Pharmacy Practice and Education in Romania
Abstract
:1. Introduction
2. Design
- Pharmacy practice
- ⚬
- Community, hospital, and industry
- ⚬
- Organisation
- ⚬
- Legislation
- ⚬
- Education and training
- The adoption of the EU sectoral directive 2013/55/EU [2] in pharmacy practice and education
- The impact of the Bologna declaration [3]:
- ⚬
- Organisation of the degree course with the existence or not of a bachelor/master structure,
- ⚬
- Implementation of ECTS and the Erasmus programme on student and staff exchange [6].
3. Evaluation and Assessment
3.1. Organisation of the Activities of Pharmacists, Professional Bodies
3.2. Pharmacy Faculties, Students, and Courses
3.3. Teaching and Learning Methods
3.4. Subject Areas
3.5. Impact of the Bologna Recommendations [3]
3.6. Impact of EU Directive 2013/55/EC [2]
4. Discussion and Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Total Population | 19,511,000 |
---|---|
Life expectancy at birth m/f (years) | 71/79 |
Healthy life expectancy at birth m/f (years) | 59/59 |
Total expenditure on health per capita | $1074 |
Item | Numbers | Comments |
---|---|---|
Pharmacists | Circa 13,600 | 3533 work in Bucharest and 10,067 elsewhere 1435 inhabitants/community pharmacist (Bucharest 525 inhabitants/community pharmacist) EU average: 2145 [1] |
Pharmacies | 5938 | Inhabitants/pharmacy: 3286. EU average: 4407 [1] Pharmacists/pharmacy: 2.3. EU average: 2.1 [1] |
Competences and roles of community pharmacists | The competencies of community pharmacists are:
| |
Is ownership of a community pharmacy limited to pharmacists? | No | The community pharmacies are private institutions. Their owners need not be pharmacists as long as they hire a pharmacist as the manager. |
Rules on geographical distribution of pharmacies? | Yes | Demographic criteria only [8,9].
|
Are drugs and health care products available to the general public by channels other than pharmacies? | Yes | Through stores that sell plants or medicines from plants and OTC (Plafar) only. Recently e-pharmacies have appeared, but their legal status is not yet clearly established. Despite the fact that present legislation imposes a series of conditions for the way pharmacies work and how they sell drugs, these do not directly restrict marketing them online. According to a draft normative act, online marketing for OTC drugs will be allowed for authorised pharmacies only, with the goal to reduce the risks to which the online buyers are exposed at present. |
Item | Numbers | Comments |
---|---|---|
Are persons other than pharmacists involved in community practice? | Yes | There are two types of assistants working in pharmacies:
|
Their numbers and status | >120,000 | |
Organisations providing and validating education and training of the 3-year courses | The curricula of postsecondary schools was up-graded and extended by university pharmacy faculties for the education of medical assistants for pharmacy starting from 2004 onwards, and validated by Romanian Agency for Quality of University Education (ARACIS) [11]. In a second phase the Ministry of Education and the Ministry of Health imposed the same curricula on post-secondary schools. Thus practically the structure is essentially similar with some quantitative differences. Entrance exams and final evaluations are similar, but they receive a different diploma [12]. | |
Subject areas | Fundamental disciplines:
| |
Competences and roles | Dispensing and counselling of: Medical assistants: OTC medicines and plant products Pharmacy assistants: drug products |
Item | Numbers | Comments |
---|---|---|
Does such a function exist? | Yes | |
Number of hospital pharmacists | 692 | One hundred and twenty in Bucharest (17%) and 572 in the rest of the country. Hospital pharmacies are small with 1–2 pharmacists and 2–3 medical assistants. The number of specialists is insufficient to cope with the demands of the numerous patients hospitalized. Therefore it is necessary to increase the numbers of staff for the development of patient care. The lack of specialist staff is also due to the low salaries in hospitals. |
Number of hospital pharmacies | 564 | One hundred and twenty in Bucharest (21%) and 444 in the rest of the country. |
Competences and roles of hospital pharmacists | These are similar to those in other EU member states [1]. |
Item | Numbers | Comments |
---|---|---|
Industrial Pharmacy and Pharmacists | ||
Number of pharmacists working in industry | Around 120 | |
Competences and roles |
| |
Pharmacists working in other sectors | ||
100–200 | ||
Sectors in which pharmacists are employed | Clinical Trials, Armed Forces, National Medicinal Agency |
Item | Comments | |
---|---|---|
Registration of pharmacists | Yes | The National College of Pharmacists has colleges in each district, including Bucharest [13]. All the branches are active in registration of pharmacists. After graduation, in order to work as a pharmacist, the candidate must obtain the Pharmacists’ Membership Certificate from the National Pharmacy College. Further continuous educational training is required—pharmacists have to accumulate 40 continuous education credit points/year in order to carry on with their pharmacy practice. |
