An Opinion On Provisional Registration

While the idea of provisional registration has divided the profession we decided to hear from those directly affected the exam cancellation how it has affected them and what their views are. We will be publishing opinion pieces for and and against the provisional registration to allow the profession have a clearer understanding of the impact. Today's opinion piece is by Noel Kizere, a pre-registration pharmacist.

COVID-19 has undeniably disturbed normality. It caught us by surprise, now we find ourselves in ‘unprecedented times’. Amidst the uncertainty, the 3 main clinical professions have found themselves stretched thin. There is a need for frontline staff. The GMC and NMC were proactive in their response and quickly issued a mandate fast tracking final year medics and student nurses to the frontline. Our cohort of pre-registration pharmacists, eager to join our peers on the frontline waited to find out our fate. When mass gatherings were banned it was announced that both sittings were cancelled. The GPhC then declared they had considered all possible options and concluded that the appropriate response was to delay exams until late 2020 or early 2021 with a possibility of a provisional register in the interim.

Many of us were devastated but we accepted this as a viable option. However, since the initial announcement, we have spent the last 4 weeks in anguish awaiting clarification. The announcement raised more questions than it answered, and the provisional register proved to be rather divisive.

There are 3 main factions. Those concerned with ‘the integrity of the register’, those in support of provisional registration and those in favour of automatic registration. I like some of my peers find myself somewhere in the middle the latter two. Whilst I recognise that the provisional registration is arguably the most viable solution, I also recognise the impact of delayed registration and the possible consequences of a provisional register. I also find it ironic that we as a learned community continue to place so much emphasis on exams as the measure of ability to practice safely. One would expect that MPharm courses and Pre-registration training ought to be sufficiently robust to ensure that in any events trainees can be deemed fit for practice without the need for a final assessment. Pharmacy schools are regularly revalidated therefore the GPhC must be sufficiently satisfied that teaching at these sites is uniform and of sufficient quality. Furthermore there are many factors that affect exam performance such as performance anxiety, luck and exam technique. Another concern is that of public perception, how can we as a profession expect the public to trust that we are as capable as we say we are when we do not trust our own training to equip us for practice without relying on the results of an assessment? Pharmacy has fought hard for to change public opinion, but I believe this will set us back. How will the public view our stance when the GMC and NMC gave full backing to their trainees? 

My concerns regarding provisional registration:

For provisional registration to work the GPhC needs to ensure that we are able to practice as pharmacists (albeit under supervision) and be suitably compensated (Band 6 etc).. The GPhC will need to convince organisations and companies to employ provisionally registered pharmacists whilst also taking on the next cohort of pre-registration pharmacists and ensuring that their training is not infringed by the presence of a provisional pharmacists that also requires  supervision. There also needs to be a degree of flexibility because there are those like myself who had to relocate for our pre-registration year. We are facing the possibility of not having a place to live should our landlords refuse to extend our tenancy. What about locuming? Can we locum do that? In short, provisional registration cannot be a fancy title for ‘pre-registration pharmacist’. It needs to guarantee that we are employed and treated on an equal basis to newly qualified pharmacists albeit with supervision.

Having said that, I recognise that the GPhC is there to protect the public. If they conclude that we are unsafe until the assessment deems otherwise then fair enough. Provisional registration can be a fair solution for the majority. But this is a prime opportunity for the GPhC to engage with and change perception amongst the next generation of pharmacists. They are a regulatory body, but they are our regulatory body. This is an opportunity for them [GPhC] to build a mutually beneficial relationship based on respect.

A qualified pharmacist recently asked me “How would you feel if you got provisional registration and then failed the exam”. Therein lies the problem. Akin to the angry drivers who once they get their licence forget the excitement and terror of being a learner. I ask all pharmacists to remember what it felt like being in our position, before you saw your name on the register. You’d spent 4 years navigating the hurdles of your undergraduate degree and you made it. Pharmacy was more than a passion it was a way of life. A dream that was just one final hurdle away. Remember that feeling? Unfortunately some never go on to experience this feeling, every year there are those who fail to the assessment, those who cannot realise the dream we all share. Provisional registration is an opportunity for our cohort to realise that dream and even though some will unfortunately never make it onto the full register “Tis better to have loved and lost than never to have loved at all”.

For this reasons I fully support the proposal for a provisional licence in the interim period between now and the assessment.

Author: Noel Kizere