Motivations Toward a Career in Pharmacy*

Motivations Toward a Career in Pharmacy* J. Tyrone Gibson and Mickey C. Smith

T

wo recent reports have highlighted the potential for serious future pharmacy manpower shortages. Rodowskas 1 has described a significant "prescription gap," while Rucker and Sobaski 2 estimate that future developments, including national health insurance, would result in serious pharmacy manpower shortages. For these reasons and because, as we have previously noted,3 students may choose pharmacy for the wrong reasons, study of the factors in the choice of pharmacy as a career seems warranted. Some work has already been done, although most of it has been concerned with the medical profession and medical students. Talk about health professions and professions in general is frequentJy based on generalizations from what is known about physician groups. 4 However, it seems doubtful that pharmacy and other " professions would be enough like the medical professions to make such generalizations correct. Witness the number of " medical shows" on television and the number of "pharmacy shows." Certainly this affects visibility of a profession and most likely other aspects, too. Davis has reported on an extensive study of the social characteristics of more than 30,000 college students. Medical students received special attention in this study, but pharmacy students did not. In the health field Rosinski 6 has discussed the implications of the social background of medical students, but McCormack's7 preliminary evidence, presented in 1956, that social class might have a bearing on the attitudes of pharmacy students was largely ignored. It should not be too surprising if pharmacy were influenced by inheritance. As Caplow points out-"The most significant of directly inherited urban occupations are those which have a proprietorial element. " 8 A large percentage oftoday's practicing pharmacists remain proprietors of "drugstores. " *Supported financially by Pharm aceutical Sciences .

574

the R esearch Institute of

the

In her study of pharmacists McCormack found 17 percent with pharmacist fathers, plus an additional 11 percent with relatives who were pharmacists. 9 Burlage found among Texas pharmacy students that more than 24 percent were motivated to study pharmacy by members of the family, but he did not indicate that these influentials were pharmacists. 10 Pharmacist influence (not necessarily family) accounted for 31 percent of the career motivations. Ohvall and Hammel studied the influence of pharmacist and relatives on choice of a type of career within the profession. Again, however, the two were separated, pharmacists being motivating factors in about 15 percent of the cases and relatives in about 15 percent also. 11 Two characteristics of pharmacy as an occupation make it desirable to deJve further into the effects of inheritance on those entering the profession. First, pharmacy is presently in the stage of development \Xhich Barber 12 described as that of an "emerging profession." If the process of professionalization is to be completed, it will be affected by preconceptions and prior influences on the part of the supposedly malleable new students coming from "drugstore families." Second, pharmacy is a "marginal profession" 13 with two potential heritages, one to the profession itself and the other to the small retailer, entrepreneurial element. Social studies are needed to determine the effect of family relationships upon the profession. The markedly high number of pharmacist fathers (nearly 10 percent) in a survey of pharmacy students suggests that choice of occupation may be strongly affected by the presence of pharmacists in the family. The potential, as yet not demonstrated by research, that professional orientation may also be a part of the family legacy should not be ignored. Although a cause-effect relationship was not demonstrated, Hornosty found in Canada that a business (versus professional) orientation was found significantly more often among students whose fathers were pharmacists. 14

Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION

Substantial numbers enter pharmacy school with the end in view of going back to "take over" the family pharmacy. The second force would seem more likely to apply to those with relatives who are pharmacists. Given limited information about alternative careers, such as high school students may have at hand, the knowledge of pharmacy gained from observation of the activities and rewards of an uncle or cousin may be sufficient to sway the individual faced with the choice. The study reported here is part of an ongoing effort to learn more about what forces are at work in bringing the individual to the final commitment to pharmacy. Methodology

