[Special Feature: 10th Anniversary of the Faculty of Pharmacy] The Past, Present, and Future of the Keio University Faculty of Pharmacy

2018/10/05

It was on March 26, 2007, that Keio University and Kyoritsu University of Pharmacy signed the merger agreement (photo). After a year of various adjustments, a transfer ceremony was held in April 2008. Kyoritsu University of Pharmacy was established in 1930 as Kyoritsu Women's College of Pharmacy at a time when higher education institutions for women were in high demand. By the time the Keio University Faculty of Pharmacy launched in 2008, it was a historic pharmaceutical university celebrating its 88th anniversary. Its graduates are active in many medical settings, primarily in hospitals and pharmacies. In 2006, the six-year pharmaceutical education system began, and as the need for enhanced pharmacist training grew, Kyoritsu University of Pharmacy established its position in Japan as a model for such education. Before I moved to Kyoritsu University of Pharmacy in April 2007, I observed its activities from the outside. I always held great respect for the wide range of programs they offered, from student education to lifelong learning and international exchange, winning numerous "Good Practice" (GP) grants from the Ministry of Education, Culture, Sports, Science and Technology. This legacy was inherited by the Keio University Faculty of Pharmacy, and major workshops for the six-year pharmaceutical education system have consistently been held at Keio.

The background behind why a long-established institution like Kyoritsu University of Pharmacy sought a merger with Keio University was heavily influenced by the situation of Japanese pharmaceutical departments at the time (Figure). In Japan around the time of the merger, in addition to a declining trend in university applicants due to the falling birthrate, new pharmaceutical universities were being approved one after another. The number surged from 46 schools in 2002 to 74 in 2008, leading to concerns about both securing student numbers and a decline in quality. Furthermore, with the start of the six-year pharmaceutical education system, long-term practical training in hospitals and pharmacies became mandatory. Many single-subject pharmaceutical universities without their own hospitals struggled not only to secure excellent applicants but also with how to conduct practical training.

Keio University is a comprehensive university with faculties in the humanities, social sciences, science and technology, and healthcare. It provides an environment where broad character development, which is difficult at a single-subject university, can be realized. Pharmacists are members of the medical profession and are required to have a rich sense of humanity in addition to specialized knowledge and skills. For this reason, studying liberal arts is more important than just studying pharmacy, and there were voices of expectation for the merger with the Juku in this regard. Furthermore, the existence of the School of Medicine, Faculty of Nursing and Medical Care, and the hospital raised great expectations for a team-based medical approach that could be practiced from student days—something difficult for a single-subject university. In fact, interaction with students from other faculties through the one-year liberal arts curriculum and club activities at Hiyoshi has provided breadth to the personalities of Faculty of Pharmacy students, who might otherwise risk having a narrow perspective. Additionally, the Inter-Professional Education Program, conducted three times (early, middle, and late stages) until the final year, allows students to study while being conscious of their professional role as pharmacists by working on problem-solving together with students from the School of Medicine and Faculty of Nursing and Medical Care. Above all, by becoming a member of a leading private institution like Keio University, the deviation score of incoming students has risen from around 60 before the merger to consistently maintaining 65 or higher, meeting expectations for securing excellent students. The presence of students from Keio's integrated schools, educated under the philosophies of independence and self-respect and Shachu cooperation, also contributes to broad character development and the realization of team activities. The Dual Degree Program with the Graduate School of Business Administration, which began immediately after the merger, is another program unique to a comprehensive university.

