The first adjunct training manual for foreign training pharmacist for local training orientation to national pharmaceutical service requirements in Zambia

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ADJUNCT TRAINING MANUAL
FOR FOREIGN
TRAINED PHARMACISTS
PREPARED & COMPILED BY DR L.T.M. MUUNGO
HEAD, DEPARTMENT OF PHARMACY
University of Zambia, School of Medicine
Version 1
(2003)

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Authored by:
Lungwani T.M. Muungo DipPharm BScPharm, MPhil, PhD, LMPharmSZ
Head of Department, Department of Pharmacy, School of Medicine
University of Zambia, Lusaka, Zambia
First Version 2004
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, without the prior written expert
knowledge of the academic copyright Author.

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Table of Contents
Preface…………………4
Background…………………….5
Adjunct training for pharmacists…….7
Mission………………………………………8
Vision………………………………….9
Core values……………………9
Annexure…………….11

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PREFACE
This adjunct training manual was prepared by Dr. L.T.M. Muungo, on behalf of the
delegated authority of Health Professions Council of Zambia to the Dean’s office
for School of Medicine at UNZA, in screening out the qualifications of the health
trained professionals from outside the Zambian-based health system, mainly to
give guidance for the same process but with focus on pharmaceutical
professionals:
 outlines the University training pathways for the pharmaceutical pathways in
terms of infra-structure, functions of academic human resource and
trainees, general training policies and procedures;
 provide assistance in dealing with matters formal transition from academic
qualification of the pharmaceutical trained persons to professional suitability
for professional registration
 identify and encourage use of UNZA teaching services which are available
to support both academic and support of national health policy guidelines.
 afford ready access to basic training material information and knowledge
that provides professional guidance towards the conduct of any person that
is applying to be on pharmacists register under HPCZ
Emphasis is placed on general university responsibilities and policy that have been
delegated by the health professions authority to manage the qualifications of all the
health professionals as they apply to be registered on respective registers under
the custody of HPCZ. Detailed procedures are outlined in the orientation training
program.
Adjunct trainees are encouraged to retain a copy of this training manual as part of
their individual personal files for ready and useful reference. Additionally, an
electronic copy of the manual is available from the coordinator of the program
Suggestions for improving on the initial content of the training manual should be
directed to the coordinator of the program, through the Dean’s office of the host
school at UNZA.
This training manual has been prepared for general informational purposes only,
no statement appearing in the document constitutes a contractual obligation by the
neither the Pharmacy Department nor the program hosting School at UNZA.
The Department of Pharmacy, under the authority of the hosting school at UNZA,
reserve the right to alter the terms of official policy statements and/or this Adjunct
Training Manual at any time, without advance notice.

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1.0. BACKGROUND
A good number of pharmacists currently working within Zambia have been trained
locally. However, a number have been trained from abroad or overseas and come
to practice Pharmacy in Zambia. It is of paramount importance to establish through
theoretical, practical, oral and written assessment, the pharmaceutical knowledge,
attitude, skill and suitability of the foreign-trained applicant to register and practice
as a Pharmacist in Zambia.
Moreover, foreign-trained pharmacists especially face inherent technical difficulties
and practical challenges to practice pharmacy in Zambia – a situation that can also
negatively affected the image of the profession in the country. The Zambian
pharmacy practice regulatory system is also insensitive to this broad spectrum of
pharmacy training in that it accepts any qualified person with a degree in pharmacy
from abroad despite the content and depth of training one may have followed.
The outcome from the field of pharmacy practice is that professionalism has not
been adhered to and that the profession itself has been opened to a variety of
manipulation by anybody that carries a label-claim of being trained pharmacist.
Because of this, the professional process of dispensing medicines has moved from
well-designated places called pharmacy dispensaries into the streets and by
anybody. This view has been a great concern to the country in general and to the
Pharmaceutical Society of Zambia (PSZ) in particular. In view of this, PSZ came up
with a program of professional training dubbed as ‘Structured Internship
Training’ (SIT).
The main aim of SIT after each accepted degree in pharmacy qualification
including that of BPharm degree from UNZA is to offer the new pharmacy
graduate, seeking first-time registration in Zambia, a process of transitional

