Table 6 Subthemes and supporting quotes within the theme “Concerns”

Higher cost of study and value

Cost of education to parents and the government budget

AC12_SAP_U4, EXP4_PSc, PR1, PR3, ST1

“The negative effect is the cost of education to parents and the government budget of at least six hundred million baht (£12,253,000 or $18,421,000) a year, without being able to see the benefit in the short or long term. Improving pharmacists’ competencies is a great thing but we have many ways to improve them, such as, via studying or working in real life situations.” (AC12_SAP_U4)

“A 5 yr programme will not increase cost. This increasing cost gave a burden to the government, students and users or employers due to when we had longer period of study, we will ask higher rate of salary in both public and private sector.” (EXP4_PSc)

“I think the cost is quite heavy. In case where we do not have money, this might be a problem.” (PR 1)

“The cost is not much harder because he (her son) helps himself. He got a scholarship from the faculty and works part-time job with his teacher. When he comes back home, he rarely asks for money. He needs only approximately 5,000 baht (£100 or $150) per month. He is a very good saver. He rarely buys new clothes.” (PR 3)

“The Pharmacy Council should prepare salary or compensation for our degree. I heard that they increased our salary by only 1,000 baht (£20 or $31) a month compared to the 5 year programme. It is not worth it to study another one year, when we have to spend approximately 100,000 baht (£2042 or $3070) for this extended year. There should be other ways to encourage us to work hard and deserve our salary.” (ST1)

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Real experience worth than training

AC2_PC_U4, AC7_PSc_U4, AC12_SAP_U4

“I think about the difference between a 6 ^th year pharmacy student who has clerkship with an unprepared preceptor for one year and a 5- year pharmacist who works for one year. They should have different levels of maturity.” (AC12_SAP_U4)

Higher cost of study and its’ value (continued)

Wasting time and lost opportunity

AC11_PSc_U5, AC12_SAP_U4, EXP4_PSc

“IP-PD student study for 6 year in laboratory and train for R&D but they work in community pharmacy due to the higher salary. They did not use their knowledge and their specialty. It wasted their time and opportunity to work because they have to study and training for one more year instead of working,” (AC11_PSc_U5)

“Improving pharmacist’s competency is a great thing but we have many ways to improve it, such as, via studying or working in real life situation. I did not see the benefit of the extended for one year or the worth of this change. Why it should not be Master degree instead of bachelor degree. Parents have to support cost for another year and social lost pharmacist for another year.” (AC12_SAP_U4)

“They loss opportunity to work. If they graduate in five year, they will work faster for 1 year.” (EXP4_PSc)

A 5-year programme still need in some areas

EXP4_PSc, EXP10_HOS, PM10, PHY7

“A 5-year programme in Pharmaceutical had enough and appropriate basic knowledge to work as pharmacy professional.”(EXP4_PSc)

“I think they are suitable to work in hospital setting but detailer might not need 6 years or production line in hospital might need a 5 year programme.” (EXP10_HOS)

“I want it to be a voluntary PharmD, rather than all six year PharmD. Who want to learn six year, they can learn. Five year curriculum is also need.” (PM10)

“I think the 6 year programme probably too much due to their services might not need to study for 6 years. Most of them might not work with patient in the hospital. Some pharmacists work at community pharmacy that might need the different competencies.” (PHY7)

Thai context different from the US context

AC16_SAP_U2, PM2, PM9, PM10

“I do not see the benefit of the extended one year or the worth of this change. Why should it not be a master’s degree instead of a bachelor degree? Parents have to support the cost for another year and society has lost a pharmacist for another year.” (AC16_SAP_U2)

“We are not prosperous but we are not very poor either. We should undertake appropriate education. The issue is that we would like to follow the western model. We can find our own way. I do not think six years is the best study programme in the world.” (PM10)

Mismatch between the pharmacy graduates’ competencies and the requirements of the job market

Mismatch competency and market’ needs within pharmaceutical care tract (e.g. hospital and community pharmacy settings)

EXP1_COM, EXP2_COM

“In the past, the basic skill of Thai pharmacist is able to work as a community pharmacist. Now, the responsibility of community pharmacy had totally changed. Within PC-PD programme, it should be separated into hospital pharmacist and community pharmacist because they have different required competencies.” (EXP 1_COM)

“Some faculties taught their PC-PD graduates that they should work in hospitals only. Students told me that they were not interested in community pharmacy but came here because it is only a compulsory rotation.” (EXP2_COM)

Mismatch competency and market’ needs within industrial pharmacy tract

AC10_PSc_U5, AC11_PSc_U5, EXP1_COM, EXP5_COM, PM9

“The private sector hired graduates from other other areas such as scientists who have a PhD degree. If you compare pharmacists who have a bachelor’s degree and scientists who have a PhD. pharmaceutical companies need PhDs more than pharmacists because they have more experience in R&D” (AC10_PSc_U5)

