School of Pharmacy 50th Anniversary – The Students’ Perspective

Soraya Alizadeh Campbell Hewson Jessica Kocher Ling Lin Harsha Prakash Rachel Wong Jie Min Yew

A 4th Year undergraduate report submitted in partial fulfilment of the requirements of the degree Bachelor of Pharmacy at the University of Otago, 2012

Acknowledgements We thank our supervisors for sharing their expert knowledge and constant encouragement: Dr Susan Heydon & Mr Michael Bagge, Social Pharmacy, New Zealand‘s National School of Pharmacy.

Interviewees that participated in this project – we sincerely appreciate your time and perspectives.

Literature searching was facilitated by Anne Jackman, Senior Librarian, Hocken Collection.

University of Otago Medical Library Staff. Specifically Sarah Gallagher, Academic Liaison Librarian, for help with past exam papers.

Donna Jones, Secretary & Personnel, Otago University Students‘ Association; for making available the Critic magazine collection.

Patti Napier, School of Pharmacy Postgraduate Student in Master of Health Sciences, for being absolutely wonderful with background information.

Professor Stephen Duffull, Dean, New Zealand‘s National School of Pharmacy; for approval of this project and insight into the White Coat Ceremony.

Emeritus Professor F.N. Fastier, the first Dean of New Zealand's National School of Pharmacy;
we thank you for your wonderful book Pharmacy teaching at Otago University: how it began

and for participating in an interview with Dr Susan Heydon.

Abstract Introduction The history of New Zealand‘s National School of Pharmacy has not been considered from the students‘ perspective. As the school will celebrate its 50th Jubilee in April 2013, this perspective is important to document.

Aim To explore the perspectives of current and past pharmacy students’ on aspects of academic and social culture at the School of Pharmacy.

Method Databases, the University Calendar, the Otago University Students’ Association Critic magazine collection and Pharmacy student yearbooks were reviewed. Semi-structured interviews were conducted with current and past pharmacy students using an interview schedule. Interviews were analysed thematically.

Results The BPharm first appeared in the University Calendar in 1960. The course has changed significantly over the years. The main growth of numbers occurred in the 1990s. There are more female than male pharmacy students and the number of international students has increased and diversified over the years. Interviews showed that today pharmacy is generally not the first choice for most students but a few feel a vocational pull into the profession. Social connections are forged between students through various activities and events organised by the pharmacy student association. Course specifically, interviewees thought placements gave a realistic view about the pharmacy profession, summer

studentships gave students the chance to increase research experience and postgraduate studies are only pursued by a few graduates.

Conclusion This study explored the changes of pharmacy students’ perspective over time with respect to academic and social aspects. The history of the pharmacy school would not be complete without an appreciation of its students.

Contents To be completed Acknowledgements ii Abstract iii Contents iv Introduction 1 Method 5 Results 6 Discussion 8 References 15 Appendix 1 17 Appendix 2 18

Introduction New Zealand‘s National School of Pharmacy will celebrate its 50th Jubilee in April 2013. A book will be written by Dr Susan Heydon documenting the history of the pharmacy school. An important consideration of this history will be the perspectives of the school‘s past and current students.

The formalisation of pharmacy education in New Zealand occurred in 1960 when a two year pharmacy course began at the Central Technical College (later renamed Central Institute of Technology (CIT)) in Petone with a maximum intake of 75 students each year. The course comprised of two years of full-time study and was followed by a two year apprenticeship. This was changed in 1969 to a three year course followed by a one year apprenticeship. (Louise Shaw)

The development of a degree in pharmacy at Otago University was inspired by the profession itself lobbying the government. In essence, pharmacists wanted all pharmacy education to be in a university with an adequate education system. This was summarised by Louise Shaw in her book, Prescriptions for Change? dispensing with men: a history of women in New Zealand pharmacy, 1881 - 1991:

―Modern trends show clearly that pharmacy in the future will demand a much more intimate knowledge of pharmacology and pharmaceutical chemistry if it is to meet the challenge of the rapid advances in drug sciences. To do this its education system must be directed at producing pharmacists with a basic education and an organized intellectual training capable of handling its future needs.‖

This lobbying resulted in the development of a pharmacy degree within the Department of Pharmacology in the 1960s. The aim of the Otago course was to provide specialists for manufacturing, teaching and research positions whereas the course in Petone was regarded as the principal training ground for retail pharmacists.

The initial intake was one student, although this student failed medicinal chemistry and was not the first graduate. The first graduates of the School of Pharmacy were three students in 1965. Over time the intake to pharmacy grew to around 20-25 students but this growth was hampered by the small faculty and poor teaching facilities. In 1989, the Minister of Education decided to site all pharmacy education at the University of Otago. This resulted in the closure of the larger-intake CIT in 1991. In 2009 the school increased its intake of international students with its first Malaysian government funded scholarship students. This batch of students studying at Otago would complete their internship in Malaysia. Intake to the School of Pharmacy has increased to its present level of approximately 140 students per year.

While the history of the establishment of New Zealand‘s National School of Pharmacy has been somewhat documented, that of the pharmacy student experience is non-existent. The aspects of a pharmacy students experience from how they gain entry into the course, how they find their time during the course both academically and socially is unknown. Furthermore, how the pharmacy course has evolved in terms of the content covered has not been considered. As such, the aim of this project is to explore the perspectives of current and
past pharmacy students‘ on aspects of academic and social culture at the School of Pharmacy.

Method Initially there were no clear objectives. As such meetings were organised with our supervisors to create the objectives of the project before any research was done. Topics to explore were decided upon by the authors and each member of the group was assigned a topic to explore in detail. This project was discussed with the Dean of the School of Pharmacy and was approved, therefore ethics approval was not sought.

The source of data for this report was divided into two categories: literature searching and semi-structured interviews. The following databases were searched using pharmacy, student, history, school of pharmacy, Otago University, perspectives, gender, female and pharmacy, student exchange as keywords: Google Scholar, Embase. The NEWZTEXT database was used to look for relevant articles from the Pharmacy Today magazine. A Hocken Library tour was given by Anne Jackman to introduce us to historical literature searching. The University of Otago Medical Library and Hocken Collections catalogues were searched using the previous keywords. Otago University Students‘ Association Critic magazine collection between the years 1963 and 2011 was examined for any pharmacy related news or events. Several Pharmacy Student yearbooks were reviewed (see appendix 2) for any relevant aspects of academic and social culture changes at the pharmacy school.

A visit to Otago Daily Times office yielded no results regarding the history of School of Pharmacy. An e-mail was sent to Wayne Angus, International Officer, to enquire about international student numbers between the years 2000 to 2012. Otago University‘s graduation office was contacted for any documented changes in the graduation ceremony and statistics of the number of pharmacy graduates in the last fifty years. Photographs were obtained from

the School of Pharmacy‘s website, publically accessible Facebook page and internal database Syrett.

As The New Zealand Association of Pharmacy Students Otago (NZAPS-O) plays a significant part in the social life of pharmacy students we approached them with the hopes of getting some background information. Our queries were unreplied despite follow-ups with NZAPS-O and hence we have omitted a detailed history of the NZAPS-O in this research report.

For information regarding experiential learning James Windle and Aynsley Peterson, placement co-ordinators, were contacted and referred us to Dr Beresford and Patti Napier. Dr Beresford no longer worked in the University, hence she could not be contacted.

We intended to track the evolvement of subjects that were offered originally to current subjects that focus on clinical pharmacy and social pharmacy by looking through past years‘ examinations. Half way through the research, this idea was aborted and it was decided that as student researchers it would seem more appropriate and manageable that we focused mainly on the social perspectives of being a student. However, sometime after the semester break, upon discussion with our supervisors, the idea was revived and we sought to draw out a brief sketch of the course changes. This was done originally with the intention to add depth to our understanding of past students‘ responses which would enable us to better interpret the interview results. Upon encountering difficulties interpreting information gathered from sources stored in the Medical Library we consulted Dr Heydon. She suggested that the University calendars would be the best source of information on subjects offered over the years and these were readily accessible in the Central Library.

Calendars of the University were available from 1877 to 2012.While it was our original idea to note down the subjects offered in the Bachelor of Pharmacy degree, we could not contain our curiosity as to what happened before 1963, the year the degree course started. As a result we found ourselves scanning through the indexes of the calendars before 1963. The earlier calendars proved not to have indexes which forced us to read through all the pages looking for any pharmacy-related keywords.

