Since Elizabethan days our English friends have been known as turners of neat phrases. Adroitness at expressing rather complex ideas in simple, and often times clever terms is with them an art. The other day in reading about the coronation, I saw that a British gardener of note said that the proper way to prepare a beautiful lawn for the coronation was to start 200 years ago. In thinking about our Diamond Jubilee, I was struck by the similarity of circumstances and wondered if we might not say that the way to have a vigorous School of Pharmacy in 1953 is to start 75 years ago. Now such a statement would be more than a paraphrase of a clever bon mot, for 75 years ago was, historically, the correct time to start a college in Pittsburgh. I have neither the time nor the talent to develop that historical theme properly, but I would like to defend the thesis in a superficial way at least.
First of all, the University of Pittsburgh at that time was just about 100 years old. Despite the fact that the University has been somewhat slow in recognizing her full maternal responsibility for us, I can never think of the School of Pharmacy apart from the University. After all, Professor Phillips of the chemistry department was the midwife at our birth. It is of more than passing interest that a part of Professor Phillips' obstetrical fee was the requirement that we purchase a spectroscope, a research tool rather rare in those days, and an oxy-hydrogen lantern for visual education-so you see we were to become a modern child with scholarly presage. But back to the theme-the University, at that time, was sufficiently mature in terms of scholarship to have made great contributions to us, if we had had the wisdom to know how to use them.
Secondly, 1878 was the time when higher education was beginning to throw off the yoke of a, certain kind of narrow ecclesiasticism and sterile classicism in short our birth coincides with the beginning of the phase of American education called modern.
Third, this was the period when many great Universities were forming Schools of Pharmacy. The University of Michigan, for example, formed such a school in 1867 and the University of Wisconsin followed in 1883. This led to a concept of pharmaceutical education which, while rapidly becoming recognized, is not completely accepted even yet and which is capable of yielding a profession truly worthy of the name.
So, I repeat, the School of Pharmacy of the University of Pittsburgh had the good sense to be born at the right time to develop into a college of rank.
I would like to spend the time reviewing with you the glorious history of these past 75 years, but instead I will talk about some pharmaceutical education problems of the present and the more immediate future. Had I the courage and the audacity I would attempt to predict what the next 75 years will bring, but caution restricts me to the time required to live Out our first century. We have to think of the past, not because it is our duty but because it is a necessity of fate that the past merges into the present and future in such a way that it cannot be ignored.
Pharmaceutical education at Pitt does not operate in a vacuum. It is tied in with education in its other aspects at this University and it is an integral part of pharmaceutical education throughout the nation and even the world. My position brings me in contact with schools throughout the land; I have visited over one-third of the colleges from Boston to Los Angeles and from Houston to Chicago during this academic year. This stimulating experience has made it possible to see trends in pharmaceutical education in a broad way.
Education in pharmacy in the United States has gone through distinct periods not unlike ladies' hats, and at times equally bizarre. At first all pharmaceutical education was training, not education, by apprenticeship-in modern parlance "on-the-job" training. Later such training was coupled with formal education in schools and colleges. Although we have progressed to the point where all pharmacists must have at least 4 years of formal education, and the colleges in one state require the 4 years to be preceded by at least 2 years of preprofessional collegiate education, we have never seen fit to eliminate completely the on-the-job phase of the educational process.
During the days when all or nearly all of the training took place in the community pharmacy, the pharmacist recognized himself as a part of the pedagogical process. I fear that such is not always so now, for it has been known to happen that the apprentice be given short shrift as far as such training is concerned. Frequently, knowledge of this has led the colleges to attempt to fill the void by teaching things for which they are ill-suited. The time has come when it is imperative that the educator and the practitioner sit down together and delineate more critically their respective functions.
The ability to establish and maintain proper relations between pharmacist and patron, pharmacist and physician, and pharmacist and fellow pharmacist, for example, can be taught best in the field. While principles of prescription practice can be and should be taught in the college, skill, accuracy, and dispatch are best developed at the prescription counter. To attempt to gain familiarity with a vast number of brand names, proprietary drugs, and packaging types in a formal way can have little meaning to the uninitiated student. The mechanics of inventory control, purchasing and record keeping of narcotics, and evaluation of the seasonal fluctuation of goods sold are all things which the practitioners can teach better than we.
