Wow. The 2016 NAPLEX Pass Rate and What Went Wrong

The 2016 NAPLEX Pass Rate was posted a little while back.  I wasn’t surprised by a drop in the pass rate for 2016.  What I was surprised by was how BIG the drop in the NAPLEX pass rate was.

The NAPLEX has been getting a facelift over the last few years.  I wrote a while back about the changes in the NAPLEX and gave you some speculation about what might happen and why changes were being made.  You can go back and read that here if you are interested.

Back to the 2016 NAPLEX results. The drop from 2015 to 2016 was much bigger than I had thought it would be.  I expected a decrease in pass rate, but not that big.  I will focus on the first time attempts.  The numbers:

  • 2014 NAPLEX pass rate 94.88% – very respectable
  • 2015 NAPLEX pass rate 92.64% – a drop, but not a crazy one
  • 2016 NAPLEX pass rate 85.86% – HARD TO IGNORE THAT DROP

Why did it drop so much?  This obviously needs to be looked at closely.

  1. The obvious answer and the one that the education community probably hopes is that the substantial drop in test scores is due to the change in the content of the test.  Certainly could play a role, but that large of a drop?
  2. Test fatigue.  The number of questions on the NAPLEX is now up to 250 questions.  That is a ton of content and when you are doing a significant number of case based questions as well as calculations, that makes that number feel even larger.  Some students are better test takers than others, but 6 hours for an exam is a long time.
  3. A larger concern for the profession of pharmacy; are schools accepting applicants that they likely wouldn’t have been accepted 10 years ago? Classrooms obviously have to be filled or at least close to filled for colleges of pharmacy to make it financially. Some maybe are, some maybe aren’t?
  4. How much of an impact are the newer colleges of pharmacy?  If you look at the numbers, there’s certainly an argument to be made.
  5. Is information about the worsening job prospects for pharmacists trickling down to high quality students and leading students down the path of becoming NP’s, PA’s, or MD’s?
  6. What was also a little alarming for the profession as a whole was that the number of 1st time students taking the exam.  It has gone up by nearly 1,000 in just 2 years time.

Tell me what you think below?

If looking for prep material for the NAPLEX, feel free to check out the resources from Meded101.com

 

 

40 Comments

  1. cheryl

    I live in California and 20 years ago we had 3 pharmacy schools and our own state exam. The Pass rate was usually slightly above 50% they exam took 2 days and it was given twice a year. I don’t think that the NAPLEX pass rate is not alarming at all. It was MUCH easier that the California exam I took as I took them both upon graduation. Twenty years ago there were 3 pharmacy schools in my state and I happened to see as of yesterday there were 12 schools here now. Something has got to change and quality IS an issue.

    Reply
    • Michael

      Hear, hear. I took it when it was a two-day exam.
      1st day multiple choice, all day and case study essays the second day. They are complaining of the length and content! Sorry, no sympathy on the length and the content you need to know. It is not like it is written by non-pharmacist. If all the subject matters are covered in your school curriculam, then it is a matter of reviewing and proper preparation. But, if you were under qualified to begin with to be in a pharmacy school and a warm body paying student to fill a seat and passed along, then you only have yourself to blame for lack of due-diligence and being somewhere where you don’t belong to begin with.

      Reply
  2. Eric

    250 questions, if in one day is excessive! I know in other countries that would be a two day exam and 2/3 of the questions would count to the overall score. The other questions would be pilot questions.

    Reply
  3. Bruce greenwald

    The emphasized part of education is now all clinical. The practice of pharmacy and the art of pharmCy are gone in our education. Yet go to any Walgreens or cvs in the US and there is no time to take a piss or eat lunch. Much less bring clinical into the practice.
    How can we learn to run or practice in a clinical mode if we do not first learn to crawl And walk by or learning to talk with our patients. Most patients are not compliant with directions and until we solve this issue outcomes will not improve.
    You want us to run a Coumadin clinic e with INR values but we do not have time to talk to a patient about the drug and all it’s restrictions. And then there is mail order where our job is a commodity and that is what has become an assembly line like we are building a car or widgets. This is not pharmacy and it is not the art of pharmacy. By letting our educators tilt our education towards clinical while business moved into assembly line mode we have ruined our profession.
    We are selves allowed to happen and we alone have the power to fix it. And we have not even talked about the PBM ISSUES like dispensing fees of one dollar. For this one dollar you went to school for six years?shane on us for allowing this.

    Reply
    • Norma

      Well said

      Reply
      • Francis Otchere PharmD., Rph

        You hit the nail right on the head and I hope corporate greed will make way for some of the things you emphasized be implemented.

