Before you even begin...

Back in the day, when I first started this blog, I used to get dozens of emails a day about all sorts of things relating to the FPGEE®, and becoming a US pharmacist in general. Now, all these years later, having kept the site up and running, I almost only ever get one question - I have passed the FPGEE® and got my certificate but can you help me find a sponsor. That means, basically, that you have done all the hard work for absolutely nothing. And there are thousands out there just like you. The US pharmacy market is slowly getting saturated (it is not quite, but it is getting that way ) but I think the truth is that US employers don't want to import foreign pharmacy grads anymore for financial reasons (it costs a lot to get them through the legal processes involved at every step) plus of course in most areas these days there are sufficient US pharmacy grads to fill the needs of the nation. Not an excess, but enough. So should you still want to go through all this effort firstly know and understand that unless you already hold a green card (which completely changes everything) the chances of you actually finding a sponsor for an H1b Visa after you have passed the FPGEE® and TOEFL® and got your FPGEC® certificate in hand, are now a tiny fraction of what the situation was prior to 2008 when I moved to the US. Reduction in the FPGEE Examinees and the Pass Rate Three thousand forty-five applicants sat for the FPGEE in 2008, a decrease of 20.7% compared to the 3,841 applicants who sat for the examination in 2007. Moreover, the number of applicants who took the examination in 2009 was 2017, which reflects a reduction of 33.8% from 2008. This decrease may be the result of 1 or more of the following reasons: (1) the FPGEC® requirement that internationally educated pharmacists earn their professional degrees from 5-year curriculum programs, (2) the difficulty of obtaining a visa, and (3) the decrease in recruiting of international pharmacists by chain pharmacies as the pharmacist shortage in the United States has leveled off. It gets pretty hard to find the numbers of exam takers after 2009, but from the 2013 annual report of the treasurer of the NABP there was this little snippet: The Foreign Pharmacy Graduate Equivalency Examination® (FPGEE®) saw a decrease in activity compared with 2011. There was a 14.6% decrease in FPGEE administrations. The FPGEE was administered in the fall and spring of 2012, with a total of over 1,690 exams in 2012, versus 1,980 exams in 2011. So from the heights of around 4000 exam takers around 2008 the numbers have consistently dropped to just 1690 taking it in 2012. Generally half of whom are retaking the test. In addition both the TOEFL® and FPGEE® can now ONLY be taken in the US, and the cost to sit the FPGEE alone is over $1200 without the expense of getting to America. The TOEFL® varies by location but is around $185 and is often the hardest exam for many foreign pharmacy graduates to pass (the spoken section in particular) which many have to re-take again and again until the finally reach the grade required. Now, as I said, I am still contacted by people every so often seeking my advice (99% for either finding a sponsor or tips on passing the Naplex - both of which I have posted in these blogs so go search them out). But for those of you thinking of starting along this path of great expense I just wanted to make it absolutely clear to you, right from the start, although you may be successful, you may absolutely be about to waste an awful lot of time and a great deal of money, for absolutely nothing. Now if that didn't put you off, please continue and enjoy the story of my roller coaster ride...

Additional Entry - New info!!

PLEASE IGNORE ALL DATES GENERATED BY THE BLOGSITE AS THAT IS THE ONLY WAY I CAN MAKE THE SITE READ FROM TOP TO BOTTOM I have just found out (thanks Manohar!) that there are certain states that will give you a reduced internship if you score a higher mark on your FPGEE®. If I had known that I might have bloody-well revised a bit. Anyway, below I copy the hours related to the FPGEE® score for the Washington Foreign Graduate Pharmacy Internship, as it is currently listed on their website (this may change, don't rely on me, check for yourself, etc). Score Intern Hours 75-90 1500—at least 1200 hours must be earned prior to the examinations 91-105 1000—at least 800 hours must be earned prior to the examinations 106-120 500—all hours must be earned prior to the examinations Over 120 300—all hours must be earned prior to the examinations Taken from: https://fortress.wa.gov/doh/hpqa1/HPS4/Pharmacy/Documents/PharmacistForeignGraduate.pdf So check the state board where you are aiming to work, and see if there is any benefit if you do get a really good passing mark. And again, thanks Manohar for bringing this to my attention. And if anyone else has any corrections or additional bits of information I can add to the blog PLEASE TELL ME - things change, and I'm only human! Just as a little aside, the "registered trademark" sign in between H1B and Lottery in the name of this blog is not necessary, but I was contacted by the NABP® and told in no uncertain terms to delete three chat groups I had set up to "discuss" the FPGEE® and CPJE®/MPJE® and told to put a ® sign whenever their name appears. In response to their request I have deleted the chat groups and started to place the ® sign thoughout the blogs as I re-read them and edit them, but for the sake of conformity in my blog titles I thought I'd add an extra one in there where it doesn't really have to go. Sorry if this bores you, but being chased down by the NABP® just adds yet another level of sparkle to my otherwise shining story :-) Farmacyst

