The NAPLEX is an examination pharmacists take to become licensed. While many pharmacy schools have high passing rates, people inevitably fail this test each year. Here, an experienced pharmacist and educator discusses reasons why people fail the NAPLEX.
Authored By: Christopher Bland, Pharm.D., BCPS, FIDSA
For most recent pharmacy school graduates life is good, as they pass their licensure examinations (including the North American Pharmacist Licensure Examination [NAPLEX]) and officially become a new pharmacist. Some recent graduates however do not pass the NAPLEX – and it happens more than you may think!
The National Association of Boards of Pharmacy (NABP) recently published the cumulative pass rate from 2013-15 of pharmacy schools on its website . The average pass rate (all attempts) from programs accredited by the Accreditation Council for Pharmacy Education (ACPE) has decreased from 95% in 2013 to 91% in 2015. Therefore it is not a stretch to say that over 1,000 pharmacy students fail the NAPLEX on an annual basis. Does that get your attention?
Why does this happen? There are a number of reasons based on my experience that I believe students likely fail the exam which I will overview in this column…
1. You didn’t take the exam seriously
I addressed this concern in my last column and pleaded for serious study! Sometimes faculty members or preceptors may influence a lackadaisical approach by saying things like “everybody passes” or “it’s a piece of cake” which is unfortunate.
Some students choose to minimally study or not study at all, often forfeiting free/discounted resources from their school of pharmacy or potential new employer.
Unfortunately many of the students who fail the NAPLEX do so by just a few points. In all likelihood if extra effort would have been present they would have passed.
2. You didn’t start studying early enough
As my good friend Scott Sutton who is editor of the NAPLEX Review Guide says, “Cramming does NOT work for this exam”.
Ideally a longitudinal study process starting early in the last year of pharmacy school works best where you are working on areas of weakness such as oncology, HIV, etc. all year long to convert these weaknesses to strengths.
3. You missed a lot of calculations questions
How many calculations questions did you practice before your exam? Most students perform very few calculation problems throughout their last year of pharmacy school while on rotations. Yet this is a significant portion of the exam with the potential for these questions to be fill in the blank (Constructed-Response) which makes the question even more difficult.
Practicing calculations is crucial for the NAPLEX.
4. You have a side effect knowledge deficit
Often students are pretty good at “drug placement”, such as the first-line medication therapies or drugs of choice. This is often a primary focus during rotations. However, students often struggle with basic side effect knowledge which is important for the NAPLEX.
It is absolutely vital to know the most common side effects (such as peripheral edema for dihydropyridine calcium antagonists) but also serious less common side effects that are often black box warnings (such as felbamate and aplastic anemia) to perform well.
5. You didn’t finish the exam
This one happens too often. Taking a practice test is very helpful to gauge how quickly you will finish the test. When is the last time you took a 4-hour examination?
Most students know if they tend to be the last ones to finish tests throughout pharmacy school. This will become even more important in November 2016 when the exam increases from 185 questions to 250 questions and the exam is lengthened to 6 hours.
It is important to realize that there is no penalty for guessing! A question is counted wrong if not answered. It is best if pressed for time to answer all questions quickly than to leave blank!
…I hope this will help you refocus on where you can be helped when you retake the NAPLEX. Chances are at least one of these reasons will be the difference in passing the examination on the next attempt.
1. National Association of Boards of Pharmacy. NAPLEX School Pass Rate: 2013-2015. Available at: http://www.nabp.net/programs/examination/naplex/school-pass-rate. Accessed 7/7/2016.
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