Creation of pharmacies and control of territorial distribution | Yes | A dossier has to be presented in order to open a new community pharmacy. This contains information on: The registration number from the Trade Register of the new commercial society created The personal employed (professional qualification, number) The work programme The proof of ownership The proof of the demographic criteria. This must be sent to the Ministry of Health, Department of Strategies and Medicine Politics. After verification of legal criteria, inspections are performed, by the Ministry of Health and the College of Pharmacists, in order to release the authorisation to function. |
Ethical and other aspects of professional conduct | Yes | Romania has a Code of Ethics for pharmacists approved by the General Assembly of Pharmacists in 2009 [13]. |
Quality assurance and validation of university courses | Yes |
Item | Number | Comments |
---|---|---|
Number of pharmacy HEIs in Romania | 11 |
|
Public pharmacy HEIs | 2 |
|
Independent faculty | Part of “Medicine & Pharmacy” HEIs |
|
Faculty attachment | Attached to a medical faculty |
|
Do HEIs offer B and M degrees? | No | All pharmacy schools have a five-year integrated system. There is no split between the first years 1–3 and years 4–5, and there is no “diploma” that gives the right to work after completing the first three years. |
Teaching staff | ||
Staff | Around 100 at each HEI = circa 1000 in all | There is no national database of teaching staff in pharmacy. |
Professionals from outside the HEIs, involved in E&T | Around 3% of staff | The professionals from outside the HEI’s involved in education and training are community pharmacists in charge of the traineeship period, researchers from hospitals or research units. |
Students | ||
Number of places on entry following secondary school | Around 50–250 per HEI | Around 50–200 students for smaller faculties, and 250 for Bucharest and Cluj, together with 50–100 places for training in English or French languages. |
Number of applicants for each entry place | 100–400 per HEI | Around two applicants per place, but the number of candidates diminishes in time following massive emigration of the young population to other countries. |
International students (EU) | 2% | Students from Greece, Bulgaria. |
International students (non EU) | 20% | Students from: Albania, Jordan, Iraq, Iran, Israel, Lebanon, Macedonia, Moldavia, Mongolia, Morocco, Nigeria, Palestine, Syria, Tunisia. |
Specific pharmacy-related entrance examination. | Yes | Botany or anatomy and organic chemistry—subjects with potential application in pharmacy. |
Other form of entry requirement at a national level | Yes | Graduates who already have a degree from other faculties (medicine, chemistry, biology) and want to obtain a pharmacy degree can start on advanced entry, 2nd or the 3rd year based on ECTS. |
Graduates that become registered pharmacists. | Difficult to establish given drop-out rate. | |
Advanced entry | ||
Entrance after a first bachelor year. | no | |
Fees per year | ||
For home and EU students | 9000 RON (circa €2000) | |
For non-EU students | €6000 |
Item | Comments | |
---|---|---|
Do HEIs Provide Specialised Courses? | Yes | In order to work in industry or a hospital as an executive it is sufficient to be a graduate of the integrated five-year programme. One can become a “Qualified Person” after two years’ activity in certified (Good Manufacturing Practice, Good Clinical Practice, Good Laboratory Practice) industrial units in the field of qualitative analysis of the medicines, quality control of active substances, or any other tests required to check the quality of medicines. The certification is validated by the National Medicines Agency after evaluation of the activity of the candidate. It is not mandatory to be a pharmacist in order to become a Qualified Person. In order to obtain a leading position in a hospital pharmacy it is necessary to become a “specialist” following two years’ education in the framework of “rezidentiate” in a faculty of pharmacy and a final exam. Only a small number of hospitals have pharmacists specialized in clinical pharmacy. Most of them are “specialists” in community pharmacy. |
Item | Comments |
---|---|
Have there been any major changes since 1990? | The change in the governmental regime in 1989 and the preparation for joining the EU in 2007, promoted harmonisation with EU pharmacy practice and education. Other forces were at work. Privatization of pharmacies induced a substantial increase in the number of pharmacies leading to an increase in the number of faculties of pharmacy (from four to 11) and ten times the number of students. Following a drastic reduction in the preparation of medicines in the pharmacy, the preponderance of chemical sciences disciplines has diminished in favour of medical disciplines in the pharmacy degree. |