As we progressed along this vein, we also decided to see how the Department of Pharmacy and later the Pharmacy School evolved. The calendars had a section that showed all the departments and faculties as well as the names of the respective staff. From this we were able to piece together the structural changes as well as the people who led the department from the onset. This interest grew when we noticed differences between our findings and the brief summary of the Pharmacy School‘s history which is available from the official website.

Finally, we noticed from the calendars that there was a period of time when Honours and Master of Pharmacy programmes were offered to students. As the current Pharmacy course neither has an honours nor a master programme (except the Master of Clinical Pharmacy programme) we thought it will also be interesting to document these changes.

Using an inductive approach semi structured interviews were conducted. A total of seventeen
past and current students from the Otago School of Pharmacy were interviewed u sing an

interview schedule. Ten interviewees were current while seven were past pharmacy students;
nine interviewees were male and eight female. Participants were from a diverse age range, ethnicity, and occupations which are presented in table X. The interview schedule was created

to explore several different broad aspects of academic and social which includes: why

students chose to study pharmacy at Otago University, how they found their time as a student, perspectives on gender and pharmacy, international student perspectives and finally an opportunity for brief feedback on what students believed needed to change with the pharmacy course. (See appendix 1 for the full interview schedule).

Age 19 19 19 21 22 22 23 23 23 26 28 32 34 34 40 47 50

Ethnicity Fijian Indian Caucasian Taiwanese Korean Chinese Chinese Chinese Chinese Korean Fijian Indian Chinese Caucasian Yemen Caucasian Caucasian

Year graduated P2 P2 P2 P4 P3 P4 P4 P4 P3 P3 2006 2003 2000 2001 1995

Nationality New Zealand New Zealand New Zealand New Zealand Malaysian New Zealand Malaysian Malaysian New Zealand New Zealand Malaysian New Zealand New Zealand New Zealand New Zealand

Gender M F F M F M M F F M F M M F M M F

Occupation Student Student Student Student Student Student Student Student Student Student Community pharmacist Community pharmacist Lecturer Lecturer Community pharmacist Part-time lecturer/Pharmacy owner/ Locum Lecturer/ Consultant/ Researcher

Caucasian 1988 New Zealand Caucasian 1984 New Zealand Table X: Interviewee demographics

Each interviewer conducted at least one practice interview with a non-pharmacy related person to best determine how to phrase questions to elicit a well thought response. The interviewees were made aware their contribution was anonymised by removal of all identifiable information. Interviewees had the right to withdraw at any point during the interview or chose not to answer a question. All data were stored on password protected computers. Interviewees were selected in a non-randomised method. During the interviews, the data was collected with various ways. While most of the interviewers used a voice

recorder, other interviewers had to resort to other methods such as note-taking due to limited resources at the time. To increase efficiency some of the interviews were conducted in pairs. Due to time constraints, not all interviews were fully transcribed and not all interviews were conducted face-to-face. Interviewees were given the option of either a face-to-face interview or via email correspondence. Some interviews were carried out by email correspondence, especially the past students of school of pharmacy because it was more convenient.

The interviews were analysed thematically. This is detailed in the chapter titled Thematic Analysis in the book Principles of Social Research. In brief, this analysis was started by an initial coding of the interviews. Each interview was read in detail with notes written on each interview with a view to understand what was said. These notes were then collated and discussed in detail by the project members. Using the ‗Cut and Paste‘ method where interview extracts were collated together under the same heading on a Microsoft Word document, common themes emerged. By this method it became apparent what the majority and minority of the students perceived.

Results and discussion: The Origins of Pharmacy at the University of Otago The first hint of pharmacy in the University of Otago started off in 1883 with a subject taught to medical students called Materia Medica by the Faculty of Medicine. According to the university calendars this subject included the preparation, description, properties, physiological action, therapeutic uses and doses of drugs and pharmaceutical preparations. It also included the classification of remedies according to action as well as the art of prescribing.

In 1892 the subject Practical Pharmacy was introduced to medical students in addition to Materia Medica. Classes were conducted by the dispenser at the hospital. This was still under the Faculty of Medicine.

In 1930 both Materia Medica and Practical Pharmacy were replaced by two subjectsPractical Pharmacology and Pharmacology and Therapeutics. These remained in the syllabus of medical students under the Faculty of Medicine. This change marked the shift of focus towards Pharmacology. Following this, in 1959, Pharmacology and Therapeutics was listed as a paper for the second medical professional examinations which Bachelor of Medicine and Bachelor of Surgery students have to pass. This was described as practical pharmacy which was concerned with the action of drugs in health and disease whereas Practical Pharmacology was described as a Pharmacy class which was offered to students doing a Bachelor of Medical Science degree or Master of Medical Science degree. Practical Pharmacology did not appear in the calendars after 1961 but Pharmacology and Therapeutics carried on.

Up until 1962, there was no mention of either a Pharmacy or Pharmacology department although there was a Therapeutics department listed under the Faculty of Medicine. Pharmacology lecturers including the then Senior Lecturer Frederick Noel Fastier were from the Department of Medicine of the Faculty of Medicine so it would appear that Pharmacology was administered by the Department of Medicine.

In 1963, there was a change to this structure. Pharmacy became a department by itself under the Faculty of Medicine and the Administrative Head was Frederick Noel Fastier who was still at that time an Associate Professor in Pharmacology. However in 1964, Pharmacy and Pharmacology merged into one and that was the start of the Pharmacology and Pharmacy

Department. This partnership ended in 1970 when each became a separate department Pharmacology became a department of its own under the Faculty of Medicine while Pharmacy came under the Faculty of Science.

In 1971, Professor F.N. Fastier who was listed in the Department of Pharmacology returned as Acting Administrative Head to the Pharmacy Department. In 1972, Professor F N Fastier became Chairman of the Department of Pharmacology so Professor H Taylor took over as Head of the Pharmacy Department and he occupied this position until 1981. In the University‘s calendar of 1982 there was no named Head of Pharmacy so it can be assumed that the position was not filled for that year. In 1983 it was indicated that Professor Donald G Perrier led the Pharmacy Department but there was no mention of his title. 1985 marked the return of the Pharmacy Department to the Faculty of Medicine and probably the last year of Professor Perrier‘s administration. In 1986 the position of professor was once again vacated. In 1987, Professor Michael S Roberts assumed leadership (his title was not mentioned) until 1989 when Professor Peter F Coville became Chairman of the Department. In 1990 the Division of Health Sciences was started and the Department of Pharmacy came under the Otago School of Medicine. In 1991, Professor Coville became the first Dean of the Pharmacy School which was still under the Division of Health Sciences but separated from the Otago School of Medicine. In 1999, Professor Ian G. Tucker became Dean and in 2011, Professor Stephen Dufful took over the position.

As indicated in the University‘s calendars, the leadership of the Pharmacy Department and later the School of Pharmacy are listed as follows:

Table X: Leaders of the School of Pharmacy throughout the years. Period 1963 1971 1972-1981 1983-1985 1987-1988 1989-1990 1991-1998 1999-2010 2011Name of Professor F.N. Fastier F.N. Fastier H. Taylor Donald G. Perrier Michael S. Roberts Peter F. Coville Peter F. Coville Ian G. Tucker Stephen Duffull Title Administrative Head Acting Administrative Head Head Chairman Dean Dean Dean

Although the Bachelor of Pharmacy course first appeared in the calendar of 1960, the first graduates were only in 1965. On the other hand, the Pharmacology course was offered to postgraduate students only as Postgraduate Diploma in Science from 1976 to 1985 and it was only in 1986 that Pharmacology began to be offered as a Bachelor of Science degree.

In 1988, Pharmaceutical Sciences was introduced to postgraduate students as Postgraduate Diploma (PHSC4) and Masters in Science (PHSC5). Although Pharmaceutical Sciences continued to be mentioned in the calendars up to 1993, PHSC4 was effectively not offered from 1992 to 1993. Pharmaceutical Sciences was eventually not listed in the postgraduate courses but incorporated in the pharmacy undergraduate curriculum. Coincidentally it was also in 1993 that Pharmacology started offering more papers.

The evolution of the BPharm degree examinations The course as current undergraduate pharmacy students know today has evolved dramatically over the years. In retrospect the focus of the course had shifted from one that was structured predominantly on the pharmaceutical sciences to one that has more elements of therapeutics and pharmacokinetics as when in 2002 the Quality Use of Medicines was first introduced as a subject. There were many changes over the years from 1960 with the last change in 2009

when Essentials of Drug Action replaced Foundations of Pharmacology for Pharmacy. Another change was the addition of the practical aspects of being a pharmacist which can be seen in 1993 when externships were incorporated into the second, third and fourth years and in 1984, with the introduction of Pharmacy Practice and Professional Practice.

