How will I know if PEBC received my application?

How do I update my contact information?

What is the procedure for withdrawing from an examination?

If I withdraw from an examination does it count as one of my attempts?

Can I postpone my examination?

What if I wish to change the location of my examination?

If I fail an examination, when will I receive my feedback report?

I would like clarification of my feedback report.  How do I arrange this?

I have used up all my attempts at the examination. Can I petition for an additional attempt?

How do I contact the Registrar directly?

I lost my PEBC certificate.  What can I do to get a replacement?

I received my pharmacy degree outside of North America.  What are the steps I need to follow for PEBC certification?

I received my pharmacy degree outside of Canada.  My university cannot send an original, currently-dated transcript.  What should I do?

I graduated outside of Canada and have not yet received my final university degree certificate.  What do I need to do?

I am applying for Pharmacist Document Evaluation.  What do I need to do if my documents are not in English or French?

I want to apply for Pharmacist Document Evaluation, but my application and documents will arrive at PEBC at different times.  Is this a problem?

Do I need to wait until my Document Evaluation has been completed to apply for the Pharmacist Evaluating Examination?

After I complete Document Evaluation, how long do I have to pass the Pharmacist Evaluating Examination?

What happens if I do not successfully pass the Pharmacist Evaluating Examination within 5 years of completing Document Evaluation?

After I successfully complete the Pharmacist Evaluating Examination, how long do I have to pass the Pharmacist Qualifying Examination?

I have completed Pharmacist Document Evaluation.  How do I arrange for PEBC to send a copy of my Licensing Statement to a provincial or territorial regulatory authority?

General Questions

How will I know if PEBC received my application?

Please be advised high volumes of applications arrive daily into our office.  There can be a delay in processing depending on the incoming volume.  Once your application has been processed, you should receive an automated e-mail confirmation of receipt.  We only notify candidates if something is missing or incorrectly submitted, to allow them the opportunity to supply or correct it. Your official notification of acceptance into an examination will be mailed out to you approximately three weeks prior to the examination date.
PLEASE DO NOT CONTACT the PEBC office by telephone, fax or email to confirm receipt of your application or to check your examination location assignment.

How do I update my contact information?

Email your updated contact information to pebcinfo@pebc.ca.

What is the procedure for withdrawing from an examination?

If you know you will not be able to write the exam in the sitting you applied for, you will need to withdraw in writing (e-mail, fax or letter) and re-apply with a new application, fees and photos for the next sitting you wish to take. Please refer to our Withdrawal and Refund policies at our website under the relevant examination header.

If I withdraw from an examination does it count as one of my attempts?

No, you must attend the examination in order for it to count as an attempt.

Can I postpone my examination?

No. You must withdraw from the examination you are currently accepted for and submit a new application and fee for the next examination you wish to write.

What if I wish to change the location of my examination?

You will need to send a written request by mail or courier. You will need to include the site change fee of $50CAD payable by Canadian certified cheque, bank draft or money order. Please check the information for the examination you wish to write as there is a different site change deadline for each examination.

If I fail an examination, when will I receive my feedback report?

The PEBC will send feedback reports automatically to all those candidates who were not successful in their exam(s).  The reports should be ready 6-8 weeks from the date that the results were released. They will be mailed as soon as they are ready. Yours will be mailed to the permanent address that we have on file for you. Kindly send us an email or note in writing any time your address changes.

I would like clarification of my feedback report.  How do I arrange this?

If you would like to have a discussion with a PEBC staff member about your feedback report, please email PEBC and provide us with a block of time over a two-week period along with a daytime telephone number where you can receive a call during business hours.

I have used up all my attempts at the examination. Can I petition for an additional attempt?

Candidates are permitted three attempts at a PEBC examination, after which they are required to complete remediation prior to a fourth (final) attempt. The only situation in which candidates may be allowed an additional attempt at an examination is if they are granted a “No Standing” status on an examination sitting on the basis of medical conditions or compassionate grounds (such as bereavement). However, petitions for consideration of a “No Standing” status are only considered if they are received within 7 calendar days after the examination, accompanied by appropriate, official supporting documentation. Petitions received more than 7 calendar days after an examination (e.g., upon receipt of an unsuccessful examination result) are NOT considered.

How do I contact the Registrar directly?

The Registrar is not available for telephone discussions or in-person meetings with candidates. Matters requiring the Registrar’s consideration must be documented in writing and sent to the attention of the Registrar either by mail, fax or email (to the general PEBC email –pebcinfo@pebc.ca).

I lost my PEBC certificate.  What can I do to get a replacement?

If you would like a replacement PEBC Certificate, you will need to make a statutory declaration in the presence of either a lawyer, notary public or commissioner for oaths, stating you lost your certificate or it was damaged (whatever the case may be) and require a replacement.  There is also a $100 administrative fee in the format of either a certified cheque, money order or bank draft made payable to PEBC, for a replacement certificate.  Please include your name and current mailing address when requesting your replacement certificate.

International Graduates

I received my pharmacy degree outside of North America.  What are the steps I need to follow for PEBC certification?

If you received your Bachelor of Pharmacy outside of North America, your first step is to have your documents evaluated. You will need to apply for this. Please visit our website and click on Document Evaluation where you will find all the necessary information and print the application form.

Currently, the fee for Document Evaluation is CDN$530 made payable to the Pharmacy Examining Board of Canada.

You will need to contact your graduating institution where you received your Bachelor of Pharmacy and request them to send your transcripts, currently dated, directly to us:

The Pharmacy Examining Board of Canada
717 Church Street
Toronto, ON Canada M4W 2M4

You will also need to contact your Licensing Authority and request that they send a currently-dated Licensing Statement directly to our office.

You will then need to write the Evaluating Examination.  The next sitting will be held July 4 & 5, 2012, with the deadline to apply being Thursday April 5, 2012.  This information is also at our website.  The fee for this exam is $515.  The examination will also be available overseas in London, England at an additional administrative fee of $365.

After you have passed the Evaluating Examination, you must also go through the Qualifying Examination, which can only be completed within Canada.

We do not supply old exam papers for any purposes.  You will find a Syllabus outlining the topics and sub-topics you may encounter in the Evaluating Examination which is free of charge from our website under Evaluating Exam.  This booklet assists candidates in preparing for their areas of study for the Evaluating Examination.  If you are unable to access this information online and would like a hard copy, please send an International Money Order in the amount of $35 in Canadian funds made payable to the Pharmacy Examining Board of Canada.  Upon receipt of your payment, we shall send you a Syllabus.

The PEBC does not require language proficiency testing, such as TOEFL, TSE or IELTS.  You may wish to contact the provincial licensing authority of the province in which you wish to practice to enquire about their language proficiency requirements.

As for immigration questions, please contact your local Canadian Embassy and enquire with them.  You do not need to be a Canadian citizen or permanent resident to undergo Document Evaluation or write our exams.  You may apply to write the exams in Canada on a visitor’s visa.  Once your exam application has been processed, and your primary address is outside of Canada, PEBC issues a letter of confirmation you may present to the Embassy in support of your visa application.

If you are unable to access the information and application forms via the internet, please remit a certified cheque, money order or bank draft in the amount of $35, made payable to PEBC, along with your written request including your name and address, and we shall post the information package out to you.

I received my pharmacy degree outside of Canada.  My university cannot send an original, currently-dated transcript.  What should I do?

As stated in our literature, we do not accept a photocopy of a transcript.  If the University cannot send an original currently-dated transcript, please ask them to send an attested photocopy attached to a currently-dated letter (written on University letterhead and signed by a University official) stating that they are unable to send an original transcript and the reason why.  Alternatively, you may ask the affiliated college you attended to send an original, currently-dated transcript directly to our office.

I graduated outside of Canada and have not yet received my final university degree certificate.  What do I need to do?

If you have not yet received your final university degree certificate, you will need to either provide PEBC with a letter from the Dean of your Faculty of Pharmacy stating your final university degree certificate has not yet been issued and when it will be issued; OR, make a statutory declaration in the presence of a lawyer, notary public or commissioner for oaths, stating your final university degree certificate has not yet been issued and when it will be issued.  PEBC does not accept the provisional certificate.

I am applying for Pharmacist Document Evaluation.  What do I need to do if my documents are not in English or French?

PEBC requires an original, currently-dated transcript sent directly to our office by the university.  And PEBC requires an original, currently-dated licensing statement (letter of good standing) sent directly to our office by the licensing authority.  If either of these documents is issued in a language other than English or French, the candidate must also send us an official translation into English or French.
PEBC requires a certified copy of the University Degree Certificate.  This means the lawyer, notary public or commissioner for oaths sees the original, makes a photocopy and signs that photocopy to make it a certified copy.  The candidate sends us the certified copy of the University Degree Certificate with their application for Document Evaluation.  If the University Degree Certificate is issued in a language other than English or French, PEBC will also require an official translation into English or French.
If the candidate’s birth certificate was issued in a language other than English or French, PEBC will also require an official translation of this document into English or French, along with a certified copy of the birth certificate in its original issued language.
In all cases where an official translation is applicable, PEBC requires the original of the official translation.

I want to apply for Pharmacist Document Evaluation, but my application and documents will arrive at PEBC at different times.  Is this a problem?

PEBC expects your transcript and licensing statement to arrive separately, as they must be sent directly to our office by the issuing authority; that is, the university and the licensing body.  We save all incoming documents, so if they arrive before your application for Document Evaluation, don’t worry.  All documents will be matched up based on the information you provide on your application form.

Do I need to wait until my Document Evaluation has been completed to apply for the Pharmacist Evaluating Examination?

No. You can submit your Evaluating Examination application with your Document Evaluation application and they will be evaluated together. It is not recommended that you wait until after your Document Evaluation has been completed as you may miss an upcoming Evaluating Examination deadline.

After I complete Document Evaluation, how long do I have to pass the Pharmacist Evaluating Examination?

Once your documents have been favourably evaluated, you have up to five years to pass the Evaluating Examination.

What happens if I do not successfully pass the Pharmacist Evaluating Examination within 5 years of completing Document Evaluation?

If you are unable to write the Evaluating Examination within the five-year period from your Document Evaluation or if you have any remaining attempts and the five years from Document Evaluation has expired, your file will be closed.  You will then need to request in writing (e-mail, fax, or letter) to have your file re-opened, including in your request your full name, PEBC ID# and current mailing address.  You will then receive instructions in a letter sent via Canada Post informing you what you must do to have your file re-opened for you to take your remaining attempts for a renewed five-year period.

After I successfully complete the Pharmacist Evaluating Examination, how long do I have to pass the Pharmacist Qualifying Examination?

