmacy (TSBP) before they may practice in Texas. At the beginning of this year, the TSBP had 21,248 pharmacists on record, of which 16,793 were considered “active” and residing in Texas. About one-half worked in community pharmacies, either independently owned or part of a drug store chain, grocery store, department store, or mass merchandiser. About 21 percent work in hospitals, and others work in clinics, mail-order pharmacies, pharmaceutical wholesalers, education, government, and other healthcare facilities and enterprises. Selected Findings Pharmacy Education • Texas has four pharmacy schools, located in Austin, Houston (2), and Amarillo. An additional school is scheduled to open at Texas A&M University-Kingsville (TAMUK) in fall 2005 and will graduate its first class of students by spring 2009. The University of the Incarnate Word (San Antonio) also plans to open a pharmacy school in 2006; if plans are met, it would begin producing graduates in 2010. • Applications to pharmacy school have increased by 62 percent from 1999 to 2003, returning to levels set in the mid-1990s. • The number of pharmacy graduates dropped in the mid- to late 1990s as schools transitioned from a five-year to a six-year degree program. The transition contributed to a nationwide shortage of pharmacists. The four existing schools now report an upturn in enrollment and should graduate 380 new pharmacists in 2005 (a 38 percent increase from 2000). With an estimated 60-85 new students scheduled to graduate from TAMUK in seven years, the Coordinating Board projects 455 new graduates from public institutions per year by 2010. The University of the Incarnate i Word expects to graduate an estimated 50-55 students by 2010, yielding a potential total of about 508 per year. • Many pharmacy programs in other states are larger than those in Texas institutions. Texas ranked eighth among the 10 most-populous states in average class size. The ranking suggests that Texas pharmacy schools could increase their class size and remain within the norm for schools in states with similarly large populations. • Texas residents have less opportunity than residents of nine of the 10 most-populous states to attend an in-state pharmacy school. Texas would need to accommodate 80 new students annually to meet the “opportunity average” of these populous states. The state will meet the current average in three years, when TAMUK admits its first class of students. • The majority of the state’s PharmD students are women (66 percent). The state’s graduates are significantly more ethnically diverse than graduates from other professional schools. While Hispanics are still under-represented (as compared to their percentage of the total state population), the TAMUK school should increase Hispanic enrollment given its location in the state. • The Metroplex is the most significantly under-represented region in the pharmacy student population but has more pharmacists per 100,000 population than most other regions of the state. (That latter point probably reflects its function as a major medical center.) • In recent years, schools have developed satellite and distance education programs to provide educational opportunities to students in other locations. These programs are usually less costly and have a shorter start-up time for producing graduates. • The four existing pharmacy schools say that, with additional resources, they could expand their class size by fall 2006. To increase by 30 percent (128 new students overall), all of the schools would need (to a varying degree) new classrooms, laboratories, faculty, and practice sites. Several schools would also increase the number of students at their satellite programs as part of that expansion. Cost estimates are not available for all of the schools, and it is unclear if the state’s formula funding would cover many of those expansion costs. Pharmacy Practice • Based on 2000 data, Texas is ranked 39th among the 50 states in the number of pharmacists per 100,000 population. • Of the approximately 16,793 licensed pharmacists practicing in the state, 30 percent will reach retirement age (65) within the next seven to 19 years. • Among all pharmacists practicing in Texas, 60 percent graduated from Texas schools. Among pharmacists who graduated from Texas schools in the last 10 years, 85 percent reside in the Gulf Coast (43 percent), Metroplex (30 percent) and Central Texas (12 percent) regions. Among pharmacists who graduated from out-of ii state schools during this same period, one-half reside in the Metroplex. This suggests that the Metroplex has successfully recruited graduates from other regions and states. • Pharmacists are not evenly distributed among the Texas population. The Gulf Coast, High Plains, and Metroplex regions have the most pharmacists per 100,000 population. All of these regions have major medical centers. Of other areas studied for this report, the 19 southern-most counties in the South Texas region and the Upper Rio Grande region have the fewest pharmacists per 100,000 population. (These areas also have the fewest physicians per 100,000 population.) • The Texas State