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Over the last 20 years, pharmacy practice in Malaysia has undergone radical change due to health care transformation and changes in the population s expectation of the pharmacist s role in society. The latest statistics published by the Ministry of Health (MoH) in December 2012 reveals that there are a total of 8,632 registered pharmacists in Malaysia serving an approximate population of 29 million [19]. This can be translated as one pharmacist catering for 3,355 persons. The MoH, as the major employer of pharmacists, expects to attain the World Health Organization (WHO) recommendation of 1:2000 by 2016, this translates into a need for approximately 18,000 registered pharmacists [20]. Pharmacists in the public sector are remunerated with good salaries and compulsory service has led to a workforce shortage in community pharmacy and industry. To overcome these shortages, service liberalisation in selected parts of the private sector is currently being allowed.

In the USA, pharmacy education addressed the national shortage of pharmacists and other health professionals with robust expansion of capacity in the last decade. The USA experienced a nationwide shortage of pharmacists (and other health professionals) in the 2000-2008 timeframe. Educational institutions responded by increasing the size of classes and by initiating new pharmacy programmes at universities that had not offered PharmD education previously.

Thai pharmacy workforce is still critically insufficient, lower than the Thai government s strategic plan and also lower than WHO s criteria [21]. The limited success in human resource for health planning might be due to lack of accurate information, lack of inappropriate planning, limited support to long term strategic planning and lack of participation of relevant stakeholders. Moreover, the new pharmacy workforce maybe more attracted to the private sector offering higher salaries and compensation [22].

Due to harsh socio-economic challenges that Zimbabwe has faced, many pharmacists left to pursue their careers in other regional countries as well as abroad. The resulting demand for pharmacists has forced an increase in the intake of students from an enrolment of 25 students to 60 in the past decade. Low levels of Emirati health professionals within the UAE means that the health care system continues to rely on expatriates. While this meets the immediate needs of the community, it is not sustainable. Increasing the number of appropriately qualified Emirati nationals in the health care system has the potential to stabilise the health workforce and decrease the reliance on an expatriate workforce. Since Saudi Arabia s independence, the government succeeded to provide health and pharmaceutical services to its people free of cost. Private hospitals providing paid services to ensure the rapid health care access to the community has increased the need for pharmacists and resulted in hiring qualified professionals from neighbouring countries and abroad. However, due to the current developments in the education

system, it can be assumed that in future Saudi pharmacy institutions will be in a position to meet the future demand of pharmacists in industry and clinical sector.

Once pharmacy students graduate from Chilean universities, they are immediately hired with good wages. The number of graduates in Chile has been kept at equilibrium regarding the needs of the country and the number of graduates emerging from each of the nine schools of pharmacy. Ninety per cent of graduates go into community pharmacy (largely chain pharmacies). A number of graduates are working at the level of regulatory affairs, mainly at the Ministry of Health and its organisms, i.e., National Institute of Public Health. The remainder go into hospital pharmacy and there is now very little pharmaceutical industry in Chile, as it has moved to Brazil and Mexico.

Clinical capacity building

Alignment of curricula with actual practice activities is important for a number of reasons including job satisfaction and to provide the best health care for patients. As pharmacists roles in health systems become more patient- focussed there is a need to develop both clinical faculty and clinical training sites where pharmacy students can contextualise their learning. The development of the courses and the clinical training sites does not always however develop in tandem.

In UK, pharmacists will need to draw on their scientific training and their clinical communication skills so an integrated undergraduate and pre-registration programme will ensure that professionals are able to contextualise their learning and apply their knowledge and learning in practice settings.

In Malaysia it is becoming increasingly difficult to accommodate pharmacy students from both public and private institutions for clinical pharmacy and industrial placements.

Thailand has accommodated the challenge of clinical capacity with an agreement in 1984-85 to train their academic staff in schools of pharmacy in USA, to be able to gain site exposure and experience in patient care [23 - 25].

The profession in Jordan is witnessing several trends such as the cross-country expansion of faculties and the introduction of more clinically-oriented degrees, as well as the development of academic pharmacy through the development of teaching methods and continued investment in staff education.