For years, Pakistan did not have a structured residency pathway for pharmacists to develop the skills needed for specialized hospital and clinical pharmacy practice. But that changed in 2020, thanks to a team of pharmacists who helped Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore become the first hospital in Pakistan to achieve ASHP accreditation for its residency program.
“This was a major milestone for us, not only as an institutional achievement but also as part of our responsibility to advance pharmacy practice in Pakistan,” said Omar Akhlaq Bhutta, the hospital’s director of pharmacy.
Today, the hospital operates first-year residency programs in Lahore and Peshawar, and a second-year residency program in Lahore. The majority of its 24 graduates have continued working for the medical center, with the rest taking posts in Saudi Arabia, the United Kingdom, and the United States.
The ASHP News Center spoke with Bhutta; Saba Mazhar, residency program director and member of ASHP’s International Accreditation Committee; and Adeel Siddiqui, preceptor and assistant manager of pharmacy to learn more.
Why was it important for your hospital to start a pharmacy residency program?
Bhutta: Training opportunities for pharmacists were mostly unstandardized; only a few institutions were working toward advanced pharmacy practices aligned with international standards. Our hospital has always believed in strengthening the pharmacy profession and creating meaningful learning opportunities for pharmacists. We had an internal residency-style training program with rotations in ambulatory care, aseptic services, inpatient care, and clinical pharmacy, but we recognized that if we wanted to truly advance clinical pharmacy in Pakistan, we needed a stronger, more structured system. When ASHP introduced the international pharmacy practice residency pathway (IPPRP), we moved forward with accreditation immediately.
How did you start your program?
Mazhar: We initiated the pharmacy residency program in 2014. At that stage, our focus was on ensuring that core learning experiences were incorporated, particularly those essential for pharmacists working in oncology practice settings. We began with a small cohort of four trainees and a limited scope. However, there was strong enthusiasm and commitment behind the initiative. Despite its modest beginnings, the program played an important role in shifting the mindset of the pharmacy profession locally and demonstrated the value of structured clinical training.
How did ASHP help you develop and expand the program?
Bhutta: ASHP played a significant role in helping us develop and expand our program. Their standards helped us build a competency-based residency model focused on clinical excellence, leadership, and patient-centered care. We had the privilege of working closely with respected ASHP leaders such as Lynnae Mahaney, Paul Bush, and David Warner, whose guidance and collaboration were invaluable. Their participation in our conferences and symposiums further strengthened our journey.
This initiative also encouraged other leading institutions in the area, including Shifa International Hospital and Aga Khan University Hospital, to develop similar structured training platforms and pursue accreditation. Today, several organizations are moving in the same direction, which will continue to strengthen pharmacy practice and improve patient care across the country.
How did you grow the program over time?
Mazhar: We first strengthened the Lahore site by expanding learning experiences, adding more preceptors, and enhancing clinical exposure. Once the program was well-established, we expanded to our Peshawar site and successfully launched the IPPRP there, extending the same quality of structured residency training to another campus. We later introduced the International Advanced Pharmacy Practice Residency Program (IAPPRP), a second year of postgraduate training, becoming the first hospital in the region to offer this advanced level of training. We enroll two pharmacy graduates each year in IPPRP and one in IAPPRP. Five are currently enrolled across Lahore and Peshawar.
Our success created momentum nationally. Shifa and Aga Khan hospitals started ASHP-accredited IPPRP programs. We started a residency networking symposium with participation from almost all major hospitals in Pakistan.
Tell us more about IAPPRP.
Mazhar: From the beginning, our vision was not limited to one year of residency alone. We remained in close contact with the ASHP team and discussed the need for an advanced pathway. As soon as ASHP launched the advanced program in 2022, we immediately started working on implementation. The focus of IAPPRP is to develop leadership skills in second-year residents, enabling them to practice more independently, take on advanced clinical responsibilities, and contribute at a higher level to patient care and pharmacy services. We look forward to achieving full accreditation following an ASHP audit.
What are you most proud of regarding these programs and your trainees?
Siddiqui: Our residents are gaining visibility globally; their research in quality improvement is getting published in well-reputed journals and their work is recognized and winning awards. We developed a team of board- and ASHP-certified preceptors who are training residents. This program has significantly elevated the level of the pharmacy profession in the country, helping to advance clinical practice standards and professional development. It creates a new hope for pharmacists in Pakistan.
