The North American Pharmacist Licensure Examination (NAPLEX) is the clinical exam that allows a pharmacy graduate to become a licensed pharmacist. The NAPLEX is designed to evaluate your knowledge of pharmacy practice and is required for pharmacist licensure. It is a 6-hour exam composed of 225 questions, and students are allowed 5 attempts to pass it. We’ve broken down the 2023 NAPLEX Pass rates and will help you understand what it means if you are taking this exam in 2024.
There are 144 pharmacy schools in the US, and the statistics for each University are reported to the NABP and summarized each year. Here are two important takeaways from the NABP 2023 NAPLEX Pass Rate report.
- In 2023, 11,537 students attempted the NAPLEX at least once. This is much lower than previous years (13,267 students in 2022 and 14,013 in 2021).
- 78.6% of students passed the NAPLEX on their first attempt compared to 77.7% in 2022 and 81.8% in 2021.
How does this compare to past years?
Looking back 10 years, in 2013 the national pass rate for ACPE-accredited on the 1st attempt pass rate was 95.87%. When comparing this to the 2023 1st attempt pass rate of 78.6%, it is clear that there has been a large decline in NAPLEX pass rates.
Advice For Graduates – 2024 NAPLEX
The NAPLEX used to be a “gimmie” for pharmacy graduates. That is no longer the case. You need to take this exam seriously, or you will be one of the 20+% that is retaking this exam. Here are a few common pieces of advice that I give students.
- Start early and utilize your time wisely
- Review the content outline
- Develop a gameplan/study schedule
- Have an accountability partner (usually another student) that checks in weekly with progress
- Focus on areas of weakness
Here are a few more pieces of advice that still apply from a previous post
What Is Causing the Decline in NAPLEX Pass Rates?
Content Outline Changes
Every 5 years the NAPLEX updates its blueprints to stay up to date with the ever-changing field of pharmacy. Historically, each time a change like this occurs, a decline in pass rates is seen. The exam was previously updated in 2016, which increased the length of the exam, and the latest update occurred in 2021. After each of these updates, we saw a slight decline in pass rates, which was unsurprising. However, these slight decreases do not justify the almost 20% decline in pass rates in the last 10 years.
COVID-19 and Education
There are many other factors that may have contributed to the decline in NAPLEX pass rates. One idea is that the COVID-19 pandemic had a large impact on both students and professors. Students graduating during and after the pandemic had to adapt to APPE rotation cancellations, online lectures, and labs, bouncing in and out of quarantine, etc. At the same time, professors had to quickly adapt their teaching style to match online or hybrid schooling. All of these factors may have led to a lower quality of education, lower student retention, and lower pass rates.
Declining Enrollment and Smaller Applicant Pool
Another contributing problem is low enrollment rates around the country. As pharmacy school enrollment rates continue to decline, many schools have suspended or lowered Pharmacy College Admission Test (PCAT) requirements. In fact, as of January 2024, the American Association of Colleges of Pharmacy (AACP) will no longer be offering the exam.
These are just some of the many factors contributing to the NAPLEX pass rates that we have seen in the past few years, but what does this mean for the future? How will Universities adapt to these low numbers? As enrollment continues to drop and the field of pharmacy continues to expand, it will be interesting to see how these numbers fluctuate in the next few years.
What other factors do you think are NAPLEX Pass Rates?
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This article was written by Sara Hoag, PharmD Candidate in collaboration with Eric Christianson, PharmD, BCPS, BCGP.
Resources:
North American Pharmacist Licensure Examination ® Passing Rates for 2021-2023 Graduates.; 2024. https://nabp.pharmacy/wp-content/uploads/NAPLEX-Pass-Rates-2023.pdf
lmcinally. Falling Test Scores | COVID-19 is just one reason | NABP Blog. National Association of Boards of Pharmacy. Published February 15, 2023. https://nabp.pharmacy/news/blog/test-scores-have-been-falling-covid-19-is-just-one-reason/
Pharmacy School NAPLEX Pass Rates (2016-Present) – ClinCalc.com. clincalc.com. Accessed March 28, 2024. https://clincalc.com/Pharmacy/NAPLEX.aspx
Naplex Pass Rates 2013 | PDF | Health Education | Pharmacy. Scribd. Accessed March 28, 2024. https://www.scribd.com/document/249219819/Naplex-Pass-Rates-2013-1
I think there is a huge misalignment between NAPLEX competence areas and ACPE standards. When 14% of the exam is on Calculations and 11% on Compound, Dispense, or Administer Drugs, or Manage Delivery Systems, someone should start to ask if the curriculum reflects that “weighting”.
I think your advice is spot on. Cramming is a bad idea.
As a recent graduate, I can attest to the fact that COVID-19 has had a huge impact. My first year was online, and my APPES were also all hybrid. With regards to the actual exam, the kind of questions that they are asking don’t seem relevant to what is happening in practice. Interestingly, I did not have a single Diabetes question on my exam, no COPD or Asthma, and very little HTN… All the major disease states that the majority of pharmacists deal with on a daily basis, I was not asked.
I had at least 8 chemo questions, Chemo is such a unique field of medicine and people spend their entire careers learning and understanding it. Yet, as a new pharmacist, we are expected to know it and know it well. Even though, only a small handful will ever actually deal with it in the real world. There needs to be a serious discussion amongst the people who write the questions, because as it stands, this is not a minimum competency exam. I work with pharmacists who have been in the field for 20 years and they could not pass this test….