Guide to Become a Licensed Pharmacist in USA: NAPLEX, FPGEE, and Board of Pharmacy Examination

Introduction

For international pharmacists aspiring to practice in the United States, achieving licensure is a pivotal career achievement. The process, though rigorous, unlocks numerous opportunities in one of the world’s foremost healthcare markets. This guide delves into the essential steps of this journey, focusing on the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and the North American Pharmacist Licensure Examination (NAPLEX).

Key Takeaways:

• Verification of Eligibility
• NABP e-Profile Creation
• English Proficiency
• FPGEE Examination & FPGEC Certification Application
• NAPLEX Preparation and Registration
• MPJE or State-Specific Jurisprudence Exams
• Supervised Training Requirements
• Final Licensure
• Continuous Professional Development

USA Pharmacist Licensing Process – Overview

The path to becoming a licensed pharmacist in the USA for foreign graduates involves several key steps. This comprehensive guide outlines the process from initial eligibility verification to the final licensure, providing a roadmap for international pharmacy graduates.

Step-by-Step Licensing Guide

 

1. Eligibility and Skill Assessment:
   • Verification of eligibility and English proficiency.
   • Assessment of foreign pharmacy education through the Foreign Pharmacy Graduate Equivalency Examination (FPGEE).
2. Obtaining the FPGEC Certification:
   • Successful completion of the FPGEE leads to the Foreign Pharmacy Graduate Equivalency Certification (FPGEC), aligning international graduates with US Doctor of Pharmacy standards.
3. Passing the NAPLEX:
   • Candidates must pass the North American Pharmacist Licensure Examination (NAPLEX) to demonstrate their readiness for practice.
4. Additional Examinations and Training:
   • Completion of the Multistate Pharmacy Jurisprudence Examination (MPJE).
   • Undergoing supervised training for 1500 hours to meet practical experience requirements.
5. Final Licensure:
   • Upon fulfilling all state-specific requirements, candidates are granted the license to practice as registered pharmacists in the USA.

This structured approach ensures that international pharmacy graduates are thoroughly prepared and meet the comprehensive standards set by the US healthcare system for pharmacists.

Step-by-Step Process for Pharmacist Licensure in the USA

Eligibility Check Process

• Ensuring Eligibility

The first crucial step in the U.S. licensing process for foreign-trained pharmacists is to verify eligibility. This involves confirming educational requirements, such as a 4-year Bachelor of Pharmacy degree for those who graduated before 2003 or a 5-year pharmacy education (PharmD) for graduates after 2003. Prepare and organize all necessary documents, including your pharmacy degree, transcripts, and identification.

TOEFL iBT for FPGEC

• English Proficiency Requirement

For Indian PharmD students and other international candidates, passing the TOEFL iBT is mandatory for the FPGEE process. The test evaluates Reading, Listening, Speaking, and Writing skills in a single session at an approved ETS test center. Ensure your scores are sent directly to the FPGEC using ID number 9103. The minimum required scores are 22 in Reading, 21 in Listening, 26 in Speaking, and 24 in Writing. This step verifies English proficiency essential for effective communication in U.S. pharmacy practice.

NABP e-Profile Setup

• Creating Your Professional Profile

The NABP e-Profile is a crucial online platform for pharmacists, providing access to career resources, exam registrations, and regulatory compliance. Accuracy in your e-Profile information is vital for a smooth licensure process and ongoing professional development. To create an e-Profile, visit the NABP website https://nabp.pharmacy/programs/foreign-pharmacy/fpgee/ , select the appropriate profile type (Individual or Business), and complete the required fields with your details. The website offers tutorials for setting up and managing your e-Profile, ensuring you have the necessary support for your pharmacy career in the USA.

FPGEC Application Process for Foreign-Trained Pharmacists

The Foreign Pharmacy Graduate Equivalency Committee (FPGEC) certification is essential for foreign-trained pharmacists aiming to practice in the USA. This guide outlines the steps, fees, and documentation required for a successful application.

FPGEC Application: Key Steps, Fee, and Documentation

• Online FPGEC Application

• Initial Step: Begin by completing the FPGEC application via your NABP e-Profile, following successful TOEFL iBT scores achievement.

• Fee Payment

• Application Fee: A non-refundable fee of $550, combining a $100 administrative fee and a $450 document evaluation fee, payable exclusively through credit or debit card. Note: The fee increases to $750 starting March 1, 2024.

• FPGEC Document Submission

Requirement Category	Description
Attestation and Photo Requirements	Document Attestation: Mail physical documents within three months of application. The attestation form must be signed in the presence of a consular official, magistrate, or notary. Photo Specifications: Include two recent, identical passport-size photos; one attached to the attestation and one unmarked in the e-Profile. Valid Photo ID: A certified photocopy of a valid photo ID is required, ensuring name consistency across ID, e-Profile, and all FPGEC documents.
License/Registration Documentation	Licensure Proof: Submit certified proof of an unrestricted license or registration from the country of your pharmacy degree or practice. Certification must include issue date, number, official seal or stamp, and an authorized signature.

