Overview of community pre-registration training in UK

In July last year, I relocated to York to do my pharmacist pre-registration training after graduating with my MPharm (Master of Pharmacy) degree in Manchester. The training is a one-year programme, and all 12 months of my training takes place in a small independent multiple pharmacy.

Looking back at the beginning, I was initially clueless of what the day-to-day duties of a pre-registration trainee were despite going for a few 2-day community pharmacy placements during my degree.

But after completing nearly 9 months of training as of today, I now understand what my responsibilities are and what to expect from my training. Of course, every community pharmacy is different in terms of the level of busyness and opportunities to learn; this is just a general overview.

What is pre-registration training?

Pharmacist pre-registration training is essentially an “on-the-job training” which all MPharm graduates must complete before they can register as a pharmacist with the General Pharmaceutical Council (GPhC), the regulator of pharmacists in UK. There are two main sectors of training: community and hospital.

During your pre-registration training, you will be assigned a tutor—an experienced pharmacist whose ultimate goal is to groom you to become a competent pharmacist. Your tutor is also the sole decision-maker on whether you are signed off as competent at the end of your training.

That’s not all though. You also need to sit and pass an exam called the Registration Assessment before you can become a pharmacist. The exam consists of two papers that test primarily on calculations and clinical knowledge. Again, your tutor decides whether you are competent enough to sit for this exam.

What are the job duties?

Most patients in the UK collect their medications from community pharmacies. Therefore, ensuring that they get their medicines in a timely manner is the most important aspect of working in a community pharmacy.

Since you are not a pharmacist yet, you can’t do the final check on the patient’s medication before packaging them. Thus, majority of your work revolves around dispensing prescriptions.

My daily responsibilities mostly entail picking medicines from shelves and ordering stock. Another significant job duty I have is addressing minor ailment queries, and recommending an OTC (Over the counter) treatment if appropriate. In the UK, people are highly encouraged to go to the pharmacy for minor illnesses instead of their GP.

That sounds like the job scope of a dispenser, and yes it is. There are a few pharmacist-related tasks that I assist in such as controlled drug stock management and conducting clinical audits. You could be involved in doing more pharmacist-related stuff depending on the services your pharmacy provides.

Expectations from working in community pharmacy

As a pre-registration trainee, I used to think that learning is my number one priority at the workplace. But that’s not the reality. The smooth day-to-day running of the pharmacy is the top priority.

Judging from my main responsibilities, there isn’t much clinical knowledge you can gain from picking medicines and ordering stock. And that is true, only if you pay little attention to the prescription and don’t ask yourself questions like what the medicine is for, is it appropriate for the patient etc.

When I think about the dispensing process as a whole, the pre-registration trainee has to do both the workload of the dispenser and the pharmacist. The dispenser’s sole concern is to pick the right medicines from the shelves while the pharmacist’s responsibility is to carry out the final check.

The trainee is expected to both pick the right medicines and do a “final check” before handing the medicines to the pharmacist.

But in a busy and fast-paced pharmacy, where there are many items to dispense and patients to serve, do you really have time for all that?

Therefore, the natural tendency is to skip your personal clinical check and just dispense the prescription right away. There are many days where I feel more like a dispenser than an up-and-coming pharmacist.

There is higher potential to develop clinical knowledge from counselling patients on minor illnesses. But depending on your luck, you may find that you eventually reach a “saturation point” because almost all the queries are about the same few issues.

Expectations of your tutor

Your tutor has the overall goal of developing you into a competent pharmacist. So, does that mean that your tutor will put in significant effort to facilitate your learning?

Ideally, yes. But if your pharmacy branch is normally quite busy, your learning becomes an afterthought.

On some days, I only truly learn or apply clinical knowledge at work if something unusual happens in the pharmacy, like an uncommon prescription or patient query. Otherwise, most days can be quite monotonous. You may wonder whether your work is actually helping you with your exam preparation.

I suppose, in a busy pharmacy, the best way to make use of your tutor is to ask questions when the pharmacy is less hectic. Not asking questions at all will likely result in your tutor assuming that your knowledge is optimal.

In actual fact, most of my learning—in terms of clinical knowledge—comes from self-studying at home. It is easy to agonise over whether your tutor is doing enough to aid your learning.

But at the end of the day, your relationship with your tutor is all-important. After all, your tutor decides whether you pass your training or not.

Both of you have the same overall responsibility of ensuring the smooth running of the pharmacy, and your tutor needs your help to make this happen.

All I can really do is focus on doing my part properly and ensure that the pharmacy doesn’t get overwhelmed with prescriptions. Don’t give your tutor a reason to question your work attitude or collaboration.

And on that note, your work relationship with the rest of the pharmacy team is crucial too. If the dispensers don’t like you, they are not going to cooperate if you need a favour from them. There is no joy working in a pharmacy where the dispensers always bypass you for the pharmacist because they have no trust in you.

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