New Hampshire Licensing Guides for Immigrant Pharmacists

Welcome, Important Information and Tips

Congratulations on exploring how to become a licensed pharmacist in the United States! Following are some tips and important information for you to know. This is a 4 to 6 year process, so prepare yourself well. The following pages will give you specific step-by-step information on how to proceed and will also provide some time and cost comparison information to help you decide what you want to do. Please take time to read this entire summary to get a total picture of how you wish to proceed.

PLANNING

You need a clear and realistic plan to succeed in becoming a licensed pharmacist in the U.S. Take the time to develop a strategy for issues such as:

  • Money: You will need significant savings, a loan, and/or a job that helps pay for this process.
  • Preparation: You will need to invest resources in test preparation to pass your examinations. You will have to prepare U.S.-style marketing materials and perfect your interview and presentation skills in English.
  • Network: You will need to rebuild a professional network. One option for earning money while you go through this process is to find work in a lower-ranking healthcare profession.
  • Flexibility: You will be more likely to find a position once you are licensed if you are flexible about geography, shift work, and employer.

Pay Attention to Detail: All documents you submit either on paper or online are official: take your time to fill them out carefully and make sure your name and other information are used in exactly the same way on each document. Mistakes in these simple details are a common source of delays and complications in the licensing process.

GET DEGREE EVALUATED

Make sure your foreign degree is likely to be accepted by the Foreign Pharmacy Graduate Equivalency Committee before you start its certification program. Your degree will not be evaluated immediately, so you may use valuable time and resources preparing for and even passing the program’s exam, only to learn later that your degree disqualifies you.

CHECK TRANSFER CREDITS

If you graduated after 2003 from a four-year pharmacy program you will have to return to school in the U.S. and complete requirements for a Pharm.D degree. Your foreign degree could count for a significant amount of transfer credits or for placement in a special advanced standing program. State your case with more than one pharmacy school and share your credential evaluation: it is possible that one school may grant more credits than another.

INVEST IN TEST PREPARATION

If you can afford it, invest some money in test preparation. There are online and in-person formats available, including a moderately priced service by the National Association of Boards of Pharmacy (NABP). Investing money wisely now to make your licensing process a success will get you into a job that pays well that much faster!

MARKET YOURSELF AMERICAN STYLE:

Being able to market yourself in a way that appeals to U.S. employers can play a deciding factor in your success. You may need outside guidance to assess what parts of your education and experience you should highlight, and how to present yourself to potential employers. You must learn how to overcome any cultural divide and target your presentation to a U.S. audience. Many people, who are well qualified, do not find employment because they are unable to successfully prove their value over other candidates. Consider this an opportunity to make your international experience a selling factor in this process.

REGISTER AS A PHARMACY TECHNICIAN

This is a good first step back into pharmacy and is necessary for participation in the 1,500-hour course of clinical instruction you need to license as a pharmacist. Remember that you will not be able to earn hours towards your clinical program until the State has approved the course.

GET YOUR QUESTIONS ANSWERED

Be your own advocate throughout the licensing process. Seek clarification about questions and concerns directly from official sources. If you feel your degree has been misinterpreted or you do not understand a fine point of the state regulations, organize your questions, contact Continental Testing Services (CTS), Pearson VUE, or the New Hampshire Board of Pharmacy (NHBP), and ask for assistance

How The Profession Is Organized In New Hampshire

The New Hampshire Board of Pharmacy (NHBP) regulates the profession of Registered Pharmacist in New Hampshire. The NHBP reviews the credentials of foreign pharmacy graduates directly. The National Association of Boards of Pharmacy (NABP) administers all tests related to licensing eligibility for foreign pharmacy graduates through the testing agency Pearson VUE:

  • FPGEE – Foreign Pharmacy Graduate Equivalency Examination – standardized pharmacy test for international candidates
  • NAPLEX – North American Pharmacist Licensure Exam – skills and knowledge of pharmacy
  • MPJE – Multistate Pharmacy Jurisprudence Exam – pharmacy law

EMPLOYMENT

According to the Bureau of Labor Statistics, more than 60% of pharmacists work in independent or chain retail drugstores, and hospitals employ another 23%. Outside of a clinical pharmacy setting, pharmacists in the United States also find work with pharmaceutical companies in research or sales roles; in insurance companies working with medical benefit packages; or with government agencies working in health policy and services.

