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Lack of time, space and training top pre-reg exam complaints

pre-reg pharmacy
BPSA: Question on tonicity of glucose 5% solution "distressed" many candidates

A lack of time, desk space and adequate preparation topped complaints about June's pre-registration exam, according to the British Pharmaceutical Students’ Association (BPSA).

In its annual report to the General Pharmaceutical Council (GPhC) of members' feedback from the exam, the BPSA said the “overwhelming majority” of the 582 emails it received “consisted of concerns regarding paper two of the assessment”.

“Over 500” respondents said the exam “was not a true nor accurate reflection of real practice”, while “approximately 320” complaints referred to the question of the “controlled drug register discrepancy” – with the general feeling regarding this question being of disappointment and confusion”, the BPSA said in its report earlier this month (July 11).

“Distressed” by glucose 5% solution

“The question regarding the tonicity of glucose 5% solution also distressed many candidates, who stated in their feedback that they are still unable to find the answer to this within the British National Formulary (BNF).”

A “majority” felt the questions were “unnecessarily wordy”, said the BPSA, which also highlighted concerns about “unreasonable time pressure”, the “incredibly noisy” Excel London exam venue, and “insufficient desk space”.

A “common phrase” from the feedback was that the exam “felt like a test of speed, rather than a test of clinical knowledge and competency”, the BPSA said.

“Cheap labour”

A “vast majority” of candidates also commented on the training they had received throughout their pre-reg year, the BPSA noted.

“Candidates were extremely dissatisfied with the lack of regulation of training providers and pre-registration tutors,” said the BPSA, with “some” feeling they had “been used as ‘cheap labour’”.

“It was commented upon that some training providers had also misled them in their revision and learning, providing ‘easy’ mock questions,” it added.

19 recommendations

The BPSA used this feedback as the basis of 19 recommendations for how the GPhC could improve the exam.

BPSA president Stephen Messham told C+D the feedback covered “the usual issues”. “Quite a lot of feedback is of the assessment not being representative of the [registration assessment] framework.”

The GPhC is “very willing to listen to the BPSA”, and the student organisation is “quite fortunate that other organisations actively seek our involvement”, he added.

GPhC response

The GPhC told C+D it would take the feedback into consideration – as it does each year – and would submit a report to its council in September.

The regulator stressed it is vital the exam reflects the actual practice of a newly qualified pharmacist, but also said it is committed to working with organisations to ensure it better understands issues and identifies appropriate actions for improvement.

It pointed out that it had released guidance for pre-reg tutors in 2014 and, although training and study time are the responsibility of those funding the training, it is dedicated to making improvements.

A petition triggered by the perceived difficulty of the September 2016 pre-reg exam garnered almost 700 signatures, with some students threatening to protest. The pass rate of the exam was the lowest in five years, at 41%.

The results of this year's summer pre-reg exam are expected to be published tomorrow (July 28).

How did you find your registration exam?

Pharmacist Pharmacist, Community pharmacist

Its a well know fact that Pre-regs are used as cheap dispensers. Unfortunately due to the constant rinsing of pharmacy funding, contractors and multiples are cutting down on dispensing staff and instead relying on pre-regs (as a cheap, they get paid through the drug tariff). Unfortunately, the little time that the trainees were allowed to study at work has been replaced with dispensing and serving on the shop counter. 

Jonny Johal, Pharmacy Area manager/ Operations Manager

The BPSA should focus more on the passing and less on the moaning. The pass rate is too high for manpower planning, the only people who gain are those in the GPhC, they have all these registration fees to collect. It is a captive market. 