• Mailing Address for Document Submission

• Send To: NABP, Attn: FPGEC, 1600 Feehanville Drive, Mount Prospect, IL 60056-6014. Ensure correct addressing for smooth processing.

• ECE Application

• General Evaluation Report: Apply for this report at ECE, providing all necessary documents to verify your pharmacy degree.(https://read.nxtbook.com/nabp/bulletin/fpgec_bulletin/step_3.html)

Required Documents for ECE: Official Transcript and Degree Proof Standards

Required Document	Details
Official Transcripts	Must be sent directly from the educational institution. Include detailed listings of courses and grades. Transcripts must come in a sealed envelope directly from the institution.
Degree Proof	Submit proof of your degree, indicating the title and award date. The degree must clearly display the title and date issued.

• ECE Report and Fees

• Report Ordering: Order a General Evaluation Report for FPGEC purposes, including an additional copy for direct submission to FPGEC.
• Validity and Fees: The report is valid for two years; check ECE’s website for current fees and withdrawal information. (https://www.ece.org/ECE/Credential-Evaluations/US-Institutions/School-and-Organization-Specific-Applications/National-Association-of-Boards-of-Pharmacy)

This comprehensive guide aims to facilitate the FPGEC application process for foreign-trained pharmacists, ensuring they meet all requirements for pursuing licensure in the USA.

FPGEE Examination Registration Process

Embarking on the journey to become a licensed pharmacist in the USA involves navigating through a series of steps with the Foreign Pharmacy Graduate Examination Committee (FPGEC) and Educational Credential Evaluators (ECE). Here’s how to proceed:

Completing the Applications

Step	Action	Details
1. Initial Steps	Submit complete applications to both the FPGEC and the ECE.	Establishes your eligibility for the FPGEE.
2. Application Evaluation	Applications are reviewed.	Typically within an 8-week period. Assesses your credentials and qualifications thoroughly.
3. Acceptance Notification	Receive eligibility confirmation through your NABP e-Profile.	Indicates you can proceed in the licensure process.

Examination Registration steps you need to follow:

Step	Action	Details
1. Register for the FPGEE	Via the NABP e-Profile	Your central hub for managing the examination process.
2. Authorization to Test (ATT)	Receiving ATT from Pearson VUE	Post-registration, allows you to schedule your examination.
3. FPGEE Identification Card (FIC)	Obtaining Your FIC	Issued by the FPGEC, vital for the examination process.
4. Scheduling the Exam	Exam Appointment	With your ATT, schedule your exam at a convenient time and location through Pearson VUE.
5. Sitting for the Exam	Examination Day	Attend the scheduled exam session and sit for the FPGEE.

FPGEE Examination Overview:

Aspect	Detail
Structure	Type: Computerized test Questions: 200 Duration: 4.5 hours including two 15-minute breaks
Testing Locations	Availability: Pearson Professional Centers across the continental US, excluding Alaska, Hawaii, and US territories
Exam Schedule	Timing: Conducted annually, typically in October Details: Specific dates available on the NABP website (https://nabp.pharmacy/programs/foreign-pharmacy/fpgee/)
Exam Fee	First Attempt: $650 Retake Fee: $750 within the same application period
Cancellation and Refund Policy	Refund: Available for cancellations made at least 5 business days before the exam, subject to a $100 fee No Refunds: For cancellations within 5 business days or discrepancies in cancellation processes
FPGEE Attempt Limit	Window: 2 years from application acceptance Attempts: Maximum of five lifetime attempts

FPGEE Examination Syllabus Overview

The syllabus is meticulously structured into four major content areas, each contributing a distinct percentage to the overall examination score.

Content Area	Percentage	Description
Basic Biomedical Sciences	10%	Covers essential biomedical science topics relevant to pharmacy, including human anatomy and physiology, biochemistry, microbiology, and pathophysiology. Focuses on understanding fundamental principles crucial for comprehending advanced pharmaceutical and clinical sciences.
Pharmaceutical Sciences	33%	This extensive section encompasses topics such as medicinal chemistry, pharmacognosy, pharmacology, pharmaceutics, and pharmacokinetics. Emphasizes the science behind drug development, drug properties, and their physiological actions.
Social/Behavioral/Administrative Sciences	22%	Addresses the social, behavioral, and administrative facets of pharmacy practice, including pharmacy management, healthcare delivery systems, pharmacoeconomics, pharmacoepidemiology, and social/behavioral pharmacy aspects. Evaluates the candidate’s grasp of the broader pharmacy practice context, including healthcare policy, patient behavior, and pharmacy service management.
Clinical Sciences	35%	Focuses on clinical and therapeutic aspects of pharmacy, covering clinical biochemistry, therapeutics, evidence-based practice, patient assessment, and pharmacotherapy. Critical for its direct relevance to applying pharmaceutical knowledge in clinical settings, ensuring the safe and effective medication use in patient care.