Demand for pharmacists is high, as in many healthcare professions. An aging population, new drug treatments and insurance coverage of prescriptions are reasons the occupation is expected to grow by 14% growth from 2012-2022 (Reference Link: http://www.nhes.nh.gov/elmi/products/documents/projections.pdf). The Mean Annual Wage nationally was $119,270 in 2015 (from the Bureau of Labor Statistics, http://www.bls.gov/oes/current/oes291051.htm).

Communication skills and knowledge of medical information systems are important factors in career success for pharmacists. Their responsibilities in advising both doctors and patients continue to grow with the development of new medicines, disease management methods, and opportunities to monitor patient treatment plans to prevent potential harmful drug interactions.

INCREASING PROFESSIONAL STANDARDS AND INELIGIBLE PHARMACY PROGRAMS

Reform in pharmacy education in the US now means that new pharmacy graduates will only qualify for licensing if they hold a 5-year professional degree – a Doctor of Pharmacy (Pharm.D) or its equivalent. This change went into effect for all students graduating after January 1, 2003.

While 5 years is now the standard for US professional degrees in pharmacy, it is not the case worldwide. Unfortunately, foreign-educated pharmacy candidates who graduated from a 4-year program after the change date cannot qualify for the Foreign Pharmacy Graduate Equivalency Certification process with their current degree. Not even internships or extra coursework after graduation can count towards the 5-year minimum.

Currently, there are only two ways for you to become eligible if you are in this situation:

  • You can use your foreign degree as a basis for transfer credit to a US or other 5-year pharmacy program and graduate from the new institution with a 5-year professional degree (some pharmacy schools even offer special advanced standing programs for foreign pharmacy graduates)
  • If you completed pre-pharmacy coursework before entering your 4-year program, you may be able to gather this documentation and have it count towards the 5 year total

Another trend in professional standards applies to pharmacy technicians. Previously, this entry-level pharmacy position required registration in New Hampshire but did not require an examination. Beginning in 2008, new hires must pass a certification exam within two years of registration (see the Other Careers and Credentials section for more information).

Eligibility For Licensing

The process for obtaining a license as a pharmacist in New Hampshire is as follows:

I. COMPLETE THE FOREIGN PHARMACY GRADUATE EXAMINATION COMMITTEE (FPGEC) CERTIFICATION PROGRAM

The purpose of the Foreign Pharmacy Graduate Examination Committee (FPGEC) Certification Program is to document the educational equivalency of your foreign pharmacy education. This certification is a four-step process. The following information outlines the process and you can find more program information in the Important Links section.

  • Application package for the FPGEC Certification Program and the Foreign Pharmacy Graduate Equivalency Examination (FPGEE): The application can be downloaded from the National Association of Boards of Pharmacy (NABP) website. It requires several supporting documents, including proof of a foreign pharmacist license or an accepted substitute. Fee: $1,200 (in 2015), which includes document evaluation ($450) and payment of test ($750)
  • Credential Evaluation Application. Educational Credential Evaluators, Inc. is the only credentialing organization accepted by the National Association of Boards of Pharmacy (NABP). You must submit your official transcripts and proof of degree, plus translations submitted according to the instructions found in the application package. This step often takes a year or more. Fee: $85 (in 2015.)
  • Passing the Test of English as a Foreign Language (TOEFL) iBT Scores: The TOEFL iBT is the sole English language proficiency examination accepted for candidates seeking FPGEC Certification. The TOEFL iBT must be completed by all foreign pharmacy graduates, even those who are native English speakers. There are no exceptions or waivers to these requirements.
    * The minimum score requirements for the TOEFL iBT (in March 1, 2014) are as follows: Reading – 22; Listening – 21; Speaking – 26; Writing – 24.
  • Foreign Pharmacy Graduate Equivalency Examination (FPGEE):
    FPGEE will be explained in more detail in the section on testing.

IMPORTANT NOTES ON THE FOREIGN PHARMACY GRADUATE EXAMINATION COMMITTEE (FPGEC) CERTIFICATION PROGRAM:

  • Your Certification Program file will close after two years unless you go through an extension process with the Foreign Pharmacy Graduate Examination Committee
  • If you sit for the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and fail, you will have to resend your application and pay $600 (in 2015) to retake the exam.
  • Completing your foreign credential evaluation does not occur early in the Certification program. If you are a pharmacy graduate from 2003 or later and think your pharmacy degree may not be equivalent to a first professional degree (a 5-year PharmD), you are participating in this process at your own risk. Candidates like you have spent a lot of time and money – even passed the Certification program exam! – before learning they are disqualified based on the credential evaluation. Get advice early from FPGEC or a Pharm.D program to understand if your degree is likely to qualify.

