A Guide for Foreign Pharmacists to Become Licensed in the United States

A foreign pharmacy graduate is a pharmacist whose undergraduate pharmacy degree was conferred by a recognized school of pharmacy outside of the 50 United States, the District of Columbia, and Puerto Rico. This definition is regardless of whether you are a US citizen, permanent resident (green card holder) or an illegal immigrant.
However, if you are a foreign national and attended a pharmacy school in the US, you are not considered a foreign pharmacy graduates.

Traditional Foreign Graduate Pharmacist Licensure Pathway

The Major steps are:
1.            Apply and take the Foreign Pharmacy Graduate Equivalency Exams (FPGEE)
2.            Take Test Of English as a Foreign Language (TOEFL)
3.            Obtain Foreign Pharmacy Graduate Examination Committee (FPGEC) Certification
4.            Take the North American Pharmacist Licensure Examination (NAPLEX)
5.            Take the pharmacy law test
STEP 1
Take the FPGEE
To qualify for the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) one must satisfy 1 of 2 options
OPTION 1: for graduates before January 1st 2003
Complete at least a four-year pharmacy curriculum in their home country
OPTION 2: for graduates on or after January 1, 2003
Complete at least a five-year pharmacy curriculum in their home country.
Note that Coursework and internships completed after pharmacy school graduation will not be considered in determining the minimum required curriculum length).

The FPGEE Exam
The FPGEE is a 250-question multiple-choice computerized examination administered over a five and half hour testing period.
•Effective January 1, 2012, an FPGEE score report will be valid for five years from the test date.
• FPGEE is administered twice in a year and they are only offered in USA. One in spring and the other in Fall.
•The examination is a comprehensive measure of knowledge in four major pharmacy content areas:
16% – Basic Biomedical Sciences
30% – Pharmaceutical Sciences
22% – Social/Behavioral/Administrative Pharmacy Sciences
32% – Clinical Sciences.
STEP2
There are many TOEFL exams. The TOEFL iBT is the only one that is considered for Pharmacy Graduate Examination Committee (FPGEC) certification.
The minimum score for the various sections on the test are:
• Reading – 21
• Listening – 18
• Speaking – 26
• Writing – 24
It is important to note that these minimum scores should all be attained in ONE testing. This means that all scores must be reported in one official score report.
STEP 3
After passing both the FPGEE and the TOEFL iBT, and submitted all the necessary documents to the FPGEE, you will receive the FPGEC certification.
Almost all the states accept FPGEC certification for obtaining a pharmacist license. Each state may require pharmacy internship hours.
STEP 4
Before you can be a licensed pharmacist in the US, one needs to pass the NAPLEX. This is the same pharmacy licensure exam that US graduates take. Visit the local pharmacy board for more directions on the state law test. It is important to note that pharmacists can apply and be licensed in multiple states.

Alternate Foreign Graduate Pharmacist Licensure Pathway

Complete at least a five-year pharmacy curriculum in their home country before applying for the FPGEE is the main reason why most foreign pharmacists cannot take the traditional foreign pharmacist pathway. The change from a four-year to a five-year educational curriculum requirement has enabled the FPGEC Certification Program to be consistent with the revised standards of US pharmacy school curriculums. However, since many foreign pharmacy schools are 4 year programs it has made it more difficult for foreign graduates to become licensed in the US. 
There are 2 major alternative pathways:
Apply directly to a Pharmacy program
There are 2 pharmacy schools programs for recently graduated foreign pharmacist that that did not complete a 5-year program. These schools offer a 3-year top up program for foreign pharmacist to obtain a PharmD degree and take the NAPLEX exam after graduation.
•PharmD for International Pharmacist offered by Nova South Eastern University (NSU) in Florida.
• International Post Baccalaureate PharmD (IPBBP) offered by Western University in California
Other pharmacy schools, for example California Northstate University in California, may consider a foreign applicant if they meet the prerequisites for admission or if they take required courses that may be missing from their transcript.
Admission to pharmacy schools is very competitive. The current ratio is 1 in 7 applicants  are accepted to traditional programs. The 2 foreign pharmacy graduate programs have a higher acceptance ratio because of the high demand for those programs. It is very normal for foreign pharmacist to apply for a couple of years before they are admitted to a pharmacy school. Foreign trained pharmacists should not be discouraged if they have to apply to multiple schools for multiple years before admission.

Start Afresh

For all those years that some people wait in line and keep applying for a foreign graduate program, you can broaden your choices by applying to a pre-pharmacy school and take pre-requisites classes. This will allow you to compete with all other applicants to both traditional and foreign graduate PharmD programs.

Challenges for Foreign Graduate Pharmacists

Cannot Pass FPGEE
Every step comes with its challenges. There are foreign pharmacists who just cannot pass the FPGEE and so are considering starting all over. Some foreign pharmacists have been stuck on this step for years. If you cannot pass the FPGEE for whatever reason consider:
•             Attending a review class
•             Get a personalized teacher
•             Change your learning strategy
•             Address any language challenges
Cannot Pass TOEFL
For most applicants, the Speaking section is their challenge. This is mainly because of the foreign accent. If you cannot pass TOEFL
•Take an English or Speech class at a community college
•Attend classes specific for TOEFL iBT
Cannot Get into NOVA University (NSU) or Western University Foreign Graduate Programs
Over the years, these programs have gained tremendous popularity amongst foreign pharmacists. Thus it is not surprising that people who pass the Western University’s Internal Assessment with a score of 160 (120 is passing) out of 200 still do not get accepted into the program. NSU accepts about 30 students whereas Western takes about 20 students per year. However the applicants to these schools range from 100 to 500 per year. The average admission grade point average (GPA) for Western University in 2012 was 3.67.

Financial Issues

Attending pharmacy school is expensive. The tuition per year ranges from 10,000 to 50,000. If money is an issue, but you still want some education, you can
•Consider a PhD.
• Ask a US citizen or permanent resident to cosign a private student loan if you are not a permanent resident or citizen

Time Constraints

If unable to commit to the time it will take to attend pharmacy school there are other alternatives.
• Find nontraditional pharmacy jobs or pharmacy jobs that do not require a license.
• Teach at a pharmacy technician school
• Work in the pharmaceutical industry

Conclusion

The pharmacy license process is full of challenges for the foreign trained pharmacist. However, a good number have been able to overcome these obstacles. There are so many opportunities for foreign trained pharmacist in the pharmaceutical world. If getting a license is not happening for you consider other ways to use your education and make a decent living.

References and Resources

FPGEC Certification Program
Nova Southern University International PharmD Program
Western University International Post-Baccalaureate PharmD (IPBP) program
California Northtstate University