Technical Standards For Completion Of Curriculum

Introduction

It is the policy of The Texas A&M Irma Lerma Rangel College of Pharmacy that no person shall be denied admission or graduation on the basis of any disability, provided that the person demonstrates ability to meet the minimum standards set forth herein. Standards are developed as criteria to achieve the Doctor of Pharmacy degree in preparation for postgraduate training in any of the varied fields of pharmacy and for licensure as a practicing pharmacist. Further, the safety of the patient, on whom the pharmaceutical education process is largely focused, must be guarded as the final and ultimate consideration. Therefore, it is not only reasonable but also essential for good patient care to require minimum standards for the education of pharmacists.

The faculty of the Rangel College of Pharmacy is charged to: devise a curriculum that provides the student with the fundamental science principles of pharmacy, acquire the skills of critical judgment based on evidence and experience, attain expertise and confidence in using clinical skill and communication, and develop an ability to use principles and skills wisely in solving problems of disease.

In designing the curriculum, the faculty introduces current advances in the basic biomedical and clinical pharmacy sciences, including therapy and technology, changes in the understanding of disease, and the effect of social needs and demands on pharmaceutical care. The faculty should foster in students the ability to learn through self-directed, independent study throughout their professional lives.

Rangel College of Pharmacy faculty have a responsibility to society to matriculate and graduate the best possible pharmacists. Thus, admission to the Rangel College of Pharmacy is only offered to those who present the highest qualifications for the study and practice of pharmacy.

Technical standards presented in this document are prerequisite for admission to and graduation from Rangel College of Pharmacy. All courses presented as part of the curriculum are required in order to develop essential skills required to become a competent pharmacist.

The goal of the Rangel College of Pharmacy is to prepare students broadly to practice pharmacy with special emphasis on practicing in primary care settings. Pharmacy education requires that the accumulation of scientific knowledge be accompanied by the simultaneous acquisition of skills and professional attitudes and behavior. Regardless of the eventual type of practice, students must demonstrate competence in those intellectual, physical, and social tasks that together represent the fundamentals of being able to provide contemporary pharmaceutical care.

Students will be judged by their respective program faculty not only on their scholastic achievement and ability, but also on their intellectual, physical and emotional capacities to meet the full requirements of the college’s curriculum. As an advisory body to the dean, the admissions committee is instructed to exercise judgment on behalf of the faculty to recommend the entering class, and to consider character, extracurricular achievement, and overall suitability for the pharmacy profession based upon information in the application, letters of recommendation, and personal interviews.

Graduates of colleges of pharmacy must have the knowledge and skills to function in a broad variety of clinical, administrative and leadership situations and to render a wide spectrum of pharmaceutical care. The Rangel College of Pharmacy acknowledges Section 504 of the 1973 Vocational Rehabilitation Act and PL 11-336, the Americans with Disabilities Act (ADA) 1993, but ascertains that certain minimum technical standards must be present in the prospective candidates.

The Accreditation Council for Pharmacy Education requires that the curriculum provide a general professional education, enabling each student to eventually practice as a pharmacy generalist. This requires the development of broad knowledge, skills, behaviors, ongoing self-directed learning, and the eventual ability to deliver competent pharmaceutical care within a reasonable time frame and within the context of legal and ethical framework of the profession.

The basic science curriculum includes the study of biochemistry, medicinal chemistry, molecular biology, immunology, physiology, pharmaceutics, pathology and pharmacology; all within the context of application to solving clinical problems. The practice skill curriculum includes the behavioral, administrative, supervisory, economic, legal, ethical, analytical, integrative, historical and contextual aspects of practice. The basic sciences and practice skills curricula are interwoven and are designed to establish a core of knowledge necessary for understanding pharmacotherapeutics and undergoing advanced clinical training. The clinical curriculum includes diverse experience in primary care, in ambulatory and inpatient setting, and in specialized environments such as long term care, and managed care or compounding practices. The basic science, practice skills and clinical experiences develop the ability to practice pharmacy with the goal of providing cost effective improvement in patient outcomes, independently or with a team or other health care professionals, regardless of the future choice of practice site. The faculty requires each student to pass each required course and all of the clinical rotations, to graduate.

