The Irish Pharmaceutical Students Association and the 5 Year integrated Irish M.Pharm program
On Thursday 24th January, over 500 students from the 3 Schools of Pharmacy in Ireland, gathered in Dublin city centre to protest changes to the Pharmacy degree and placement conditions. A report was launched by the Union of Students in Ireland (USI) and the Irish Pharmaceutical Students’ association, which included results of a survey of 4th Pharmacy students that had untaken the first unpaid 4 month placement from September-December 2018. The report highlighted the detrimental effects that the unpaid placement model was having on students’ financially and in terms of health and motivation. The report outlined a number of recommendations to the schools of pharmacy and the pharmaceutical society of Ireland (PSI), the regulatory body for the profession.
What changes did the new 5-year integrated M.Pharm program bring to the degree?
The degree previously was a 4+1 model, where students would complete their 4-year undergraduate degree in one of the three schools of pharmacy and then complete a 12-month internship year organised by the PSI and facilitated through one of the schools of pharmacy, Royal College of Surgeons. The cost of this final year to students was an approximate €3,000 fee. The 5-year integrated program moved away from this model, and saw students remain in their respective schools of pharmacy for the duration of the 5-years of the degree. The 12-month internship year was divided into two core practice placements, 4-months to be undertaken in 4th year and 8-months to be undertaken in 5th year. As the students were now remaining in their respective universities for the 5th year of the degree program, a masters fee would be required to be paid, which ranges depending on the university from between €7,500 and €8,500. A massive increase from the €3,000 final year fee of the old 4+1 program.
A national forum that produced the recommendation for these changes stressed that students should remain a student for the full five years of study, contrary to the 4+1 model where students become employees for their internship year. The PSI sought to change pharmacy internships from “one of an employer-employee relationship to a teacher-learner”, where payment of students would be seen to compromise this desired relationship. Therefore, before undertaking placement students were required to sign a placement agreement stipulating that “they had agreed to undertake an unpaid student placements”.
Why were these changes made?
In 2008, the PSI commissioned the review of pharmacy education and established the Pharmacy Education and Accreditation Reviews (PEARs) Project, which sought to provide recommendations for the improvement of pharmacy education in Ireland. The PEARs report was published in 2010, which included the recommendation of moving to a new 5-year integrated program and the establishment of a national forum. It should be noted that the PEARs report did state that removal of all payment and the move to a fee charging fifth year could decrease the attractiveness of pharmacy as a degree and impact recruitment. Nevertheless, the National forum for Pharmacy Education and Accreditation was established by the PSI in August 2011, to implement the recommendations of the PEARs report. Public consultation on the draft accreditation standards for this new integrated degree program was opened in September 2013. In December 2013, the PSI approved the accreditation standards for this degree. The legislation governing these changes was signed off by the minister for health at the time, Leo Varadkar in 2014. The Affiliation for Pharmacy Practice Experiential Learning (APPEL) was setup in 2015 to manage placements, as a central body for the three schools of pharmacy. In September 2015, the first students started the new integrated degree program. In 2016, student APPEL representatives for each year of the new program were established in order to voice students concerns to APPEL and the schools of pharmacy. These representatives began talks with a number of stakeholders to argue against the changes that had been made, outlining the negative effect they would have on students and the degree. Unfortunately, despite over 2 years of meetings and discussions, these concerns fell on deaf ears. Fast-forward to September 2018 and those same first year students who so eagerly began their degree in 2015, were embarking on their 4-month practice placement, unpaid and unmotivated.
The Irish Pharmaceutical Students Association and the 5 Year integrated Irish M.Pharm program
On Thursday 24th January, over 500 students from the 3 Schools of Pharmacy in Ireland, gathered in Dublin city centre to protest changes to the Pharmacy degree and placement conditions. A report was launched by the Union of Students in Ireland (USI) and the Irish Pharmaceutical Students’ association, which included results of a survey of 4th Pharmacy students that had untaken the first unpaid 4 month placement from September-December 2018. The report highlighted the detrimental effects that the unpaid placement model was having on students’ financially and in terms of health and motivation. The report outlined a number of recommendations to the schools of pharmacy and the pharmaceutical society of Ireland (PSI), the regulatory body for the profession.
What changes did the new 5-year integrated M.Pharm program bring to the degree?
The degree previously was a 4+1 model, where students would complete their 4-year undergraduate degree in one of the three schools of pharmacy and then complete a 12-month internship year organised by the PSI and facilitated through one of the schools of pharmacy, Royal College of Surgeons. The cost of this final year to students was an approximate €3,000 fee. The 5-year integrated program moved away from this model, and saw students remain in their respective schools of pharmacy for the duration of the 5-years of the degree. The 12-month internship year was divided into two core practice placements, 4-months to be undertaken in 4th year and 8-months to be undertaken in 5th year. As the students were now remaining in their respective universities for the 5th year of the degree program, a masters fee would be required to be paid, which ranges depending on the university from between €7,500 and €8,500. A massive increase from the €3,000 final year fee of the old 4+1 program.