So I predict, if I may be so bold, that one of the next trends in pharmaceutical education will be the more careful prescription of the duties of the master to the apprentice or, more properly, the intern.
Those of you in pharmaceutical practice are more aware than I of the rapidity with which new drugs become available. Apparently well over 50 per cent of the drugs handled by the pharmacist today were non-existent as short a time as 10 years ago. Students know that the sciences ancillary to pharmacy are changing with equal rapidity. We exchange facts for new ones so frequently, that it is now virtually impossible to teach a pharmacist all of the facts and ideas that he should know. Educators' appreciation of this situation is leading to a new concept of education. We are endeavoring now to teach students how to think like a doctor, to think like an engineer, or to think like a pharmacist.
The emphasis is away from piling fact upon fact and toward the fundamentally more difficult inculcation of methods of thinking in a certain pattern. Pharmaceutical education will inevitably show this same trend. This may, at times, lead you to disappointment in the product of our colleges when you get the student as a new employee. After you have supplemented his education with your experience, you will be pleased with the novitiate's grasp.
Pharmacy is inexorably tied up with medicine. According to the Commonwealth Fund report of 1952, medicine is now in the second of three stages as far as education is concerned. According to this report, the first phase is that initiated by the Flexner report of 1910 and may be thought of as the scientific phase or the period of the specialist. In recent years, however, psychology, anthropology, sociology, and the other behavioral sciences have entered the picture and the physician is becoming concerned with the patient's interaction with his environment. That is, we are now in the second phase of medical education, a transitional phase in which the concept of comprehensive medicine is beginning to modify the definition of scientific medicine. The third phase will be some "reconciliation between what has been called scientific medicine and what is now called comprehensive medicine, some better adjustment of the specialist to the generalist, and some restructuring of both medical education and medical care to fit the needs of a more knowledgeable social order." If medical education is going to undergo some such change, pharmaceutical education and practice will have, in some way, to adjust.
Perhaps a more horizontal structuring of the curriculum is the answer. Instead of a review of all of the scientific facts concerning the antibiotics (and I am not minimizing the value of these facts) the pharmacist should see more of the picture. What are the economic and social implications of the discovery of the antibiotics in our time? Certainly the increased longevity and decreased absenteeism in industry in this country, the changed death rate in whole continents dependent upon disease to maintain the birth-death equilibrium and many other such consequences are of as much interest to pharmacists, or should be, as the classical pharmaceutical facts.
Another trend in pharmaceutical education, as I see it, is an ethical one. I was about to say that we in the schools have never been able, but perhaps it is more honest to say, we have rarely tried, to develop techniques for inculcating professional ethics. Since integrity of character is one of the prerequisites for admission to our schools of pharmacy, it would appear that lack of knowledge of moral law is not the missing factor. It seems that ability to function ethically in very complex social situations is difficult. Perhaps we need, first of all, to define the ethics of professional situations more accurately and precisely, and then develop a system of teaching in this area by a method akin to the case system of the law school.
But enough of speaking in generalities. Let us don the robes of the seer and the prophet and see what can be expected at the University of Pittsburgh during the last quarter of our first century. Actually the trend lines have been so well established by Dean Reif and his staff, and the groundwork has been so well laid by preceding deans and their staffs, that prediction should not be difficult.
