By Sarah M. Lawrence, PharmD, MA
The NAPLEX or North American Pharmacist Licensure Examination is, for most pharmacy students, one of the final steps towards licensure as a Registered Pharmacist. The exam is given by the National Association of Boards of Pharmacy and is a computerized test made up of 185 questions of varying design.
Currently, the NAPLEX is administered nationwide at Pearson testing centers. Participants have about four hours to complete the test, with a scheduled break after two hours. Subjects tested on the NAPLEX include pharmacotherapy, dispensing, public health, literature interpretation and statistics and general knowledge about drug products and dosage forms.
Although you will not be able to register for the NAPLEX until after you have graduated from pharmacy school, it’s never too early to begin thinking about the exam and preparing. What form that preparation will take is highly dependent upon where you are in your pharmacy education.
While it’s not necessary for first year pharmacy students to embark upon a formal plan of NAPLEX study or purchase study materials right away, there are some key things you can do throughout your pharmacy school education to make sure that you gain the knowledge and skills necessary to pass this important exam.
During your pharmacy school classes
Remember that everything you learn in pharmacy school is designed to prepare you to become a capable pharmacist. If you can achieve that goal, passing the NAPLEX should be just a formality. Although it seems too obvious, the best advice a new pharmacy student can follow is to pay attention in school.
Developing good study habits and time management skills from day one will help you in a number of ways. Everything builds upon previous knowledge in pharmacy school. A strong foundation in the basic sciences will help you excel in therapeutics. The knowledge you gain in therapeutics will be utilized and expanded upon during Advanced Pharmacy Practice Experience (APPE) rotations. Finally, you’ll put all that knowledge to the test in the NAPLEX.
Make sure that you gain a solid understanding in all of your pharmacy school classes, but particularly in pharmacology and pharmacotherapy. Important topics for the NAPLEX include pharmaceutical calculations, interpretation of laboratory data, brand/generic drug names, dosage forms and major adverse effects and of course, therapeutics. In other words, know the practical stuff you’ll use every day as a pharmacist, not just to pass the NAPLEX, but also to take care of your patients. That’s the ultimate goal.
Everyone wants to know what level of detail they should know for the NAPLEX. The honest answer is that it depends. During the didactic portion of your pharmacy education, you will be taught and learn all things drug related in exquisite detail. Drug mechanism of action, indications, contraindications, adverse effects, monitoring and drug interactions are all very important to understand, but it is impossible to memorize every detail about every single drug.
You must commit the basics to memory: what common lab values mean and how to react to them, how to treat conditions like heart failure, diabetes and hypertension, antibiotic mechanism of action and spectrum of coverage, major and common drug interactions, what drugs are indicated or contraindicated in special populations (pediatric, pregnant women, the elderly). This is not an exhaustive list, so just understand that there are some things you are going to have to KNOW and know well, for both the NAPLEX and your career as a pharmacist.
Use whatever tools you have at your disposal to maximize your learning. For learning brand/generic drug names, it may be helpful to purchase a small notebook and keep a running list of drugs you encounter during class, rotations or employment. If flashcards help you with memorization-oriented tasks, you can make traditional paper flashcards or use one of the free online flashcard services. There are also free and paid sites that allow you to create, save and share quizzes and learning games. These can be a great tool to utilize when you must incorporate a lot of information into your knowledge base.
During rotations
APPE rotations are the time for you to put your classroom learning to the test and learn how to apply information to patient care situations. Your APPE year will be very busy and at times, overwhelming, but many students report learning as much or more on rotations as they did in the classroom. The active learning you’ll engage in during APPE is great preparation for the NAPLEX.
Some schools have their students take the Pre-NAPLEX prior to the start of rotations. The Pre-NAPLEX is a fifty question practice test that is designed to simulate the actual NAPLEX. The Pre-NAPLEX can be taken twice and costs $50 each time. It takes about 70 minutes to complete and is formatted to be similar to the computer-based NAPLEX exam. It is by no means required or necessary to complete the Pre-NAPLEX, but it is certainly an option for interested students.
Once you are out on rotations, you will have a lot to occupy your attention. You don’t have to make studying for the NAPLEX a priority during the early part of APPE, but there are things you can do to continue the preparation you started during your classroom studies.
Continue to make learning brand/generic drug names a priority. The NAPLEX uses brand/generic names interchangeably, so you should be comfortable with both. You’ll find that this knowledge serves you well not only for the exam, but also when you’re out in practice, where it’s common to see some drugs listed by brand name and others by generic. Be sure you review brand names for older drugs like amitriptyline and nortriptyline. Although their brand products are rarely dispensed anymore, they are still fair game for the exam.
There are other ways to maximize your learning on rotations and help you prepare for the NAPLEX. One is to take the opportunity to look up things you don’t know and teach the concepts to yourself. You’ll encounter things you haven’t seen before on rotations. Rather than being discouraged by this, take the opportunity to research these unfamiliar concepts and jot down a few sentences or bullet points about them. If you do this, you’ll be much more likely to remember the concept later.
