Hungary

Hungary has nearly 10 million inhabitants and about 8,200 pharmacists. There are 2,394 community pharmacies, most of them having been privatised in 1990, or founded later and there are 129 institutes of pharmacies .Every pharmacy has a compounding lab, and compounding is heavily emphasized as part of pharmacy practice. All medications, even OTCs, are kept behind the counter, which allows pharmacists to manage medication interactions and make appropriate recommendations.

Since the introduction of a new law in 2011, the rules governing pharmacy ownership in Hungary have been made stricter each year, resulting in one of the most restricting regimes in Europe. This has happened in spite of fairly significant lobbying by European and local pharmacy chain owners. The express purpose of the strict requirements was to protect the interests of local individual private pharmacists by excluding (typically non-Hungarian) institutional pharmacy chains from the Hungarian market.

Institutional investors in existing pharmacies were obliged to appoint a local pharmacist as director of the pharmacy and to sell at least 25% of their shareholding to the director or other private pharmacists by January 2014. By 2017 there is an obligation on investors to sell at least 51 per cent of the pharmacy to the pharmacists, thus effectively putting all pharmacies under the control of individual local pharmacists. There is an additional restriction, limiting the maximum number of pharmacies which may be owned by one individual pharmacist to four, with the evident intention of outlawing pharmacy chains.

Education

Every year 1,500 students attend the four faculties, and 300 students complete their studies.

Graduate education:

The faculties admit students after a successful entrance examination in two general subjects (Biology and Physics or Chemistry), nowadays combined with matriculation.

Every year nearly 300 students start their studies in all four faculties according to a given quota determined by the ministry; foreign students have to pay for their education.

Training is given in Hungarian and in English, the latter only for foreign students.

The curriculum includes five years of basic and special studies. The first two years cover basic sciences and are taught outside the Pharmacy faculties. In the next three years emphasis is given to specialised knowledge in pharmaceutical and medicinal fields. Three elective subjects have to be selected in the ninth semester from more than 25 different topics.

Types of training involve lectures (48%), seminars (3%) and practice (50%) which are evaluated after oral or written tests.

Students must then write a thesis under the instructions of a tutor and defend it before the final exam.

One month’s compulsory summer practice after years 2, 3 and 4 has to be given in a public or institutional pharmacy or within industry. Before and during the 10th semester the students have to spend 2+4 months in a practical training programme (min. 18 weeks in a community pharmacy and the rest in a hospital pharmacy).

The final exam includes a written test, practical work and a theoretical part, the last two being given before a general board. On successful completion of their studies, they get their diploma which leads to the degree of Master of Sciences. 2009 was the first time pharmacists were given a doctor’s title, which is not a scientific one, but gives them the right to use “Dr” before their name.

Postgraduate education:

There are two main fields for pharmacists to get further education after getting their diploma:

• Specialisation of pharmacists,
• doctoral programs.

All pharmacists who work on fields where they must renew their registration every 5 years, have to take part in continuing education (CE) or Life Long Learning (LLL) and collect a prescribed number of points. For all other pharmacists it is not obligatory.

Continuing education:

The system has operated from year 2000, within a legal framework.

Pharmacists working in public and hospital pharmacies are required to collect 250 points every 5 years. The points are of two types: practical and theoretical.

The number of practical points is 100 (20 p.a.) and are given when somebody works full or part time.

The theoretical scores (150 per 5 years) have to be collected in three main categories:

• obligatory courses (organised only by universities) (50 points per 5 years),
• obligatory elected courses (hosted by universities) (25 points per 5 years),
• freely elected courses (the rest of theoretical points).

The types of courses include: congresses, conferences, training courses, individual training course etc. Other opportunities to collect points include scientific publications, patents, giving lectures etc. When pharmacists specialise or get a PhD degree automatically get 50 points p.a. Distance learning is an individual category.

The maximum number of points is limited (20 points p.a.) and one point is given after three questions are answered correctly. Answers are always checked by a competent committee.