LICENSURE

LICENSURE - LICENSING INFORMATION

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Getting Your License
To become a licensed pharmacist, you must meet the requirements of the state or jurisdiction in which you are seeking licensure. The following examinations and other qualifications are prerequisites for licensure in most US jurisdictions. You are encouraged to contact the board of pharmacy of the state in which you wish to practice for their specific licensure requirements.

NAPLEX
The North American Pharmacist Licensure ExaminationTM (NAPLEX®) is required in all US jurisdictions except California, which administers its own examination. NAPLEX, which is developed by the National Association of Boards of Pharmacy® (NABP®), is a computer-adaptive test that assesses the candidate's ability to apply knowledge gained in pharmacy school to practice situations.
The NAPLEX is a four-hour and fifteen-minute examination that consists of 185 five-option multiple-choice test questions. A majority of the questions on the NAPLEX are asked in a scenario-based format (ie, patient profiles with accompanying test questions). To properly analyze and answer the questions presented, you must refer to the information provided in the patient profile. Interspersed among these profile-based questions are "stand-alone questions," whose answers are drawn solely from the information provided in the question.
The NAPLEX is administered daily at authorized Prometric Testing CentersTM throughout the United States. Information bulletins and application forms for the NAPLEX are available from the state boards of pharmacy. Effective January 1, 2003, NAPLEX candidates will pay a base fee of $300 and a $130 vendor administrative fee for a total registration fee of $430.

MPJE
Most states require a drug law examination as a condition of licensure. The Multistate Pharmacy Jurisprudence ExaminationTM (MPJE®) is currently administered in 45 US jurisdictions and is based on a nationally uniform content blueprint, with questions that are tailored to assess the pharmacy jurisprudence requirements of individual states.
In cooperation with participating state boards of pharmacy, the MPJE is uniformly developed, administered, and scored under policies and procedures developed by NABP's Advisory Committee on Examinations and approved by NABP's Executive Committee. The content of the MPJE is approved by boards of pharmacy, practitioners, and educators from around the country through their service as MPJE Review Committee members, item writers, and board of pharmacy representatives.
All candidates are tested on their mastery of pharmacy law as outlined in the MPJE Competency Statements. Each participating state board of pharmacy approves those questions that are specific to the federal and state laws of the jurisdictions in which candidates are seeking licensure. Candidates must take a separate exam for each state or jurisdiction in which they are seeking licensure.
The MPJE is a two-hour, computer-adaptive examination that consists of 90 five-option multiple-choice test questions. It is also administered daily at authorized Prometric Testing Centers. Effective January 1, 2003, MPJE candidates will pay a $110 base fee and a $60 vendor administrative fee for a total registration fee of $170.
Practice Examinations
Some states require candidates for licensure to pass a laboratory or practice examination to ensure that candidates can accurately and safely prepare and dispense medications. Check with your state board of pharmacy to determine whether this is a requirement in the state in which you are seeking licensure.

Internships
All state boards of pharmacy require candidates to complete an internship or externship before licensure. Such practice experience usually consists of 1,500 hours of experience that are gained during pharmacy school (beginning after the first year of training). Some states require that internship hours be gained solely after graduation from pharmacy school and before licensure. The internship process is subject to state board of pharmacy regulations. Each intern, internship site, and preceptor must register with the state board of pharmacy to have the hours counted toward licensure.

NAPLEX Score Transfer
NABP's NAPLEX Score Transfer Program allows candidates to transfer their NAPLEX score to additional jurisdictions in which they wish to obtain a license to practice pharmacy. Candidates who participate in the Score Transfer Program and fulfill all other requirements for licensure in the jurisdiction to which they transfer their score will be awarded a license by examination.
The Score Transfer Program differs significantly from NABP's electronic Licensure Transfer Program™ (ELTP™), which is a service NABP provides for licensed pharmacists. Unlike score transfer, licensure transfer does not permit the pharmacist to attain a license by examination in another jurisdiction. Instead, their license in the new jurisdiction is considered a license by licensure transfer.
The distinction is important, particularly if the newly licensed pharmacist ever again needs to transfer his or her license to another jurisdiction, because the ELTP™ requires that a license by examination be used to transfer a pharmacist's license to another jurisdiction. In other words, pharmacists cannot reciprocate their license using a license that has been obtained by licensure transfer. For this reason, NABP strongly recommends that pharmacists keep their license by examination valid and current.
Score transfer candidates must complete all the examination requirements that are required by the primary jurisdiction for licensure, including any locally administered exams. Primary jurisdictions can refuse to allow a candidate's score to be transferred if the candidate does not complete all of the jurisdiction's examination requirements.
Currently, all states except California and Florida participate in the NAPLEX Score Transfer Program. Candidates are encouraged to contact the score transfer jurisdiction directly to determine their requirements for licensure. The current score transfer fee is $75.00 per state.