For the first year there were three subjects namely zoology (B Art), physics as in fundamental principles of physics, heat, light, sound, electricity and magnetism and chemistry 1 (B Art). This first year examination was the intermediate examination prescribed in the regulations for the Degrees of Bachelor of Medicine and Bachelor of Surgery and all the conditions also apply to Pharmacy students. Currently this same examination has been extended to other students aiming for bachelors‘ degrees in health sciences disciplines such as Dental Surgery, Medical Laboratory Science and Physiotherapy. Re-named Health Sciences First Year, the current year (2012)‘s subjects are Foundations of Biochemistry, Cell and Molecular Biology, The Chemical Basis of Biology and Human Health, Human Body System 1 and 2, Biological Physics and Foundations of Epidemiology. From three basic science subjects in 1960, first year Health Science students must currently obtain passes in seven subjects to proceed to the next year of their chosen fields. Along the way subjects like Mathematics and Statistical Methods and language and communication subjects were added and discarded.

Changes continued on through the years. Year 2 Pharmacy students in 2012 are studying for subjects like Microbiology and Immunology, Physiology, Biochemistry, Physical Pharmacy A and B, Biopharmaceutical Chemistry, Introduction to Drug Action, Quality of Medicines and Principles of Pharmacy Practice as compared to the original year 2 subjects in 1960 which were Pharmaceutical Chemistry 1 (2 papers) or Chemistry 2 (B. Sc) and Physiology including Biochemistry or Physiology 2 and Biochemistry 2 (B. Sc). The number of subjects

which started increasing in 1984 reached a total of ten in 1998 but dropped down to nine the following year and this number has remained till today although changes were made to the subjects offered.

Year Four Pharmacy subjects in 1960 total three and continued to dwell on pharmaceutics as two of the three subjects were Pharmaceutical Chemistry 2 (2 papers) and Pharmaceutics 1 (2 papers) while the third was Microbiology 2 (B. Sc). This emphasis carried on till 1975 when Pharmacy 2 (3 papers) appeared on the scene and in the 1980s when Pharmacy Practice, Anatomy and Diseases in Man were introduced. Biopharmaceutics and Pharmacokinetics were introduced in the 1990s. More subjects were added on through the years reaching a total of 12 subjects in 1988 (inclusive of a research paper for Honours students). Year 3 Pharmacy students take on 7 subjects currently and these are Human Diseases, Essentials of Drug Action, Drug Delivery Systems, Drug Disposition and Pharmacokinetics, Professional Pharmacy Practice A and B and Quality Use of Medicines A.

Similarly for Year Four the shift to Pharmacy appeared in 1975 with the inclusion of Pharmacy 3 (5 papers) and developed further in 1984 when Pharmacy 4 (6 papers) and Pharmacy Practice 3 as well as Professional Practice were among the subjects Pharmacy students had to take. Pharmaceutical subjects such as Pharmaceutical Manufacturing, Pharmaceutical Technology and Pharmaceutical Sciences remained until 2002. Clinical Pharmacokinetics was examined from 1987 until 2002. From 2003 onwards the total number of subjects Year 4 Pharmacy students had to take dropped to four and these remained unchanged until the present year, 2012. These are Professional Pharmacy Practice C, Elective Study, Quality Use of Medicines B and C. Subjects for Year 4 of the Bachelor of Pharmacy

Degree in 1960 were Pharmacology (2 papers) and Pharmaceutics 2 (including Pharmacognosy and Forensic Pharmacy).

The following will give a clearer comparison of the subjects in 1960 and 2012: 1960 Year 1 - Zoology (B. Art), Physics, Chemistry 1 (B. Art) Year 2 – Pharmaceutical Chemistry 1 or Chemistry 2 (B. Sc), Physiology including Biochemistry or Physiology 2 and Biochemistry 2 (B Sc) Year 3 – Pharmaceutical Chemistry 2, Microbiology 2, Pharmaceutics 1 Year 4 – Pharmacology, Pharmaceutics 2 (including Pharmacognosy and Forensic Pharmacy)

2012 Year 1 – Foundations of Biochemistry, Cell & Molecular Biology, The Chemical Basis of Biology & Human Health, Foundations of Epidemiology, Human Body System 1, Human Body System 2, Biological Physics.

Year 2 – Microbiology & Immunology (for BPharm), Biochemistry (for BPharm), Physiology (for BPharm), Physical Pharmacy A, Physical Pharmacy B, Biopharmaceutical Chemistry, Introduction to Drug Action, Quality of Medicines, Principles of Pharmacy Practice

Year 3 – Human Disease, Essentials of Drug Action, Drug Delivery Systems, Drug Disposition & Pharmacokinetics, Professional Pharmacy Practice A, Quality Use of medicines A, Professional Pharmacy Practice B

Year 4 – Elective Study, Quality Use of Medicines B, Professional Pharmacy Practice C, Quality Use of Medicines C

Pharmacy Postgraduate Studies When Bachelor of Pharmacy first appeared in the calendar in 1960, no other course was offered under Pharmacy. It was only in 1965 when a second course, the Master of Pharmacy was offered. Later in 1976, when Pharmacy was under the Faculty of Science, the Bachelor of Pharmacy with Honours degree was added.

From 1985 to 1991, due to the return of Pharmacy into the Faculty of Medicine, pharmacy graduates had similar options as medical graduates and could select from a variety of medical postgraduate diplomas which were offered apart from the Master of Pharmacy degree and the Bachelor of Pharmacy with Honours degree. It was not until 1988 that three more pharmacyrelated postgraduate courses became available: Postgraduate Diploma in Hospital Pharmacy, Postgraduate Diploma in Pharmacy Practice and Certificate in Pharmacy Practice.

In 1992, these five postgraduate courses were offered exclusively to Pharmacy students reflecting the fact that Pharmacy was run from a school of its own, the School of Pharmacy. However, in 1993, the Certificate in Pharmacy Practice was dropped and in 1994 the Postgraduate Diploma in Hospital Pharmacy and Postgraduate Diploma in Pharmacy Practice were replaced with Master of Clinical Pharmacy, Postgraduate Diploma in Clinical Pharmacy and Postgraduate Diploma in Pharmacy. In 1998, the addition of Postgraduate Certificate in Pharmacy brought the number of postgraduate courses to six. However, 1998 was also the final year when the Bachelor of Pharmacy with Honours was offered.

As the Master of Pharmacy course is no longer offered from 2012, the following are the current postgraduate courses offered under Pharmacy: -Master of Clinical Pharmacy -Postgraduate Diploma in Clinical Pharmacy -Postgraduate Diploma in Pharmacy -Postgraduate Certificate in Pharmacy

Why study at the University of Otago? Interviewees commonly spoke about choosing to study at the University of Otago as a means to increase their personal independence from their family in their home city. One P4 student who grew up in Auckland believed that the choice between Otago and Auckland was easy,

―So the only other place you could study pharmacy was Auckland. I wanted to get away and live away from my parents – to gain some independence. I thought moving to Otago to study, gave me that opportunity.‖

The challenges that may have come about with moving to a new city for this student were mitigated by the ―really good supportive services making that transition so I think, think living at a Hall made it really easy to move out.‖ A P2 student also spoke of a similar choice, stating that if he attended Auckland University he would have been forced to live with his extended family – something she detested, forcing her to choose Otago. Some Malaysian international students who were on government scholarship stated that their government had supported them to attend Otago University, leaving these students with no other choice. Other international students chose Otago University because Auckland University Pharmacy School do not offer places to international students

(http://www.fmhs.auckland.ac.nz/faculty/undergrad/bpharm/entry.aspx). One student spoke about Otago being in close proximity to their home town making the choice simple, while other students chose Otago for its excellent health sciences reputation. The above P4 student that chose Otago over Auckland University reflected on that decision and believes that coming to Otago has been a good decision.