“Most of the pharm sciences students worked in community pharmacies because they got higher salaries than industrial plants but they were not well trained.” (AC11_PSc_U5)

“PSc-PD graduates should not do practice in community pharmacies unless they have been passed the training and gained skills and competency to qualify to work as community pharmacist.” (EXP1_COM)

Although IP-PD graduates can work in other services such as community pharmacy but they can work in certain levels. It will be difficult when they work in advanced services. Community pharmacy career is improved the services. It will provide the services to chronic and complex diseases patients. IP-PD graduates will struggle." (PM9)

Number of IP-PD was higher than job market needed

AC1_PSc_U1, PC10_PSc_U5, AC13_PC_U4, AC21_D_U5, AC22_D_U1, PM7, PM9

“The number of IP-PD students was higher than job market need. I knew the job market. I feel empathy for students.” (AC1_PSc_U1)

“There is limited job position in pharmaceutical industrial. They need only 200 pharmacists per year. However, it still has pharmacy shortage. I do not know the reason why graduates do not want to work in industrial." (PM7)

“The number of pharm sc graduates should be reduced.“ (PM9)

Mismatch between the pharmacy graduates’ competencies and the requirements of the job market.

Capacity of production depends on supply side

AC1_PSc_U1, AC15_PSc_U2, AC21_D_U5, PH1_HOS, PM4, PM_6, PM9

“This is problem in a level of policy. We might not base on principles of market demand.” (AC1_PSc_U1)

“We have a readiness and preparedness in industrial pharmacy more than clinical pharmacy so we have the number of IP-PD more than PC-PD.”(AC15_PSc_U2)

“Basically, our basic structure is mainly in pharmaceutical sciences area. Number of pharmaceutical sciences academic staff higher than Pharm care staff. So, we have high number of student in IP-PD tract because we have to consider about education management.” (AC21_D_U5)

IP-PD graduates have a competitor in the job market

AC11_PSc_U5, EXP7_PB, PM7

“Pharmaceutical company need PhD more than pharmacist because they had more experience in R&D.” (AC11_PSc_U5) (Note: PharmD degree in Thailand equivalent to Bachelor degree)

“The opportunity of the 6-year IP-PD students would be less because manufacturers might hire a 4-year scientist instead. It might save cost for manufacturers. Pharmacist will have competitor in the job market.” (EXP7_PB)

Need more communication

AC1_PSc_U1, AC3_PC_U4, AC9_SAP_U1, AC12_SAP_U4, AC13_PC_U1, AC21_D_U5, AC22_D_U1, EXP4_PSc, EXP5_PSc, PM1, PM4, PM5, PM10, ST1

“I feel uncomfortable about this change. It needed more consideration before creating this new curriculum. It needed communication to answer questions such as the necessity for change, the direction of change, and the main barrier that should be considered.” (AC13_PC_U1)

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“There was confused about Pharmaceutical sciences. What is their scope and competency? Someone said all work which is non-pharm care is pharm sciences. We have to discuss about their competencies, regarding to the need of users.” (EXP5_PSc)

“It's a top down policy of the powerful people at that time. It should have more serious consideration of views or listening to each other.” (PM10)

Lack of resources

Too quick and not ready

AC1_PSc_U1, AC2_PC_U4, AC3_PC_U4, AC10_PSc_U5, AC12_SAP_U4, AC15_PSc_U2, AC21_D_U5, EXP5_PSc, PM2

“Everything was move too fast. Even policy is suite for the future but we have no personnel to serve the policy. We should prepare PharmD preceptors then change to an entry level PharmD.”(AC3_PC_U4)

“There was many problems such as preceptors were not ready, academic staff also were not ready.” (EXP5_PSc)

Contrast view

“We have been informed about this change for many years before the PCT announced.”(AC15_PSc_U2)

“It seems like question of “Which came first the chicken or the egg?” If preceptors are not ready, we should train them. If preceptor is not enough, we have to increase the number of preceptor.” (PM2)

Lack of preceptors and training sites

AC2_PC_U4, AC5_SAP_U1, AC9_SAP_U1, AC10_PSc_U5, AC13_PC_U1, AC18_PC_U3, AC19_PC_U3, AC20_PC_U3, AC22_D_U1, EXP3_HOS, EXP4_IP, EXP5_IP, EXP7_PB, EXP8_PB, EXP9_HOS, EXP12_COM, PH3_HOS, PH9_HOS, PH6_HOS, PH7_HOS, PH10_HOS, PH11_HOS, PH12_HOS, PH15_COM, PH16_COM, PH20_IP, PH21_IP, PH24_HOS, PH25_HOS, PM3, PM4, PM9, PM10

