My pre-reg exam answers were probably 'implausible'

"The GPhC highlighted exam issues that plagued me as a pre-reg pharmacist"

Trainee pharmacists need common sense in the exam hall and in pharmacy practice, says Kristoffer Stewart

Once again, I want to congratulate all those who passed their pre-registration exam. It has been a long, hard slog, but you've made it. For those who did not pass this time around, I wish you good luck in your September resit, and advise you to read carefully the General Pharmaceutical Council’s (GPhCs) exam feedback.

While reading some of the feedback this week, I almost felt a sense of nostalgia – or was it nerves? The GPhC highlighted some of the issues that plagued me throughout my years of studying, namely reading the questions correctly and considering the “plausibility” of an answer.

In paper one (the calculations paper) they described areas where candidates performed less well – such as the duration of infusion rates, incorrect rounding of figures, and applying “the situation to a patient”. These remind me so much of the problems I faced in school, whether it was in physics – when common sense was often necessary – or in maths, where, if you didn’t read a question correctly, you would take your answer on a tangent.

Do these issues translate to real life? I think so. Not only is it important to get your calculations right when you are in an exam situation, it is relevant to how we deal with our everyday role – no matter what pharmacy sector your work in. For example, if a patient comes to you with a complaint, you can’t simply jump on the first word they say and diagnose them on the spot. That would make us no more useful than a quick Google search.

Rather, pharmacists need to be meticulous when it comes to the consultation: ask the 'WWHAM' questions; consider the patient’s answers; ask follow-up questions; and apply logic in the assessment.

The GPhC highlighted several recurring issues in candidate's answers to the second part of the exam, with common errors around “understanding the difference between adverse drug reaction and allergy”, as well as “the most appropriate analgesia to offer to patients”. These issues may be addressed by studying the right resources beforehand, and re-reading the question during the actual exam to ensure you understand what you are answering.

However, I felt that one of the issues the regulator raised – “candidates are expected to know when treatment can be recommended, and when patients should be referred” – doesn’t necessarily have a quick and easy fix. In fact, some qualified pharmacists still struggle with this. I am a member of several social media groups where pharmacists ask their peers questions – often regarding appropriate treatment and advice. This shows that even qualified pharmacists can be unsure and require support.

The ability to make the right call is often down to experience. Pre-reg tutors have the opportunity to help their trainees gain this experience by involving them in their patient consultations, engaging them on how they would help an individual and challenging them to think and behave like a pharmacist.

This will not only boost their confidence, but also enable them to apply common sense to a situation – attributes needed for both the exam hall and pharmacy practice.

Kristoffer Stewart is CPD and clinical editor of C+D, as well as a locum community pharmacist. Email him at or contact him on Twitter @CandDKristoffer


Ilove Pharmacy, Non Pharmacist Branch Manager

The uncomfortable truth is the quality of pharmacy graduates recedes year on year together with public perception of community pharmacists. Universities will lie because the tuition fees of £9k per annum per student are very welcome. Quantity is much more important than quality.

Multiples do not care as they're reducing wages constantly and eventually will do away with troublesome pharmacists altogether.


You might not like it but this is the truth.

Michael Franks, Community pharmacist

Wouldn't it be a good idea for these questions to be published in full in the c & d and the PJ? The profession should see how hard these questions were. The pass rate appears to be appalling but perhaps when we see the questions one's initial reaction might change.

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