The UAMS College of Pharmacy Marks its 50th Year
Pharmacy Education in Arkansas Began in the 1950s
The key ingredient for establishing a School of Pharmacy in Arkansas in the 1950s wasn’t — as one might expect — medicinal chemistry itself; rather, according to Larry D. Milne, Ph.D., dean of the UAMS College of Pharmacy, “It was about adequate funding within a durable educational institution.”
The college celebrates its 50th anniversary this academic year, and today’s faculty members acknowledge hefty measures of good sense, good luck and good timing at the beginning.
Prior to 1951, educating pharmacists in Arkansas was an exercise in disappointment. No single school or program offered pharmacy training that continued beyond a decade of their founding; with most lasting less than ten years. Between 1906 and 1951, Arkansas students aspiring to become pharmacists matriculated at a number of places, including the Pharmacy Department in Physicians & Surgeons Medical College, University of Arkansas Medical School, Little Rock College Department of Pharmacy, Jonesboro Junior College, and College of the Ozarks. Many others learned the profession at out-of-state schools.
As 1950 ended, the nexus of pharmacy education in the state was a department within the College of the Ozarks in Clarksville. That changed in 1951 when a rapid series of events culminated in the establishment of a permanent School of Pharmacy in Little Rock; which has since become a part of what is known today as UAMS.
Wylie Lynn Hurie, president of the College of the Ozarks until 1949, had convinced the Arkansas Pharmacists Association (APA) to sponsor locating a pharmacy school there in 1946. Many students used their GI Bill benefits to study pharmacy at the small Presbyterian-affiliated college. In 1949 the General Assembly appropriated $50,000 on a continuing basis for the Board of Pharmacy to use “to promote pharmacy education.” Despite this hopeful and enthusiastic beginning, the pharmacy program lasted only five years at the college.
In February 1951, the decision by the board to transfer the entire $50,000 annual appropriation to Ozarks’ Department of Pharmacy was overturned by the Arkansas Supreme Court in Garret vs. Arkansas. This decision barred the College of the Ozarks, a private institution, from receiving an appropriation from the state of Arkansas. That decision set other events in motion.
Opportunity Arose from a Change in Circumstances
APA appointed a special Committee on Pharmacy Education to explore ways to preserve a program within the state. University of Arkansas President Lewis Webster Jones soon became involved. He considered whether the pharmacy program at Ozarks might be transferred to the university campus in Fayetteville. Another possibility was to join the pharmacy program with the existing School of Medicine in Little Rock. That option found particular favor with Governor Sid McMath, who earnestly hoped to establish a Medical Center in the capital city. The university president ultimately endorsed the governor’s plan.
To assure proper accreditation for the school within a University Medical Center (UAMC) in Little Rock, Jones hired Robert P. Fischelis, vice president of the American Pharmacists’ Association (APhA) as a consultant. Fischelis, a former dean who was widely respected in the profession, planned a curriculum that met the needs of the university system and the expectations of the American Council on Pharmaceutical Education (ACPE).
Meanwhile, APA and university administrators collaborated to identify the founding dean for the school. While planning proceeded, the Arkansas General Assembly provided crucial support through Act 323 of 1951; it formally created the School of Pharmacy and appropriated continual funding.
In July of that same year, Stanley Mittelstaedt, Ph.D., was hired as assistant dean. He had emerged from the interview process as the leader acceptable to President Jones, to the governor, and to the APA leadership. An experienced pharmacy educator and World War II veteran, Dr. Mittelstaedt at once moved to Little Rock to begin the grueling labor of creating a school in short time. Through July and August, he hired the initial faculty and began preparing a building at the corner of 17th and Lewis Streets in Little Rock for opening the school and admitting students. He also planned the schedule for students at the Fayetteville campus, since only senior students enrolled in classes at the Little Rock site.
Equipment and supplies were transferred from the pharmacy building at the College of the Ozarks and were re-assembled at the laboratories. Lab benches were constructed on site with materials at hand. These were the darkest days of the Korean War, and building material — particularly metal — was extremely difficult to procure. In some cases, troughs to carry off water from lab benches were made of wood and then waterproofed with roofing materials.
Perhaps the most delicate matter was the process for transferring the pharmacy students then enrolled at Ozarks. They had to decide in short order between relocating from Clarksville to Little Rock or to other schools. As part of the agreement with ACPE, Ozarks pharmacy students were permitted to transfer if they wished to other accredited pharmacy schools in the United States. Forty-nine seniors elected to move to Little Rock and completed their degrees at the new School of Pharmacy.
By September 1951, faculty consisting of Mittelstaedt; Roy Jones, assistant professor of economics; R.O. Bachman, assistant professor of pharmaceutical chemistry; and Edward Christensen, assistant professor of chemistry, was in place, and the school opened to students. The following May, the seniors who relocated to Little Rock emerged from the program as the class of 1952, the inaugural class of what is today the UAMS College of Pharmacy.
The premier year of the college was both historic and challenging. Students who were also recent war veterans returned to a full-time college environment after years away from the classroom. Younger students with two years of college experience faced a demanding curriculum that carried them quickly toward maturity. Many of the pioneer class members were already married, so they coped with the challenge of balancing school and family responsibilities. For some, the college was their first experience of living in a large city. For all of them, it included worrying about wartime shortages and dealing with the uncertainties arising from the Red Scare and the Cold War.