After you complete the Evaluating Examination, there is no specified timeframe during which you must take and pass the Qualifying Examination.  However, both Parts of the Qualifying Examination must be successfully completed within a three-year period of passing one Part.  If you do not complete the process within this time period, you will be required to apply to the Board asking for the opportunity to take the remaining Part.  If the examination and blueprint have changed significantly since you started the Qualifying Examination process, you may be required to complete both Parts.

I have completed Pharmacist Document Evaluation.  How do I arrange for PEBC to send a copy of my Licensing Statement to a provincial or territorial regulatory authority?

If you would like PEBC to send a copy of your Licensing Statement or Letter of Good Standing to a provincial or territorial regulatory authority, you will need to send a written request and a certified cheque or money order or bank draft in the amount of CAN$50.00. The Pharmacy Examining Board of Canada will send the document directly to the appropriate provincial or territorial regulatory authority.

Registration Procedures for International Pharmacy Graduates 

The role of provincial governments and The Pharmacy Examining Board of Canada (PEBC) in licensing

Each province in Canada is responsible for issuing a license to practise pharmacy in that province. All provinces, except Quebec, require applicants educated outside of Canada to have The Pharmacy Examining Board of Canada (PEBC) Certificate of Qualification.

This Certificate is a major requirement for licensing in each province, but the Certificate alone does not mean you have the right to practice.

In addition to the PEBC Certificate of Qualification, each province has additional licensing requirements. These may include practical experience, English or French language skills, and jurisprudence examinations. You must contact the regulatory authority of the province in which you choose to practice to receive full information about their requirements. The contact information for the provincial and territorial regulatory authorities is available on the PEBC website.

Click here for the addresses of the provincial and territorial regulatory authorities.

How to receive your PEBC Certificate of Qualification

As an international pharmacy graduate, you must follow the 2-step Evaluation Procedure before you can write the Pharmacist Qualifying Examination. Once you have favourably completed the two steps, you will then be eligible to take the Pharmacist Qualifying Examination.

Language Proficiency Requirements

Language Proficiency Tests are not required by the PEBC. However, Provincial Regulatory Authorities do require these tests.

Pharmacists seeking licensure must meet the respective provincial requirements in order to become licensed within an individual province. Therefore, candidates for licensure are advised to contact the regulatory authority for the province in which they are seeking licensure to receive full information regarding language fluency requirements.

For all matters regarding immigration, please contact your local Immigration Authorities directly. PEBC cannot provide information or answer questions about immigration.

On  the Pharmacist Evaluating Examination, you will be examined in the following subject areas, shown below. These subject areas were revised in 2005.

The approximate percentage of questions for each of the four major subject areas represented on an examination is shown in parentheses.

BIOMEDICAL SCIENCES (25%)

Biochemistry/Genomics and Molecular Biology/Nutrition/Clinical Biochemistry
Physiology/Functional Anatomy and Immunology
Pathophysiology and Pathology
Medical Microbiology

PHARMACEUTICAL SCIENCES (35%)

Pharmaceutics and Drug Delivery Systems
Pharmacokinetics and Biopharmaceutics
Medicinal Chemistry
Pharmacology
Toxicology and Clinical Toxicology
Pharmaceutical Analysis
Biotechnology and Pharmacogenetics

PHARMACY PRACTICE (30%)

Therapeutics (Including Non-Prescription Medications)
Professional Practice Skills

BEHAVIOURAL, SOCIAL AND ADMINISTRATIVE PHARMACY SCIENCES (10%)

Pharmacy Administration: Management/Health Care Systems/Pharmacoeconomics
Biostatistics/Pharmacoepidemiology
Bioethics

Both formal education and practice experience prepare you for the Pharmacist Evaluating Examination and licensure as a pharmacist. In order to determine what additional learning needs you have, prior to taking the examination, you should assess the knowledge and skills that you have already acquired, in comparison with the subject areas and their weightings outlined in theExamination Blueprint. You are in the best position to determine how much and what kind of preparation is necessary for you.

In addition to your university education and personal learning, the ideal tool for acquiring Canadian pharmacy practice skills is to undertake “hands on” practice experience working in a Canadian pharmacy setting with direct patient care services. Practice experience will offer insights into Pharmaceutical Care practice, the Canadian Health Care System, jurisprudence and ethical issues, as well as commonly seen aspects of therapeutics.

Remember that inadequate language proficiency will affect your performance. Effective written and verbal communication skills (at levels satisfactory for a health professional) are essential competencies for practice and for success in taking the PEBC examinations. Do not overlook this important step in your preparations.

Once you have identified your learning needs, it is your responsibility to find suitable reference sources, materials and/or additional experience to prepare for the Pharmacist Evaluating Examination. A partial list of references and learning resources (review guides, textbooks, federal legislation and Internet resources), is in the Pharmaceutical References and Learning Resourcessection. The Internet Resources section includes a listing of some Continuing Education (CE) learning opportunities that are available to you. This list is not intended to serve as a handbook or complete overview, nor should you assume that these references are the source of the examination questions.

It is important for candidates who are unsuccessful in an attempt, to focus on improving behaviours and learning, with actions and strategies that are closely linked to the goal of achieving success. This involves undertaking those activities and improvements that will make a significant difference for the next examination attempt. Simply retaking another examination, without making improvements, will not achieve a successful outcome. It is crucial to give serious consideration and assess the effect that completed learning activities and remediation efforts have made in improving one’s readiness to take the next examination.

The sample questions contained in this booklet are provided as illustrations, to assist you to become familiar with the examination format and phrasing style. NO additional sample questions or content from previous examinations are available.

Please check the PEBC website from time to time for any additional information about resources and/or updated sample questions.

Pharmacist Evaluating Examination Syllabus

A syllabus has been compiled to guide candidates preparing for the PEBC Pharmacist Evaluating Examination. It contains sample outlines of Canadian university level pharmacy course material, in subject areas considered important to the background knowledge base in the pharmaceutical sciences and preparation for the practice of pharmacy. The material found in this syllabus gives sampling from a variety of sources, and its purpose is to serve ONLY as a guide to the curriculum content of current pharmaceutical education in Canada.

This information may be helpful in your preparation to write the Pharmacist Evaluating Examination. However, this syllabus should NOT be interpreted to be the blueprint for the construction of questions for the Pharmacist Evaluating Examination.

The revised syllabus is available here. If you would like a paper copy of this syllabus, please send your request along with the fee of $35 (certified cheque, money order or international bank draft in Canadian funds only). Please note that cash is not accepted.

Application Procedure
Examination Fee
Examination Centres
Changing Examination Centres
Bilingual Examination Booklet
Special Needs Testing Arrangements
Withdrawal/Refund Policies
Withdrawal/Absence for Special Circumstances

Application Procedure
You may apply for Document Evaluation and the Pharmacist Evaluating Examination online.  However, you cannot apply online for Document Evaluation and the Pharmacist Evaluating Examination at the same time. You must first apply for Document Evaluation and wait for PEBC to send you an email with your assigned PEBC Identification Number (usually takes one to two weeks). When you have received your PEBC Identification Number, you may then apply online for the next sitting of the Pharmacist Evaluating Examination. Please note that, if you apply online, you must still print off your completed online application form(s) and submit them, along with the checklist(s) and required documentation, to PEBC by the application deadline date. If you complete an application form online but do not send the printed form to PEBC, you will be charged an administrative fee of $100 (Canadian) and your application will not be processed and will be treated as a withdrawal.
If you have funds on account with PEBC, you cannot apply online and you need to print off the application form(s) and complete them manually. Application forms are available: Application form in printable PDF format. You must download and print a copy of the form. PEBC is developing an online application and payment process. Please visit the PEBC website regularly for updates. There are English and French versions of the application forms. Please select the correct version, choosing the same language in which you wish to take the examination. The checklist on page two of the application form must also be completed and signed before the application form is sent to PEBC.

Please note that application forms cannot be delivered in person to the PEBC office.

Please keep us informed about any changes to your contact information (address, telephone number, email address), by advising us in writing by fax, mail or email.

Instructions for first page of application:
1. Enter your name on your application exactly as it appears on your identification.

2. You must indicate the following:

• your chosen examination date
• preferred language for the examination
• preferred location (city) for the examination

3. Fill out all other information requested being sure not to miss anything as it is all required.

4. You will need two, identical, passport-acceptable photographs (with date taken, stamped or written on back by the photographer), for each application. They must have been taken within twelve months of the examination date. They cannot be photocopies or digital prints and must be identical. Staple one photograph to the top, left corner of each application form. Paste one photograph in the box provided in the bottom, right corner of each application form.

5. You will need to find an acceptable witness with any of the following qualifications:

• a notary public
• a commissioner for oaths
• a lawyer
• a staff person at a Canadian Embassy

6. While in the presence of your witness:

• Sign the application yourself in the space provided
• Have your witness fill in city, date, name, signature & title/profession
• Have your witness seal, stamp or sign the front of the photograph located in the bottom, right corner of the application. The signature needs to cover part of the photograph and application.

Checklist (page two of application):

A checklist has been provided that you will need to sign, date and include with your application. Please go through it carefully in order to double check that you are including all of the information required. If all of these instructions are not followed we may have to ask for documents to be resubmitted which could cause you to miss the deadline.

Receipt of Application:

Completed application forms (including checklists) and all supporting documents must be receivedno later than the application deadline date. This includes applications that were printed and paid for using the online process.  Applications that are received after the deadline date will NOT be processed but will be held for a future examination date.

Overseas candidates who require a visa to take the examination in Canada are strongly encouraged to apply for their visa prior to the application deadline date. Candidates are not eligible for a refund due to a visa refusal, unless they have withdrawn from the examination either before the application deadline date or at least 8 weeks before the date of the examination.

Please do NOT contact the PEBC office by telephone, fax or email to confirm receipt of your application or to check your examination location assignment. If you wish to know whether PEBC has received your application, you must send it by a courier service or by Canada Post (Security Registered), and request an Acknowledgement of Receipt from the delivery service.

Application receipt acknowledgement will NOT be provided by phone or fax. When your application has been received and reviewed by the PEBC office, an email acknowledgment will be sent to your email address within 2 to 4 weeks. Please note the email acknowledgment does NOT ensure that your application is accepted; it simply indicates that PEBC has received your examination application.

Examination Fee

The examination fee is $515 ($880 for the London, England centre).