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development from academic to practice-based knowledge, to a point that enables
them to function as independent and individual professional practitioners.
This developmental process should objectively allow the trainee to:
1. Develop the skills required in the professional practice of pharmacy
2. Develop the ability to transfer skills and concepts to new situations
3. Apply knowledge gained during academic studies to practice scenarios
4. Gain new knowledge, in addition to academic, relating to practicing pharmacy
The SIT development is in line with requirements for Medicines & Allied
Substances Act of 2013, of the Zambian laws that provides; that the
pharmaceuticals to the public should only be distributed or supplied from a
designated and recognised pharmaceutical outlet directly under the management /
supervision / control of a registered pharmacist. By definition, ‘Registered
Pharmacist’ means a person registered as a pharmacist under the Health
Professions Act.
The regulations of this Act provides that such a registered health professional
(practitioner) must be in possession of a primary degree in pharmacy and will have
made a formal application to be either on ‘Temporary’ or ‘Provisional’
registeration for maximum of 2 years and also depending on the primary degree
training background. Additionally, the applicant is expected to write and pass the
end of SIT before being allowed to transfer to full register for pharmacists. Because
the legal requirement has not segregated in the past, the Health Professions
Council of Zambia (HPCZ) has found it prudent to screen everybody that intends to
practice as health practitioners in Zambia, including pharmacy, through relevant
units in the School of Medicine so that foreign training is verified for comparison
with the locally existing professional training. This has been done through
conducting both verbal and written interviews and after which, appropriate
recommendations have been made to HPCZ.

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2.0. ADJUNCT TRAINING FOR PHARMACISTS
The University of Zambia, School of Medicine, through the Department of
Pharmacy has designed a training programme dubbed as ‘Adjunctive Training
for Pharmacists’ (ATP). The Main Aim of this programme is to bridge up all
programmes from overseas training to the local requirement. ATP aims not to give
a complete new start in pharmacy training but objectively allow the trainee to:
1. Harmonize or blend the gained pharmaceutical knowledge from abroad into
those of Zambian requirements,
2. Be reminded of some key elements in pharmacy training as required for
pharmacy practice in Zambia,
3. Attain a minimum standard level of pharmacy practice for all those that
intend to be pharmaceutical professional practitioners in the country,
4. Be assisted, for those that are genuinely seeking to practice pharmacy in
Zambia and not just for business or job seeking,
5. Be assisted to understand the Internship Training Programme (ITP) and be
able to pass the end of Internship Training examination, which also, marks
the end of professional training in pharmacy before one takes up
professional responsibilities.
6. Train after being assessed with appropriate or minimum required
qualifications for temporary registration under the Health Professions
Council of Zambia (HPCZ).
These objectives can only be achieved if the trainee is actively involved in real-life
tasks and situations in addition to receiving information and being given the
opportunity to observe others. Adequate self-evaluation and feedback must
accompany such experience on performance, which the trainee should then use to
improve future performance. The adjudicate training for pharmacists will be

