American Journal of Pharmaceutical Education 2011; 75 (4) Article 65.

LETTERS
Current State of Pharmacy Education
in the Sudan
To the Editor. The last decade has witnessed a great
interest among Sudanese regarding pharmacy education.
This resulted in establishment of a large number of pharmacy
schools and continued submissions for approval of
new ones. Currently there are 14 schools (5 public and 9
private), all but one of which are located in Khartoum. Their
combined annual admission is about 1800 students (60-400
students per university), with fewer male students than female
students (1:4). The undergraduate admission policy of
these schools is governed by the Board of Higher Education
of Sudan, which sets the minimum admission requirement
as a ‘‘predetermined percentage’’ in Sudan HighSchoolCertificate
(SHSC). Now pharmacy has become second only to
medicine among students’ choices for university education.
The top SHSC students (about 700 out of 423,000) are
usually admitted to the faculties of medicine, pharmacy, and
dentistry at the University of Khartoum. Established in
1902, the University of Khartoum is the oldest and largest
university in the country and graduates about 16,800 bachelor
and 6,000 postgraduate students annually. The Faculty
of Pharmacy at the university was established in 1964 and
remained the only one for 3 decades. Before 1991, the number
of students enrolled in the 5 years bachelor program was
less than 200. As of 2009-2010, there were approximately
860 pharmacy students (330%increase) and about 170 graduate
each year. The undergraduate curriculum follows the
traditional full academic year system. The total number of
hours for the bachelor of pharmacy degree (BPharm) is 3960
hours (4 years, excluding the preliminary year) and consists
of 1680 hours of theory (42.4%) and 2280 hours of experiential
work (57.6%). Additionally, students have 200 hours
of training at a community or a hospital pharmacy after the
second and third years, and 200 hours of pharmaceutical
industry training at the end of the fourth year. Although
some clinical aspects are taught sporadically throughout
the curriculum, the majority of the teaching and practical
training is product focused. Teaching methods are confined
to large group lectures using the white board andmultimedia
projection and small group practical sessions. Traditional
written, practical, and oral examinations and assignments
are used to evaluate students’ learning. The curricula and
methods of teaching and evaluation are more or less similar
at all pharmacy schools in the Sudan. The only exception is
that some schools follow what is called a modified semester
system where the academic year is divided into 2 semesters
and each semester is evaluated separately.

The challenges facing Sudanese pharmacy schools are
finding the means with which to keep pace with recent
developments in pharmacy education given the actual
needs of our country and the facilities available.At present,
the facilities, manpower and other resources available do
not allow full operation of a patient-focused doctor of pharmacy
(PharmD) or master of pharmacy (MPharm) degree
program in Sudan. The most suitable alternative is to start
by offering 2 options for the first pharmacy degree: bachelor
of pharmacy (BPharm) or master of pharmacy
(MPharm) to allow for a smooth transition between them.
Clinically oriented teaching involves the availability
of qualified clinical pharmacists for the supervision and
follow-up of clinical activities as part of the curriculum.
The country lacks such human resources. Accordingly, a
2-yearmaster in clinical pharmacy (MCP) was established
by the Faculty of Pharmacy, University of Khartoum, in
2004 beforemodification of the undergraduate curriculum.
The program is the first of its kind in the country and
attracts 70-100 applicants annually. Although class size
is initially limited to 20 students, high demands on the program,
especially by theMinistry ofHealth and other universities,
have forced the Faculty to extend to 30 students. To
date, the program has graduated 141 clinical pharmacists.
Parallel to establishment of theMCPdegree, restructuring of
the pharmacy at the University of Khartoum-affiliated Soba
Hospital to introduce modern services for clinical pharmacy
training and practice was initiated. This was considered
as a major breakthrough in hospital pharmacy service
upgrading which was unprecedented by any other development
for the past decades.
Unfortunately, undergraduate curriculumdevelopment
is held back by many constraints such as interdepartmental
conflicts regarding the belonging of clinical pharmacy, fear
among some academics that patient-focused teaching will
replace their subjects, and shortage of qualified academic
staff members. These difficulties need to be resolved in
order to provide an educational program that can appropriately
address contemporary and foreseeable future changes
in the pharmacy profession. This requires a high level of
collaboration between all involved parties.
Sumia Sir-Elkhatim Mohamed, BPharm, MPharm, PhD
University of Khartoum, Sudan