II. SUBMIT LICENSURE BY EXAMINATION APPLICATION AND COMPLETE AN APPROVED CLINICAL TRAINING PROGRAM

APPLICATION

After you earn your Certification it is time to apply for Licensure by Examination to the New Hampshire Board of Pharmacy (NHBP) Link: http://www.nh.gov/pharmacy/pharmacists/naplex.htm. Your examination process will not start at this time, but the application is your first point of contact with the State and leads to your next immediate step: the 1,500 hour clinical training program required of all foreign pharmacy graduates. The application form is called “Original Licensure in NH (NAPLEX)” on the NHBP website. Some of the items in your application to NHBP will include:

  • 2- page Application for Licensure by Examination (note: this application opens your file at NHBP, but you won’t be considered eligible for the exams in Step III until your internship is completed and accepted by NHBP)
  • Foreign Pharmacy Graduate Examination Committee (FPGEC) Certification
  • Credential evaluation from Educational Credential Evaluators, Inc.
  • Official transcripts issued by school of pharmacy with school seal affixed and certified translation
  • Passport style photo and copy of birth certificate

Fee: $265 (in 2015) made payable to: Treasurer – State of New Hampshire

CLINICAL TRAINING PROGRAM

NHBP will send you guidelines for the 1,500-hour clinical training program. Program participants are commonly called “pharmacy interns,” although there is no special intern status or license in New Hampshire. In fact, you will have to arrange your own 1,500-hour internship in a hospital or retail pharmacy under the supervision of a pharmacist licensed in New Hampshire.

The supervising Pharmacist must write a letter to NHBP confirming that clinical training will occur and outlining its proposed content. The State Board of Pharmacy, which meets every other month, will review this documentation and make a recommendation to the NHBP director. You will need to receive NHBP approval before you can begin earning hours towards your 1,500 hour goal.

This approval is for a specific internship under a specific pharmacist. Unfortunately, if your circumstances change and you abandon your program before completion, you will need to start all over again with a new, pre-approved, 1,500-hour clinical training program. For more information, see the Important Links section.

REGISTERING AS A PHARMACY TECHNICIAN

To work behind the counter in a New Hampshire pharmacy for your internship, you will first need to register as a pharmacy technician. This is a simple process, which only costs $25 (in 2015.) In fact, many foreign pharmacy graduates work as pharmacy technicians even before beginning the licensing process. It allows you to earn a modest income while adapting to a US pharmacy environment. However, you only start to accumulate internship hours after NHBP approves your clinical training program: none of your earlier experience as a pharmacy technician will count towards this goal. More information about registering as a Pharmacy Technician is in the section Other Careers and Credentials.

III. PASS EXAMS: NORTH AMERICAN PHARMACIST LICENSURE EXAMINATION (NAPLEX) AND THE MULTISTATE PHARMACY JURISPRUDENCE EXAM (MPJE)

The North American Pharmacist Licensure Examination (NAPLEX) tests your skills and knowledge of pharmacy, while the Multistate Pharmacy Jurisprudence Exam (MPJE) tests your knowledge of laws that apply to the profession. All pharmacy graduates must pass these exams before being licensed in New Hampshire – whether they graduated from a US or a foreign program.

Once you complete your application and clinical training as described in Step II, the New Hampshire Board of Pharmacy (NHBP) will send you a letter confirming that you are eligible to register for the NAPLEX and MPJE. You can take the exams in any order.

To register for both the NAPLEX and MPJE exams, go to the National Association of Boards of Pharmacy (NABP) web site and complete the online application process for exams. Be sure to select NH as your primary state for the MPJE and NAPLEX.

Links to the website links can be found in the Important Links section.

North American Pharmacist Licensure Examination (NAPLEX) Fees: $505 (in 2015.)

NAPLEX Results:

  • Scores will be sent to the New Hampshire Board of Pharmacy (NHBP) and they will report them to you
  • Minimum passing score = 75
  • If you fail, you must wait at least 91 days to test again. Candidates will be limited to five attempts to pass the NAPLEX.