In the first place, it is safe to predict that the School will be integrated more closely with the University as a whole, especially as to physical plant and improvement in general education. Man does not live by bread alone, and certainly pharmacists do not live by only that which is embraced by the Rx symbol. We are more than pharmacists: we are husbands and wives, fathers and mothers, citizens, neighbors, churchgoers, community leaders, members of fraternal and service organizations - all of these and many more. It is essential that we take part in church activity, local political affairs, health councils, and other community activities that give us a measure of the pulse of social and health needs. We are a selected few, not only because we have a college education, but because we have in addition a professional education. Professional people are highly specialized people in their work and they come in contact with other highly specialized individuals daily, because that is the nature of our complex society. Now the danger is that we will think that the running of public affairs should be entrusted to a specialized class. We are apt to forget that ours is a democracy of workers - not of a leisure class. It will be a great tragedy, then, if professional people abdicate their interest in public affairs, entrusting all to others, many of whom are intellectually inferior. If we do not inform ourselves of the larger issues of our times and meet them with selfless concern, we are nothing short of derelict in our duties to our fellow man. General education at the University should assist us in preparing for this responsibility. Perhaps in the future a part of this broad education will be placed into preprofessional years.
Another prediction for the next 25 years is a closer integration with the other health science professions. Pharmacy cannot only gain much from such integration; it can give much too. In the vast medical center that is growing rapidly at Pitt, pharmacy can make a valuable contribution to the multiple hospitals. The pharmacist as a specialist on drugs should be the key man on the therapeutics board, assisting in keeping the inventory within bounds and keeping the staffs informed about the countless new drugs as they are placed on the market. A useful professional service will be rendered to the other health professions and pharmacy will gain value for its educational program.
An important feature of the integration will be that which pharmacy can contribute to medical science education by way of special instruction about drugs to the students of medicine, dentistry, and nursing. There is a sphere of practicality that is often not covered by the strictly scientific courses and, as a matter of fact, the School of Pharmacy is already functioning in this area. Further, when other health science students see for themselves the many phases of interest of the pharmacist while they are students, improvement in future interprofessional relations is bound to ensue.
The fact that the University of Pittsburgh has a Graduate School of Public Health strengthens all of the health sciences. It is now possible to explore further, with expert advice, pharmacy's role in community health and in health education. We have acknowledged for some time that the pharmacist is in a strategic position as far as the number of contacts with the public is concerned. Those contacts must be given more meaning. I predict that within the next 25 years Pitt will have become a leader in this field by co-operating more closely with the other health sciences. Distribution of health information, active Health Conference, the development of techniques for getting seekers after participation in programs such as the Diabetes Detection Drive, the Rural self-medication into professional hands-these things and more will be developed.
Pitt has become a leader in the field of pharmacy administration, the economic side of pharmacy. The next 25 years should see an expansion in this area as research is developed further. One frequently hears from one group that there are too many pharmacists or, from other sources, too few. Studies of the distribution of stores and manpower in relation to economic and professional needs are needed. Perhaps Pitt will be the focal point of such studies.
Pharmacists are interested in finding ways to extend their professional services. The more time and energy that can be devoted to professional activity the less will be needed in less professional areas. This will take constant research and thought. No one is in a better position to take the lead in such studies than the University of Pittsburgh where we have taken the lead in pharmaceutical economics. I predict that the research findings in this area will be transferred ultimately into the field in some form of extension service or in-service training.
The last prediction is concerned with graduate education and research. This area will expand, for the University recognizes that the secret of good teaching, in the last analysis, rests on scholarly research and professional activity.
Although the graduate area will always be small in relation to the undergraduate area, this is the creative area from which will come research workers and teachers. Research workers are needed by industry and government, and teachers are needed for our 74 colleges of pharmacy. The Ph.D. program develops a scholarly attitude among teachers, and without a faculty of distinguished scholars, not only well trained but constantly productive, a college is sterile. No charm of personality, no busy work on committees, no fluent speakers in the classroom, no fraternities, no College newspapers, can keep a college from becoming a hollow shell if it has not scholarship. If a teacher is not a scholarly teacher, even the most elementary student is cheated, for he receives merely facts and not that enthusiasm to interpret facts, and that capacity to acquire more and fresh facts that should be the aim of the College to develop.
In closing, it is fitting that we gather here tonight to celebrate the achievements of the past 75 years and look forward to that which is to come. On this Diamond Jubilee we recognize that education is Pharmacy's diamond - not the shiny, glittery diamond that is used only for ornament, but the kind of a diamond that cuts and polishes everything it touches, bringing usefulness to man.