Fees must be paid in Canadian funds, by certified cheque, money order or bank draft. Post-dated certified cheques are not acceptable. All payments from outside of Canada must be in the form of an international money order or bank draft, drawn on a Canadian bank. The international money order or bank draft must be one that can be cleared through the clearing system in Canada and not through a manual process (by collection).  Money orders or bank drafts issued by a non-Canadian based bank must indicate the transit number of the designated Canadian bank, using standardized coding which is encoded at the bottom of the money order.  If the transit number is not encoded PEBC will be unable to cash the money order and your application fee cannot be processed in time to take the examination you have applied for. PEBC is experiencing problems cashing some international money orders and bank drafts. This can lead to additional collection fees and delays in processing applications. PEBC encourages international candidates to use the online applications for document evaluation or examination fees and pay by credit card, if possible.

PEBC reserves the right to change fees for the Pharmacist Evaluating Examination, at any time, as required.

Examination Centres

The Evaluating Examination will be held at university locations in Canada each summer and winter, as approved by the Board. The examination centres include: Vancouver, Edmonton, Saskatoon, Winnipeg, Toronto, Montreal, Halifax and St. John’s.

The examination will also be available overseas in London, England at an additional fee of $365 (Canadian funds).

It is recommended that you NOT make your travel arrangements more than one month in advance of the examination date.

Changing Examination Centres

If you wish to change examination centres after your application has already been submitted, you must mail your written request, together with an administrative fee of $50 (certified cheque, money order or bank draft) to the PEBC office. All payments from outside of Canada must be in the form of an international money order or bank draft, drawn on a Canadian bank. The international money order or bank draft must be one that can be cleared through the clearing system in Canada and not through a manual process (by collection).  Money orders or bank drafts issued by a non-Canadian based bank must indicate the transit number of the designated Canadian bank, using standardized coding which is encoded at the bottom of the money order.  If the transit number is not encoded PEBC will be unable to cash the money order and your application fee cannot be processed in time to take the examination you have applied for.The request and payment must be received no later than:

November 25, 2011 for the January 11 & 12, 2012 Pharmacist Evaluating Examination.

or

May 25, 2012 for the July 4 & 5, 2012 Pharmacist Evaluating Examination

Bilingual Examination Booklet

The Pharmacist Evaluating Examination is available in both official languages: French and English.

If you wish to have a bilingual (French/English) Examination Booklet, you must complete the French version of the application form and indicate that you wish to write the examination in French.

Special Needs Testing Arrangements

If you have a physical impairment, or other disability which substantially limits one or more major life activities, you may make a request for special needs accommodation, which must be submitted at the same time as your examination application. All requests for accommodation for special needs testing arrangements should be submitted to the Registrar-Treasurer and are subject to review and approval. Confidentiality will be maintained.

If you use assistive devices such as hearing aids or a wheelchair or any other assistive devices, then you must also submit a written request for accommodations together with the appropriate documentation and your application form. Should the need for an assistive device arise after submission of the application, you must notify PEBC immediately.

You must provide a request letter that clearly states the nature of your disability and its severity, and the nature of special arrangements requested. Your request must be accompanied by an official, original letter (on office stationery) from a qualified professional appropriate for evaluating the disability. It is your responsibility to provide acceptable documentation.

The intent of the letter from your professional evaluator is to provide *current supporting documentation, including:

• details of the disability, including a professionally-recognized diagnosis, diagnostic procedures, test results and other findings in support of the diagnosis
• history, time frame and assessment of current functioning
• description of the current functional limitation due to the stated disability and its impact on daily life and work activities
• description of the accommodations that have been provided by educational institutions
• specific recommendations for testing accommodation and why these are needed
• name, address, telephone number and qualifications/credentials of the professional expert.

*Current – i.e., completed within the last 6 months for psychiatric disabilities, last 3 years for learning disabilities, attention deficit hyperactivity disorder (ADHD) and all other disabilities (NOTE:  this requirement does not apply to physical or sensory disabilities of a permanent or unchanging nature).

PEBC will assess such requests on an individual basis, and, if deemed appropriate, will provide reasonable testing accommodations. However, NO change will be made in the examination content or PEBC rules and policies. You will be required to sign an acknowledgement of the agreement reached with PEBC in advance of the examination date.

PEBC reserves the right to assign the centre(s) where the accommodations can be offered, as all accommodations may not be available at any given examination centre. This may require that a candidate accept assignment to a centre other than his or her preferred centre choice(s).

Since arrangements for some accommodations may have significant cost and other resource implications, a candidate who has signed an agreement to the conditions of an accommodation will be bound by those conditions.

Withdrawal/Refund Policies

If you withdraw or are absent from the examination, part of the examination fee for each application will be refunded according to the following conditions:
(i) If your notice of withdrawal is received, in writing, by fax or mail (including email), in the PEBC office on or before the application deadline (see General Information) an administrative fee of $100 for each examination application, will be charged. Your full fee less $100 will be refunded for each application.
(ii) If you withdraw after the application deadline and up to 8 weeks before the date of the examination, an administrative fee of 50% of the fee for each examination application will be charged. 50% of your fee will be refunded for each application.
(iii) If you withdraw less than eight weeks before the examination, your full fee for each examination application is forfeited.
(iv) Withdrawal due to failure to graduate will be considered case by case.  A refund minus an administrative fee of $100 for each examination application will be considered.
(v) Absence because of certified illness, emergency or bereavement, will be considered case by case.  Refunds of up to 50% of the examination fee will be considered.

When you request a refund, you must return your PEBC Identification / Card of Admission (if issued), along with appropriate supporting documents (e.g., original medical certificate).  The medical certificate must clearly indicate the nature of the medical issue that necessitated the withdrawal from the examination.  A medical certificate which is dated more than two days after the examination date will not be accepted.  All supporting documents must be received by PEBC within seven calendar days of the examination; there will be no exceptions to this policy. Candidates may choose to send the medical certificate or other supporting documentation by fax or PDF (e-mail), so that it is received by the PEBC office within seven days, and then immediately send the original documents by post or courier so that they are received by PEBC within 14 days.

Refunds are processed after the examination session.  After a withdrawal, when you re-apply for a future examination session, you must submit a new application form with new photographs and the necessary fee.  There is a processing charge of $20 for refunds prepared in the form of a money order (refunds for overseas cannot be processed in the form of a cheque). This amount will be deducted from the total amount of the refund.
Please note that candidates are not eligible for a refund due to a visa refusal, unless they have withdrawn from the examination either before the application deadline date or at least 8 weeks before the date of the examination.

Withdrawal/Absence for Special Circumstances

If unplanned incidents arise immediately before or during the examination or before dismissal from the examination, the Presiding Officer (Part I) or Chief Administrator (Part II) is authorized by the Board to make decisions regarding admission to or continuation through the examination, at his/her discretion.
If you are unable to attend an examination sitting or complete the examination because of illness or for a compassionate reason (e.g., bereavement), you must immediately notify the PEBC office. If the matter arises suddenly on the day of the examination or just before, you must immediately notify:

• the PEBC office
• for Part II (OSCE/OSPE), the Chief Administrator or examination staff in the assigned examination centre by calling the emergency contact number on your Location Information sheet included in your Identification / Card of Admission materials

Candidates are strongly encouraged not to attempt the examination and to make an appropriate withdrawal if, prior to the examination, they are ill or have extraordinary circumstances, including bereavement, that may affect their performance in the examination.

Any request for a refund or for another consideration must include documentation verifying the circumstances. The written request, together with appropriate documentation, must be received by the PEBC office no later than 7 calendar days after the examination.
If absent due to illness, you must provide an original medical certificate, verifying that you were examined at the time of the illness. The date of the certificate must be appropriate for or match the examination date (i.e., certificates dated more than two days after the examination date will not be accepted).
If absent due to bereavement, you must provide a copy of the death certificate, verifying that the bereavement was at the same time as the examination.
Refunds of up to 50% of the examination fee will be considered on a case by case basis for absences due to special circumstances.

Office Hours

The PEBC office hours are Monday to Friday, 9:00 am to 4:00 pm, for receiving telephone calls and written correspondence by regular mail, email and fax. PEBC is not available for in-person candidate visits. Application forms may not be delivered in person, to the PEBC office.

Note that the office is closed for lunch between 12:00 noon and 1:00 p.m. and no telephone calls are received during the lunch break.

Correspondence

Once you start the PEBC evaluation process, you will be assigned a PEBC Identification Number. Always include your PEBC Identification Number in any correspondence and when contacting the office, whether by phone, fax or email.

Please allow sufficient time to receive a response to any enquiry you make, before contacting the office about the same matter again.

Document Evaluation Approval Deadline Dates

These are the deadline dates for Document Evaluation, that apply to the listed Pharmacist Evaluating Examination dates. Please check and follow all deadline dates carefully.

If you wish to be considered for an upcoming scheduled Pharmacist Evaluating Examination, you must submit your applications and fees for both Document Evaluation and the Pharmacist Evaluating Examination before the application deadline date.

Examination Dates

2-DAY FORMAT:
The Pharmacist Evaluating Examination will be held over a two-day period, with a 3.5 hour (half-day) written, multiple-choice question examination sitting held on each of the two days.

As regulated health care professionals, pharmacists are responsible and accountable to patients through legislation and the standards and bylaws of the professional regulatory authority in the province in which they practise. Provincial legislation and standards set out the requirements for licensure to practice. One of the requirements for initial registration and licensure is certification of an applicant’s knowledge, skills and abilities at entry to practice. This certification is granted by the PEBC to those who successfully complete the PEBC Qualifying Examination – Part I (MCQ) and Part II (OSCE). The Board is responsible for:

• assessing the qualifications of pharmacists and pharmacy technicians on behalf of provincial pharmacy regulatory authorities
• ensuring that entry-level pharmacists and pharmacy technicians have the necessary professional knowledge, skills and abilities to practise pharmacy within their scope of practice, in a safe and effective manner.

More information is available on the PEBC website: About Us

Registration and Licensure to Practise as a Pharmacist in Canada

Seeking initial registration and licensure to practise as a pharmacist involves the following:

• completion of an approved pharmacy education program, in which the academic institution awards a degree as evidence that the student has successfully completed an approved course of study to become a pharmacist
• successful completion of an evaluation of entry-level competence to practise pharmacy safely and effectively
• fulfilling all requirements of a provincial or territorial regulatory authority, demonstrating the individual’s overall qualification and readiness to begin practice as a pharmacist.

The provincial and territorial regulatory authorities (with the exception of Québec) use the Certificate of Qualification, issued by PEBC, as one requirement for licensure. PEBC certification alone doesNOT give an individual the right to practise pharmacy. In addition to PEBC certification, each province has additional requirements, such as practical experience, language proficiency, and jurisprudence examinations on pharmacy legislation and practice standards.

Registration and the granting of a provincial or territorial license provides evidence to the public of the individual’s overall qualification, practice training, and readiness to begin practice as a pharmacist in that jurisdiction. PEBC certification alone does NOT give an individual the right to practise.

For further information regarding licensing requirements in a province or territory, contact theprovincial regulatory authority (PRA) in the province or territory where you are seeking licensure.

Language Proficiency

Candidates for licensure are advised to contact the appropriate provincial regulatory authority for full information regarding language proficiency requirements for licensure in an individual province or territory.

Although PEBC has no language fluency requirements, you are advised that language proficiency will affect performance in both the Evaluating Examination and the Qualifying Examination (Part I and Part II). Effective written and verbal communication skills (at levels satisfactory for a health professional) are essential competencies for practice and for success in taking the PEBC examinations. Do not overlook this important step in your preparations.

Eligibility Requirements for International Pharmacy Graduates Seeking to Take the Qualifying Examination

1. American

If you are a graduate possessing a professional undergraduate degree in pharmacy, accredited by the Accreditation Council for Pharmacy Education (ACPE), you may apply directly for the Qualifying Examination. However, you must first have your qualifications assessed to confirm your eligibility, and you need to contact the PEBC office for further information. All graduates of American Universities must arrange to have their final transcripts sent to PEBC, directly from the university.

2. All Other International Pharmacy Graduates

For all other graduates, you must first have your qualifications evaluated (through PEBC Document Evaluation and the PEBC Evaluating Examination) to determine your eligibility to take the Qualifying Examination. If you have not yet been evaluated in this manner, you should contact the PEBC office, in writing, or check the PEBC website: www.pebc.ca for further information.

PEBC’s Two-step Evaluation Process

If you do NOT meet the eligibility requirements (listed above) to directly take the Qualifying Examination (Part I and Part II), you must first have your qualifications evaluated. The evaluation procedure is a two-step process:

Document Evaluation

• The first step is the evaluation of certain documents to ensure that you possess a qualification that is acceptable for admission into the Evaluating Examination. If your documents have not yet been evaluated, please contact the PEBC office, in writing, or check the PEBC website: www.pebc.ca for further information. Once your qualifications have been evaluated and ruled acceptable, you are eligible to write the Evaluating Examination.

Evaluating Examination

• The second step is the successful completion of the Evaluating Examination. The Evaluating Examination is designed to determine if you have completed a program of study comparable to that accredited by The Canadian Council for Accreditation of Pharmacy Programs (CCAPP). It will evaluate your knowledge in all areas of current pharmaceutical education in Canada. Once you pass the Evaluating Examination, you will then be permitted to apply for the Qualifying Examination (Part I and Part II).

Most of the style conventions of the Qualifying Examination will become evident as you work through the sample questions and stations provided in this booklet.

Questions about drugs are based on issues that are relevant to practice, and generally concern those most commonly prescribed or those recommended for use in a certain situation.

Laboratory values and drug levels will be reported in the International System of Units (SI).

Abbreviations and symbols used will be those an entry-level pharmacist should recognize and will be written in accordance with SI and other health care publications.

Style Conventions – Part I (MCQ)

SI Units:

The answers in calculation questions and the majority of values presented will be in SI (metric) units. However, you may be required to convert from the avoirdupois or apothecary systems before performing your calculation in instances where the conversion factor should be commonly known by an entry-level pharmacist (e.g. pounds to kilograms).

Drug Names:

Generally a drug will be referred to by its generic or common name. In those instances where a specific trade name is used, its generic or common name will also be given.

Language:

Negative words, such as NOT, NEVER, and EXCEPT are capitalized and printed in boldface, in order to draw your attention to the kind of response expected.

EXAMPLE: All of the following statements are correct, EXCEPT:

Numeric Formatting:

Decimal Separator

In the English language (including Canadian English documents), a period is generally used as a decimal separator. For example, “two and four-tenths” is represented by “2.4″.

In Canadian French documents, a comma is used as a decimal separator. For example, “two and four-tenths” is represented by “2,4″.

For formatting and consistency purposes, some numbers on the examination may include a decimal point with a trailing zero (e.g., 5.0).  In practice, the use of a trailing zero is strongly discouraged by the Institute for Safe Medication Practices, due to the risk of misinterpretation.

Thousands Separator

In the English language (including Canadian English documents), a comma is generally used as a thousands separator. For example, “two thousand five hundred” is represented by “2,500″.

Sometimes no thousands separator is seen, for example, “2500″.

Often, when there are two numbers to the left of the thousands separator, a space is used. For example, “twelve thousand five hundred” may be represented by “12 500″.

In Canadian French documents, a space is used as a thousands separator, for example “2 500″.

PEBC has tried to standardize the numeric format on written examinations to use a comma as a thousands separator; however, as noted in various medical references, the other previously mentioned formats may also be seen.

In Summary: two thousand = 2,000 = 2000 = 2 000

Formulas:

The formulas shown on the Formulas – Part I MCQ page will be printed in each Examination Booklet and therefore do not need to be memorized. Molecular and atomic weights will be supplied when necessary.

Standardized PEBC Calculators:

A PEBC standardized model, scientific calculator, removed from its case, will be provided to all candidates writing Part I (MCQ). The model is SHARP Scientific calculator EL-510R. A picture layout of the calculator and basic instructions for its use are enclosed in this booklet to assist you in familiarizing yourself with this calculator in advance of the examination date (see Calculators). This information will also be printed in each Examination Booklet.

Format of Examination Questions – Part I (MCQ)

The Pharmacist Qualifying Examination – Part I consists entirely of multiple-choice questions. You will be required to select the best answer from the responses listed. In some questions, you may believe there is a better answer than those provided. You should always mark the answer that isbest among the responses that accompany the question. Two examination question formats will be used in the examination: single answer, and combined-response, described as follows:

Classic Single-Answer Question (Type A)

This type of question requires that you answer a question or complete a statement by choosing a single best response of those provided, as in the following example:

The cephalosporins act by:
a.   inhibiting cell wall synthesis.
b.   altering the function and permeability of the cell membrane.
c.   inhibiting protein synthesis.
d.   inhibiting translation of genetic information.
e.   inhibiting synthesis of essential metabolites.

Combined-Response Question (Type K)

To answer this type of question you must determine whether the best answer consists of one, two, or all three of the components listed. You must select a response that contains ALL OF THE CORRECT information but NO INCORRECT information. Each of the combined-response questions will always have the same set of possible alternatives:

a.   I only
b.   III only
c.   I and II only
d.   II and III only
e.   I, II and III

as shown in the following example:

Suitable antioxidants for an aqueous vehicle would include:
I     vitamin E.
II   ascorbic acid.
III  ethylenediamine-tetra-acetic acid (EDTA).

a.   I only
b.   III only
c.   I and II only
d.   II and III only
e.   I, II and III

Examples of multiple-choice questions (MCQs) are found in Qualifying Examination Sample Questions section.

These examples are representative of the question format and phrasing style used in the examination, and the content of these sample questions is intended to illustrate a variety of the competency areas tested within the examination blueprint.

General Reference Information

The Pharmacy Examining Board of Canada does not endorse any preparatory course material of any kind, and any pretence by an individual or group in making such a claim is liable to legal prosecution.

It is the candidate’s responsibility to utilize suitable reference materials and other resources in preparation for taking the Qualifying Examination. You should identify your personal learning needs in accordance with the examination blueprint (and consideration, if applicable, of feedback from any previous examination attempt).

It is important for practising pharmacists to continually stay up to date with therapeutics and clinical guidelines and other pharmacy practice issues. This includes staying current as new developments reach practice and the workplace. Compared to other references, one of the limitations of textbooks is the lag time before updated editions appear. It is important for candidates to use current information when preparing for the Qualifying Examination.

As per the NAPRA competency 4.2, pharmacists are expected to be familiar with the use of a variety of drug information resources and have a working knowledge of which references are useful in specific situations.

Some of the most current information about pharmacy practice in Canada can be found on the National Association of Pharmacy Regulatory Authorities (NAPRA) website (www.napra.ca). The “NAPRA Model Standards of Practice” further explain and illustrate the NAPRA competencies, which are the basis of the PEBC Qualifying Examination blueprint. Many other useful resources and practice tools can also be found on the NAPRA website.

From time to time, additional reference and learning resource suggestions may appear on the PEBC website.

In addition to your university education and personal learning, the ideal tool for acquiring Canadian pharmacy practice skills is to undertake “hands on” practice experience working in a Canadian pharmacy setting with direct patient care services. Practice experience will offer insights into the role of the pharmacist in patient care, the Canadian health care system, legal, professional and ethical issues; drug information and critical review of the scientific literature; and commonly seen clinical, therapeutic, technical and other practice scenarios.

There are a number of structured, preparatory “bridging” programs currently available in Canada, including: the International Pharmacy Graduate (IPG) Program in Ontario at the University of Toronto; the Canadian Pharmacy Practice Programme in British Columbia (at the University of British Columbia Point Grey Campus) and the International Pharmacy Bridging Program in Alberta (Bredin Institute in Edmonton). Please refer to the Internet Resources – Bridging Programs section for contact information about these programs. You may also wish to contact the regulatory authority in other provinces for information regarding other assistance or programs for acquiring skills for practice as a pharmacist in Canada.

The following listings are intended as a general guide and cover a variety of topics and may be helpful to you as you prepare to take the Qualifying Examination. This list covers a wide variety of topics, but it is NOT intended to serve as a detailed syllabus nor should it be assumed that these resources are the source of examination questions. The content of the Qualifying Examination – Part I and Part II is not based on a particular reference textbook, but rather on the NAPRA competencies as indicated in the examination blueprint. Listings are presented in the following three sections:

• pharmacy review guides,
• pharmacy textbooks,
• internet resources.

Pharmacy Review Guides

These four American pharmacy review guides are comprehensive subject reviews containing a large number of multiple-choice questions, covering many subject areas related to pharmaceutical education and pharmacy practice issues. Note that drug names and units of measure may be different in Canada. Federal law review questions must be avoided as they are based on American legislation, not Canadian.

Appleton and Lange Review of Pharmacy, by Hall and Reiss, McGraw-Hill Medical.

Appleton and Lange’s Quick Review Pharmacy, by Generali and Berger, McGraw-Hill Medical.

PharmPrep: ASPH’s NAPLEX Review, by Eiland and Ginsburg, American Society of Health-System Pharmacists, available as an online/book package.
website: www.ashp.org (click on Store then Student Resources section)

Comprehensive Pharmacy Review, ed. by Shargel et al, Lippincott Williams and Wilkins.

