UKCOP is First School of Pharmacy to Require Coursework in Diagnosis as Part of PharmD Program

When we launched our new core curriculum in the fall of 2016, we did so with the commitment to continue advancing the pharmacy profession. As the pharmacy practice model has moved from hometown apothecaries to pharmacists being a central point of care for many in the United States, we wanted to make sure our students were more than equipped to practice at the top of their license. As a result, we introduced Differential Diagnosis as a required 2-credit hour stand-alone course for our third-year professional students.

We are continuing to develop collaborative patient care protocols with our medical colleagues and work toward building more sustainable models of pharmacy practice in the ever-changing landscape of healthcare. To that end, we believe it is important to utilize a common language and be explicit about what students are learning in terms of pharmacists’ clinical decision-making abilities using diagnostic reasoning.

When pharmacists provide patient-centered care, they engage in the differential diagnosis process, whether they realize it or not. Differential diagnosis is the process of developing a list of potential causes of a patient’s presenting symptoms, prioritizing and risk stratifying the possibilities in terms of severity, probability, and ability to treat. Actively engaging in the differential thought process enables students to see and discuss how differential diagnosis is applied in pharmacy practice and how it differs from its application in medical practice, which is an important distinction. For example, pharmacists utilize differential diagnosis when patients present to the pharmacy counter with a symptomatic complaint and ask for a recommendation when evaluating whether a patient’s symptoms are due to a potential drug therapy problem, or when evaluating the appropriateness, safety, and efficacy of drug therapy for an established diagnosis.

Our instructors for the class work as an interprofessional team, which consists of physicians, physician assistants, and pharmacists. Each section of the class meets weekly for 110 minutes to review patient cases with the instructors and think through and discuss possible diagnoses.

The course emphasizes the application of clinical reasoning through the process of differential diagnosis, a formalized and tangible process that enables instructors to add varying degrees of complexity and depth to the education students already receive, with the ultimate goal of preparing them to fully utilize the Pharmacists’ Patient Care Process.

Being clear about the fact that our students are learning differential diagnosis allows the use of a common language across professions and fosters a necessary skill to address healthcare gaps in primary care. Using common language enhances interprofessional communication, mutual understanding in terms of clinical decision-making abilities, and mutual respect regarding roles, responsibilities, and scopes of practice among health professions.  

Our students tell us that differential diagnosis training in pharmacy school improved their critical thinking skills, developed their clinical judgment, and built their confidence in communicating with patients and medical professionals regarding patient care. With this type of advanced training, our student pharmacists can be better advocates for their patients and better collaborators and communicators with other healthcare professionals. Our hope is to see this translate into confident pharmacists and change-agents for advancing the profession of pharmacy.