NAPLEX 2016 Changes – What You Should Know

There are some NAPLEX (North American Pharmacist Licensure Examination) changes that are happening that pharmacy students need to be aware of.  The changes are scheduled to take place on November 1st, 2015.  So what are the NAPLEX 2016 changes and why are they happening?

The length of the exam as well as the NAPLEX content outline is changing.

  • The length of the exam is going from 185 to 250 questions
  • Assessing Pharmacotherapy to Assure Safe ad Effective Therapeutic Outcomes section goes from approximately 56% of the exam to 67% of the exam
  • The “Recommend, and Provide Health care Information that Promotes Public Health” section of the exam will disappear

Here is some speculation on why the NAPLEX changes are happening:

  1. I believe the primary goal of this change is to make the exam more “clinical” in nature.  What I would speculate this means for NAPLEX exam takers is more clinical scenarios where you are asked to recommend the “best” medication.  With the pharmacist’s role in the healthcare system evolving, I suspect NABP’s intent is to make sure graduates are ready to handle making recommendations and understanding how to optimize medication therapy.
  2. Why is the length changing?  I suspect that the consensus on the length would be that most would feel like 250 questions is brutally long.  I’m pretty weird compared to most folks, but I actually like the idea of a longer exam and maybe that is just the statistics part of my brain.  If you know your stuff well, the more questions asked, the more opportunity to put your knowledge on display.  The other advantage of more questions is you should be able to get more wrong (or at least that is what I would think) and still pass.
  3. Black Helicopter Conspiracy Theory:  Is the “new” NAPLEX going to be more difficult?  What is one of the most common frustrations of current pharmacists? The pharamcy education news I’ve seen all over social media is about the massive increase in pharmacy graduates over the last few years. I’m not an expert on the rapid expansion of the number of pharmacy graduates, but in my mind, there are three major ways to prevent the rapid increase in new pharmacists.  The first one is to reduce the number of pharmacy schools and/or class sizes.  Again, not an expert, but overall, it doesn’t look like that is going to happen anytime soon.  The second one is to make it more difficult to pass pharmacy school. That could possibly happen at isolated colleges of pharmacy, but I doubt that will ever cause a significant reduction in the number of graduates.  The other obvious way is to make the final bar (NAPLEX) more difficult to hurdle.  So is this the master NABP plan to reduce the number of new pharmacists?  Only time will tell.  It will be interesting to follow the NAPLEX pass rates over the next few years.

What do you think?

Eric Christianson, PharmD, BCPS, CGP

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  1. PhuongLan Cao

    I am thinking that NABP may be trying to introduce more confident pharmacists. I recalled having a young pharmacist who frantically called me for help with finding an “adult liquid Benadryl”. All she could find on the shelf was the “children Benadryl” and she was having an angry adult customer who demanded the liquid version!

  2. K. Schilli, PharmD.

    NABP did not think through about what impact it would have on existing pharmacists when they allowed states to open up more schools of pharmacy to alleviate the pharmacist shortage. As a result, more supply than demand was evident for more than two years, making it about a year before a new grad could get a job, and impossible for more experienced pharmacists to get or keep a position. I question the wisdom of making the test longer. To me, a true test of “knowing your stuff” is exactly that…not the quantity of questions you can answer, but the quality of the answer to questions that were written to solicit quality answers. In other words, less questions with more practical emphasis should be the goal of the test. If NABP intent is to optimize medication therapy, then let’s go back to the root source (the educative process itself) and make changes so that by time the student takes the exam, they are more than prepared to not only pass it, but afterwards practice with assurance and self-esteem.

    • Eric Christianson

      Thanks for the comment! I do not know this answer, if someone does please help clarify…Does NABP have any say in approving new colleges of pharmacy, or is AACP the only organization that approves a new college of pharmacy?

      • Phillip Thornton

        ACPE accredits schools of pharmacy. So it is not either AACP or NABP. However, graduates must pass the NAPLEX at an equivalent rate as comparator schools of pharmacy or risk getting an additional visit by ACPE questioning the curriculum and/or educational methods. AACP is a support for the schools of pharmacy and help shape policy within accreditation and licensing standards.

        • Eric Christianson

          Thanks Phillip!

  3. José Ignacio Morte

    Creo que dificultar el acceso es la forma más realista y mejor
    1º Los farmacéuticos estarán mejor preparados pudiendo realizar su trabajo mejor
    2º Su aportación al Sistema de Salud será más útil y eficiente

  4. Cole

    There has certainly been a dilution of what it means to be a PharmD, I wonder if it was really necessary to discard the Bachelor’s in pharmacy (and those who obtain a BS would largely fill a community pharmacy role). My primary care physician asked me “What happened to the PharmD degree? Those letters used to really mean something, but now everyone in every grocery store has them – and I just can’t trust recommendations from ‘PharmDs’ like I could in the past.” Definitely a telling indictment of the direction we’re headed – and hopefully these NAPLEX changes can facilitate/spark some changes.

    • Eric Christianson

      Interesting perspective Cole, thanks for sharing!

  5. Michael

    Making the board exam more difficult to pass in order to have less new grads in the work force is terrible if that’s what they are doing. All they are going to accomplish by this is having a bunch of over-educated Home Depot employees (I didn’t want to say fast food) with an astronomical student loan burden they will never be able to pay off. Why intentionally do this to someone? It’s cruel.

    The universities done care if you leave unemployed. They are in it to get paid. More students equals more money. And like any other college out their, the admission administrators will tell potential students that the outlook for jobs is good. It doesn’t matter what the industry. They want paying students.

    The ACPE screwed this up by allowing too many new schools to open. Someone needs to save a kid a stop him at the front door before they drop a ton of money.

    My theory is this: Pharmacy schools keep track of the hiring stats of all new grads. These stats are always high. However, they do not keep track of these grads after the first year. It seems all new grads find a job somewhere. The major pharmacies are screaming, “We need more pharmacists!” So, new schools open and more and more new grads are pumped out. These new grads end up unemployed later to make room for the next wave of new grads. And it continues year after year. Eventually, we get to a point that there are several people vying for one position. What does this do? It drives down salaries. While crappy, its actually brilliant from a corporate standpoint.

    New grad from 2015 gets job for $100,000
    New grad from 2016 cant get job. Needs job so is willing to take job for $90,000
    New grad from 2017 cant get job. Needs job so is willing to take job for $80,000
    This cycle will continue until people simply stop applying to pharmacy schools because they don’t want to go through six years of school and incur high loan debt for a job that pays $40,000

    • john

      remember, all pharmacists don;t practice in community pharmacy

  6. john

    ACPE as stated or any agency has any control of the number of “new” schools OR the increase in enrollment of the older schools. If a college or University meets the requirements of ACPE, the school will be accredited. It costs millions to open a new school plus the hiring of acceptable faculty. I for one hope the new school graduates will raise the bar of what has become glorified techs of too many pharmacists. “do you have any questions for the pharmacist?” is the worst closed ended question spoken at most pharmacy counters and when the patient does have a request, he must talk to the pharmacist next to a cash register.



  1. Wow. The 2016 NAPLEX Pass Rate and What Went Wrong - Med Ed 101 - […] about what might happen and why changes were being made.  You can go back and read that here if…

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Written By Eric Christianson

October 11, 2015

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