Are any major changes envisaged before 2019? | Two factors: (1) the decrease in the number of young people in Romania, and (2) the increase in emigration of pharmacists to other EU countries, impose an in-depth analysis of the aims and methods of pharmacy education and training, based on the competences required by the labour market and future practice. |
Method | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Total | % |
---|---|---|---|---|---|---|---|
Lecture | 308 | 336 | 350 | 350 | 238 | 1582 | 32.4 |
Tutorial + Practical | 434 | 462 | 490 | 434 | 266 | 2086 | 42.8 |
Project | 0 | 0 | 0 | 0 | 60 | 60 | 1.2 |
Traineeship (community or hospital pharmacy) | 60 | 60 | 60 | 120 | 780 | 1140 | 22.1 |
Electives + Optional | 14 | 14 | 14 | 14 | 14 | 70 | 1.4 |
Total | 816 | 872 | 914 | 918 | 1358 | 4878 | 100 |
Subject Area | Year 1 | Year 2 | Year 3 | Year 4 | Year 5 | Total | % |
---|---|---|---|---|---|---|---|
CHEMSCI | 238 | 238 | 238 | 168 | 0 | 882 | 20.1 |
PHYSMATH | 238 | 0 | 0 | 56 | 0 | 294 | 6.7 |
BIOLSCI | 154 | 14 | 336 | 14 | 14 | 532 | 12.1 |
PHARMTECH | 28 | 14 | 84 | 140 | 210 | 476 | 10.8 |
MEDISCI | 0 | 182 | 98 | 392 | 168 | 840 | 19.1 |
LAWSOC | 14 | 14 | 0 | 42 | 56 | 126 | 2.9 |
GENERIC + TRAINEESHIP | 172 | 172 | 60 | 60 | 780 | 1244 | 28.3 |
Total | 844 | 634 | 816 | 872 | 1228 | 4394 | 100 |
Item | Comments |
---|---|
“Comparable degrees with diploma supplement” | The degree structure is comparable to that observed in other EU member states (see above). A diploma supplement is delivered according to European directives (it is both in Romanian and English). |
“Two main cycles (B and M) with entry and exit at B level” | There is a five-year integrated course with no possibility of graduation after three years |
“European Credit Transfer System (ECTS) system of credits with links to life-long learning (LLL)” | Theoretically, this system was accepted and formally adopted in 1998. Practically, it was applied step-by-step. The transfer of credits was accepted between faculties of pharmacy and later between faculties of pharmacy, medicine and chemistry, all inside Romania. The acceptance of credits from foreign universities is discussed case-by-case. |
“Addressing obstacles to mobility” | Both language barriers and lack of financial support. Only incoming students receive language tuition. |
European/international quality assurance of courses | Maybe in the near future. Pharmacy courses and traineeship are validated by the Ministry of Education and the Romanian Agency for Quality Assurance in Higher Education (ARACIS [11]). |
European dimension | Our staff was involved in European Projects: Cooperation in Science and Technology (COST) Joint Research Center (JRC) Ispra PHAR-QA the follow-on from PHARMINE |
ERASMUS staff exchange to Romania from elsewhere | Rare |
ERASMUS staff exchange from Romania to other HEIs | Not frequently |
ERASMUS student exchange to Romania from elsewhere | Less than 5 students/year |
ERASMUS student exchange from Romania to other HEIS | Number of student months: 3–6 2 students in 2008, 3 students in 2009, all to Italy |
Item | Comments |
---|---|
“Evidence of formal qualifications as a pharmacist shall attest to training of at least five years’ duration, …” | This applies. |
“…four years of full-time theoretical and practical training at a university or at a higher institute of a level recognised as equivalent, or under the supervision of a university.” | Yes, applied ad literam (4.5 years of full time theoretical and practical training and six months traineeship in a hospital or community pharmacy). Professors from the pharmaceutical technology department validate the traineeship through an oral/written examination in which the student must solve a problem in pharmaceutical technology (e.g., a pharmaceutical preparation). At the end of this period, the student must also present a notebook with his/her activity in the practice period and be able to answer questions regarding pharmaceutical practice. |
“…six-month traineeship in a pharmacy which is open to the public or in a hospital, under the supervision of that hospital’s pharmaceutical department.” | Industrial traineeship is allowed in a community or hospital traineeship, but for only one of the six compulsory months |
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Sandulovici, R.; Mircioiu, C.; Rais, C.; Atkinson, J. Pharmacy Practice and Education in Romania. Pharmacy 2018, 6, 5. https://doi.org/10.3390/pharmacy6010005
Sandulovici R, Mircioiu C, Rais C, Atkinson J. Pharmacy Practice and Education in Romania. Pharmacy. 2018; 6(1):5. https://doi.org/10.3390/pharmacy6010005
Chicago/Turabian StyleSandulovici, Roxana, Constantin Mircioiu, Cristina Rais, and Jeffrey Atkinson. 2018. "Pharmacy Practice and Education in Romania" Pharmacy 6, no. 1: 5. https://doi.org/10.3390/pharmacy6010005
APA StyleSandulovici, R., Mircioiu, C., Rais, C., & Atkinson, J. (2018). Pharmacy Practice and Education in Romania. Pharmacy, 6(1), 5. https://doi.org/10.3390/pharmacy6010005