“We have to have our own staff to teach our students at practice sites because pharmacists have high workload. We have MOU with hospitals and have a great support from both faculty and hospital administrators.” (AC5_SAP_U1)

“It increases the load of preceptors, of which they are still the same number. Every faculty is competing.” (AC22_D_U1)

“Increasing to the 6-year programme and release students out into the real world to find experience for themselves is not the right way. Lecturers or master’s degree students should be trained and transfer their experience to students. At least 20 students will be trained at each site, but the site employs only one pharmacist.” (PM4)

Plan to develop preceptors and teacher practitioners

AC3_PC_U4, AC5_SAP_U1, AC18_PC_U3, AC19_PC_U3, AC20_PC_U3, AC21_D_U5, AC22_D_U1, AC23_D_U2, AC24_D_U3, AC25_PC_U3, EXP3_HOS, EXP4_IP, EXP5_IP, EXP7_PB, EXP8_PB, EXP13_HOS, PH9_HOS, PH19_RD, PM9

“Newly PhD or young staff are work hard for faculty but they did not have time to do their own career ladder. Leaders have to protect them. We should have a good mentor for them.” (AC3_PC_U4)

“The most important factor in the new programme is preceptors and teacher practitioners. We have teacher practitioners (TP) to work in hospital as teacher for students and also practice at training site.” (AC5_SAP_U1)

Good attitude of preceptors

AC2_PC_U4, AC8_PC_U4, PH2_HOS, PH6_HOS, PH10_HOS, PH11_HOS, PH24_HOS

“Training pharmacy students is my responsibility. I am a pharmacist and I want to make the pharmacy profession stronger. I am proud to be a preceptor.” (PH24_HOS)

Barriers to be a preceptor (e.g. workload, time)

AC10_PSc_U5, EXP6_PB, EXP13_HOS, PH25_HOS, PH16_COM, PH17_RD, ST8, PH021_IP, PH23_PB, PH30_COM

“Being preceptor took a pharmacists’ time.” (EXP13_HOS)

“You want an effective preceptor but you never train us. Is it too demanding? We already have a high workload.” (PH25_HOS)

“Some of them might not ready to train us because of they did not have enough time due to their high workload.” (ST8)

Lack of resources (continued)

Lack of academic staff in pharmaceutical care area

AC2_PC_U4, AC4_PC_U3, AC9_SAP_U1, AC10_PSc_U5, AC21_D_U5, AC25_PC_U3, PM9

“We need real expertise staff in pharm care that they should have residency degree or board certify but there were a very low number of this group of academic staff.” (AC21_D_U5)

“Pharmacy graduates in pharm care preferred to work in the hospital more than to be a lecturer because of high salary and less stress. We are lack of lecturers and teacher practitioners.” (PM9)

Lack of practical experience of the faculty members in both pharmaceutical care and pharmaceutical sciences

AC10_PSc_U5, EXP1_COM, EXP2_COM, EXP5_IP, EXP13_HOS, EXP7_PB

“Most of academic staff works on their research but rarely work in real practice settings.” (EXP7_PB)

Separate licences

Specialty competency should have separate license

AC12_SAP_U4, EXP1_COM, EXP2_COM, EXP5_PSc, EXP7_PB, PM1, PM5, PM6

“I encourage the separate license because each specialty required different competency. For example, within pharmaceutical care, there should separate into hospital pharmacist and community pharmacist. IP-PD should not practice in community pharmacies unless they pass the training and qualify to work as community pharmacist.”(EXP1_COM)

“Pharmacy professional in each track will be developed. In far future, there is might be a separation of licensed." (PM1)

“The big issue was relating to license, but at that time, the council is not ready to give two licenses. As a result, every university have to change to six-year curriculum with one license.” (PM5)

“Separate licences seems to narrow down pharmacists’ opportunities to work in various settings. However, we need to be specialised, which requires different competencies. So, there should be separate licenses.” (PM 6)

Contrast view

“I did not agree about separate license. Why we have to close our opportunity? (EXP5_PSc)

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Different programme and two examination

AC9_SAP_U1, AC10_PSc_U5, AC11_PSc_U5, AC14_SAP_U5, PM6, PM9

“If they study the difference programmes from first year, they should have difference license.” (AC9_SAP_U1)

“We will have two pharmacy licensure examinations. The first examination is for the core competency. The second examination is for the specialty. Why we have just only one license?” (PM6)

Competencies of the entry level pharmacy graduates

EXP1_COM, EXP2_COM, EXP6_PB, EXP13_HOS, PM1, PM3, PM10

“The confusion in our pharmacy profession that we never talk is about the in- depth of core competency in the entry level PharmD programme.” (EXP6_PB)