These technical standards specify those attributes the faculty considers necessary for completing pharmacy training, enabling each graduate to subsequently enter clinical practice, residency or fellowship training. These standards describe the essential functions students must demonstrate in order to fulfill the requirements of a general pharmacy education, and thus, are prerequisites for entrance, continuation, and graduation from the Rangel College of Pharmacy. A candidate for the Doctor of Pharmacy
degree must meet or exceed the required aptitude, abilities, and skills in five areas:

  1. Observation;
  2. Communication
  3. Sensory and Motor Coordination and Function;
  4. Conceptual, Integrative and Quantitative Abilities;
  5. Behavioral and Social Attributes; and
  6. Ethical Values

These areas are described in detail below. The program faculty will monitor maintenance of these standards. Students must be able to independently perform the described functions. The Rangel College of Pharmacy will consider for admission any applicant who demonstrates the ability to perform or to learn to perform the skills listed in this document. Applicants are not required to disclose the nature of their disability(ies), if any, to the admissions committee. However, any applicant with questions about these technical standards is strongly encouraged to discuss the issue with the chair of the admissions committee prior to the interview process. If appropriate, and upon the request of the applicant/student, reasonable accommodations will be provided.

The Rangel College of Pharmacy recognizes that certain student disabilities can be accommodated without compromising the standards required by the college and the integrity of the curriculum. Technological compensation can be made for some handicaps in these areas, but a candidate should be able to perform in a reasonably independent manner. The college is committed to the development of innovative and creative ways of opening the curriculum to competitive and qualified disabled candidates, while protecting the care of patients. The use of a trained intermediary means that a candidate’s judgment must be mediated by someone else’s power of selection and observation. Therefore, third parties cannot be used to assist students in accomplishing curricular requirements in the five skill areas specified above.

Certain chronic or recurrent illnesses and problems that interfere with patient care or safety may be incompatible with pharmacy training or practice. For example, testing positive for hepatitis B or having active tuberculosis may be considered a reason for automatic dismissal as exposing patients to this threat is unconscionable. Other conditions that may lead to a high likelihood of student illness should be carefully considered. Deficiencies in knowledge base, judgment, integrity, character, or professional attitude or demeanor, which may jeopardize patient care, may be grounds for course/rotation failure and possible dismissal.

Observation

Students must also be able to observe demonstrations and conduct exercises in a variety of areas related to contemporary pharmacy practice, including but not limited to, monitoring of drug response and preparation of specialty dosage forms. A student must be able to observe a patient accurately at a distance and close at hand, noting nonverbal as well as verbal signals. Specific vision-related requirements include, but are not limited to the following abilities: visualizing and discriminating findings on drug or fluid monitoring tests; reading written and illustrated material; observing demonstrations in the classroom or laboratory, including projected materials; observing and differentiating changes in body movement; observing anatomic structures; discriminating numbers and patterns associated with diagnostic and monitoring instruments and tests, and competently using instruments for monitoring drug response. Observation requires not only the use of the sense of vision, but other sensory modalities as well. It is enhanced, for example, by the use of the sense of smell.

Communication

A candidate should be able to speak to, hear, and observe patients in order to elicit information; describe changes in mood, activity, and posture; and perceive verbal as well as nonverbal communications. Students must be able to relate effectively and sensitively with patients and their caregivers and or partners, and convey a sense of compassion and empathy. A candidate must be able to communicate effectively and with sensitivity towards patients and patient care givers. Communication includes not only speech, but also reading and writing. Students must be able to communicate quickly, effectively, and efficiently in oral and written English with all members of the health care team. Specific requirements include but are not limited to the following abilities; communicating rapidly and clearly with the health care team on rounds; eliciting a thorough history from patients; and communicating complex findings in appropriate terms to patients and their caregivers, partners, and various members of the health care team (fellow students, physicians, nurses, aides, therapists, social workers, and others). Students must learn to recognize and promptly respond to emotional communication such as sadness, worry, agitation, and lack of comprehension of communication. Each student must be able to read and record observations and care plans legibly, efficiently, and accurately. Students must be able to prepare and communicate concise, but complete summaries of individual encounters and complex, prolonged encounters with patients. Students must be able to complete forms or appropriately document activities according to directions in a complete and timely fashion.