As mentioned earlier, since the six-year pharmaceutical education system aims to train pharmacists, the enhancement of clinical pharmacy education is essential. Keio University Hospital is one of the facilities providing cutting-edge medical care in Japan. Conducting practical training at such an advanced hospital makes it possible to achieve the goals of the six-year pharmaceutical education. On the other hand, the Department of Pharmacy that accepts practical trainees is one of the few university hospital pharmacy departments that conducts outpatient dispensing in-house, and it is extremely busy. At the time of the merger, Keio University Hospital had no experience accepting more than 20 students at once, and both the Department of Pharmacy side and the Faculty of Pharmacy side started with their own anxieties. Discussions during the preparation stage involved not only stakeholders from the Faculty of Pharmacy and Department of Pharmacy but also the Hospital Director, the Vice-President in charge, and the Vice-Presidents in charge of Shinanomachi and Shiba-Kyoritsu. In addition to negotiating the number of sessions, student capacity, and training fees, it was agreed that the personnel costs for two clinical instructors in the Department of Pharmacy would be allocated from the Faculty of Pharmacy budget. Subsequently, a specific training program was created, centered on the two clinical instructors and the Faculty of Pharmacy's Practical Training Committee.

The initial training program was primarily focused on "objects," such as dispensing and injection preparation (Table). However, in the hospital practical training of the six-year pharmaceutical education system, it was expected that more time would be devoted to bedside medication counseling and team medicine. Therefore, it was necessary to create a situation where students could experience these activities. This led the Department of Pharmacy to review its operations and take on new tasks. The fact that the Department of Pharmacy, which had a conservative tendency, began to move toward new pharmacist duties can be called a synergy effect triggered by the acceptance of Faculty of Pharmacy students. As shown in the table, the training period for dispensing and injection preparation has now been halved, while the training period for medication counseling and specialized team ward activities has doubled. This was made possible by the Human Resources Department's consideration in hiring personnel so that tasks not requiring a pharmacist license could be outsourced. Currently, the training period for ward pharmacy duties is comparable to other hospitals, and the fact that outpatient dispensing can be experienced has actually become a "selling point" for Keio University Hospital.

A major part of pharmacist training education is handled by clinical faculty members known as practitioner-teachers. In principle, clinical faculty are required to have at least five years of practical experience as a pharmacist. However, even with five or more years of experience, clinical skills can drop sharply within a few years if one becomes a full-time university faculty member and leaves the clinical site. Therefore, maintaining and improving the clinical skills of clinical faculty has been one of the challenges. To solve this, the Faculty of Pharmacy requested the Department of Pharmacy to accept "Clinical Faculty OJT (On the Job Training)," which began in 2014. Currently, four people at Keio University Hospital, one at the National Cancer Center, and two at the University Community Pharmacy are undergoing OJT. Effective practical training is only possible with high-quality preparatory study at the faculty, and it can be said that the clinical faculty OJT is functioning effectively. Furthermore, many pharmacists from the hospital's Department of Pharmacy are involved in preparatory study, and the fact that the hospital and faculty are working together as one to provide guidance is a major achievement of the merger.

Along with the enhancement of pharmacist training education, the enhancement of research was also expected at the time of the merger with Keio University. Research in the Faculty of Pharmacy consists of two pillars: drug discovery research and clinical pharmacy research. For both, collaboration with the School of Medicine and the Faculty of Science and Technology is essential for the development of research. While many departments already have a track record of research collaboration with departments in the School of Medicine and Faculty of Science and Technology on an individual basis, initiatives for the faculty and graduate school as a whole include the Keio Medical and Pharmaceutical Science and Engineering Commons (MPEC) for young researchers and the "Research Clinical Experience Program" for graduate students held jointly with the Graduate School of Medicine. From the 2018 academic year, at the initiative of Dean Kanazawa of the Faculty of Pharmacy and Dean Amaya of the School of Medicine, the acceptance of research students who graduated from the Faculty of Pharmacy into School of Medicine laboratories also began. Additionally, since the start of OJT in 2014, an annual research seminar has been held between the Department of Pharmacy and faculty members, including those in basic sciences, to promote joint research. This is an initiative that leads to so-called "Reverse Translational Research," where challenges from the clinical site are brought back to the faculty for research. As a foundation for this, the "Department of Hospital Pharmacy" was established within the Faculty of Pharmacy in 2016, and I came to serve concurrently as the Director of the Department of Pharmacy and a Professor of the Department of Hospital Pharmacy. Furthermore, one of the three faculty positions in the department is a rotational position from the hospital's Department of Pharmacy. This allows them to experience education and research as a faculty member for a limited period, serving as a bridge between the Faculty of Pharmacy and the hospital, while also training pharmacy staff with research capabilities. This personnel arrangement was realized with the understanding of the executive team, including the Vice-President in charge of the Shinanomachi Campus, the Hospital Director, and the Administrative Officer.