General Pharmacist Licensure Requirements

Age
Age requirements vary by state.
Educational Eligibility Requirements
To be licensed, a pharmacist must have graduated from a school of pharmacy approved by the state board of pharmacy or accredited by the American Council on Pharmaceutical Education (ACPE). Except for the School of Pharmacy at the University of Puerto Rico and the PharmD program of the Lebanese American University in Byblos, Lebanon that was accredited by ACPE in June 2002, no school of pharmacy outside the United States holds ACPE accreditation.
Graduates of foreign pharmacy schools may meet the educational eligibility requirements for licensure by:

o Graduating from a US school or college of pharmacy;
o Earning Foreign Pharmacy Graduate Examination CommitteeTM (FPGEC)® Certification; and/or
o Following other procedures approved by the state in which licensure is sought.

Relicensure
Of the 53 US jurisdictions (50 states plus DC, Guam and Puerto Rico) that report to the NABP Survey of Pharmacy Law, 51 require pharmacists to complete a certain number of continuing education units (CEUs) before they can renew their licenses. CEUs must be obtained through a program presented by a provider that is accredited by the American Council of Pharmaceutical Education (ACPE) or that is recognized by the state board of pharmacy.
Most states require the pharmacist complete approximately 15 hours of continuing education each year, the majority of which must be from a didactic, or live, presentation. CEUs from ACPE-accredited providers may be secured through such venues as local seminars and regional, state, and national meetings, home study certificate courses, and articles that appear in professional journals.

Goals and Objectives of the FPGEC

1. to inform foreign pharmacy graduates about FPGEC Certification and the Foreign Pharmacy Graduate Equivalency Examination™ (FPGEE®);
2. to evaluate the qualifications of foreign pharmacy graduates who apply for FPGEC Certification;
3. to oversee the development of the FPGEE; and
4. to cooperate with other agencies concerned with foreign pharmacy graduates.

Definition of a Foreign Pharmacy Graduate
NABP's Foreign Pharmacy Graduate Examination Committee® (FPGEC®) defines a "foreign pharmacy graduate" as a pharmacist whose undergraduate pharmacy degree was conferred by a recognized school of pharmacy outside the 50 United States, the District of Columbia, and Puerto Rico. US citizens who have completed their pharmacy education outside the United State are, therefore, considered to be "foreign pharmacy graduates," whereas foreign nationals who have graduated from schools in the United States are not.

FPGEC Certification
NABP provides the FPGEC Certification program as a means of documenting the educational equivalency of a candidate's foreign pharmacy education, as well as the license and/or registration. In the process of FPGEC Certification, candidates provide documents that verify their educational backgrounds and licensure and/or registration. The pharmacy program that each candidate completed must have been at least a four-year curriculum at the time of graduation. Beginning January 1, 2003, foreign-educated pharmacists will be required to have earned their professional degree from a five-year curriculum program in order to apply for FPGEC Certification. The program change affects only those foreign-educated pharmacists who have earned a pharmacy degree after January 1, 2003. These pharmacists must have graduated from a five-year degree program. The new curriculum requirements do not apply to foreign-educated pharmacists who have earned a four-year degree prior to January 1, 2003. These individuals will remain eligible for the FPGEC Certification under the current program requirements. Candidates must pass the FPGEE and obtain a total score of 550 or higher on the paper-based Test of English as a Foreign Language (TOEFL) or 213 or higher on the computer-based TOEFL. Candidates must also pass the Test of Spoken English (TSE) with a score of 50 or higher. The TOEFL and TSE must be successfully completed within two years (either before or after) of passing the FPGEE. The TOEFL and TSE must be completed by all foreign pharmacy graduates, even those who are native English speakers. For more information about TOEFL and TSE, contact TOEFL/TSE Services, PO Box 6151, Princeton, NJ 08541-6151. Telephone (609) 951-1100.