―Compared to a lot of my friends who stayed in Auckland I am more World Orientated… I think the friendships that Otago students have are far stronger and intimate than the friendships formed by Auckland students. I suspect with many students in Auckland they live at home with their parents and I know that with my friends they do that they still live with their parents. Their lives and the activities that they can do are highly limited by what their parents allow them to do so they can‘t just have friends over, they can‘t run the house how they want like we can in Dunedin.‖

The students above who spoke of a choice between Otago and Auckland Universities were current students or past students who graduated in recent years. Before the establishment of The University of Auckland School of Pharmacy in the year 2000 (http://www.calendar.auckland.ac.nz/archive/2006_Calendar.pdf ), which introduced another layer of choice for prospective pharmacy students, Otago University was the only New Zealand tertiary institution that offered a pharmacy course between 1991 and 2000. Prior to 1991, prospective pharmacy students had the choice between Otago and the CIT located in Wellington. Interviewees that chose Otago over CIT to study pharmacy during this time period commonly stated that the diploma in pharmacy offered by CIT was less attractive than the the pharmacy degree offered by Otago. One interviewee that attended Otago between

1982 and 1984 stated she chose Otago to study pharmacy over CIT as she wanted to pursue an academic pharmacy career. ―At that time, there were two places to do pharmacy in NZ. There was the programme which took 25 students a year at Otago, Bachelor of Pharmacy. There was a course up in Wellington which was called CIT - Central Institute of Technology -which is now closed and they ran a much larger course ummm…it was probably really orientated towards community pharmacists and then sometime after I graduated that site was closed down and all those students essentially went to Otago and the faculty came to Otago as well and this all became much bigger…in those days it [Otago] was a very science orientated programme, it was very much orientated towards hospital pharmacy and pharmaceutical science for the pharmaceutical industry...‖

As stated in that quote, the CIT was closed in 1991 to amalgamate with Otago University to create the Bachelor of Pharmacy degree we now have today.

Why study pharmacy? The majority of those interviewed stated that pharmacy was not their first choice as a health professional course, with medicine and dentistry commonly their first choice. One P4 student responded in the typical fashion as the majority of interviewees stating, ―Well…to be honest I originally came here to try to study Dentistry but that didn‘t work out so I went to Pharmacy instead…Wasn‘t my first choice but I‘m glad I came here to be honest.‖ One practicing pharmacist did not gain entry into veterinary studies at Massey University so chose to study pharmacy at Otago, reflecting that ―their loss, School of Pharmacy‘s gain."

On the flip side some chose to study pharmacy because they felt a vocational pull into the profession. Some interviewees spoke of having family members who are pharmacists sparking inspiration for their entry into the profession. A practicing pharmacist reflected that pharmacy was a driving interest as a career path since he was eight years old as he ―loved the smell and what they did.‖ Interestingly, this interviewee who enthused about his career choice did not have a family member who was a pharmacist or any substantial contact with the profession, the driving force behind him being ―something that did not give up on me.‖ A few interviewees were initially interested in non health professional courses, but after some consideration pharmacy was their desired course. For example, a P4 student that was initially interested in a degree in pharmacology and toxicology changed his mind to pharmacy after discovering that he liked the ―idea of interacting with patients in my day to day career so I decided to pursue pharmacy.‖

Reflection of the time in pharmacy school Irrespective of the interviewee‘s reasons for entry into pharmacy most expressed they enjoyed their time at pharmacy school. Most past students felt that ―it was a good experience‖ while some current students feel that even though they have enjoyed their time so far, they ―hope the studies would be more patient focused soon or in the upcoming years.‖ Many interviewees believed they managed to balance their pharmacy study with their extracurricular activities to create a good student experience. Some past students mutually agreed that pharmacy allowed them to cherish the close friends they made in the course through ―spending many hours together in labs, tutorials and so on.‖

White Coat Ceremony New Zealand‘s National School of Pharmacy held an inaugural White Coat Ceremony on Saturday 25th of February 2012 in the Hunter Centre, Dunedin (facebook ref). Professor Stephen Duffull introduced the ceremony to the school for two significant reasons.

―I wanted to instil a sense of pharmacy identity into the P2 students. In this sense, identity was intended to mean the student would identify themselves as part of a profession and in particular as part of the profession of pharmacy. The goal is for students to think of themselves as pharmacists-in-training and be able to distinguish this cultural identity from being a student. Clearly we are keen for students to embrace both cultural identities (university student and pharmacist-in-training). I also wanted to welcome students from HSFY [Health Science First Year] into pharmacy. Previously we had no formal method for recognising the great success that students have in being admitted to the Bachelor of Pharmacy degree.‖ (Personal communication ref)

During the ceremony students were presented with a copy of the School‘s Professional Code of Conduct and a new Dispensing Coat embroidered with the School‘s logo (facebook ref). The first White Coat Ceremony was held in 1993 at Columbia University College of Physicians and Surgeons for medical students, while for pharmacy students the first ceremony was held at the University of Kentucky in 1995 (ref). A number of studies and a task force during the early 1990‘s determined that there was a general negative disposition among pharmacy students towards their profession, with these attitudes becoming more negative as they progressed through school (ref). One study declared that pharmacy teachers are responsible for instilling a sense of professionalism in pharmacy students and

encouraging each student to develop a personal practice philosophy. The White Coat Ceremony is an attempt at developing that professional attitude, with 73% of the schools of pharmacy in the United States as of 2002 conducting an annual white coat ceremony (ref). However, little is known about the pharmacy students‘ perspective of this ceremony. The majority of students that were interviewed liked the idea of the White Coat Ceremony. The following quotation from a P4 student pithily summarises the viewpoint held by most interviewees.

―I think it is an excellent idea – it is another one of those things that goes along with the code of conduct and name badges and all that stuff that helps pull together a very coherent and strong pharmacy school that will produce very passionate and competent graduates. It shows that the school takes itself seriously as a pharmacy school in NZ.‖

However, one P2 student held a minority viewpoint. Initially expressing that they liked the ceremony, this student continued on to state that the ceremony was a waste of resources, ―Perhaps some of that money could have gone into somewhere else quite frankly… Better reinvestment of funds, you know.‖ One practicing pharmacist was unsure about the worth of the ceremony, ―I guess. Does it involve drinking? Other than as an intern I‘ve never worn a stupid white coat. As a purely symbolic ceremony, hey, why not!‖

One can see the introduction of the White Coat Ceremony has generated different viewpoints, with the majority of those interviewed in favour of the ceremony. Brown et al. stated ―the efficacy of the ceremony cannot be evaluated solely on its own merit; it must be viewed as part of a comprehensive set of educational strategies.‖(ref) While the impact the ceremony has had on professional socialisation remains to be seen or measured, it does appear that the

ceremony is here to stay with a definite ―Yes‖ from Professor Duffull when asked if the ceremony will continue in future years (ref).

Figure X: Professor Stephen Duffull & Dr Rhiannon Braund engage with P2 students at the White Coat Ceremony on Saturday 25th of February 2012

Social life of pharmacy students Students who came to Dunedin from around New Zealand and internationally commonly expressed that they did not have family networks in Dunedin, and hence social connections that were forged at pharmacy school were crucial to the students‘ social life. In the past there was a Pharmacy students association which was renamed to New Zealand Association of Pharmacy Students of Otago (NZAPS-O) in 1995. An attempt at facilitating these social connections was the New Zealand Association of Pharmacy Students Otago (NZAPS-O) which was formed in 1995. The main reasons students joined NZAPS-O was they believed it would provide an enjoyable experience along with their pharmacy education. In the past being a member of NZAPS-O was beneficial for mainly drinking and partying resulting in some students not joining. Currently discounts extend to other areas such as eating venues, over the counter purchases at pharmacies and shuttle services. Some current students did not join because of the perception that most of the activities organized are centred around drinking and are ―retarded and pointless.‖ Some students feel more activities should be organized that do not relate to drinking as it not acceptable to all cultures and should be in the interest of all the students. Students who normally joined NZAPS-O did lots of activities outside pharmacy school and so would have more friends outside pharmacy who they would invite to the NZAPS-O events. One pharmacy student stated that NZAPS-O provides information on courses and training, which was the main reason he joined.

Nowadays, the prominent role NZAPS-O plays is exemplified with the following events on the social calendar: the Pharmacy ball, the International food and desert night, a formal graduation dinner, a P2 camp, Wine and Cheese night, a bus pub crawl, Southern man/Miss Pharmacy, St Patrick‘s day celebration and a ski trip. The events that are favourites of today‘s pharmacy students include the pharmacy ball and the revue which satirises life at the

pharmacy school. A practicing pharmacist recounted that the annual Happy Hours event was ―the legendary event‖ of the time he was at university, although it is now no longer offered by NZAPS-O. Other past events that are no longer offered include: staff versus students rugby, an international barbeque night, ten pin bowling, and a P4 Pharmbake tour that involved a variety of activities over a three day period (yearbooks).