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conducted under the supervision of the Department of Pharmacy and in modular
format and ONLY applies on those that are eligible for temporary registration.
Candidates that are found not eligible for ATP will be referred to a degree
conversion programme approved by UNZA through the Department of Pharmacy
for the programme ranging from 2 – 4 years depending on the entry qualifications.
For this training programme, the modules have been designed to address mainly
the areas of (Annex 1):
1. Communication knowledge and skills in pharmacy practice
2. Pharmaceutical technology and skills in pharmacy practice
3. Pharmacy Law & Ethics
Best on the above outlined objectives, the Philosophy of this program under the
Department of Pharmacy aims to operate from the premise that each person
should be:
 treated with dignity and respect, afforded an equal opportunity to acquire a
complete educational knowledge and practice experiential expectations as
they desire to practice pharmacy in the country,
 given an opportunity to discover and develop their aptitudes and insights of
pharmacy practice expectations for Zambia,
 be provided with an opportunity to equip themselves life-long and
professional responsible citizenry status as they mingle with fellow national
citizens from the point of the acquired better health-life living process.
3.0. MISSION:
The training program of pharmacy at the University of Zambia offers and
develops to deliver professional attained graduates through life-long
career development and transfer of pharmaceutical educational
knowledge and skills for individual professional development, and the

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support of national health services which prepare individuals to live and
work in an increasingly technological and global community society.
4.0. VISION:
UNZA programs in general have operated on the model aspect of tertiary
education for Zambia and the pharmacy training program at UNZA is not an
exceptional to that UNZA category. Hence, such a quality is extended to others in
the line of pharmaceutical career qualifications by providing:
 uniqueness of qualifications
 progressive, highest quality learning
 outstanding
 exceptional programs to serve the community, opportunities, and support
services
5.0. CORE VALUES:
 Excellence - We seek excellence in all our endeavors and we are
committed to continuous improvement.
 Intellectual Freedom - We believe in ethical and scholarly questioning in
an environment that respects the rights of all to freely pursue knowledge.
 Diversity - We respect others and value diversity of opinions, freedom of
expression and other ethnic and cultural training backgrounds.
 Integrity - We are committed to the principles of truth and honesty, and we
will be equitable, ethical and professional in our delegated duty.
 Service - We believe that serving others is a noble and worthy endeavor
with our genuinely acquired pharmaceutical knowledge and skills.
 Stewardship of Resources - We are dedicated to the efficient and effective
use of all resources in form of human beings with formal awkward
pharmaceutical knowledge. We accept the responsibility of the public’s trust
through national authority departments and are accountable for our
institutional actions and result outcomes.

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The orientational training program for foreign trained pharmacist will be delivered in
form of modular courses. Each module has been organized into units. The number
of units per module is not standard, that is, they vary in number depending on the
size of each module. The core module is ‘Pharmaceutical knowledge and skills in
pharmacy practice’ while the other two are supporting modules. This is so because
a pharmacist may not ably work as one if communication is a problem and outside
the legal requirements. However, the three modules are all very significant for the
training program.
Each trainee participant is expected to pass the assessment procedures for ATP
examination. The minimum composite score required at professional level is 70%
and above. The School of Medicine, through the Department of Pharmacy will then
make standard recommendations for each individual applicant to continue SIT
under the Pharmaceutical Society of Zambia (Annex 2) depending on the outcome
of ATP final assessment. For the module details, you are referred to the annexure
section:

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6.0ANNEXURES
Annex 1:
MODULE OUTLINE OF THE ADJUNCT TRAINING PROGRAMME
MODULE 1: Pharmacy Law & Ethics
This module has the following units:
Unit 1: Essential communication skills for pharmacists
1.1Patient-centered communication and elements of basic communication
1.2 Non-verbal communication
1.3Effective tools for interpersonal communication
1.4Interaction with patients
1.5Interaction with other healthcare professionals
Unit 2: Professional ethics
2.1Core values for professional practice
2.2Introduction to building a foundation for ethical decision-making in
professional practice
2.3Ethical issues in professional relationships: Application of ethical
foundation
2.4Distinguish law and institutional policy issues from ethical standards
2.5Role of the Pharmaceutical Society in professional practice
Unit 3: Pharmaceutical Regulatory Affairs and Pharmacy Law
3.1 Regulation of Health Services and Health Practitioners
3.2 The Regulation of Pharmaceutical services and Pharmacy Practice
3.3 The roles, functions and organization of Pharmaceutical Society of
Zambia (PSZ) and other health regulatory bodies
3.4 The Roles of the Pharmacist in Administrative and Regulatory
Pharmacy