At present, 49 states recognize FPGEC Certification as a prerequisite for pharmaceutic licensure. The FPGEC Certificate is not a license to practice pharmacy. Applicants who receive the FPGEC Certificate may be qualified by the state boards to take the pharmacy licensing examination in those jurisdictions that accept this certification. A few states, however, may also approve foreign graduates who are not FPGEC-certified on the basis of their credentials. For information, contact the appropriate state board of pharmacy office. Because the licensure requirements vary from state to state, candidates are advised to directly contact the board(s) of pharmacy of the state(s) in which they desire licensure.
To obtain additional information about the FPGEE and the FPGEC Certification Program, contact the FPGEC at custserv@nabp.net.

NABP Resources
NABP offers a variety of publications designed to help pharmacists prepare for licensure, including:

Survey of Pharmacy Law
A comprehensive review of aspects of pharmacy law for the 50 states, the District of Columbia, Guam, and Puerto Rico.
Revised annually, the Survey consists of four sections: organizational law, licensing law, drug law, and census data. Footnoted charts in each section summarize such areas of interest as the issuance and renewal of licenses, prescribing and dispensing authority, pharmacy technicians, state drug restrictions, and patient counseling requirements. $20

NAPLEX/MPJE Registration Bulletin
Available from the state boards of pharmacy, the Bulletin provides information about these two examinations, the Competency Statements that form the test blueprints, and important information regarding exam registration, preparation, administration, and score transfer. Registration forms are included. No Charge.

FPGEC Bulletin
Available from the FPGEC at custserv@nabp.net, the Bulletin offers important information about the FPGEC Certification program, including the requirements for earning the FPGEC certificate, the documents required for the evaluation process, and registration procedures for the FPGEE. An application for the FPGEC Certification program is included. No Charge.

NAPLEX

What is the NAPLEX?
The NAPLEX®, or North American Pharmacist Licensure Examination™, is developed by the National Association of Boards of Pharmacy® (NABP®) for use by the state boards of pharmacy as part of their assessment of competence to practice pharmacy. It is a valid and objective examination that tests your mastery of the most important aspects of competent practice, as defined in the NAPLEX competency statements.
In cooperation with participating state boards of pharmacy, the NAPLEX is uniformly developed, administered, and scored under policies and procedures developed by NABP's Advisory Committee on Examinations and approved by NABP's Executive Committee. The content of the NAPLEX is approved by boards of pharmacy, practitioners, and educators from around the country through their service as NAPLEX Review Committee members, item writers, and board of pharmacy representatives.
Preparing for the NAPLEX
Your formal education, internship, and practical experiences all prepare you for the NAPLEX and licensure as a pharmacist. The NAPLEX has been designed to assess how well you can apply your learning and skills to actual practice situations and to evaluate your ability to meet the responsibilities of the practice of pharmacy. You should base your preparation on the knowledge that you have acquired during your professional education. You should be competent in evaluating and responding to situations that occur in daily practice. Consult the NAPLEX Competency Statements for a description of possible examination question topics.
Candidates are advised that NABP does not sanction, endorse, or recommend any particular review course or study guide for use in preparation for the NAPLEX..

The Computer-Adaptive NAPLEX
The examination is administered using a computer-adaptive approach, which allows it to be individualized to meet each candidate's level of ability. That measure is compared to a predetermined, minimally acceptable level of competence that the examinee must meet or exceed in order to pass the examination. Computer-adaptive testing (sometimes referred to as CAT) selects the next question to administer based on your responses to the previous questions. Therefore, you must respond to all questions selected for you. Omitting a question is not permitted. Computer-adaptive testing will not permit you to change your response to a question once you have moved on to the next question. To summarize:

·         You cannot omit or skip a question.

·         You cannot go back and review a question.