FPGEE: Test Day Guidelines and Results Overview

Essential Guidelines for Test Day

Arrival and Identification

• Punctuality: Arrive at least 30 minutes early. Late arrivals may forfeit their exam without a refund.
• Identification: Bring your FPGEE Identification Card (FIC) and a government-issued photo ID, plus a secondary ID with your name and signature.
• Security Check-in: Expect a security check-in at Pearson VUE centers and store personal items outside the testing room.
• Prohibited Items: Leave electronics, books, and other prohibited items at home. Use only test center-provided materials.

During the Exam

• Non-Disclosure Agreement: Adhere to the NABP’s Non-Disclosure Agreement and understand the consequences of misconduct.
• Inclement Weather Policy: Check with Pearson VUE for rescheduling, but note there are no refunds if the test center is open.

FPGEE Results Quick Summary

 

Understanding the results process of the FPGEE is important for candidates seeking licensure in the USA.

Category	Details
Result Availability	Results are posted in the NABP e-Profile about 8 weeks after the exam.
Passing Score	A minimum score of 75 is necessary for passing.
Score Reporting	Scores are scaled to ensure fair performance comparison across different exam forms.
Score Validity and Retakes	Validity: FPGEE scores are valid for 5 years. Annual Retakes: The exam can be retaken annually with a retake fee of $750.
Rescore Request	A rescore can be requested within 60 days of result receipt for a $200

Following these guidelines and understanding the results process are key steps toward achieving licensure as a pharmacist in the USA.

FPGEC Certification Process

Achieving the Foreign Pharmacy Graduate Equivalency Certification (FPGEC) marks a pivotal milestone for candidates aiming to become licensed pharmacists in the United States.

Achieving Certification

Examination Success Requirement: Successful passage of the FPGEE along with meeting all other prerequisites, such as the TOEFL iBT.

Certification Award

E-Profile Update: The certification date is promptly updated in the candidate’s e-Profile upon achieving FPGEC certification, making this information readily accessible to pharmacy boards.

Understanding the FPGEE results and the subsequent certification process is essential for foreign-educated pharmacists in their quest for licensure in the U.S., signifying a crucial step in their professional advancement.

NAPLEX: North American Pharmacist Licensure Examination Overview

 

The North American Pharmacist Licensure Examination (NAPLEX) is a very next step for pharmacy licensure in the United States, administered by the National Association of Boards of Pharmacy (NABP). It evaluates the competency of pharmacy graduates, including foreign-educated pharmacists with FPGEC Certification.

Key Aspects of the NAPLEX

Aspect	Details
Exam Duration	Total Time: 6 hours and 40 minutes, encompassing the Non-Disclosure Agreement (NDA), tutorial, question answering, breaks, and a post-exam survey.
Exam Format	A 6-hour, computer-based test with 225 questions, where 200 contribute to the final score and 25 are pretest questions.
Examination Breaks	Two optional 10-minute breaks are provided, with any additional breaks reducing total exam time.
Question Types	Includes scenario-based and stand-alone questions, focusing on practical and theoretical knowledge.
Navigation	Answering Questions: Must be done sequentially with no option to skip or change answers after confirmation.

Post-Examination Process

Aspect	Details
Access to Results	NABP member boards use the results to determine if candidates meet the minimum competency standards for pharmacy practice.
Retakes	Requires starting the eligibility process anew, including a $100 application fee and a $475 examination fee.
Waiting Period	After a failed attempt: A mandatory 45-day waiting period is imposed, with some jurisdictions possibly requiring longer.
Attempts Limit	Up to three attempts within a 12-month period and a total of five attempts are allowed, subject to specific board regulations.

Overview of the Multistate Pharmacy Jurisprudence Examination (MPJE)

 

The Multistate Pharmacy Jurisprudence Examination (MPJE) is an essential legal examination for pharmacists, focusing on pharmacy law. Administered by the NABP, the MPJE is pivotal for assessing legal and regulatory knowledge for licensure in the US.

Aspect	Details
Purpose of the MPJE	Determines eligibility for pharmacy licensure and supports licensure transfer across states or jurisdictions.
Candidates for the MPJE	US pharmacy graduates, licensed pharmacists aiming for new jurisdictions, and FPGEC-certified pharmacists.
Jurisdiction-Specific Nature	The MPJE is specific to each state or jurisdiction, necessitating separate examinations for each.
Exam Format	A 2.5-hour adaptive, computer-based test with 120 questions, including 100 scored and 20 pretest questions.
Navigation During the Exam	Questions must be answered sequentially without the option to skip or revisit after confirmation.
Breaks	No scheduled breaks are included, with any taken counting against the total exam time.
Retaking the MPJE	Requires starting a new eligibility process, including application fees.
Waiting Period After a Failed Attempt	A 30-day waiting period is required, with some jurisdictions possibly imposing longer periods.
Attempts Limit	Up to 5 attempts are allowed per jurisdiction, subject to board regulations.