        Reply
      • Dessie

        I couldn’t agree with you more.

        Reply
    • BigSalRPh

      My goodness I couldn’t agree anymore!!! Ya had me nodding my head on your first paragraph!!! I am a highly paid assembly line worker who has no time for anything why? Oh wait…did that whole screen go red? Yup, back to my assembly line as now I am considered a slow pharmacist as I didn’t verify them all by the “promised time”! Who’s promise? Mine or CVS’s??

      Reply
    • Patricia Poczciwinski

      Couldn’t have said it any better!

      Reply
    • L. Bryant

      Well stated. I would add…Shame on our professional organizations for not speaking up & standing up on our behalf to save our profession. Clearly, individual pharmacists do not have enough power/authority to even demand a restroom break or a meal break in a 12 hr shift. It needs to be the professional organizations and/or a professional union to save the PRACTICE of pharmacy in the retail setting.

      Reply
      • Shannon H

        I hope you are donating to the PAC for your local and national organization representing your area of practice. Pharmacists in general have been notoriously apathetic in political activism. Tell your organizations what you want in your practice!

        Reply
    • Mike

      I’d probably add in the “Drive-Through” component as well? Since when did pharmacy stoop to the level of fast-food?? Bet your ass you’ll never see a drive-through MD’s office….

      Reply
    • dr_joyous

      This is the best comment I have seen thus far. Still scrolling but I totally agree

      Reply
    • Robin

      Amen brother! This is one result of our professional organizations selling us out & deciding that we need to all be Pharm D’s. All businesses, whether retail, hospital, mail order, etc are only interested in the bottom line–how much they can squeeze out of us for the least amount of money. It is not cost effective to give proper patient care. I’m a BS Pharmacist with 35 years of experience in many different settings, so I know exactly how they all work.

      Reply
    • Andy

      Lol i feel sorry for anyone that slaves for big retail, groceries stores are so much better. You could say i was on of those paying warm bodies (blame my young age and craming undergad mentality), but i made it and now i work at a government run facility and practice at a higher clinical level than most of my classmates.

      Reply
  4. Cathy

    I am a BS grad with 25 years of experience community and hospital. Having trained several residents and students, I have noticed a significant decline in quality of grads. Experience is so much more important to produce a competent clinician ready to recommend medication therapy than these students are receiving. The schools and the health system in general does not have the opportunities needed to prepare the large number of students coming through the program.

    Reply
    • Mike

      Agreed. It’s all about test-taking, and very little about critical thinking skills. I remember pre-rounding for the ID service during my fellowship with contingency plans B through E in case plan A wasn’t viable once we got to the bedside because we needed a plan for that patient NOW and not having the luxury of “looking it up” afterward. Very rarely do you see students do that these days and just give up after their first answer.

      Reply
  5. Michelina

    There should be regulation of the amount of pharmacy schools being built, and also the amount of students being accepted. Students should not be accepted to just get their money, and then failing them out. Why isn’t there any sort of regulation with the amount of pharmacy schools being built and the amount of students being accepted? This is not acceptable. This is ruining the pharmacy profession. The surplus of Pharmacist’s is ruining our profession and not to mention our pay.

    Reply
  6. Billy

    I’d like to say school comparisons. Among each other and individual school results from year to year.

    Reply
  7. Sally Huston

    I don’t have a problem with that pass rate at all. The Certified Public Accounts Exam Pass rate is consistently around or just under 50%. It is not unusual for these students to take these exams multiple times. I think our standards have been too low for too long. The pharmacy profession is finally requiring more of our graduates and that is reflected in the falling pass rate. Students who wish to qualify as a pharmacist need to be knowledgeable. We are accepting more and more students into the profession- and while some may not be as strong as others, I don’t have a problem giving these students the opportunity to try to get into this much needed, very desirable profession with so many career opportunities. If 15% of the students have to go back and work hard to really master material- I don’t have a problem with that? We should be at least as demanding as certified public accountants- after all, patient’s lives are at risk.

    Reply
  8. Sally

    Certified Public Accountant pass rates have been around 50% for years! I have thought the NAPLEX should be harder for years. With patient lives at risk, we should be at least as demanding as CPAs.
    If more students want to try to get into this great profession, I don’t have a problem with that. Some may have to work harder to master the material, and may have to try more than once to pass the NAPLEX. So be it.

    Reply
    • Adam

      You can’t judge the competence of professionals by their license exam pass rate. Do you feel your pharmacist is under qualified? Pharmacists are consistently the most trusted profession. How can that be if they were incompetent?