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3.5 The Medicines and Allied Substances Act 2012
3.6 The Health Professions Council of Zambia and Health Professions
Act 2009
3.7 The scope & administration of CAP 96 ‘Psychotropic Drugs Act’ as
administered by DEC
3.8 Legal categories of medicines in Zambia
Duration: 16 Weeks
Lectures: 3 hours / week
Tutorials: 1 hour / week
Assessment: Assignments, Monthly tests and End of the module examinations
References & Readings:
1. Pharmaceutical Practice; A. J. Winfield & R. M. E. Richards, 2nd edition, 1998
2. Success in Communication; Stuart Sillars, 2002
3. Sociology; Stuart Sillars, 2002
4. Communication Skills for Pharmacists; Bruce A. Berger, 2002
5. Relevant Acts of Zambian Parliament on medicines and Pharmacy practice
6. Constitutions of relevant professional organizations
7. Pharmaceutical Practice; Diana M. Collett & Michael E. Aulton, 1996

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MODULE 2: Pharmaceutical Technology & Skills in Pharmacy Practice
The module has the following units:
Unit 1: Formulation systems of pharmaceutical preparations and clinical
applications
1.1Solid drug delivery systems
1.2Semi-solid drug delivery systems
1.3Liquid drug delivery systems
1.4Oral dosage forms
1.5Non-oral dosage forms
1.6Modified release dosage forms
Unit 2: Introduction to Dispensing
5.1.Dispensing as a professional process
5.2.The Prescription
5.3. Posology
5.4. Dispensing Techniques, Equipment & Good Dispensing Practice
5.5. Selection of Ingredients for Dispensing
5.6. Packaging & Labelling of medicines
5.7. Patient counseling
5.8. Compliance, Adherence and Concordance
Duration: 16 Weeks
Lectures: 3 hours / week
Tutorials: 1 hour / week
Assessment: Assignments, Monthly tests and End of the module examinations

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References & Readings:
1.1.Pharmaceutics: The Science of Dosage Form Design, 2nd Edition, M.
Aulton, 2002, Churchill Livingstone
1.2.Physical Pharmacy, 4th
edition, Martin Alfred
1.3.Physicochemical Principles of Pharmacy; 3rd
Ed. 2004, D. Attwood and
A. T. Florence, Churchill Livingstone
1.4.Ansell’s Pharmaceutical Dosage forms and Drug Delivery Systems, 8th
edition, 2004, Allen Lloyd
1.5.Dispensing for Pharmacy Students; Cooper & Gunn, 1979

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MODULE 3: Clinical Skills & Therapeutics for Pharmacists
The module has the following units:
Unit 1: Introduction to clinical pharmacy and therapeutics
1.1 Definition, development and scope
1.2 Concepts of Clinical Pharmacy and Therapeutics
Unit 2: Basic concepts of drug therapy
2.1 Clinical Pharmacokinetics and individualization of Drug Therapy.
2.2 Clinical applications of drug usage during infancy and in the elderly
2.3 Special precautions in drugs usage during pregnancy & lactation.
2.4 Concept of essential drugs and rational drug use
Unit 3: Patient data analysis
3.1 Patient case history: medication history, assessment and evaluation
3.2 Adverse drug reactions: Medical and drug related problems and
pharmacovigilance
3.3 Pharmaceutical care plan.
3.4 The basics of drug interactions
3.5 Interpretation of Clinical laboratory Tests
Unit 4: Pharmacological management of disease conditions
4.1. Cardiovascular disorders
4.2. Central nervous system disorders
4.3. Endocrine disorders
4.4. Respiratory diseases: TB drugs
4.5. Principles of antimicrobial and anticancer therapy
4.6. HIV/AIDS, Malaria & Tuberculosis
4.7. Gastrointestinal disorders

