Supporting PharmD graduates after unsuccessful licensing examination attempts

Abstract

Not passing the North American Pharmacy Licensure Examination (NAPLEX) is the reality for a significant number of PharmD graduates. The average first time pass rates for the NAPLEX have experienced significant drops since 2017, hitting an all-time low (76.6 %) for the Class of 2023. While most candidates eventually pass the NAPLEX, a staggering 3228 PharmD graduates remain unlicensed due to unsuccessful licensure examinations from cycle years 2022 to 2024. Further decline is anticipated with impending changes to the structure of the NAPLEX in 2025. Unfortunately, unlicensed graduates are unable to practice and earn pharmacist salaries, leaving them with significant student debt. This commentary, examines the key drivers of this problem and suggests pragmatic measures to support the success of graduates who have not yet passed NAPLEX.