The United States offers vast opportunities for pharmacists, with competitive salaries and a wide range of career paths. However, for foreign pharmacy graduates, the journey to becoming a licensed pharmacist in the USA can be complex. This guide will walk you through the steps, eligibility requirements, and exams necessary to achieve your goal.
Understanding the U.S. Pharmacy Landscape
Pharmacies in the United States are located in diverse settings, including drug stores, grocery stores, hospitals, and other healthcare facilities. Pharmacists in the U.S. earn an average salary of $99,000 to $140,000 per year, depending on factors like location, experience, and type of employment. However, before you can practice in the U.S., you must navigate a series of steps to meet the licensure requirements.
Educational Requirements and FPGEE Eligibility
The first critical step in becoming a licensed pharmacist in the U.S. is ensuring that your educational background meets the requirements set by the National Association of Boards of Pharmacy (NABP).
FPGEE Educational Requirements:
As of January 1, 2003, the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) mandates that foreign-educated pharmacists must have earned their professional degree from a pharmacy program that is at least five years in length.

BPharm Graduates: In countries like India, the Bachelor of Pharmacy (BPharm) program typically lasts four years, making these graduates ineligible for the FPGEE under the current rules.
MPharm Graduates: Some candidates assume that completing a two-year Master of Pharmacy (MPharm) degree in addition to a BPharm would meet the five-year requirement. However, this combination is not recognized for FPGEE eligibility. MPharm graduates, especially those in clinical pharmacy, should directly contact the NABP for specific guidance on their eligibility.
PharmD Graduates from India: Indian PharmD graduates are eligible to sit for the FPGEE and can proceed with the subsequent steps to become licensed pharmacists in the U.S.
The Pathway to USA Licensure: Key Steps for Foreign Graduates to become a registered Pharmacist
1. Pass the FPGEE (Foreign Pharmacy Graduate Equivalency Examination):
Eligibility: To be eligible for the FPGEE, you must have completed a pharmacy program that meets the five-year requirement.
Exam Content: The FPGEE evaluates your knowledge in four key areas: basic biomedical sciences, pharmaceutical sciences, social/behavioral/administrative pharmacy sciences, and clinical sciences.

Application Process: To apply, you must first submit your educational credentials to the NABP for evaluation. Upon approval, you can register for the FPGEE.
2. English Proficiency Test (TOEFL):
- In addition to passing the FPGEE, you must demonstrate your English language proficiency by passing the Test of English as a Foreign Language (TOEFL). This requirement is crucial for ensuring that you can effectively communicate in a clinical setting in the U.S.
3. Complete Required Internship Hours:
- After passing the FPGEE, you must complete a required number of internship hours, which varies by state (typically between 500 and 1,500 hours).
Clinical Rotations and Experiential Learning: Many pharmacy schools incorporate these internship requirements into their curriculum through clinical rotations or experiential learning, giving you practical, hands-on experience in various pharmacy settings.
4. Pass the NAPLEX (North American Pharmacist Licensure Examination):
Purpose: The NAPLEX assesses your competency to practice as a pharmacist in the U.S. It covers topics such as pharmacotherapy, patient management, and pharmaceutical care.

Preparation: It’s crucial to prepare thoroughly for this exam, as it plays a significant role in determining your readiness to practice.
5. Pass the MPJE (Multistate Pharmacy Jurisprudence Examination):
State-Specific Requirement: Some states require the MPJE, which tests your knowledge of pharmacy law, regulations, and the legal responsibilities of pharmacists in the U.S. This exam is tailored to the laws of the specific state where you intend to practice.

Preparation: Since the MPJE is state-specific, you’ll need to study the regulations pertinent to your chosen state.
Alternative Pathways for Foreign Graduates
If you do not meet the eligibility requirements for the FPGEE, you may consider the following alternative pathways:
Pursue a PharmD in the U.S.: If your current qualifications do not meet FPGEE requirements, enrolling in a Doctor of Pharmacy (PharmD) program in the U.S. is a viable option. This path ensures eligibility for licensure after graduation.
Work in the Pharmaceutical Industry: If becoming a licensed pharmacist in the U.S. is not feasible, you may pursue a Master of Science (MS) in pharmaceutical sciences in the U.S. This can lead to careers in research, regulatory affairs, or the pharmaceutical industry.
Final Considerations
The process of becoming a licensed pharmacist in the U.S. as a foreign graduate is demanding but achievable with the right approach. It involves navigating complex requirements, passing rigorous exams, and completing essential practical experience. Each step brings you closer to a rewarding career in the U.S. healthcare system.
For the most accurate and up-to-date information, always consult directly with the NABP or the pharmacy board in the state where you wish to practice.