Pharmacy Textbooks (current editions)

The following references are examples of textbooks currently being used in Canadian pharmaceutical education programs. Many of these textbooks are available from the university bookstores associated with the various Canadian Pharmacy programmes or other retail booksellers, including online sources. The listings shown first are major textbook references which form the framework for studies in pharmacology, pathophysiology and therapeutics courses.

Applied Therapeutics, The Clinical Use of Drugs, ed. by Koda-Kimble, Lippincott Williams and Wilkins. (Patient case-based comprehensive reference)

Clinical Pharmacy and Therapeutics, ed. by Walker and Whittlesea, Churchill Livingstone.

Goodman & Gilman’s: The Pharmacological Basis of Therapeutics, ed. by Brunton et al, McGraw-Hill.

Principles of Medical Pharmacology, ed. by Kalant et al, Saunders Canada.

Pharmacotherapy: A Pathophysiologic Approach, ed. by DiPiro, Talbert, et al, McGraw-Hill Medical.

Pharmacotherapy:  Principles and Practice, by Chisholm-Burns et al, McGraw-Hill Medical

Clinical Drug Data, ed. by Smith et al, McGraw-Hill.

The next six listings are all textbooks published by The Canadian Pharmacists Association, Ottawa, ON (www.pharmacists.ca) and may be ordered by phone:             1-800-917-9489       (Canada only) or            613-523-7877      .

Therapeutic Choices, Canadian Pharmacists Association.

Self Care Two-volume set
1) Patient Self-Care (PSC) Helping Patients Make Therapeutic Choices, Canadian Pharmacists Association.
2) Compendium of Self-Care Products (CSCP), Canadian Pharmacists Association.

Compendium of Pharmaceuticals and Specialties (CPS), Canadian Pharmacists Association. Useful overview information is found on the front page “CPS At a Glance” and by checking the “Table of Contents” listing of information sections and topics.

Pharmacy Management in Canada, Canadian Pharmacists Association.

Safe and Effective: The Eight Essential Elements of an Optimal Medication-Use System, ed. by MacKinnon, Canadian Pharmacists Association.

The Merck Manual of Diagnosis and Therapy, by Porter, Merck Publications.

Clinical Pharmacokinetics, by Murphy,American Society of Health-System Pharmacists Publication.

Applied Pharmacokinetics and Pharmacodynamics: Principles of Therapeutic Drug Monitoring, et by Burton et al, Lippincott Williams and Wilkins.

Hansten and Horn’s Drug Interactions Analysis and Management, by Hansten and Horn, Lippincott Williams and Wilkins.

Drug Information: A Guide for Pharmacists, by Malone, Kier and Stanovich, McGraw-Hill Medical.

Contemporary Drug Information: An Evidence-Based Approach, by Gaebelein and Gleason, Lippincott Williams and Wilkins.

Principles of Scientific Literature Evaluation Critiquing Clinical Drug Trials, by Ascione, American Pharmacists Association Publications.

How to Read a Paper: The Basics of Evidence-Based Medicine, by Greenhalgh, BMJ Publishing Group.

Making Sense of Critical Appraisal, by Ajetunmobi, Arnold Publications

Remington: The Science and Practice of Pharmacy, The Pharmaceutical Press.

Martindale The Complete Drug Reference, by Sweetman, The Pharmaceutical Press.

Pharmaceutical Calculations, by Ansel, Lippincott Williams and Wilkins.

Pharmaceutical Care Practice, by Cipolle, Strand and Morley, McGraw-Hill, Medical.

Communication Skills in Pharmacy Practice, ed. by Tindall, Beardsley, et al, Lippincott Williams and Wilkins.

Pharmacists Talking with Patients, by Rantucci, Lippincott Williams and Wilkins.

Drugs in Pregnancy and Lactation, by Briggs et al, Lippincott Williams and Wilkins.

Pharmacoethics A Problem-Based Approach, by Gettman and Arneson, CRC Press.

Ethical Issues in Pharmacy, Weinstein, Applied Therapeutics.

Supervision: A Pharmacy Perspective, by Wick, American Pharmacists Association Publications.

Herbal Medicines, by Barnes, Pharmaceutical Press.

Natural Medicines Comprehensive Database, Therapeutic Research Faculty.

Boh’s Pharmacy Practice Manual, by Stein, Lippincott Williams and Wilkins.

Focus on Safe Medication Practices, Rantucci, Stewart and Stewart, Lippincott Williams and Wilkins.
Methadone Maintenance: A Pharmacist’s Guide to Treatment, Isaac et al, CAMH Publication.

On-Line Information Sources

PubMed – www.ncbi.nlm.nih.gov/pubmed – free access to primary literature through Medline

Cochrane Library – www.cochrane.org – access to systematic reviews of the effects of healthcare interventions

Rxfiles – www.rxfiles.ca – limited free information is available on-line; access otherwise by subscription

Subscription-Based Drug Information Databases

Micromedex Healthcare:  DRUGDEX – drug information database; POISINDEX – information on drug overdoses and toxicologic exposures

Lexicomp – drug information database

Dynamed – evidence-based clinical reference tool

The following listings include a selection of websites with specific kinds of information such as current legislation, pharmacy practice resources, and other timely topics which are useful to practising pharmacists and those who are seeking licensure as pharmacists in Canada. Note that provincial regulatory authorities other than those listed may offer similar resources that you can access.

Websites Helpful For Pharmacy Practice:

National Association of Provincial Regulatory Authorities www.napra.ca
Useful links include the following:

Pharmacy Practice and Regulatory Resources
Pharmacy Practice Resources section includes:
• Distribution of Medication Samples
• Drug Information Resources
• Minimizing Medication Errors
• Oral Contraceptives for Emergency Contraception
• Pharmacy Care Plans

Federal Drug Legislation
National Drug Schedules (I, II and III)
Licensing/Registration

Health Canada www.hc-sc.gc.ca

Federal legislation includes the following acts and regulations which pertain to pharmacy practice in Canada:

Canada Health Act  – From menu at left, click on “Health Care System”, then click on the link for: Canada’s Health Care system: Canada Health Act information.

From main page, use the search button at the top to find information on:
• Food and Drugs Act and Regulations
• Controlled Drugs and Substances Act (CDSA) and Regulations (including Precursor Control Regulation)
• Narcotic Control Regulations
• Benzodiazepines and Other Targeted Substances Regulations
• Marihuana Medical Access Regulations

MedEffect: Advisories, Warnings and Recalls and Canadian Adverse Reaction Newsletter, under Health Canada’s “Drugs and Health Products”  , click on “MedEffect”

Canadian Agency for Drugs and Technologies in Health www.cadth.ca
• Useful links include “Common Drug Review” and “Optimal Use”

Privacy Legislation – Department of Justice
https://www.priv.gc.ca/
• See link for Personal Information Protection and Electronic Documents Act (PIPEDA)

Public Health Agency of Canada www.phac-aspc.gc.ca
• See link for “Immunization & Vaccines” for Canadian Immunization Guide Seventh Edition – 2006.

College of Pharmacists of British Columbia www.bcpharmacists.org
On Main Menu:
• Resources
• Professional Development

Ontario College of Pharmacists www.ocpinfo.com
• CE for Pharmacists
• Professional Practice

Dalhousie University (Halifax, Nova Scotia) https://pharmacy.dal.ca
• Resources
• Continuing Pharmacy Education

Please visit websites regularly, for updates and corrections.

For Suggestions for Clinical Practice Guidelines

To obtain up to date evidence-based information designed to assist in patient care decisions for the management of specific disease states, you may search, using your Internet browser, for “Canadian Consensus Guidelines” or “Clinical Practice Guidelines” (and narrow the search by selecting a specific disease state).  Adding the current year to your search will help to ensure that most recent updates to guidelines are listed at the beginning of your search results.

Some examples include the following:

• Hypertension (Canadian Hypertension Education Program) 2012 Recommendations for the Management of Hypertension
• Diabetes (Canadian Diabetes Association) 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada
• Asthma (Canadian Thoracic Society) 2010 Asthma Management Guideline
• COPD (Canadian Thoracic Society) 2007 Update Recommendations for the Management of COPD

Additional:
• The Canadian Medical Association Journal (CMAJ) website (www.cmaj.ca) offers other clinical practice guidelines and information on a variety of disease topics

• Health Canada website (www.hc-sc.gc.ca) – click on Health Concerns and Healthy Living from menu at the left

• Public Health Agency of Canada (www.publichealth.gc.ca) – click on Diseases and Conditions from menu at the left

Other:

Canadian Society of Hospital Pharmacists (CSHP) – www.cshp.ca – click on “Publications” – “Statements” are open access but other publications require a membership login

Canadian Patient Safety Institute (CPSI) – www.patientsafetyinstitute.ca – click on “Education” or “Tools and Resources”

Developing Pharmacy Practice: A Focus on Patient Care
www.who.int/medicines/publications/WHO_PSM_PAR_2006.5.pdf (content topics include Pharmaceutical Care, Pharmacy practice trends, Drug Information and literature appraisal, and Phamacoeconomic analysis)

Institute for Safe Medication Practices
www.ismp.org click on “Medication Safety Tools and Resources” section

US National Library of Medicine – Drugs and Lactation Database (LactMed) https://toxnet.nlm.nih.gov

For Information about International Pharmacy Graduate “bridging” programs:

www.ipgcanada.ca (Ontario)
Canadian Pharmacy Skills
Enhanced Language Program

www.pharmacy.ubc.ca/programs/non-degree-programs/practice  (British Columbia)
Canadian Pharmacy Practice Programme

www.bredin.ab.ca (Alberta)
International Pharmacy Bridging Program

For Information about Continuing Education (CE) Learning:

Continuing Education in Pharmacy in Canada is coordinated by CCCEP: the Canadian Council on Continuing Education in Pharmacy. CCCEP-approved learning programs are available from a wide variety of sources. Some of these include the following:

Canadian Pharmacists Association (CPhA) (www.pharmacists.ca)
Go to Quick Links and click on CE, then click on Online Learning Centre

Canadian Healthcare Network (www.canadianhealthcarenetwork.ca)
Provides CE lessons from Pharmacy Practice and other sources
• Register for CE Online

Teva Canada (www.tevacanada.com) – Click on Pharmacists, then Continuing Education

rxBriefCase (www.rxbriefcase.com)
Includes links to various CE learning resources, including the Mylan Collaborative Series

Provincial Regulatory Authorities (PRAs) and the schools of Pharmacy within Canadian universities offer information and access to other CE learning opportunities (see PRA listing)

Most CE learning modules are designed to enhance individual knowledge in Therapeutics and Disease State Management. When choosing to self-study with CCEPP-approved CE learning modules, it is important for a candidate to self-assess the wide range of available disease state and therapeutics topics and make selections to ensure that:
1) individual gaps in knowledge will be addressed, and
2) disease topics reflect those seen most frequently in patient care practice settings, as well as those where drug therapy plays an important and critical role in patient care outcomes.

