Abstract
BACKGROUND: The pharmacy profession has a troubling contradiction. While pharmacy graduate is predominantly working in retail, it is interesting to note that there is an increasing preference from pharmacy students to avoid community pharmacy work settings. A trend which needs to be considered in light of workforce implications. METHODS: A validated questionnaire was used to determine attitudes and perceptions towards retail pharmacy careers in a cross-sectional survey of 248 third-year through fifth-year pharmacy students by assessing clinical responsibilities, working environment factors and professional development opportunities. RESULTS: Hospital pharmacy was the most popular career choice (39.5%), over twice as popular as interest in the community setting (20.2%), although 82.4% also report having retail experience. Students identified the interpersonal strengths of retail pharmacy as job security (weighted mean of 4.10), teaching opportunities (3.81), and patient interactions (3.72). Yet favorable images clashed with realities in operations. Insurance navigation got very low marks (weighted mean 2.26) as did business management responsibilities (2.46) and work schedules (2.59). Perhaps most revealing, the large amounts of experience did not resolve ambivalence in the field, but may have strengthened it. There were statistically significant attitude changes with academic progression (F(2,245) = 4.79, p = 0.009), but effect sizes were still small. CONCLUSION: Findings subvert traditional assumptions about experiential learning and direct attention to systemic strains between professional ideals and workplace limitations. Future pharmacists showed limited interest in pursuing careers in retail pharmacies. In an era of austerity, pharmacists’ salaries may not be overly high, but finding ways to address real-world issues and devising ways to provide value to the workplace goes a long way to attracting motivated pharmacists. Targeted interventions may help attract and retain talented pharmacists in this sector. Business skills in educational settings may need to be re-defined. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-025-08377-z.