A recent C+D article said that some candidates in the June pre-registration exam gave “implausible” answers. I was intrigued by this, and so in true journalistic style I submitted a freedom-of-information request for examples. This is what came back:
Q1. You receive a prescription for an unlicensed special. It is a contractual requirement to dispense with reasonable promptness. When do you tell the patient to return?
Candidate’s answer: The following day
Invigilator’s response: That is unrealistic, since such scripts are always presented at 6pm on a Friday night. It will be at least Wednesday, as in the meantime two locums will have ignored this script and the pharmacy manager will have phoned round to source the most profitable option.
Q2. Using the drug tariff, calculate the payment for the following prescription comprising these four items: haloperidol 500mcg tablets x 28; pregabalin 300mg capsules x 56; alginate dressing 10cm x 10 cm x 10; single inguinal truss x 1
Candidate’s answer: £275.74
Invigilator’s response: Totally implausible. No one will remember to enter the price for haloperidol 500mcg tablets, the pregabalin might have been £300 in last month’s price concession, but it’s back to £1.78 this month, the clinical commissioning group has banned reimbursement for dressings on FP10, and no one in your county knows how to fit a truss any more.
Q3. What is the name of the organisation that supports community pharmacy by developing and negotiating contract payments and new services?
Candidate’s answer: The Pharmaceutical Services Negotiating Committee
Invigilator’s response: Almost any other answer would have been acceptable.
Q4. When do the duties of the responsible pharmacist end?
Candidate’s answer: When they sign out the RP register at the end of their shift.
Invigilator’s response: No – they end once they’ve made two urgent deliveries of medication on the way home, received seven phone calls over the next three days to query the locations of scripts, and explained why they ordered that expensive drug from a main wholesaler instead of from the owner’s blacklisted anonymous supplier.
Q5. What is the purpose of a monitored dosage system (MDS)?
Candidate’s answer: To support medication administration for patients requiring adjustment, in line with the Disability Discrimination Act.
Invigilator’s response: The purpose of MDS is fourfold: to allow care agencies to avoid the need to train staff or employ anyone with English language skills; to prevent relatives having to visit their dribbling and incontinent parents; to give 100-hour pharmacies something to do between 6pm and 11pm; and to use up those odd quantities of patient-returned drugs.
Q6. What are the essential qualities of a modern pharmacist?
Candidate’s answer: Professionalism, the highest clinical standards, and a strong moral and ethical standpoint.
Invigilator’s response: A thick skin, large overdraft, caffeine addiction, psychiatrist on speed dial, and bladder the size of a camel.
So from examining just these few examples, I completely agree that some pre-reg candidates are totally unprepared for life as a pharmacist.