Over the weekend I read the C+D article about the petition protesting the “unsuitable” June pre-registration exam, which apparently has received more than 900 signatures. Can that really be right? I had to have a look at the question paper myself to find out:
Question 1: You are considering buying a community pharmacy business. Describe the clinical governance and due diligence enquiries you would make to assess its appropriateness.
This is obviously inappropriate. The only way a pre-reg would be able to buy a pharmacy business these days would be if they won the Euromillions lottery or if a relative bequeathed it to them in their will.
Question 2: You are the responsible pharmacist in an average dispensary doing 7,500 items a month. Other than actual dispensing, list the weekly and monthly activities your three dispensers would do to satisfy the General Pharmaceutical Council (GPhC) inspection requirements.
There are a number of problems with this question. Firstly, there’s no way your company would justify three dispensers for that size of business. Secondly, no one would have time to do anything other than dispensing, so you have to pray that you’re given the six weeks’ notice of the inspection so can cram all of the writing of SOPs and governance documents into that time.
Question 3: You receive a prescription for chloramphenicol eye drops and mercaptopurine for an asplenic eight-year-old child with purpura and gluten enteropathy. What is the concentration of mercaptopurine in a solution prepared by mixing 800ml of 40% w/v and 250ml of 30% w/v that would be suitable for this patient?
A perfect question to prepare candidates for the impossible situations they will face in community pharmacy, where we rarely have enough time, enough information, enough support staff, or access to enough online resources. It is also typical of Centre for Pharmacy Postgraduate Education (CPPE) questions, where if you got this one wrong the CPPE “helpful hint” would be: “You achieved 40% in this attempt – try answering the questions more phlegmatically.”
Question 4: List the names and roles of all staff in the local hospital pharmacy department. Grade their abilities with respect to discharge competence, their experience with biologicals, who is most influential on the drug interface group, and what they had for lunch.
This is a perfect example of a community pre-reg student question, as it introduces you to the meaningless priorities of secondary care. You can get extra marks if you present all this information on one sheet of A4 paper and label it “plan on a page”.
Question 5: Your NHS England region drugs budget is £192 million overspent. This equates to an £82,000 cut in prescribing costs for each GP practice. Assuming your clinical commissioning group has already banned scripts for gluten-free products and hayfever remedies, rank the following in order of priority to be cut:
a) broad-spectrum antibiotics
b) emergency hormonal contraception
c) public swimming baths
d) community pharmacy.
Nb. Any answer that didn’t put community pharmacy as the next priority for spending cuts would be an automatic fail.
There you are – these questions seem to reflect life in community pharmacy perfectly, so I honestly don’t know what the students are protesting about.