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4.8. Skin disorders
Duration: 16 Weeks
Lectures: 3 hours / week
Tutorials: 1 hour / week
Assessment: Assignments, Monthly tests and End of the module examinations
References & Readings:
1. Basic & Clinical Pharmacology, 12th edition, Katzung B.G, 2011. Mc Graw
Hill, Medical Publishing Division. New York.
2. Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12th
edition. Brunton L.L. 2010. The McGraw-Hill Global Education Holdings,
LLC
3. Basic Clinical Pharmacokinetic 5th Ed. (2009), M.E. Winter. Lippincott
Williams & Wilkins
4. Koda-Kimble and Young's Applied Therapeutics: The Clinical Use of Drugs,
BrianK. Alldredge et al. 10th Ed (2009). Lippincott Williams & Wilkins
5. Walker, R & Edwards, C (2011). 5th
Edition. Clinical Pharmacy &
Therapeutics. Church Livingstone. ISBN 9780702042935. International
ISBN 9780702042942.
6. Tietze, K. J (2011). 3rd
Edition. Clinical Skills for Pharmacists: A Patient-
Focused Approach. Mosby, St. Louis. ISBN 9780323077385
7. Snelling, M. & Stoner, N (2012). 2nd
Edition. Oxford Handbook of Clinical
Pharmacy. Oxford University Press, New York. ISBN 9780199603640

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PRACTICALS & PLACEMENTS:
The training site for practical sessions and clinical placements will be at the
University Teaching Hospital (UTH)
The candidate will be required to do practical sessions on rotation basis in the
following units:
1. Dispensing practicals: UTH Main pharmacy (2weeks) and High cost
pharmacy (2weeks)
2. Internal medicine: 4 weeks
3. Surgery: 2 weeks
4. Paediatric pharmacy: 2 weeks
5. Obstetrics and Gynecology: 2 weeks
Guidance Notes:
1. The Objectives and unit outlines for the modules will be given separately during
lectures.
2. The timing as indicated is a tentative one pending to agreed time with the
students during lectures, bearing in mind their other engagements.
3. The reference section is not absolute either, but may be modified depending on
the latest editions available.
4. The specialty units in each module will be taught or tutored by experts in those
areas that have been specifically engaged for the program.

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Annex 2
SUPERVISED PRE-REGISTRATION TRAINING RECOMMENDING FORM
Applicant Full Name: ………………………………………………………………
Applicant Reference Number: ……………………………………….
To: The National Coordinator PSZ Continuing Education in Pharmacy
I (name in full)…………………………………………………, on behalf of The
School of Medicine / Department of Pharmacy that has been mandated to
assess the suitability of the applicant onto the Register of Pharmacists on
behalf of Health Professions Council of Zambia and having successfully
administered the adaptation modules for the period running from
………//………//…….. to ……….//……….//……….., hereby DECLARE that the
applicant, whose personal identifying particulars are shown above, has been
assessed on the following field of adjunct pharmacy training, on the Date
of……….//……….//……….as follows:
MODULE 1: Pharmacy Law & Ethics:
………………………………………………………………
MODULE 2: Pharmaceutical Knowledge & Skills in Pharmacy Practice:
………………………………………………………………
MODULE 3: Clinical Skills & Therapeutics for Pharmacists:
……………………………………………………………...
Any other relevant assessment information:
…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………
Having completed the prescribed period of adaptation training and that the
School has assessed the applicant, we write to:
*Recommend / Not Recommend
For his / her* full supervised pre-registration training under the
Pharmaceutical Society of Zambia.
Recommended by:
Name: ……………………………………………. Signature: …………….……
(Programme Coordinator, Department of Pharmacy)
Date: …………………….…………
Endorsed by:
Name: ……………………………………………. Signature: …………….……

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(Head, Department of Pharmacy)
Date: …………………….…………
Official Stamp: