Journal of pharmaceutical health care and sciences · 2026
An eight-year national follow-up study on the employment trajectories of early-career pharmacists in Japan up to 2020.
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Ando Takahito, Shiroiwa Takeru, Imai Shinobu, Fushimi Kiyohide, Yasuhara Masato
Аннотация
BACKGROUND: Geographic and sectoral maldistribution of pharmacists has become a critical challenge for Japan's healthcare system. While the number of community pharmacists continues to rise, the chronic shortage of hospital pharmacists persists. This study aimed to clarify longitudinal career trajectories, inter-sector mobility, and predictors of leaving employment among early‑career pharmacists in Japan, using nationwide census‑based data covering all licensed pharmacists.
METHODS: We conducted an eight‑year longitudinal cohort study using individual‑level data from the Statistics of Physicians, Dentists and Pharmacists from 2012 to 2020. The cohort included 7,242 pharmacists (3,458 men and 3,784 women) who obtained their pharmacist license in 2011-2012 and were continuously identified in all five survey waves. Employment sectors were categorized into 10 groups. Using generalized estimating equations (GEE), we analyzed the odds of being "unemployed" (defined as having no institutional affiliation), adjusting for gender, survey year, and age.
RESULTS: At baseline (2012), hospital and community pharmacists accounted for 84.6% of the cohort. By 2020, the proportion of community pharmacists had increased, whereas the proportion of hospital pharmacists had substantially declined. Among those initially employed in hospitals, 34.5% left the hospital sector within eight years, and 83.6% of these individuals transitioned to community pharmacies. In contrast, 88.9% of community pharmacists remained in the same sector throughout the study period. The proportion unemployed among men remained below 1.0%, while the rate among women increased from 0.4% to 3.7%. GEE analysis demonstrated that women had a significantly higher ratio of being unemployed over time compared with men, independent of age (adjusted odds ratio 1.203, 95% CI: 1.118-1.293, p < 0.001).
CONCLUSIONS: A substantial outflow from hospitals to community pharmacies was observed among early‑career pharmacists in Japan, suggesting that the hospital pharmacist shortage results not only from recruitment challenges but also from significant retention issues during the career continuation process. Additionally, women exhibited a distinctively higher ratio of career interruption. Policies that enhance retention through incentives for specialization in hospitals, along with targeted support for women's career continuity, are essential for sustaining the pharmacist workforce.
METHODS: We conducted an eight‑year longitudinal cohort study using individual‑level data from the Statistics of Physicians, Dentists and Pharmacists from 2012 to 2020. The cohort included 7,242 pharmacists (3,458 men and 3,784 women) who obtained their pharmacist license in 2011-2012 and were continuously identified in all five survey waves. Employment sectors were categorized into 10 groups. Using generalized estimating equations (GEE), we analyzed the odds of being "unemployed" (defined as having no institutional affiliation), adjusting for gender, survey year, and age.
RESULTS: At baseline (2012), hospital and community pharmacists accounted for 84.6% of the cohort. By 2020, the proportion of community pharmacists had increased, whereas the proportion of hospital pharmacists had substantially declined. Among those initially employed in hospitals, 34.5% left the hospital sector within eight years, and 83.6% of these individuals transitioned to community pharmacies. In contrast, 88.9% of community pharmacists remained in the same sector throughout the study period. The proportion unemployed among men remained below 1.0%, while the rate among women increased from 0.4% to 3.7%. GEE analysis demonstrated that women had a significantly higher ratio of being unemployed over time compared with men, independent of age (adjusted odds ratio 1.203, 95% CI: 1.118-1.293, p < 0.001).
CONCLUSIONS: A substantial outflow from hospitals to community pharmacies was observed among early‑career pharmacists in Japan, suggesting that the hospital pharmacist shortage results not only from recruitment challenges but also from significant retention issues during the career continuation process. Additionally, women exhibited a distinctively higher ratio of career interruption. Policies that enhance retention through incentives for specialization in hospitals, along with targeted support for women's career continuity, are essential for sustaining the pharmacist workforce.