Provisional Registered Pharmacist Training: Hospital or Community

Introduction

The Registration of Pharmacists Act 1951 requires provisionally registered pharmacists (PRPs) to complete their training at training premises recognized by Pharmacy Board Malaysia, which may be either public or private institutions.

• A complete list of training premises for PRPs can be found here.

Hospital Pharmacy

Prior to the liberalisation, all pharmacists were required to complete PRP training at government hospitals, which could involve a long wait for placement.

• MOH practices 2 years of compulsory service, consisting of minimum one year of PRP training and one year of FRP, as well as one year of optional service.
• After obtaining full registration, pharmacists are required by Section 11C of the Registration of Pharmacists Act 1951 to work an additional year. Failure to do so may result in a fine not exceeding RM50k and the revocation of the pharmacist's full registration.
• Once completed the compulsory service, you can either resign straightaway or stay while finding new jobs.
• Also, those who extended their PRP beyond one year can use the optional one year to fulfil the legal requirement of compulsory one year of FRP service.
• I still remember it was about an 8-month wait before I started my PRP training at a government hospital.

Today, you may have to mentally prepared that your contract may expire without a permanent post.

NOTE: In recent years, there are PRP positions available in the private hospitals too, but are limited.

PRP training at a government hospital is a fun yet TIRING rotational-based experience, designed to expose pharmacists to various hospital pharmacy fields, such as

• Therapeutic drug monitoring
• Parenteral nutrition
• Cytotoxic drug reconstitution
• Inpatient
• Outpatient
• Clinical services

The reality of PRP life is defined with sleepless night and never-ending assignments and works.

• PRPs are slowly nurtured to learn more on clinical management as well as familiarising themselves with drug dispensing and counselling.
• Moreover, different from government clinic, PRPs have more weekends and after office hours shifts.
• PRPs are also expected to read guidelines and to complete works, logbooks and presentations.
• Sometimes, they are scolded for silly mistakes or may felt worthless.

Nonetheless, this fruitful provisional registered year at hospital may not necessarily prepare what you need when you venture into community pharmacy later. However, working at community pharmacy is still a viable option.

Community Pharmacy

On the other hand, PRP training at a community pharmacy can offer an early exposure to community pharmacy tasks and workload, as well as business and management insight (both inventory and staff).

Different from hospital practice where we tend to obey medications written on prescription, community pharmacists are trained to make quick decisions regarding patient care (such as suggest treatment for minor ailments or recommend a natural supplement), which is uneasy at first.

• Since the retail setting is not as busy as hospital, we now have the opportunity to dig out patient issues and make a justified clinical recommendation.
• Hence, an excellent community pharmacist is certainly more than a salesman or saleswoman.

Nonetheless, due to business nature, they may have sale targets to achieve.

The Decision

Believe me, we all once lost when we were young. Nonetheless, the decision of whether to choose hospital or community pharmacy training should depend on

• How do you view yourself in ten years' time?
• Do you mind retails sale job?
• Are you very passionate with hospital pharmacist jobs (including working at outpatient pharmacy)?

Bear in mind, although lots of you are ambitious to learn and apply clinical knowledge at clinical wards (as brainwashed at university), this may not necessarily happen.

• At a hospital, most pharmacists end up doing dispensing jobs at inpatient or outpatient pharmacy. Some pharmacists may be involved in inventory control instead.
• On the other hand, given the nature of the work, there are plenty opportunities at community pharmacy for you to make clinical judgement in recommending products or referral to doctor.

Nonetheless, choosing a job should ideally be based on your passion and interest.

• When you are passionate about what you do, it is easier to stay motivated to put in the extra effort, even when things get tough.
• Also, you will be less likely to regret having made such a decision later on.

Anyway, at the end of the day, you still need to decide for yourself.

• Life is not a mathematical equation.
• We may not choose the same path and we never know what lies ahead of our life.

Advice to Fresh Pharmacy Graduates

Although the challenges that you face at hospital and community pharmacy setting are different, attitude matters the most to be a good pharmacist.

• It is not decided by how many HDs you scored in university exam, but your attitude, passion and efforts in becoming better.
• No doubt that a good foundation in pharmacy will give you a head start in the journey, but that's all. The journey ahead is still far.

A first- or second-year pharmacy student may think that there are lots that I did not know in pharmacy is because university syllabus has not taught yet. Well, it is correct to a certain extent. But, even after you graduated, in your first few months of working,

• You may often find yourself for do not know lots of things still.
• You may be still confused with brand names and generic names of medications or do not know the usual dosing of a medication.
• You may have difficulty to explain what you have known in lay man term to a patient (i.e. to apply your knowledge in your daily practice).

It is totally fine; we once were so ignorant when we just finished 4 years of university too.

• Even me today, after working for five years, there is still lots that I have not learned up.
• So, do not panic! Do not lost trust in yourself!

Always volunteer to serve your patient (customer)! Things will just get better with each attempt.

• I still remember the first week of my community pharmacy placement, I felt so hopeless of myself for not able to help my customer even with simple queries.
• The customer, on the other hand, consoled me, it is okay to not know this time, but next time you shall know how to answer to the next customer.

Every day, we may meet a (or more) new or unfamiliar question(s).

• It will be much more when you first embarked on the journey.
• I would highly encourage you to jot the questions down and read it up later.
• There is no shortcut in the journey of knowledge. You must put in efforts and self-initiatives to become better. Nonetheless, it is quite a joyous experience when you just read up a certain topic recently and your customer/patient is asking on it today.

Let me secretly tell you one more thing, only on the last day of my first community pharmacy placement, my preceptor told me this.

• Although I may have not noticed, he has been listening to my conversation with customers and is readily to step in if I provide a wrong recommendation.
• I felt touched at that point of time.

Lastly, at the end of your provisional registered year, you should know which reliable reference that you may look up to find a certain piece of information.

• We are all eventually going to be on our own feet.

Summary

I always say, your brain does not suddenly become an encyclopaedia once you completed your provisional registered training.

• Hence, when you are in provisional registered year, please put in efforts to become a good, reliable pharmacist.
• You should not keep excusing your ignorance for you are not fully registered yet or fully registered pharmacist did not teach you.
• Be responsible for the mistakes that you make (if any).

Always remember Swiss Cheese Model of Medication Errors.

• Pharmacist is one of the important lines of defence!

NOTE: You may refer Provisionally Registered Pharmacist Handbook, 2023 to have some insights on different career pathways.

External Links

• Proses Permohonan Pegawai Farmasi Gred UF41 (Lantikan Baru)
  
• MMA Says Stress Is Part Of Doctor's Job & That Current Training System Should Remain, 2022
  
• PRP FAQ Series: Community Pharmacy, 2021
  
• PRP FAQ Series: Private Hospital, 2021
  
• PRP FAQ Series: Ministry of Health Malaysia (MOH), 2021
  
• PRP FAQ Series: Pharmaceutical Industry, 2021
  
• PRP FAQ Series: R&D Academia, 2021
• #GovtoPrivate: Pharmaceutical Industry, 2021
  
• #GovtoPrivate: Community Pharmacy, 2021
  
• #GovToPrivate: Private Hospital, 2021
  
• PRP Checked! Part 1: Life as a PRP in Hospital in East Malaysia, 2021
  
• PRP Checked! Part 2: Life as a PRP in Clinic in West Malaysia, 2022
  
• Provisionally Registered Pharmacist Handbook, 2023