      Reply
  9. Anne Jarrett

    To see if test fatigue is the problem, simply spread it out over two days with breaks. Otherwise, I agree that the proliferation of pharmacy schools is the problem. It is a good source of income for universities, so it is inevitable that less qualified students are accepted.

    Reply
  10. Susana

    NAPLEX is long overdue for a makeover to be more clinical-oriented. Remember, exam asks for minimal competency to pass and become a pharmacist. There are many pharmacy schools that focus on merely accepting students, and not so much on teaching.

    Reply
  11. John

    Keep an eye on Illinois legislature bill next month. If pharmacists are lucky, theywill be able to take 30min lunch, especially those working for 13 straight hours on their feet without a break. But then remember which larger chain’s HQ is in IL? hmm… with $4 Rxs, pharmacists are pushed to fill more Rxs, more vaccinations, MTMs, CMRs to make up for declining revenues..!!! Looks like we don’t need pharmacists who can pass NAPBLEX handsomely but we need pharmacists who can fill fastest Rxs on assembly line. May be NABPLEX should be comprised of how many Rx you can fill in 250 minutes(roughly 4 hrs)…!!!

    Reply
  12. Francis Otchere PharmD., Rph

    You actually hit the nail right on the head. I hope corporate greed will eventually give way for some of these changes initiated by academia to take hold in our profession. Also, I believe as pharmacists, we should always strive to educate patients and reset their expectations whenever possible to help change the “fast food” world mindset in order to save our beloved patients-centered profession.

    Reply
  13. John

    1. Too many schools = too many students. Pharmacy schools are forced to accept poor quality candidates to fill seats and meet financial mandates of University. Also may be partly due to job outlook.

    2. ACPE. Accreditation standards force schools to pass those low quality students or risk losing accreditation or at least not get full term of review. Based on accreditation standard to graduate students accepted into school. (Lower pass rates per school will also jeopardize accreditation too).

    3. Professors’ promotion and tenure is (partially) based on student reviews of teaching. Easier classes/tests, less accountability = better reviews. Even if the students had the aptitude, they are not being held accountable for learning the material.

    Reply
  14. Andrew Dafforn

    Here are the observations of one person who took the 2016 NAPLEX, which may or may not be reflective of everyone who took the test. 1) Pharmacy schools focus their teaching the main disease states that you will encounter in most settings, such as metabolic disorders (Diabetes, Hypertension, Hyperlipidemia). Of the 250 questions on the NAPLEX, I had less than 5 questions on any of these common disease states! 2) I had quite a number of questions on more rare disease states, such as HIV and Hepatitis C, and the latest treatments for them (where treatments are rapidly changing). 3) There were quite a few questions on cancer, which I believe is a good thing. Unfortunately, cancer guidelines are rather fluid (there are no printed guidelines, as NCCN updates them on a near daily basis), making it tricky to cover those topics in 2nd and 3rd years pharmacy school and have current knowledge by the time you take the NAPLEX. (I was fortunate enough to have a 4th year rotation at a cancer clinic a couple months prior to the NAPLEX.) 4) Some 2016 graduates may have been overly confident regarding the NAPLEX and attempted to take it too soon, putting more of their focus on the MPJE (state pharmacy laws/regulations) test.
    Although I passed the NAPLEX the first time (I took it in mid-June), I started setting aside some time to study for it in mid-February. I got one NAPLEX study guide and went through all the topics that I felt I did not know sufficiently well (ie. rare disease states) to prepare. I wish the class of 2017 my best on the NAPLEX.

    Reply
    • Rajan Radhakrishnan

      But the new format started only in November 2016? How did you have 250 questions in June?

      Reply
  15. Carol

    I am a former pharmacist and now an MD. I am surprised that this pass rate is being looked at as “low”.
    It is not. In addition, I agree with what has been said re: the quality of pharmacy grads over the last few years. I work with pharmacists daily and am surprised at how many are not able to write well, nor are they able to think innovatively to solve a problem. In essence, they were taught to be robotic in their practice and the art of pharmacy was not at all part of their curriculum. Just my opinion, of course, but I was proud of my undergrad pharmacy education and it troubles me to see this deterioration. Acceptance rates to pharmacy school should be reviewed, and perhaps the pharmacy curriculum, but not the exam.