·         You cannot change an answer to a question once you have confirmed an answer and moved on to the next question.

NAPLEX Competency Statements
NABP has developed the NAPLEX Competency Statements. The Competency Statements summarize and outline the knowledge and skills that you are expected to have acquired before you take the NAPLEX, and that you are expected to be able to demonstrate in answering the examination questions. All NAPLEX questions are based on these Competency Statements, which are reviewed and revised as necessary. A strong understanding of the Competency Statements will aid in your preparation to take the NAPLEX.

Area 1 Manage Drug Therapy to Optimize Patient Outcomes (Approximately 50% of Test)

1.1.0 - Evaluate the patient and/or patient information to determine the presence of a disease or medical condition, to determine the need for treatment and/or referral, and to identify patient-specific factors that affect health, pharmacotherapy, and/or disease management

 

1.1.1 - Identify and/or use instruments and techniques related to patient assessment and diagnosis

1.1.2 - Identify and define the terminology, signs, and symptoms associated with diseases and medical conditions

1.1.3 - Identify drug and non-drug methods of preventing and treating diseases and medical conditions

1.1.4 - Identify patient factors, biosocial factors, and concurrent drug therapy that are relevant to the maintenance of wellness and the prevention or treatment of a disease or medical condition

 

1.2.0 - Assure the appropriateness of the patient's specific pharmacotherapeutic agents, dosing regimens, dosage forms, routes of administration, and delivery systems

 

1.2.1 - Identify drug products by their generic, trade, and/or common names

1.2.2 - Identify the known or postulated sites and mechanisms of action of pharmacotherapeutic agents

1.2.3 - Evaluate drug therapy for the presence of pharmacotherapeutic duplications and interactions

1.2.4 - Identify indications, contraindications, warnings, and precautions associated with a drug product's active and inactive ingredients

1.2.5 - Identify physicochemical properties of drug substances that affect their solubility, pharmacokinetics, pharmacologic actions, and stability

1.2.6 - Interpret and apply pharmacokinetic principles to calculate and determine appropriate drug dosing regimens

1.2.7 - Interpret and apply biopharmaceutic principles, and the pharmaceutical characteristics of drug dosage forms and delivery systems, to assure bioavailability and enhance patient compliance

 

1.3.0 - Monitor the patient and/or patient information and manage the drug regimen to promote health and assure safe and effective pharmacotherapy

 

1.3.1 - Identify pharmacotherapeutic outcomes and endpoints

1.3.2 - Evaluate patient information to determine the safety and effectiveness of pharmacotherapy

1.3.3 - Identify, describe the mechanism of, and remedy adverse reactions and iatrogenic or drug-induced illness

1.3.4 - Prevent, recognize, and remedy noncompliance and drug misuse or abuse

1.3.5 - Identify and remedy interactions or contraindications with diagnostic or monitoring tests or procedures

 

Area 2 Assure the Safe and Accurate Preparation and Dispensing of Medications (Approximately 25% of Test)

2.1.0 - Perform calculations required to compound, dispense, and administer medication

 

2.1.1 - Calculate the quantity of medication to be compounded or dispensed; reduce and enlarge formulation quantities, and calculate the quantity or ingredients needed to compound the proper amount of the preparation

2.1.2 - Calculate nutritional needs and the caloric content of nutrient sources

2.1.3 - Calculate the rate of drug administration

2.1.4 - Calculate or convert drug concentrations, ratio strengths, and/or extent of ionization

 

2.2.0 - Select and dispense medications

 

2.2.1 - Determine whether a particular drug dosage strength or dosage form is commercially available, and whether it is available on a nonprescription basis

2.2.2 - Identify commercially available drug products by their characteristic physical attributes

2.2.3 - Interpret and apply pharmacokinetic parameters and quality assurance data to determine equivalence among manufactured drug products, and identify products for which documented evidence of inequivalence exists

2.2.4 - Identify the appropriate packaging, storage, handling, and disposal of medications

2.2.5 - Identify and describe the use of equipment and apparatus required to administer medications

 

2.3.0 - Prepare and compound extemporaneous preparations and sterile products

 

