A New Doctor of Pharmacy Pathway

With the passage of time, pharmacists may not fully grasp the nuances of the education and training required for the bachelor of science in pharmacy (BSPh) degree of the past vs today's doctor of pharmacy (PharmD) degree. Many understandably assume that receiving a PharmD degree involves significantly more time in education and training and a drastically different curriculum. But is that assumption valid?

Time in Education and Training: Then and Now

A pharmacist licensed in Tennessee in 1968 with a BSPh degree from the University of Tennessee was required to complete 2 years of preprofessional courses, 3 years of professional pharmacy education, and 9 months of supervised internship. Therefore, the total time required for licensure was 6 academic years. Today, some accelerated PharmD programs allow students to complete 2 years of preprofessional coursework in as few as 3 calendar years of professional pharmacy education, including necessary practice experiences, for a total of about 6 academic years.¹

Thus, the minimum time required for pharmacy licensure today is about the same as it was in 1968; however, today’s graduates receive a doctorate, while their predecessors were awarded a bachelor’s degree. If the time spent in education and training has remained constant, one might think the curriculum must have changed dramatically and almost overnight. But did this happen at every school?

Curriculum Evolution: Continuous Adaptation

In 2019, writing for Pharmacy Times, Alex Evans, PharmD, BCGP, noted: “A History of the UNC School of Pharmacy ([by George H.] Cocolas) has, at the very bottom of the document, a comparison of a BSc curriculum and a PharmD curriculum. The primary change in the last year was that the entire experiential portion of the education moved into the school. The didactic portion of the curriculum has also certainly evolved in that time period, but there have always been curriculum changes, and in fact the curriculum in pharmacy school is already very different than when I graduated in 2010. I hope it continues to evolve to suit the changing educational needs and roles of pharmacists.”²

If the BSPh degree had continued, the curriculum would have changed in concert with the development of new drug classes and expanded roles of pharmacists. Therefore, it would be unreasonable to compare pharmacists based on their completion of BSPH and PharmD curricula separated by years or decades.

Many pharmacists now being licensed in the US and Canada are not PharmD graduates. There are pathways for international pharmacists with bachelor’s and master’s degrees to become fully licensed, even though the curricula of their schools vary.

The New Clinical Pharmacists

Although pharmacy schools in California offered the PharmD degree as early as the 1950s, its adoption across the rest of the US occurred much later. The first waves of post-BS PharmD graduates occurred in the 1970s and 1980s. Those new “clinical pharmacists” may have benefited from the perception that their add-on doctoral degree conferred a certain status. This is the impression some practitioners and educators—including me, at the time—wanted to convey. Naturally, those graduates wanted to preserve any professional and financial advantages gained from their degrees, and many clinician-educators resisted attempts to redesign curricula to ensure that all students graduate with a PharmD degree.

Legislative Recognition of Equivalency

During the BSPh-PharmD transition, when I was a clerkship coordinator, it was not unusual for a BSPh pharmacist preceptor to ask, “Why doesn’t the school just issue PharmD diplomas to us? I am training your students in my pharmacy. They will graduate as doctors, and I am left behind as a registered pharmacist.”

The university did not act on these requests, but the Tennessee General Assembly did. Under Tennessee Code Annotated §63-10-204 in 2024: “‘Doctor of Pharmacy’ means a person duly licensed by the board of pharmacy to engage in the practice of pharmacy. ‘Doctor of Pharmacy’ and ‘pharmacist’ shall be used interchangeably.”³

All Tennessee pharmacists received updated licenses with doctor of pharmacy, replacing their old certificates labeled with pharmacist. Many pharmacists adopted DPh, rather than PharmD, to reflect this recognition.

Similarly, in 2024, Oklahoma enacted a statute, Title 59, §353-1, stating, “The terms ‘pharmacist,’ ‘DPh,’ and ‘Doctor of Pharmacy’ shall be interchangeable and shall have the same meaning wherever they appear in Oklahoma statutes and regulations.”⁴

These legislative measures ensured that all licensed pharmacists, regardless of their original degree, were recognized as equals. Because the scope of practice of BSPh and PharmD graduates is identical, it is apparent that these legislatures viewed the degrees as being functionally equivalent.

Residencies and Specialty Board Certification

With the advent of board certification and structured 1- and 2-year pharmacy residency programs, the PharmD degree was no longer seen as the identifying moniker of “advanced practice pharmacists.” Resistance to all-PharmD programs faded, exposing a deeper issue: failure to acknowledge that many so-called “lesser pharmacists” were already providing effective direct patient care in traditional settings, thus disregarding the vital and consistent contributions of the pharmacist majority.

To propagate residencies and specialty board certification, well-placed pharmacy educators developed their own definition of “direct patient care,” thereby excluding typical hospital and community pharmacists and enshrining a pernicious minority philosophy for the future of pharmacy practice. The authors wrote: “It is important to recognize that traditional pharmacy services such as counseling, immunizations, health screening, or medication reconciliation provide value to the health care system. However, these examples are not what we mean when we use the term direct patient care.”⁵ How much more direct can one get than one-on-one counseling, providing a disease-preventing immunization, identifying a potentially debilitating chronic disease, or avoiding possible health issues?

A New Pathway for Professional Recognition

While pharmacists have obtained recognition through educational institutions or legislative action, qualified pharmacists may now receive a PharmD diploma or certificate of equivalency from Saints Cosmas and Damian Health Sciences College⁶—an exempt institution incorporated in Anguilla, a British Overseas Territory. The college was founded to verify the source credentials of entry-level professional bachelor of pharmacy graduates of US and Canadian schools. Those meeting education, training, and licensure standards equivalent to those required for a PharmD may be awarded a PharmD diploma or certificate of equivalency.

The 2 accrediting bodies of North American pharmacy schools are likely to object to the retroactive issuing of diplomas. However, because Saints Cosmas and Damian Health Sciences College is not under the purview of either organization, any such resistance to recognition of equivalency is not a defining issue.

Summary and Conclusion

Today, BSPh and PharmD pharmacists work side by side, sharing the same roles and responsibilities. They passed the same licensing exams, are subject to the same continuing education requirements, and maintain licensure through the same authorities. BSPh and PharmD pharmacists are equals, deserving of the same title and respect. With a clear pathway to fairness, qualified BSPh pharmacists can be recognized as PharmD pharmacists via a time-efficient process. Like Scarecrow in The Wizard of Oz, they lack only 1 thing: a diploma.

REFERENCES

1. PharmD program structures. American Association of Colleges of Pharmacy. Accessed February 23, 2026. https://www.aacp.org/resource/pharmd-program-structures

2. Evans A. PharmD or RPH: does it matter? Pharmacy Times. February 18, 2019. Accessed February 23, 2026. https://www.pharmacytimes.com/view/pharmd-or-rph-does-it-matter

3. 2024 TN Code § 63-10-204 (2024). Accessed February 23, 2026. https://law.justia.com/codes/tennessee/title-63/chapter-10/part-2/section-63-10-204/

4. 59 OK Stat § 353.1 (2024). Accessed February 23, 2026. https://law.justia.com/codes/oklahoma/2024/title-59/section-59-353-1/

5. Carter BL. Evolution of clinical pharmacy in the USA and future directions for patient care. Drugs Aging. 2016;33(3):169–177. doi:10.1007/s40266-016-0349-2

6. About the saints – SS Cosmas and Damian. SS Cosmas & Damian Society. Accessed February 23, 2026. https://www.cosmas-and-damian.org/saints