The data reported below were gathered by means of questionnaires administered to students in 16 schools of pharmacy. These students were mostly third-from-the last year in their program. Development of the questionnaire (hereinafter referred to as a Reasons Scale) required several steps. Items comprising the Reasons Scale were generated from several sources. These sources include the general occupational choice and related literature, the pharmacy occupational choice literature, personal interviews with 53 pharmacy students, an open-ended questionnaire to two separate samples of pharmacy students and informal conversations with graduate students and faculty within pharmacy administration The general occupational choice literature yielded approximately 38 distinct variables (not necessarily mutually exc1usive) affecting occupational choice. These were identified and listed in order to provide a rather rough indicator of how well the Reasons Scale covered the range of variables. Burlage 15 polled 385 students at the University of Texas college of pharmacy to ascertain their " . . . motivating influences for enrolling in the college ... " One hundred and twenty-six separate responses were listed by Burlage. Little analysis of these responses was done

except to identify the responses as coming from a fall, spring or summer pharmacy student. Nevertheless, these "motivating influences" were used as a resource for item generation. Pratt 16 studied approximately 400 pharmacy students (as best can be determined from his paper) at the University of California. Twenty-six statements were generated (source not given) to tap each of four categories-"economic factors, social factors, personal factors, and those . . . associated with previous experiences." These items were ranked according to their relative frequency and how frequently a given item ranked as first, second, third, etc. in importance. No mention of item reliability or stability was made by Pratt. These items serve as a source for the Reasons Scale. An open-ended questionnaire was developed to get pharmacy students to list all" the reasons they could think of for choosing pharmacy as a major. The questionnaire was administered to 69 third-from-the last year students at the University of Mississippi ' and 21 third-from-the last year students at the Howard University college of pharmacy (a predomin~ntly black school). The former listed 303 reasons with a mean of 4.5 reasons per student and the latter listed 198 reasons per student with a mean of 9.4 reasons per student. A content analysis of the 501 reasons listed by these 89 students yielded the bulk of reasons comprising the Reasons Scale finally developed. Many of the 501 reasons were much the same in content and differed only in phrasing. By repeated examination of the reasons listed approximately 50 distinct reasons were identified. These statements were put into phrase, and in a few cases, sentence form. Reasons extracted from the sources described above were composited and a scale consisting of 80 reasons or items was the product. Seventy-three of these items were phrased so that they could be rated on a continuum from one to seven with one corresponding to no importance and seven corresponding to most importance with the remaining values, two through six assigned in a similar fashion by the respondent. This questionnaire was pretested by administering it to 55 fourth-year pharmacy students. The purpose of this preliminary administration was to determine how well students understood the direction's, individual items, rating format, mutual exclusiveness of certain questions and any unforeseen shortcoming of the questionnaire. An estimate of the test-retest reliability of the Reasons Scale was obtained by administering the instrument to the last year class at a school of pharmacy. The instrument was administered to the students by their

J. Tyrone Gibson is presently an assistant professor of pharmacy administration and a member of the graduate faculty at the University of Houston college of pharmacy. He earned his l}S in pharmacy and MS in hospital pharmacy from the University of Georgia. His PhD in pharmacy administration was granted by the University of Mississippi. In addition to teaching at both the undergraduate and graduate levels, he has served as a commissioned officer in the U.S. Public Health Service, during which time he was assigned to FDA. He is a member of APhA, ASHP and the American Public Health Association.

Mickey C. Smith is chairman of and professor in the department of health care administration and assistant director of the bureau of pharmaceutical services at the University of Mississippi, where he earned his PhD. He earned his BS in pharmacy and MS in pharmacy administration at St. LOllis College of Pharmacy. Author of over 80 professional publications including three textbooks, Smith is currently preparing two additional books. A member of APhA and the Academy of Pharmaceutical Sciences, Smith is a fellow of the American School Health Association, assQciate member of ASHP, member of the American Sociological Association and the American Association of Comprehensive Health Planning.