The MPJE ensures pharmacists possess not only clinical proficiency but also a comprehensive understanding of the legal and regulatory framework within their specific state or jurisdiction.

State Pharmacy Licensing Process: California

 

Effective Date: January 1, 2004

California introduced a new examination program for applicants aspiring to become licensed pharmacists within the state. This update stems from legislative changes enacted through SB 361 (Figueroa, Chapter 539, Statutes of 2003), amending the Business and Professions Code sections 4200, et seq.

Key Changes Include:

Introduction of a revised examination format.

Updated eligibility criteria for applicants.

Adjustments to the licensure process in line with modern pharmacy practices.

Applicants are encouraged to review the updated Business and Professions Code sections 4200 and subsequent sections for comprehensive details on the new licensure requirements and examination program.

Mandatory Examinations

NAPLEX and CPJE

Requirement: Candidates must pass the North American Pharmacist Licensure Examination (NAPLEX) and the California Pharmacy Jurisprudence Exam (CPJE).

Purpose: These exams assess pharmaceutical knowledge and pharmacy law understanding, respectively.

Intern Pharmacist License

Pre-Licensure Requirement

Obtaining an intern pharmacist license is crucial for completing the required pharmacy practice experiences in real-world settings.

Internship Hours : Completion of Practical Experience

Hours Required: A total of 1,500 intern hours must be completed, offering practical exposure in both community and institutional pharmacy settings.

Locations: Intern hours can be accumulated at multiple locations across the U.S.

Documentation of Internship Hours

Intern Hours Affidavit

Form 17A-29: Candidates must accurately document their intern hours using the Pharmacy Intern Hours Affidavit form(s), detailing experiences in community and institutional settings.

Resources for Licensing Process

California board of pharmacy website Offers comprehensive information and guidelines about the licensing process, including examinations, internships, and additional licensure requirements. (https://www.pharmacy.ca.gov/)

Final Licensure Procedure:

The final licensure not only signifies the pharmacist’s ability to meet the comprehensive standards set by the U.S. healthcare system but also marks a significant milestone in their professional journey, opening up vast career opportunities within one of the world’s leading healthcare markets. Continuous professional development remains essential even after achieving licensure, ensuring pharmacists can continue to provide the highest quality of care in an ever-evolving field.

1. Completion of Requirements: Candidates must have completed all prior steps, including examinations and training, specific to their licensure pathway.
2. Application Submission: Applicants submit their final licensure application to the state board of pharmacy where they wish to practice. This application includes proof of all completed requirements, including passing scores for necessary exams and evidence of completed supervised hours.
3. State-Specific Requirements: Some states may have additional requirements, such as background checks or further documentation, which must be satisfied.
4. Fee Payment: A fee is typically required with the final licensure application. The amount varies by state.
5. Granting of License: Upon verification of the application and fulfillment of all criteria, the state board of pharmacy grants the candidate a license to practice as a registered pharmacist in the United States.

Continuous Professional Development

Continuous Professional Development (CPD) is emphasized as a crucial aspect of the licensure process for international pharmacists in the United States. It highlights the importance of ongoing learning and adaptation within the pharmacy profession. CPD ensures that pharmacists remain up-to-date with the latest practices, technologies, and regulations, thereby maintaining the high standards of patient care expected in the U.S. healthcare system. This commitment to lifelong learning is not only a requirement for maintaining licensure but also a fundamental component of professional growth and the ability to effectively contribute to a dynamic and evolving healthcare landscape.

Conclusion

The guide for international pharmacists aiming for licensure in the United States outlines a rigorous but rewarding pathway. It highlights essential steps from eligibility verification to passing key examinations like the FPGEE and NAPLEX, along with state-specific tests and supervised training. This process ensures that pharmacists meet the high standards of the U.S. healthcare system. The inclusion of continuous professional development emphasizes the importance of ongoing learning and adaptation in the profession. Changes, such as California’s updated examination program, reflect the dynamic nature of pharmacy practice and education. Achieving licensure in the USA opens up vast career opportunities for international pharmacists, marking a significant milestone in their professional journey.

Ultimately, this guide underscores the commitment required to achieve pharmacist licensure in the USA, a journey that, while challenging, offers substantial rewards in terms of career opportunities and the ability to contribute to one of the world’s leading healthcare markets. For international pharmacists, the pathway to licensure is not just a professional requirement but a gateway to fulfilling their potential in a dynamic and evolving field.

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