Meanwhile, the "Drug Discovery Research Center" was established in 2014 as a research platform with an eye toward collaboration not only within Keio but also outside the Juku. It initially started as a virtual entity, expected to introduce a talent pool of researchers to those inside and outside the Juku and serve as a catalyst for joint research. The reason it became virtual was the issue of research space. While the Shiba-Kyoritsu Campus is very convenient in terms of transportation, space is extremely limited. Within this, we finally managed to create a small rental lab space, and since the 2017 academic year, we have launched three joint research projects in collaboration with multiple companies, academia, and national research institutes, evolving from virtual to real. This is currently a highlight of the Faculty of Pharmacy's research side, and it is expected that Keio's drug discovery research will develop based on this foundation.

Ten years after the merger, collaboration with other faculties within Keio has progressed dramatically. However, the three healthcare-related faculties that conduct joint education are currently dispersed across three campuses—Shinanomachi, Shonan Fujisawa, and Shiba-Kyoritsu—which is somewhat inefficient. In the education and research of the three healthcare faculties, common teaching materials and equipment are often used, and considering future team medical activities, it would be effective to have an environment where certain year levels spend time on the same campus. In fact, human body model simulators, which are very expensive teaching materials, were difficult for the Faculty of Pharmacy to purchase alone, and physical assessment training had been a long-standing challenge for the faculty. However, since last year, we have been able to conduct this at the Shinanomachi Campus by borrowing simulators for medical education. Even in basic research, a system for the joint use of expensive analytical equipment has been established, but proximity of campuses would make them even easier to use. It would also make it easier for faculty members to teach their specialized academic fields to other faculties and for students to attend lectures in other faculties or graduate schools. While IT can be used to cover for the distance between campuses, face-to-face interaction also has meaning. Space issues exist not only at the Shiba-Kyoritsu Campus but at all campuses in the city center, and this is a challenge for the entire Juku.

Recent research grants tend to support research projects where multiple different fields collaborate. I believe this means that the diversity of researchers is important for dynamic research development. To create innovative new drugs, it is not enough to simply create candidate substances; it is necessary to conduct research and development that includes everything from medical sciences, pharmacy, and nursing to social sciences like economics, such as investigating clinical effects, considering patient usability, and even thinking about insurance systems and marketability. It can be said that such comprehensive research can only be carried out by Keio University, which possesses a variety of faculties. In recent medical care, keywords like big data, AI, and data scientists frequently appear. In the future, collaboration with the Faculty of Science and Technology and the Faculty of Environment and Information Studies will also be essential. Furthermore, Keio University has produced many graduates in industry and politics, and it is possible to receive guidance and support from these seniors. I hope that research that leads Japan and the world will be disseminated from Keio in the spirit of Shachu cooperation and "Jiga Sakuko" (creating history oneself).

Regarding the career paths of Faculty of Pharmacy graduates, during the Kyoritsu University of Pharmacy era, the overwhelming majority went to pharmacies, excluding those who went on to graduate school. After the merger, the number of pharmacy pharmacists has halved, while those going to pharmaceutical companies have doubled. What is even more characteristic is that the number of graduates finding employment in banks, securities firms, IT and electronics industries, trading companies, and consulting firms—fields not directly related to pharmaceuticals—is gradually increasing. This is one of the fruits of a single-subject pharmaceutical university merging with a comprehensive university. For the Faculty of Pharmacy to collaborate across faculty walls as a member of Keio University and send out leaders in diverse fields, such as internationally active researchers and leading pharmacists, will be the best way to give back to everyone who worked hard for the merger.