regular instructor. One week later the instructor told the class that "I was told that the computer goofed up the data and we need to complete the questionnaires again. You ~hould answer by following the directions on the questionnaire as you did last we~k." Seventy-eight students completed both questionnaires. All items were significantly different from zero at the alpha = .05 level with the exception of one. Results A total of 1,223 students completed the questionnaire. Since they were given a one-seven range of possible ranking for reasons leading to the choice of pharmacy as a major, only those reasons which were obviously important or obviously nonimportant will be discussed here. In Table I (page 576) we have ranked a series of reasons identified by more than half of the respondents as being of "great importance" (six or seven on the scale) as reasons for choosing pharmacy as a major. To conserve space, reasons identified by more than half of the students as being of "no importance" (one or two on the scale) will not be presented in a table. The most salient results are presented as part of the discussion that follows. Of 74 reasons originally generated from the scale, 39 were indicated by half or more of the respondents as strongly important or unimportant. Discussion Only nine reasons were indicated as of "great importance" by the respondents. Not surprising was the listing

of four reasons relating to financial remuneration and security. Maslow's theory6 states that physical and security needs are the first needs a person attempts to satisfy. These findings are in general agreement with this theory although the hierarcHy was admitted by not one, two, three, four as would be suggested by Maslow's theory. The presence of an element of altruism is suggested by the inclusion of the reasons "opportunity for service to people" and "opportunity to be a professional person." If there is an element of altruism present in students' motivations toward pharmacy, this would be compatible with the emerging clinical concept. That this element may exist in first-year-pharmacy students is an especially encouraging finding. With an ever-increasing government role in health care delivery and a trend towards more socialistic institutions, altruism would seem to be a desirable value for some pharmacy students to possess. Also included in the top nine reasons were three general interest reasons. These reasons imply that beginning students come to pharmacy because they perceive pharmacy as a "scientific" major that will yield satisfaction as an occupation. At the same time an interest in drugs is indicated. The reasons listed as of "great importance" by students suggest to the authors that a student would be relatively comfortable as a student within , a school of pharmacy. His involvement with science courses such as chemistry, pharmacology, bacteriology and their accompanying labs would certainly be compatible with his general interest in science and drugs. There is a good

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TABLE I

Rank of Important Reasons for Choosing Pharmacy "Great ImporFrequency of Response, Number* tance" Percent

Reason I can get a good job after college Financial security (my future occupation will provide a secure income) Opportunity for service to people Security of employment (I will be sure of getting a job) Science interest (a scientific major is the most interesting.) Satisfaction from field (I am interested in the kind of thing studied by people in this major.) Potential income (it will help me later to earn a high salary.) Interest in drugs Opportunity to be a professional person

*N

66 . 3 63 . 2

762 760

61. 8 61. 6

759

61.6

723

58 . 6

687

55 .7

684 653

55.5 53.0

= 1,233

possibility that the merits of providing a service to the public and minimization of the business aspects of pharmacy wou]d be encouraged in many of his professional years courses. In some of our schools the student will be given exposure to real, live patients which should serve only to whet the appetite of a student possessing altrmst1c, service-oriented values and aspirations. The authors cannot help but wonder if the values alluded' to above and subsequently cultivated in a school of pharmacy allow the young pharmacist to be content in the real world (if contentment is what we desire in pharmacists). Is ..the real-world environment compatible with the person and system described or will "reality shock" occur in the young pharmacist? How many pharmacy students will become "a professional person"? Pharmacy at the present time woul d seem to provide the financial remuneration and security sought by aspiring students based on favorable economic indicators generally afforded pharmacy. Thirty reasons were indicated as of "no importance" by responding pharmacy students. These findings may damage some of our "sacred cows" of recruiting. The reason listed as "chance to take over a relative's business once I graduate" was indicated as of "no importance" by 90.3 percent of respondents . It was outranked in "no importance" only by the reasons "influence of being in ROTC" and "influence of having served in military service." Based on this finding, it is a small wonder that community pharmacists sometimes report a lack of interest in ownership and/or material functions in the young pharmacists. Clearly, we may be recruiting the wrong kind of student if we want managers and entrepreneurs in large proportions in the nation's pha~­ macies. 576

