North American Pharmacist Licensure Examination Absolute Failures Warrant Monitoring of Colleges and Schools of Pharmacy

Over the past three years, 7,978 graduates of pharmacy programs have failed the North American Pharmacist Licensure Examination (NAPLEX) on the first attempt. At present, the ACPE monitors programs with a passage rate of ≥2 standard deviations (SD) below the national mean pass rate. In 2023, this would lead to monitoring seven programs that produced 140 failures out of the total of 2,472 failures (i.e., 5.7%). In our view, this is neither equitable nor demonstrative of sufficient accountability. Analysis of failure counts among the 144 programs reported by NABP demonstrates a distribution curve highly skewed to the right. After evaluating average failure counts across all the programs, we suggest that schools with absolute failures ≥2 SD higher than the average number of failures of all programs should be flagged for monitoring. Based on the 2023 data, this corresponds to ≥35 failures/program. This threshold would flag 18 programs and 36.5% of the total failures. Of the seven programs that will be monitored based on the current Accreditation Council for Pharmacy Education criteria, only one would be captured by the ≥35 failure method of selection with the remaining six contributing only 85 total failures to the pool. Thus, if both criteria were to be applied, i.e., ≥35 failures and of ≥2 standard deviations below the national mean pass rate, a total of 24 programs would be monitored (16.6% of the 144 programs), that contribute 987 (39.9%) of the total failures.