2.3.1 - Identify and describe techniques and procedures related to drug preparation, compounding, and quality assurance

2.3.2 - Identify and use equipment necessary to prepare and extemporaneously compound medications

2.3.3 - Identify the important physicochemical properties of a preparation's active and inactive ingredients; describe the mechanism of, and the characteristic evidence of, incompatibility or degradation; and identify methods for achieving stabilization of the preparation

 

Area 3 Provide Drug Information and Promote Public Health (Approximately 25% of Test)

3.1.0 - Access, evaluate, and apply information to promote optimal health care

 

3.1.1 - Identify the typical content and organization of specific sources of drug and health information

3.1.2 - Interpret and evaluate data presented in textual, tabular, or graphic form

3.1.3 - Evaluate the suitability, accuracy, and reliability of information from reference sources by explaining and evaluating the adequacy of experimental design, and by applying and evaluating statistical tests and parameters

 

3.2.0 - Educate patients and health care professionals regarding prescription medications, nonprescription medications, and medical devices

 

3.2.1 - Provide information regarding a medication's therapeutic actions, and describe appropriate remedies to minimize the principal untoward effects resulting from drug therapy

3.2.2 - Provide information regarding a medication's precautions, warnings, contraindications, and interactions with food

3.2.3 - Provide information regarding the proper storage, administration, and disposal of medications

3.2.4 - Identify products and describe techniques for the self-monitoring of patients' health status

3.2.5 - Provide advice regarding the selection, use, and care of medical/surgical appliances or devices, durable medical equipment, and medication administration equipment

 

3.3.0 - Educate patients and the public regarding wellness, disease states, and medical conditions

 

3.3.1 - Provide information regarding medications used in the prevention and treatment of diseases and medical conditions, including emergency patient care

3.3.2 - Provide information regarding nutrition, lifestyle, and other non-drug measures that are effective in promoting health, or preventing or minimizing the progress of a disease or medical condition

 

Stylistic Conventions
Most of the stylistic conventions of the NAPLEX will become evident as you work through the sample questions provided in this Guide. You may find it helpful, however, to note the following information:

 

1.        Every effort has been made to exclude questions about drugs that have been recalled or removed from the market. Questions about drugs generally concern the drugs most commonly given for a certain condition or in a particular situation.

2.        Depending upon the question, a drug may be called by its generic name, its trade name, or its common name.

3.        In calculation questions, weights and measures are considered to be the equivalents found in standard pharmaceutical references.

4.        Molecular and atomic weights are supplied when necessary.

5.        In calculation questions, you should assume that each quantity is meant to be measured with the same degree of precision. For example, if 2g of ointment is prepared using 0.25g of x and 0.416g of y, each of these values should be assumed to have three significant figures; i.e., 2.00g, 0.250g, and 0.416g.

6.        Negative words, such as NO, NOT, NONE, NEVER, and EXCEPT, are capitalized and printed in boldface type to draw attention to the kind of response expected.

Abbreviations and Symbols
The abbreviations and symbols used on the NAPLEX are those that an entry-level pharmacist should recognize. Generally, these are written in accordance with accepted style manuals, published for health professionals and commonly used in practice. The list below is partial, not exhaustive, but it will give you an idea of the types of abbreviations and symbols used on the NAPLEX.

 

