3.2 Pharmacy Interns & Preceptors: Licensure, Scope & Supervision

Why this matters

Interns gain the 1,440 internship hours Oregon requires for pharmacist licensure. They are tested on two fronts: what an intern may do, which depends on academic progress and the supervisor, and the paperwork that governs intern and preceptor licenses. These rules are in OAR 855-120 (effective March 1, 2024).

Intern licensure (OAR 855-120-0010 to -0050)

To be licensed as an Intern, an applicant must be enrolled in or have completed a Doctor of Pharmacy (or Bachelor of Pharmacy) program at an accredited school or college of pharmacy, or be certified by the Foreign Pharmacy Graduate Examination Committee (FPGEC). Applicants living in the United States must also show citizenship, permanent residency or a qualifying visa.

An intern license is not a back-door pharmacist license. Graduates who don't become licensed pharmacists within the post-graduation renewal must stop practicing as interns.

Internship hours (OAR 855-120-0190 and -0195)

A pharmacist applicant must complete 1,440 hours in an approved internship program. Programs include school-based experiential programs, a program for FPGEC-certified foreign graduates, and equivalent programs approved by other U.S. boards. Out-of-state internship experience can count under OAR 855-120-0195. Most of an intern's overall experience in a program must be under a licensed pharmacist preceptor.

What interns may do (OAR 855-120-0135 and -0150)

An intern may practice pharmacy only as the rules authorize, and only as the supervising pharmacist or healthcare preceptor permits within that preceptor's own scope. When practicing, an intern follows the pharmacist rules in OAR 855-115.

Two sets of limits apply:

All interns must not:

• Practice pharmacy except as permitted by the supervising pharmacist or healthcare preceptor.
• Engage in discrimination, harassment, intimidation or assault in the workplace.
• Communicate with a patient who prefers a language other than English, or who uses signed language, unless the intern is an OHA-registered health care interpreter or the supervising pharmacist or preceptor is fluent in that language. This covers counseling, patient care services and billing.
• Provide a patient care service the supervising pharmacist is not trained and qualified to perform.

First-year interns (until they finish their first academic year) may observe but must not:

• Conduct a DUR or drug regimen review, counsel patients, or advise on therapeutic values.
• Provide medication therapy management, or practice under a clinical pharmacy agreement, collaborative drug therapy management or a statewide protocol.
• Prescribe vaccines, drugs or devices.
• Perform verification.

After the first academic year, an intern may do these things under supervision, including prescribing under protocols and performing verification, if properly trained and permitted. Older references stating that interns may never verify, or that one pharmacist may supervise only one intern, are wrong under current Oregon rules.

Supervision ratio

A pharmacist or preceptor may supervise no more than four interns in direct patient care activities. For non-direct activities, such as a health fair giving general rather than patient-specific information, the limit is professional judgment (OAR 855-115-0122; OAR 855-120-1122).

Preceptors (OAR 855-120-1010 to -1205)

Oregon licenses preceptors. A pharmacist preceptor must have practiced as a pharmacist in any state for at least one year immediately before applying. A pharmacist in an ASHP-accredited residency who has been licensed at least six months is an exception. Non-pharmacist healthcare preceptors must hold an active license in good standing. Non-healthcare professionals need a master's or doctoral degree in their specialty.

A preceptor must:

• Display the preceptor license in plain sight.
• Supervise each intern's actions and verify that each intern holds a current Oregon intern license.
• Provide experiences that, in the preceptor's judgment, build the intern's competency.
• Follow the confidentiality, duty-to-report and prohibited-practice rules for preceptors.

A school's Internship Program Supervisor oversees school-based programs under OAR 855-120-1205.

Exam scenario

A second-year PharmD student with a current Oregon intern license works in a community pharmacy. Under the supervising pharmacist's direction, they may counsel on a new lisinopril prescription and complete a hormonal contraception assessment under the statewide protocol, provided the student has completed the required training. A first-year student in the same pharmacy could only observe those activities. If the patient prefers Vietnamese and neither the intern nor the pharmacist is proficient, both must work with an interpreter from the OHA Health Care Interpreter Registry.