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How to Study for the Pharmacy Curriculum Outcomes Assessment (PCOA)

How to Study for the Pharmacy Curriculum Outcomes Assessment (PCOA)

There's a new acronym on the rise in pharmacy education. One that's striking fear in the hearts of students everywhere.


The Pharmacy Curriculum Outcomes Assessment.

It's been at least a month since we've used a Home Alone reference... ( Image )

It's been at least a month since we've used a Home Alone reference... (Image)

But what exactly IS the PCOA? And how can you prepare for it?

That's where we come in. 

Because when students email us with questions, we just can't help ourselves. It's like setting off the bat signal at tl;dr pharmacy headquarters.

There's a pharmacy student who needs our help!! ( Image )

There's a pharmacy student who needs our help!! (Image)

So get comfy and read on. We'll unravel this thing piece by piece until we get an understanding of it. Then we'll talk about the best approach to studying for it. 


What is the PCOA?

The Pharmacy Curriculum Outcomes Assessment (PCOA....pronounced PeeKoa) is a brain child of the National Association of Boards of Pharmacy (NABP). The same folks who bring you the NAPLEX and the MPJE. 

It was designed to make NABP money to function as a tool to help pharmacy schools assess the effectiveness of their curriculum at meeting the standards set forth by the Accrediation Counsel for Pharmacy Education (ACPE).

The PCOA has actually been around for a number of years (since 2008), but only a small percentage of pharmacy schools made use of it. 

That has changed. In 2016, with the number of pharmacy schools in the US growing, ACPE decided that something should be done to ensure consistency. So, they have adopted the PCOA as a mandatory part of their accreditation standard.

Any school that wishes to maintain accreditation with ACPE will need to be on board the PCOA train.

So the PCOA is (or soon will be) a required test for your pharmacy education. At a minimum, you'll take it before you start your APPE rotations as a P4 student. Or, if you're one of the "lucky" ones, some schools administer the PCOA several times throughout your education to show/monitor your educational progression. 


What's on the PCOA?

It's just another version of the pre-NAPLEX, right? 


Artist depiction of the PCOA ( Image )

Artist depiction of the PCOA (Image)

The PCOA is sort of a beast. It encompasses literally everything you've covered in your first 3 years of pharmacy school. You are just as likely to be asked the mechanism of action of midazolam as you are to be asked which functional group makes it more sedating than other benzos. 

There are 4 primary categories covered...

  • Basic biomedical sciences (10%)

  • Pharmaceutical sciences (33%)

  • Social, behavioral, and administrative sciences (22%)

  • Clinical sciences (35%)

These are further broken down into their (many) subcategories (which correlate with ACPE standards).

You can find a handy full breakdown of what's covered on the PCOA here


The PCOA is 225 multiple choice questions. Afterwards, you'll get a:

  • Percentile score (how you ranked against everyone else in the country)

  • Percentage score (how you did on the actual test you took)

  • Scale score (your 'corrected' percentage score after removing unfair or poor questions)

  • Trophy (not really)

These scores are broken down by each individual area of the PCOA. So you'll know exactly how you did (in terms of percentage and compared to everyone else) on each of the subcategories tested. 

This is good news for you, because it means the PCOA is a useful tool to help you identify your weak spots. You can use it to shore up your weak spots for the upcoming APPE rotations and eventually the NAPLEX.  

Here's a general PCOA timeline. Refer to your school and NABP for specifics on your actual timeline, as it may vary. 

In early November, you'll register for the PCOA through the NABP. You can find instructions on how to do that here

In mid-January (2 weeks before the PCOA), you can take a practice PCOA. It's 50 questions. 

Sometime in late-January, you'll take the actual PCOA. 


How to Study for the PCOA

Alright, that's all fine and dandy. But it's not why you're here. You want to know what you actually need to do to prepare for the PCOA. 

You also want to know if the PCOA is even worth studying for. It's not like it impacts your grade, right? Does it even matter?

In short, yes. Here's why...

As this becomes required for every accredited school in the country, your program will be increasingly focusing on it.

"My school's PCOA scores are higher than yours!" ( Image )

"My school's PCOA scores are higher than yours!" (Image)

Right now, programs can only compare themselves to each other using things like NAPLEX pass rates and the percentage of students matching for PGY1 residencies. But with the PCOA becoming a requirement, it's another potential way to compare schools. PCOA scores will become part of the standard on which schools are measured. 

PCOA scores will be looked at during ACPE accreditation visits. And it stands to reason that schools with lower scores could eventually end up on academic probation. To be clear, I'm just conjecturing here...this is not the current situation. But it seems like a plausible future scenario to me. 

Furthermore, it's not crazy to foresee PGY1 programs including PCOA scores as part of their application packet. When evaluating candidates, PGY1 programs don't have all that much to assess your knowledge base. 

You've got a GPA, some letters of recommendation, and a few APPE rotations. 

But now, since everyone will be taking the PCOA, it's not unreasonable to think that PGY1 programs might start asking for your scores. It's another tool they can use to narrow down hundreds of applicants.