THE STORY SO FAR.

This Blog is the follow on from my first blog at fpgee-test.blogspot.com which tells the story of how I managed to take and pass the FPGEE, an exam for non-American pharmacists to show equivalency to American pharmacy students, prior to starting their post-college education. As you can read on the fpgee-test blogsite, passing wasn't all that difficult for me, although I can assure you it was no easy matter being allowed to sit the exam, as the paperwork to prove my equivalency was quite horrendously onerous. Anyway, that's all behind me now, thank goodness. And this blog tells the story of what comes next. As the name of the blog suggests - and chances are that is why you are reading this - what comes next ends up becoming a pathway leading to obtaining an H1B sponsor. I was SO naive of the process when I started on this path it is only fare that I warn you now that this is a very difficult path, and in my opinion it is weighed very much against the numbers of people that sit the FPGEE exam that don't have a Social Security Number and/or a work permit or green card and have no idea how difficult it is going to be to get a visa by the H1B route. Hopefully, by the time you read the whole of this blog you will be more aware of the very small chance of success that foreign pharmacists actually have of getting to America. And just to explain the last part of the process first, once you do get to America as an intern, there are still two more sets of exams to take to become a fully qualified Registered Pharmacist (R.Ph), namely the Naplex and the MPJE (Multistate Pharmacy Jurisprudence Examination), but more on the specifics of those exams in later blogs! The next post will explain the crazy conversations I have had with various people and organisations to try and work out what you're supposed to do with the FPGEE certificate once you have it! Farmacyst

Have FPGEE® will iBT TOEFL® next...

So, I sat back and enjoyed the moment, having passed the first hurdle to becoming an American pharmacist. I had passed the FPGEE®. I knew what I had to do next, which was to take and pass the required proof of English reading, listening and writing - called the iBT-TOEFL® test. From the paperwork the NABP® posted out with their original information it was quite clear that this test was a basic requirement for ALL non-US pharmacists, even if they were from an English speaking country. The NABP® would not send out their FPGEC® certificate unless they had received the TOEFL® result, which is sent direct from TOEFL® to NABP® using code 9103 whilst signing up for the TOEFL®. I should add this number may change in the future so please don't take my word for it that it is the correct or current number. It was when I took the test though! I didn't think I needed to revise for the test, or even look up on the internet what it entailed. I am English aren't I! What a mistake. I was at the test centre as requested 30 minutes before the start time of 12 noon. I went in and met a friendly assortment of people who all had fairly strong foreign accents. I felt a bit embarrassed being there, but on the other hand I felt confidant I would pass. We filled out a waiver, similar to the one we signed at the FPGEE® saying we would not, on pain of death and eternal damnation ever reveal what goes on behind the secretive closed doors of the iBT-TOEFL®. Signed and dated we were lead to another room where we had our various identifications confirmed. I had my passport in hand. And thence to the exam room (after one last run to the loo!). I should add at this point that I believed for some reason, the exam lasted one and a half hours. At this point I was advised it lasted between four and five hours. And I was hungry. I take my seat and put on a set of head-phones. There is a voice test to check the sound level and then another waiver and off we go. I shant go in to the specifics of the exam of course, but the first two hours involved a combination of listening through the head-phones, reading and watching things on the console, and then answering multiple choice questions. It was all fairly easy although it required focus. If you lost concentration you could easily forget something important. I remained focused! After 2 hours the computer allowed you a 10 minute break. I went to the loo and got ready for round two. Speaking. This was a little embarassing, as us Brits are not so keen to talk into microphones in a room full of strangers, but I braved it for the greater good. After another sound check I was asked to speak for a minute on a particular subject. It's not that easy speaking about something for a whole minute. I was talking nonsense by the end I am sure. I should have looked in to the format of this test a bit more! Having now become familiar with the process the next verbal section was much better. I made notes, wrote a bit about what I was to say, and spoke slowly and clearly until the time ran out. Better! I could hear the guy two seats down from me do his spoken section a little later. He had said it was his weakness. He was right. All he said was errrrrr and ummmmm and hesitated a lot, and he was very, errr, accented. I hope he passed but I wouldn't hold my breath for him. Even my first response was better than his, but I wasn't nervous or stuttering along I suppose. I just spoke. Anyway we eventually come to the written section which was really tough. First they give you something to listen to and something to read and you have to write a precis of the two giving you opinion as to which is correct. Sounds easy, but isn't so straightforward and requires some thinking. I should point out that ALL the examples used in the test were of a scientific nature. The subject matter is of course irrelevant to your use of English, but it did make the test very interesting for me, and perhaps kept me more alert than if the test had been on Music or Art. And finally the test ended with two large freestyle writing sections (typing not hand-written). The last one was slightly longer and slightly more complex. I kept deleting and re-writing sections. I was half-way through re-writing a sentence when the screen was blocked by a box declaring the test had finished! Then there was an opportunity to scrap the result and NOT have it sent to any 3rd parties you may have wanted the result to be forwarded to and that included yourself! So if you absolutely knew you had messed up bigtime I guess you could save yourself from some embarrassment; but as far as I was concerned I just didn't want to accidentally press the wrong button! I was the first to finish from the group and the test had taken me 4 hours and 20 minutes. I was exhausted and starving. Blimey. Once step further along though... Farmacyst ***Addendum*** Thanks go to a kind colleague who has allowed me to pass on the following information: The first time I took the exam my scores were: R=17 L=23 S=27 W=28. After 6 months, I took the exam again and got: R=23 L=27 S=24 W=24. The first time I took the exam, I was surprised with my score in Reading so I emailed them asking if I can request for that Section be re-scored. They said they can only re-score the Speaking & Writing Sections of the exam. So, the second time I sat the exam I requested for a re-scoring of the Speaking Section only, which cost $60, and on the re-score now got a score of 28 in Speaking. The fee was returned as soon as they posted my new score. If I wanted a recount of the Writing Section as well, that would have been another $60! If you honestly think that you did better than the scores you received, then don't hesitate to request for re-scoring. --- So, unlike the FPGEE® which in my opinion is never worth having re-scored, it seems that not only is this VERY worthwhile getting re-scored if you think you did better than the score they gave you, but it also seems that if you are correct and they did underscore you, then they are even kind enough to return your fee! ***

iBT TOEFL® RESULT!!

The NABP® states {here} the (current) requirements for passing the TOEFL® as: To be eligible for FPGEC® Certification, you must pass the TOEFL® iBT or both the TOEFL® and TSE®. The minimal acceptable score for the TOEFL® iBT is: Reading – 21 Listening – 18 Speaking – 26 Writing – 24 You must complete all four sections in one testing session; scores for the four sections must be reported on one official score report. If you score less than the minimum score in any section, you will not be considered for FPGEC® Certification. If you take the TOEFL® and TSE®, the following scores must be obtained: TOEFL® – 550 (paper-based) or 213 (computer-based) TSE® – 50 If you score less than the minimum score on either the TOEFL® or the TSE®, you will not be considered for FPGEC® Certification. -- So the results are through 2 whole days early! Good on you TOEFL® people. And here's what they gave me:

Test Date	Reading	Listening	Speaking	Writing	Total
February 10, 2007	30	29	29	30	118

And please remember I am born, bred and educated in England, so that 29/30 for speaking I find somewhat irritating :-) Should I ask for a recount? Anyway, another hurdle in time, money and energy overcome. Next comes the FPGEC® certificate from the NABP® and then I can apply to the Florida state board of pharmacy for a (I think this is right) "Foreign Graduate Internship" deficiency letter. Well, actually thats not quite true - I am applying for an Internship Certificate, but I can't get one as I don't have a USA Social Security number. I can't get an SSN until someone gives me a job and applies for an H1B visa on my behalf (the timing of which is CRITICAL - and will be discussed in another blog entry soon) - and then I can give the SSN to the Florida State Board of Pharmacy who can then issue me with a full licence to work in a pharmacy and do the hours required, sit the NAPLEX® and the MPJE® and finally, one day, become a fully licensed US pharmacist, with a US work visa and eventually a US Green Card!! Eventually. Farmacyst.

A long long time later.....

Ok, so I get my FPGEC certificate about 6 weeks after taking the iBT-TOEFL test, and immediately contact the Florida State board to request a deficiency letter. Beautiful. Everything seems to be going to plan. I receive the deficiency letter (that was probably back in about April 2007? - Can I remind you the dates on this blog are nonsense as you cant get them to appear in reverse date order, so I just picked Dec 31st and each new post I enter has the preceding date, but is a meaningless date in respect of the timeline of my story here). So, where was I. I have the FPGEC and now I have the Florida deficiency letter. Now what? Well, now I need a job! If at this point you have an American wife/husband simply walk in to Walmarts, go up to the pharmacy counter and ask for a job. You can then fill out some forms, collect your name badge, and start working away on your intern hours. If at this point you don't have an American husband/wife, and therefore DONT have an American Social Security Number (SSN) you can tie your legs around your neck and twist them till the blood stops reaching your brain, because there's a heap of problems waiting for you. To put it simply, you need a job, but you can't get a job without an SSN, and you can't get an SSN without a job. The easiest answer is to go to the big chains like Rite Aid, Walgreens, Walmart, Eckerd, Albertsons, Longs or CVS (later I will show just how many visa's each of these managed to obtain in the 2007 lottery). They are used to dealing with foreign graduates and have special departments set up for it. Some other smaller companies do too, but they obtain very very few H1B visas. So I emailed CVS and Walmart back in April 2007, to tell them I have an FPGEC and a state deficiency letter, and guess what their response was? Walmart: PLEASE CONTACT US AGAIN IN NOVEMBER CVS: PLEASE CONTACT US IN EARLY 2008. Fan-dibbly-tastic. So, after everything I've gone through, I now have to sit back, wait for another group of FPGEE'rs to pass their exams and catch up with me (I'm not bitter, everyone deserves to get through) and then wait until either November or next January just to find out if these chains are even interested in me. Great. So I sit, and I wait. Tick tock. In the interim I have spoken with LOADS of people. Friends. Friends of friends. Strangers. Strangers friends. Random weirdos. Anyone really. And I have learnt a great deal of stuff. One area I have investigate but never needed was the possibility of doing a higher degree (masters or PhD) from a US University. This gives the benefit of a 1-year post degree work permit, which can therefore be used to do an internship and escape the H1B lottery rush, although I note that in 2008 that even this route was over-subscribed so not a 100% guarantee. And there is also another route which involves working for a voluntary organisation, or hospital or Government department, which I also believe somehow circumvents the H1B route. As I say, I'm not particularly familiar with these other routes, but I believe they may well be of interest to some of you reading this, and would love to update this blog with more info on these other options, so please email me! In my next entry I shall write more about the specifics of the H1B visa. Good luck everyone, Farmacyst.

And then it got painful...

OK friends, I know some of you have been waiting a LONG time for this update, so I hope you enjoy it - trust me, every minute of the last year has been a hellish roller-coaster ride of agony, ecstasy, fear and expense. Are you sitting comfortably? Then we shall begin.... Just a very short precis, I had passed my FPGEE, passed by iBT-TOEFL, received my FPGEC certificate, applied and received my Florida deficiency letter, and had the rest of the year free to find an employer willing to sponsor me for an H1B application. Good, and if you recall both Walmart's and CVS's autoresponders asked me (in April 2007) to contact them at the very end of 2007 or early 2008. I also started to talk to people, on the net and through friends, who had experience of US internships. Some, if they are to be believed, appear to have some horror stories that are quite frightening. I heard of "pharmacy graduates" doing nothing but filling trays with meds for a whole year and never seeing a computer or a customer. I heard of "pharmacy graduates" on wages that waitresses would refuse. And I heard of "pharmacy graduates" in care home settings that don't really dispense medication, never see prescriptions and have to sell their soul to the devil for a few years after qualifying before being released from their chains. I have also heard of Pharmacy Graduates who earn very very good incomes (well over $60,000 whilst training) and are throughly trained, and have excellent terms, conditions, perks and benefits. So be careful who you go to people, there are good and bad employers out there. The net result of about 6-months of chit chat was basically, in total, and when you look good and hard at it, about nothing. I got to October 2007 with the same two email addresses for CVS and Walmarts to contact, and not a lot else to show for my efforts. Near the end of October 2007 I emailed both CVS and Walmarts. Walmarts auto-responder will always say "thanks for calling, we'll contact you in 7 days". I got that, and after 7 days I got nothing else. CVS I had already obtained the area recruiters direct email address back in May (I have kept these emails - and I recommend you all do to - keep them ALL, the positive one's, the negative one's and the one's that don't answer - because 6 months later when you want to make contact you'll want to remember which one's were positive towards you, etc). So anyway, I actually ended up phoning the area recruiter for Florida (her title to be correct is Manager, Professional and College Relations,CVS Caremark - whoever/whatever they are). We had a good chat, and I left it that she would direct me to the actual manager for the area I wanted to live in, for me to arrange an interview directly. Tick, tock, tick, tock. November, and I contact Walmart. Auto-responder still on. I contact my "friend" at CVS and say I haven't heard from the local man. She eventually gets him to communicate with me via email and I am starting to think about a trip to Florida to meet up for an interview. End of November and I chat on the phone with the CVS Pharmacy Supervisor. Again this goes well and I am starting to look in the calendar for a chance to take a weeks break (obviously just after Christmas/New Year) to have an interview. -- Interlude: I have since spoken with many foreign graduates who have been interviewed over the phone. I couldn't possibly say whether it was in my interest to meet up in person or not, but it does seem to me now, that my perceived need to go and meet them in person was not as essential as is actually the case. But I wanted a holiday too, so what the hell. -- And then, as if by magic, come December, the lines of communication with my contact shut down. I can't get him to answer an email. I email the original contact. nothing. I email Walmarts: You will be contacted in 7 days. I email Walmarts again, with a simple question: Are you sponsoring H1B's in 2008? I get a response! "Please contact us in January 2008". Fantastic. I once more email the original CVS contact and ask her if they are sponsoring H1B's? I had had a horrible feeling that perhaps the pharmacy chains had decided to shut shop on the H1B lottery for the year as a kind of dispute against the expense they are forced to bear. -- interlude: The H1B application fee must, by law, must be paid for by the sponsor. They can either be applied for as a regular petition or, for an extra $1,000 can be premium processed, which means the results are offered (as a yes or a no) within 15 days from the close of the annual H1B window. The overall costs (see http://www.newh1.com/newh1b_pricing.html for the facts as I know them, are around $3,000 for regular and around $4,000 per premium petition - so no cheap affair. I am also aware that at least one of the most well-known chains demands their foreign applicants to pay the $1,000 for premium processing, even though I am not completely sure they are legally entitled to ask for this, but I guess they know the laws better than little old me) -- Anyway, finally the "Manager, Professional and College Relations,CVS Caremark" - responds to me:

Unfortunately we aren't able to offer you a position for this coming year. We do sponsor visas and will be in 2008, but we have reached our quota of how many we will be offering for Florida.

Gulp. Spit. Punch. I immediately go beserk with activity on the internet. I Google for every flipping pharmacy chain small and large, up and down the length and breadth of America. I send my resume to any pharmacist fool enough to put their email on the internet. I literally email anyone and everyone I can find, specifically mentioning I am looking for an H1B sponsor. -- Interlude: If you don't tell them you need an H1B you will get hundreds of responses, but they will all eventually come to nothing. So save yourself the agony, and tell them the truth first, so they can be honest back, and say they don't want you, and save you both a lot of emails. The only other advise is that wherever they are, tell them that is exactly where you want to be! -- By mid December, from all my emails, I had 3 responses. A New York based company say they are not taking on H1B's this year, but wish me good luck. A regional manager for a South Eastern Chain store offers me some hope. And a chap in California also offers me some hope. Walmart's are still offering to contact me in 7 Days. Next up, the fruit of all my hard labours! Good luck to all, Farmacyst.