The numbers of pharmacists in Saudi Arabia are expected to rise with the increase in the number of pharmacy colleges. Deciding on the preferred career pathway is one of the major decisions a prospective pharmacist should make prior to graduation. The present multi-institutional study showed that clinical pharmacy was the most common pathway chosen by pharmacy interns and that the choice was mostly influenced by internship training. A similar finding was reported in a study from Sudan, where the clinical pharmacy was ranked the top selected career path (30% of 220 survey respondents), which was influenced by previous training experience (80%) . Interestingly, the study also found that curriculum content was another major influencing factor (70%) unlike our study that found that such factor had an impact on career choice of only 17.8% of the participants. A study from a large pharmacy college in Saudi Arabia found that work environment, advancement opportunities, and salary were the major factors influencing career choices . Studies from Saudi Arabia and China demonstrated that salary, advancement opportunities, and a motivating environment for growth were particularly important to males, whereas a flexible and stable workplace was important to females [11, 12]. Previous studies from Saudi Arabia and abroad found that most pharmacy students opt to work as clinical pharmacists, hospital pharmacists, or community pharmacists, followed by preferences to work in other sectors, such as academia, research laboratories, factories, and pharmaceutical companies [13,14,15]. Such findings corroborate with observations from our study, except that community pharmacy was ranked very low with only 4% selecting it as a career choice. A study from Jordan, however, found that academia and research were the most preferred choices . Structured internships in pharmacy colleges typically last 8 to 12 months, during which time students gain experiences in a variety of pharmacy fields, including clinical pharmacy, hospital pharmacy, community pharmacy, and pharmaceutical companies or factories . Pharmacy interns get to have field training and shadowing during the internship year, unlike theoretical study during didactic years. Therefore, it was not unexpected to find it the top influencing factor in our study.
Introducing career pathway exploration to first year pharmacy students was evaluated in a study of 508 students who were given a four-week course to describe in-depth various pharmacy career pathways . The authors reported a change from initial career plans in 50.8% of the students with many indicating that they would select different elective courses and seek new training opportunities compared with the students’ report prior to the course (P < 0.001). Early training in direct patient care, such as that offered in summer training or as part of the college curriculum, was shown to improve pharmacy students' knowledge, confidence, and skills in communicating with and caring for patients. Moreover, students found such training to be a positive and meaningful experience, which emphasized their desire to pursue a career in clinical practice [19,20,21]. The fact that only 14.7% of the study participants indicated that summer training guided their career choice suggests the need to put more emphasis on early pharmacy training to maximize its benefit and impact. Pharmacy colleges that do not currently mandate summer training after junior and senior years are recommended to encourage their students to make use of their free time during the summer to be trained in any pharmacy-related field.
Most pharmacy colleges in Saudi Arabia have switched their undergraduate programs from the BPharm program to the PharmD program, owing to its comprehensive clinical component, which aligns with the Kingdom’s vision to enhance the quality of healthcare while reducing mistakes that may harm patients and impact the economy . Despite that, it remains important to educate prospective pharmacists on non-clinical roles of a pharmacist. A set of recommendations were presented by Park, et al. to help prospective pharmacy graduates select appropriate career pathways. They recommended recognizing the skills, technical and non-technical, possessed by pharmacy graduates prior to graduation, identifying unique career pathways to assist the students to explore potential alternatives, and educating the faculty and students prior to internship about job opportunities beyond the typical health-system setting .
Saudi Arabia is striving to expand its pharmacy services in various sectors, not only through increasing the number of undergraduates of pharmacy colleges, but also through increasing the number of professional clinical pharmacists and highly educated pharmacists. This has been accomplished by the fast growth of general and specialized pharmacy practice residency programs, as well as Master of Science (MSc) and Doctor of Philosophy (PhD) degree programs in different pharmacy fields [2, 17]. Currently, there are more than 22 hospitals that offer general pharmacy residency programs in Saudi Arabia, some of which also offer specialized programs in different medical specialties, such as critical care, oncology, and infectious diseases . Nine pharmacy colleges in Saudi Arabia offer more than 25 MSc degree programs in various specialties, and one offers five PhD programs based on information listed on these colleges’ websites. The rapid development of such programs is crucial to graduate pharmacists with advanced knowledge and skills that could be utilized in different pharmacy-related jobs, which would ultimately improve the economy and provide better income to the pharmacists. Although the growth of pharmacy residency and graduate pharmacy programs has been noticeable, less attention has been given to pharmacy fellowship programs, which have a great emphasis on research. Research fellowship programs were originally developed in the United States, where many Saudi pharmacists obtained their postgraduate training, including completing fellowship training . As only one pharmacy fellowship program is available in Saudi Arabia, it is suggested that well-established pharmacy colleges develop and promote research fellowship programs (clinical or laboratory-based) to further enhance the multidimensional research skills of pharmacists who would work in clinical, research, or industrial settings. Such a step can help nationalize the pharmaceutical industry; hence, contribute to the Kingdom's 2030 vision.
Academic advising and mentorship can have a great influence on selecting future career pathways according to a systematic review by Chan, et al., which evaluated the impact of academic advising on career opportunities exploration and the feedback from advisees . In fact, academic advising and mentorship can help students set educational objectives that would enable them to attain their career aspirations . Additionally, when one pharmacy school mandated academic advising, students reported positive feedback regarding the experience compared with students who did not receive advisement when advising was not mandatory . All these reports signify the paramount role of academic advising in career pathway selection. Therefore, it is recommended that pharmacy colleges consider promoting academic advising to improve its impact on career exploration and selection since it was only reported by 15% of the participants in this study as an influencing factor. On another note, the marketing of careers in different pharmaceutical fields by former graduates through conferences or invitations to speak at pharmacy colleges had an impact on numerous participants in the current study as shown in Table 3. Moreover, previous graduates and employers are also encouraged to promote a better understanding and explanation of their careers on social media since only 17.8% of participants reported being influenced by information they found on such platforms even though one survey found that pharmacy students use all common social media websites for professional and educational purposes .
Broadening the vision of pharmacy students regarding the various career pathways using the aforementioned strategies (training, academic advising, meeting with former graduates, etc.) may help increase the retention rate since a small fraction (10.4%) of respondents to the current survey reported intentions to change career to other than a career in pharmacy. The reporting of interest in continuing to practice pharmacy by a large proportion of participants (89.6%) confirms results from a global study of 1,423 pharmacy students, of whom 1,110 (78%) opted to practice pharmacy after graduation .
As this is the first large multi-institutional study exploring the career pathway interests of pharmacy interns in Saudi Arabia and the factors influencing them, it has a few limitations. While we utilized the APhA’s career pathways list, some pathways were not included in the survey due to their lack of applicability in Saudi Arabia, such as mail service and home health care. Another limitation with regards to the influencing factors is the potential overlap between different factors. For example, the factor ‘previous graduates’, which was intended to mean live meetings and discussions, can also fall under social media if such graduates promoted their careers on social media platforms.