Sensory and Motor Coordination and Function

Candidates should have sufficient motor function to elicit information from patients by various screening maneuvers. A student should be able to execute motor movements reasonably required to participate in the general care and emergency treatment of patients. They must be able to respond promptly to urgencies within the practice setting and must not hinder the ability of their co-workers to provide prompt care. Examples of such emergency treatment reasonably required of pharmacists include arriving quickly when called, cardiopulmonary resuscitation, the preparation of sterile intravenous medications, and application of pressure to stop bleeding, participating in the initiation of appropriate procedures, and rapidly and accurately preparing appropriate emergency medication and others. Such actions require coordination of both gross and fine muscular movements, equilibrium, and functional use of the senses of touch and vision.

Students must have sufficient sensory and motor function to monitor drug response and to prepare and or dispense pharmaceuticals. A candidate should be able to perform basic laboratory tests (such as blood glucose and lipid levels), administer immunizations (intramuscular and subcutaneous), compound sterile and non-sterile dosage forms, use current technology for drug information evaluation, and read basic EKGs, drug blood levels, and other laboratory results. It is also necessary for the student to be able to access information sources (both paper and electronic) within a reasonable time frame and record data correctly so that it is readable at a later time.

Intellectual - Conceptual, Integrative and Quantitative Abilities

A candidate should possess sufficient intellectual, conceptual, integrative and quantitative abilities to complete a rigorous and intense didactic and experiential curriculum. These abilities include measurement, calculation, problem reasoning, analysis, judgment, numerical recognition and synthesis. In addition, the candidate should be able to comprehend three-dimensional relationships and to understand the spatial relations of structures. Especially important is the appropriate and rapid calculation of dosages and dosage adjustments in a variety of conditions such as renal or hepatic failure, obesity, cardiac or respiratory arrest, etc.

Additionally, calculations involving appropriate dilution or reconstitution of drug products, electrolytes, etc., must be made accurately and quickly. Problem solving, a critical skill demanded of all pharmacists, requires all of these intellectual abilities and must be performed quickly, especially in emergency situations. Students must be able to identify significant findings from history, physical assessment, and laboratory data; provide a reasonable explanation and analysis of the problem; determine when additional information is required; suggest appropriate medications and therapy; develop appropriate treatment plans to improve patient outcomes; develop patient counseling information at a complexity level appropriate to a particular situation; and retain and recall information in an efficient and timely manner.

The ability to incorporate new information from peers and/or instructors, and to locate and evaluate new information from the literature to be used appropriately in formulating assessments and pharmaceutical care plans is essential, as is good judgment in patient assessment and therapeutic planning for disease management. Students must be able to identify and communicate the limits of their knowledge to others when appropriate and be able to recognize when the limits of their knowledge indicate further study or investigation is essential before participating in decision making. Students must be able to interpret graphs or charts describing biologic, economic or outcome relationships.

Behavioral and Social Attributes

Empathy, integrity, honesty, concern for others, good interpersonal skills, interest and motivation are all personal qualities that are required. Candidates must possess the emotional health required for full use of their intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the screening and care of patients, and the development of mature, sensitive, and effective relationships with patients of differing cultures and backgrounds. Students must be able to develop professional relationships with patients and their caregivers and partners, providing comfort and reassurance when appropriate while protecting patient confidentiality.

Candidates must possess adequate endurance to tolerate any physically, intellectually, and emotionally taxing workloads and to function effectively under stress or with distractions. At times this requires the ability to be aware of and appropriately react to one’s own immediate emotional responses and environment. For example, students must maintain a professional demeanor and organization in the face of long hours and personal fatigue, dissatisfied patients, and tired colleagues. All students are at times required to work for extended periods, occasionally with rotating shifts. They must be able to adapt to changing environments, to display flexibility, and to learn to function in the face of uncertainties inherent in the clinical problems of many patients. Students must also develop the skills necessary to instruct and supervise technical personnel assisting with the delivery of pharmaceutical services. Students are expected to accept appropriate suggestions and criticism and if necessary, respond quickly, appropriately, and cooperatively by modification of behavior. Empathy, integrity, concern for others, interpersonal skills, interest, and motivation are all personal qualities that should be assessed during the admission and education processes.