Another great way to learn is by teaching others. Topic discussions can be a great learning tool during rotations. By researching a topic and presenting it to others, you’ll strengthen your own knowledge base. Discussions with preceptors and other pharmacists are especially helpful in giving real world context to classroom/book knowledge and “real world” pharmacy practice. As you participate these types of learning activities, be sure to keep your handouts and notes for later review for the NAPLEX.
Midway through your APPE rotations, it may be time to start researching different NAPLEX prep products and consider purchasing one of more of them. There are a number of other NAPLEX review products available for purchase. Your options include books, in person lectures and classes, online material, question banks and smart phone applications. Only you know when you need to start studying and what type of product will work best for you.
All student members of the American Pharmacists Association (APhA) can get a free copy of The Complete Review for Pharmacy. APhA’s Pharmacy Library features searchable content from the book as well as hundreds of practice exam questions covering a variety of NAPLEX topics. The book is very detailed, and some students have even called it overwhelming, but the online practice tests are a very useful way to test your knowledge. You can customize the practice tests by subject area and use them to evaluate your strengths and identify areas in which additional review is needed.
RxPrep is another NAPLEX preparation system that seems to be a favorite of students and employers, with some companies purchasing it for their newly graduated pharmacists. One new Walgreens pharmacist described the book as containing “everything you need, and nothing you don’t” for the NAPLEX. In addition to the book, students can also purchase access to RXPrep Online, which includes access to 65 lectures. An online quiz bank and iPhone application are also available for purchase.
Other options include the Kaplan NAPLEX review book and the Lange Q & A for pharmacy. The Kaplan book provides a succinct and easy to understand review of different content areas, with short quizzes at the end of each chapter for self evaluation. Kaplan includes a full length paper practice exam and access to online practice tests and resources. The Lange book provides numerous pharmacotherapy and practice-based questions and a CD with hundreds of additional questions for review.
Besides books and courses, there are also other choices to consider. Those of you who have an iPhone or use Android will find at least a few NAPLEX apps in the marketplace. If you invest in a NAPLEX preparation app, you can use it during downtime during rotations or while waiting for appointments or traveling. Smartphone apps are a quick and easy option to get in some review when you don’t have much time.
It’s important to find a NAPLEX prep product that suits your learning style and fits in your budget. With so many choices, it can be a bit overwhelming. Just do your due diligence. Before investing in a product, read the reviews and ask your friends and colleagues for their feedback. The good news is that having lots of options means you’re likely to find something that will work for you!
Another important task during APPE is to research what you will need to do to become licensed in your jurisdiction of choice. Requirements vary by state, so be sure to contact your state Board of Pharmacy for specifics. You’ll need to apply to take the NAPLEX and Multistate Pharmacy Jurisprudence Exam (MPJE or CPJE in California), pay all related fees, and will have to submit an application and fee to your state Board of Pharmacy. Your college of pharmacy will most likely take care of filling out forms certifying your education and intern hours, but be sure you verify what they will be submitting so you can take care of any additional documentation that is required.
Getting ready for the big day
After you graduate from pharmacy school, your state board of pharmacy will have to certify your eligibility to sit for the NAPLEX. How quickly this happens varies tremendously by state. Once you are certified, you will receive an Authorization to Test (ATT), which allows you to sign up for a test date and time.
Deciding when to test can be a challenge. You may want some time to continue reviewing and studying for the exam, but waiting too long may bring its own stresses and the risk of forgetting key information. Your employer or residency program may have deadlines for licensure that they expect you to meet. Be sure you are aware of these and plan accordingly.
Once you’ve chosen and confirmed a test date, you can map out a final course of study that works for you. If you have prepared all along for the NAPLEX, you should have a good idea of how much more review you need and how much time you have to devote to it. Take into account whether or not you will be working, travel plans and family obligations.
To give yourself the best chance of success, your study plan should be achievable and reasonable. The more you plan, the better prepared you’ll feel. It may be helpful to write out a calendar and assign different topics to specific days and set up self evaluation checkpoints at periodic intervals. Above all, just keep moving forward. The end is in sight.
The night before the exam, make sure you know how to get to your testing center, check your two forms of identification and GET A GOOD NIGHT’S SLEEP. If it helps you to review the night before an exam stick to something simple like brand/generic. The last few hours before the NAPLEX are not the time to attempt to learn a difficult or unfamiliar topic.
The day of the exam, you should arrive early at the testing center, as multiple students share the same exam time. When you sign in, you’ll present your two forms of ID, be photographed and have your palm scanned. The test center will provide a writing pad and marker for your use. Although the NAPLEX contains an onscreen calculator, you can request a handheld one if desired.
During the exam, make sure you read the questions carefully. You must view the entirety of any patient profiles provided before you can move on to the next question. This is helpful in that it forces you to slow down and view the whole profile. If you don’t know the answer to a particular question, guess and move on. No one question will make or break your score, so don’t get bogged down or discouraged. Keep moving forward.
If you’ve planned well and prepared yourself, you can be confident in your preparation and that you know enough to pass the NAPLEX. After all, you’ve been preparing for this for years. Good luck!
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