The sample questions that follow are NOT intended or designed to be a sample examination and do NOT represent an exact model of the Pharmacist Qualifying Examination-Part I, in terms of difficulty and proportion of topics. However, individually, these examples are intended to be representative in format and phrasing style of the types of questions found in the Qualifying Examination-Part I. They also illustrate a variety of the competency areas contained in the examination blueprint. Please note that these questions are reviewed and updated periodically.

See the bottom of the page for the answers to the sample questions.

COMPETENCY 1: Patient Care

1.   RY is an 85 year old male who lives alone, currently takes 12 different medications. For the past 2 weeks he has telephoned to ask the pharmacist what dose of diuretic he should be taking (this medication looks similar to another tablet that he takes). He calls again today with the same question. After answering his question, the most appropriate pharmacist action should be to:

a.   call RY’s family doctor to suggest changing the diuretic to something that looks different.
b.   suggest that RY have the labels on his prescription bottles changed to a bigger font for easier reading.
c.    recommend that the pharmacy use a blister packaging dosette to dispense RY’s medications.
d.   suggest that RY write down the answer to his question so that he does not need to phone again.
e.   recommend that RY have his hearing and vision tested at his next physician visit.
2.  AD is a 58 year old male with diabetes, angina and erectile dysfunction. His physician consults the pharmacist in order to decide if AD would be a good candidate for sildenafil. The use of sildenafil is CONTRAINDICATED for AD if he takes:

a.   isosorbide 5-mononitrate.
b.   metoprolol.
c.   glyburide.
d.   ASA.
e.   enalapril.

3.  RP has a prescription for famciclovir for shingles (prescribed 2 days ago), and is uncertain about filling it, due to the high cost. Based on the known effectiveness of famciclovir for herpes zoster, benefits that the pharmacist should discuss with RP include:
I    prevention of acute zoster-associated pain.
II   faster healing time for rash.
III  less and shorter duration of post-herpetic neuropathic pain.

a.   I only
b.   III only
c.   I and II only
d.   II and III only
e.   I, II and III
4. Common etiologic agents of community-acquired pneumonia include:
I    Escherichia coli.
II   Haemophilus influenzae.
III  Mycoplasma pneumoniae.

a.    I only
b.    III only
c.    I and II only
d.    II and III only
e.    I, II and III
5.   Iron may decrease the absorption of which of the following medications?

a.    Ramipril
b.    Atenolol
c.    Moxifloxacin
d.    Ibuprofen
e.    Glyburide
6.   Which of the following medications is the most appropriate choice for treatment of neuropathic rather than nociceptive pain?

a.    Nabilone
b.    Tramadol
c.    Ibuprofen
d.    Meperidine
e.    Nortriptyline
7.   Appropriate auxiliary labelling for clarithromycin suspension includes which of the following?

a.    Shake well before using.
b.    Take with plenty of fluids.
c.    Avoid prolonged exposure to sunlight.
d.    Keep refrigerated.
e.   May cause discolouration of urine.
8.   The pharmacist fills a prescription for sumatriptan 100 mg tablets for a patient with migraine. Appropriate information to provide to the patient includes which of the following?

a.    If the sumatriptan does not relieve the headache within four hours, ergotamine may be used.
b.    If no relief is achieved in two hours, sumatriptan may be repeated.
c.    If the headache is partially relieved with a single tablet, the dose may be repeated after two hours.
d.    The maximum dosage of sumatriptan 100 mg in any 24 hour period is six tablets.
e.    If relief is not achieved, no other medication can be used for at least 24 hours.
9.   JG has been taking metoclopramide 20 mg, po q6h for the past 3 days as part of her chemotherapy regimen. She normally takes 4 doses daily, with each meal and at bedtime. This morning, she forgot to take her morning dose before leaving home for a hospital check-up. When she arrives at the clinic, she asks the pharmacist what she should do about her missed dose, as she expects to be home again around 11:00 am. The pharmacist should advise JG to:

a.    take the missed dose immediately when she gets home and continue as scheduled.
b.    take two doses at lunchtime to make up for the missed dose.
c.    skip the missed dose and take the next scheduled dose at lunchtime.
d.    skip today’s medication and resume her normal schedule tomorrow.
e.    space 4 doses into the remaining hours between when JG gets home and her bedtime.
10.   EK is a 25 year old female who presents to the pharmacy requesting Plan B^® (levonorgestrel) for emergency contraception following an episode of unprotected sex 12 hours ago. After speaking with EK, the pharmacist decides she is a good candidate to receive Plan B^®. The pharmacist should include all of the following information in counselling EK, EXCEPT:

a.    the effectiveness of Plan B^® in EK’s situation is likely to be better than 90%.
b.    Plan B^® works mainly by dislodging an implanted fertilized egg from the endometrium.
c.    EK should take two tablets of Plan B^® as a single dose.
d.    side effects may include nausea, vomiting, breast tenderness, cramps and spotting.
e.    if vomiting occurs within one hour of dosing, a repeat dose may be warranted.
11.   All of the following are reasons that elderly patients are more susceptible to drug-induced cognitive changes, EXCEPT:

a.    they are more likely to take multiple drugs.
b.    they may have hepatic dysfunction.
c.    they may have renal dysfunction.
d.    they are more sensitive to CNS effects of drugs.
e.    they have increased metabolic rates for producing psychoactive metabolites.
12.   For a child with asthma, all of the following factors are indicators of poor control, EXCEPT:

a.   number of visits to the Emergency Room.
b.   limitations on daily activities.
c.   awakening at night with asthma symptoms.
d.   keeping one canister of salbutamol at home and one at school.
e.   number of parent work days missed due to the child illness.
13.   Assessment of a patient’s asthma control should include all of the following factors EXCEPT:

a.    immunization status.
b.    inhalation technique.
c.    use of inhaled β2 agonist.
d.    use of inhaled corticosteroid.
e.    changes in environmental triggers.
14.   Which of the following liver enzymes is the first to be elevated in a case of an acetaminophen overdose?

a.    Lactic dehydrogenase (LDH)
b.    Alanine transaminase (ALT)
c.    Aspartate transaminase (AST)
d.    Alkaline phosphatase (ALP)
e.    Gamma glutamyl transpeptidase (GGT)

15.   AJ is a 24 year old, married female, who is planning to become pregnant in the near future. AJ has no medical conditions, no allergies, and is not currently taking any medications. What vitamin supplement should the pharmacist recommend to AJ to prevent neural tube defects in her baby?

a.    Niacin
b.    Vitamin D
c.    Folic acid
d.    Pyridoxine
e.    Ferrous sulphate
16.  Side effects which the pharmacist should monitor in DS, when looking for the effects of excessive topical corticosteroid use, include:
I     pruritus.
II    telangiectasias.
III   striae.

a.   I only
b.   III only
c.   I and II only
d.   II and III only
e.   I, II and III

COMPETENCY 2: Professional Collaboration and Teamwork

17.   FR is a 70 year old female client who presents to the pharmacist, complaining of nausea, diarrhea and dizziness for the past three days.  Her medication profile includes: ASA, digoxin, enalapril, and amiodarone. She denies any recent diet changes and the only change to her medications was the addition of amiodarone last week. She believes she must have picked up a “stomach bug” and would like something for symptom relief. The most appropriate pharmacist recommendation for FR is to:

a.    take loperamide and dimenhydrinate for symptom relief.
b.    take increased fluids and bed rest until the symptoms resolve.
c.    contact FR’s physician to discontinue the ASA until these symptoms resolve.
d.    contact FR’s physician to discontinue amiodarone until these symptoms resolve.
e.    contact FR’s physician to suggest that a digoxin level be taken.

18.   DS is a 27 year old male who comes to the pharmacy seeking advice because, for the past 24 hours, he has experienced abdominal cramping, mild fever and frequent, loose stools with some blood loss. DS thinks it may be related to the antibiotic he has been taking for a dental abscess. Current medications include: clindamycin 150 mg QID x10 days, started 8 days ago, and losartan 25 mg daily for hypertension, started 3 months ago. The most appropriate pharmacist response is that these symptoms:

a.    are expected, transient side-effects of clindamycin; treat symptoms and continue medications.
b.    may indicate an interaction between clindamycin and losartan; pharmacist call to dentist is warranted.
c.    may indicate clindamycin-related pseudomembranous colitis; seek immediate medical attention.
d.    may indicate losartan-related pseudomembranous colitis; seek immediate medical attention.
e.    are probably unrelated to DS’s medications; treat for flu symptoms and follow-up if no improvement.

19.   FD, a 58 year old male with hypertension, asks the pharmacist if cranberry juice would be useful for his current symptoms, which include frequency and a large volume of urine, but no urgency, or painful urination. Further questioning reveals that for the past 2 months he has also experienced polydipsia and polyphagia. The pharmacist should refer FD to his physician because these symptoms are consistent with:

a.    cholelithiasis.
b.    a urinary tract infection.
c.    prostate hyperplasia.
d.    diabetes mellitus.
e.    renal complications of hypertension.
20.   A local physician approaches the community pharmacist to collaborate on a health promotion pamphlet addressing medication adherence. Which of the following is NOT an appropriate topic for the pamphlet?

a.    The team relationship of the patient with both his physician and pharmacist
b.    The service of the pharmacy providing reminder calls for medication refills
c.     Advice to bring upcoming refill requests to scheduled physician appointments
d.    The various kinds of reminder packaging available to assist patients
e.    Referral to industry-sponsored consumer websites for information regarding medications
21.   Academic detailing by pharmacists provides a service to physicians by:

a.    educating on improved prescribing legibility.
b.    advising on optimal patient interviewing techniques.
c.    recommending strategies to avoid medication wastage.
d.    providing current information on best prescribing practices.
e.    promoting the use of physician samples given to patients.
COMPETENCY 3: Ethical, Legal and Professional Responsibilities

22.   According to the Narcotic Control Regulations of the Controlled Drugs and Substances Act, which of the following practitioners may prescribe narcotic drugs?