Highlights of the College’s First 50 Years
The ensuing 50 years brought profound changes in the practice of pharmacy and in pharmacy education. The graduates of 1952 faced three principal career pathways. Most chose community pharmacy practice, and they eventually owned and operated an archetypal “corner drug store.” A few entered hospital-based practice and focused their career on drug compounding and inventory. Others worked for drug manufacturers or wholesalers and marketed pharmaceuticals to pharmacists and physicians. As to education, the curriculum of 1952 required two years of pre-pharmacy instruction followed by two years of professional study.
New Influences upon Pharmacy
By the 1960s, two emerging influences affected the economic basis for pharmacy practice. The first was the arrival of national-scale chain drug stores in the Arkansas retail marketplace. At first confined to larger cities, today these stores are quite prevalent; most Arkansas towns have at least one — such as Wal-Mart — and often several chain store outlets. As a result of chain store operations, many pharmacists have become corporate employees instead of independent practitioners.
Independent pharmacists have not vanished. The second trend is the development of market niches in pharmacy that no chain store can serve economically. The independent pharmacy practitioner may be in compounding practice, may be a consultant for long-term care facilities, or may be active in creative practice models. Within hospitals, pharmacists no longer fit the worn-out cliché of hanging out in a basement room mixing therapeutic concoctions. They participate actively in direct patient care. The common bond among all these new models is that pharmacists seek to apply their clinical expertise directly to the end-user of modern medicines — the individual patient.
Changes in Pharmacy Education
Practice has evolved profoundly and so has education. By 1958 the curriculum had changed; a third year was added to the professional program. This “2 + 3” model remained unchanged in Arkansas for more than 30 years. The college moved from the Lewis Street locale to the then-new Shorey Building on the UAMS campus at West Markham Street. Within that six-semester structure, pharmacy students learned how to provide for the health-care needs of Arkansas patients. As years passed, more time was devoted to education related to direct patient care. Finally in 1989, the faculty recommended to Dean Larry Milne that the college add a fourth year to its curriculum and offer the doctor of pharmacy degree. The curriculum was further reinforced, and a final year of experiential education in patient care settings became the capstone of learning. The faculty and administrators of 1951 would still have recognized the program, but would have marveled at the transformation.
Strong Leadership and Faculty Continuity in the College
Remarkably, the college has had only two deans during its first half-century; and they have evenly divided the 50 years between them. Mittelstaedt achieved what no previous pharmacy educator in Arkansas had done. He made a college where there was none, and he made it permanent. Under his guidance, the college grew in faculty and class size. In 1976, the 25th anniversary year, Mittelstaedt’s impending retirement was announced and a search committee was formed to seek his successor.
The result of the search was the appointment of Milne, who arrived on campus in January 1977. At the time Milne was the youngest dean of a pharmacy college in the country. He now is one of the most senior deans in the nation, and he is also the senior dean on the UAMS campus. He has led the college through its transition to a more clinically focused bachelor’s degree program. This formed the platform to develop the doctor of pharmacy curriculum.
The number of faculty has more than doubled in the past 25 years, and the mix of faculty has changed remarkably. Today, more than half of the faculty serve in the Pharmacy Practice Department, reflecting the change in emphasis from the distributional work that formerly occupied most of a pharmacist’s time toward a strong focus on patient care. The term “cognitive services” perhaps best catches the character of this change, for the emphasis is on the pharmacist’s involvement in selecting, monitoring and adjusting drug therapy, rather than on the work of filling orders for medicines.
Faculty members have pioneered new trails in pharmacy practice. One of these was William Heller, Ph.D., faculty member and Hospital Pharmacy director. Dr. Heller innovated methods to reduce medication errors that are still in use today. He also became a champion for unit dose drug distribution, which is today the foundation of drug dispensing in all hospitals and extended-care facilities.
Marc Jordin, Ph.D., appointed the same year (1955) as Heller, contributed as a long-time teacher of and mentor to many successful pharmacists. Other faculty worked diligently to establish the Drug Information Center and the Poison Control Center; both of which are early models for successful practice in the country.
Closer to present time, faculty have been actively engaged in defining practices and evaluation standards for Disease State Management, the cognitive service model that promises to transform future practice. The research productivity of the college has also been transformed in recent years, and the faculty has gained national funding. Through the years, however, the central concern remains the quality of teaching, in order to provide Arkansas patients with expert pharmacists.
What’s Past is Prologue
During this half-century, “The Med Center” in Little Rock was transformed. What had been the University Medical Center with two colleges (Medicine and Pharmacy) became the University of Arkansas for Medical Sciences with six colleges. Meanwhile, the graduate program became independent of the Fayetteville campus. UAMS is now one of the largest employers in the state and is represented throughout Arkansas by the Area Health Education Centers (AHEC) Program. Every AHEC site has at least one full-time College of Pharmacy faculty member.
Although much has changed in the past half-century, much has endured — particularly the essential connection between education in basic science and in clinical skills. Governor McMath’s prescience in insisting on a Medical Center has certainly been validated. Health-care education, including pharmacy, has become more useful to the public precisely because it has been changed by the insights gained in clinical practice. The decision to make the College of Pharmacy part of an interdisciplinary medical center has remained for fifty years the core source of strength for the program. Fifty years hence, the college will continue to celebrate its role as a constituent college in an academic medical center.