    Reply
    • B

      I am a pharmacist that has been practicing for roughly 6 year. In those 6 years I have seen a lot change, from quality of student to the practice of pharmacy. I was previously a pharmacy supervisor with a large corporate chain that I decided to leave do to the direction the company was heading. Here are a few: 1. Volume of scripts you fill per day (many days pharmacies were forced to fill 450+ scripts/day with just one pharmacist) 2. While a supervisor, I had the honor of interviewing interns and pharmacists. I can honestly say many interns ( from end of 1st year to graduate) have no people skills and wondering in the schools simply just accepted students based on grade merit alone. You can be the smartest individual out there but if you cannot talk to your patient what difference are you going to make with them. For some companies , they are still simply just looking for a warm body to keep things running rather than looking for clinicians that help their patients 3. Yes, adherence rates are as bad as they seem. This is purely my opinion, Calling patients to remind them to refill the medication on time is good. However, the approach is a reactive task to keep scripts in their pharmacy large corporate chains and judging pharmacist on how well they do. When we should be asking what can we go as pharmacists to be proactive, 1.how about adequately staffing pharmacists so they are able to talk to their patients and counsel them (when’s the last time you walked into a pharmacy and saw every patient being counseled on every new drug that they are receiving not refills just new prescriptions.), 2. when will companies start providing those cheap 2 cent 7- day medication adherence containers to there pharmacists so that while counseling we can use constructive tools the patient can use to help remember if they took their medications rather than simply just handing a bottle of pills to their patients., and 3. companies start treating their pharmacists and technicians like people and not robots give them time to be clinicians (assembly line approach as you refer to it above).

      Back to pass rates, I believe this is a step in the right direction. University need to step up to the plate, prepare students for a life of serving patients and life long learning, not simply memorizing what you need to know on a test. A great example of this, recently recieved a 3rd year pharmacy student that does not know the top 200 drugs . Look I know we are not perfect but there is a difference between not knowing the classes, brand name generic names, indication, etc. and just forgetting something. I want to help train students I am receiving to get better at counseling, be able to make recommendations to physicians, understand DURs, etc. not be retracting the student what they should have learned in their first year of school. ( I will never claim to be the best or smartest pharmacist out there because I know that I am not and know many smarter than I am but I will say I am a competent pharmacist that have my patients best interest at heart.)

      Where pharmacy is heading in the future I am always excited to see, it does not bother me like some because change is inevitable. Adaption is survival in any job and life.

      Clinical based thinking is where pharmacy is
      heading we need to adapt to change, like the Naplex is doing. When we start to realize and accept that, we can adapt and the results will come back up. Maybe with a little help, pharmacists, universities, boards of pharmacy can help to improve the practice of pharmacy from where it has gone today (all about numbers and amount of prescriptions filled) and back to being about the patients we serve.

      Reply
      • Nnaemeka

        As a Foreign registered pharmacist, i think you opinion is interesting.

        Reply
      • Christy

        I can tell you that a large California school does not teach brand generics at all. There is no top 200 course so the interns come in essentially not knowing anything. I was shocked to learn this, but the school seems to hear them toward biotech and other fields rather than a retail pharmacist. The schools has had their accreditation reviewed several times.

        Reply
  16. Jesmar Gil

    I’m a unregistered foreigner Pharmacist, soon I will take all test to obtain my certification in Illinois and all your comments scare me, but I know now that I should prepare very well. Any suggestions for me. Thanks

    Reply
    • Patricia Poczciwinski

      Don’t be scared. Prepare! Eric has a NAPLEX review guide which you will find very helpful!

      Reply
      • Jesmar

        Awesome. I will contact Eric soon

        Reply
      • Maggie

        Hi Patricia, I am seeking for someone to help me review Naplex.

        Reply
  17. Michell

    It’s just sad. The state of pharmacy is just very sad. I have been out of school since 1995. I have worked mostly retail. It has just gotten worse as each year goes by. I am ready to throw in the towel and make a career change. I have been unemployed for over 9 weeks. That’s pretty sad. I am a good pharmacist. Those that do the hiring…..well, I don’t know what they are looking for, but it’s obviously not me after 21 plus years of working. Something needs to change and it needs to change quickly. I don’t advise anyone to go to pharmacy school anymore.

    Reply
  18. Bo

    Everyone keeps saying how the NAPLEX having 250 questions is a factor. However, for 2016 from May to October when new grads could take the test, it was still 185 questions with 35 being demo questions. That’s 6 months of the old test format, with only November and December of 2016 being 250 questions. Also, most grads made it a point to take the 185 question version of the NAPLEX so they wouldn’t have to take the 6 hour test that started in November.

    Reply
  19. Shane

    NAPLEX was too easy. Almost everyone passed. For the profession to be valued and respected by other healthcare professionals and the public, it has to be hard. People want answers to the difficult questions, not the easy street they used to ask on NAPLEX. Take the time after school to study slowly and be the best clinical pharmacist you can. That’s the future…for you and the profession. Retail is generally dead-end.

    Reply

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Written By Eric Christianson

February 12, 2017

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