Is Low Pharmacy School Enrollment Leading to Lower Admission Standards?

Declining pharmacy school enrollment has resulted in lower quality applicants. These candidates have lower GPAs, PCAT scores, and NAPLEX first-time pass rates. The statistics reveal that pharmacy schools need to prioritize quality over filling seats.

PharmCAS is the pharmacy school application hub for most colleges. Their data include GPAs, PCAT scores, number of applications, etc. from 133 of the 142 U.S. pharmacy schools. PharmCAS had 86 schools in 2009 and 133 schools in 2022.¹ From 2009 to 2017, PharmCAS averaged 16,967 applicants. In the 2022-2023 cycle, 11,227 students applied to pharmacy schools.¹ From 2009 to 2017, students submitted an average of 77,231 applications. The 2022-2023 cycle had 31,128 applications submitted to schools.¹ There are two explanations for this decrease. First, students must pay a fee for each school application, so applying to less programs is cheaper.² Second, students feel optimistic they will get accepted, so they apply to less schools.

Per PharmCAS data, pharmacy schools accepted 86.8% of applicants in 2023 compared to 34.1% in 2004.¹ To be fair, twice as many schools used PharmCAS in 2023, so more slots were available. The more telling statistic is the mean accepted applicants/school. Pharmacy schools had a mean of 108.9 accepted applicants in 2004 compared to 73.3 in 2023.¹ This means the number of accepted applicants has dropped by ~35 students/school in the last 19 years.  There are too many slots open and not enough quality students to fill them.

A lack of quality applicants has led enrollment standards to wane. The average cumulative GPA for accepted applicants has decreased from 3.43 in 2004 to 3.35 in 2023.¹ The average science GPA has decreased from 3.34 in 2004 to 3.20 in 2023.¹ All the GPAs show most students have received A and B grades, which is not terrible. The downward trend is worrisome and needs to either plateau or return to its previous norm.

In 2014, ~75% of schools required the PCAT. Today, no PharmCAS schools require the PCAT for admission.¹ Yet, some students still take the exam. In 2014, the PCAT composite percentile for accepted applicants was 63.32 compared to 52.41 in 2023.¹ This reduction mirrors the decline of GPAs.

In the U.S., schools are no longer able to meet their target enrollment. In 2017, pharmacy schools enrolled 15,192 first year (P1) students, but the cumulative target was 15,934.¹ That is 742 students short of the target, which is seven pharmacy classes’ worth of P1 students.  As an aside, in 2017, schools had the capacity to enroll 17, 050 students.¹ In 2022, schools enrolled 10,776 P1 students compared to a target of 13,674.¹ That is 2,898 students short of the target, which is 29 pharmacy classes’ worth of P1 students! Schools cannot even reach their low-bar targets, let alone their maximum capacity.

Enrolling lower quality candidates may increase a school’s attrition rate. The AACP Profile of Pharmacy Students report contains attrition rates for current pharmacy students.³ The AACP counts attrition as academic dismissals, student withdrawals, and delayed graduations. In recent years, the rate of attrition has been creeping up: 12.5% in 2020, 13.1% in 2021, and13.3% in 2022.^3,4 This increase suggests that some schools enrolled students that cannot pass their curricula.

The alarming statistics are the NAPLEX first-time pass rates. The pass rates peaked in 2008 with a 97% pass rate for candidates taking the NAPLEX for the first time.⁵ Since 2008 the rate has declined. The mean first-time pass rate in 2023 was 77.5%, which is almost 20% lower than the peak in 2008.⁶ In 2016, the NAPLEX underwent an update with different passing standards.⁷ It is unclear if the test’s changes and/or student quality are to blame.

The changes in GPA, PCAT scores, and attrition rates are not alarming but show a trend that needs to stop. The troubling statistic is the decline of first-time NAPLEX pass rates. These data suggest that schools are either not educating or enrolling to a high standard. Pharmacy schools should not admit students whose gumption is not a good fit for pharmacy. Schools need to enroll quality students, so they can create quality pharmacists.

Please note that the AACP (American Association of Colleges of Pharmacy) bears no responsibility for interpretations presented or conclusions reached in this article. This includes data from the 2022-2023 PharmCAS Applicant Data Report, 2021 AACP Profile of Pharmacy Students Report, and 2022 AACP Profile of Pharmacy Students Report.

References

1. PharmCAS Applicant Data Report 2022-2023. American Association of Colleges of Pharmacy (AACP).  2023. Accessed September 9, 2024. https://drugchannelsinstitute.com/files/2022_23%20PharmCAS_Applicant_Data_Report.pdf
2. PharmCAS (Pharmacy College Application Service). PharmCAS Application Fees and Fee Waivers. PharmCAS. Unknown publish date and date updated. Accessed September 9, 2024. https://help.liaisonedu.com/PharmCAS_Applicant_Help_Center/Starting_Your_PharmCAS_Application/Getting_Started_with_Your_PharmCAS_Application/5_PharmCAS_Application_Fees_and_Fee_Waivers#:~:text=PharmCAS%20charges%20%24180%20for%20the,and%20how%20to%20pay%20it.
3. Profile of Pharmacy Students Fall 2022. American Association of Colleges of Pharmacy (AACP). 2022. Accessed September 9, 2024. https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.aacp.org%2Fsites%2Fdefault%2Ffiles%2F2023-06%2Ffall-2022-pps-enrollments-appendix_0.xlsx&wdOrigin=BROWSELINK
4. Profile of Pharmacy Students Fall 2021. American Association of Colleges of Pharmacy (AACP). 2021. Accessed September 9, 2024. https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.aacp.org%2Fsites%2Fdefault%2Ffiles%2F2023-06%2Ffall-2021-pps-enrollments-appendix.xlsx&wdOrigin=BROWSELINK
5. ClinCalc. NAPLEX First-Time Pass Rates: Pharmacy School National Board Exam. ClinCalc.com. Updated 2015. Accessed September 9, 2024. https://web.archive.org/web/20150923170403/https:/clincalc.com/Pharmacy/NAPLEX.aspx
6. North American Pharmacist Licensure Examination^® Passing Rates for 2021-2023 Graduates. NABP. January 26, 2024. Accessed September 9, 2024. https://nabp.pharmacy/wp-content/uploads/NAPLEX-Pass-Rates-2023.pdf
7. Ried L, Hunter T, Bos A, Ried D. Association between accreditation era, North American Pharmacist Licensure Examination testing changes, and first-time pass rates. Am J Pharm Educ. 2023;87(3):ajpe8994. doi: 10.5688/ajpe8994