a.    Veterinarians
b.    Nurse practitioners
c.    Podiatrists
d.    Midwives
e.    Physiotherapists
23.   The ethical principle of veracity requires that pharmacists:

a.    respect the rights of others to make choices.
b.    do good to patients, placing the benefit of the patient over other factors such as cost.
c.    avoid, remove or prevent harm.
d.    act with fairness, to allow people to receive that to which they are entitled.
e.    act with honesty, without deception.
24.   JN, a 17 year old male with a highly resistant form of testicular cancer, is in hospital for treatment. He is an intelligent, articulate young man. His parents are insisting that the physician treat him with the latest experimental therapy, but JN does not want to undergo the treatment. If the physician goes ahead and gives the experimental therapy what ethical principle will have been violated the most?

a.    Confidentiality
b.    Non-maleficence
c.    Justice
d.    Veracity
e.    Autonomy
25.   Which of the following medications does NOT require witnessed destruction?

a.    Ketamine
b.    Nabilone
c.     Diazepam
d.    Testosterone
e.    Gabapentin
26.   The Canada Health Act (1984) embodies all of the following principles, EXCEPT:

a.    affordability.
b.    accessibility.
c.    comprehensiveness.
d.    portability.
e.    universality.
27.   ST is no longer satisfied with the service she has been getting at Pharmacy X across town, so she comes to your pharmacy requesting a refill of 3 months’ supply on a prescription for an oral contraceptive that she originally had filled at Pharmacy X. What is the correct procedure for obtaining the remaining refills?

a.    The pharmacist must contact Pharmacy X to get the prescription refills transferred, and document the transfer appropriately.
b.    The pharmacist cannot refill this prescription without phoning the prescribing physician.
c.    The pharmacist may refill the prescription as long as the patient provides you with the label from the original prescription.
d.    The pharmacist may refill the prescription and notify Pharmacy X within 24 hours that this has been done.
e.    Inform ST that the prescription resides at Pharmacy X and she must return there for refills.
28.   According to federal legislation, which of the following examples shows a legally correct refill designation on a written prescription for dexamphetamine?

a.    Repeat twice.
b.    Repeat monthly.
c.    Repeat as needed.
d.    Repeat twice as required.
e.    Repeat twice at 14 day intervals.
29.   According to the Benzodiazepine and Other Targeted Substances Regulations, what is the expiry date for refilling a prescription for lorazepam?

a.    Six months from the date written
b.    Six months from the date originally filled
c.    One year from the date written
d.    One year from the date originally filled
e.    No specific expiry date; at the pharmacist’s discretion
30.   The standard of publicly funded health care in Canada is mandated by:

a.    the Canada Health Act.
b.    individual provinces and territories.
c.    Health Canada’s Health Environment and Consumer Safety directorate.
d.    Canadian Agency for Drugs and Technologies in Health.
e.    National Association of Pharmacy Regulatory Authorities.
31.   The pharmacist receives a phone call from a physician who wishes to leave a verbal prescription for 30 alprazolam 0.25 mg tid, with 2 repeats. It is a new prescription for the patient. Which of the following statements is true?

a.    Prescriptions for benzodiazepines should be filed with the narcotic and controlled prescriptions.
b.    The prescription should not be dispensed because verbal prescriptions are not allowed for benzodiazepines.
c.    The prescription may be dispensed for the original quantity only, because refills are not permitted.
d.    Transfer of this prescription is permitted as long as the prescription is only transferred once.
e.    Keeping reports of sales in a manner that permits an audit is required for all benzodiazepines.
32.   For a drug going through research and development processes in Canada, which of the following statements is true?

a.    Application for patent protection is granted for a maximum period of three years.
b.    A New Drug Submission must be filed in order to start clinical trials.
c.    Clinical trials involve three phases assessing animal safety and efficacy.
d.    Each package size of a drug product must have a unique Drug Identification Number (DIN).
e.    Health Canada under the Food & Drugs Act & Regulations provides Notice of
Compliance.

33. Which of the following is the national voluntary organization for advocacy of pharmacists and  patient care?

a.    Canadian Foundation for Pharmacy
b.    Canadian Pharmacists Association
c.    Canadian Patient Safety Institute
d.    Institute for Safe Medication Practices
e.    National Association of Pharmacy Regulatory Authorities
COMPETENCY 4: Drug, Therapeutic and Practice Information

34.   Which of the following would be the most useful reference to learn what combination of antiretroviral agents is currently recommended as a first line therapy to treat HIV infection?

a.    Meta-analyses
b.    Randomized, controlled trial
c.    Pharmacology textbook
d.    Clinical practice guidelines
e.    Compendium of Pharmaceuticals and Specialties
35.   Which information source would be most appropriate to consult first, to determine if labetalol is a cardioselective beta-blocker?

a.    Compendium of Pharmaceuticals and Specialties
b.    Randomized, controlled trial data
c.    Meta analysis of beta blocker therapy
d.    Cochrane Library database
e.    Case reports
36.   Type II statistical error in a study comparing 2 drug treatment regimens occurs when:

a.    the control drug is not a “gold standard” treatment.
b.    a statistically significant difference exists but the difference is not clinically important.
c.    the population under investigation does not represent the population with the disease.
d.    the data shows no difference between 2 treatment regimens and a difference actually does exist.
e.    the data shows a difference between 2 treatment regimens but a difference does not actually exist.
37.   An adequately powered, randomized controlled trial conducted over 2 years demonstrated that the primary outcome (a serious cardiovascular event) occurred in 15% of the patients who received the new drug, whereas the primary outcome occurred in 25% of the patients who received a placebo. The relative risk reduction achieved with the new drug is:

a.    10%.
b.    15%.
c.     25%.
d.    40%.
e.    50%.
38.   In an adequately powered, randomized controlled trial conducted over 3 years, a specific serious side effect (i.e. reduction in leukocytes) with conventional therapy is seen in 0.5% of the study sample. In patients who receive a newly discovered drug, only 0.45% experience the same side effect. Based on these results, the minimum number of patients that would need to receive the new drug for 3 years to statistically demonstrate the prevention of one episode of this side effect in at least one patient (i.e., NNT) is:

a.    15.
b.    20.
c.    150.
d.    200.
e.    2000.
COMPETENCY 5: Communication and Education

39.   For elderly patients with chronic respiratory conditions, which of the following vaccinations are usually recommended on a yearly basis?
I     Influenza virus
II    Pneumococcus
III   Meningococcus

a.    I only
b.    III only
c.    I and II only
d.    II and III only
e.    I, II and III
40.   All of the following are appropriate suggestions for a pharmacist to give to a patient with allergic rhinitis from multiple environmental triggers, to minimize exposure to possible allergens, EXCEPT:

a.    open windows to get fresh air into the home.
b.    clean and vacuum on a regular basis.
c.    wash bed linens regularly in hot water.
d.    use mattress and pillow covers.
e.    remove any carpets, if possible.
41.   DS wishes to protect her children from West Nile infection and requests information from the pharmacist regarding insect repellents. All of the following are correct responses from the pharmacist, EXCEPT:

a.    DEET is the most effective insect repellent available.
b.    when needed, sunscreen should be applied to the skin prior to DEET application.
c.    DEET effectively binds to the skin and should not be reapplied after swimming.
d.    DEET should be washed off young children once they return indoors.
e.    products containing citronella oil have a very short duration of effect.
42.   A pharmacist is conducting public education sessions on the role of inhaled medications in patients with asthma.  Which of the following is the most appropriate indicator of improved asthma control?

a.    A decrease in the number of bronchodilator doses used prior to exercise.
b.    A decrease in the number of bronchodilator doses used per month.
c.    A decrease in the number of corticosteroid doses used per month.
d.    An increase in the number of bronchodilator prescriptions filled per month.
e.    An increase in the number of corticosteroid prescriptions filled per month.
43. Which of the following medications is LEAST likely to cause embarrassment and worry about social stigma in a school-age child?

a.    Insulin
b.    Phenytoin
c.    Venlafaxine
d.    Amoxicillin
e.    Methylphenidate
44.   When counselling a patient who is upset over a new diagnosis and need for medications, which of the following strategies is NOT appropriate for the pharmacist to use?

a.    Providing a private environment for the interaction
b.    Advising the patient that things will be okay
c.    Probing to clarify the patient’s concerns
d.    Letting the patient vent his/her feelings
e.    Ending with an encouraging statement

45.  Which of the following factors that vary with cultural diversity does NOT directly impact on pharmacist-patient dialogue and communication?

a.    Eye contact
b.    Hand gestures
c.    Facial expressions
d.    Interpersonal space
e.    Personal learning style
COMPETENCY 6: Drug Distribution

46.   A biological safety cabinet would be the best choice when preparing a parenteral formulation of:

a.    aminophylline.
b.    doxorubicin.
c.    magnesium sulfate.
d.    nitroglycerin.
e.    penicillin.
47.   A physician wants to switch a terminally-ill patient from slow release morphine sulphate tablets, 15 mg twice daily, to a liquid morphine sulphate dosage form because the patient has difficulty in swallowing tablets. If a morphine sulphate solution containing 5 mg per mL is prescribed q4h, what volume should be dispensed for a 20 day supply to provide the same pain relief as the tablet regimen?

a.    20 mL
b.    60 mL
c.    80 mL
d.   100 mL
e.   120 mL
48.   A patient is currently taking 220 mg of anhydrous zinc sulphate. To receive the equivalent amount of elemental zinc, how many milligrams of zinc sulphate heptahydrate (•7 H₂0) would the patient have to take? (Molecular weights: zinc 65, ZnSO₄ 161, H₂0 18)

a.    123 mg
b.    220 mg
c.    300 mg
d.    392 mg
e.    545 mg
49.   Given that 30 g of a mild corticosteroid ointment covers the entire surface of any adult for one application, how much ointment (in grams) should be dispensed for an 18 year old patient who requires treatment on approximately 20% of her body with twice daily application for 14 days?

a.    6 g
b.    12 g
c.    84 g
d.    124 g
e.    168 g
50.   BV is a 62 year old, obese female who visits a walk-in-clinic while her physician is away on vacation. She presents to the pharmacist with the following prescription:
Losec^® (omeprazole) 30 mg
M: 30
Sig. i daily
The pharmacist knows that this product is only available in 10 mg or 20 mg strengths and that BV’s profile shows that she was previously on the 20 mg strength of this medication. The most appropriate pharmacist response is to:

a.    tell BV that the physician has made a prescribing error.
b.    ask BV why she visited the clinic today and what the physician told her about the prescription.
c.    dispense using omeprazole 10 mg and adjust the quantity and dose accordingly.
d.    assume the prescriber was thinking of Prevacid^® (lansoprazole) 30 mg and change the prescription accordingly.
e.    recommend to BV that she wait to see her regular physician when he returns.
51.   Which of the following isLEAST appropriate to consider when a hospital pharmacy manager is organizing assigned responsibilities for clinical pharmacists in the department?

a.    Disease/medical area of interest of the individual
b.    Communication and interpersonal skills of the individual
c.    Advanced training or credentials of the individual
d.    Individual’s length of employment at the hospital
e.    Willingness of the individual to upgrade learning and skills
52.   Which of the following pharmaceuticals is regulated federally under the Precursor Control Regulations of the Controlled Drugs and Substances Act, as a precursor chemical for illicit drug use?

a.    Dextromethorphan
b.    Dimenhydrinate
c.    Diazepam
d.    Pseudoephedrine
e.    Testosterone
53.   A patient has been taking an opioid analgesic for the past three months for back pain resulting from a workplace injury. All of the following behaviours could be indicators of a developing addiction disorder, EXCEPT:

a.    incidents of lost prescriptions.
b.    frequent requests for early refills.
c.    prescriptions from multiple physicians.
d.    patient concerns regarding side effects.
e.    patient concerns regarding lack of efficacy.