Social Pharmacy Courses Are Often
Neglected in the Developing World
To the Editor. Contemporary pharmacy professionals
are one of the major contributors to health care systems in developed countries. Increasing demands for pharmacy
trained professionals in response to the rapid growth of
the health care and pharmacy industry are reminders of
the beneficial roles of pharmacists in health and health
care issues. This is probably due to the fact that in these
countries, the role of the pharmacist has transformed from
being merely a medicine compounder and dispenser to
one having importance in many other areas. Besides providing
manufacturers with technical information on drug
composition, counseling health professionals, ie, physicians
and nurses, on how to select and use drugs, pharmacists’
responsibilities in the developed world include
patient wellness, health promotion and education, disease
prevention, and family planning. This ability to assume
a pivotal role in the health care sphere and act as a watchdog
over the well-being of people requires appropriate
skills. In fact, in recent years, there have been exciting
changes in pharmacy education in developed countries.
Difficulties in meeting health care needs and inadequacies
in patient services among others have led to the redirection
of pharmacy education from a product to a patient
orientation. Also, continuously innovating and incorporating
components of pharmaceutical sociology as advocated
by the Nuffield Foundation1 has played an important
role in the progression of academic and practice orientation
in developed countries.
Over the last 30 years, pharmacy institutions and pharmacy
training in the developed world have increasingly
involved commitments in upgrading education through
modernizing facilities, well-trained senior staff members,
emphasizing subjects including hospital pharmacy, clinical
pharmacy, biopharmaceutics and toxicology, and pharmacy
practice. This provided opportunities for active and
continuous interaction and collaboration between industries
and academic institutions. Pharmacy curricula also have
been changed by incorporating pharmaceutical sociology
components, ie, social pharmacy, to provide pharmacy
undergraduates with more opportunities and exercises that
promote constant interaction with communities. Pharmacy
practice continues to move from a focus on products to
a focus on patients in the developed world and in countries
such as the United Kingdom, the system for pharmacy education
is predicted to continue evolving over the coming
years tomeet and anticipate changing roles for pharmacists
within the health care system.2
In contrast to the developed world, an substantial proportion
of the population of developing countries has
a higher level of unmet health needs.3 Factors associated
with this situation include some specific challenges, ie, societal
factors, health care deficiencies andmore importantly
a shortage of health care professionals. The World Health
Organization (WHO) has long believed that pharmacists couldmake a greater contribution to the provision of health
care.4 To this end, this institution has launched many strategies
for developing countries.Addressing the strategies by
which primary health cares can be improved, the World
Health Organization has argued, since the last decade, for
the need to focus on strategies towards using pharmacists as
active health professionals.5 It also has been suggested for
the need to increase the participation of pharmacists in all
levels of the public health system, which is fundamental
to achieving substantial improvement in the health status
of populations as well as to achieving full preparedness to
respond to any type of mass casualty event. There is a close
relationship between the training received and the type of
pharmacy practice. Indeed a pharmacy student trained with
more health care dispositions will tend to play an important
role in the health care system than a student trainedwith less
emphasis on health care management. In an effort to address
strategies on which to base the preparation of future
pharmacists, WHO has suggested the need for graduate
level education followed by one year of practical training
before one is capable of effectively performing the role of
a pharmacist. In another attempt to promote the production
of future pharmacists with social responsibilities, WHO
pinpointed seven roles to which education and professional
development of pharmacists should aspire; these are caregiver,
decision-maker, communicator, leader, manager,
life-long learner and teacher 6.
Overview on the recent literature on pharmacy education
has shown that while in the developed world ideal
frontline pharmacists of the future (or 7 star pharmacists)
are increasing in number, efforts to incorporate social
pharmacy in pharmacy training are just in the curtainraiser
in many developing countries. The notion of social
pharmacy, the key course that has rendered pharmacists
of the developing countries to become active health care
managers, is still unknown in most parts of the developing
world. A common characteristic of these countries is that
health care systems are generally deficient and the number
of health care professionals is insufficient to meet increasing
health needs. One way to overcome this impediment
would be the provision of health care by pharmacists trained
with more social and behavioral aspects of illness and health
as well as opportunities of constant interactions with communities;
this is mandatory to the incorporation of more
pharmaceutical sociology components in current pharmacy
curricula.
Omar Saad Saleh Abrikaa, BSc, PhD Candidate,
MohamedAzmiAhmad Hassalia,BPharm,MPharm, PhD,
Abduelmula R. Abduelkaremb, BSc, MPhil, PhD
aUniversiti Sains Malaysia, Penang, Malaysia
bAjman University, United Arab Emirates REFERENCES
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macro-economic policies. Oxford J Med Health Promot Intl.
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www4.samford.edu/schools/pharmacy/ijpe/206/capper.pdf.
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