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Nearly 35 years ago the Board of Pharmacy Specialties (BPS) was created by the American Pharmacists Association (APhA).  Today six specialties have been recognized and more than 10,000 pharmacists have been certified through examination.  Recently BPS released the eligibility requirements for board certification in ambulatory care pharmacy.  I was pleased to see the requirements for this new specialty published since I participated in the development of the petition requesting recognition for this specialty (and two others) and it has been a long time since the last specialty was approved in the mid 90s.  But the specific eligibility requirements for examination surprised me and caused me to reflect on the requirements for each of the existing specialties. I was quite surprised at the extent of the variation among requirements.  The following table briefly summarizes the current requirements.

Note: All candidates for examination for all specialties must be graduates of a pharmacy program accredited by the Accreditation Council for Pharmacy Education (ACPE) or a program outside the U.S. that qualifies the individual to practice in the jurisdiction and hold a current, active license to practice pharmacy in the U.S. or another jurisdiction.

There is limited alignment among these requirements and it is not clear why they vary.  A specialty residency is recognized in most cases, but not all.  In some cases additional experience in the specialty is required while for others it is not.  In the case of Pharmacotherapy, an applicant may sit for examination immediately after completion of a PGY1 residency.  Strangely, no PGY2 residency qualifies an applicant to sit for the Pharmacotherapy exam; not even a PGY2 residency in Pharmacotherapy.  This is oddly different from all of the other BPS-approved specialties and is the only specialty that recognizes a “generalist” residency with no further training or experience as adequate preparation in the specialty area.  This seems to imply that a PGY1 residency is a specialty residency, which is inconsistent with ASHP’s residency accreditation standards.  It is also interesting that a PGY2 residency in internal medicine is not recognized in the eligibility requirements although BPS has acknowledged that this training aligns to some extent with this specialty.

Optimally, there should be close alignment between the preparation of specialists through accredited education and training programs and ASHP has encouraged BPS to examine this issue as it plans for future specialties.  When the emergence of specialties in pharmacy was in infancy it was logical that the many of specialists were self-taught, but as pharmacy’s cadre of specialties matures one would hope that increasingly most specialists would complete structured training programs that prepare them for practice in their respective specialties.  BPS has taken the positive step of being more proactive in examining the profession’s needs for new specialty areas.   As BPS contemplates the addition of more new areas, perhaps it is time to more carefully examine the link between specialty training and certification and to harmonize eligibility requirements of existing specialties.  What do you think?