Prescriptive plans

Professor Stephen Duffull is no typical academic. Despite breaking new ground in pharmacometrics – simply put, the science of measuring how drugs act within the body – his journey to that so-called “ivory tower” has been firmly based in the real world.

“From a research perspective, having 12 years in clinical practice means my research is focused towards patients and finding ways to improve patient care. Culturally I'm a researcher who's a pharmacist, not a pharmacist who's a researcher, but I'm not your standard academic.”

Perhaps that's why the current Dean of the School of Pharmacy has grand plans for the school's future, with a renewed focus on enhancing the core undergraduate programme, while also strengthening research outputs: well timed as the school heads towards its 50th-year celebrations.

The National School of Pharmacy started life as the Department of Pharmacy in 1960 under the leadership of the then Associate Professor [of Pharmacology] Fred Fastier, with the first cohort of students taken in 1961, completing in 1964 and graduating in 1965 – the first in New Zealand with a university pharmacy degree. In 1963, the first pharmacy-specific subject was offered, which marks the jubilee date.

“The goal is to create a much more focused degree that will fill the goals of the community and the profession.” – Professor Stephen Duffull.

During the 1970s, the course developed a strong reputation, but intakes remained limited to around 20-25 students with progress hampered by the small faculty (no more than about half a dozen) and relatively poor accommodation in temporary facilities behind the Dental School. In 1981 American Professor Donald Perrier was appointed Dean and set about improving the situation for the Department of Pharmacy, including initial processes that ultimately were manifested in a change of location to the Adams Building, the transfer from the Faculty of Science to Medicine and a restructured bachelor's degree recognising the increasing importance of clinical pharmacy elements rather than, predominantly, the pharmaceutical sciences.

In 1989, the Minister of Education announced his decision to site all pharmacy education at the University of Otago, which led to the closure of the larger-intake, diploma-awarding school at the Central Institute of Technology in 1991. Professor Peter Coville, appointed in 1989, became Dean of the School of Pharmacy in 1991, and was succeeded by Professor Ian Tucker in 1999, then Duffull in 2010. Today the undergraduate degree remains core to its teaching priorities, with around 120 students accepted each year.

“We've had a lot of alumni and staff who have done some amazing things over the years,” says Duffull. “We've had medical directors of pharmaceutical industry, many have gone onto senior academic roles – professorships in various locations – and many others working in the profession.”

But, according to Duffull, because the BPharm qualification is followed by another year of training run by another organisation – the Pharmacy Society of New Zealand – there is a current disconnect between the training students receive at the University and the training at intern level after they graduate.

As the school heads beyond its first 50 years, Duffull wants to see more opportunities for students to become part of the profession before they graduate – with internship-style placements occurring during the course of study and registration occurring (like medicine and dentistry) at the end of their undergraduate degree.

“The goal is to create a much more focused degree that will fill the goals of the community and the profession,” says Duffull. “I want to try to lead the profession, lead the school forward into a new style of thinking about what pharmacy can offer in terms of patient care, and move further away from the standard traditional dispensing-supply versions of pharmacy, which will always exist to a certain extent, but many pharmacies are out there doing many, many more things.

“I think we need to have our students exposed to the bigger picture and a variety of different settings – from primary and secondary care to community and rural pharmacies.

“It'll require massive changes, but I think the change is critical. I don't think we can continue to move forward to educate pharmacists for the future unless we start to think of more integrated models of training.”

Duffull himself began life in pharmacy cycling around the streets of Christchurch, delivering packages for his pharmacist grandfather. But, despite the family connection, Duffull claims to have had a mixed relationship with the area of study.

It was purely by “accident” that he first studied pharmacy. He was accepted into the course in Wellington a week earlier than he was accepted by the University of Canterbury into his planned double major in systems analysis and business. The “career-focused” Duffull completed his training in Wellington, followed by an internship at Greenlane Hospital in Auckland and a year on the South Island's West Coast in a community pharmacy, before returning to Christchurch Hospital in 1987.

“I moved from a place that was quite forward thinking in Auckland and doing lots of exciting clinical stuff to a place which did nothing at all of any clinical importance [Christchurch Hospital],” he says. “At the time, it was really all about supply and, because I was a male, I had to carry heavy items around the place and that was it. It was very uninspiring. I was bored, so I went to work in a pub in North London.

“It was good for me because I realised working in a pub was worse. I had to keep thinking to make things work.”

Duffull returned to Christchurch where he found things had improved but, more importantly, in 1989 he moved out of pharmacy into clinical pharmacology, where he remained for eight years.

“Clinical pharmacy is about individualising the use of medicines to meet patient needs, whereas clinical pharmacology is all about the science behind the process. The two disciplines are really extensions of each other.”

This new direction sparked Duffull's research interests and he began a master's degree part-time and then a PhD, completed in 1997 in which he began specialising in phamacometrics – the discipline that quantifies the clinical pharmacological response to drugs and answers questions like how quickly will a drug work, how much effect is to be expected and how long will a drug's effects last? Outcomes for patient care include identifying the best medicine and dosing regimen to meet the needs of individual patients.

After his PhD, Duffull went to the University of Manchester for a postdoctoral fellowship, where he was working with the world's best in pharmacometrics, before taking a lectureship (and later, associate professorship) in Brisbane in 2000. In 2006 he came to Otago to take up the inaugural Chair in Clinical Pharmacy – a new position aimed at building the strengths of the school. He was also an adjunct Professor at the University of California, San Francisco, and an honorary Professor at the University of Queensland. An award-winning researcher, Duffull was appointed Dean in 2010.

While the School of Pharmacy has offered postgraduate courses since 1986, today there is a renewed focus on research, with around 40 PhD students conducting work in a diverse range of areas. Clinical pharmacy has moved from strength to strength and social pharmacy became established as a new discipline, with leadership provided by the appointment of Australasia's first Professor and Chair of Social Pharmacy, Pauline Norris, in 2008. The disciplines of social pharmacy and clinical pharmacy have now replaced the former discipline of pharmacy practice.

Add to that, the impressive research outputs of staff at the school and Duffull says it is currently “solid”, but that he would like to see it become a centre of excellence, attracting larger grants and more international collaborations.

“The school has a long, proud history,” says Duffull. “In the 1990s it became more research efficient, but if we look at our research outputs in 1996 and compare it to now, it's gone up by five- or six-fold. There are some members of staff now who almost turn out as much research as the entire staff in the school in 1996.

“If you went back 15 years, the school would be unrecognisable to what it is now. The building's the same – it still leaks – but ignoring all that, research is an example of where the school has triumphed over the last 10 years and picked up from being good to almost great.

“We're no longer dependent on one or two champions. Today, we have a diverse range of people – historians, psychologists, pharmacists, medicinal chemists, immunologists, microbiologists, a whole range of people – hardcore science to humanities, all collaborating extremely well together.”

– AMIE RICHARDSON