Multistate Pharmacy Jurisprudence Exam (MPJE) Fees: $210 (in 2015.)

MPJE Results:

  • Scores will be sent to the New Hampshire Board of Pharmacy (NHBP) and they will report them to you
  • Minimum passing score = 75
  • If you fail, you must wait at least 30 days to test again. Candidates will be limited to five attempts to pass the MPJE.

Both tests are discussed in greater detail in the next section Tests.

Once you have successfully passed both NAPLEX and MPJE, the New Hampshire Department of Financial and Professional Regulation will submit your file to the New Hampshire Board of Pharmacy for a licensing decision.

Tests

As a foreign pharmacy graduate you will take three tests during your New Hampshire licensing process, all developed by the National Association of Boards of Pharmacy:

  • Foreign Pharmacy Graduate Equivalency Examination (FPGEE)
  • North American Pharmacist Licensure Examination (NAPLEX)
  • Multistate Pharmacy Jurisprudence Exam (MPJE)

GENERAL TEST PROCEDURES & BASIC CHARACTERISTICS:

  • Approval required before testing: testers will make an appointment to test once they are approved by National Association of Boards of Pharmacy (NABP) or by the New Hampshire Board of Pharmacy (NHBP) and receive an Authorization to Test (ATT) notice. The ATT includes detailed instructions for choosing a testing center and scheduling a date to sit for your exam. It is recommended that you schedule your exams soon after you receive your ATT.
  • Testing sites: the tests are administered by the testing company Pearson VUE in test centers nationwide. Limited space means that the centers can have full schedules – it is best to set up an appointment online soon after you receive authorization. Visit http://www.pearsonvue.com/nabp/ or call Pearson VUE Customer Service at 888/709-2679 to schedule an appointment.
  • The test is a computer-based test, called a variable length adaptive test. This means that the test will adjust its difficulty level, content, and number of questions based on your answers. The test will continue until all content areas are covered in the required proportions, and the system is 95% certain that your abilities are either above or below the passing standard due to its analysis of your answers. As a result, you may be asked to answer anywhere from 75 to 265 items. Test takers with either very high or very low abilities tend to have the tests with the fewest items. You are not allowed to skip any questions, but you should avoid making random guesses, as this can quickly lower your score. The exam is mostly multiple-choice but other question types are also included. You will be given a short tutorial that will expose you to the different question types. You cannot bring reference materials or other testing aids to the exam. An on-screen calculator is provided for some problems.
  • No returning to finished questions: once you confirm your answer you will not be allowed to return to it or make any changes.
  • Testing day procedures: on the day of the test, you must bring the ATT and 2 types of approved identification. You will be fingerprinted and photographed before your test, and will be fingerprinted when you re-enter the testing area after breaks. You should arrive at least a half hour early; you will not be allowed to take the test if you arrive more than a half hour late for your appointment.
  • Rescheduling or not completing tests: each exam has strict policies for giving notice if you have to reschedule your exam. There are different costs involved in making changes. If you miss your appointment or abandon the test, you will be charged all fees and may have to do additional paperwork to re-qualify.

TEST-SPECIFIC DETAILS ON EACH TEST FOLLOW.

FOREIGN PHARMACY GRADUATE EQUIVALENCY EXAMINATION (FPGEE)

The Foreign Pharmacy Graduate Equivalency Examination consists of 250 multiple-choice questions and lasts 5 1/2 hours.

The test is only offered 2 times a year. This means that it is especially important to schedule your appointment as soon as you receive an Authorization to Test (ATT).

The FPGEE tests four content areas:

  1. Basic Biomedical Sciences: 16% of questions
  2. Pharmaceutical Sciences: 30%
  3. Social, Behavioral, and Administrative Pharmacy Sciences: 22%
  4. Clinical Sciences: 32%

The National Association of Boards of Pharmacy encourages candidates to take the FPGEE online practice exam for $50 (in 2015.)

NORTH AMERICAN PHARMACIST LICENSURE EXAMINATION (NAPLEX)

The North American Pharmacist Licensure Examination (NAPLEX) consists of 185 multiple-choice questions and lasts 4 hours and 15 minutes.