Steven Marley, Community pharmacist

I love my job - I qualified in 2013 and went through hell to get where I am now, in a job I love but my future is far from certain. I really do feel sorry for all those who failed, but I am not sure I feel less or more sorry for those who passed. Whether or not the exam is harder one year than another year, the prospects certainly do not improve with each passing year. I find myself sometimes wishing I did a different degree course, but not because I do not like my job. It is that I do not know how much longer I will have it. Hopefully as long as possible. I cannot do anything different, I am 'moulded' as a community pharmacist. Too much blood sweat and tears has gone into it, and I do not have it in me to do all that again for something else.

community pharmacist,

This is probably the most positive comment I have read in a while :) 

Steven Marley, Community pharmacist

Forgot to mention I started my studies at age 29, and extensive research showed pharmacy as the best career to suit my skills. Things started to go bad in the sector when I was at university (I was keeping an eye on things), but I was where I was and just had to stick with it. I am ten years older than most pharmacists qualified this long, which is the main reason I am 'moulded'. I get immense satisfaction from doing my job, and it is a highly skilled job. I feel however that the amount of effort made to get this far, for most people they are only able to do this once in a lifetime. Look at any MPharm syllabus and it is full of empty and dishonest promises.

Stephen Eggleston, Community pharmacist

I find I am conflicted in my reaction to this. On the one hand, to have completed a degree course and then fail the registartion exam seems harsh. On the other, I wonder what the pass rate for professional qualifications are in other area - just because you get a degree does not mean you are competent to be a Pharmacist. While I cannot comment on quality of training or the exam itself, there is no one to blame for inadequate preparation than the student themself. As for the complaint that Pre-reg's are used as "cheap labour", that has been a common complaint since Adam was a lad, although I think it is fair to say some students may have too high an opinion of themselves, given that some (but by no means all) bring very little to their employer

L H, Community pharmacist

The only thing my pre-reg taught me (20 years ago) was how NOT to run a pharmacy.  They were the embodiment of if you have the right location you can be crap and still do well.  They took no interest in teaching students but conversely that employer disinterest led me to be a better tutor down the track.   

Ilove Pharmacy, Non Pharmacist Branch Manager

Standards have been dumbed DOWN(GCSEs, A levels, Degree course) and the quality emerging at pre-reg is LOW.

Despite all the A*'s and 1st class degrees handed out like smarties. This is the unspoken truth not that it matters where community pharmacy is concerned as it's in ruins.

Andy Burrells, Community pharmacist

Definitely not Degrees that are dumbed down. I just think students have lost the art of critical thinking.
They're taught that guidelines are king and if its not in the BNF it can't happen. It's why so many employers insist they locum for a few month first because they need to see the real world just isn't like that.
They talk of bringing in some level of SP/IP into the degree, but it will never happen while students just accept everything and challenge nothing.

Arun Bains, Community pharmacist

The pre-reg year is basically free labour if you decide to go with a multiple.

Beta Blocker, Primary care pharmacist

Absolutely correct. I was a dispensing robot for a year and somehow passed the exam.

Mehmet Fopal, Pre-reg Pharmacist

Once again like every year.. The GPHC actively offers an open ear for constructive debate but year in year out just cant seem to get it right. The BPSA are pretty much useless in taking their job seriously in relaying student concerns.. and yet again we face the same scenario every year. congratulations to those who passed..   

Ilove Pharmacy, Non Pharmacist Branch Manager

In other words you'd hve failed the old exam.

community pharmacist,

Not necessarily. The old calcs questions were still easy but the clinical questions did not apply to modern practice and therefore would not be useful when qualifying. 

community pharmacist,


I sat the pre-registration exam in June 2016 and thought the exam was fair. Calculations was at the level I expected and I did not feel rushed for time. Of course some of the clinical questions I had to guess but I was not aiming for 100% and understand that there will be a mix of questions in terms of difficulty as we all came from different backgrounds with different experience. 

Having compared my pre-reg exam to the old-style question I definitely prefer the newer style. I feel it reflects modern practice and it has encouraged me to use SPCs in practice which can help make a final decision. I have noticed that some more senior pharmacists are reluctant to use resources other than the BNF and the MEP. 


Z PreReg, Pre-reg Pharmacist

With all due respect you cannot compare the June 2016 exam to the June 2017 one. 95% of you passed and many described it as 'so easy' whereas the 2017 exam simply left everyone baffled and annoyed. The exam we were given did not reflect practice at all. 

community pharmacist,

You're right 95% was a very high pass rate and I cannot comment on the June 2017 exam but I still think 78% is a fair pass rate. 

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