Ethical Values

A candidate must demonstrate professional demeanor and behavior, and must perform in an ethical manner in all dealings with peers, faculty, staff, and patients. Questions of breech of ethical conduct will be referred to the assistant dean for student affairs for resolution under the Student Code of Conduct. Students must also meet the expected ethical standards set forth by the profession. Good moral character, decent values and principled judgment are paramount attributes for being a professional. In order to participate in key components of the curriculum, a student must be able to obtain and maintain a valid Pharmacists Intern License from the Texas State Board of Pharmacy and pass requisite criminal background checks and random illegal drug screens required by affiliated clinical institutions.

Candidates for the Doctor of Pharmacy degree must have somatic sensation and the functional use of the senses of vision and hearing. Candidate’s diagnostic skills will also be lessened without the functional use of the senses of equilibrium, smell, and taste. Additionally, they must have sufficient exteroceptive sense (touch, pain, and temperature), sufficient proprioceptive sense (position, pressure, movement, stereognosis, and vibratory), and sufficient motor function to permit them to carry out the activities described in the section above. They must be able to consistently, quickly, and accurately integrate all information received by whatever sense(s) employed, and they must have the intellectual ability to learn, integrate, analyze, and synthesize data.

Any faculty or administrative team member may question any enrolled student’s or candidate’s (for admission) ability to meet any technical standard. A request for such an investigation into a specific individual must be made in writing to the associate dean for academic affairs (for currently enrolled students) or the assistant dean for student affairs (for applicants), detailing the reasons why such an evaluation is deemed necessary. The dean will be notified if such a request is granted. The procedures outlined below in the Operative Policy Section will be followed if such an action is taken.

Applicable Technical Requirements

All applicants for admission and already enrolled students in the program must be able to answer yes to all of the questions or statements listed below. Failure to meet any of the necessary technical standards is considered grounds for denying admission to and for dismissing a student from the program.

  • Is the candidate able to observe demonstrations and participate in experiments in the basic pharmaceutical sciences?
  • Is the candidate able to analyze, synthesize, extrapolate, solve problems, and reach therapeutic judgments and monitoring parameters?
  • Does the candidate have sufficient use of the senses of vision and hearing and the somatic sensation necessary to perform a physical assessment? Can the candidate perform palpation, auscultation, and percussion?
  • Can the candidate reasonably be expected to relate to patients of all cultures and backgrounds and establish sensitive, professional relationships with them?
  • Can the candidate reasonably be expected to communicate therapeutics options and decisions to the patient and to colleagues with accuracy, clarity, and efficiency?
  • Can the candidate reasonably be expected to learn and to perform routine laboratory tests and screening procedures?
  • Can the candidate reasonably be expected to perform with precise, quick, and appropriate actions in emergency situations?
  • Can the candidate reasonably be expected to display good judgment in the assessment and treatment of patients?
  • Can the candidate reasonably be expected to possess the perseverance, diligence, and consistency to complete the Rangel College of Pharmacy curriculum and to enter the practice of Pharmacy?
  • Can the candidate reasonably be expected to accept criticism and respond with the appropriate modification of behavior?
  • The candidate has never been charged with or convicted of an offense that would disqualify him/her for licensure or passing a background check.
  • The candidate has demonstrated proper professional judgment and has never exhibited bad or improper moral behavior.
  • The candidate has never exhibited insensitive behaviors to other cultures or those different from him/her?