A national forum that produced the recommendation for these changes stressed that students should remain a student for the full five years of study, contrary to the 4+1 model where students become employees for their internship year. The PSI sought to change pharmacy internships from “one of an employer-employee relationship to a teacher-learner”, where payment of students would be seen to compromise this desired relationship. Therefore, before undertaking placement students were required to sign a placement agreement stipulating that “they had agreed to undertake an unpaid student placements”.
Why were these changes made?
In 2008, the PSI commissioned the review of pharmacy education and established the Pharmacy Education and Accreditation Reviews (PEARs) Project, which sought to provide recommendations for the improvement of pharmacy education in Ireland. The PEARs report was published in 2010, which included the recommendation of moving to a new 5-year integrated program and the establishment of a national forum. It should be noted that the PEARs report did state that removal of all payment and the move to a fee charging fifth year could decrease the attractiveness of pharmacy as a degree and impact recruitment. Nevertheless, the National forum for Pharmacy Education and Accreditation was established by the PSI in August 2011, to implement the recommendations of the PEARs report. Public consultation on the draft accreditation standards for this new integrated degree program was opened in September 2013. In December 2013, the PSI approved the accreditation standards for this degree. The legislation governing these changes was signed off by the minister for health at the time, Leo Varadkar in 2014. The Affiliation for Pharmacy Practice Experiential Learning (APPEL) was setup in 2015 to manage placements, as a central body for the three schools of pharmacy. In September 2015, the first students started the new integrated degree program. In 2016, student APPEL representatives for each year of the new program were established in order to voice students concerns to APPEL and the schools of pharmacy. These representatives began talks with a number of stakeholders to argue against the changes that had been made, outlining the negative effect they would have on students and the degree. Unfortunately, despite over 2 years of meetings and discussions, these concerns fell on deaf ears. Fast-forward to September 2018 and those same first year students who so eagerly began their degree in 2015, were embarking on their 4-month practice placement, unpaid and unmotivated.
What were the effects of these changes on students?
The results of the survey conducted in conjunction with the USI, highlighted the negative effects that 4-months of unpaid placement was having on students. The non-employee status left many students and supervisors in limbo, as to what “activities” the students should be given to do. For many this resulted in them conducting the exact same work as the other employees in the establishment, with the exception of them receiving no remuneration for their share of the work. Below are some statistics from the report, that the illustrate the situation.
99.3 % of students believed there should be financial support while on placement.
94.1% of students felt there should be payment while on placement, with a primary focus on the need for payment for the 5th year 8-month placement at the very least, recognising the significantly longer period of placement and additional high fee burden.
74.5% of students indicated that they were treated the same as any other employee, for example in terms of tasks, working hours and duties.
51.8% of students said they had considered dropping out of the degree program as a result of ‘workload or financial pressures on placement’
These views culminated in the publication of a letter from University College Cork’s 4th year pharmacy students addressed to the PSI, outlining the issues facing students on placement. This letter gathered massive attention on social media and following another letter of support published by Trinity and RSCI Pharmacy Students, the mainstream media began to pick up on the students concerns. A petition was launched by IPSA and the USI, which received over 6,000 signatures demanding change. This issue received massive support from pharmacists, other healthcare professionals and politicians alike. The PSI published a statement washing their hands of the problem, stating that a ban on payment was not included in the legislation and was not something that they were enforcing. Focus then turned on APPEL and the schools of pharmacy as to what could be done to resolve these growing issues.
Less than 24 hours before the launch of the report, an email was received by every pharmacy student from their respective heads of schools stating that following a meeting, they had decided that the ban on receiving payment for placements was being removed and payment would now be at the discretion of the placement providers. This email, while welcomed by students, was also met with caution due to its ambiguous nature. The issue of the dramatic increase in fees for the final year had also not be addressed at all. Therefore, the following day student from across the country gathered in Dublin for the launch of the report. A panel of speakers including the Irish Pharmacy Union’s Secretary General and other representatives from different pharmacy sectors, spoke out in support of the students concerns. A rally outside the Dáil then followed led by USI, before students marched to deliver the 268-page signed petition to the offices of the PSI. The event was featured by a large number of media outlets, indicative of the support for the campaign. Student representatives from IPSA and the three schools of pharmacy were subsequently invited to a meeting that day with the Minister for Higher Education, Mary Mitchell O’Connor, to discuss the fee increase for the final year and the financial burden it placed on students.
Current situation
Since the campaign launch, meetings have been held between APPEL student representatives and the heads of schools. A meeting has also been arranged in the next few months for a meeting with the registrar of the PSI. Current 3rd year students are currently in the middle of the matching process for their 4th year placements. Initially students were informed that 93 of the 420 placements available for next year were paid, but subsequently a number of organisations have provided clarification stating they will be paying students. It is thought that more paid positions will be available for the 5th year placements, due to it being 8-months in length vs only 4-months. The issue of final year fees remains unclear, but students are committed to continuing the fight to ensure that a pharmacy degree in Ireland does not become a degree solely reserved for societies elite.
This article was written by
Danny Paul
IPSA Public Relations Officer
PEARs report - https://www.thepsi.ie/libraries/education/pears_project_report.sflb.ashx
Draft Accreditation Standards – public consultation
Pharmacy Student Campaign Report – http://usi.ie/wp-content/uploads/2019/01/Pharma-Report-5.pdf