NAPLEX tests three content areas:

  1. Assess Pharmacotherapy to Ensure Safe and Effective Therapeutic Outcomes: about 56% of questions
  2. Assess Safe and Accurate Preparation and Dispensing of Medications: about 33%
  3. Assess, Recommend, and Provide Health Care Information that Promotes Public Health: about 11%

The National Association of Boards of Pharmacy encourages candidates to take the NAPLEX online practice, called the pre-NAPLEX, exam for $65 (in 2015.). It contains questions that were used on older tests, and the computer program works under conditions similar to the real NAPLEX.

MULTISTATE PHARMACY JURISPRUDENCE EXAM (MPJE)

The Multistate Pharmacy Jurisprudence Exam tests your knowledge of both Federal laws and the laws of the state you plan to get licensed in. Therefore, there is a customized MPJE for each state and if you want to be licensed in more than one state, you will have to pass multiple versions of the MPJE.

The MPJE consists of 90 multiple-choice test questions and lasts 2 hours.

The MPJE tests 3 content areas:

  1. Pharmacy Practice: about 84% of questions
  2. Licensure, Registration, Certification, and Operational Requirements: about 13%
  3. Regulatory Structure and Terms: about 3%

Time And Costs

Successfully licensing as a Registered Pharmacist in New Hampshire depends on a number of factors, including:

  • The completeness of your educational and professional records and a qualifying degree program
  • Your performance on several tests
  • Your ability to find an internship placement
  • Your free time and expendable income

We provide two hypothetical scenarios to show some of the variety of results that immigrant professionals may find when they seek to become pharmacists in New Hampshire. Please consider these scenarios as two examples out of many possibilities. Your experience will vary.

TWO HYPOTHETICAL SCENARIOS FOR PHARMACIST LICENSING:

Numbers are from 2015

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Other Careers And Credentials

PHARMACY TECHNICIAN:

A Pharmacy Technician is an entry-level staff position in a hospital or retail pharmacy that usually earns an hourly wage and requires only limited pharmacy education.

Becoming a Pharmacy Technician can have some advantages:

  • You will have a first US credential that makes you more employable and able to earn some income to support your licensing process
  • You will not have to wait for your FPGEC certification to begin working in a pharmacy environment
  • You will be able to gain US work experience and adapt to a US pharmacy environment with fewer professional responsibilities
  • Once you become a Pharmacy Intern you may be a more attractive candidate because of your US job experience and the range of responsibilities you are allowed as both an Intern and a Technician
  • You may improve your chances of receiving a salary as you complete your 1,500 internship hours

Registering as a Pharmacy Technician includes showing proof of some types of pharmacy education, plus an application packet, which you can find in the Important Links section.

Beyond Licensing

MAINTAINING LICENSURE

Pharmacists must meet continuing education requirements of 15 hours every year. The education must be given by a provider approved by the American Council on Pharmaceutical Education, the American Medical Association, or the New Hampshire Board of Pharmacy. You must also renew your license every year. The New Hampshire Board of Pharmacy sends a notice reminding you to renew your license at least 6 weeks prior to its expiration, so be certain to keep your contact information up-to-date with their office. If you let your license expire, you will have a much more complicated process to restore the license.

The New Hampshire Board of Pharmacy also has active in practice requirements. You must have 400 hours active in practice in 4 years immediately prior to date of application, or have completed a board approved refresher program within 2 years of application, or have successfully completed NCLEX examination within 2 years of application.

JOINING A PROFESSIONAL ASSOCIATION

State and national associations for pharmacists provide opportunities for professional development and networking. They also help set acceptable working conditions for the profession and give information and opinions on policy in New Hampshire and across the U.S. Their websites may offer useful orientation to pharmacy candidates about the licensing and examination process, including test preparation. They often provide Continuing Education to members as well.

STATE:

  • New Hampshire Pharmacists Association
  • New Hampshire Society of Health-System Pharmacists

NATIONAL:

  • American Pharmacists Association
  • American Society of Health-System Pharmacists

The Important Links section has more information on these associations. There is a large variety of specialized professional associations for pharmacists based on workplace, specialty, ethnicity, gender, or religion.

LICENSING MOBILITY (RECIPROCITY)

The state of New Hampshire has a reciprocal agreement to honor the pharmacy licenses of certain states. For more information, visit the New Hampshire Board of Pharmacy website.

LICENSING AND REGULATION

CREDENTIALING ORGANIZATION

TESTING

PROFESSIONAL ASSOCIATIONS

MORE INFORMATION

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