Operative Policy

In order to implement the Technical Standards, the following application of the Technical Standards for Completion of the Curriculum will be

  • An abbreviated copy of this policy will be placed in each application packet. The copy is for information and requires no action on the part of the applicant.
  •  At the time a letter of acceptance is tendered to an applicant, the letter will be accompanied by another copy of the policy, together with the detailed technical standards adopted by the faculty for completion of the Rangel College of Pharmacy curriculum. At that time the candidate must respond in writing that s/he does/does not accept the offer of admission.
  • Further, the candidate must state in writing that s/he has read the technical standards for completion of the curriculum and that s/he can perform or meet the technical standards with or without reasonable accommodation.
  • If the candidate does require accommodation, the accommodation must be specifically stated in writing. Further, the candidate will be required to submit written verification of disability and recommendations for accommodation. Such verification must be mailed from an appropriate professional to the Assistant Dean for Student Affairs.
  • The assistant or associate dean will confer with appropriate Texas A&M University System and university officials, with legal counsel if indicated, and with at least one faculty member who is conversant with appropriate testing for and accommodation for the specific disability. This group may require further examination and/or testing by a professional approved by the college. Such examination/testing would be at the college’s expense. The additional documentation will be reviewed by the above committee which then will render a decision regarding the student’s ability to meet the standards for completion of the curriculum with reasonable accommodation.
  • If the applicant is judged to be able to meet the technical standards, the assistant dean for student affairs will notify the associate dean for academic affairs in writing regarding the accommodation to be provided to the student. The student will receive a copy of that letter.
  • If the student desires any change in accommodation, either deletion or addition of accommodation, that request must be presented in writing to the associate dean for student affairs. The committee which prescribed the initial conditions for accommodation will rule on the request and will notify both the student and the associate dean for academic affairs of any change.
  • If the accommodations requested cannot be met in a reasonable manner, then the letter of acceptance to the Rangel College of Pharmacy will be withdrawn on the basis that the student cannot meet the standards for completion of the pharmacy curriculum. The student will be notified by the assistant dean for student affairs verbally and in writing of such a decision.
  • If the student disagrees with the decision of the committee, s/he may appeal in writing to the dean of the Rangel College of Pharmacy. Bases for appeal will include:
    • due process was not followed
    • a policy or procedural error was committed which adversely affected evaluation of the student
    • the information considered by the committee was not sufficient to justify the decision of the committee
  • An appeals committee will be appointed by the dean of the Rangel College of Pharmacy to review the student’s written petition. If the committee judges that there is a basis for appeal, it will hear the student and such other persons whom the student designates, may talk with the initial evaluation committee, may seek such other expertise as appears reasonable in arriving at a decision, and will make a recommendation to the dean.
  •  At the appeals hearing, the student may choose to be accompanied by legal counsel, in which case the Texas A&M University Health Science Center counsel will accompany the assistant dean for student affairs. In the event the student chooses to be accompanied by legal counsel, s/he must notify the assistant dean for student affairs at least 10 days in advance of the hearing. The attorneys will act in an advisory capacity only and may not address the committee.
  • Upon receipt of the recommendation of the committee, the dean will make a final decision and will so notify in writing both the student and the assistant dean for student affairs. This step exhausts the student’s appeal.
  • If an enrolled student becomes unable to meet any of the prescribed Technical Standards during the course of their professional education at the Rangel College of Pharmacy, the associate dean for academic affairs can require the student to submit written verification of disability and recommendations for accommodation. Such verification must be mailed from an appropriate professional to the assistant or associate dean.
  • The associate dean for academic affairs will confer with appropriate System and university officials, with legal counsel if indicated, and with at least one faculty member who is conversant with appropriate testing for and accommodation for the specific disability.
  • This group may require further examination and/or testing by a professional approved by the college. Such examination/testing would be at the college’s expense. The additional documentation will be reviewed by the above committee which then will render a decision regarding the student’s ability to meet the standards for completion of the curriculum with reasonable accommodation.
  • If the applicant is judged to be able to meet the technical standards, the associate dean for academic affairs will notify the assistant dean for student affairs in writing regarding the accommodation to be provided to the student. The student will receive a copy of that letter.
  • If the accommodations requested cannot be met in a reasonable manner, then the student will be withdrawn from the Rangel College of Pharmacy on the basis that the student cannot meet the standards for completion of the pharmacy curriculum. The assistant dean for student affairs will notify the student verbally and in writing of such a decision.
  • As before, if the student disagrees with the decision of the committee, s/he may appeal in writing to the dean of the Rangel College of Pharmacy. The same basis and procedures described in above operative steps 8-11, inclusive will be followed.