817 779

It appears that organized recruiting efforts are considered of little importance by beginning students. This is evident from the response that the influence of vocational guidance counselors was of "no importance" to 78.8 percent of the responding students while 75.3 percent of them reported career day programs as of "no importance." This finding could be a result of little or no exposure to these recruiting stimuli. The importance of available financial assistance or the lack thereof is frequently listed as a significant barrier to persons aspiring to health care occupations. Such does not seem to be the case for these respondents. The reasons "limited financial resources for education" and "availability of financial aid for people in this major" were listed as of "no importance" in their choice of pharmacy as a major by 73.1 percent and 65.9 percent of the respondents, respectively. It appears that a student's associates' and work experiences may be less influential than we thought. "No importance" was the response Jisted by 55 to 60 percent of the respondents to the items relating to the importance of the influence of friends, relatives and work experience in a related occupation. A slightly larger number of students felt that the influence of a particular teacher and of hospital experience was of "no importance." With 55.1 percent of respondents stating that "an impression of this major gained from reading a book, pamphlet, or other literature" is of "no importance," we can only wonder about the utility of such recruiting materials as Shall I Study Pharmacy ? Are students simply unaware of this booklet, not reading it or does it carry a message that is perceived as of "no importance" regarding the choice of a college major? Further study is needed

Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION

to obtain a definitive answer to these questions. It is interesting that more than half the respondents stated that the reason "close relationship of this major to another which could not be attained" was of "no importance." Students may not be choosing pharmacy because it is the "best thing next to medicine," for example. This would be further evidence that pharmacy is not chosen as a substitute occupation. The reason "selling aspects of my future occupation" was listed as of "no importance" by slightly more than half the responding students. This could be taken to mean that students do not object to "up-front" selling activities. It could also be taken to mean that students in general do not feel that selling activities are of much importance to them. The latter possibility is especially disconcerting since a large part of the duties of many pharmacists now involve selling. Recruiting Implications It should be especially encouraging to recruiters that only nine reasons are required to explain what more than half the responding students feeJ are the reasons of "great importance" for choosing pharmacy as a college major. To attract the largest number of students to pharmacy financial and security reasons should be emphasized, tempered by attention directed to making the point that pharmacy is a "scientific" major with particular emphasis on drugs. Moreover, it should be made obvious (and believable) that pharmacy provides an opportunity to be a professional person while simultaneously providing the opportunity for service to people. . What may not be so obvious is that attracting large numbers of people to pharmacy may have shortcomings. What aspirations do these recruits possess? Are the various aspirations held by these potential recruits proportional to the aspirations needed by those employers ultimately employing these future pharmacists? Will persons primarily concerned with finances and security be innovative enough to adapt to our rapidly changing health care delivery system (if we indeed have a system as some have wondered)? Will this kind of a person be able and willing to adjust to a third-party payment system such as will likely be brought about with passage of a national health insurance scheme?

Scope The findings of this study are limited due to the concentration on students who chose pharmacy. As we have stated previously, comparative data are

needed from students who did not choose pharmacy. Although this study serves mostly to identify the tip of the iceberg pertaining to the socialization of pharmacists, it does serve to marshal evidence that the process of pharmacy career choice may be markedly different from what we thought. It suggests that at least a re-tliialuation of our recruiting emphasis needs to be done. A departure from the past practice of recruiting large numbers of students solely on the basis of prior academic achievement may be necessary and desirable in order to produce the kind of pharmacist needed by the public-and pharmacy-of the future. A subsequent paper wil1 explote race and sex differences in career choice motivations. •