Taking the NAPLEX
The computer-adaptive NAPLEX is available for administration on a daily basis, Monday through Saturday, excluding holidays, through the Prometric Testing Centers™. Consult the Prometric Thomson Learning™ Web site located at www.2test.comfor a complete list of Prometric Testing Centers.
The NAPLEX consists of 185 questions. Of these, 150 questions have been pretested and validated previously, while 35 questions are being pretested or evaluated for use in future examinations. The pretest questions are indistinguishable from other questions and are interspersed throughout the examination. Your responses to the pretest questions are recorded for statistical purposes and do not play any part in calculating your score. Only your responses to the 150 validated questions will contribute to your score.
All questions on the NAPLEX examination are five-option, multiple-choice items. There are no fill-in-the blank or essay questions. The NAPLEX questions have only one correct answer. As you determine which answer is correct, you should consider the five alternatives given and select the best answer from the alternatives listed. You should select the answer that is best among the responses that accompany the question.
Many of the questions on the examination are associated with scenarios or patient profiles, while others are stand-alone items that do not require you to refer to a scenario. Questions associated with a scenario or profile should be answered within the context of the scenario in which they appear. For instance, penicillin might be the drug of choice to treat most patients who are suffering from strep throat, but if the scenario indicates that the particular patient has a penicillin allergy, another drug should be selected. Remember, it is important that you answer the questions within the context of the scenario/profile.
In no case on the exam will you find that answering one question correctly depends upon correctly answering another question. You will be able to answer each question independently from the questions that surround it. Therefore, answering one scenario question incorrectly does not mean that you will incorrectly answer other questions in that scenario set.
You will have four hours and fifteen minutes to complete the examination, with a 10-minute mandatory break after approximately two hours of testing time. Additional time will be allowed for you to review a short tutorial at the beginning of the examination and to complete a computer-administered evaluation questionnaire at the end of the examination.

Examination Results
The minimum acceptable passing score on the NAPLEX scale is 75. The passing score reported is NOT a percentage value. The score is calculated by first determining the candidate's ability level on the NAPLEX, and then comparing that to the predetermined minimum acceptable ability level established for the NAPLEX. The passing standard has been established by a panel of pharmacy experts, and the ability level that defines the passing standard is the same for all NAPLEX administrations.
To receive a test score, you must have completed at least 162 questions on the examination. Candidates completing less than 162 questions will NOT have their score reported. Candidates completing at least 162 questions but less than 185 questions will have a penalty applied and their scores adjusted accordingly in order to reflect the number of questions that remained unanswered.
NABP will report your NAPLEX score to the board of pharmacy that conferred your eligibility approximately five days after your scheduled test day. The board of pharmacy will report your score to you. Check with the board of pharmacy for an estimation of when you may expect to receive your score after you have taken the examination.
NABP does NOT release scores to candidates, and score results are NOT released at the test center. By applying to take the NAPLEX, you authorize NABP to release your test score to the board of pharmacy. NABP will not release your scores to any other party. NABP does not have the authority to report, nor will it report, any individual scores by telephone, fax, or letter.
Diagnostic reports will also be provided by the board of pharmacy to candidates who fail the examination along with the examination results. The diagnostic report will indicate the failing candidate's relative performance in each major competency area, to identify areas that may require further review. Because of the secure nature of the NAPLEX, no further review of the test questions is allowed.
The NAPLEX is the means by which boards of pharmacy can assess the entry-level competence of candidates for licensure. Any other use of individual NAPLEX scores is inappropriate and is not condoned by NABP.

 

Pre-NAPLEX™
Preparing for the North American Pharmacist Licensure Examination™ (NAPLEX®) is much easier when students use the Pre-NAPLEX™. The only NAPLEX practice exam written and developed by the National Association of Boards of Pharmacy® (NABP®), the Pre-NAPLEX will familiarize students with the NAPLEX testing experience.
Because the Pre-NAPLEX is similar to the actual NAPLEX in many ways, students who take the Pre-NAPLEX will have a chance to “preview” the NAPLEX experience before exam day. In fact, the questions on the Pre-NAPLEX are actual questions that have previously appeared on the NAPLEX exam.
Students who complete the Pre-NAPLEX will not only be able to practice for the NAPLEX, but will also be given an estimated, scaled score based on their answers to the Pre-NAPLEX questions. Pre-NAPLEX scores are interpreted in a similar fashion as the NAPLEX. Please note that, like other practice exams, students’ scores on the Pre-NAPLEX will be similar to what they can expect to receive on the NAPLEX, but may not be the actual score attained, nor is it a guarantee of passing the NAPLEX examination.
For added convenience, Pre-NAPLEX is Internet based so it can be accessed at home, the library, school, or work. Students can register for and take one or more of the exams online at www.pharmacist.com or www.nabp.net. The Pre-NAPLEX consists of three different exam forms, each with 50 questions. The cost for each Pre-NAPLEX attempt is $50. Students can sit for the Pre-NAPLEX at any time on any day.
Click here for more information regarding the Pre-NAPLEX at www.PreNaplex.com.