54.   In a hospital pharmacy, which of the following is the most effective strategy to enhance safety and minimize the incidence of interpretation errors associated with verbal medication orders?

a.    Use of bar code technology on medication orders
b.    Use of tall man lettering on medication orders
c.    Use of automated dispensing technology
d.    Requirement for a read-back to the prescriber of all verbal orders
e.    Restricting the acceptance of verbal orders to oral medications only

55.   Which of the following classes of medications is most likely to be administered by the intravenous piggyback method?

a.    Antibiotics
b.    Opioids
c.    Insulins
d.    Erythropoiesis regulating hormones
e.    Neuromuscular blocking agents
56.   Which of the following actions would NOT contribute to promoting a safe medication use system in a pharmacy?

a.    Providing patients with information on medications
b.    Attention to environmental conditions in the pharmacy
c.    Offering developmental programs for staff education
d.    Rotating staff regularly to assume different responsibilities and tasks
e.    Maintaining processes for documentation of medication incidents
COMPETENCY 7: Understanding Management Principles

57.   MT, a pharmacy technician, has worked in a community pharmacy for 5 years. He is well-trained and welcomes new learning opportunities. His manager, now wanting to delegate a new technical project to him, should:
I     discuss suggested steps to accomplish the project.
II    negotiate a time schedule for completion of the project.
III   provide support and follow-up as required.

a.    I only
b.    III only
c.    I and II only
d.    II and III only
e.    I, II and III
58.   Which of the following is NOT a benefit of performing medication reconciliation activities in a hospital setting?

a.    Reduction of medication errors
b.    Reduction of inventory pilferage
c.    Reduction of preventable adverse effects
d.    Assessment of patient adherence to therapy
e.    Enhanced accuracy of patient allergy information
59.   Factors that determine bioequivalence of two brands of a drug include:
I     the taste of the preparations.
II    the physical appearance of the preparations.
III   pharmacokinetic parameters of the preparations.

a.    I only
b.    III only
c.    I and II only
d.    II and III only
e.    I, II and III
60.   Which of the following criteria should be considered when reviewing a medication for addition to the hospital formulary?

a.    The amount of samples provided to hospital physicians
b.    Research funds donated to the hospital by the pharmaceutical company
c.    National adverse drug reaction reports
d.    Whether it is a gluten-free oral formulation
e.    The length of patent period remaining
61.   In deciding what medications are appropriate for its formulary, the hospital must consider a drug’s efficacy, associated workload, and acquisition cost. Several new intravenous antifungal agents (drug A, drug B, drug C, and drug D), all with equal efficacy to drug E, have recently become available. Currently the hospital stocks drug E, which has been available for several years. Data for the medications is as follows:

The most appropriate choice for the hospital is:

a.    Drug A.
b.    Drug B.
c.    Drug C.
d.    Drug D.
e.    Drug E.
The next section includes EXAMPLES OF THE CASE SCENARIO FORMAT, in which there are two or more questions in sequence, which are related to the patient information provided in the (bolded) stem information shown at the top of the case.

QUESTIONS 62 TO 64 INCLUSIVE REFER TO THE FOLLOWING:

SM is a 34 year old female who, while vacationing in Mexico, began prophylactic treatment for travellers’ diarrhea. Shortly thereafter she complained of a feeling of fullness in her ears, black stools and a black tongue.

62.   Which of the following drugs could be the cause of SM’s complaints?

a.    Bismuth subsalicylate
b.    Cotrimoxazole
c.    Diphenoxylate
d.    Loperamide
e.    Attapulgite
63.   Organisms commonly implicated in the cause of travellers’ diarrhea include:
I     Bacteroides fragilis.
II    Escherichia coli.
III   Shigella sp.

a.    I only
b.    III only
c.    I and II only
d.    II and III only
e.    I, II and III
64.   Which of the following is the most appropriate option for future prevention of traveller’s diarrhea if SM is travelling to Mexico?

a.    Ciprofloxacin
b.    Tetracycline
c.    Erythromycin
d.    Trimethoprim
e.    Clindamycin
QUESTIONS 65 TO 67 INCLUSIVE REFER TO THE FOLLOWING:

PQ is a 75 year old patient who has just been diagnosed with hypothyroidism. Her past medical history is significant for congestive heart failure, type 2 diabetes mellitus, osteoporosis and chronic stable angina, all of which are well-controlled. Her medications include:

Metoprolol 25 mg bid
Calcium carbonate 1250 mg bid
Vitamin D 1000 IU daily
Glyburide 2.5 mg bid
Enalapril 10 mg bid
Furosemide 40 mg daily
Nitroglycerin SL spray prn

65.   PQ should be started on a low dose of levothyroxine because of her:

a.    age.
b.    gender.
c.    diabetes.
d.    metoprolol use.
e.    nitroglycerin use.
66.   Appropriate counselling and follow-up for PQ with initiation of levothyroxine includes all of the following, EXCEPT:

a.    separate the levothyroxine dose from calcium tablets by several hours.
b.    take levothyroxine on a full stomach for greater absorption.
c.    improved control of thyroid levels may also improve her glycemic control.
d.    physician follow-up is needed in 6-8 weeks to have her thyroid function tests repeated.
e.    closer monitoring of her angina should be done during dosage titration of levothyroxine.
67.   Which of the following parameters is the most appropriate for PQ’s self-evaluation of the effectiveness of levothyroxine therapy?
a.    Increased energy
b.    Weight loss
c.    Improved vision
d.    Less frequent angina
e.    Less frequent urination
QUESTIONS 68 TO 71 INCLUSIVE REFER TO THE FOLLOWING:

A family health team is reviewing recent guidelines for dyslipidemia and cardiovascular risks. Physician colleagues ask the pharmacist for information on the recommendations for monitoring patients in various categories.

68.  The current recommendation for performing a baseline plasma lipid profile in men is to screen all males over the age of:

a.   35 years.
b.   40 years.
c.    50 years.
d.   55 years.
e.   60 years.
69.  Lipid profile screening is important in all patients who have a history of:

a.   COPD.
b.   GERD.
c.    diabetes.
d.   osteoarthritis.
e.   liver disease.
70.   Which of the following is the primary assessment tool recommended to quantify a patient’s= 10-year risk for total cardiovascular disease?
a.   Reynolds risk score
b.   Framingham risk score
c.   SCORE risk estimator
d.   TIMI risk score
e.   CHADS II score
71.   Which of the following is the most appropriate bio-marker to assess patients who are at intermediate risk for cardiovascular diseases and who do not otherwise qualify for lipid-lowering therapy?

a.   Homocysteine
b.   Creatinine clearance
c.    Lipoprotein-associated phospholipase A2
d.   Soluble vascular cell adhesion molecule-1
e.   High-sensitivity C-reactive protein
QUESTIONS 72 and 73 REFER TO THE FOLLOWING:

HM is a regular client at the pharmacy. He has been taking quetiapine 300 mg bid for 8 months to help control his schizophrenia symptoms but he has recently noticed that some of his symptoms have been worsening. Prior to starting quetiapine, HM took risperidone therapy for 2 years. HM tells the pharmacist that now his psychiatrist would like to change his regimen to clozapine.

72.   In assessing the possible change to clozapine for HM, which of the following statements is the most appropriate for the pharmacist to consider?

a.    This change is appropriate, as clozapine may help for patients who fail on other antipsychotics.
b.    This change is appropriate, as most patients with schizophrenia will eventually require clozapine.
c.    This change is not appropriate, as clozapine will likely produce the same effect as quetiapine.
d.    This change is not appropriate, as the cost of monitoring and risk of adverse effects with clozapine is too high.
e.    This change is not appropriate, because the preferred recommendation is to add clozapine to the current quetiapine.
73.  HM is concerned about the possible adverse effects from clozapine. When discussing monitoring with HM, which of the following statements is the most appropriate to include?

a.    Severe problems affecting the blood occur in about 5% of patients taking clozapine.
b.    Problems affecting the blood do occur rarely and regular blood labwork would be recommended.
c.    The risk of this problem occurring is the highest after one year or more of treatment.
d.    Blood labwork done monthly will help to avoid any adverse effects from clozapine.
e.    The prescriber has already assessed this risk and has determined that the risk for HM is low.
QUESTIONS 74 TO 76 INCLUSIVE REFER TO THE FOLLOWING:

WW is a 55 year old, obese male (BMI 35) with newly diagnosed type 2 diabetes.  His most recent fasting blood glucose is 9.6 mmol/L and A1C is 8%.   He also suffers from hypertension and osteoarthritis in his knees.  His current medications are: ramipril 20 mg daily and acetaminophen 500 mg qid.

74.  Which of the following agents is the most appropriate choice for WW at this time?

a.    Gliclazide
b.    Sitagliptin
c.    Insulin
d.    Metformin
e.    Acarbose
75.  If the anti-hyperglycemic agent chosen for WW is having its intended benefit, the most appropriate therapeutic outcome would be:

a.    achieving target A1C at 3 months.
b.    fasting blood sugars < 6.1 mmol/L within 1-2 weeks.
c.    decreased BMI within 3 months.
d.    improved blood pressure control.
e.    decreased 10 year coronary event risk.
76.  WW would like advice regarding self-monitoring of his blood glucose. Which of the following statements is most appropriate for WW at this time?

a.    Blood glucose should be tested upon arising and before each meal
b.    Regular self-monitoring of blood glucose may help in achieving optimal control.
c.    WW should avoid testing at alternate sites (e.g., forearm) since accuracy is        reduced in obese patients.
d.    Self-monitoring will help WW to adjust the dosing of oral therapy in relation to meal size.
e.    WW should test for nocturnal hypoglycemia at least 3 times weekly.

Part I – Answers to Sample Questions