10. Burlage, H.M ., "Motivating Influences to the Study of Pharmacy," Amer. J . Pharm. Ed., 27, 75 (Winter 1963)

References

1. Rodowskas, C.A. Jr. JAPhA, NS10, 196 (April 1970) 2. Rucker, T.D., a nd Sobaski, W.J., "Pharmacy Manpower Tomorrow, " paper presented before American Pharmaceutical Association, Houston (Oct. 25, 1970) . 3. Braun, D., Gibson, J .T ., and Smith, M .C., "A Study of Some Factors in Pharmacy Career . Choice," unpublished manuscript 4. Pavalko, R.M., " The Predental Student : A Study of Occupational Choice and Professional Recruitment," PhD thesis, University of California at Los Angeles, 6 (1963) 5. Davis, J. A., "Undergraduate Career Decisions," Aldine Publishing Co., Chicago (1964) 6. Rosinski, E.F ., "Social Class of Medical Students," JAMA, No.2, 193 (July 1965) 7. McCormack, T . ~., " The Druggists' Dilemma: Problems of a Marginal Occupation," Amer. J . Soc., 61,308 (Jan. 1956) , 8. Caplow, T., The Sociology of Work, University of Minnesota Press, Minneapolis, 76 (1954) 9. McCormack, p. 310

11. Ohvall, R .A., and Hammel, R.W., "Career Decisions of Pharmacy Undergraduate~," Amer. J. Pharm. Ed., 27, 81 (Winter 1963) 12. Barber, B., and Lynn, K .S., The Professions in America, Houghton Mifflin, Boston (1965) 13. McCormack, p. 308. 14. Hornosty, R .W. , "A Study of Pharmacy Students in Canada With Parti~ular Emphasis on the Factors Involved in the Choice of Field Within the Profession," unpublished M.A. thesis, University of British Columbia (1966) ·15. Burlage, H.M., "Motivating Influences to the Study of Pharmacy," Amer. J. Pharm. Ed., 27, 75 (Winter 1963) 16. Pratt, R., "Analysis of a Pilot Study of Factors That Motivate Individuals to Elect the Health Sciences as a Career, With Special Referen ce to Pharmacy," Amer. J. Pharm. Ed., 20, 175 (Spring 1956) 17. Maslow, A .H., Motivation and Personality, Harper and Row, New York (1954)

Drug Recalls The following data have been compiled from the Federal Food and Drug Administration Weekly Recall Report covering the period July 19, 1973, to August 8, 1973. Pharmacists and others possessing drug inventories are reminded to check their stock again to be certain that they do not have any of the products on the list. Anyone who has additional facts on any of the listed recalls which he feels will assist in completing the recall is urged to send such data to the editor of this JOURNAL.

Product

Manufactu rer or Distributor

Antihemophilic Factor (Human) Lyophilized, 200 units per vial with sodium chloride injection, 25 ml, and administration set

Scientific Products Div: Abbott Laboratories (Los Angeles, Calif.)

Floropryl (Isoflurophate 0.1% in peanut oil), 5 cc dropper bottle

Merck Sharpe and Dohme (West Point, Pa.)

Mylaxen (Hexafluorenium bromide 20 mg per ml), 10 cc vials Neosporin Aerosol (100,000 units polymyxin B sulfate, 100 mg. neomycin sulfate, 8,000 units zinc bacitracin per 90 Gm.) Osmitrol Injection (Mannitol 5%, 10%, 15% and 20%), 150 ml, 250 ml, 500 ml and 1,000 ml bottles

Taylor Pharmacal Co. (Decatur, III.) Burroughs Wellcome Co. (Greenville, N.C.) Travenol Laboratories Div. of Baxter Laboratories (Morton Grove, III.)

Lot Number

Quantity

50813 4,000 50814 units 50815 50816 50817 50820 50821 50822 50823 50827 50828 50829 50833 50835 50838 50841 50842 50844 50847 50848 15,000 All outstanding boftles stock Unknown Alliots 809F 810F ZM14L7 ZM14L8 ZM14L9 ZM14N8 ZM14H2 ZM14H6 ZM14H6B ZM14LO ZM14L1 ZM14L2 ZM14L5 ZM14L6 ZM14N5 ZM14N6 ZM14H4 ZM14H5 ZM14H7 ZM14H8 ZM14L3 ZM14N4 ZM14H3 ZM14H3B ZM14H9

Unknown

Unknown

Recall-Reason , Suspected pyrogens

Product D j str ,bution National I ntern ati onal

Subpotency

National I nternationa I

Particulate matter in vial Mold contamination

Nation a l In te rna tional Californ ia Canada

Manufactured from material containing pyrogens

Natio n al

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