Over the past decade, we have observed a decline in the North American Pharmacist Licensure Examination (NAPLEX) pass rates, with an average first-time pass rate of 76.08% from 2022-2024. By contrast, the average pass rate was 82.32% from 2017-2019. A spike in the rate of pharmacy residency non-completion has also been observed for the past 5 years. American Society of Health-System Pharmacists (ASHP) research shows that the number of residents who did not complete their program increased and that nearly half of those students cited “licensure issues” as their non-completion reason. This likely means that they did not pass or did not take the NAPLEX or the Multistate Pharmacy Jurisprudence Examination (MPJE) exam and were therefore unable to obtain licensure. Although residencies are optional, more students have decided to pursue residency after graduation, making this a growing concern.
In the American Journal of Pharmaceutical Education’s recently published article discussing how stakeholder collaboration can aid in NAPLEX pass rate improvements, the authors discuss the roles of various stakeholders in preparing pharmacy students for the NAPLEX. As a key stakeholder during pharmacy students’ final year in their PharmD curriculum, preceptors can help their students on rotation prepare to pass the NAPLEX.
Creating a Culture of “NAPLEX Awareness”
All pharmacy educators, preceptors, and exam writers share the same goal: to create the next generation of practice-ready pharmacists. However, each stakeholder is focused on their particular area of expertise, and this may result in students or residents misunderstanding the breadth of subject matter covered by the NAPLEX. Regardless, the Advanced Pharmacy Practice Experience (APPE) environment or residency workplace can be a great tool for NAPLEX study. Preceptors should take time to connect the dots between real-life patient care scenarios they encounter and NAPLEX content, further preparing their students to pass the exam.
One way to achieve this would be to integrate the NAPLEX content domains and subdomains in the NAPLEX Content Outline directly into the APPE learning objectives for the specific practice setting. Students can use the content outline as a “study guide” to understand the topics covered on the NAPLEX.
Prior to releasing the latest version of the NAPLEX content outline, we conducted a practice analysis engaging practicing pharmacists to determine Tasks and Knowledge, Skills, and Abilities (KSAs) for pharmacy practice. We have created the NAPLEX Domain Crosswalk relating the KSAs to the NAPLEX content domains. Preceptors can use these available resources to create a learning environment focused on their practice setting for students to apply and advance their knowledge, skills and abilities in a supervised environment. By providing timely feedback during the length of the rotation, preceptors can help to identify areas of opportunity for students to improve prior to applying to take the NAPLEX after graduation.
Exam Scheduling Best Practices
Preceptors can also make sure that students have access to the NAPLEX/MPJE Candidate Application Bulletin and have them sign up for our NAPLEX email series to get tips sent directly to their inbox. This blog post is another great resource for students, as it covers the exam scheduling process in great detail. Preceptors should encourage students to schedule the NAPLEX as soon as possible, as it has been shown that students are more successful on the exam when it is taken within 90 days of graduation.
One issue that can arise is how the time constraints of residency positions can conflict with scheduling and taking the NAPLEX. Residency directors can make their residents aware of the exam scheduling process, including applying for eligibility, receiving their Authorization to Test (ATT), and scheduling their exam. Residents should be granted time off to take the exam, if necessary, including any possible travel time involved. Residents should prioritize scheduling and taking the NAPLEX as soon as possible, as most residency programs have a deadline for licensure, which is typically 90-120 days from the start of the residency. Studying for the NAPLEX should be encouraged while residents are preparing for the start of their residency programs. By scheduling early, the resident is proactively planning for a potential need to schedule a second attempt before the deadline in case their first attempt was unsuccessful.
Use Practice Exams as Study Tools
NABP practice exams are great tools to prepare students for high-stakes exams like the NAPLEX. The Pre-NAPLEX is the only practice exam currently available on the market that uses actual past NAPLEX questions and helps students prepare for test day with a realistic test experience. The practice exam includes 100 questions that are similar in content and format to the ones students will see on test day and scaled score results are issued right away. Another useful practice tool is the NAPLEX Advantage, a proctored practice exam administered by schools of pharmacy. Find more useful advice about the NAPLEX to share with students on our website.