At Otago University, drinking has become a recognised part of the student culture and, to some, an increasingly big area of concern. One past year student stated, ―We never felt the need to burn stuff and trash people‘s homes.‖ Some international students upon arrival to Dunedin found this drinking culture shocking, but slowly they acclimatised. A P3 international student stated ―I got slowly used to it because I‘m not involved in drinking.‖ Drinking is part and parcel of most pharmacy student events with this social convention increasing in prevalence over the years according to opinion from students. Some students expressed that they did not appreciate the drinking focus of the events and hence did not attend many of them on offer. A P2 student believed that, ―in the past years Dunedin was the centre of rock and roll and students knew how to have fun. Whereas nowadays it is just about drinking too much that it can‘t be handled by the students and vomiting it all out.‖ Activities outside of pharmacy that past pharmacy students commonly enjoyed included: bike racing, socialising at the pub and going for a walk in the Botanical Gardens. Today‘s pharmacy students generally spend their spare time exercising at the gym, surfing the internet, socialising on Facebook and watching movies. Some students had part time jobs unrelated to pharmacy such as working in an architecture firm.

Figure X: Pharmacy student social life. Top: pharmacy students from an unknown year play rugby. Bottom: the 2012 NZAPS-O committee

Experiential learning Pharmacy placements were part of the course since 1986, as recalled by an interviewee, but it was only made an official part of the pharmacy programme in 1993 (R findings). Past students thought that experiential learning was poorly structured. A practicing pharmacist that graduated in 1986 stated that he participated in community and hospital placements, along with a visit to a pharmaceutical company. The pharmacist recalls on his hospital placement, ―Sitting down with a whole lot of clinical case notes and doing nothing else. It was more hands on, with no manual, set activities, or professional assessments.‖ While the pharmacist recalled a lack of structure, he acknowledged placements are hugely important and provide a means for undergraduates to check their knowledge against the standard expected in

community and hospital pharmacy. Another interviewee who studied in the early 1980‘s also told of no set placements incorporated into the course, with their internship providing more pharmacy experience:

―[No] Formal ones, yea so some people might work in a community pharmacy...more like a part time job...because I was working in a hospital - I think I spent one week in a pharmacy in Levin, that was my community experience to give me some community experience. Erm, but during my programme in the school , the only time we would have had community experience was we would have a day or two in different community pharmacies...during my internship I was allowed to do a week of community pharmacy in Levin, while I was based in Palmerston North Hospital and that was to give me exposure to community pharmacy while I was doing my internship. When I was doing my internship, I think that was almost the first time they were trying to structure the internship objectives and goals...so I was like a guinea pig when they were starting to think about ways to ensure that interns got certain kinds of experiences during their internship and formalising all that…So I‘m a fossil - I date way, way back.‖

A pharmacist who graduated in 1995 detailed a placement programme that was radically different to that of the 1986 student. The placements were two days of community placement in P2, one week placement in a community pharmacy in both third and fourth year, and one week hospital placement in fourth year. It was assessed in the form of a work-book. Although the student could not recall the activities on these placements, he did recall a lot of standing around and observing.

The pharmacy students of today have a very similar experience to the 1995 student, with the exception of the community placement in third year being a one week rural placement which was incorporated into the course later. Activities common in hospital placement includes for present students: GP clinic visits, aseptic dispensing, ward visits, medication history taking, processing prescriptions and medicines reconciliation. Activities common to community pharmacy placements include: differential diagnosis, legality checking, prescription calculations, processing of prescriptions, stock checking and blister packaging. While students expressed that they initially find it difficult to get used to the pharmacy environment, many students enjoy the placements with some students desiring more time on placement to further understand the role of a pharmacist. Students feel there is wide variation in the way preceptors mark the placement manuals, with some preceptors marking strictly and awarding little marks, whereas some students get full marks with relaxed preceptors

Current students expressed that along with the contract changes that have come into force this year, community pharmacy preceptors were busy and had little time for mentoring the students, as such they had to spend time outside the dispensary.

In 2002 a week long Melbourne trip was organised consisting of 50 students giving them the opportunity to experience industrial pharmacy along with shopping, entertainment and partying. In this trip the pharmacy students had presentations on the opportunities available in the pharmaceutical industry. The trip also involved interactive sessions, factory tours, presentation on marketing and Australian law. A tour of the Victorian College of Pharmacy was described by the students as, ― ... we soon realised just how small our Otago school was.‖ The students described the trip as ―the experience that the other years should jump at, it was a

real eye-opener there are so many opportunities for pharmacists out there that we aren‘t exposed to in our training here [Otago]‖(year book ref)

A new experiential placement was introduced in 2012 titled Inter-professional Education programme (IPE). University of Otago health professional students - pharmacy, medicine, physiotherapy and dental - in their final year of study spent five to six weeks in collaboration together located in and around the Gisborne region in association with the Tairāwhiti DHB and primary health care providers. Each week of the placement had a different theme: interdisciplinary appreciation and patient-centred collaborative practice, rural health care, Hauora Māori, and chronic conditions management. To develop the students‘ understanding of these themes scheduled, visits to health providers in the Gisborne area was facilitated. Wilson Shen stated the following on his overall experience;

―The Tairawhiti IPE programme was an undergraduate experience that you could not get anywhere else! Not only did it provide us with the standard community placement experience, the programme threw us into an assortment of educational and eyeopening adventures. I encourage all students to consider this inter-professional placement.‖

Figure X: IPE students with pharmacy school staff (L-R): Mr James Windle, Soo Foong Chew, Andrew Davis, Campbell Hewson, Wilson Shen & Professor Pauline Norris

Graduation The colour of the graduation hood has been spectrum green ever since the inaugural graduation ceremony in 1965. Emeritus Professor F.N. Fastier recounted in his book Pharmacy Teaching at Otago University: How it began, that he rejected the ―garish yellow‖ colour initially offered by the university for pharmacy graduands. Fastier subsequently went on a shopping expedition for a new hood colour and declared ―That‘s it!‖ when a piece of green cloth was presented. Fastier concluded that ―Any pharmacy graduands who dislike their hoods will now know whom to blame.‖ (Fastier book reference). Three graduates when interviewed said the pharmacy hood colour was blue, although no evidence has been found of any changes made to the present colour of spectrum green colour to support this.

The parade along George Street has been a fixture of graduation for a long time where graduands are given the opportunity to be acknowledged by their friends and family. However, a past student who had graduated in 1984 recounted:

―Ah…in those days we didn‘t have a graduation parade. My parents were late anyway and their car actually got towed because they parked in the wrong spot. But we did make it on time to my graduation. We just went to the Town Hall, we were seated and all the students went up when their names were called and walked across to receive their certificate. And there was a reception that evening.‖

Overall, most interviewees illustrated a similar graduation ceremony experience with little change over the years. The theme of a simultaneously ―sweet and sad experience‖ was shared by many. The content feeling of achieving a milestone in their life was tempered by the sadness of leaving the close friendship network they had at pharmacy school. An interviewee who graduated in the year 2000, felt that students who ―had secured their internships felt much more at ease and enjoyed their time at the graduation ceremony and parade.‖

The options of graduation ceremonies in May, August and December were not available to all the past students. The May graduation was initially the only graduation ceremony due to the delay caused by exam papers being sent overseas to be marked. According to a Critic Magazine in 1999, a graduation ceremony in December was introduced later which became open to all students which would have been popular for students going abroad. This was supposed to be introduced a few years earlier but due to issues raised from some students, was not followed on. Over the years it has become apparent that the social gathering before or after the graduation ceremony has been organised more by the student body rather than the school of pharmacy. Morning tea and a formal dinner has been among the main events organised by the students. However, according to the Critic magazines (1976-1977, Volume 53), there used to be a

Grad‘s Ball on the evening of the graduation day which rounded off the days events. At present, there is no such event on offer for the graduands.

1965

1973

1976

1981

1984

1992

1991

2003

2006

2009 2010 Figure X: The pharmacy graduating class throughout the years

2011

Summer studentships The main objective of providing summer studentships, according to the School of Pharmacy website, is to ―encourage the students to undertake a research project in any field relevant to pharmacy‖. Summer studentships emerged from the cessation of the honours programme, Ann Walker, a pharmacy school laboratory technician, stated: ―I wasn‘t really sad to see the Honours programme go, as some of the Honours students used to go without sleep for days to get their projects written up in time – and then there was the Honours student who attempted suicide by carbon monoxide poisoning because the pressure got too much. Honours was replaced by the Summer Studentships‖(Campbell’s ref 2005 NZAPS mag)

From majority of the interviews it is clear that summer studentships were offered within the school of pharmacy as far back as 1988. Past students recollected that the summer studentships were not offered to the class as a whole and were reserved specifically for Honours and international students. At present, the website entails general guidelines, a selection criteria and a list of the projects available for the programme. According to most of the interviewees, the students‘ choice of taking up a summer studentship was influenced largely by the range of projects given. Social pharmacy, clinical pharmacy and pharmaceutical science projects are typically offered today. Gleaned from the interviews social pharmacy projects were introduced later compared to clinical projects which were initially on offer. Over time social pharmacy has become a more prominent aspect of the pharmacy curriculum and hence summer studentship projects. This is evident through the introduction of the Professional Practice papers in 1984 which aimed to, among other objectives; increase the students‘ awareness of social pharmacy (exam ref from R)

Current pharmacy students opined that one of the main incentives for undertaking a studentship was the monetary gain of a scholarship, ―getting the money‖. In contrast, one past student believed that having a job over the summer "paid better" than undertaking a summer studentship. Building professional relationships with lecturers, learning new experimental techniques, making new connections with fellow students and "the chance to lead to further employment within the department" were positive outcomes from summer studentships for both past and present students. For some current and ex-students who would have liked to pursue a project, the timing of these projects was inconvenient as they had the desire to spend time with family and friends after a busy year of studying.

Figure X: Summer students 2011/12, (L-R) Arnold Lee, Hayneil Solanki, Joy Hu, Teresa Lepa, Catherine Fletcher, Wilson Shen, Suchaya Sanhajariya, Matthew Cross, Jessica Fairhall. Absent: Michelle Park, Campbell Hewson, Andrew Davis

Pharmacy student exchange Past students who were previously based at the Wellington CIT were not provided with the opportunity of a student exchange programme. A few past students stated that their ―curriculum was too demanding and faced quite a few financial constraints back in the day.‖ Student exchange programmes emerged as an extracurricular option for many students at the

University of Otago. Unfortunately, research of the School of Pharmacy yielded no such programmes. Interviewees were questioned on the prospect of having a designated exchange programme for the pharmacy programme and their feedback was documented. Most previous and present students expressed interest in undertaking a student exchange programme whilst highlighting the need for clinical exposure and assessment of the different roles pharmacists have in other countries. This assumption is based on the reasoning that ―encountering the unfamiliar and establishing new personal and specialist contacts help to broaden one‘s horizon,‖ and this may not have been achieved by studying an extra semester at university.

According to a recent Swiss university survey (ref), the prospect of travel and improving knowledge of foreign languages was the primary motivation for most participants in any exchange programme. However, this theory was not supported by majority of the past and present interviewees.

Another theory proposed by the above study was an aspiration to better current specialist knowledge. One current student expressed that he would like to undertake the programme just so that he ―could compare the different pharmacy models, how they are run etc. in order to get a good business perspective.‖ A P4 student confirmed this theory, ―Exchange programmes would give exposure to what the other side of the world is studying compared to what we do here in Dunedin.‖ Another beneficial factor that emerged from the interviews was establishing useful connections for the purpose of future job opportunities, with majority of interviewees expressing European countries as a popular site for an exchange programme. Overall, the idea of an student exchange was warmly welcomed by most current students unlike a few of the past students who would prefer a familiar place such as their home as their

study location. A past student verified this, ―No, I never felt the need to do one because I was quite comfortable with the study environment here at Otago.‖

While student exchanges have never previously been offered, Otago pharmacy students‘ participation in the annual International Pharmacy Student Federation (IPSF) world congress has developed close networks with other pharmacy students that has paved the way for a 2013 student exchange for one P3 student to Cezch Republic. The 2012 IPSF world congress was held in Egypt with four Otago school of pharmacy students in attendance along with 500 students from across the world. NZAPS-O 2012 President Jay Gong summarised the congress:

―It was an amazing experience getting to know other cultures and how pharmacy is practiced in their countries. It gave us a global perspective on pharmacy practises and how might the profession of pharmacy change in the future with new technology.‖

Figure X: School of Pharmacy students that participated in the 2012 International Pharmacy Student Federation (IPSF) world congress, Egypt. (L-R): Jay Gong (P4), Sara Ammar (P4), Brendon Mcintosh (P3) & Pareezat Rahman (P4)

International pharmacy students When the school of pharmacy was formally established in 1960 there were no international students. A past year student ascribed that the immigration policy in New Zealand had not been established at this time, hence international students in tertiary education was hindered. Gradually after the policy was developed, the number of international students in pharmacy increased. Data from the University of Otago International Office showed that between the years 2000 to 2012, the number of international students has slowly increased with a decrease in numbers between 2005 and 2009 due to the decline in enrolments from China, an occurrence at every New Zealand institution (see Figure X). This gradual increase was reflected in the interviews with past year students. A past year student who studied at the school during the1980s recalled that ―there was only one or two international students in their class.‖ Another past year student who studied at the school during the 1990s stated that there were about five to eight Malaysians in pharmacy during that year. In his opinion, ―there are not as many Asians as now, six Middle Easterns and many more Caucasians than now.‖

From some of the interviews with current students, most agreed that the diversity of the students has increased dramatically. From the interviews, some past year students stated that during their time most of the official international students were from the Middle East, with just a few from Asia. Current students said that most of the international students in pharmacy are from Asia, with Malaysians accounting for half the international pharmacy student numbers - many of whom are funded through government scholarships.

Figure X: The Number of International Students between the years 2000 to 2012

Postgraduate education Over the last twenty years, the postgraduate programme had been changed a lot. The biggest change is that the number of PhD students has increased, not just because the school has become larger, but also because more professors have come into the school and lead to more research topic. Laboratory equipment have become more specialised as well. Most people who did the postgraduate study found it is very useful and would regret if they did not choose to study it at the beginning.

Compared to the number of students in the undergraduate degree, the number of students in the postgraduate degree is relatively small. After interview some current students, it showed that some current P4 students are interested in postgraduate study, while most of the P3 and P2 students have not thought about it yet. There are many reasons why current students want to study postgraduate programme. A fourth year student stated:

―I am interested in a postgraduate study. Research is more interesting than just standing in a pharmacy all day. And I am not a hundred percent sure of my feelings it is somewhere towards pharmacokinetics or more likely formulation sciences. Other reason to do postgraduate is to be a lecturer.‖

A few other students also said that they are interested in postgraduate studies and wanted to pursue study topics such as clinical pharmacy as they thought it would be beneficial for those who wanted to go into hospital.

However, not all students are interested in study postgraduate at this stage. One P4 students thought that a four-year study period is enough and would like to work after the degree. One P3 student said, ―I have not thought about it yet, not at this stage. Because I think the most important thing to me is finish my degree, get a license and practice because I want to have a way to apply my knowledge. Post graduate studying means more studying in the school which I would probably do three or four years into my practice.‖

Many students harbour a desire to do postgraduate study while not many of them actually do. This is based on different reasons for each person. One of the international students from Malaysia said, ―... Otago has various postgraduate stuff that I [am] interested in, but I have to go back to Malaysia after graduation due to the contract and Malaysia doesn‘t have the same stuff and is more on general stuff and doesn‘t have the area I want [to]

specialize in and I want [to] specialize in clinical pharmacy stuff e.g. cytotoxic or antibiotic stuff can help with professional career and help to up skill the knowledge.‖

For one interviewee, postgraduate study is a second choice or back up plan. she said, ―... depends on whether I get a good position. if I don‘t, I would like to pursue further studies in the future.‖

Those who chose to study postgraduate had different reason. One postgraduate student stated that ―I just want to learn more and I felt that my learning has slowed down and I wasn‘t happy with that so I took up a paper.‖ Some students also thought that it has a large influence in clinical pharmacy and a way to progress in the hierarchy of the hospital.

Pharmacy student gender distribution According to three current students, there is a shift in the gender balance within the pharmacy profession with a steady increase of females entering this course. Students believe that in the future, pharmacy might be considered as a ―feminine profession.‖ Additionally, a lecturer who graduated in the year 2000 is of the opinion that pharmacy is now dominated by females as compared to earlier days when there were more male pharmacists.

From the early 1960s, the number of females studying pharmacy increased from around 10% to about 50% in 1970. The Vice-President of the Pharmacy Council suggested limiting the number of females entering pharmacy school but this was rejected by the training institutions during the 1970s and 1980s. In 1978, there were more female than male students at CIT,

whereas at the pharmacy school of Otago the ratio for male to female students was closer to 50:50 (Louise Shaw).

However, the ratio of females to males has increased at the Otago University. According to six past year students, who started at the School of Pharmacy between 1984 and 2003, there were more female students during their time at the Otago Pharmacy School. In 1984, the number of female students at the CIT and Otago University doing the pharmacy course was greater than male students with the ratio of 60:40 and this ratio remained the same during 2003 at the Otago Pharmacy School. Most current students believe that there are still more females than males at present, with approximately 60% the class female.

Is gender an issue in pharmacy? Pharmacy occupation in New Zealand has undergone a rapid change in its gender composition particularly in the 1970s and 1980s that marked a rapid feminization of the profession. This changing gender composition is closely linked to changes in the education and training of pharmacists. The move from an apprenticeship system to full-time tertiary education was an important factor in opening the profession to women by providing equality of access. (Louise Shaw)

From the interviews, majority of the interviewees thought that gender could be an issue in pharmacy. According to a P2 student, most lay people will have the idea of what gender a pharmacist and a pharmacy technician should be. A female P2 student believes that males usually struggle with compounding skills which could be due to their lack of cooking skills. The student stated,

―They have issues heating things up in the water baths without putting water into it and they don‘t know that it ruins it –much like how if you were going to melt chocolate to bake a cake or something, you put that in hot water right, but you don‘t want any of the water going into the chocolate right?‖

Therefore female pharmacy students may find it easier to develop extemporaneous compounding skills.

Both current students and practicing pharmacists typically articulated that pharmacy is a good occupation for females. Women with children might prefer a flexible career that allows them to work part time when raising children and pharmacy might be their choice as pharmacy locum and part time positions enable this flexibility. Furthermore, females are often seen to be more perceptive and caring towards the needs and problems of others as they are more sociable, which can be useful in patient interactions. In addition, a male practicing pharmacist who graduated in 1988 noted that females in pharmacy are important as they are able to make more firmer and clearer decisions than males and are ―going to drive a lot of things that we do in community.‖ He mentioned that females are outperforming the males with more females entering and graduating university than males, while males may be less attracted to the profession, in turn leading to the feminisation of pharmacy. A male pharmacist distinctly described the feminisation of the profession as the ―Cinderellaness‖ of pharmacy as an allied-medical profession overall.

Two pharmacists that graduated in the years 2003 (male) and 2006 (female) believe that most patients prefer to consult with a male pharmacist, particularly an older male who is perceived to be more knowledgeable. One practicing female pharmacist detailed,

―My boss who is a tall man and whenever patients approach us, they will go to my boss and think he is the pharmacist and it still happens today. There‘s still the perspective that between the two of us my boss looks more like a pharmacist than I do.‖

Furthermore, two male pharmacists (1995 and 2000) mentioned that women are underrepresented as owners of pharmacies, with ownership being less appealing to females. They perceive this gender imbalance can cause some problems in terms of ―workforce planning.‖ On the other hand, only a few current students did not think that gender is an issue in pharmacy. According to these students the main role of a pharmacist does not depend on gender, but on the efficiency of a pharmacist. Their view was; no matter the gender the basic job of a pharmacist is solely dispensing drugs.

Although gender and pharmacy was historically an issue, today females are generally accepted in the profession. The current issue is that of the patients‘ preference. A P4 student insightfully recognised that a patient may be more comfortable discussing some health issues with either a male or female pharmacist and that this is applicable to all health professions.

Pharmacy School – the best and the worst aspects Interviewees were asked about their most favourite and least favourite aspects of the School of Pharmacy. Over the years it has become apparent that the pharmacy school staff are one of the best aspects of the school. A P4 student stated that Kathy Ferguson, Undergraduate Administrator, is a favourite of his, ―I really like… Kathy, the admin staff she is really

friendly she knows what she is doing and she is so competent that everything runs smoothly when she is in charge.‖ While a P2 student has an appreciation for most of the academics.

―Professor Duffull is really, really quite cool. Erm, Dr Green is a little bit… weird. [Laughs] No, at times, he can be weird at times, but he is really, really awesome and he‘s really, really chill about everything. You can go up to him and say, ‗Yo, what‘s up Dr Green?‘ And he‘ll actually respond. Dr Walker is awesome. He is awesome – I mean the things he researches on – really, really, really, really amazing.‖

Students also enjoy the way the curriculum is taught. Many of the interviewees appreciated the QUM papers and the self-directed learning that goes along with it. Students enjoy the opportunity to take certain medicines in pharmacology to understand the effect it has on the body, while one student admitted that she did not appreciate the report writing that had to go with these laboratories.

When questioned about their least favourite aspect of the pharmacy school, interviewees believed that some components of the course need to change. Many past and present students did not like ―Some pretty boring medicinal chemistry lecturers,‖ while a P4 student believes pharmaceutical sciences are explored too much, ―We spend too much time doing dissolution stuff – way too much time. We spend too much time of the pharmaceutical sciences in the first two and a half years and not enough on the clinical stuff.‖ Other responses included the Adams Building being ―absolutely horrific and atrocious looking‖ and in need of ―a remodel one way or another.‖ Two current students believe that pharmacy students need their own common room to socialise and study in. Another two current students expressed that the

quality of students admitted into pharmacy school is lacklustre. A P4 student was not impressed with the intellectual capacity of some students.

―It‘s too easy to get in, the calibre of some people that get in is incredibly low it‘s unbelievable really. I do know some people that got 51% in one of their papers in health sci – I just think that‘s not on. I think the criteria for getting into pharmacy school should be stricter, I think there are too many graduates coming out of the combined pharmacy schools.‖

While a P2 student was not impressed with the motivations for his fellow students decision to do pharmacy. ―So you‘ve got that group of people who really wanted to do Medicine and didn‘t get in –so they are all bitter about it and say, ‗Oh we are never going to earn enough money…my life sucks and I am going to spend my entire life creating creams and ointments.‘ And then you‘ve also got this group of people who want to become pharmacists and do not do anything else for the rest of their lives which is fair enough – however they are also extremely lazy. That‘s what I really, really, really don‘t like about pharmacy. Just the people. How I wish there were some more people who are passionate about pharmacy.‖

Feedback Most of the students would like to have more placements throughout their pharmacy course. According to the students, four placements throughout pharmacy course are not enough and one P2 student added that ―adding more placements could help with promoting professionalism in this field.‖ More placements earlier in the course may create a sense of

identity with the profession potentially increasing professionalism throughout the course. Students also suggested the lectures and course contents should be reorganised so they are evenly loaded and do not have overlapping content. One of the P4 students stated that ―lecturers need to have another way of presenting their information such as putting in more pictures. The information we need to know - sometimes they go too technical.‖ However, there were also a few pharmacists mentioned that the pharmacy course is quite well structured and not many changes are needed.

The majority of those interviewed stated that pharmacy course does partially equip students for the real working life as a pharmacist. According to one of the pharmacists, the pharmacy education was excellent and has covered a whole range of materials that students need to learn. However, community pharmacy is also part of a business which he thought ―in a business acumen sense this almost set up graduates to fail in the real world.‖ P4 students also stated that ―school can never equip students to be fully prepared for the real world…From the knowledge part yes, but from the interaction, practical and social, no.‖ Besides, according to another pharmacist, it is not possible for the school to teach everything that students need to know when they practice as a pharmacist. Therefore, only the materials that are important will be covered in the school. However, one of the P4 students does not think the pharmacy course has equipped student for the real working life as he mentioned ―the situation where students learn at the pharmacy school is more towards to an ideal situation which cannot be really apply in real life.‖ whereas another past year student stated that, ― even now in practice there are some things (cases) that might only come up once every 3 to 6 months, so I guess that‘s what internship is for.‖

When asked how and what professionalism was perceived to be, a past student stated that,

―Professionalism is an attitude. And it is a fundamental attitude so you can try to teach people about professionalism and to some extent.. you will be successful by highlighting certain things that are professional and ethical and what is not professional and not ethical. But it is fundamentally an attitude so if you start out with the right attitude about what are the appropriate things and what are not appropriate things and what are the things you should be doing as a professional, that right attitude, erm, then you‘ll do fine in your career. There are always going to be some situations where you have to make certain decisions about something at some point and if you have a clear foundation on how you view things it would be a lot easier for you to make some of those decisions.‖

The majority suggested that some changes to the course are needed in order to promote professionalism. The changes include that an inter-professional practice programme, mandatory community work, and a dress code for final year students like medical students. Some students suggested that more promotion about pharmacy course can help to increase its awareness. Finally one P4 student thought ―using a filtering system like dentistry and medicine which have interview and UMAT to filter students to enter pharmacy school.‖

Limitations This study utilised interview participants from a small, non-random sample some of whom were known personally to the interviewers. This personal connection to the interviewees may have facilitated a more in depth discussion of students‘ perspectives. An under-representation of some populations occurred: with a lack in the number of past students between the 1960‘s and the 1970‘s due to them not being accessible for an interview. Additionally, more males

than females were interviewed, most interviewees were from Asian ethnic groups and only a few participants were NZAPS-O members. Not all interviews were recorded, and only a few were fully transcribed as such perspectives may not be fully understood. Some people that were contacted did not respond to email enquiries or email interviews. This study‘s small sample size was sufficient to explore students‘ perspectives of their time at pharmacy school, but results should be interpreted with caution and a larger sample would be needed to further appreciate these perspectives.