Again, this can be used to your advantage (if you do well on the PCOA that is...). If your GPA is on the lower side, a solid PCOA score can demonstrate that you have a firm grasp of the material. Additionally, if you've taken the PCOA several times, your scores can document your academic progression and show that you are "teachable." Residency programs love residents that are "teachable."  

So, in my humble opinion... 

With our increasingly saturated profession, it is worth putting some effort into the PCOA. 

Now. On to the more important question of how to actually prepare for the PCOA.


Your PCOA Success Plan

Before jumping into your action plan, let me start by saying that the best way to prepare for the PCOA is to put a good faith effort in all of your classes for the first 3 years of pharmacy school. 

If you've studied hard, and have a general understanding of topics from P1 to P3, the PCOA will not be that bad.

That's a very boring and "canned" answer, but it's truth.

However, this wouldn't be a tl;dr pharmacy article if I stopped there. So...if you skated by and don't remember anything about triturations, and pKa's, then it's time to get to work.

Here's what you do...

For starters, your overall study focus should be broad, not deep

The PCOA is hard to "study for" in the sense that you can't cram years of information into about a month of studying (on top of the tests you have for classes that actually impact your GPA). 

There's too much material for you to be an expert in all of it. So you need to approach studying with a jack of all trades mentality. A light (but well thought out) review should be enough to get you on the right track.

Really, I think the bulk of PCOA studying comes down to strategically planning how and what you're going to study. Since you're just brushing up on the topics, you shouldn't need to spend an insane amount of time on the "grinding it out" studying part. 

Look back at the PCOA content breakdown... 

Notice that the two biggest categories are clinical sciences and pharmaceutical sciences. Also look at what subcategories comprise "clinical" and "pharmaceutical."

This is important, because as pharmacy students, we have a tendency to focus on 'drug stuff.' Mechanisms of action, side effects, contraindications, counseling points, etc. 

That serves us well in professional life after school, but if you give it too much focus now you will not do well on the PCOA

We also tend to study things we already understand. It makes us feel good and gives us a little dopamine kick. Unfortunately, it also gives us a false feeling of preparedness. 

So your study plan needs to combat these tendencies. 

I would literally print out the PCOA content breakdown, and map out the categories/subcategories with the coursework you've gone through throughout your P1 - P3 years. 

Dig out your old notes, and use those for a reference. Did you burn your old biochem notes? Ask a friend to borrow theirs. Use YouTube, Wikipedia, and Khan Academy to supplement if you need to. 

Spend the majority of your time focusing on clinical and pharmaceutical sciences (a combined 68% of the test), but do not sleep on biomedical sciences and social sciences. You cannot perform well on the test without them, and the questions may be broad enough that you won't need a more than a cursory knowledge to succeed. 

Highlight your weak spots when you're mapping out the PCOA standards to your own course work. Be honest with yourself here. You want to spend most of your time focusing on the stuff you don't know.

If you're like most students, some common areas you'll probably need to brush up on are:

  • Biostats

  • Pharmacoepidemiology/literature evaluation

  • Pharamcoeconomics

  • Ethics

  • Pharmacogenomics

  • Sterile compounding

  • Herbals and supplements

  • MTM

  • Basically the entire pharmaceutics course

Doesn't look as sexy as studying for infectious disease, does it? But discipline yourself and get through it. Again, you don't need to be an expert. You just need to understand the basic concepts.

Broad, not deep.

Finally...make sure you take the practice PCOA two weeks before the actual PCOA. It's 50 questions, and it will give you a good sampling of the types of questions you'll encounter. It also highlights your knowledge gaps, so you can better plan your last couple weeks of studying.

Official stat's aren't compiled with the practice PCOA, but the general consensus I've heard by asking around is that your practice score tends to correlate with your actual score. 

Follow the above plan, and when you take the actual PCOA, you should do fine. You don't need to get every question correct to get a good score. 


What happens if you fail the PCOA?

While the PCOA isn't exactly a pass/fail test, a lower percentage and percentile score is less than desirable. What do you do if this happens to you?

Obviously this will depend on your school. They will have a specific policy outlined that you should familiarize yourself with. 

Generally there is some sort of a remediation process. The school might offer (read: require) you to attend weekly sessions that highlight the areas where your class performed poorly. 

The school's action plan may also depend on your overall GPA. For example, if your GPA is in the lower 25th percentile, and your PCOA score is also low, they may craft an action plan to lift you up. If your GPA is high, but your PCOA score is low, they may look at why the discrepancy exists. 

Either way, because ACPE accreditation will now depend on PCOA scores, your school will have some sort of action plan to bring you up to speed. Look there for further details.


PCOA Summary

Let me close stating that I have not personally taken the PCOA. But I have spoken with (literally) dozens of students who have. I've also interviewed several faculty members at current PCOA schools to gather their insights on the test and how to prepare for it. 

Side note: Thank you to everyone who helped me write this article!!

The general consensus is that the PCOA is not that bad. Don't let it cause you unnecessary grief. It's a respectable foe. One you need to pay due diligence to when preparing. But it's not impossible. If you remember even a little bit from your first 3 years of pharmacy school, you'll be fine with a little strategic review.

Good luck.  


PS: Interested in Residency? Check out our new guide, Mastering the Match: How to Secure a Pharmacy Residency!

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