Conclusion: The changes in the subjects offered by the University of Otago Pharmacy course reflect the dynamic evolvement from the very beginning when it was initially a subject called Materia Medica taken by medical students to the current Bachelor of Pharmacy programme and postgraduate studies. It has been a long journey of enhancement, refinement and specialisation which saw the establishment of clinical pharmacy and social pharmacy studies in the current programme. As with all dynamic studies, change is an on-going process and future pharmacy students may be studying from even wider perspectives.

This study also explored the changes of pharmacy students‘ perspective over time with respect to academic and social aspects. In summary, the main findings are that pharmacy students have commonly chosen to study at Otago University to increase their personal independence from their family, while pharmacy typically not being their first choice as a health professional course. Although it is generally perceived that the number of females has been increasing over the years along with a gradual acceptance of females into the profession, the ratio of males to females has not actually changed. The number of international students has been increasing dramatically and the diversity has also become wider. The aspects of the

graduation ceremony and parade has remained fairly consistent over the years. It has been found that the summer studentship programme was introduced to substitute for the cancellation of the honours programme, subsequently no significant changes in this programme were identified. Student exchange programmes were and are still highly favoured in terms of gaining a different perspective of pharmacy, travelling opportunities and acquiring more experience. The placements have evolved overtime and new placements have also been introduced for the students to gain more experience such as the Melbourne trip in 2002 and IPE in 2012. While some students are interested in doing a postgraduate programme, not all of these students actually ended up doing one.

Although not an objective of this report, the authors would like to request the School of Pharmacy staff to examine our findings - particularly the sections on why students choose to study pharmacy, the best and worst aspects of the pharmacy school and the brief feedback section on what students believe needs to change. An appreciation of these perspectives by the school could lead to an improvement in how the pharmacy course is delivered. The past and present are like two sides of the same coin. It is clear that one cannot exist without the other – nor can the past be truly understood without knowledge of what is present. Such is what we understand of history. Likewise, the history of the School of Pharmacy would not be complete without an appreciation of the perspectives of its students. Therefore, this study has filled a crucial gap in knowledge of the development of the School of Pharmacy.

As the School will be celebrating its 50th Jubilee next year, we hope that it will use this event to reflect on its achievements, as a platform from which many more exciting changes can take place in the future.

On that note we would like to end with a quote from an anonymous author: ―Life is a journey, not so much to a destination, but a transformation.”

References: To be completed…..

Appendix 1: School of Pharmacy 50th Anniversary Interview Schedule General Questions: Age Where are you from? (Country specific or city specific for NZ students) What is your ethnicity? Where did you go to high school? P2, P3, P4 Year started at SOP? Year graduated from SOP? How did you get into pharmacy? (Straight from high school, HSFY?) Why choose to study at the University of Otago? What made you want to do pharmacy? What made you want to continue with it? Was pharmacy your first choice as a health professional course? (Potentially medicine or dentistry could have been your first choice). Is anyone in your family a pharmacist? How did you find your time as a student? What is your favourite thing about the pharmacy school? (Prompts: The Adams building elevator, the teachers, the dean, dissolution labs, the other pharmacy students…) What is your least favourite thing about the pharmacy school? (Prompts: Being so busy workload wise compared to practically everyone else, the teachers, exams, chemistry were never going to use…) What is your views on how the pharmacy school has changed over the years? (Everyone except P2s) Summer studentship: Did your class have the option of summer studentships? Did you ever consider doing a summer studentship during your study? Why? What do you think would have been/ were the benefits of engaging in this programme? Why? Student exchange: Was your class given the option for a student exchange programme? Would you have liked to pursue an exchange programme? Why? Where would you have liked to have gone? What do you think would have been/ were the benefits of engaging in this programme? Why? White Coat Ceremony P2 interviewees only: Did you attend the White Coat Ceremony? Why? What did you think about it? (Great to meet new people, waste of time, free food…) What are your views on pharmacy? Did the White Coat Ceremony help to change/shape your views? Every interviewee except P2 students: Do you know what a White Coat Ceremony is? Quoted from New Zealands' National School of Pharmacy Facebook page: It is a ceremony that marks the marks the student's transition from the study of preclinical to clinical health sciences where students are presented with a Dispensing Coat highlighting their entry into a professional programme of study. The purpose of the ceremony is to give students an opportunity to construct their identities as pharmacists by identifying with the profession and themselves as part of the profession.

What do you think about this ceremony? Why? Would you have liked a White Coat Ceremony to mark your entry into pharmacy? Around what time do you think your perspective about the pharmacy profession began to develop? Was this a gradual process or was there some event that changed the way you thought about pharmacy? What do you understand professionalism to be? Do you understand it by wearing something like a white coat – if you wear jeans does that make you professional? Females and pharmacy: What's the gender distribution during your time in pharmacy school? (More males than females, more females than males or about equal?) In what ways does gender influence pharmacy? Is gender an issue? Experiential learning: What types of placement(s) did you do during your time at University? (Community, rural, hospital) How many days did you do for each placement each year? How was the placement assessed? What activities did you do during your placement? Tell me your views about the placement. International students: Which country do most of the international students come from in your pharmacy class? Why did you choose to study in New Zealand? Is there a difference in the idea of pharmacy between your home country and in NZ? (More/less respected profession in home country…) Are there any difficulties or barriers to you studying here? Did you have any difficulty with studying pharmacy in an English language? What are your views about studying pharmacy at the University of Otago? Every interviewee excluding people in postgraduate education: Have you ever thought about postgraduate education in pharmacy? If so, what area do you think you would like to work in? (Pharmaceutical Sciences, Clinical Pharmacy and Social Pharmacy) Social life of a pharmacy student - to give us a sense of your time outside the classroom: Do you belong to NZAPS? Why? Do you take part in any activities outside of pharmacy? Do you have friends outside of pharmacy? Do you have any family networks in Dunedin? Did you have any former networks you could connect with in terms of social life? High school friends? Did you grow away from them? Opportunity for feedback: Do you think anything needs to change with the way the pharmacy course is structured? Do you think the pharmacy course has equipped you for the real working life as a pharmacist? (P4 and past students) Are there any changes you would like to see made to the course in order to promote professionalism?

Appendix 2: Pharmacy School Yearbooks 1. Students Associate N.Z. Pharmacy School (1979) 2. School of Pharmacy Yearbook (1980) 3. School of Pharmacy Yearbook (1981) 4. School of Pharmacy Yearbook (1982) 5. School of Pharmacy Yearbook—The Extra Pharmacopocia (1983) 6. Goodbye Spy, Hello… (1984) 7. Lets it all hang out (1985) 8. A.I.D.—All into dmqs seriously! (1987) 9. Pharmacy—can your body take it?? (1988) 10. Pharmacy Magazine (1989) 11. Pharmacy Magazine Students=PMS (1990) 12. Pharmacy School Magazine (1991) 13. Pharmacy school Magazine (1992) 14. The Pharmacy School Magazine (1993) 15. Pharmacology Magazine (1993) 16. Pharmacy School Magazine (1995) 17. Pharmacy Magazine (1996) 18. Pharmacist‘s Day—Pharmacy School Magazine (1997) 19. PHM (1998) 20. Pharmadelic Body! (1999) 21. Pharmacy (2000) 22. MAGgot Pharmacy (2001) 23. The Muppet Show (2002) 24. Coming soon to a Pharmacy near you: Pharmlander (2003) 25. Joel Tyndall Fan Club Pharmacy Yearbook (2007)